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Biomedical subjects

R G Laessle

Publications and source records attributed to R G Laessle.

At least 19 recordsLinked to original sources

Overweight and basal metabolic rate in boys with attention-deficit/hyperactivity disorder.

We investigated a possible association between attention-deficit/hyperactivity disorder (ADHD) and overweight by measuring weight status and energy expenditure (basal metabolic rate, BMR) in 39 ADHD-boys with hyperactivity (mixed hyperactive/impulsive and inattentive or predominantly hyperactive/impulsive) and 30 healthy boys. The age range for the total group was 8-14 years. Weight and height were measured by a calibrated scales and stadiometer. Body mass index standard deviation scores (BMI-SDS) were calculated. BMR was determined by indirect calorimetry. Significant differences were obtained between the ADHD- and the control-group, but not between ADHD-subgroups. Both BMI-SDS and BMR were higher in the group of ADHD-boys, whereby the differences were more marked when they were older. More overweight and obese subjects were found in the ADHD-sample. Impulsive behavior in ADHD-boys with hyperactivity may lead to an increased food intake, which is then likely to overcompensate the heightened energy expenditure.

Adolescent↗

Laboratory measurement of cumulative food intake in humans: results on reliability.

The universal eating monitor (UEM) of Kissileff for laboratory measurement of food intake was modified and used with a newly developed special software to compute cumulative intake data. To explore the measurement precision of the UEM an investigation of test-retest-reliability of food intake parameters was conducted. The intake characteristics of 61 normal weight males and females were measured repeatedly in the laboratory with a measurement interval of 1 week. Yogurt of preferred flavor served as test meal. Test-retest-reliability of intake characteristics ranged from .64 (number of bites) to .83 (bite-size) and was .73 for initial eating rate, but only .16 for change of eating rate. Sex, BMI and eating habits according to TFEQ-factors had no significant effects on reliability of intake characteristics. The retest-reliability for all but one of the laboratory intake measures is comparable to standards of personality questionnaires and seems not to be influenced by sex or trait characteristics of eating behavior.

Adult↗

Parental influences on eating behavior in obese and nonobese preadolescents.

OBJECTIVE: To determine parental influences on obesity, the eating behavior of 80 obese and normal weight children (aged 8-12 years) was investigated in the laboratory. METHOD: A controlled repeated measures design was used. The mother was either present or absent while the child was eating in the laboratory. The eating style was measured by recording cumulative eating curves with a universal eating monitor, using yoghurt as a standardized experimental meal. RESULTS: The eating behavior of obese children differed significantly from normal weight children only when the mother was present in the laboratory. Overweight children ate faster with larger bites and showed an acceleration of their eating rate toward the end of the meal. DISCUSSION: Such an eating style can be hypothesized to explain an increased calorie intake in obese children, promoting a positive energy balance in the long term. The data support a learning model of obesity in childhood, which also has implications for family treatment.

Body Mass Index↗

Parental influences on laboratory eating behavior in obese and non-obese children.

OBJECTIVE: To determine parental influence on obesity, eating behavior of 80 obese and normal weight children (aged 8-12 y) was investigated in the laboratory. DESIGN: A controlled repeated measurement design was used. The mother was either present or absent while the child was eating in the laboratory. MEASUREMENTS: The eating style was measured by recording cumulative eating curves with a universal eating monitor, using yoghurt as a standardized experimental meal. RESULTS: The eating behavior of obese children differed significantly from normal weight children only when the mother was present in the laboratory. Overweight children ate faster with larger bites and showed an acceleration of their eating rate towards the end of the meal. CONCLUSION: Such an eating style can be hypothesized to explain an increased calorie intake in obese children, promoting a positive energy balance in the long-term. The data support a learning model of obesity in childhood, which also has implications for family treatment.

Child↗

A comparison of resting metabolic rate, self-rated food intake, growth hormone, and insulin levels in obese and nonobese preadolescents.

The objective was to investigate metabolic (resting metabolic rate), behavioral (energy intake), and endocrine variables (fasting insulin and growth hormone levels) potentially responsible for a positive energy balance in obese children in a cross-sectional study. The study was in 25 obese children aged 8 to 12 years and 21 nonobese children of the same age range. Weight, height, lean body mass (LBM) and fatmass (FM) were measured by bioelectrical impedance analysis, resting metabolic rate (indirect calorimetry) for the duration of 25 min, 7-day food records and fasting levels of insulin and human growth hormone (HGH). In the total sample, no differences were found in resting metabolic rate (RMR controlled for differences in weight) and energy intake between groups, whereas fasting insulin level was significantly higher and basal growth hormone concentration was significantly lower in the obese children. In RMR, there were significant age-dependent differences only in 10-year-old children, with the obese subjects showing lower values. The results fit in a multidimensional model, taking into account a critical period in prepubertal age for the development of childhood obesity. This period may be characterized by a reduced RMR, which results in an increased body weight, even if there is no excessive energy intake.

