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Biomedical subjects

L J Cheskin

Publications and source records attributed to L J Cheskin.

At least 19 recordsLinked to original sources
PubMed2000

Weight-control behaviors among adults and adolescents: associations with dietary intake.

BACKGROUND: This study aimed to assess the prevalence of weight-control behaviors and their associations with overall dietary intake among adults and adolescents. METHODS: Participants included 3,832 adults and 459 adolescents from four regions of the United States. Cross-sectional data were collected on energy and nutrient intake, weight-control behaviors, body mass index (BMI), and sociodemographics. RESULTS: Current weight-control behaviors were reported by 52.7% of the study population (adult women, 56.7%; adult men, 50.3%; adolescent girls, 44.0%; adolescent boys, 36.8%). Weight-control behaviors were consistently and positively associated with socioeconomic status among adults, but not among adolescents. Among "dieters," unhealthy practices were reported by 22.7% of adult women, 21.3% of adult men, 30.4% of adolescent girls, and 18.5% of adolescent boys. Adults trying to control their weight reported healthier nutrient intakes than those not trying to control their weight, in particular when moderate weight-control methods were employed. Among adolescents, there were fewer differences across dieting status and these were not suggestive of healthier intakes among dieters than nondieters. CONCLUSIONS: Weight-control behaviors are reported by a large percentage of the population. Weight-control behaviors tend to be healthier among adults than among adolescents, in terms of the types of behaviors used and their impact on nutrient intakes. Obesity prevention interventions should emphasize the importance of using healthy weight-control practices.

Adolescent↗
PubMed2000

Early adopters of olestra-containing foods: who are they?

OBJECTIVE: To identify the characteristics of people consuming olestra-containing foods when first introduced at a test-marketing site. DESIGN: Data are from the Olestra Postmarketing Surveillance Study (OPMSS). After the introduction of olestra into a large test-marketing site, study participants received 3 follow-up telephone calls, at 3-month intervals, in which they were questioned about their diets during the previous month. SUBJECTS/SETTING: 1,007 adults in Indianapolis, Ind, who participated in a baseline clinic visit (before introduction of olestra into the food market) and completed at least 2 of 3 follow-up telephone calls (after the introduction of olestra into the market). STATISTICAL ANALYSES PERFORMED: Logistic regression was used to examine associations between olestra consumption and sociodemographic characteristics, health conditions, attitudes toward health and diet, and health-related behaviors. RESULTS: Olestra consumption on at least 1 of the follow-up telephone calls was reported by 41.5% of the study sample, and consumption on 2 or more telephone calls was reported by 20.0% of the sample. Factors associated with early adoption of olestra-containing foods included white ethnicity, higher education, overweight, absence of diabetes, attitudes indicative of diet and health concerns (e.g.; perceptions that there is a strong relationship between diet and disease), and a lower fat intake. APPLICATIONS/CONCLUSIONS: In spite of the controversy surrounding the introduction of olestra into the food market persons with attitudes indicative of diet and health concerns were likely to be early adopters of olestra-containing foods. Dietitians and other health care providers should inquire about intake levels of foods with fat substitutes and ensure that these foods are not being consumed in excessive amounts or being consumed instead of nutrient-dense foods that are naturally low in fat.

Adolescent↗
PubMed2000

Naltrexone alters subjective and psychomotor responses to alcohol in heavy drinking subjects.

Preclinical studies support endogenous opioid system involvement in alcohol reinforcement and consumption; however, recent clinical trials and human laboratory studies have provided mixed findings of the effects of naltrexone (a non-selective opioid antagonist) on alcohol responses. This study used a within-subject design (n = 23) to investigate naltrexone effects (0, 50 and 100 mg qd) on subjective and psychomotor responses to alcohol (none, moderate, high) in heavy drinkers. Before alcohol administration, subjects reported decreased desire to drink alcohol when maintained on 50 mg compared with placebo naltrexone. Following alcohol administration, active naltrexone significantly increased subjective ratings of sedative, and unpleasant/sick effects and decreased ratings of liking, best effects and desire to drink. Naltrexone generally did not alter subjective or objective indicators of drunkenness. Finally, high doses of naltrexone and alcohol interacted to produce the greatest decreases in liking and best effects. Findings support the role of endogenous opioids as determinants of alcohol's effects and suggest that naltrexone may be particularly clinically useful in those treatment patients who continue to drink heavily.

