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Biomedical subjects

S I Barr

Publications and source records attributed to S I Barr.

At least 37 records · Page 2Linked to original sources
PubMed1997

Rethinking postoperative diets for short-stay orthopedic surgery patients.

OBJECTIVE: To examine postoperative meal tolerance and meal preferences of short-stay orthopedic surgery patients. DESIGN: A patient survey was designed with input of nurses and former patients. Patient interviews focused on the first two meal trays provided, fluids offered, and perceived hunger after surgery. SUBJECTS/SETTING: Subjects (n = 31) were adult orthopedic inpatients who were within 24 hours of surgery conducted while they were under general anesthetic and who had received at least one postoperative meal tray. STATISTICAL ANALYSES PERFORMED: Descriptive statistical procedures were performed and chi 2 tests were used to compare responses at the first and second meals. RESULTS: At the first meal after surgery, most patients reported adverse postoperative symptoms. Twenty-six (84%) patients had received regular meals. Fifteen (48%) patients reported eating almost nothing, yet 12 (39%) reported eating most or all food provided. Twenty-six (84%) patients thought a meal consisting of a combination of fluid and solid items would have been acceptable. At the second postoperative meal, fewer adverse symptoms were reported. Accordingly, most patients were able to eat the regular meal and considered solid food appropriate. Twenty-nine (94%) patients thought the amount of fluid provided after surgery was adequate. Eight (26%) patients reported feeling unreasonably hungry at some point after surgery. APPLICATIONS/CONCLUSIONS: Short-stay orthopedic surgery patients recover quickly from general anesthesia; however, patients vary in postoperative symptoms, meal tolerance, and meal preferences. Findings from this survey were applied to the development of a postoperative meal protocol, now in use, that features meals containing a combination of solid and fluid items.

Adult↗
PubMed1996

Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada. 5. Physical activity as therapy for osteoporosis.

OBJECTIVE: To examine exercise as a therapy for people with osteoporosis. OPTIONS: Immobilization, standing low-load and high-load physical activities. OUTCOMES: Risk of injury, quality of life, risk of falls and fractures, strength and posture and pain management. EVIDENCE: Relevant epidemiologic studies, clinical trials and reviews were examined, including the large-scale FICSIT trial in the United States, a prospective 4-year study of women enrolled in an exercise program in Toronto and the large-scale Study of Osteoporotic Fractures. VALUES: Minimizing risk of injury and increasing quality of life were given a high value. BENEFITS, HARMS, AND COSTS: Moderate physical activity in people with osteoporosis can reduce the risk of falls and fractures, decrease pain and improve fitness and overall quality of life. It may also stimulate bone gain and decrease bone loss. Its positive effects are an adjunct to other interventions, such as hormonal therapy. It may give patients the confidence to resume regular activity and can provide social interaction and support. During exercise programs, proper nutrition is necessary to prevent excessive weight loss and impaired immune function resulting from inadequate protein, vitamin and mineral intake. RECOMMENDATIONS: Immobilization should be avoided if possible in anyone with osteoporosis or at increased risk for osteoporosis. Regular, moderate physical activity is recommended for those with osteoporosis. Elderly people should be assessed for risk of falling to identify those in greatest need of an exercise program. Community group exercise programs are beneficial. Younger people with osteoporosis also need exercise that will preserve or improve bone mass, muscular strength, endurance and cardiovascular fitness. Weight loss as a result of physical activity should be avoided and adequate intake of protein, vitamins and minerals assured. Because the benefits of physical activity are independent of the effect of other therapies, physical activity is an essential adjunct to appropriate nutrition and other therapies. VALIDATION: These recommendations were developed by the Scientific Advisory Board of the Osteoporosis Society of Canada at its 1995 Consensus Conference. They are in agreement with the position taken on osteoporosis and exercise by the United States Center for Disease Control and Prevention and the American College of Sports Medicine. SPONSORS: Sponsors of the 1995 conference included the Dairy Farmers of Canada, Eli Lilly Canada, Inc., Hoffmann-La Roche Canada Ltd., Merck Frosst Canada Inc. and Procter & Gamble Pharmaceuticals Canada Inc.

Accidental Falls↗
PubMed1996

Ovulatory premenopausal women lose cancellous spinal bone: a five year prospective study.