Body Composition↗

Biological and psychological correlates of intermittent dieting behavior in young women. A model for bulimia nervosa.

The eating disorder bulimia nervosa is characterized by alternating periods of strict dieting and overeating. Patients also report mood fluctuations, frequent eating related thoughts, fear of loss of control over eating, impairment of cognitive abilities such as concentration, and somatic complaints. The present study attempted to clarify to what extent these symptoms are consequences of the dieting behavior. Nine healthy young women, classified as unrestrained eaters, were set on a intermittent dieting schedule over 4 weeks. Four days each week (Tue, Wed, Thu, Fri) they had to reduce their intake below 600 kcal/day, the other 3 days they could eat without restrictions. Psychological variables were assessed by means of a standardized diary. Biological indices of starvation were also measured repeatedly. There was no substantial weight loss after the 4 weeks, although subjects had significantly increased levels of beta-hydroxybutyric acid during the dieting periods, and decreased levels of t3 after 2 weeks. The reported tendency to overeat and the actual calorie intake during the days of unlimited access to food showed a significant increase over the 4-week period. Eating-related thoughts, feelings of hunger, and fear of loss of control were significantly more frequent during periods of dieting, compared to days of normal eating. Subjects also reported worse mood, heightened irritability, difficulties concentrating, and increased fatigue. These results suggest that a substantial part of symptoms of bulimic patients might be associated with the frequent periods of an extremely restrained eating behavior.

3-Hydroxybutyric Acid↗

Cortisol levels and vigilance in eating disorder patients.

Elevated plasma levels of cortisol, as well as deficits in cognitive processes such as attention, have been observed in patients with eating disorders. The association between plasma cortisol and performance in vigilance task was studied in 17 patients with bulimia nervosa or anorexia nervosa during the acute phase of their eating disorder. In comparison to normal young women, the patients had a significantly lower hit rate in a discrimination task and showed an impaired perceptual sensitivity index. They also displayed significantly longer reaction times to hits, but not to false alarms. Cortisol levels of the patients were significantly higher than those of the normal controls. When patients were divided according to their median cortisol level, the patients with higher levels performed significantly more poorly than did the patients with lower levels. In the total patient sample, cortisol levels showed a significant negative correlation with hit-rate (r = -.54) and a significant positive correlation with reaction time to hits (r = .70). Other clinical characteristics were not related to cognitive performance. These results suggest a possible role of cortisol in the development of attentional deficits in eating disorder patients.

Adult↗

Everyday eating behavior and menstrual function in young women.

OBJECTIVE: To examine the association of different types of everyday eating behavior with disturbances of menstrual function. DESIGN: Prospective cohort study with two groups, low dietary restraint (n = 13) and high dietary restraint (n = 9), identified with the Three-Factor Eating Questionnaire by Stunkard and Messick. SETTING: Research clinic. PARTICIPANTS: Normal volunteers (students and young professionals). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Frequent serum and urine samples for determination of estradiol (E2), progesterone (P), and metabolites. Food and behavioral diaries. RESULTS: Eleven of the 13 women with low dietary restraint had menstrual cycles that fulfilled the following standard criteria: Serum E2 maximum of 440 pmol/L or more, P maximum of 19 nmol/L or more, and luteal phase length of 9 days or more. Only 2 of the 9 women with high dietary restraint had cycles that satisfied these criteria. Of the remaining 7, 1 had an anovulatory cycle and 6 had decreased P concentrations (P less than 0.05) and/or a shortened luteal phase (P less than 0.02). CONCLUSIONS: High cognitive restraint in everyday eating behavior may be a risk factor for the development of menstrual disturbance in young women.

Adult↗

Gonadotropin secretion in bulimia nervosa.

