Lucene Wisniewski

Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.

Obese children 8-12 years old from 61 families were randomized to treatment groups that targeted increased exercise, decreased sedentary behaviors, or both (combined group) to test the influence of reinforcing children to be more active or less sedentary on child weight change. Significant decreases in percentage overweight were observed after 4 months between the sedentary and the exercise groups (-19.9 vs. -13.2). At 1 year, the sedentary group had a greater decrease in percentage overweight than did the combined and the exercise groups (-18.7 vs. -10.3 and -8.7) and greater decrease in percentage of body fat (-4.7 vs. -1.3). All groups improved fitness during treatment and follow-up. Children in the sedentary group increased their liking for high-intensity activity and reported lower caloric intake than did children in the exercise group. These results support the goal of reducing time spent in sedentary activities to improve weight loss.

Habituation and dishabituation of human salivary response

Habituation may be relevant for understanding how sensory stimuli influence factors related to ingestive behavior. In the first of three experiments in humans we showed that salivation and hedonic ratings to lemon or lime juice habituated within 10 presentations, and dishabituation of the salivation and hedonic ratings to the original juice were observed after a new juice was presented. Experiment 2 replicated the habituation and decrease in hedonics to lemon juice, and showed both dishabituation and a relative increase in hedonics when chocolate taste, rather than another juice, served as the dishabituating stimulus. In a third experiment we showed a video game, a nontaste stimulus, could serve as a distractor to prevent the development of habituation, as well as a dishabituator after habituation had occurred.

Child and parent factors that influence psychological problems in obese children.

This study assessed the influence of child and parental obesity and parental psychiatric symptoms on psychological problems in obese 8-11-year-old children. Child psychological problems were measured using the Child Behavior Checklist/4-18, whereas adult psychiatric symptoms were measured using the Cornell Medical Index. Multiple linear regression analyses showed parental psychiatric symptoms were related to child psychological problems for six of eight problem behavior scales. Child obesity made no independent contribution to child psychological problems, and parental obesity was related to child problems on only one scale. The most prevalent problems were Anxiety/Depression for 15% of the boys and Social Problems for 20% of the boys and 12.8% of the girls. These results suggest a broader conceptualization of factors that influence behavior problems of obese children than their degree of obesity.

Effect of food change on consumption, hedonics, and salivation

This study assessed the influence of introducing a new food after repeated presentations of one food on food consumption, hedonics, and salivation. Male subjects were provided repeated 150-calorie courses of pizza or cheeseburger until satiety. Hedonics and salivation were measured before each course. Subject were then provided an additional 450 calorie course of the same or the new food. During the development of satiety, subjects showed reliable increases in fullness and decreases in hunger and hedonics. Salivation briefly increased to maximal salivation, followed by reliable decreases. No differences in pattern of change for fullness, hunger, hedonics or salivation were noted across foods. Presentation of the new food resulted in significantly greater caloric consumption than another serving of the same food (130 vs. 44.5 kcal), an increase in hedonics and salivation relative to presentation of the same food, with no influence on hunger or fullness. These results suggest that after satiety develops, response recovery for subjective, physiological, and behavioral components of eating can be observed when new, palatable foods are presented.

Differences in Salivary Habituation to Palatable Foods in Bulimia Nervosa Patients and Controls

Objective Bulimia nervosa (BN) patients have been shown to experience anomalous responses to food and food cues. We investigated the response to food over time by presenting repeated food cues and measuring changes in physiological (ie, salivation) and subjective responses. Method Subjects were 18 BN women and 18 matched control women. Two palatable food stimuli, regular or frozen yogurt, that varied in macronutrient composition but had similar sensory characteristics, were presented to subjects repeatedly during a laboratory session. After two baseline salivation measures, subjects were presented with eight trials of one of the two yogurts. On Trial 9 a lemon juice dishabituator was presented, with the yogurt stimulus presented again at Trial 10. Results We found that control subjects had decreased salivation after repeated food presentations. In comparison, BN subjects failed to show a decrease in salivation. The desire to binge increased over trials for the BN subjects, but remained stable for normals. Conclusions These data suggest that salivary habituation may be abnormal in BN patients.

