Biomedical subjects

R R Wing

Publications and source records attributed to R R Wing.

At least 145 records · Page 8Linked to original sources

PubMed1990

Ten-year follow-up of behavioral, family-based treatment for obese children.

Using a prospective, randomized, controlled design, we examined the effects of behavioral family-based treatment on percent overweight and growth over 10 years in obese 6- to 12-year-old children. Obese children and their parents were randomized to three groups that were provided similar diet, exercise, and behavior management training but differed in the reinforcement for weight loss and behavior change. The child and parent group reinforced parent and child behavior change and weight loss, the child group reinforced child behavior change and weight loss, and the nonspecific control group reinforced families for attendance. Children in the child and parent group showed significantly greater decreases in percent overweight after 5 and 10 years (-11.2% and -7.5%, respectively) than children in the nonspecific control group (+ 7.9% and + 14.3%, respectively). Children in the child group showed increases in percent overweight after 5 and 10 years (+ 2.7% and + 4.5%, respectively) that were midway between those for the child and parent and nonspecific groups and not significantly different from either. At 10 years, child height was related strongly to the height of the parent of the same sex (r = .78 children were 1.8 cm taller than their parents, with no differences in height between groups.

Analysis of Variance↗

PubMed1990

Growth in obese children treated for obesity.

This study assesses the growth patterns during a 5-year period in children aged 6 to 12 years treated for obesity using behavioral family-based treatment procedures. Previous studies have suggested a decrease in height velocity after weight reduction, but these results did not consider either the height of the parent or the greater height of obese than nonobese children. Results show that at entry, obese children are taller than their nonobese peers (74th percentile), and that even after 5 years, they remain taller than the norm (65th percentile). Child weight and level of physical maturity accounted for 54% of the variance in predicting baseline height percentile. Entrance height and parental height accounted for 9% of the variance in changes in height percentile, both adjusted for parental height. Weight change did not correlate with growth adjusted for parental height. These results do not suggest that negative effects on height are a long-term side effect of child weight control.

Behavior Therapy↗

PubMed1990

Physical activity and cardiovascular risk: a cross-sectional study of middle-aged premenopausal women.

The relationship between self-reported physical activity and cardiovascular risk factors was evaluated in a population-based sample. The sample included 541 premenopausal women recruited for a study of the natural history of risk factor change associated with change in sex hormone status. Physical activity was assessed using the Paffenbarger Activity Questionnaire. Women were classified according to quartile of weekly energy expenditure into groups of 0-500, 501-999, 1,000-1,999, and 2,000 kcal or greater. Results showed that the more active the women, the lower their blood pressure and heart rate. More active women had lower cholesterol and triglycerides, and higher high-density lipoprotein (HDL) cholesterol. Tricep and suprailiac skinfolds, fasting insulin, and insulin/glucose levels were also lower among the more active women. When the analysis was repeated controlling for the effect of education and body mass index, the statistical test for linear trend remained significant except for the trend for heart rate, total cholesterol, and triglycerides. Women reporting activity of 1,000 kcal/week had higher high-density lipoprotein cholesterol and lower diastolic blood pressure, body mass index, skinfolds, fasting insulin, and fasting insulin/glucose ratios compared with women reporting lower levels of activity. Only those women who reported 2,000 kcal/week had significantly lower total cholesterol, triglycerides, and low-density lipoprotein cholesterol, and higher HDL2 cholesterol; women reporting less activity did not differ with regard to these lipids and lipoproteins. The study suggests that physical activity is associated with improved cardiovascular risk profiles among middle-aged women and that the beneficial effects of activity are seen at different levels for specific risk factors.

Adult↗

PubMed1990

Influences of natural menopause on psychological characteristics and symptoms of middle-aged healthy women.

We investigated the psychological and symptom consequences of the natural menopause in a longitudinal study of 541 initially premenopausal healthy women. All women were given an extensive evaluation at baseline. After 3 years of follow-up, 69 women ceased cycling for 12 months; another 32 women had ceased cycling and had taken hormone replacement therapy for a total of 12 months. These women were reevaluated in a clinic examination identical with the baseline examination, as were 101 age-matched premenopausal control women. Comparison among groups at the baseline and follow-up examination showed that natural menopause led to few changes in psychological characteristics, with only a decline in introspectiveness and an increase in reports of hot flashes being apparent. We conclude that natural menopause did not have negative mental health consequences for the majority of middle-aged healthy women.

Adaptation, Psychological↗

PubMed1990

Five-year follow-up of family-based behavioral treatments for childhood obesity.

