L.H Clemens

The Effect of Eating Out on Quality of Diet in Premenopausal Women

OBJECTIVE To compare the intake of women who report varying levels of frequency of consuming food at commercial facilities outside the home. DESIGN A 1-week descriptive study of dietary intake in women. Subjects completed daily diet records that included information regarding the source of the food eaten at each meal or snack. The sample was divided on the basis of the number of meals each subject reported obtaining from a commercial establishment outside the home. Of the 129 subjects, 56% (n = 72) reported eating out 5 times or less during the week of recording (Low Eating Out group) and the remainder (n = 57) reported eating out between 6 and 13 times (High Eating Out group) SUBJECTS/SETTING One hundred twenty-nine premenopausal women were recruited via community advertising for an investigation of health habits. This study was conducted in a midsouthern US city. STATISTICAL ANALYSES PERFORMED Results were analyzed using independent sample t tests and chi 2 tests. RESULTS Mean intake was compared for the groups. The High Eating Out group was found to be consuming significantly more total energy (2,057 kcal vs 1,769 kcal; P = .002), fat (79.5 g vs 60.6 g; P < .001), and sodium (3,299 mg vs 2,903 mg; P = .043) and marginally more carbohydrate (261.5 g vs 234.6 g; P = .055) and protein (71.5 g vs 65.4 g; P = .066). Total fiber or calcium intake did not differ between the groups. CONCLUSIONS Our study demonstrates that women who report eating out a greater number of times per week report more total energy intake as well as higher fat and sodium intakes. However, the High Eating Out group did not consume significantly more fiber or calcium in the extra energy consumed.

Medical Costs are Reduced when Children with Intractable Epilepsy are Successfully Treated with the Ketogenic Diet

The ketogenic diet is used for children with drug refractory epilepsies. Although this diet was developed early in the 20th century, its use was infrequent until recently. One of the concerns about the ketogenic diet is the cost of initiating the diet. The process generally involves an inpatient visit that can last several days. In this study, the health care costs for 15 children with drug refractory epilepsy who received their care at Vanderbilt University Medical Center were compared for the period of time 6 to 12 months before they began the ketogenic diet and 6 to 12 months after they began the ketogenic diet. All comparisons within each child were done on the same amount of time before and after initiation of the diet. Total costs affiliated with care for the 15 children were:

The relationships between ethnicity, gender, and short-term changes in energy balance following smoking cessation

352,820.20 for the prediet period,

Cigarette smoking is associated with energy balance in premenopausal African-American adult women differently than in similarly aged white women

41,221.91 for the diet initiation, and

Research and the clinical dietitian: perceptions of the research process and preferred routes to obtaining research skills.

149,436.86 for the postdiet-initiation period. We conclude that successful maintenance on the ketogenic diet provides a substantial financial benefit.

A placebo controlled randomized trial of the effects of phenylpropanolamine and nicotine gum on cessation rates and postcessation weight gain in women

Although weight gain is a well-established consequence of quitting smoking, the energy balance mechanisms responsible for postcessation weight gain are not clear. Furthermore, although gender and ethnicity are important predictors of postcessation weight gain, no studies have evaluated the effects of these variables on changes in energy balance. This study investigated short-term changes in energy balance following smoking cessation in 95 smokers. In as little as 2 weeks, smoking cessation was associated with a significant increase in body weight (1.05 kg). Smoking cessation was also associated with an increase in energy intake (1440 kJ/day), and no changes in energy expenditure (physical activity; resting energy expenditure, REE) were observed. Changes in body weight and energy balance did not differ by gender or ethnicity. Predictors of weight gain included baseline carbon monoxide (CO) level, baseline REE per kg of body weight, and changes in energy intake. These findings provide valuable information about the mechanisms responsible for at least the early stages of postcessation weight gain.

Reliability and Validity of a Brief Questionnaire to Assess Calcium Intake in Female Collegiate Athletes

OBJECTIVE: To investigate the differential association of cigarette smoking with energy balance in African-American and white premenopausal women.DESIGN: Cross-sectional study of energy balance, weight, and smoking in women.SUBJECT: A total of 374 women: 191 African-American (mean age=29.8±6.5 y) and 183 white women (mean age=28.9±7.1 y).MEASUREMENTS: Weight, cigarette smoking habits, resting energy expenditure, dietary intake, and physical activity.RESULTS: There were no significant differences in dietary intake by race or smoking status. The model for physical activity was significant (P=0.0004), with body mass index (BMI) having the largest effect on activity (P<0.001). Smoking status was related to activity, with the heaviest smokers reporting more activity than nonsmokers (P=0.008) or light smokers (P=0.028). The model for resting energy expenditure (REE) was significant (P<0.0001), with the largest again being BMI (P<0.001). There was also an interaction between ethnicity and smoking status (P<0.0001) such that African-American nonsmokers and light smokers tended to have lower REE than several other groups, most often the African-American moderate heavy smokers. The model for BMI was significant (P<0.0001) with an interaction for ethnicity and smoking status (P=0.0009). African-American nonsmokers and light smokers had significantly higher BMIs than most of the other groups.CONCLUSION: African-American women who were the heaviest smokers had a lower adjusted BMI than the heaviest smoking white women. This effect, at least partially, may be related to an increased REE in the African-American smoking women. While energy intake did not appear to be important in this relationship, energy expended in physical activity appeared to be increased with smoking, as was REE.