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Biomedical subjects

K D Ward

Publications and source records attributed to K D Ward.

32 records · Page 2Linked to original sources

Are weight concerns predictive of smoking cessation? A prospective analysis.

Participants in an 8-session, community based smoking cessation intervention rated whether they would stay quit if they experienced weight gain. The majority reported that they would not relapse to smoking, even after a 20-lb, (9.07-kg) weight gain. Those who were weight concerned were more likely to be female, to weight less and be normal or underweight, and to report chronic dieting. This group was also significantly less likely to be abstinent posttreatment, and at the 1-, 6- and 12-month follow-ups. Individuals presenting for formal smoking cessation interventions may be less weight concerned than the general population of smokers. However, weight-concerned smokers who do present for treatment are less likely to quit smoking. Implications for recruitment and intervention are discussed.

Adult↗

Changes in bone mineral content in male athletes. Mechanisms of action and intervention effects.

OBJECTIVES: To determine changes in bone mineral content (BMC) in male athletes, to examine the mechanisms of changes, and to evaluate the effects of intervention. DESIGN: Dual-energy x-ray absorptiometry (DEXA) tests were administered over a 2-year period, and calcium loss during training was determined by analysis of sweat and urine. Calcium supplementation was administered during year 2. SETTING--A midsouth university. PARTICIPANTS: Eleven members of a college Division I-A basketball team. INTERVENTION: Based on observed calcium loss, athletes received differential levels of calcium supplementation. Intervention commenced the week prior to the fall training season and continued through postseason play. MAIN OUTCOME MEASURE--Changes in BMC. RESULTS: Total body BMC decreased 3.8% from preseason to midseason of year 1 (mean decrease, 133.4 g, P = .02), increased nonsignificantly by 1.1% (mean increase, 35.3 g, P = .22) during the offseason, but decreased an additional 3.3% during summer months when practices resumed (mean decrease, 113.1 g, P = .01). Dermal calcium loss averaged 247 mg [corrected] per training session. From preseason to late summer, there was an overall decrease of 6.1% in total BMC and a 10.5% decrease in BMC of the legs. Calcium supplementation was associated with significant increases in BMC and lean body mass. CONCLUSIONS: Bone loss is calcium related and exercise is positively related to BMC provided that calcium intake is sufficient to offset dermal loss.

Absorptiometry, Photon↗

Influence of insulin, sympathetic nervous system activity, and obesity on blood pressure: the Normative Aging Study.

OBJECTIVE: To examine the association of insulin and sympathetic nervous system activity with blood pressure elevation in a cross-sectional study of 752 nondiabetic male participants of the Normative Aging Study, aged 43-90 years. METHODS: Testing included a physical examination, medical history, fasting and post-carbohydrate insulin and glucose levels determinations, an anthropometric examination, and 24 h urine collection for catecholamine level determination. Total obesity was represented by body mass index, central obesity by the abdomen circumference:hip circumference ratio, and sympathetic nervous system activity by 24 h urinary excretion of norepinephrine. RESULTS: Systolic and diastolic blood pressure (SBP and DBP, respectively) were positively related to body mass index, abdomen:hip ratio, norepinephrine excretion, and insulin levels in univariate analyses. The relationship between insulin level and SBP and DBP persisted after adjustment for body mass index, abdomen:hip ratio, norepinephrine, age, smoking, physical activity level, and antihypertensive medication use. The norepinephrine level was related to SBP and DBP after adjustment for insulin level, age, smoking, physical activity level, and antihypertensive medication use, and these relationships remained marginally significant after further adjustment for body mass index and abdomen:hip ratio. In contrast, neither body mass index nor abdomen:hip ratio were related to blood pressure after adjustment for insulin level. Among participants in the lowest tertiles both of insulin and of norepinephrine levels, 10% were hypertensive, compared with 35% in the highest tertiles of these variables. In a multiple logistic regression model, insulin level, norepinephrine level, and an interaction term for insulin level with norepinephrine excretion were independent predictors of hypertension. CONCLUSIONS: The results suggest that insulin level and sympathetic nervous system activity are associated with hypertension among middle-aged and elderly men.

Adult↗

Personality and the incidence of hypertension among older men: longitudinal findings from the Normative Aging Study.

Personality predictors of hypertension incidence were studied in 838 community-residing men from the Normative Aging Study. They were followed over a mean of 17 years during which time 38% developed hypertension. Stepwise proportional hazards regression was used to identify scales from the Cattell 16 Personality Factor Questionnaire that predicted hypertension incidence, controlling for biomedical, social, and behavioral risk factors. There was a significant negative relation between the personality trait of emotional stability and the incidence of hypertension, controlling for baseline blood pressure, education, and alcohol consumption. These results support those who argue that personality characteristics predict the development of hypertension.

Adaptation, Psychological↗

The relationship of epinephrine excretion to serum lipid levels: the Normative Aging Study.

