Biomedical subjects

Arnold D M Kester

Publications and source records attributed to Arnold D M Kester.

29 records · Page 2Linked to original sources

PubMed2004

Alcohol energy intake and habitual physical activity in older adults.

Alcohol forms a significant component of many diets and it supplements rather than displaces daily energy intake. Surprisingly, alcohol intake does not systematically increase body weight. The present study assessed whether a higher level of habitual physical activity in the daily environment is associated with a higher alcohol intake. Alcohol intake as part of total food intake was measured with a 7 d dietary record while at the same time physical activity was monitored with a tri-axial accelerometer for movement registration. Subjects were twenty women and twenty-four men, aged 61+/-5 years, of BMI 27.1+/-4.6 kg/m(2). Between subjects, there was a positive association between the level of habitual physical activity and alcohol intake (r 0.41; P<0.01). The subjects with higher alcohol intake had a higher activity level. On days with and days without alcohol consumption there was no difference in physical activity within subjects. In conclusion, it was shown that subjects with higher alcohol consumption are habitually more active. This may explain the lack of increasing body weight through additional energy intake from alcohol.

Alcohol Drinking↗

PubMed2003

Physical activity in confined conditions as an indicator of free-living physical activity.

OBJECTIVE: The main determinants of daily energy expenditure are body size and physical activity. Activity energy expenditure is the most variable component of total energy expenditure. It was assessed whether the physical activity level in confined conditions is an indicator of free-living physical activity. RESEARCH METHODS AND PROCEDURES: Activity energy expenditure was measured over 1 day in a confined environment of a respiration chamber (floor space, 7.0 m(2)), where activities were restricted to low-intensity activities of daily living, and over 2 weeks in a free-living environment using doubly labeled water. Subjects were 16 women and 29 men (age, 31 +/- 10 years; BMI, 24.2 +/- 2.7 kg/m(2)). RESULTS: The free-living activity level of the subjects, as a multiple of resting energy expenditure, was 1.76 +/- 0.13. Activity energy expenditure in the chamber was 47 +/- 13% of the value in daily life, and the two values were correlated (r = 0.50, p < 0.001; partial correlation corrected for age, gender, and BMI: 0.40, p < 0.01). The chamber value explained 25% of the total variance in free-living activity energy expenditure. DISCUSSION: The activity level of a subject under sedentary conditions is an indicator of activity energy expenditure in daily life, showing the importance of nonexercise activity for daily energy expenditure.

Activities of Daily Living↗

PubMed2003

Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials.

BACKGROUND: The effects of dietary fats on the risk of coronary artery disease (CAD) have traditionally been estimated from their effects on LDL cholesterol. Fats, however, also affect HDL cholesterol, and the ratio of total to HDL cholesterol is a more specific marker of CAD than is LDL cholesterol. OBJECTIVE: The objective was to evaluate the effects of individual fatty acids on the ratis of total to HDL cholesterol and on serum lipoproteins. DESIGN: We performed a meta-analysis of 60 selected trials and calculated the effects of the amount and type of fat on total:HDL cholesterol and on other lipids. RESULTS: The ratio did not change if carbohydrates replaced saturated fatty acids, but it decreased if cis unsaturated fatty acids replaced saturated fatty acids. The effect on total:HDL cholesterol of replacing trans fatty acids with a mix of carbohydrates and cis unsaturated fatty acids was almost twice as large as that of replacing saturated fatty acids. Lauric acid greatly increased total cholesterol, but much of its effect was on HDL cholesterol. Consequently, oils rich in lauric acid decreased the ratio of total to HDL cholesterol. Myristic and palmitic acids had little effect on the ratio, and stearic acid reduced the ratio slightly. Replacing fats with carbohydrates increased fasting triacylglycerol concentrations. CONCLUSIONS: The effects of dietary fats on total:HDL cholesterol may differ markedly from their effects on LDL. The effects of fats on these risk markers should not in themselves be considered to reflect changes in risk but should be confirmed by prospective observational studies or clinical trials. By that standard, risk is reduced most effectively when trans fatty acids and saturated fatty acids are replaced with cis unsaturated fatty acids. The effects of carbohydrates and of lauric acid-rich fats on CAD risk remain uncertain.

Adult↗

PubMed2003

Using a correction factor to correct for overreporting in a food-frequency questionnaire does not improve biomarker-assessed validity of estimates for fruit and vegetable consumption.