This article presents the 5-year outcome of family-based behavioral treatment of obesity for 6- to 12-year-old children in 162 families across 4 treatment outcome studies. Results suggest that treatments that use (a) conjoint targeting and reinforcement of child and parent behavior or (b) reciprocal targeting and reinforcement of children and parents are associated with the best child outcomes. Predictors of child success include self-monitoring, changing eating behavior, praise, and change in parent percent overweight. Parental outcome is predicted by self-monitoring weight, baseline parent percent overweight, and participation in fewer subsequent weight control programs.

Behavior Therapy↗

PubMed1990

Psychological stress and glucose metabolism in obese and normal-weight subjects: a possible mechanism for differences in stress-induced eating.

Acute psychological stress has been found to impair the handling of a glucose load in normal-weight individuals and to produce a delay in gastrointestinal transit time. The present study utilized the same paradigm to compare 10 obese and 10 normal-weight subjects. All subjects participated in two counterbalanced sessions (stress and nonstress). At each session, subjects were fed a carbohydrate load, and glucose was measured 0, 30, 60, 90, and 120 min after the load. On nonstress days, subjects relaxed after the drink; on stress days, subjects participated in 30 min of competitive tasks. The stressor significantly delayed the glucose response in the normal-weight subjects but did not affect the glucose response in obese subjects. This finding may have implications for differences between obese and normal-weight individuals in stress-induced eating, possibly explaining the decreased consumption of normal-weight individuals during stress.

Anger↗

PubMed1990

A double-blind, placebo-controlled trial of fluoxetine plus behavior modification in the treatment of obese binge-eaters and non-binge-eaters.

To determine whether fluoxetine is effective in the long-term treatment of obesity and whether it is particularly useful in the treatment of obese binge-eaters, the authors randomly assigned 45 obese subjects (22 with binge-eating problems and 23 without binge-eating) to fluoxetine (60 mg/day) or placebo in a 52-week double-blind trial. The 21 subjects who completed the trial made 13 clinic visits and were taught basic behavior modification strategies. Patients treated with fluoxetine plus behavior modification lost significantly more weight than those treated with placebo plus behavior modification. However, the drug did not appear to have a differential benefit for binge-eaters.

Adolescent↗

PubMed1990

Accuracy and reliability of the Caltrac accelerometer for estimating energy expenditure.

The Caltrac accelerometer is designed to assess energy expenditure during normal activity. The aims of the present study were (a) to determine the interinstrument and intersession reliability of the Caltrac and (b) to validate these instruments with measures of oxygen uptake (VO2) and determine whether Caltracs accurately reflect differences in energy expenditure due to sex, body weight, and speed. Caltracs were found to have very good interinstrument and intersession reliability and to accurately reflect differences in expenditure due to sex, weight, and speed. However, Caltracs consistently over-estimated energy expenditure by an average of 9-13%. The absolute percent error (percent error without consideration of the sign) of the Caltrac was greater, averaging 23%. The correlations between Caltrac and VO2 averaged 0.68-0.74. Thus, the Caltracs seem well suited for studies of activity level of groups, but may be less useful in estimating an individual's activity.

Adult↗

PubMed1990

Weight gain associated with improved glycemic control in population-based sample of subjects with type I diabetes.

Previous studies have suggested that weight gain is an identifiable risk of efforts to lower blood glucose with intensive insulin therapy in type I (insulin-dependent) diabetic subjects. This study examined this relationship in a population-based sample of type I diabetic subjects participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Four hundred five adults (aged greater than or equal to 21 yr) with type I diabetes, who were diagnosed before age 30 yr, were studied from 1980 to 1982 and in a follow-up examination from 1984 to 1986. Weight gain over the 4-yr interval averaged 1.8 +/- 5.9 kg. Weight gain was significantly associated (r = -0.26, P less than 0.001) with improvements in glycosylated hemoglobin levels; the quartile of subjects with the greatest improvements in glycemic control gained 3.4 kg, whereas the quartile of subjects with the smallest improvements in glycemic control lost 0.6 kg. Weight gain was also correlated with increases in the number of shots of insulin per day and change in the treatment regimen from one type of insulin to a combination of short- and long-acting insulins. These results suggest that weight gain may be an adverse consequence of improved glycemic control. Efforts to better understand the mechanism explaining weight gain and to prevent weight gain are needed.

Adult↗

PubMed1990

Depressive symptomatology in obese adults with type II diabetes.