Cognitive behavioral interventions in the management of severe pediatric obesity

The prevalence of pediatric obesity has increased significantly, and the greatest increase in prevalence has occurred among the heaviest children. Severe pediatric obesity is associated with higher rates of medical and psychosocial morbidity than is milder obesity. Although the efficacy of family-based behavioral weight control programs in the treatment of moderate pediatric obesity is well established, there is little information on the treatment of severe obesity. We believe that family-based cognitive behavioral interventions, which focus on increasing healthy eating behaviors and physical activity and decreasing unhealthy eating and sedentary behaviors, are critical for these children. Treatment adaptations that address inappropriate eating among children, peer teasing, and poor body image also are useful in managing this high-risk population.

Targeting premeal anxiety in eating disordered clients and normal controls: A preliminary investigation into the use of mindful eating vs. distraction during food exposure

OBJECTIVE Studies have demonstrated that negative affect increases prior to food intake in individuals diagnosed with an eating disorder. Mindfulness has been supported empirically to treat experiential avoidance stemming from anxiety. Thus, the current objective in this study is to empirically compare mindfulness vs. thought suppression invention during a food exposure in both clinical and nonclinical samples. METHOD In a 2 (Group: clinical vs. nonclinical) × 2 (INTERVENTION: mindfulness vs. distraction) counterbalanced within treatment design, the current investigation sought to determine the differential effectiveness of a brief mindfulness intervention vs. a brief distraction intervention in women diagnosed with AN and BN in a clinical and nonclinical sample during a food exposure. RESULTS Results indicated that the eating disorder group reported a significant increase in negative affect after the mindfulness intervention as compared to the distraction intervention, whereas the nonclinical group reported a significant decrease in negative affect after the mindfulness intervention as compared to the distraction intervention. DISCUSSION Preliminary findings suggest that clinicians may want to proceed cautiously when using mindful eating in those with severe eating disorders during the early stages of food exposure. Limitations and future directions are discussed.

Salivary responding and the duration of measurement

The Strongin-Hinsie Peck whole-mouth salivation measure (Peck, 1959) is typically collected for a 2-min duration. This study compared saliva collected for 120 sec with saliva collected for shorter durations (30 and 60 sec) over repeated presentation of gustatory cues. Results showed reliable increases in salivation from a water stimulus baseline to the first presentation of lemon juice as a function of measurement duration. Repeated measures analysis of variance showed overall decreases in salivation across each measurement duration, with a greater rate of habituation for the 120-sec interval than for the 30- and 60-sec intervals. These data suggest that shorter measurement intervals can be used to measure salivation in acute and repeated measurement paradigms, but the change in response to repeated stimulus presentations is more pronounced for the longer measurement duration.

Binge Eating Problems in an Adolescent Medicine Clinic

Clinically significant problems with binge eating are common among adult women. Persistent binge eating is associated with significant psychiatric morbidity, including anxious and depressive symptomology, and with the development of obesity, a major public health problem. The age of onset of eating problems is most frequently during adolescence, and eating disorders are the third most common chronic illness among adolescent females. Despite the scope and significance of this problem, few individuals with eating problems seek treatment, and little is known about the treatment of disordered eating in community settings. In the present investigation we sought to determine the prevalence of binge eating and associated concerns about shape and weight among adolescent women seeking medical care in an urban adolescent medicine clinic. Patients provided demographic information and were asked to complete the Bulimia Test-Revised (BULIT-R), a questionnaire designed to assess the severity of eating-disorder symptomology. Subjects were 64 female adolescents who kept medical appointments at the Adolescent Medicine Clinic of the Children’s Hospital of Pittsburgh. Patients ranged from 12 to 18 years of age. Forty-six percent (30/64) identified their race as African-American. Thirty-one percent (20/64) were obese with a body mass index 2 30. Only one patient reported eating-disorder symptoms suggestive of a full-blown eating disorder, with a BULIT-R score > 88. However, 22% of the subjects reported that they considered themselves to be binge eaters, 19% of the subjects reported feeling obsessed about the size and shape of their bodies, and 28% of the subjects endorsed feeling tormented about thoughts of being fat or gaining weight (FIG. 1). Young African-American women were likelier than Caucasian women to report that they were binge eaters (33% vs. 1 1.8%, p < 0.05) (FIG. 2). Binge eating and associated concerns about shape and weight are common among adolescent women in a primary health care setting. Binge eating may be overlooked