To correct for overreporting of fruit and vegetable (FV) consumption in a food-frequency questionnaire, summary questions about consumption of main FV groups are often used to calculate correction factors. This study compared the ability to rank people according to their FV intake of those summary questions and the sum of questions on individual FV items within categories, and of corrected or uncorrected estimates of specific sorts of FV. Healthy middle-age women (n = 161) completed a food-frequency questionnaire about FV consumption during the previous month and gave a single fasting blood sample. Correction factors were calculated as the reported frequency on a summary question divided by the summed frequencies of all items in a category. Plasma carotenoids and vitamin C served as biomarkers of FV consumption. Significant correlations between FV consumption and biomarkers were observed (e.g., Spearman's correlation coefficient r with total carotenoids/vitamin C: 0.32/0.34 for vegetables, 0.30/0.25 for fruits). Summary estimates of cooked, raw and total vegetable consumption correlated higher with biomarkers than sum estimates. For fruits no differences in correlations between sum and summary estimates were observed. Applying a correction factor on the consumption of carrots and total cabbage resulted in lower correlations with relevant biomarkers. For broccoli/cauliflower, Brussels sprouts and citrus fruits, correlations with biomarkers did not change after correction. We conclude that summary questions may suffice to rank individuals according to their intake of main FV categories, and that correction for overreporting of individual FV items is probably not advisable when ranking individuals according to intake of these items.

Adult↗

PubMed2003

Seasonal variation in sleeping metabolic rate, thyroid activity, and leptin.

We investigated seasonal variation in sleeping metabolic rate (SMR) and the possible relation to body composition, thyroid activity, and leptin. Twenty-five healthy volunteers were examined four times during the year: in spring (April, May), summer (July, August), autumn (October, November), and winter (January, February). Body composition was determined using a three-compartment model based on underwater weighing and the deuterium dilution method. SMR was measured during an overnight stay in a respiration chamber. A blood sample was taken for the analysis of free and total thyroxine, TSH, and leptin. SMR showed a significant seasonal variation (P < 0.01) with a maximum in winter (4.54 kJ/min) and a minimum in summer (4.34 kJ/min). The amplitude was 0.10 +/- 0.02 kJ/min, and the phase was November 5th. Season explained 17% of the intraindividual variation in SMR. The circannual rhythm in SMR could not be explained by changes in body composition, thyroid activity, or leptin. Interindividual variation in SMR was explained by fat-free mass (P < 0.001) and leptin (P < 0.001).

Adult↗

PubMed2002

Is there an increased risk of dying after depression?

Although a lot of research has been performed on the relation between depression and subsequent mortality, the results show contradictory findings. In this study, the authors investigated mortality in depressed people compared with nondepressed people in a large-scale retrospective cohort study based in general practice in the province of Limburg, the Netherlands. All subjects diagnosed with depression between 1975 and 1990 were included and compared with subjects matched on birth year who never were diagnosed with depression. Follow-up ended on April 30, 2000. Hazard ratios and their 95% confidence intervals were calculated using stratified Cox proportional hazards models adjusted for age, sex, and socioeconomic status. Subgroups based on sex and age at the diagnosis of depression were evaluated separately. A total of 68,965 patients were followed for an average of 15 years. Among 1,362 depressed subjects 132 died, and among 67,603 nondepressed subjects 4,256 died. The adjusted hazard ratio for depressed versus nondepressed subjects was 1.39 (95% confidence interval: 1.16, 1.65). A significant interaction was observed between the age at diagnosis of depression and sex. A moderate positive association between depression and subsequent mortality was identified.

Adult↗

PubMed2002

Comparison of near infrared reflectance analysis of fecal fat, nitrogen and water with conventional methods, and fecal energy content.

OBJECTIVES: To evaluate Near-Infrared Analysis (NIRA) method for determining fecal fat, water and nitrogen. DESIGN AND METHODS: The results of fecal fat, water and nitrogen by NIRA were compared with results of van de Kamer and Acid Steatocrit (AS), Dumas and vacuum drying methods for fat, nitrogen and water respectively. Results of fat determining methods were also compared with total fecal energy as obtained by bomb calorimeter. RESULTS: NIRA results correlated significantly (p < 0.001) with standard methods for nitrogen (r = 0.79), fat (r = 0.84 and r = 0.88 for van de Kamer and AS respectively) and water (r = 0.91). The limits of agreement for nitrogen and fat results were too wide for the methods to be used interchangeably. The fecal fat results correlated significantly (p < 0.001) with fecal energy results. CONCLUSION: NIRA may be valuable for monitoring malabsorption but the diagnostic value remains to be determined.

Energy Metabolism↗

PubMed1996

The influence of children's vocal expressions, age, medical diagnosis and information obtained from parents on nurses' pain assessments and decisions regarding interventions.

This article reports on a study that examines the influence of task-related factors on nurses' pain assessments and decision regarding interventions. In an experimental design pediatric nurses (n = 202), were exposed to different cases, each case being a combination of a vignette and a videotape. For every case subjects were asked to assess the child's pain and to state whether they would administer an analgesic. The results indicated that pediatric nurses attributed more pain and were more inclined to administer non-narcotic analgesics to children who vocally expressed their pain than to children who were less expressive. Furthermore, the interaction results between the child's expression and the medical diagnosis revealed a trend indicating that nurses attributed the most pain to the child when the diagnosis was severe and the child vocally expressed his pain.

Adenoidectomy↗

PubMedDate not supplied

Course of fatigue between two cycles of adjuvant chemotherapy in breast cancer patients.