Adult↗
PubMed2000

Olestra consumption does not predict serum concentrations of carotenoids and fat-soluble vitamins in free-living humans: early results from the sentinel site of the olestra post-marketing surveillance study.

In 1996, the U.S. Food and Drug Administration approved olestra, a fat substitute, for use in snack foods. Previous studies had shown that olestra consumption could reduce absorption of carotenoids and fat-soluble vitamins. To determine the association between consumption of olestra-containing snack foods and serum concentrations of carotenoids and fat-soluble vitamins in a free-living population, we interviewed independent population-based cross-sectional samples of 1043 adults before olestra was available and 933 adults 9 mo after olestra snacks were introduced into the marketplace in Marion County, IN, the first major test market for olestra. A cohort composed of 403 adults from the first survey, oversampling those most frequently reporting olestra consumption during follow-up telephone interviews, completed a second survey. We assessed diet, lifestyle factors and olestra consumption, and collected blood for assays for the serum concentrations of six carotenoids, four fat-soluble vitamins and lipids. Nine months after the introduction of olestra into the marketplace, 15.5% of Marion County residents reported consuming an olestra-containing snack in the previous month, with a median frequency among consumers of 3.0 times per month. There were no significant associations or consistent trends for decreased serum carotenoids or fat-soluble vitamins associated with olestra consumption, although cohort members consuming >/=2 g/d of olestra had adjusted total serum carotenoids 15% lower compared with baseline. There were increases in serum vitamin K concentrations associated with olestra consumption (P = 0.03 in the cross section and P = 0.06 in the cohort). In summary, there was no statistically significant evidence in this free-living population of associations between olestra consumption and decreased serum concentrations of carotenoids and fat-soluble vitamins.

Adolescent↗
PubMed1999

Optimism and obesity treatment outcomes.

To examine the ability of the personality dimension dispositional optimism to predict short-term obesity treatment outcomes (weeks of program attendance and weight loss), 177 consecutive persons seeking outpatient treatment at a university-based weight management center completed the revised Life Orientation Test (LOT-R; Scheier, Carver, & Bridges, 1994) and underwent a comprehensive medically monitored weight loss program. The overall LOT-R and optimism subscales did not correlate with either attendance or weight loss. However, the pessimism subscale was positively associated with weeks of attendance.

Adolescent↗
PubMed1999

Is the prevalence of successful weight loss and maintenance higher in the general community than the research clinic?

OBJECTIVE: The prevalence of successful weight loss remains unclear. In 1982, Schachter concluded that in the general population, the rate of "self-cured" obesity approached 63%-much higher than the rate from clinical trials. Several subsequent studies have addressed this issue. RESEARCH METHODS AND PROCEDURES: Our initial goal was to meta-analyze these studies to evaluate the validity of the original hypotheses and the extent to which additional investigations supported the findings. We began by restating Schachter's hypotheses in precise, testable terms. RESULTS: A systematic review of these studies found many methodological limitations and much heterogeneity among the samples studied, hypotheses addressed, and operational definitions. Some of these limitations appear to stem from the lack of clear, precise statements of the exact hypotheses tested. Differences among studies are delineated, and we outline why meta-analytic pooling of these data appears inappropriate. CONCLUSIONS: The current data are inadequate to draw any definite conclusions regarding the cure rate of obesity. Criteria for the adequate study of success rates with "self-cure" in the general population are proposed.

Female↗
PubMed1999

Impact of weight loss on health-related quality of life.

