PubMed Health⌕ Search

Biomedical subjects

R W Jeffery

Publications and source records attributed to R W Jeffery.

At least 19 recordsLinked to original sources
PubMed1992

Do weight concerns hinder smoking cessation efforts?

This study examined the hypothesis that weight concerns interfere with smoking cessation efforts. Four hundred fifty-nine women screened for participation in a smoking cessation treatment program completed Stunkard's Three Factor Eating Questionnaire (1981), measures of smoking-specific weight gain concern, and smoking history measures. Success in current cessation efforts was assessed 6 months following treatment. The restraint subscale of the TFEQ was associated with lower baseline level of nicotine dependence, a history of smoking fewer cigarettes, and longer prior periods of successful smoking abstinence. Baseline level of nicotine dependence and treatment group were significant predictors of smoking cessation at 6 months posttreatment. Restraint score was marginally predictive of higher rates of abstinence from smoking at 6 months when baseline level of nicotine dependence and treatment group were controlled. These results do not support the hypothesis that weight concerns interfere with smoking cessation attempts.

Adult↗
PubMed1992

Weight cycling and cardiovascular risk factors in obese men and women.

This study examined the relationship between weight cycling and cardiovascular risk factors in 101 obese men and 101 obese women. Weight cycling was defined in three ways by retrospective self-report: 1) number of previous weight losses of greater than or equal to 4.5 kg, 2) total weight lost in prior weight-loss attempts, and 3) the difference between highest and lowest weight as an adult. Cardiovascular risk factors included blood pressure, total and high-density-lipoprotein cholesterol, triglycerides, fasting and 2-h glucose values, waist-to-hip ratio, and percent of dietary calories from fat. Results did not support the hypothesis that weight cycling increased cardiovascular risk factors in either men or women. Of 88 associations examined, only 7 showed differences with P less than 0.05 and of these, 6 were opposite in direction to that hypothesized. We conclude that warnings about the health hazards of repeated dieting may be premature.

Adult↗
PubMed1992

Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors.

We investigated whether weight loss decreases the waist-hip ratio (WHR) in overweight men and women, and whether changes in WHR relates to change in cardiovascular risk factors, independent of change in weight. Weight loss correlated significantly with decreases in the circumference of the waist and hips, and decreases in WHR in men and women. At comparable levels of weight loss, men had greater decreases in the waist, and smaller decreases in the hips than women, resulting in greater decreases in WHR. Cardiovascular risk factors improved significantly with weight loss. However, after controlling for weight loss, there was no evidence that change in WHR or change in circumference measures were related to change in risk factors. These data suggest that WHR is modifiable by weight loss, especially in men, but that change in WHR may not be independently related to changes in cardiovascular risk factors.

Adipose Tissue↗
PubMed1992

Smoking cessation in women concerned about weight.

BACKGROUND: Weight gain after smoking cessation is often cited by women smokers as a primary reason for not attempting to quit smoking or for relapsing after a cessation attempt. METHODS: A randomized trial of 417 women smokers was conducted to test the addition of two weight control strategies to a smoking cessation program. Participants received the standard smoking cessation program, the program plus nicotine gum, the program plus behavioral weight control, or the program plus both nicotine gum and behavioral weight control. Weight and smoking status were measured at the end of treatment and at 6 and 12 months posttreatment. RESULTS: Smoking cessation rates were highest in the group receiving the smoking cessation program plus nicotine gum. Weight gain did not vary by treatment condition, so its effect on relapse could not be examined by group. There was no significant relationship between weight gained and relapse in individuals. CONCLUSIONS: The added behavioral weight control program was attractive to the participants and did not reduce smoking cessation rates. However, it did not produce the expected effect on weight, thereby restricting our ability to examine the effect of weight control on smoking cessation and relapse.

Adult↗
PubMed1991

Demographic, knowledge, physiological, and behavioral variables as predictors of compliance with dietary treatment goals in hypertension.

