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Biomedical subjects

L H Epstein

Publications and source records attributed to L H Epstein.

At least 145 records · Page 8Linked to original sources
PubMed1987

Long-term effects of modest weight loss in type II diabetic patients.

Since most obese patients with type II diabetes are unable to achieve ideal body weight, this study examined whether more modest weight losses would provide a long-term benefit. Type II diabetic patients (N = 114) were treated in a behavioral weight control program and followed up for one year. Weight loss was significantly correlated with improvements in glycosylated hemoglobin values at posttreatment (r = .55) and one year (r = .51). Patients who lost more than 6.9 kg or had more than 5% reduction in body weight had significant improvements in glycosylated hemoglobin values at one year, while patients losing less weight had nonsignificant changes and those gaining weight had significant worsening. Thus, modest weight loss can have a long-term impact on glycemic control. However, the improvement in glycemic control for a given weight loss was greater initially than at one year, suggesting that energy restriction, in addition to weight loss, may contribute to initial improvement. Neither percent overweight nor diabetes treatment affected weight loss.

Adult↗
PubMed1986

The cardiovascular effects of nicotine during stress.

The acute cardiovascular effects of smoking during stress may be greater than those of smoking or stress alone, a finding which could have implications for determining which smokers may be at particular risk for coronary heart disease (CHD). Methodological problems inherent in using tobacco smoking to deliver nicotine (believed responsible for smoking's cardiovascular effects) prevent clear examination of the cardiovascular effects of inhaled nicotine. This study compared the cardiovascular increases due to a video game stress task plus 1.0 mg nicotine with those of stress or nicotine alone using an aerosol method of presenting nicotine in measured doses. Twelve young male smokers each participated in four conditions on 4 separate days: stress + nicotine, stress + placebo (stress alone), rest + nicotine (nicotine alone), and rest + placebo. The effects of stress and nicotine were additive for heart rate but less than additive for systolic and diastolic blood pressure. These results indicate that the combined effects of stress and nicotine may be relevant to understanding the prevalence of CHD among smokers. They also suggest that the effects of each on cardiovascular activity may be different, as the effects are independent for heart rate but overlap for blood pressure.

Adolescent↗
PubMed1986

The effects of nicotine chewing gum on the sensitivity to muscle tension.

It has been shown that smoking can alter the sensitivity to muscle activity in female smokers. The present study was designed to assess the effects of smoking cessation and nicotine replacement on sensitivity to muscle tension. Twenty-five women were randomly assigned to one of two groups. One group was given nicotine chewing gum during the withdrawal period and a second group was given no nicotine replacement. Results showed a significant difference in sensitivity at post-test for subjects given nicotine gum compared to subjects receiving no nicotine replacement. These results are consistent with the hypothesis that nicotine alters sensitivity to muscle tension.

Adult↗
PubMed1986

Does self-monitoring of blood glucose levels improve dietary compliance for obese patients with type II diabetes?

Self-monitoring of blood glucose levels is currently being recommended for obese patients with type II diabetes to improve weight loss and glycemic control. To determine whether self-monitoring of blood glucose levels improves dietary compliance in these patients, 50 obese patients with type II diabetes were randomly assigned either to a standard behavioral weight control program or to a weight control program that included self-monitoring of blood glucose levels and focused on the weight-blood glucose relationship. Both groups lost significant amounts of weight and maintained their losses for at least one year; reductions in medication could be made for 70 percent of patients. These data suggest that the behavioral weight control used in this study may be of benefit to patients with type II diabetes. However, there was no evidence that the addition of self-monitoring of blood glucose levels to the treatment program improved the outcome in terms of weight loss, reduction in medication, dietary compliance, or mood state.

Adult↗
PubMed1986

Calorie-counting compared to exchange system diets in the treatment of overweight patients with type II diabetes.

Patients with diabetes are usually placed on exchange system diets to ensure a nutritionally adequate intake. However, there have been few studies which have actually compared the nutritional adequacy of diets selected by patients on exchange system diets, with that selected by patients on the calorie-counting diets typically used in behavioral weight control programs. This study compared the nutritional adequacy of the diets selected by overweight patients with Type II diabetes who had been randomly assigned to either an exchange system diet or a calorie-counting diet. Three-day food diaries were completed by all patients at the start and end of a 16-week weight control program. No significant differences were observed between patients on the calorie-counting diet compared to those on the exchange system diet with respect to nutrient intake, macronutrient distribution, or percent of the RDA obtained. Patients on both types of diet reported decreases in the proportion of calories from fat. The average intake exceeded 100% of the RDA for all nutrients except calcium. This study suggests that patients are able to improve the nutritional adequacy of their intake while following either a calorie-counting or an exchange system diet.

Behavior Therapy↗
PubMed1986

The nicotine paradox: effect of smoking on autonomic discrimination.

Smoking reduces negative affect while it increases sympathetic nervous system activity. However, theories of emotion predict that increased autonomic arousal should increase rather than reduce negative affect. One explanation for this paradox is that nicotine interferes with perception of autonomic activity. We evaluated the effect of smoking on autonomic activity perception by measuring performance on a heartbeat detection task after a high or low dose of nicotine or not smoking. A group of nonsmokers also completed the task. Results failed to support the hypothesis. In light of previous research, the results suggest EMG perception may be more important to the negative affect reduction phenomenon than perception of autonomic activity.