Healthy premenopausal women with regular cycles are believed to be increasing or maintaining bone density. However, few studies have prospectively documented spinal cancellous bone, the bone that changes rapidly in response to reproductive hormones, in this population. Furthermore, our previous one-year study documented that 24% of the one-year bone change by quantitative computed tomography (QCT) was related to subclinical ovulatory disturbances (short luteal phase and non-ovulation) in the presence of regular menstrual cycles. The purpose of this study was to document the cancellous bone change over five years in this initially ovulatory, premenopausal cohort of 66 healthy women. Thirty-seven women, who continued to be premenopausal and have regular cycles, completed this five-year study. Those enrolled differed only by being older and weighing less than those who could not be contacted (n = 19) or who declined to participate (n = 10). Documentation of current ovulatory characteristics was obtained for at least three cycles in 27 women. At the five-year assessment, the volunteers were 40.6 (range 26-47) years old, weighed 58.5 (41-77) kg, and were 160.9 (149-174) cm in height. All were premenopausal, healthy, nonsmokers with regular menstrual cycles (mean 27.7, range 24-33 days). Six women with intervening events (such as pregnancy or use of oral contraceptives) had interval (12 to 60 months) QCT changes similar to the remaining 31 (-7.98 vs. -4.92 mg/cm, p = 0.1, respectively). Mean five-year QCT was 143.0 +/- 20.2 mg/cm, whereas the initial mean value was 151.9 +/- 20.1 mg/cm. Significant QCT loss over five years (-8.9 +/- 6.2 mg/cm) (95% Cl -6.9 to -11.0) correlated with QCT change in the first year (r = 0.629, p < 0.001). First-year change was not related to the subsequent four-year interval change (r = -0.056, p = 0.74), however. Five-year QCT change was not related to age, weight, osteoporosis family history, estimated calcium intake, or exercise, but did correlate with year one luteal index (luteal/cycle length) (r = 0.339, p = 0.043). Significant cancellous spinal bone loss occurs in healthy, ovulatory premenopausal women, and is influenced by subclinical disturbances of ovulation.

Adult↗
PubMed1995

Dieting attitudes and behavior in urban high school students: implications for calcium intake.

PURPOSE: Adolescence is a time of rapid gain in bone density which may be influenced by calcium intake. This study assessed whether dieting concerns, known to be prevalent in adolescent girls, were associated with the calcium intake of adolescents of varying ethnicity. METHODS: Students (n = 856) completed an instrument which assessed current weight, desired weight, height, age, ethnicity, calcium intake using a food frequency questionnaire, dieting concerns using the Eating Attitudes Test dieting subscale (DS), taste enjoyment of dairy products, and type of milk consumed. RESULTS: Among 782 students with useable responses, most girls (69.1%) wanted to lose weight and most boys (54.2%) wanted to gain weight. Asian girls had lower body mass index (BMI) than Caucasians (19.3 +/- 2.1 vs 20.8 +/- 2.6 kg/m2, p < 0.05), but desired BMI did not vary by ethnicity in either girls or boys. Asian girls also had lower DS scores than Caucasians, but the difference was not significant with current BMI as a covariate. Girls' DS scores were higher than those of boys (6.3 +/- 6.5 vs 2.3 +/- 3.2, p < 0.001), and estimated calcium intakes were lower (815 +/- 528 vs 1149 +/- 701 mg/day, p < 0.001); however, DS scores were not associated with calcium intake for either sex. Especially among girls, dieting and body size concerns were associated with taste enjoyment of certain dairy products, and with the type, but not the amount, of milk consumed. Girls using skim milk had higher DS scores than those using low-fat or whole milk. CONCLUSIONS: In this non-clinical sample, greater concern about dieting and body size did not directly compromise calcium intake but was associated with the type of milk used.

Adolescent↗
PubMed1995

Nutrient intakes and eating behavior scores of vegetarian and nonvegetarian women.