The Hypertension Prevention Trial (HPT) was a multicenter, randomized trial testing calorie control, sodium restriction, and potassium increases in the prevention of hypertension in 841 men and women. Thirty four variables that were potentially related to changes in urine sodium, urine potassium, and weight were examined individually and together across 3 years of treatment and maintenance sessions. Univariate and multivariate analysis did not reveal a consistent pattern of variables associated with successful attainment of treatment goals or failure to do so. Baseline levels of urine sodium, urine potassium, and weight were the variables most consistently associated with compliance. Household composition, such as number of people living in the house or marital status and control over selection and preparation of foods, was associated with compliance in sodium reduction treatments. Number of complaints about the diets were positively associated with noncompliance. Attendance at treatment sessions was generally associated with compliance especially for weight loss. Practical implications of these results are discussed.

Adult↗
PubMed1991

Prevalence of dieting among working men and women: the healthy worker project.

Examined dieting to lose weight in a population of 2,107 men and 2,540 women employed in 32 worksites in the upper Midwest. Lifetime prevalence of this behavior was estimated to be 47% in men and 75% in women, and point prevalence was reported as 13% and 25% in men and women, respectively. Lifetime prevalence of participation in organized weight-loss programs was 6% in men and 31% in women; current prevalence was 1% in men and 6% in women. The strongest correlate of dieting behavior was relative body weight. In logistic regression analyses, dieting tended to be associated positively with education and occupational status and, in men only, was more prevalent among those with a history of hypertension. Dieters reported lower food intakes than nondieters, but the two groups did not differ consistently in reported physical activity. Overall, dieting appears to be a pervasive behavioral U.S. phenomenon that may contribute in part to population differences in the prevalence of obesity.

Adult↗
PubMed1991

Use of carbon monoxide breath validation in assessing exposure to cigarette smoke in a worksite population.

Assessed the usefulness of carbon monoxide (CO) breath validation of self-reported smoking status in a large worksite population (N = 4,647). CO assessment was performed as part of a baseline survey procedure. CO levels differed substantially in relation to self-reported smoking status and amount smoked. Correcting for ambient exposure (estimated by mean CO levels among never smokers) produced more satisfactory results than uncorrected CO levels. Striking company differences were observed in mean CO exposures among self-reported never smokers. An unexpected finding was that 17.1% of current smokers reported smoking less than daily. Although the CO measure was excellent in detecting moderate and heavy smokers, it was inadequate in detecting occasional and light smokers. If detection of occasional or lighter smoking is critical to the purposes of the study, the more expensive (but more accurate) cotinine measure is preferred.

Adult↗
PubMed1991

Population perspectives on the prevention and treatment of obesity in minority populations.

Possible causes of population differences in obesity prevalence are discussed: biologic susceptibility, treatment availability or effectiveness, and shared behavior patterns leading to caloric imbalance. It is argued that obesity in minority groups in the United States is best understood as a variation on a larger cultural theme, the creation of an environment in which highly palatable foods are accessible to all at low cost and physical activity is not required. Inequities in access to health education, treatment services, and environmental opportunities are probably responsible for the exacerbation of obesity and its attendant health conditions in some minority groups. Programs for the prevention of obesity in minority populations need to address these inequities and also to consider ways to counteract the historical trends in the United States toward nutritional excess in the population as a whole.

Cultural Characteristics↗
PubMed1991

Socioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project.

Obesity and health behaviors that influence energy balance (diet, exercise, and dieting to lose weight) were examined in a population of 2108 and 2539 working men and women in relation to socioeconomic status (SES). The hypothesis investigated was that the inverse relationship between SES and obesity observed in a number of studies is due to the fact that the distribution of obesity relevant health behaviors differs by social class. Body mass index (BMI), as expected, was found to be inversely related to SES. Higher SES was also associated with several behaviors that contribute importantly to energy balance. High SES respondents reported a lower fat diet, more exercise, and a higher prevalence of dieting to control weight. However, lower smoking rates were observed in upper SES men and women and higher alcohol consumption was reported in upper SES women. Both of these associations appear to be inconsistent with the hypothesis that the inverse association between SES and obesity is caused by differences in health behaviors. In multiple regression analyses, SES remained a significant predictor of BMI after controlling for all measured health behaviors. Weaknesses in the methodologies for measuring health behaviors and possible effects of obesity itself on social mobility are suggested as possible explanations for the residual association between obesity and SES.

