Biomedical subjects

J Westenhöfer

Publications and source records attributed to J Westenhöfer.

9 recordsLinked to original sources

PubMed2002

Severe underreporting of energy intake in normal weight subjects: use of an appropriate standard and relation to restrained eating.

OBJECTIVE: To assess the influence of different standards and restrained eating on underreporting in healthy, non-obese, weight-stable young subjects. DESIGN AND SUBJECTS: Eighty-three young adults (20-38 years, 55 women, 28 men) were assessed under weight-stable conditions with a 7-day dietary record and the three-factor eating questionnaire by Stunkard and Messick. Resting energy expenditure (REE; indirect calorimetry) plus data derived from physical activity records (PA) (Standard 1) or REE times an activity factor (AF) (Standard 2) was used as standard for total energy expenditure (TEE). For comparison, doubly labelled water (DLW) was used to measure TEE in a subgroup of subjects. RESULTS: There was an association between self-reported energy intake and Standard 2 but not with Standard 1. When compared with DLW both calculated standards were inaccurate, but Standard 2 avoided high levels of overreporting. Using Standard 2 to identify 'severe' underreporting (SU; as defined by a deviation of energy intake (EI) and TEE of >20%), SU was seen in 37% of all subjects. It was more frequently found in women than in men (49% of women, 14.3% of men, ). Underreporting subjects had a reduced EI but there were no significant differences in nutritional status (body weight and height, body mass index, fat mass and fat-free mass), energy expenditure and the proportion of energy from macronutrients between normal and underreporting subjects. However, high restraint was associated with a higher degree of underreporting in the total group, whereas disinhibition had an influence only in men. CONCLUSIONS: A high prevalence of SU is seen in non-obese subjects. Characteristics of eating behaviour (restraint and disinhibition) were associated with underreporting but seemed to have a different influence in men and women.

Adult↗

PubMed2001

[Self-control, stimulus control, relapse prevention. Behavior therapy helps in weight reduction].

Behavioral therapy is an essential part of the overall strategy for treating obesity. Successes are most evident in short-term treatment, whereas the value of the long-term approach is more difficult to assess due to a lack of adequate data. The aims of behavior-modifying measures are improving eating habits and nutritional awareness, increasing physical activity, and improving strategies for coping with psychological and social consequences. At the focus of behavioral therapeutic techniques aimed at combatting obesity is self-observation supported by stimulus-control techniques, reinforcement techniques, and help with cognitive restructuring. Furthermore, patients learn how to avoid relapse. Success over the long-term can be improved by active follow-up measures and depends, among other things, on adequate quality control. The appropriate approaches to therapeutic programs must be made transparent both to the patient involved and concerned professionals.

Behavior Therapy↗

PubMed2001

Development process of an evidence-based guideline for the treatment of obesity.

OBJECTIVES: To present the development process, summarize the content and discuss the implications of the German evidence-based guideline for the treatment of obesity. DESIGN: The target audience and the development process were defined by a multidisciplinary team of experts. A systematic search of the literature was performed to identify relevant clinical articles. The validity of published studies was systematically evaluated. After developing the draft, an external peer review process was initiated. RESULTS: Three versions of the guideline were published; an expert version, a short version tailored to primary care physicians and a patient version supporting patient participation in the decision-making process. Total development, printing and distribution costs xvere estimated to be 300,000 Euro. CONCLUSIONS: The guideline raises the awareness of obesity and related comorbidities in Germany and may improve the quality of care for obese patients. The development process could serve as an efficient model for other guideline developers.

Evidence-Based Medicine↗

PubMed1998

Functional food science and behaviour and psychological functions.

The impact of ingesting various foods on psychological and behavioural functions is a topic of both interest and concern to the general public. In this article, the scientific literature concerning demonstrated cause-and-effect relationships is reviewed, beginning with methodological considerations specific to the quantification of particular behaviours and psychological events. The essential function of food is to satisfy hunger and the need for essential nutrients. The contributions of macronutrients to appetite and satiety are described, as well as their impact on metabolism and energy balance. Functional properties of macronutrient substitutes (high-intensity sweeteners, fat replacers) and flavour enhancers are examined in relation to their contribution to hunger, satiety, and energy balance. The effects of foods and individual nutrients on the performance of diverse psychomotor tasks are studied with consideration given to the various validated quantitative tools used to assess behaviour. The effects of food components on activation, sedation, and affective states such as dysphoria are also reviewed, with special attention given to brain function and neuroactive substances such as serotonin and the endorphins. The case of hyperactivity in children is given special emphasis with reference to the potential influence of sugar and food additives. Safety issues related to food constituents and additives are discussed. Finally, a set of criteria is proposed for the evaluation and elaboration of studies in the behavioural and psychological fields, along with suggestions for future research.

