PubMed HealthSearch

Biomedical subjects

R C Klesges

Publications and source records attributed to R C Klesges.

At least 19 recordsLinked to original sources

Effects of phenylpropanolamine on withdrawal symptoms.

A prior report (Klesges et al. 1990) suggested that phenylpropanolamine (PPA) was successful in reducing the smoking withdrawal symptom of weight gain in a sample of women. The current investigation evaluates whether the effects of phenylpropanolamine (PPA; up to 10/day PPA gums) on withdrawal symptoms associated with smoking cessation are specific to weight and weight-related symptoms or whether PPA alleviates withdrawal in general. One hundred and seven adult smokers (56 men, 51 women) were randomly assigned, in this double-blind trial, to chew either 8.33 mg phenylpropanolamine gum or a placebo gum. Subjects were then aided to quit smoking for 4 weeks. PPA did not enhance cessation rates. Results from the 47 subjects who successfully quit smoking indicated that postcessation weight gain and ratings of hunger were significantly reduced in both men and women for those assigned to the PPA group relative to the placebo group. Overall, no effects of PPA relative to placebo were observed for other smoking-related withdrawal symptoms. Thus, although PPA appears to reduce weight gain and alleviate weight-related symptoms, no effects on other withdrawal symptoms were observed. Future research directions are suggested.

Adult

Are self-reports of smoking rate biased? Evidence from the Second National Health and Nutrition Examination Survey.

This study determined evidence for digit preference in self-reports of smoking in the Second National Health and Nutrition Examination Survey (NHANES II). Subjects were 4275 adult smokers. Self-reports of smoking showed a marked degree of digit preference, with the vast majority of smokers reporting in multiples of 10 cigarettes per day. When number per day was compared to an objective measure of smoking exposure (carboxyhemoglobin; n = 2070) the distribution was found to be significantly assymetrical. Analysis of the distribution of COHb and various levels of number per day indicates that the differences in distribution are not due to variability in COHb. Heavier smokers, Caucasians, and those with less education were more likely to report a digit preference than lighter smokers. African-Americans, and those with more education. Results suggest that self-reports of number of cigarettes per day may be biased towards round numbers (particularly 20 cigarettes per day). Implications for assessment of smoking behavior are discussed.

Adolescent

Is weight gain after smoking cessation inevitable?

Weight gain after smoking cessation was studied in a naturalistic setting where (1) all smokers quit and (b) risk factors for postcessation weight gain were modified. Participants were 332 military recruits (227 men, 105 women), 86 of whom were smokers who quit during 6 weeks of basic training. Results showed no significant weight changes for smokers who quit. Pretest smoking rates and feat of weight gain were unrelated to changes in weight. Results suggest that an intensive program that limits access to alcohol and foods that are high in fat and that increases physical activity can attenuate weight gain after smoking cessation.

Adolescent

Who underreports dietary intake in a dietary recall? Evidence from the Second National Health and Nutrition Examination Survey.

The present study sought to identify the presence and degree of apparent underreporting of dietary intake in 11,663 participants in the Second National Health and Nutrition Examination Survey (NHANES II). Self-reported dietary intake was compared with estimated basal metabolic rate. Underreporting was based on cutoff limits that identified plausible levels of energy expenditure for adult individuals. Results indicated that up to 31% of adults in this sample may have underreported dietary intake. Those individuals at greatest risk of underreporting were less well educated and heavier. The Sex x Race interaction indicated that for both ethnic categories, women were more likely to underreport than men, but the difference between men and women was greater among Caucasian participants. It is concluded that such factors as reduced energy needs, deliberate falsification, and measurement error inherent in dietary assessment contribute to apparent underreporting, and this occurs in a large percentage of dietary data.

Adolescent

Relationship between obesity and the metabolic effects of smoking in women.

The influence of cigarette smoking on resting energy expenditure (REE) in normal-weight and obese smokers was investigated. Participants were 20 normal-weight and 20 obese female smokers assessed over a 2-day period. The results indicated that REE increased in both obese and normal-weight smokers after smoking, but the increase was greater for normal-weight participants. The normal-weight group showed a 9.7%, 5.8%, and a 3.6% increase in REE during the three 10-min blocks constituting the 30-min postsmoking phase. However, the obese group showed a 3.9% and a 0.7% increase in REE and a 0.8% decrease in REE during this postsmoking phase. Between-group comparisons revealed a differential rate of change in REE after smoking, indicating that the obese group's change of REE at every postsmoking time point was on average 70 kcal/day below that of the normal-weight group. The metabolic effect of smoking is reproducible, and the obese smokers reliably show an attenuated effect. However, the reliability of the change is lower for both normal-weight and obese smokers. The results have potential implications for discouraging obese persons from taking up smoking and intervening among those who already smoke.

Adolescent

The effect of smoking and light activity on metabolism in men.