Adult↗
PubMed1991

Secular trend in body mass index in the adult population of three communities from the upper mid-western part of the USA: the Minnesota Heart Health Program.

Secular trend in body mass index (BMI) over 7 years (1980-1987) was examined in the upper mid-western part of the USA using annual cross-sectional data collected by the Minnesota Heart Health Program. Significant secular increase in BMI adjusted for age and education was found in both men (0.08 kg/m2/year, P less than 0.02) and women (0.19 kg/m2/year, P less than 0.0001). In women, the secular increase occurred throughout the distribution of body weights but the change in the upper end was two to three times greater than that in the other parts of the distribution. In men, most of the increase in BMI occurred in the upper end of the distribution. Prevalence of obesity (defined as BMI greater than or equal to 85th percentile at year 1: men, 30.16 kg/m2; women, 29.94 kg/m2) increased by 0.6 percent/year (P = 0.1) in men and by 1.0 percent/year (P = 0.002) in women. The results indicate that body weight is increasing in upper mid-western adults, probably largely as a result of already overweight individuals becoming more obese. The secular increase in BMI was not accompanied by systemic change in reported food intake and exercise, and could not be explained by decreased prevalence of smoking. Large increases in body weight, especially among those who are already overweight, may have a significant public health impact.

Adult↗
PubMed1990

Cholesterol reduction through low-intensity interventions: results from the Minnesota Heart Health Program.

The National Cholesterol Education Program has underscored the need for health professionals to work together to promote dietary changes and reduce blood cholesterol levels across the population. This article reports the results of an evaluation of several low-intensity intervention programs designed for the general public that could be offered on a larger scale, either through traditional outlets for short courses or on an outpatient basis after physician referral. The interventions were designed as classes, required approximately 8 hr of contact time with the participants, cost approximately $20 per participant, and were taught by nutritionists and dietitians recruited from the community and trained for this program. Results indicated that similar net reductions in total cholesterol of about 4% were achieved at 1-yr follow-up either from a course which focused on changing eating patterns or from one which focused on weight loss and weight-loss management. These results support the hypothesis that cholesterol reduction is possible with inexpensive and simple methods in healthy, low-risk populations.

Adult↗
PubMed1990

Attributions for dietary failures: problems reported by participants in the Hypertension Prevention Trial.

Assigned participants in the Hypertension Prevention Trial to one of four diets for a period of 3 years: (a) weight loss, (b) reduced sodium, (c) weight loss plus reduced sodium, and (d) reduced sodium plus increased potassium. At 6-month intervals, they reported problems they were having adhering to their diets. Problem attributions were coded along the dimensions of internality, stability, and controllability and were categorized as intrapersonal or extrapersonal. Attributions were found to differ by type of diet and sex of participant. Participants assigned to weight-loss groups were significantly more likely than those assigned to non-weight-loss groups to blame themselves for their problems with adherence, making characterological as opposed to external or situational attributions. Men perceived problems to be more controllable than women. Attributions did not predict weight loss, change in urinary sodium, or change in potassium excretion.

Adult↗
PubMed1990

Correspondence programs for smoking cessation and weight control: a comparison of two strategies in the Minnesota Heart Health Program.