The purpose of this study was to determine the course of fatigue in patients with breast cancer between 2 cycles of adjuvant chemotherapy, from the day of administration until the day of the next infusion. In a prospective cohort study, a sample of 151 patients with breast cancer receiving adjuvant chemotherapy was recruited from 6 hospitals in mainly the south of the Netherlands. Patients reported their experience of fatigue in a diary, the Shortened Fatigue Questionnaire, on a daily basis between the third and fourth treatment with adjuvant chemotherapy. Patients were treated with either a doxorubicin containing schedule or with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF, 28 days). In the 28-day regimens, infusions were given on day 1 and day 8. The days after completion of the third and the start of the fourth treatment with chemotherapy were statistically analyzed. We tested the hypothesis that the maximum fatigue score occurs in the first 4 days after treatment. The mean age of the sample was 47.2 years (SD = 8.8). Most women (84%) were married or lived together with a partner. The majority (80%) of all patients had been diagnosed with stage II breast cancer. The division between mastectomies (47%) and lumpectomies (52%) was approximately equal. Sixty percent of the patients received radiotherapy before the third treatment with chemotherapy and/or in the period they kept the diary. A chaotic pattern of fatigue between the 2 cycles of chemotherapy emerged. Smooth (splines) curves showed an average highest level of fatigue on day 3 from the start. For the 28-day regimens, another distinct peak was seen around day 11. A relatively larger number of patients experienced peak fatigue levels before day 5. The course of fatigue in the CMF group was significantly different compared with the doxorubicin regimens. The fatigue peak in the CMF group was lower. Women taking cyclophosphamide orally experienced the peak level of fatigue significantly later. Influences of other variables were not observed in any chemotherapy group. Cancer-related fatigue has a chaotic nature. The first days after treatment with chemotherapy are the worst. The type of chemotherapy has a significant impact on the course of fatigue. Improved understanding of the nature and course of fatigue could equip healthcare providers better for informing patients about what they may expect. Future research should include interventions aimed at reducing or coping with fatigue.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Peripheral arterial occlusive disease: prognostic value of signs, symptoms, and the ankle-brachial pressure index.

OBJECTIVES: To determine whether different levels of the ankle-brachial pressure index (ABPI) are associated with an increased risk for progressive limb ischemia, nonfatal and fatal cardiovascular events. To investigate the prognostic value of signs and symptoms associated with peripheral arterial occlusive disease (PAOD). DESIGN: Prospective follow-up study. SETTING: Eighteen general practice centers in the Netherlands. PARTICIPANTS: Three thousand six hundred forty-nine participants (53% female) with a mean age of 59 years (range: 40-78 years). MAIN OUTCOME MEASURES: Progressive limb ischemia, cardiovascular morbidity and mortality. RESULTS: At baseline, 458 participants had PAOD, defined as an ABPI < 0.95. Among these, 148 (32.2%) had an ABPI < 0.70. Cox proportional hazards models showed that after a mean follow-up period of 7.2 years, PAOD patients with an ABPI < 0.70 were at higher risk for cardiovascular death, compared with participants with a moderately reduced ABPI (< 0.95 - > or = 0.70): HR 2.3 versus 1.2. Older age, complaints of intermittent claudication, abnormal pedal pulses, elevated blood pressure, and coexisting cardiovascular disease at baseline were also significant independent prognostic factors for one or more of the adverse outcome events in these patients. CONCLUSION: The ABPI is inversely associated with cardiovascular mortality in PAOD patients. A low ABPI is an independent predictor for cardiovascular mortality in PAOD patients.

Aged↗

PubMedDate not supplied

Cardiovascular outcome stratification using the ankle-brachial pressure index.

OBJECTIVES: To investigate, in patients with peripheral arterial disease (PAD), the association between the level of the Ankle-Brachial Pressure Index (ABPI) at time of diagnosis and clinical outcome. METHODS: The data set of the Limburg PAOD Longitudinal Study (n=3649, mean follow-up time 7.2 years) was analyzed for this purpose. The ABPI was measured by trained personnel using handheld Doppler devices. Subjects were classified into 6 baseline ABPI categories ranging from ABPI > or = 1.10 ('certainly normal') to ABPI<0.50 ('seriously reduced'). Outcome measures were progressive limb ischaemia, cardiovascular morbidity and cardiovascular mortality. Cox proportional hazard models were used to investigate the associations (including hazard ratio's, HR) between different ABPI categories and outcome events. RESULTS: As compared to persons with an ABPI > or = 1.10 ('certainly normal'), patients with a baseline ABPI <1.00 (categories 'probably normal' and worse) were at high risk to develop progressive limb ischaemia (HR 3.3 - 9.0). Additionally, patients with a baseline ABPI <0.90 (categories 'moderately reduced' and worse) were at higher risk to experience a non-fatal cardiovascular disease (HR 1.5 - 1.7). Moreover, patients with a baseline ABPI <0.70 ('clearly' and 'seriously' reduced ABPI) were at high risk to die from a cardiovascular or other cause (HR 2.3). CONCLUSION: The ABPI can be helpful in identifying subjects at high risk for a poor cardiovascular outcome, in whom strict cardiovascular risk management would be appropriate.

Adult↗