Twenty-two normal weight women with bulimia nervosa (BN) were studied (mean age, 25 +/- 5 yr; body mass index, 20.2 +/- 2.6 kg/m2). Sixteen of them reported menstrual cycles in the range of 21-42 days, and 6 had experienced absence of menstruation for at least 3 months. Twenty-one healthy women with regular menstrual cycles (mean age, 23 +/- 2 yr; body mass index, 20.7 +/- 1.4) served as the control subjects. Frequent morning blood samples for estradiol (E2) and progesterone (P4) determinations were obtained for the duration of 1 menstrual cycle or for 6 weeks in the case of amenorrhea. LH, FSH, cortisol, and insulin secretion were studied on day 3, 4, or 5 after the onset of a menstrual cycle or on a random day in the 6 BN women with amenorrhea. Blood samples were collected at 15-min intervals from 1800-0600 h for LH and FSH and at 30-min intervals from 2400-0600 h for cortisol and insulin. Nineteen of the 21 controls, but only 10 of the 22 BN women, fulfilled the following standard criteria: maximum E2 above 440 pmol/L, maximum P4 above 19 nmol/L, and luteal phase length of 9 days or more. The 10 BN women with normal menstrual cycles had lower mean insulin concentrations than the controls (70 +/- 20 vs. 120 +/- 30 pmol/L; P less than 0.01), but gonadotropin secretion, cortisol, and T3 concentrations were similar. The 8 BN women with amenorrhea or ovulatory dysfunction (maximum E2, less than 440 pmol/L; maximum P4, less than 6 nmol/L) displayed decreased mean LH pulse frequency (2.6 +/- 2.4 vs. 5.7 +/- 2.0 pulses/12 h; P less than 0.01), increased mean cortisol (120 +/- 40 vs. 80 +/- 20 nmol/L; P less than 0.01), decreased mean insulin (90 +/- 40 vs. 120 +/- 30 pmol/L; P less than 0.05), and decreased mean T3 concentrations (1.5 +/- 0.3 vs. 1.8 +/- 0.2 nmol/L; P less than 0.01). The data suggest that BN in normal weight women is associated with an increased rate of ovarian dysfunction; decreased pulsatile LH secretion seems to be an important mechanism. Increased cortisol in the disturbed subgroup indicates that activation of the hypothalamic-pituitary-adrenal axis may play a role in the pathogenesis of gonadal dysfunction in bulimia nervosa.

Adult↗

Visual palatability of food in patients with eating disorders and dieting women.

The effects of 19 meals of different caloric content on slides on palatability and hypothetical duration of consumption were investigated in 7 patients with anorexia nervosa, 17 patients with bulimia nervosa at the beginning and after 8 weeks of hospital treatment. Nine healthy females served as controls. At the beginning of treatment, palatability of low caloric food was significantly higher and hypothetical duration of consumption of high caloric food was significantly longer in patients when compared to controls. After 8 weeks, in the patients palatability of low caloric food had decreased. Dislike for high caloric food remained stable in anorexics.

Adult↗

Circadian pattern of large neutral amino acids, glucose, insulin, and food intake in anorexia nervosa and bulimia nervosa.

Insulin, glucose, and large neutral amino acids (LNAA) were studied in 10 patients with anorexia nervosa, 13 patients with bulimia nervosa, and 15 healthy controls. Blood samples were collected at hourly intervals during the day and at two-hour intervals during the night over a 24-hour period. Ad libitum caloric and relative carbohydrate intake was significantly reduced in the anorectic and bulimic patients. Elevated concentrations of beta-hydroxybutyric acid (BHBA) were seen in the bulimic group, and low triiodothyronine (T3) concentrations in the anorectic group. Mean plasma glucose and insulin concentrations were significantly lowered in both groups. The tryptophan (Trp) to LNAA ratio was reduced in anorectic, but not in bulimic patients. These findings suggest that Trp influx into the brain is reduced in anorectic patients, possibly impairing central serotonergic function.

Amino Acids↗

A comparison of nutritional management with stress management in the treatment of bulimia nervosa.

In a comparison of nutritional management (NM) and stress management (SM) for treatment of bulimia nervosa, 55 female patients were randomly assigned to either treatment. Therapy consisted of 15 sessions in a group over three months, by the end of which, patients under both treatment conditions showed a significant reduction in the frequency of binge eating and vomiting and a significant improvement in various psychopathological features such as body dissatisfaction and depression. All improvements were maintained over 12-month follow-up NM produced a more rapid improvement in general eating behaviour, a faster reduction in binge frequency and a higher abstinence rate from binge eating. SM led to greater positive changes in certain psychopathological features such as feelings of ineffectiveness, interpersonal distrust and anxiety. NM should be regarded as a necessary first intervention in all bulimic patients. Further psychological therapy, such as SM, is indicated as well for some patients, depending on their specific psychological difficulties.

