Raimo Lappalainen

Regional cerebral blood flow during exposure to food in obese binge eating women.

Cerebral responses elicited by the sight of food were evaluated in eight obese binge eating, 11 obese and 12 normal-weight non-binge eating women. Regional cerebral blood flow (rCBF) was mapped while the subjects were looking at a picture of a landscape (control) or at a portion of food (food exposure), and was measured by [99mTc]ethyl-cysteine-dimer and single photon emission computed tomography. Exposure to food was associated with different changes in the cerebral blood flow (normalized to mean cerebellar counts) of the right and left hemispheres in the obese binge eating than in the obese or normal-weight non-binge eating women. As compared with the non-binge eating groups, the obese binge eating women had, due to food exposure, a greater increase in the cerebral blood flow in the left than right hemisphere, especially in the frontal and pre-frontal regions. In addition, strong linear correlations were observed in this group between the rCBF of the left frontal and pre-frontal regions and the increase in the feeling of hunger during the exposure to food. Left hemisphere and its frontal and pre-frontal regions could thus play a role in binge eating behavior in humans.

Reduced serotonin transporter binding in binge eating women

Abstract. Rationale: There is evidence that abnormalities in brain dopamine, norepinephrine and serotonin metabolism may play an important role in binge eating. Serotonin-active antidepressant drugs have also been found to decrease binge eating. Objective: We investigated serotonin transporter binding in obese binge-eating women. Eleven obese binge-eating and seven obese control women participated in the study. The subjects were not taking any medication known to affect serotonin (5-HT) transporters. Methods: We used single-photon emission tomography (SPECT) with the radioligand 123I-labelled nor-β-CIT, which specifically labels 5-HT transporters. Results: Obese binge-eating women showed significantly decreased 5-HT transporter binding in the mid-brain compared with obese controls (2.1±0.5 versus 2.9±0.5, respectively). Conclusions: SPECT imaging with a ligand specific for 5-HT transporters can be used to assess altered serotonin transporter binding in the living human brain. The results tentatively suggest that 5-HT transporter binding is decreased in binge-eating women.

A wireless wellness monitor for personal weight management

Despite increasing possibilities for the citizen to play a more active role in personal health management, the use of Internet based health applications remains limited. Poor usability, limited personalization, and problems with security and accessibility often frustrate a continued use. The paper presents a possible solution by actively using wireless communications and ad-hoc networking techniques to minimize the users efforts in using the application. Overweightness is a widespread and increasing problem in western countries. There are indications that self-monitoring combined with guidelines provide a good basis for personal weight management. The wireless wellness monitor implements a self-monitoring and guidance system using Bluetooth- and Jini-based networking. A scale, heart rate monitor, mobile terminal (personal digital assistant or WAP-enabled digital cellular phone), and home server communicate locally via Bluetooth. Internet based communications take care of remote use. The set-up allows us to investigate the behavior and use cases based on equipment and protocols that are expected to be in general use in the coming years. Thus, the system provides a useful test-bed for evaluating new techniques that may bring personal health management to a new level.

TERVA: wellness monitoring system

Long-term monitoring of physiological and psychosocial variables would be beneficial to investigate slowly developing deterioration in wellness status of a subject. We designed a personal wellness monitoring system (TERVA), which allows monitoring wellness-related variables at home for many weeks or even months. The TERVA system runs on a PC computer and interfaces with different measurement devices through serial interface. Measured variables include beat-to-beat RR intervals, activity level, blood pressure, weight, temperature, respiration, ballistocardiography, movements, and sleep stages. In addition, self-assessments of daily wellbeing are stored by keeping a behavioral diary. To test the system, one healthy man was monitored for 10 weeks and an aged woman was monitored for 2 weeks. The data allows conclusion that the TERVA system provides a method to investigate wellness-related data over several weeks or even months in out-of-hospital conditions.

Users’ Preferences for Ubiquitous Computing Applications at Home

We developed and evaluated a home network and ambient intelligence prototype for wellness management and home automation applications. The evaluation was based on interviews and a user trial at a simulated home environment. This paper describes users’ attitudes towards ubiquitous computing technology at home, and especially what kind of applications they would prefer to use at home. We also aimed to gather qualitative information about what kind of user interfaces would be desired for using these applications. The study generated new ideas to develop the ubiquitous computing enabled home concept further.