To examine the effect of treatment-induced weight loss on Health-Related Quality of Life (HRQL), 38 mildly-to-moderately overweight persons recruited to participate in a study to examine the efficacy of a lifestyle modification treatment program completed a sociodemographic questionnaire, the Beck Depression Inventory (BDI), the Medical Outcomes Study Short-Form Health Survey (SF-36, as an assessment of HRQL), and underwent a series of clinical evaluations prior to treatment. After baseline evaluations, participants were randomly assigned to either a program of lifestyle physical activity or a program of traditional aerobic activity. Participants again completed the SF-36 and BDI after the 13-week treatment program had ended. Weight loss averaged 8.6 +/- 2.8 kg over the 13-week study. We found that weight loss was associated with significantly higher scores (enhanced HRQL), relative to baseline, on the physical functioning, role-physical, general health, vitality and mental health domains of the SF-36. The largest improvements were with respect to the vitality, general health perception and role-physical domains. There were no significant differences between the lifestyle and aerobic activity groups on any of the study measures. These data indicate that, at least in the short-term, weight loss appears to profoundly enhance HRQL.

Adult↗
PubMed1999

Demographic, dietary and lifestyle factors differentially explain variability in serum carotenoids and fat-soluble vitamins: baseline results from the sentinel site of the Olestra Post-Marketing Surveillance Study.

Biochemical measures of nutrients or other dietary constituents can be an important component of nutritional assessment and monitoring. However, accurate interpretation of the nutrient concentration is dependent on knowledge of the determinants of the body pool measured. The purpose of this study was to identify the determinants of serum carotenoid and fat-soluble vitamin concentrations in a large, community-based sample (n = 1042). Multiple linear regression analysis was used to examine effects of demographic characteristics (age, sex, race/ethnicity, education), health-related behavior (exercise, sun exposure, smoking, alcohol consumption), and intake (diet, supplements) on serum retinol, 25-hydroxyvitamin D, alpha-tocopherol, phylloquinone, and carotenoid concentrations. Age, sex, race/ethnicity, vitamin A intake, and alcohol consumption were found to be determinants of serum retinol concentration. Race/ethnicity, vitamin D intake, body mass index, smoking status, and sun exposure were determinants of serum 25-hydroxyvitamin D concentration. Determinants of serum alpha-tocopherol were age, sex, race/ethnicity, alpha-tocopherol intake, serum cholesterol, percentage of energy from fat (inversely related), supplement use, and body mass index. Age, sex, phylloquinone intake, serum triglycerides, and supplement use were determinants of serum phylloquinone concentration. Primary determinants of serum carotenoids were age, sex, race/ethnicity, carotenoid intake, serum cholesterol, alcohol consumption, body mass index, and smoking status. Overall, the demographic, dietary, and other lifestyle factors explained little of the variability in serum concentrations of retinol (R2 = 0.20), 25-hydroxyvitamin D (R2 = 0.24), and the carotenoids (R2 = 0.15-0.26); only modest amounts of the variability in serum phylloquinone concentration (R2 = 0.40); and more substantial amounts of the variability in serum alpha-tocopherol concentration (R2 = 0.62).

Adult↗
PubMed1999

Prescription medications: a modifiable contributor to obesity.

BACKGROUND: While usually not the only factor in obese patients, prescription medications, which may increase appetite or body weight, can be important in some individuals. The cause of weight gain in such cases may go unrecognized or lead to cessation of medication with or without the practitioner's knowledge or approval. METHODS: We found illustrative cases among patients treated at the Johns Hopkins Weight Management Center, searched MEDLINE and the Micromedex Drug Information database, and organized this information by drug mechanism and indications for use. RESULTS: Most reports of medication-induced weight gain are anecdotal or gleaned from clinical trials. Notable offenders include hormones (especially corticosteroids and insulinotropic agents), and psychoactive medications (especially tricyclic antidepressants, lithium, and some antipsychotics). CONCLUSIONS: Medication-related increases in appetite and body weight are under-recognized and cause noncompliance with pharmacotherapy. A high index of awareness of the known mechanisms by which medications can lead to weight gain has the potential to prevent most medication-related contributions to weight gain and obesity.

Adult↗
PubMed1999

Tumor necrosis factor-alpha-238 and -308 polymorphisms do not associated with traits related to obesity and insulin resistance.