Adaptation, Psychological↗

Endocrine findings in restrained eaters.

Restrained (n = 9) and unrestrained eaters (n = 13) were selected from a group of healthy young women. Blood samples were collected overnight at half-hour intervals. Levels of cortisol, growth hormone, and glucose in both groups did not differ, while restrained eaters had significantly lower insulin values. After a standardized test meal of 500 kcal, restrained eaters had significantly lower norepinephrine values while insulin and glucose values did not differ from those of the unrestrained group. These findings indicate that restrained eating may have a biological basis.

Adolescent↗

Differences in food-choice frequencies between restrained and unrestrained eaters.

Reported frequency of consumption for certain food items was studied in young normal-weight women, classified into 19 unrestrained and 20 restrained eaters by the Three-Factor Eating Questionnaire of Stunkard & Messick (1985). Neither group differed in the consumption of basic foods and snacks but restrained eaters showed a strong tendency to avoid fat. A large percentage of this group was used to consuming artificial sweeteners and other calorie-reduced foodstuffs. These qualitative alterations in the everyday eating behavior of restrained eaters may be one of the links between dietary restraint and binge eating.

Adolescent↗

Mood changes and physical complaints during the normal menstrual cycle in healthy young women.

Significant emotional and physical symptoms have been linked to hormonal changes during the menstrual cycle. A critical evaluation of the available studies questions the commonly held belief in menstrual-cycle-related complaints in the majority of normal women. The present study investigated changes in mood, somatic complaints and vegetative variables during the menstrual cycle in 30 healthy young women. Normal cycle function was evaluated and cycle phases were defined according to endocrine data. For all subjects, blood samples were taken at least three times a week to measure estradiol and progesterone. Daily ratings of psychological variables revealed no significant changes in global mood or depression over the cycle. Somatic complaints such as abdominal pain and breast tenderness were significantly related to the luteal, premenstrual, and menstrual phases. Appetite increased in the periovulatory and premenstrual phases. There was a tendency for sexual interest to be highest in the post-menstrual period. Affect and vegetative variables showed no association with hormone levels but were significantly correlated with subjective stress ratings. We conclude that in most healthy young women, cycle-related hormone fluctuations are not accompanied by marked affective changes. Specific physical complaints, however, do occur, particularly in the luteal, premenstrual, and menstrual phases.

Adult↗

Energy expenditure and everyday eating behavior in healthy young women.

The doubly labeled water method was used to measure average daily total energy expenditure (EE) in 23 healthy normal-weight women classified as restrained or unrestrained eaters. Although the relative weight of restrained eaters was found to be higher (BMI 21.1 +/- 1.3 vs 20.0 +/- 1.3 kg/m2, p less than 0.03), the self-reported energy consumption of the restrained eaters, when adjusted for body composition and height, totaled approximately 410 kcal/d less energy than that of the unrestrained group (p less than 0.002). Correspondingly, the adjusted EE was found to be lower by 620 kcal/d in restrained eaters (p less than 0.005). In both groups metabolic indices of starvation (beta-hydroxybutyric acid and triiodothyronine) were in the normal range. Neither these nor weight changed from the beginning to the end of the 14-d observation period. Thus, the lower EE of the restrained group reflects diminished caloric requirements and is not an adaptive response to a temporary decrease in food intake.

Adaptation, Physiological↗

Luteinizing hormone and follicle stimulating hormone secretion patterns in female athletes with and without menstrual disturbances.

Thirty-one young female athletes and 13 age-matched sedentary controls were studied throughout one menstrual cycle or over a 6 week period. Blood was sampled on 5 days per week. Episodic gonadotrophin secretion was measured in the early follicular phase and in the late luteal phase by blood sampling over a 12-h period at 15-min intervals. Eight athletes had anovulatory cycles, nine had impaired progesterone (P4) secretion during the luteal phase and 14 had normal cycles as judged from oestradiol (E2) and P4 plasma levels. Athletes with normal cycles had shorter cycles, lower E2 maxima at midcycle, and lower E2 and P4 concentrations during the luteal phase than had sedentary controls. Episodic luteinizing hormone (LH) secretion in the early follicular phase was significantly impaired in the anovulatory athletes: the average LH values over 12 h and the number of secretion episodes were significantly reduced. No significant changes were seen in follicle stimulating hormone secretion.

Adult↗