This study compared depressive symptomatology in 32 obese subjects with type II (non-insulin-dependent) diabetes (16 men, 16 women) and their obese nondiabetic spouses. All subjects completed the Beck Depression Inventory (BDI) before participation in a behavioral weight-loss program. Diabetic subjects reported significantly more depressive symptomatology than their overweight nondiabetic spouses (10.6 +/- 6.4 vs. 7.5 +/- 6.2, P less than 0.04). Diabetic subjects scored higher than their spouses on 15 of 20 BDI items, with significant differences in feelings of being punished, perceived appearance, and interest in sex. Mean BDI score in the diabetic spouses was similar to that observed in the first 123 diabetic subjects to enter the weight-loss program (BDI 11.2 +/- 6.9). Further studies are needed to determine whether diabetic subjects differ from age-, sex-, and weight-matched nondiabetic individuals in clinical depression and depressive symptomatology.

Depression↗

PubMed1990

Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians.

There was a need to design a questionnaire that could accurately assess the activity patterns of Native Americans to evaluate the relationship between physical activity and diabetes. Such a questionnaire was developed and implemented into the data collection scheme of the prospective Pima Indian Study of Arizona. The questionnaire, which assesses historical, past-year, and past-week leisure and occupational activity, was examined in 29 Pima individuals aged 21-36 yr and was shown to be reliable with test-retest correlations (rank-order correlations ranged from 0.62 to 0.96 for leisure and occupational activity). Reproducibility of the past-year leisure physical-activity estimate was determined in 69 participants aged 10-59 yr and was found to be reliable in all age-groups with the exception of the 10- to 14-yr-old age-group (rank-order correlations were 0.31 in the 10- to 14-yr-old age-group compared to 0.88 to 0.92 in those greater than 20 yr of age). Validity of the current-activity section of the questionnaire was demonstrated indirectly through comparisons with activity monitors. The past-week leisure-activity estimate was related to the Caltrac activity monitor counts per hour (rho = 0.62, P less than 0.05, n = 17). In summary, a physical-activity questionnaire has been developed that is both reliable and feasible to use in the Pima Indian population to evaluate the relationship of physical activity to non-insulin-dependent diabetes mellitus.

Adolescent↗

PubMed1990

Variables associated with weight loss and improvements in glycemic control in type II diabetic patients in behavioral weight control programs.

Because weight loss is difficult to achieve, it would be helpful to determine whether there are subgroups of obese type II diabetic patients who benefit most from participation in a behavioral weight loss program. We studied 178 obese patients with type II diabetes, who participated in a 12-20 week behavioral weight loss program and were followed for 1 year after the program to determine whether age, gender, percent overweight, medication, duration of diabetes or fasting glucose were related to weight loss and/or to the magnitude of improvement in glycemic control experienced with weight loss. Gender was the only variable related to weight loss; males lost more weight and had greater decreases in percent overweight than females. The variable most strongly related to improvement in glycemic control was pretreatment fasting glucose level; patients with higher initial glucose levels experienced the greatest improvements in control. There was no evidence to support the belief that patients on insulin have poorer weight losses or that patients with long-duration diabetes benefit less from weight reduction than those with recent-onset diabetes.

Behavior Therapy↗

PubMed1989

Menopause and risk factors for coronary heart disease.

Postmenopausal women are believed to have a higher risk of coronary artery disease than premenopausal women. In this study, we prospectively determined changes in coronary risk factors that were attributable to natural menopause in 541 healthy, initially premenopausal women 42 to 50 years of age. After approximately 2 1/2 years, 69 women had spontaneously stopped menstruating for at least 12 months, and 32 women had stopped natural menstruation and received hormone-replacement therapy for a period of at least 12 months. An equal number of age-matched premenopausal women in the study group served as controls. In women who had a natural menopause and did not receive hormone-replacement therapy, serum levels of high-density lipoprotein (HDL) cholesterol declined as compared with those of premenopausal controls (-0.09 vs. 0.00 mmol per liter; P = 0.01), and levels of low-density lipoprotein (LDL) cholesterol increased (+0.31 vs. +0.14 mmol per liter; P = 0.04). In menopausal women who received hormone-replacement therapy, HDL and LDL cholesterol levels did not change, but the levels of triglycerides (+0.42 vs. -0.04 mmol per liter; P less than 0.001), apolipoprotein A-I (+0.18 vs. +0.03 g per liter; P less than 0.01), and apolipoprotein A-II (+0.05 vs. -0.03 g per liter; P less than 0.05) increased as compared with premenopausal controls. Natural menopause did not affect blood pressure, plasma glucose or insulin levels, body weight, the total number of kilojoules consumed in the diet, or the total number of kilojoules expended in physical activity. These results suggest that a natural menopause has an unfavorable effect on lipid metabolism, which may contribute to an increase in the risk of coronary disease. Hormone-replacement therapy may prevent some of these changes.

Apolipoproteins A↗

PubMed1989

The effect of weight control on lipid changes in obese children.