Catecholamines are known to stimulate lipolysis of triglyceride stores in adipose tissue. However, the relationship of sympathoadrenal activity to serum lipid and lipoprotein concentrations remains uncertain. Since obesity, particularly the centripetal form, has recently been shown to be associated with increased urinary excretion of norepinephrine and decreased excretion of epinephrine, the possibility that the sympathoadrenal system is involved in the lipid abnormalities associated with the centripetal form of obesity was investigated. The relationship between 24-hour urinary catecholamine excretion and serum lipid and lipoprotein levels was examined among 615 male participants of the Normative Aging Study. Epinephrine excretion was positively correlated with the high-density lipoprotein cholesterol (HDL-C) level and the ratio of HDL-C to low-density lipoprotein cholesterol ([LDL-C] r = .15, P = .0002, and r = .11, P = .007, respectively) and inversely correlated with the triglyceride level (r = -.14, P = .0005). These relationships remained significant after adjusting for the effects of age, smoking, alcohol intake, adiposity, and insulin level. Epinephrine excretion was not significantly related to levels of total cholesterol or LDL-C. Norepinephrine and dopamine excretion were not significantly related to any lipid variable. These data suggest that (1) epinephrine plays an important role in regulating lipid and lipoprotein metabolism in humans, and (2) decreased adrenal medullary activity may contribute to the dyslipidemia (increased triglycerides and decreased HDL-C) commonly observed among the obese. The sympathoadrenal system therefore, along with hyperinsulinemia, may contribute to the increased cardiovascular risk associated with the insulin resistance syndrome.

Adult↗

Menstrual cycle and dietary restraint influence taste preferences in young women.

Previous reports indicate that some women increase their consumption of sugar and fat premenstrually. To ascertain whether this is due to differences in taste acuity for sweetness and fatness and/or preference across the menstrual cycle, 25 female and 12 male undergraduates rated the pleasantness, sweetness, and fatness of 16 taste stimuli made of dairy products with varied fat contents (0%, 3.5%, 10%, 36%) and sucrose (0%, 5%, 10%, 20%) over 4 consecutive weeks. There was a marked decline in ratings over the 4 weeks of testing. Taste preferences of women were not uniform across the menstrual cycle. Those who began testing during the luteal and menstrual weeks had increased preference ratings compared to those who began during the follicular or ovulatory weeks. Preference ratings for taste stimuli containing 0% and 5% sucrose were lower in women with higher scores on a restraint of eating scale, than for women with lower scores. No differences in sweetness or fatness ratings were observed across the menstrual cycle, or as a function of dietary restraint. Men had increased preference for taste stimuli containing 10% and 20% sucrose compared to women; however, no differences in ratings of either sweetness or fatness were found as a function of gender. These data indicate that taste preference in women is not homogeneous across the cycle. Instead, many factors, including the menstrual cycle and degree of eating restraint, influence preference ratings.

Adolescent↗

The relationships of abdominal obesity, hyperinsulinemia and saturated fat intake to serum lipid levels: the Normative Aging Study.

Abdominal obesity and hyperinsulinemia are associated with abnormalities in lipid metabolism and are important risk factors for coronary artery disease. Because hyperinsulinemia frequently accompanies abdominal obesity, it is unclear whether each is independently related to lipid abnormalities. Dietary saturated fat may influence these associations since it is associated with elevated lipid levels, obesity and hyperinsulinemia. Abdominal obesity (indexed as abdomen-to-hip circumference ratio), serum insulin level and dietary saturated fat intake were examined in relation to serum levels of lipids and lipoproteins in 878 male participants of the Normative Aging Study. Abdomen-to-hip ratio and insulin level were inversely related to high density lipoprotein cholesterol (HDL-C) (r = -0.17 and -0.21, respectively), and positively related to triglycerides (r = 0.25 and 0.36, respectively). Saturated fat intake was positively related to body mass index (r = 0.20), abdomen-to-hip ratio (r = 0.13), and insulin level (r = 0.10). In multiple linear regression models, abdomen-to-hip ratio was positively related to triglycerides and low density lipoprotein cholesterol (LDL-C) after adjusting for the effects of body mass index, alcohol intake, age, cigarette smoking and physical activity level, but was not significantly related to HDL-C. When serum insulin level was included as a covariate, abdomen-to-hip ratio remained significantly related to LDL-C and triglycerides, although its relationship with triglycerides was attenuated. Insulin level remained inversely related to HDL-C and triglycerides in multivariate models which adjusted for the effects of abdomen-to-hip ratio and BMI.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

Evidence of transient heart rate change after smoking cessation.

Heart rate slows immediately after smoking cessation but it is unclear whether this is a permanent or transient effect. Examining this issue may improve our understanding of nicotine withdrawal effects. A transient heart rate pattern would suggest that the cardiovascular system adapts chronically to nicotine and requires a period of adjustment to achieve a new homeostasis after cessation. Heart rate was assessed on 110 smokers prior to quitting and at 1, 3, 8, 15, 30, 45, and 60 days post-cessation. For 12 subjects abstinent 60 days, heart rate slowed at day 1 by 8.1 bpm. Heart rate remained below baseline from days 1 through 45, although exhibiting partial recovery, and returned fully to baseline at day 60. The results indicate that heart rate exhibits a pattern of transient change after smoking cessation which seems to be a physiological effect of nicotine withdrawal.

