Biomedical subjects

Delia Smith West

Publications and source records attributed to Delia Smith West.

13 recordsLinked to original sources

PubMed2007

Placebo response in binge eating disorder.

OBJECTIVE: Placebo response in studies of binge eating disorder (BED) has raised concern about its diagnostic stability. The aims of this study were (1) to compare placebo responders (PRs) with nonresponders (NRs); (2) to investigate the course of BED following placebo response; and (3) to examine attributions regarding placebo response. METHOD: The baseline placebo run-in phase (BL) was part of a RCT investigating sibutramine hydrochloride for BED; it included 451 participants, ages 19-63, diagnosed with BED. Follow-up (FU) included 33 PRs. RESULTS: : In this study, 32.6% of participants responded to placebo (PRs = 147; NRs = 304). PRs exhibited significantly less symptom severity. At FU (n = 33), many PRs reported continued symptoms. CONCLUSION: PRs exhibited significantly less severe pathology than NRs. Placebo response in BED may transitory or incomplete. The results of this study suggest variable stability in the BED diagnosis.

Adolescent↗

PubMed2006

Readiness to change sugar sweetened beverage intake among college students.

The prevalence of obesity is a topic of concern in the United States, especially among children and young adults, and there is also a growing concern that sugared beverage consumption may contribute to increasing obesity rates. However, few studies to date have examined sugar sweetened beverage consumption trends in college students. This study investigated self-reported sugared beverage consumption, nutritional knowledge, and readiness to change sugar sweetened beverage intake in college students (N=201; 33% minority). On average, non-overweight students reported significantly greater intake of sugared beverages than overweight students, and minority students reported greater consumption than Caucasians. A substantial majority of the sample (69%) reported that they had recently reduced their intake or were maintaining a reduction in intake. However, even those students indicating reduction in consumption reported intake of at least one sugar sweetened beverage daily. This suggests that high calorie beverage intake is a significant concern among young adult college-aged populations and that interventions targeting excess sugar sweetened beverage intake may have a role in obesity prevention efforts for this population.

Adolescent↗

PubMed2006

Self-reported sugar-sweetened beverage intake among college students.

OBJECTIVE: To characterize sugar-sweetened beverage intake of college students. RESEARCH METHODS AND PROCEDURES: Undergraduates in an urban southern community campus were surveyed anonymously about sugared beverage consumption (soda, fruit drinks, energy drinks, sports drinks, sweet ice tea) in the past month. RESULTS: Two hundred sixty-five undergraduates responded (66% women, 46% minority, 100% of volunteers solicited). Most students (95%) reported sugared beverage intake in the past month, and 65% reported daily intake. Men were more likely than women to report daily intake (74% vs. 61%, p = 0.035). Soda was the most common sugar-sweetened beverage. Black undergraduates reported higher sugared beverage intake than whites (p = 0.02), with 91% of blacks reporting sugar-sweetened fruit drink intake in the past month and 50% reporting daily consumption. Mean estimated caloric intake from combined types of sugar-sweetened beverages was significantly higher among black students than whites, 796 +/- 941 vs. 397 +/- 396 kcal/d (p = 0.0003); the primary source of sugar-sweetened beverage calories among blacks was sugared fruit drinks (556 +/- 918 kcal/d). Younger undergraduates reported significantly higher intake than older students (p = 0.025). DISCUSSION: Self-reported sugar-sweetened beverage consumption among undergraduates is substantial and likely contributes considerable non-nutritive calories, which may contribute to weight gain. Black undergraduates may be particularly vulnerable due to higher sugared beverage intake. Obesity prevention interventions targeting reductions in sugar-sweetened beverages in this population merit consideration.

Adult↗

PubMed2006

The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it.

The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a lifestyle intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the lifestyle intervention and the empirical evidence to support it. The two principal intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.

Cardiovascular Diseases↗

PubMed2005

Do long-term HDL-C declines associated with a first birth vary by apo E phenotype? The Coronary Artery Risk Development in Young Adults (CARDIA) study.