This experiment examined the metabolic effects of smoking during rest and light activity under naturalistic conditions. Thirty-nine male subjects first completed a submaximal graded exercise treadmill test to standardize activity level. Then 3 groups of subjects--smokers smoking (SS), smokers not smoking (SNS), and nonsmokers (NS)--were exposed to 3 stages of rest or 3 stages of light activity with order of rest or activity randomly determined over 2 different days. Energy expenditure was monitored continuously during these sessions. Significant increases in smokers' energy expenditure were observed during light activity when compared with smokers not smoking and nonsmokers. No differences were identified among groups at rest. These findings strengthen the conclusion that smoking or its components contribute to metabolic changes during typical levels of daily activity and suggest a mechanism for the frequently observed relationship between smoking status and body weight.

Adolescent

A longitudinal analysis of accelerated weight gain in preschool children.

The purpose of the current investigation was to determine the dietary, physical activity, family history, and demographic predictors of relative weight change in a cohort of 146 children over a 3-year period. Results indicated that boys of normal-weight parents or who had only one parent overweight showed decreases in their body mass index (BMI) while those with two parents overweight showed increases. Girls with an overweight father showed BMI increases while others experienced decreases in BMI. Additionally, baseline intake of kilocalories from fat as well as decreases in fat intake were related to decreases in BMI. At higher levels of baseline aerobic activity, subsequent changes in BMI decreased. There was also a trend for changes in leisure activity--increases in children's leisure activity was associated with decreases in subsequent weight gain. Modifiable variables (ie, dietary intake, physical activity) accounted for more of the variance in changes in child BMI change than nonmodifiable variables (eg, number of parents obese). These results strongly suggest that encouragement of heart healthy dietary intake patterns and participation in physical activity can decrease accelerated weight gain and obesity, even in preschool children.

Body Mass Index

Caffeinated coffee and tea intake and its relationship to cigarette smoking: an analysis of the Second National Health and Nutrition Examination Survey (NHANES II).

Recent studies have shown that smokers' intake of caffeine is higher than nonsmokers. This investigation evaluated the relationships between smoking status and self-reported caffeine intake from both coffee and tea. Subjects were adults who participated in the Second National Health and Nutrition Examination Survey (NHANES II). Results indicated that subjects who ingested caffeine from tea were more likely to be female, less educated, younger, non-Caucasian, and lighter drinkers. In contrast, those who ingested caffeine from coffee were more likely to be older, Caucasian, heavier drinkers, and have higher incomes. Smokers were not more likely to drink caffeinated tea. In contrast, smokers were much more likely to drink caffeinated coffee, and a dose-response relationship between caffeine from coffee and smoking intake was observed. These results clarify the relationship between smoking and caffeine intake. Implications for intervention efforts are discussed.

Adolescent

The relationship between changes in body weight and changes in psychosocial functioning.

Previous studies have indicated that obesity is related to a variety of psychosocial problems. Unfortunately, the literature on the relationship between weight status and psychosocial functioning has primarily utilized clinical samples and cross-sectional designs. The current study prospectively explored the relationship between weight gain and changes in psychosocial functioning. Subjects were 195 women and 204 men recruited as part of a larger longitudinal study of cardiovascular risk factors, who attended assessment sessions once per year for 2 consecutive years. Psychosocial functioning was assessed using the Dyadic Adjustment Scale (DAS), the Family Environment Scale (FES) and the Family Adaptability and Cohesion Scale 3rd Edition (FACES-III). Subjects were categorized based on their weight status at each year so the effect of a change in weight status on changes in psychosocial functioning could be evaluated. Multivariate measures indicated no changes in psychosocial functioning as a result of change in weight status over a 1-year period for either men or women. It appears that shifts in body weight, at least in a sample of subjects with generally good levels of psychological functioning, are not associated with changes in the measured levels of psychosocial functioning.

Adult

Smoking as a weight-control strategy and its relationship to smoking status.

This investigation assessed the use of cigarettes for weight control and the relative impact of weight-control smoking and dietary restraint on current smoking status and future intent to quit smoking in 221 smokers and ex-smokers. We found that weight-control smokers were more likely to gain weight in previous quit attempts, had less formal education, scored higher on dietary restraint, and reported higher weight among biologic parents. Females who gained weight in previous cessation attempts were also more likely to be weight-control smokers. Current smoking was predicted by decreasing age, weight-control issues, lower dietary restraint, less education, more cigarettes smoked per day, less obesity in parents, and more cessation attempts. Females with higher relative weights were more likely to be smokers than males with less relative weight. The results indicated that the number of fewer prior quit attempts, higher levels of weight-control smoking, and increasing age predicted plans not to quit smoking. These results have important implications for those subjects at risk for continued smoking.

Adult

A prospective study of familial aggregation of blood pressure in young children.