Recent body-weight changes and weight loss practices in the European Union

OBJECTIVES The aim of this paper is to describe recent weight changes and weight loss practices in the EU, and in particular to describe the group of subjects who were in a recent state of weight gain. DESIGN AND SUBJECTS Overall, 15,239 adults aged 15 years and upwards composed of 1000 from each EU member state were selected to complete the interview-assisted face-to-face questionnaire. In each member state, sample selection was quota-controlled to ensure national representativeness. RESULTS This survey points to a fairly alarming tendency of more normal weight, overweight or obese European people being in a state of weight gain rather than weight loss. But it is also worrying that almost a fifth of underweight people are in the process of losing more weight. The recommendations for interventions to promote weight loss might be somewhat different between countries in the EU as the common weight loss practices differ between such countries. Overall, a campaign alone may not be effective in encouraging people to do more physical activity in Europe. Additional methods should be found. Furthermore, a combination of diet and exercise as a method of weight control is underestimated or undervalued by the general population who are either overweight or obese.

TERVA: system for long-term monitoring of wellness at home.

Long-term monitoring of physiological and psychosocial variables in out-hospital conditions would be beneficial for investigating changes in wellness status of an individual or to understand interaction between physiological and behavioral processes. We aimed to design a personal wellness monitoring system (TERVA), which would allow monitoring of wellness-related variables at home for several weeks or even months. The designed TERVA system runs on a laptop computer and interfaces with different measurement devices through a serial interface. Measured variables include beat-to-beat heart rate, motor activity, blood pressure, weight, body temperature, respiration, ballistocardiography, movements, and sleep stages. In addition, self-assessments of daily well-being and activities are stored by keeping a behavioral diary. To test the system, one healthy man used the system for 10 weeks. The system was successfully applied in out-hospital conditions. The success rate of the measurements was 70-91%, depending on the variable under consideration. The pilot study indicated that the recorded data accurately reflected the health status of the subject. The TERVA system provides a method to record and investigate wellness-related data over several weeks, or even months, outside the hospital among subjects capable of using a personal computer. Several applications of the system are discussed.

Long-term self-monitoring of weight: a case study.

The aim of this study was to examine the self‐monitoring of weight on a daily basis over a long period of time in order to understand the process of weight regain. An obese female client measured her weight every morning over a period of 10 years. The subject made a total of 2081 weight measurements. Thus, her weight was measured on 67% of all possible days. After the initial weight loss a pattern of gradual weight gain was observed. The subject gained weight during August and September, and at the end of December, in particular. Furthermore, her weight increased slightly at the weekends. This case study highlights the advantage of self‐monitoring of weight on a daily basis. Individual patterns of weight change possibly associated with season and weekly variation may be crucial when obese subjects try to maintain their weight after weight loss. However, it may take several months or even years to detect the weekly and yearly rhythms or other patterns in the data. Thus, self‐control of weight is problematic, since patterns in the weight regain process are difficult to detect. This may be one reason why self‐control of weight is so difficult.

Changes in eating and weight control habits after myocardial infarction

The focus of this study was to describe changes the patients make in eating and weight control habits 3--4 months after diagnosis of myocardial infarction, and to identify difficulties associated with the reported changes 1 month later. Subjects were 50 male patients (mean age 48 years, mean body mass index 27.9kg/m(2)) participating in an in-patient cardiac rehabilitation programme. The changes were assessed with a questionnaire (46 items) at the beginning of the rehabilitation programme and 4 days food diaries were used to assess the diet at home. Difficulties were assessed with a questionnaire (34 items) 1 month later. Nearly all patients (96%) had changed their habits after myocardial infarction. The majority of the patients (76%) reported that they had consumed foods containing less fat and many of them anticipated difficulties to eat healthily at workplace. More attention could be paid to self-change without the assistance of formal treatment among patients with cardiac disease.

Feasibility and user acceptance of a personal weight management system based on ubiquitous computing

With the fast development of information and communications technology, devices with some computing power are becoming increasingly abundant in the average home. The trend for these devices to also be provided with intercommunication functionality opens up new possibilities for health care. The availability of ubiquitous computing allows the individual to perform health-related measurements, review data or consult guidelines independent of place or time, thus providing the individual with a better means to follow certain treatment programs. In this study, we set out to implement a system based on ubiquitous computing for the application of weight management using behavioral feedback. The goals were (a) to gain insights in the technical feasibility and caveats of such a system as a basis for setting up more advanced and generic infrastructures, and (b) to study the degree to whether people are actually willing to use such a technology-laden system for their health management. The results lead us to the conclusion that such a system is possible with the current technology, although many issues need to be solved before generic architectures and implementations are a reality, and that many people, especially those who have serious weight problems, are eager to use such a system.