Mailed invitations to participate in weight loss and/or smoking cessation correspondence programs to 31,400 households in a suburban community. Two programs were offered to randomized subsets of households, a 6-month correspondence program costing +5 and the same program for free but requiring a +60 deposit to be refunded based on success in weight loss or smoking cessation. Overall, sign-up included 1,304 people for weight loss and 142 for smoking cessation. The +5 program was about 5 times as popular as the incentive program. Validated weight change after 6 months averaged about 4 lb for the +5 program and 8 lb for the incentive program. Corresponding rates of smoking cessation were about 9% and 20%, respectively. We conclude that correspondence programs for the promotion of weight control and smoking cessation are potentially cost-effective methods for reaching individuals in the community at large, many of whom would not be interested in clinic-based programs. Issues meriting further research include recruitment, especially of smokers, and evaluation of the relative trade-offs in recruitment success versus efficacy of differing treatment approaches.

Adult↗
PubMed1990

Public support for policy initiatives regulating alcohol use in Minnesota: a multi-community survey.

Public support for policies to control alcohol sales and consumption was surveyed in seven Minnesota communities. A total of 438 women and 383 men were asked to indicate their level of support of or opposition to nine different proposals designed to regulate alcohol. There was general support for all policies, which was strongly related to characteristics of respondents and type of policy proposed. Women were significantly more supportive of all items than were men. Marriage, older age and low alcohol consumption were also associated with support. Education and voter status generally were not. Policies and activities that serve primarily to protect youth received the strongest support. Restrictions and prohibitions such as limiting advertisements were less popular. The least support was expressed for increases in taxes on alcohol and for measures that would eliminate an existing practice such as prohibiting wine-cooler sales at convenience stores. The majority of respondents also indicated that they felt the individual, as opposed to the manufacturer or retailer, was responsible for problems associated with alcohol and should be the focus of intervention. Strategies for shifting the focus from the individual to environmental and regulatory control are discussed.

Adolescent↗
PubMed1979

Unexpected decrease in plasma high density lipoprotein cholesterol with weight loss.

High density lipoprotein (HDL) cholesterol is inversely related to coronary heart disease prevalence. Despite the fact that obese patients have lower plasma HDL-cholesterol concentrations, there are few prospective studies on the effect of weight loss on HDL-cholesterol. Consequently, plasma lipoprotein levels were measured in 15 obese females before and after a 10 week weight loss program. Mean weight loss was 8.6 +/- 3.9 kg (P less than 0.001). Total plasma cholesterol and low density lipoprotein-cholesterol did not change significantly. Plasma triglyceride levels decreased (P less than 0.05) as did HDL-cholesterol (P less than 0.02). A subgroup of 11 of the subjects had repeat lipid measurements 8 months after the start of treatment. Mean weight loss at this time was 12.8 +/- 0.8 kg (P less than 0.01). No subject had returned to her pretreatment weight but mean weight loss was not significantly different from the 10 week value. At 8 months all lipid values, including HDL-cholesterol, had returned to their pretreatment value. By multiple regression analysis HDL-cholesterol decreased with increasing relative weight but also decreased with increasing rate of weight loss. These results suggest that negative caloric balance produces a decrease in HDL-cholesterol that in prospective studies may obscure the inverse relationship between HDL-cholesterol and indices of obesity.

Adult↗
PubMed1979

Outpatient treatments of obesity: a comparison of methodology and clinical results.

To provide a quantitative comparison of outpatient treatments for obesity, an analysis was made of all such research published between 1966 and 1977. All articles which presented data for five or more healthy outpatients were included. Conclusions were: (1) there has been little improvement in the clinical effectiveness of weight reduction therapy since Stunkard & McLaren-Hume's (1959) review; (2) weight losses produced by different methods, from behavior therapy to anorectic medication, are very much the same; (3) the in-treatment results of diet therapies are the largest of those reviewed and deserve further attention; (4) behavior therapy produces the best maintenance of weight losses, although data from other types of therapy are very scanty; and (5) techniques for motivating clients to adhere to treatment recommendations are needed for improvement in the future. Recommendations for improving the methodology of weight-control research are also presented.

Behavior Therapy↗