OBJECTIVE: To compare nutrient intakes between vegetarians and nonvegetarians with similar health practices, and to assess relationships with eating behavior scores from the Three-Factor Eating Questionnaire. DESIGN: Survey. SETTING: Metropolitan area in western Canada. SUBJECTS: Subjects (n = 45) were participants in a study comparing subclinical menstrual disturbances between vegetarians and nonvegetarians. To be included, women had to be 20 to 40 years old, be weight stable with a body mass index (BMI; kg/m2) of 18 to 25, be a nonsmoker, exercise 7 hours a week or less, consume one alcoholic drink or less a day, and not be using oral contraceptives. Nonvegetarians (n = 22) ate red meat three times a week or more, and vegetarians (n = 23, 8 vegans and 15 lactovegetarians) had excluded all meat, fish, and poultry for 2 years or more. MAIN OUTCOME MEASURES: Nutrient intake assessed by three 3-day diet records; supplement use; body composition; and dietary restraint (conscious limitation of food intake), disinhibition, and hunger assessed by the Three-Factor Eating Questionnaire. STATISTICAL ANALYSES PERFORMED: Anthropometric variables, nutrient intakes, and eating behavior scores were compared between vegetarians and nonvegetarians using unpaired t tests, and among vegans, lactovegetarians, and nonvegetarians using one-way analysis of variance and Duncan's test. Supplement use was compared using chi 2 analysis. The Pearson correlation coefficient was used to evaluate relationships between variables. RESULTS: Diets of all women adhered closely to current nutrition recommendations. Vegetarians had lower protein and cholesterol intakes and higher percentage of energy as carbohydrate, ratio of polyunsaturated fat to saturated fat (P:S ratio), and fiber intake than nonvegetarians. Vegetarians had lower riboflavin, niacin, vitamin B-12, zinc, and sodium intakes and higher folate, vitamin C, and copper intakes. However, many differences were not apparent between the subgroup of lactovegetarians and nonvegetarians (their P:S ratios and carbohydrate, fiber, riboflavin, folate, vitamin C, and copper intakes were similar). In contrast, differences existed between the lactovegetarian and the vegan subgroups. Supplement use was similar between groups, except for greater vitamin C use by vegetarians. Vegetarians were leaner than nonvegetarians, had lower restraint scores, and had significant associations between restraint and BMI (r = .49; P < .05) and energy per kilogram body weight (r = -.60; P < .01). APPLICATIONS/CONCLUSIONS: Current nutrition recommendations can be attained by vegetarians and nonvegetarians alike, but nutrient intakes cannot be inferred from dietary pattern. In this study, the intakes of health-conscious nonvegetarians and lactovegetarians were more similar than the intakes of lactovegetarians and vegans. Vegans' calcium and vitamin B-12 intakes may need attention. Vegetarians' lower restraint scores suggest that they are not at increased risk for eating disorders.

Adult↗
PubMed1995

Energy intakes are higher during the luteal phase of ovulatory menstrual cycles.

We compared energy and macronutrient intakes across the menstrual cycle in participants (n = 42) in a study that assessed the frequency of ovulatory disturbances in regularly cycling vegetarians and nonvegetarians. Women kept daily basal body temperature records for six consecutive menstrual cycles and provided 3-d diet records near the beginning, middle, and end of different cycles. On completion of the study, temperature records were quantitatively analyzed to determine whether cycles were ovulatory, and if so, the date the luteal phase began. Diet records kept near the beginning and end of cycles were matched with temperature analysis results, and women were grouped according to whether the end-of-cycle record was kept during the luteal phase of an ovulatory cycle (group 1, n = 29), or during an anovulatory cycle or before luteal phase onset of a short luteal phase cycle (group 2, n = 13). Group 1 had higher energy intakes during the luteal than during the follicular phase (9.27 +/- 2.69 vs 8.01 +/- 2.36 MJ/d, P < 0.0001), whereas intakes of group 2 did not differ across the cycle (7.91 +/- 2.18 vs 8.20 +/- 1.48 MJ/d, NS). Both groups' macronutrient intakes were similar in records kept near the beginning and end of cycles. Documentation of ovulation is necessary in studies assessing premenopausal women's energy intakes.

Adult↗
PubMed1995

Calcium intakes of adolescent female gymnasts and speed skaters: lack of association with dieting behavior.

Calcium intake and its association with dieting behavior were assessed in female adolescents competing in an aesthetic and a nonaesthetic sport (gymnastics and speed skating). Athletes were 25 skaters and 32 gymnasts competing at a provincial level or higher. Calcium intake was assessed by food frequency questionnaire; dieting behavior by the Eating Attitudes Test Dieting subscale; and body composition by skinfolds, height, and weight. Mean calcium intakes of both groups of athletes exceeded Canadian recommendations, and skaters' mean intakes exceeded U.S. recommendations; however, many individuals had low intakes. Gymnasts were leaner than skaters and had lower calcium intakes, but this difference was not associated with Dieting subscale scores, which were similar between sports and were not correlated with calcium intake. Athletes had higher mean calcium intakes than normally active adolescents studied (measured with a similar protocol) and had lower Dieting subscale scores. Thus, although calcium intakes of some athletes require attention, sport participation was associated with increased intakes. Also, for these athletes, dieting behavior did not directly interfere with calcium intake.

Adolescent↗
PubMed1995

Medroxyprogesterone increases basal temperature: a placebo-controlled crossover trial in postmenopausal women.