The effects of weight change on serum lipid changes were assessed in a sample of 56 obese children randomly assigned to family-based behavioral obesity treatment vs controls given no treatment. Fasting serum lipid levels, height, weight, and fitness were measured at program entry and after 6 months of treatment. Children assigned to treatment showed significantly greater relative weight and weight changes than children in the control group, and the weight changes were significantly related to reductions in fasting serum triglyceride and total serum cholesterol levels and increases in high-density lipoprotein serum cholesterol. Results after 5 years of follow-up available for a small sample of treated children showed that a change in relative weight and fitness from 6 months to 5 years was also associated with changes in the high-density lipoprotein level. These results suggest that weight control in obese preadolescent children may be associated with improvement in lipoprotein profiles.

Child↗

PubMed1989

Blood glucose discrimination training in patients with type II diabetes.

This study was designed to determine whether patients with Type II diabetes could be taught to discriminate blood glucose after experiencing a variety of blood glucose levels and receiving feedback on the accuracy of their estimates. Thirty-six subjects (18 on oral agents and 18 on insulin) were randomly assigned to one of two feedback conditions: (1) current feedback, which received accurate information regarding their blood glucose levels, (2) noncurrent feedback, which received blood glucose levels from the preceding session. Subjects were exposed to a wide range of blood glucose values in six training sessions by ingesting drinks with three different caloric loads. In pre/post comparisons using several indices of accuracy, both groups showed significant improvement in estimating blood glucose levels. However, feedback on current blood glucose levels did not produce greater improvement than noncurrent. Accuracy was unrelated to the degree to which subjects reported associating internal sensations to their estimates. Failure to find differences between the two feedback conditions may have been due to the noncurrent feedback group's receiving fairly accurate information, to the difficulty of the discrimination task, and to the limited number of training trials.

Adult↗

PubMed1989

Perception of eating and exercise in children as a function of child and parent weight status.

The present study assessed the effects of child body weight (obese/lean) and familial loading for obesity (two obese parents/two lean parents) on the psychophysics of sweetness, fatness and exercise workloads, as well as subjective ratings of foods varying in sugar and fat and activities varying in energy expenditure. Children were measured in a baseline state and at 6 months after the obese children had participated in a family-based behavioral weight control program. No differences between obese and lean children in perceptual ratings were observed. However, offspring of obese or lean parents differed on intensity rating, food palatability and activity enjoyment ratings. Intensity ratings for sweetness in offspring of obese parents was increased, with a similar trend for intensity ratings for fatness. Offspring of obese parents rated all foods and activities with lower palatability and enjoyment ratings than offspring of lean parents. After a 6 month family-based behavioral weight loss treatment, obese children had significant decreases in percent overweight while lean children remained stable. Changes in the pattern of food ratings were observed for the obese children, with a reduction in liking for foods high in fat and/or sugar, and an increase in ratings for food slower in fat and sugar. The effects of parental obesity on food and exercise intensity ratings and hedonic ratings were maintained. Overall, these results suggest parental weight influences behavioral factors related to obesity in children.

Body Weight↗

PubMed1989

Relapse crises and coping among dieters.

We examined situational antecedents of dieting relapse crises and dieters' attempts to cope with temptations to overeat. We analyzed posttreatment interviews with 57 obese Ss with Type II diabetes, comparing situations in which Ss lapsed with those in which they overcame temptation to overeat. Cluster analysis yielded 3 categories of relapse crises: mealtime, low-arousal, and emotional upset situations. The clusters differed in outcome: Upset situations almost always resulted in overeating; situational factors, especially food-related cues, increased relapse risk; but performance of coping was the strongest correlate of outcome. Cognitive and behavioral coping responses were each equally associated with positive outcomes. When Ss reported combining both types of coping, they were less likely to report overeating. The dynamics of relapse crises among dieters resemble those that govern relapse crises in addictive behaviors.

Adaptation, Psychological↗

PubMed1989

Resting metabolic rate in lean and obese children: relationship to child and parent weight and percent-overweight change.

Two studies were conducted to assess differences in metabolic rate as a function of child weight (study I); and the interaction of child and parent weight (study II). In both studies obese children had higher resting metabolic rates (RMRs) than lean children (p less than 0.05). Child weight accounted for 72 and 78% of the variance in RMR in studies 1 and 2, respectively. Including parental weight did not improve the prediction of RMR. After 6 mo of treatment, obese children decreased percent overweight, whereas lean children showed no change (p less than 0.01). RMR in both groups remained unchanged after 6 mo. These results indicate that the RMR is higher in obese than in lean children, that changes in percent overweight that result from increases in height and no change in weight do not decrease RMR over 6 mo, and parent weight does not improve the prediction of child RMR.

Basal Metabolism↗