Affect↗

PubMed1996

[Ambulatory, comprehensive, behavior therapy-oriented weight reduction program (Optifast Program). An alternative therapy in obstructive sleep apnea].

We investigated the therapeutic effect of marked body weight reduction on the predominantly obstructive sleep apnea syndrome by the application of an out-patient, behaviour therapy based body weight reduction program (Optifast-program) in five of our obese apnea patients (mean overweight by Broca 53.6 +/- 24.8 kg). Mean body weight reduction was 32.7 +/- 15.8 kg after six months. The mean apnea-index of 34.5 +/- 23.1/h prior to the weight reduction dropped to 7.8 +/- 6.1/h after therapy. The mean apnea-hypopnea-index (so called "respiratory disturbance index", RDI) could be reduced from 45,7 +/- 26.0/h to 14.0 +/- 11.4/h. The best therapeutic effect on the sleep related respiratory parameters was seen in patients who reached their normal weight whereas the absolute weight reduction itself seems to be less important. Our results should encourage this causal therapy in appropriate patients.

Adult↗

PubMed1995

Interaction of vitamins with mental performance.

In the presence of a chronically insufficient vitamin supply which was verified by repeated measurements of the vitamin parameters, many unfavorable psychometric findings in the corresponding deficiency groups are observed for the vitamins C, thiamin, riboflavin, cobalamin and folate, depending on the degree of the insufficient vitamin supply. Vitamin supplementation in cases of initially insufficient vitamin supply indicate some effects in the sense of an improvement of behavior and cognitive functions. Supplemental vitamin intake in physiological dosages in addition to a vitamin-sufficient diet did not lead to an improvement of behavior and mental performance.

Adolescent↗

PubMed1995

[Chronification of sleep disorders. Results of a representative survey in West Germany].

In a representative selection of German citizens who were older than 13 years of age, 1,997 were asked about their sleep complaints. They were also asked how frequently a physician was consulted and how often sleeping pills were taken. According to our results sleep disturbances are an important health problem in Germany. Every fourth person suffers at least sometimes from difficulties in falling asleep and/or staying asleep, problems which are not due to external influences. Seven percent suffer frequently or always from these complaints; 15% report that they are frequently tired or that they are always tired during the day. Ten percent of all persons suffering from sleep complaints take sleeping pills daily or at least sometimes during the week. Forty-five percent of all persons who take hypnotics daily still frequently or always suffer from difficulties in falling asleep and/or staying asleep. Furthermore, sleep complaints tend to become chronic: 75% of the sleep-disturbed population are chronically ill, having had complaints for more than 2 years of since childhood. They suffer from sleep disturbances and from reduced performance during the following day. Nevertheless, it appears as though neither patients nor physicians take insomnia seriously. This might answer the question of why only 17% of the persons who do not suffer more than 2 years from sleep disturbances and only 49% of the chronically ill population consult a doctor because of their sleep disturbances. The results of this study indicate the importance of informing patients and physicians about insomnia and different ways of treating it.

Adolescent↗

PubMed1995

[Treatment of obstructive sleep apnea syndrome by ambulatory, comprehensive, behavior therapy oriented weight reduction (Optifast program)].

We investigated the therapeutic effect of marked body weight reduction on the predominantly obstructive sleep apnea syndrome by the application of an out-patient, behaviour therapy based body weight reduction program (Optifast-program) in 5 of our obese apnea patients. Mean body weight reduction was 32.7 +/- 15.8 kg after 6 months. The mean apnea-index of 34.5 +/- 23.1/h prior to the weight reduction dropped to 7.8 +/- 6.1/h after therapy. The mean apnea-hypopnea-index could be reduced from 45.7 +/- 25.9/h to 14.0 +/- 11.4/h. The best therapeutic effect on the sleep related respiratory parameters, was seen in patients who reached their normal weight. Our results shows that even severe, predominantly obstructive sleep apnea syndromes could be treated successfully with a marked body weight reduction.

Adult↗

PubMed1988

Behavioural factors involved in the control of food intake in man.

This paper reviews several psychological models to explain disturbed food intake: the "psychosomatic theory", the "stimulus-binding theory", the "concept of restraint eating", closely related to the "concept of latent obesity", the "set-point-theory" and the "boundary model". All are based on the assumption that there are biological regulating processes of body weight (and with this also of feelings of hunger, appetite and satiation as the determinants of food intake), nevertheless the resulting body weight can be inconsistent with social standards and individual self-concepts. In this case a cognitive control of food intake (dieting behaviour) is activated for weight regulation, which in turn interacts with biological regulatory mechanisms, and as a result leads to specific behavioural dispositions which can be supported by experiments.

Feeding Behavior↗