OBJECTIVE: To assess whether temperature is increased by medroxyprogesterone (MPA) and thus whether basal temperature records could be used to determine ovulation during cyclic MPA therapy. DESIGN: A 2-month double-blind placebo-controlled crossover trial in which oral basal temperature was measured daily. SETTING: Normal human volunteers in an academic medical environment. SUBJECTS: Eleven postmenopausal women not taking gonadal hormones. INTERVENTION: Medroxyprogesterone acetate (10 mg/d) or placebo, calendar days 16 to 25, with crossover. MAIN OUTCOME MEASURES: Comparison of mean temperature days 17 to 26 during MPA versus placebo; comparison of differences between temperatures days 7 to 16 and 17 to 26 in MPA versus placebo months; and analysis for a significant monthly thermal shift. RESULTS: The mean temperatures during MPA treatment averaged 0.27 degrees C higher than during the placebo phase and showed a significant change from pretreatment to "treatment" phases during MPA but not during placebo cycles. Eight of the MPA and one of the placebo cycles showed a shift from lower to higher temperatures days 16 to 25. CONCLUSIONS: Medroxyprogesterone acetate has a physiological progesterone-like thermal effect. Therefore basal temperature data cannot reliably indicate ovulation during cyclic MPA administration.

Adult↗
PubMed1994

Associations of social and demographic variables with calcium intakes of high school students.

OBJECTIVE: To assess usual calcium intake of urban high school students and to assess the association of social and demographic variables with calcium intake. DESIGN: A self-administered survey instrument containing the following elements: a food frequency questionnaire (FFQ) developed to estimate calcium intake; questions to elicit demographic information; and scales to reflect taste enjoyment of dairy products, social reinforcement for consumption of milk, perceptions of others' opinions about milk, and behavioral modeling of milk consumption (ie, the frequency of observing friends' and family members' use of milk). The FFQ was shown to include major sources of calcium in diets of a pretest sample (n = 130). SETTING: Urban high schools in a metropolitan setting. SUBJECTS/SAMPLES: Students in one class per grade level in six high schools (approximately 900 students) were asked to participate. Of the 856 questionnaires completed, 785 were usable. MAIN OUTCOME MEASURES: Total calcium intake, as estimated using the FFQ. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, t tests, one-way analysis of variance, correlation analysis, and stepwise multiple regression analysis were used to assess relationships of independent variables with calcium intake. RESULTS: Mean estimated calcium intakes for male and female students were 1,146 +/- 41 mg/day (mean +/- standard error of the mean) and 815 +/- 26 mg/day (P < .001), respectively, 59% of which was obtained from milk. Median intakes were 1,016 mg/day for boys and 676 mg/day for girls, and more than half the students had intakes that were below current recommendations. Multiple regression analysis revealed significant predictors of total calcium intake: gender (boys > girls); taste enjoyment of dairy products; number of meals and snacks per day; age; ethnicity (whites > Asians); behavioral modeling of milk consumption; perceptions of others' opinions, recommendations, and use of milk; and soft drink consumption (total adjusted R2 = .304). With the exception of age, these variables were positively associated with calcium intake. Regression equations developed for boys and girls separately revealed that different variables entered the equations. APPLICATIONS/CONCLUSIONS: Most of the variability in adolescents calcium intakes remained unexplained by the variables included in this study. Nevertheless, the results suggest that education programs focusing on taste enjoyment of dairy products and building on the influence of peers and family members may have a positive impact on calcium intake.

Adolescent↗
PubMed1994

Cyclic medroxyprogesterone treatment increases bone density: a controlled trial in active women with menstrual cycle disturbances.