In a prospective study, we evaluated familial aggregation of blood pressure in a sample of 175 normotensive families with children 3 to 6 yr old. Systolic and diastolic blood pressure measurements of parents and children were correlated at 1, 2, and 3 yr intervals. Spearman rank-order correlation coefficients between parents and children were significant for mother-son pairs. In particular, mother-son blood pressure correlation coefficients were significant for systolic blood pressure across all 3 yr and for diastolic blood pressure during yr 2. Further analyses were performed adjusting for body mass index (BMI), age, physical activity, sodium intake, potassium intake, and parental smoking status, and alcohol use. The Spearman correlation coefficients for mother-son pairs remained significant for yr 1 and 3 after adjusting for these blood pressure correlates. These results are consistent with cross-sectional studies and suggest that both genetic and environmental contributions to blood pressure status are important in young children.

Adult

Relationships among smoking status, body composition, energy intake, and physical activity in adult males: a longitudinal analysis.

This study evaluates the longitudinal relationships among smoking and adiposity, dietary intake, and physical activity in a group of adult males. Subjects were 101 nonsmokers and 19 regular cigarette smokers. Adiposity, dietary intake, and physical activity were assessed annually for three consecutive years. Results indicated that nonsmokers had larger tricep skinfold measurements than smokers over the 3-year period. However, dietary intake and physical activity did not differ between groups. Due to the absence of differences on these two variables for the smoking and nonsmoking groups, it was concluded that the lower adiposity in smokers was largely metabolically determined, which may make difficult the treatment of postcessation weight gain.

Adult

Relationship between dietary restraint, energy intake, physical activity, and body weight: a prospective analysis.

Dietary, activity, and body weight differences in high- and low-restrained eaters and the independent impact of dietary restraint on body weight change were evaluated in 287 adults (141 men, 146 women) followed over a 1-year period. Analyses of measures of energy intake, physical activity, and dietary restraint indicated that high-restrained eaters did not differ in physical activity compared to low-restrained eaters at baseline but were ingesting significantly fewer kcal/lb and a higher percentage of the diet from fat. Body mass was significantly greater in both high-restrained men and high-restrained women than in their low-restrained counterparts. Regression modeling procedures revealed that weight and body mass at baseline were related to weight gain in men. In contrast, weight gain in women was predicted by baseline weight and higher restraint scores. These results indicate that dietary restraint is associated with weight gain in women but not in men.

Adult

Contributions of sibling relations to the adaptation of youths with insulin-dependent diabetes mellitus.

Associations among sibling relations and the psychosocial and illness-specific adaptation of youths (N = 66) with insulin-dependent diabetes mellitus (IDDM) were examined. The findings suggest that sibling relations, especially sibling conflict, contribute an independent source of variance above and beyond that contributed by demographic characteristics, sibling constellation variables, and important dimensions of family relations in predicting the youths' adaptation. High family-life stress and high sibling status/power contributed unique variance in predicting internalizing behaviors, and male gender and sibling conflict contributed independently to externalizing problems. Sibling conflict also contributed unique variance to the youth's general self-esteem, along with social class and family cohesion, and to their adjustment to IDDM. Data suggest that parent-child dyads and sibling dyads represent interrelated and independent subsystems within the family, and that both subsystems may influence the psychosocial functioning of youths with IDDM.

Adaptation, Psychological

Relationship between psychosocial functioning and body fat in preschool children: a longitudinal investigation.

This study examined whether preschool children differed on measures of psychosocial functioning both cross-sectionally and longitudinally. One hundred and thirty-two children who varied in levels of body fat participated in the study along with their natural parents. Results indicated that the children did not differ in levels of self-esteem and family functioning as a function of their body fat. Prospectively, physical self-esteem weakly (but significantly) correlated with body fat at 1 and 2 years, and father's perception of family functioning predicted body fat at 1 year only. Results suggested that childhood obesity may not develop as a result of psychosocial factors.

Adipose Tissue

A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults.

The current investigation is a longitudinal analysis of the relationship between dietary intake, physical activity, and body weight change in adult men (n = 142) and women (n = 152). Measures of dietary intake, physical activity, and cigarette and alcohol consumption were obtained for 3 y. Results indicated a different pattern of predictors of weight change for men vs women. For women a high dietary energy and fat intake as well as increases in total energy intake were related to higher weight gain and increases in work activity levels were related to decreased weight gain. For men weight gain was predicted by increases in dietary fat intake. Sex differences are discussed as a possible moderator variable in the energy balance equation.

Adult

Discrepancies between self-reported smoking and carboxyhemoglobin: an analysis of the second national health and nutrition survey.

Environmental, self-report, and demographic factors mediated the relationship between self-reported cigarette smoking and carboxyhemoglobin among 2114 smokers and 3918 nonsmokers. Self-reported nonsmokers with carboxyhemoglobin levels between 2% and 3% were more likely to be self-reported ex-smokers, to live in a larger community, and to be younger, less educated, and male than were self-reported nonsmokers with carboxyhemoglobin levels of less than 2%. Self-reported nonsmokers with strong evidence of cigarette consumption (carboxyhemoglobin level greater than 3%) were more likely to be self-reported ex-smokers, younger, less educated, and non-White than were nonsmokers with carboxyhemoglobin levels of less than 2%.

Adolescent