Tumor necrosis factor-alpha (TNF-alpha) is expressed primarily in adipocytes, and elevated levels of this cytokine have been linked to obesity and insulin resistance. The purpose of this investigation was to test whether the TNF-alpha-308 polymorphism (previously linked to insulin resistance and increased leptin levels) and the TNF-alpha-238 polymorphism (linked to decreased insulin resistance) were associated with insulin resistance or obesity-related traits in 424 subjects self-referred to the Johns Hopkins Weight Management Center (JHWMC). There were no differences in allele frequencies of either polymorphism by obesity category in the JHWMC and a lean control group. Despite previous smaller studies that have linked insulin resistance and the 308 allele, we found no such relationship in the JHWMC population. Instead, homozygotes for this allele had a significantly lower BMI than their counterparts without the polymorphism. In addition, we found no relationship between the 238 polymorphism and BMI, fasting glucose, or log of fasting insulin.

Adult↗
PubMed1999

The distribution of body mass index among individuals with and without schizophrenia.

OBJECTIVE: The objective of this study was to estimate and compare the distributions of body mass index (BMI: kg/m2) among individuals with and without schizophrenia, and, thereby, place the weight gain-inducing effects of antipsychotic drugs into context. METHOD: Data sources were (1) the mental health supplement of the 1989 National Health Interview Survey (NHIS; N = 80,130 nonschizophrenic and 150 self-reported schizophrenic individuals), (2) baseline BMI data from a drug trial of the anti-psychotic ziprasidone supplied by Pfizer Inc (420 noninstitutionalized individuals with chronic psychotic disorders [DSM-IV schizophrenia or schizoaffective disorder]) and (3) data from the National Health and Nutrition Examination Survey III (NHANES III; N = 17,689 nonschizophrenic individuals) to act as a control group for the ziprasidone trial data. RESULTS: After age-adjusting BMI in each data set, the NHIS data revealed that men with schizophrenia have mean BMIs similar to those of men without schizophrenia (26.14 vs. 25.63, respectively). In contrast, women with schizophrenia in the NHIS data set had a significantly (p<.001) higher mean BMI than did women without schizophrenia (27.36 vs. 24.50, respectively). Moreover, each decile was higher for women with schizophrenia than for women without schizophrenia. Analysis of the ziprasidone and NHANES III data sets revealed that, on average, men with schizophrenia have mean BMIs comparable to those of men without schizophrenia (26.79 vs. 26.52, respectively). In these 2 data sets, women with schizophrenia also had a mean BMI similar to those of women without schizophrenia (27.29 vs. 27.39, respectively). CONCLUSION: Although there may be a small subpopulation of schizophrenic individuals who are underweight, individuals with schizophrenia were, on the whole, as obese as or more obese than individuals without schizophrenia, suggesting that weight gain induced by antipsychotic agents is an important concern for many individuals.

Antipsychotic Agents↗
PubMed1998

Constipation in the elderly.

Constipation affects as many as 26 percent of elderly men and 34 percent of elderly women and is a problem that has been related to diminished perception of quality of life. Constipation may be the sign of a serious problem such as a mass lesion, the manifestation of a systemic disorder such as hypothyroidism or a side effect of medications such as narcotic analgesics. The patient with constipation should be questioned about fluid and food intake, medications, supplements and homeopathic remedies. The physical examination may reveal local masses or thrombosed hemorrhoids, which may be contributing to the constipation. Visual inspection of the colon is useful when no obvious cause of constipation can be determined. Treatment should address the underlying abnormality. The chronic use of certain treatments, such as laxatives, should be avoided. First-line therapy should include bowel retraining, increased dietary fiber and fluid intake, and exercise when possible. Laxatives, stool softeners and nonabsorbable solutions may be needed in some patients with chronic constipation.

Aged↗
PubMed1998

Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey.

CONTEXT: Physical inactivity contributes to weight gain in adults, but whether this relationship is true for children of different ethnic groups is not well established. OBJECTIVE: To assess participation in vigorous activity and television watching habits and their relationship to body weight and fatness in US children. DESIGN: Nationally representative cross-sectional survey with an in-person interview and medical examination. SETTING AND PARTICIPANTS: Between 1988 and 1994, 4063 children aged 8 through 16 years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups. MAIN OUTCOME MEASURES: Episodes of weekly vigorous activity and daily hours of television watched, and their relationship to body mass index and body fatness. RESULTS: Eighty percent of US children reported performing 3 or more bouts of vigorous activity each week. This rate was lower in non-Hispanic black and Mexican American girls (69% and 73%, respectively). Twenty percent of US children participated in 2 or fewer bouts of vigorous activity perweek, and the rate was higher in girls (26%) than in boys (17%). Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day. Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day had greater body fat (P<.001) and had a greater body mass index (P<.001) than those who watched less than 2 hours per day. CONCLUSIONS: Many US children watch a great deal of television and are inadequately vigorously active. Vigorous activity levels are lowest among girls, non-Hispanic blacks, and Mexican Americans. Intervention strategies to promote lifelong physical activity among US children are needed to stem the adverse health consequences of inactivity.