Adult↗

Changes in urinary catecholamine excretion after smoking cessation.

Excretion levels of norepinephrine, epinephrine, and dopamine were assessed in 17 habitual cigarette smokers while smoking and periodically during 30 days of abstinence to determine whether a pattern of transient change existed, suggestive of sympathetic nervous system (SNS) involvement in tobacco withdrawal. Excretion of all three catecholamines declined 1 day after abstinence but did not return to precessation levels during the rest of the follow-up period. The results suggest that postcessation declines in excretion may be permanent changes caused by loss of tobacco's agonist effects, rather than transient withdrawal phenomena resulting from SNS adaptation to the stimulatory effects of tobacco.

Adult↗

Reasons for smoking and severity of residual nicotine withdrawal symptoms when using nicotine chewing gum.

Prior to smoking cessation treatment using nicotine chewing gum, 65 smokers completed the Horn Reasons for Smoking Test, the Fagerstrom Tolerance Questionnaire and were assessed on measures of smoking history including saliva cotinine concentration. These measures were used to predict severity of residual nicotine withdrawal symptoms and urges to smoke assessed on a daily basis during the first 2 weeks of attempted abstinence. Univariate analyses indicated that smoking for reasons of handling, craving and to cope with negative affect correlated positively with both residual withdrawal symptoms and urges during the first week. Smoking for reasons of stimulation and habit were also correlated positively with residual withdrawal, and smoking for pleasure correlated with urges to smoke. After controlling for concurrent level of nicotine gum use, analyses suggested that only smoking for reasons of stimulation predicted residual withdrawal. Urges to smoke were positively related to level of smoking during treatment and also to smoking for reasons of craving and handling. Thus, it appears that individual differences in reasons for smoking influence severity of residual nicotine withdrawal symptoms and urges to smoke while chewing nicotine gum. The findings for stimulation smoking and withdrawal are discussed in terms of the reinforcing properties of nicotine with different routes of administration.

Adult↗

Gender differences in the outcome of an unaided smoking cessation attempt.

There is conflicting evidence concerning gender differences in success at quitting smoking. Information is especially lacking regarding gender differences among unaided quitters who make up the vast majority of those attempting to quit. One hundred thirty-five smokers who made an unaided attempt at quitting were interviewed before quitting and were followed for 1 year after cessation. Relapse rates were extremely high both for men and women, with 62% of participants returning to regular smoking within 15 days after cessation. Women and men were equally likely to maintain short-term abstinence (through 15 days), but women were more than three times as likely to relapse subsequently. Nine percent of men, but no women, had biochemically verified sustained abstinence throughout the 1-year follow-up period. For both men and women, any smoking after the quit attempt inevitably led to full-blown relapse. Most participants resumed regular smoking within 24 hours after the first episode of smoking. Gender differences were observed for several variables related to smoking history, demographics, social support, perceived stress, and motivational factors, but these differences did not explain the increased risk of relapse for women. Our results clearly indicate that women are less likely than men to maintain long-term smoking abstinence following an unaided quit attempt, but reasons for this gender difference need further exploration.

Adult↗

Hostility and the metabolic syndrome in older males: the normative aging study.

OBJECTIVE: Several studies have shown that hostility, as measured by the Minnesota Multiphasic Personality Inventory-derived Cook-Medley Hostility Scale (Ho), is positively associated with several cardiovascular risk factors, possibly accounting for the relationship between Ho scores and cardiovascular mortality. This study was undertaken to examine associations between hostility and cardiovascular risk factors representing the metabolic syndrome in 1,081 older men who participated in the Normative Aging Study. METHODS: Subjects included men who completed the Minnesota Multiphasic Personality Inventory in 1986 and who participated in a subsequent laboratory examination within 1 to 4 years. Total and subscale Ho scores were computed, and associations with anthropometric data, cigarette smoking, dietary information, serum lipids, blood pressure, and fasting glucose and insulin levels were examined. RESULTS: The total Ho score was positively associated with waist/hip ratio, body mass index, total caloric intake, fasting insulin level, and serum triglycerides. The Ho score was inversely related to education and high-density lipoprotein cholesterol concentration. Path analysis also suggested that the effects of hostility on insulin, triglycerides, and high-density lipoprotein cholesterol were mediated by its effects on body mass index and waist/hip ratio, which, in turn, exerted their effects on lipids and blood pressure through insulin. CONCLUSIONS: The results are consistent with those of prior research and also suggest that, in older men, hostility may be associated with a pattern of obesity, central adiposity, and insulin resistance, which can exert effects on blood pressure and serum lipids. Furthermore, effects of hostility on the metabolic syndrome appear to be mediated by body mass index and waist/hip ratio.

Adult↗