BACKGROUND: High-density lipoprotein cholesterol (HDL-C) levels in premenopausal and postmenopausal women are differentially affected by exogenous sex hormones depending on their apolipoprotein E (apo E) genotype. Because endogenous sex hormones markedly increase during pregnancy, we examined whether HDL-C declines after a first birth varied by apo E polymorphisms. METHODS: In 1147 nulliparas (416 black, 731 white), fasting blood samples (nonpregnant) were drawn at baseline and at follow-up years 5, 7, and 10. Time-dependent pregnancy groups included 0 pregnancies (P0), 1+ short pregnancy (P1+), 1 birth (B1), 2 or more births (B2+). ApoE groups by alleles identified with a phenotype method included E4 (4/3 and 4/4), E3 (3/3), and E2 (2/2 and 3/2). Differences in adjusted mean HDL-C changes among pregnancy groups and ApoE groups were examined using repeated measures multiple linear regression. RESULTS: HDL-C declines associated with parity (one or more births) depended on ApoE group (ApoE*Pregnancy Interaction; p < 0.002). For B1 and B2+ vs. P0, HDL-C declines were -2.4 to -2.7 mg/dl in E4 and -3.4 to -4.1 mg/dl in E3. In E2, HDL-C declines were -6.6 mg/dl for one birth, and -11.5 mg/dl for two or more births, each relative to the 0 pregnancies (P0) group (linear trend, p < 0.001). CONCLUSIONS: The degree to which childbearing adversely affects long-term HDL-C declines varies by apo E phenotype, based on a method that accurately classifies genotype. Our findings show that 2/2 and 3/2 genotypes are associated with larger parity-related HDL-C declines than 3/3, 4/3, and 4/4 genotypes.

Adult↗

PubMed2004

Long-term plasma lipid changes associated with a first birth: the Coronary Artery Risk Development in Young Adults study.

Previous studies have reported declines in high density lipoprotein (HDL) cholesterol 1-2 years after pregnancy. In 1986-1996, the authors prospectively examined the association between childbearing and changes in fasting plasma lipids (low density lipoprotein, HDL, and total cholesterol; triglycerides) among 1,952 US women (980 Black, 972 White) in the Coronary Artery Risk Development in Young Adults study. Repeated-measures multiple linear regression was used to examine lipid changes over three time intervals (baseline to years 5, 7, and 10) in time-dependent follow-up groups: P0 (0 pregnancies), P1 (>/=1 miscarriages/abortions), B1 (1 birth), and B2 (>/=2 births). Means stratified by race and baseline parity (nulliparous or parous) were fully adjusted for study center, time, height, baseline diet, and other baseline and time-dependent covariates (age, smoking, education, weight, waist circumference, alcohol intake, oral contraceptive use, physical activity, short pregnancies). For both races, fully adjusted HDL cholesterol declines of -3 to -4 mg/dl were associated with a first birth versus no pregnancies during follow-up (p < 0.001). Higher-order births were not associated with greater declines in HDL cholesterol (B2 similar to B1, no association among women parous at baseline). In Whites, total and low density lipoprotein cholesterol declines were associated with follow-up births. HDL cholesterol declines of -3 to -4 mg/dl after a first birth persisted during the 10 years of follow-up independent of weight, central adiposity, and selected behavior changes.

Adolescent↗

PubMed2004

Relationship of social support and social burden to repeated breast cancer screening in the women's health initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps<.01). Repeated mammography decreased with frequent caregiving (p<.01). Less social strain reduced the frequency of repeated breast self-examinations (BSEs; ps<.01), but frequent caregiving and more negative life events increased repeated use of BSE (ps<.01). Interactive effects suggested that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examinations (ps<.01) and may be particularly important among low-income older women, especially those burdened by caregiving.

Aged↗

PubMed2004

Development of overweight associated with childbearing depends on smoking habit: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

OBJECTIVE: To prospectively evaluate whether childbearing leads to development of overweight in women and to evaluate the role of other known risk factors. RESEARCH METHODS AND PROCEDURES: A prospective, multicenter observational study, the Coronary Artery Risk Development in Young Adults (CARDIA) Study from 1986 to 1996, examined subjects at baseline and in follow-up years 2, 5, 7, and 10. Included were 998 (328 black and 670 white) nulliparous women, age 18-30 years, who were not overweight at baseline. Relative odds for incident overweight (BMI > or = 25 kg/m2) associated with parity change (0, 1, or 2+) and risk factors were estimated using discrete-time survival models adjusted for baseline and time-dependent covariates. RESULTS: Parity change-association with development of overweight depended on smoking habit (interaction, p < 0.001). In multivariate adjusted models, 1 and 2+ births vs. 0, respectively, were associated with increased risk for development of overweight among never smokers [odds ratio (OR) = 2.66; 95% confidence interval (CI): 1.80, 3.93, and 2.10, 95% CI: 1.24, 3.56] and decreased risk among current smokers (OR = 0.41; 95% CI: 0.17, 0.96, and 0.36, 95% CI: 0.08, 1.65). Risk was increased for black vs. white race (OR = 3.49; 95% CI: 2.59, 4.69), frequent weight cycling (OR = 1.45; 95% CI: 1.03, 2.04), and high school education or less (OR = 2.21; 95% CI: 1.50, 3.26) and was decreased for highest physical activity quartile (OR = 0.62; 95% CI: 0.43, 0.90). DISCUSSION: Childbearing contributes to development of overweight in nonsmokers but not in smokers, where development of overweight is less likely in women who bear children. Race, education, and behaviors are important factors in development of overweight in young women.