OBJECTIVE: Bone loss occurs in young women who experience amenorrhea or ovulatory disturbances. The purpose of this study was to determine whether bone loss could be prevented by simulating a more normal hormonal pattern, using treatment with cyclic medroxyprogesterone, with or without calcium supplementation, in physically active women with disturbed menstruation. DESIGN: This study was a 1-year randomized, double-blind, placebo-controlled trial. Women who were stratified by menstrual cycle disturbance were randomized into four groups. The outcome variable was the change in spinal bone density measured by dual energy techniques. SETTING: A large metropolitan area. PARTICIPANTS: Sixty-one healthy, normal-weight physically active premenopausal women aged 21 to 45 years who experienced amenorrhea, oligomenorrhea, anovulation, or short luteal phase cycles completed the study. INTERVENTION: Therapies were cyclic medroxyprogesterone (10 mg/day for 10 days per month) and calcium carbonate (1,000 mg/day of calcium) in four groups: (A) (n = 16) cyclic medroxyprogesterone plus calcium carbonate; (B) (n = 16) cyclic medroxyprogesterone with calcium placebo; (C) (n = 15) placebo medroxyprogesterone with active calcium; or (D) (n = 14) both medroxyprogesterone and calcium placebos. RESULTS: The initial bone density (mean = 1.12 g/cm2) did not differ by group (P = 0.85). The 1-year bone density change was strongly related to treatment with medroxyprogesterone (P = 0.0001) and weakly to calcium (P = 0.072) treatment. Bone density increased significantly (+1.7% +/- 0.5%, +/- SEM, P = 0.004) in the medroxyprogesterone-treated groups (A and B), did not change in the calcium-treated group (C) (-0.7% +/- 0.6%, P = 0.28), and decreased on both placebos (D) (-2.0% +/- 0.6%, P = 0.005). CONCLUSIONS: Cyclic medroxyprogesterone increased spinal bone density in physically active women experiencing amenorrhea or ovulatory disturbances. POTENTIAL CLINICAL SIGNIFICANCE: Amenorrhea, oligomenorrhea, anovulation, and short luteal phase cycles are common in premenopausal women and associated with spinal bone loss occurring at a stage of life when bone density would normally be stable or increasing. This controlled trial shows a significant gain in bone in women in the cyclic medroxyprogesterone intervention group, whereas those subjects in the placebo group lost bone. Calcium supplementation appeared to be helpful but did not reach statistical significance. The implications of these findings for the prevention of osteoporosis warrant further investigation.

Adult↗
PubMed1994

Nutrition, dieting, and fitness messages in a magazine for adolescent women, 1970-1990.

PURPOSE: This study was designed to characterize nutrition and fitness messages presented between 1970-1990 in a magazine for adolescent women; to evaluate whether these messages changed over time; and to assess the body shape portrayed as desirable, and whether this changed over time. METHODS: A data collection form was developed to code nutrition and fitness-related written items, advertisements and recipes, and the page coverage allocated to these items. Body shape was assessed by measuring bust:waist and hip:waist ratios of photographs of models wearing bathing suits or underwear. Magazines from even years between 1970-1990 (n = 132) were coded. RESULTS: Both nutrition-related and fitness-related coverage emphasized weight loss and physical appearance. Half the major nutrition-related articles presented a weight-loss plan, and weight loss was frequently addressed in other nutrition articles. The primary reasons presented for following a nutrition of fitness plan were to lose weight and become more attractive. Statements that the product or service would promote weight loss were found in 47% of nutrition-related advertisements. Nutrition coverage did not exhibit a net change over time, whereas fitness coverage increased (F = 6.6, p < .005), and the ratio of nutrition: fitness coverage changed from 10:1 in 1970 to 0.75:1 in 1990. Models' body shapes were less curvaceous than those in magazines for adult women, and the hip:waist ratio decreased over time (F = 7.3, p < .01). CONCLUSIONS: The nutrition and fitness messages in this magazine for adolescent women emphasize body shape and appearance, similar to findings from adult women's magazines, and contribute to the cultural milieu in which thinness is an expectation for women. Between 1970-1990, the emphasis on fitness increased, and the body shape of models tended to become more linear.

Adolescent↗
PubMed1994

Restrained eating and ovulatory disturbances: possible implications for bone health.

We assessed the relationship between dietary restraint and menstrual cycle characteristics in 27 ovulatory women, previous participants in a longitudinal study of spinal cancellous bone mineral density (BMD). Subjects completed the restraint scale of the Three Factor Eating Questionnaire, recorded basal temperature and exercise for at least three menstrual cycles, and completed a 3-d food record. Cycle lengths of women in the upper and lower tertiles of scores for restraint were similar [27.8 +/- 1.0 (mean +/- SE) vs 27.6 +/- 0.8 d], but luteal phase length was shorter in the former group (8.6 +/- 0.9 vs 10.8 +/- 0.5 d, P < 0.05). Age, body mass index, percent body fat, waist-hip ratio, reported energy intake, and activity were similar between groups. Because the previous longitudinal study found associations between ovulatory disturbances and bone loss, we assessed spinal BMD using dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT). BMD of women in upper and lower restraint tertiles, respectively, did not differ: DXA, 1.15 +/- 0.05 vs 1.20 +/- 0.06 g/cm2; and QCT, 140 +/- 7 vs 133 +/- 7 mg/cm3. Additional prospective studies, however, appear warranted. In conclusion, this study's results provide evidence that high dietary restraint is associated with a shortened luteal phase length.

Adult↗