Marjorie Caldwell

Health-related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow-up effects

BackgroundDespite a growing literature on the efficacy of behavioral weight loss interventions, we still know relatively little about the long terms effects they have on HRQL. Therefore, we conducted a study to investigate the immediate post-intervention (6 months) and long-term (12 and 24 months) effects of clinically based weight management programs on HRQL.MethodsWe conducted a randomized clinical trial in which all participants completed a 6 month clinical weight loss program and were randomized into two 6-month extended care groups. Participants then returned at 12 and 24 months for follow-up assessments. A total of 144 individuals (78% women, M age = 50.2 (9.2) yrs, M BMI = 32.5 (3.8) kg/m2) completed the 6 month intervention and 104 returned at 24 months. Primary outcomes of weight and HRQL using the SF-36 were analyzed using multivariate repeated measures analyses.ResultsThere was complete data on 91 participants through the 24 months of the study. At baseline the participants scored lower than U.S. age-specific population norms for bodily pain, vitality, and mental health. At the completion of the 6 month clinical intervention there were increases in the physical and mental composite measures as well as physical functioning, general health, vitality, and mental health subscales of the SF-36. Despite some weight regain, the improvements in the mental composite scale as well as the physical functioning, vitality, and mental health subscales were maintained at 24 months. There were no significant main effects or interactions by extended care treatment group or weight loss group (whether or not they maintained 5% loss at 24 months).ConclusionA clinical weight management program focused on behavior change was successful in improving several factors of HRQL at the completion of the program and many of those improvements were maintained at 24 months. Maintaining a significant weight loss (> 5%) was not necessary to have and maintain improvements in HRQL.

Weight Training Increases Fat-Free Mass and Strength in Untrained Young Women

OBJECTIVE To examine the effects of a weight training program on the resting metabolic rate, fat-free mass, strength, and dietary intake of untrained young women. DESIGN A 12-week weight training program was completed by 20 previously untrained women aged 19 through 44 years. SUBJECTS Twenty-three study subjects and 14 control subjects were recruited on a volunteer basis. Twenty study subjects and 10 control subjects completed the study. INTERVENTIONS Study subjects participated in a 12-week moderate-intensity, progressive resistance weight training program consisting of 2 supervised sessions per week with 6 types of lifting exercises per session. Resting metabolic rate, fat-free mass, strength, and dietary intake were measured before and immediately after the study. STATISTICAL ANALYSES Repeated measures analysis of variance and t tests (unequal variance and paired) were used to determine interaction effects and differences within and between groups. RESULTS The study group increased their fat-free mass (mean+/-standard deviation) from 44.2+/-5.4 kg to 46.2+/-6.0 kg (P<.001). Elbow flexion, elbow extension, and knee flexion strength all increased from 28.9+/-5.3 to 34.5+/-3.8, 16.9+/-4.9 to 22.1+/-5.3, and 39.5+/-8.6 to 48.6+/-7.3 ft-lb, respectively (P<.001). Percent body fat decreased from 29.8+/-2.8 to 27.2+/-2.6 (P<.001) without a significant change in body weight. Resting metabolic rate did not change significantly (P>.05). APPLICATION A moderate-intensity weight training program increased strength and fat-free mass and decreased body fat in normal-weight young women. Favorable changes in body composition were obtained without restricting food intake. The increase in fat-free mass did not increase resting metabolic rate significantly.

The Major Components of Human Energy Balance During Chronic β-adrenergic Blockade

PURPOSE The authors compare the major components of energy balance--dietary food intake, resting metabolic rate, and physical energy expenditure--in patients receiving beta-blocking medications and healthy controls. METHODS The authors recruited subjects who were receiving beta-blocking agents (n = 22) from local hospitals and clinics. Twenty-two healthy controls were matched to each patient based on age, weight, and gender. Resting metabolic rates were determined using indirect calorimetry. Three-day dietary intakes and physical activity assessments were analyzed. RESULTS There were no between-group differences in calories ingested or self-reported physical activity patterns. However, resting metabolic rates were lower in the beta-blocked subjects (beta-blocked = 1,541 +/- 464 kcals/day; controls = 1,817 +/- 426 kcals/day; P < 0.05). CONCLUSIONS beta-adrenergic blockade causes a reduction in resting metabolic rate. Therefore, beta-blocked individuals should increase physical activity, decrease dietary intake, or both to maintain daily energy balance and prevent weight gain that accompanies a reduction in metabolic rate.

Fatty Acid Intake and Serum Lipids in Overweight and Obese Adults: Short-term Effects of Fat Reduction, Exercise, and Weight Loss

The purpose of this observational study was to describe the relationship between dietary fatty acids and serum lipids in 154 overweight adults participating in a weight management program. Mean energy intake decreased by 252 ± 548 kcal and weight decreased by 4.1 ± 3.4 kg (P < .001). Total fat (% kcal), grams of polyunsaturated fat, monounsaturated fat, and trans fatty acids, and saturated fat decreased as did serum lipids except for triglycerides (P ≤ .001). Changes in total cholesterol were correlated with alterations in all fatty acids except for saturated fatty acids; low-density lipoprotein cholesterol (LDL-C) was correlated with a change in trans fats and high-density lipoprotein cholesterol (HDL-C) was not correlated with any variables. In the multiple regression model, 3.9% of the variance in LDL-C could be explained by trans fats after controlling for the effects of other variables; a lowering of HDL-C was associated with a change in percentage of fat kilocalories. In conclusion, trans fats appear to be associated with LDL-C. Based on these findings, it is prudent to recommend that the public limit their intake of trans fats.

Lipid Responses to Weight Loss

Abstract The Health Promotion Partnership Weight Management Program consists of a 12-week intensive phase (4 hour/week) and a 12 week tapering phase (1/2–1 hour/week) with interventions including diet (20–25%kcal/fat), exercise (15–45minutes/4x/week), and behavior management. Subjects (N=23) completing one 12-week intensive session participated in a study of lipid responses to the program. Subjects were predominantly Caucasian (100%), female (73%), college graduates (77%), with a mean age of 50±8 years and BMI of 33±5. Subjects lost weight (mean=−6.1±3.9kg, t 22df =7.4, p 22df =5.0, p 21df =2.6, p 21df =2.2, p 21df =2.1, p 22df =3.8, p 22df , =2.4, p 22df =2.7, p 22df =2.1, p 2 cholesterol (baseline mean=19.1±10mg/dl, 12-week mean=14.5±8, t 22df =3.2, p 3 cholesterol and triglycerides did not change. In conclusion, the weight management program was associated with favorable improvements in health behaviors as well as changes in serum lipids, however the decrease in HDL, particularly in HDL 2 , raises concerns about lipid responses to weight loss.

The effect of wounding on the riboflavin status of the rat

Abstract The effects of wounding on riboflavin status of the rat were investigated. Male Sprague Dawley rats were intramuscularly injected in the hind limb with lambda-carrageenan. Four groups were studied: ad libitum control (C); wounded (W); pair-fed to wounded (P); and pair-fed to wounded supplemented to receive 60μg riboflavin daily (R). All groups were fed a 15% casein diet containing 2 μg riboflavin per g diet. Decreased food intake in the W and P groups was associated with weight loss, less positive nitrogen and riboflavin balance, and increased erythrocyte glutathione activity coefficients (ERG-AC). In spite of restricted food intake, R group values were closer to C group for riboflavin balance and ERG-AC, suggesting that these parameters are affected primarily by riboflavin intake. Nitrogen balance improved but did not reach control values. Liver riboflavin was significantly lower in the W group when compared to all other groups (p