Adolescent↗

PubMed2004

Stepped-care, community clinic interventions to promote mammography use among low-income rural African American women.

Few studies have investigated community clinic-based interventions to promote mammography screening among rural African American women. This study randomized older low-income rural African American women who had not participated in screening in the previous 2 years to a theory-based, personalized letter or usual care; no group differences in mammography rate were evident at 6-month follow-up. Women who had not obtained a mammogram were then randomized to a tailored call delivered by community health care workers or a tailored letter. There were no group differences in mammography rates after the second 6-month follow-up. However, among women who had never had a mammogram, the tailored call was more effective in promoting mammography use. Tailored counseling may be an effective screening promotion strategy for hard-to-reach rural African American women with no history of screening. Further research into this strategy may facilitate efforts to reduce health disparities in underserved low-income rural African American populations.

Black or African American↗

PubMed2003

Television viewing and snacking.

With the rise in obesity in America, the search for potential causes for this epidemic has begun to include a focus on environmental factors. Television (TV) viewing is one such factor, partially due to its potential as a stimulus for eating. The current study investigated the relationship between food intake and self-reported TV viewing in an effort to identify the impact of TV viewing on specific eating behaviors. Seventy-four overweight women seeking obesity treatment completed questionnaires assessing dietary habits and TV viewing behaviors. Results suggest that snacking, but not necessarily eating meals, while watching TV is associated with increased overall caloric intake and calories from fat. Therefore, interventions targeting stimulus control techniques to reduce snacking behavior may have an impact on overall caloric intake.

Journal Article↗

PubMed2003

The impact of a family history of breast cancer on screening practices and attitudes in low-income, rural, African American women.

BACKGROUND: Women with a family history of breast cancer are at increased risk for developing cancer and, therefore, might be expected to engage in early detection practices more actively than women without a family history. Alternatively, women with a family history may avoid thinking about cancer and have attitudes and practices that do not promote early detection. METHODS: This study examined breast cancer attitudes and practices among African American women aged >or=50 who had not had a mammogram in the last 2 years. RESULTS: Phone survey data from 320 female clients of low-income, rural primary care clinics (91% African American) indicated that 15% self-reported a family history of breast cancer (FH(+)). Half of the FH(+) women did not know their relative risk of developing breast cancer. Of those providing a risk estimate, 67% perceived themselves at low risk compared with other women their age. Perceived relative risk was comparable between FH(+) and FH(-) women. Further, FH(+) women did not indicate greater worry about breast cancer, nor did they have more accurate knowledge of mammography recommendations than FH(-) women. Two thirds of FH(+) women had never had a mammogram. Monthly breast self-examination did not differ between FH(+) and FH(-) women. CONCLUSIONS: Thus, neither knowledge of a positive family history nor perceived relative risk of breast cancer was associated with either increased or decreased early detection practices among these low-income, rural, African American women who have underused mammography. Furthermore, a substantial proportion of FH(+) women had not ever participated in screening mammography. Interventions to increase mammography rates in this population of underusers are indicated.

Black or African American↗

PubMed2003

The role of postpartum weight retention in obesity among women: a review of the evidence.

Young, adult women appear to be at increased risk for substantial weight gain. Pregnancy has frequently been cited as a contributor to overweight in women. This article reviews the literature examining the role of pregnancy in the development of overweight. Average postpartum weight retention ranges from 0.5 to 3 kg; however, postpartum weight retention appears to be highly variable among women, with some women retaining as much as 17.7 kg. Excessive postpartum weight retention seems to be especially prevalent among minority women. Factors such as prepregnancy weight and excessive gestational weight gain have the strongest support as risk factors for postpartum weight retention and could guide targeted intervention efforts. However, there are few controlled studies of behavioral interventions to prevent substantial pregnancy-related weight gain or postpartum weight retention. Weight loss methods successful in promoting weight control in other populations would likely also be effective with pregnant or postpartum women, although modifications for the needs of mothers may be required. Particular attention to the needs of minority mothers is warranted given the likelihood of greater weight retention in this group.

Adult↗

PubMedDate not supplied

Altering TV viewing habits: an unexplored strategy for adult obesity intervention?

OBJECTIVES: To review literature evaluating whether television (TV) viewing reduction is a promising behavioral target for obesity treatment programs for adults. METHODS: Studies examining associations between TV viewing and obesity in adults were reviewed, as well as relevant pediatric literature. Interventions to reduce TV viewing among children were examined to inform adult interventions. RESULTS: Adult TV viewing has been consistently associated with greater obesity risk in cross-sectional and longitudinal studies. Strategies to alter TV viewing have been demonstrated effective among children but have not been tested in adults. CONCLUSIONS: Evaluation of the efficacy of targeting TV viewing among adults on weight outcomes is warranted.

Adult↗