Adolescent↗
PubMed1986

The effect of exercise on non-restricted caloric intake in male joggers.

This study examined the effects of both increasing and decreasing normal energy expenditure over periods of one week on the self-reported caloric intake of seven male joggers (22-27 years). The three levels of energy expenditure were: no exercise, regular exercise and double exercise. Despite significant difference in energy expenditure across conditions, self-reported caloric intake did not differ significantly, suggesting that energy intake was not affected by short-term changes in energy expenditure.

Adult↗
PubMed1986

The effect of family variables on child weight change.

Previous research has shown that family size, the number of obese persons living at home, and parental weight influence the development of childhood obesity. Our study reports the relevance of these factors to child weight loss during a 1-year treatment period. Multiple linear regression procedures showed that the amount of relative weight change was related to initial treatment success, the number of children in the family, and the gender of the child. Children who were more successful lost more weight initially, had fewer siblings, and were female. These results suggest that family size may interact with treatment to determine weight change. The effects of family size on outcome may be operating simply by reducing the amount of time that a parent has to spend with the child in promoting behavior change. Likewise, increased family size may be operating as a stressor, reducing the effectiveness of parents in effectively managing their children.

Adult↗
PubMed1986

Family-based behavioral weight control in obese young children.

The effects of a family-based, behavioral weight control program on weight, linear growth, and nutrient intake among 17 obese children aged 1 to 6 were studied. The 1-year behavioral treatment involved three components: diet, exercise, and child management. Treatment meetings were held weekly for 10 weeks and then monthly for the remainder of the year. Relative body weight decreased significantly from 42.1% at baseline to 24.0% overweight at 1 year and 27.8% overweight at 2 years, while height increased normally over the 2 years of observation, suggesting that the children were obtaining adequate calories to maintain growth. The caloric and nutrient intakes of the children were analyzed from 3-day food records kept by the mothers during baseline and the tenth week of treatment. The mean caloric intake was 1,457 kcal prior to treatment and 1,025 kcal during treatment. Nutrient intake exceeded the Recommended Dietary Allowances at pretreatment for the nutrients investigated and continued to exceed the RDAs for all nutrients except calcium (96% of RDA) and iron (84% of RDA) during treatment. Improvements in nutrient density were shown for all nutrients. The results suggest that obesity can be treated successfully in young children without detrimental effects on growth or nutrient intake.

Behavior Therapy↗
PubMed1985

Methodological issues related to age of onset of obesity.

Research related to age of onset of obesity may be hampered by two methodological problems: (a) inconsistencies across studies in the criteria used to define early-onset and maturity-onset obesity and (b) the failure to control for other differences between early-onset and maturity-onset obese patients. Analyzing data from 178 applicants to a behavioral weight control program, this study found that almost twice as many patients were classified as early-onset obese when the division was based on their answer to the question, "Were you overweight as a child or teenager?" than when the division was based on self-reported weight at age 21. Moreover, early-onset obese patients were younger and heavier than those with maturity-onset obesity. Further studies are needed to determine the most reliable and valid means of classifying patients as early- or maturity-onset obese.

Adult↗
PubMed1985

Effect of diet and controlled exercise on weight loss in obese children.

The effects of adding exercise to diet for weight control in obese children were evaluated by randomizing obese girls to one of two groups: diet and diet plus exercise. During the first 6 weeks of the treatment, children exercised in a supervised three times a week exercise program, in which they walked or ran 3 miles. Significant decreases from baseline weight and in percent overweight were observed for both groups during the year of treatment. Significant decreases in percent overweight were observed at 0 to 2 months and then at 2 to 6 months for the children who were exercising, whereas percent overweight in children in the diet-alone group decreased only from 0 to 2 months. In addition, a significant improvement in fitness was observed only for children in the diet plus exercise group.

Behavior Therapy↗
PubMed1985

Childhood obesity.

Several conclusions can be drawn on the basis of the research reviewed: Obese children are more likely to become obese adults than are their thinner peers. Parent weight may interact with child weight status in the etiology of adult obesity. Obese children with obese parents are more likely to become obese adults than are obese children with thin parents. The prediction of adult obesity from childhood obesity improves with the age of the child. As the obese child gets older, he or she is more likely to become an obese adult. The inclusion of parents in the treatment process is important for the success of childhood weight control. It may be best to see the parent and child separately in treatment meetings rather than together. Children with thin parents may do better in weight control than children of obese parents. Adherence to exercise is likely to be a problem with obese children, and the choice or design of an exercise program should take these adherence problems into account. Nutritional adequacy of the child's diet should be evaluated both in terms of what the child is eating as well as in terms of the prescribed diet. Likewise, growth of the obese child during dieting should be monitored and should be related to expected height, which can be based on parent height. In summary, childhood obesity is a problem that places a child at great risk for becoming an obese adult. However, a growing body of research has emerged that has identified important risk factors for the development of obesity in children. Likewise, treatment methods have been developed that produce significant and long-lasting effects on childhood weight status. Continued development of treatment methods would be of great potential importance in the prevention and treatment of this prevalent problem.

Adolescent↗