Adolescent↗
PubMed1998

Gastrointestinal symptoms following consumption of olestra or regular triglyceride potato chips: a controlled comparison.

CONTEXT: Olestra, a nonabsorbable, energy-free fat substitute used in snack foods, has been anecdotally reported to cause gastrointestinal (GI) adverse events, although such effects were not expected based on results from randomized trials, in which it was consumed in typical snack patterns. OBJECTIVE: To determine whether ad libitum consumption of potato chips made with the fat substitute olestra results in a different level of GI symptoms than regular chips made with triglyceride (TG). DESIGN: Randomized, double-blind, parallel, placebo-controlled trial. SETTING: A suburban Chicago, III, multiplex cinema. SUBJECTS: A total of 1123 volunteers aged 13 to 88 years. INTERVENTION: Subjects were given a beverage and an unlabeled, white 369-g (13-oz) bag of potato chips made with olestra or TG during a free movie screening. MAIN OUTCOME MEASURES: Total and specific GI symptoms reported during a telephone interview conducted from 40 hours to 10 days after ingestion; level of potato chip consumption; and satiety level. RESULTS: Of 563 evaluable subjects in the olestra chip group, 89 (15.8%) reported 1 or more GI symptoms, while 93 (17.6%) of the 529 evaluable subjects in the regular TG chip group did so (difference in symptom frequency between olestra and TG, -1.8; 95% confidence interval, -6.2 to 2.7; P=.47). For specific GI symptoms (eg, gas, diarrhea, abdominal cramping), there were no significant differences between olestra and TG chips. Fewer olestra chips were consumed than TG chips (60 vs 77 g [2.1 vs 2.7 oz]; P<.001), with olestra chips receiving lower taste scores (5.6 vs 6.4 on a 9-point scale; P<.001). Consumption levels did not correlate with the rate of symptom reporting in either the olestra or TG group. There was no difference in satiety scores between olestra and TG chips (5.7 vs 5.9 on a 9-point scale; P=.07). CONCLUSIONS: This study demonstrates that ad libitum consumption of olestra potato chips during 1 sitting is not associated with increased incidence or severity of GI symptoms, nor does the amount consumed predict who will report GI effects after short-term consumption of either olestra or TG potato chips.

Adolescent↗
PubMed1998

Body mass index, smoking, and mortality among older American women.

The relationship among body mass index (BMI, kg/m2), smoking status, and overall mortality remains controversial. To assess this relationship in a representative sample of older women, we used data from the Panel Study of Income Dynamics (PSID). The PSID (begun in 1968) is a prospective longitudinal cohort study designed to examine economic and demographic behavior. Respondents were 1355 women age > or = 50 when they initially completed the Self-Administered Health Questionnaire in 1990. Data collected included self-reported height and weight, years of completed education, smoking status (never versus ever), and responses to four health-related questions (e.g., retired due to ill health, difficulty eating). Respondents were followed, including the date of death if respondent died, through 1994. Cox proportional hazard regression revealed a U-shaped relationship irrespective of whether smoking was included in the model. The base of the curve was fairly wide, suggesting that a broad range of BMI is well tolerated by older women. The minimum mortality (estimated from fitted proportional hazard models) for both the smoking and nonsmoking models occurred at a BMI of approximately 34. When interactions between smoking status and BMI terms were added to the model, the interactions were not jointly significant (p = 0.071). Moreover an exploratory plot of the BMI-mortality curve among never smokers (n = 800) revealed a curve that moved away from being U-shaped toward being more monotonically decreasing. It is concluded that these data suggest that there is no evidence that the U-shaped BMI-mortality relationship observed is caused by confounding by smoking status.

Aged↗