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3.
Clin Obes ; 8(5): 313-322, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30066362

RESUMEN

The aim of this study is to examine the feasibility of a brief intervention to reduce instances of indulgent energy intake. Forty-five participants with a body mass index (BMI) ≥25 kg m-2 were randomized to one of three groups for 8 weeks. The control group was asked to complete a questionnaire every 4 days, the self-monitoring group was given the same instructions but also asked to 'say no' to indulgences. The self-monitoring and feedback group was asked to do the same but in addition to send a photograph or description of that to which they had 'said no' and were then provided with feedback. All participants reported on indulgences for 7 days prospectively at baseline and 8-week follow-up. The follow-up rate was 80%; completion of questionnaires was 63% and 87 text messages were sent. The control group reduced their indulgences by 4.1 (SD 10.0), the self-monitoring group by 13.8 (SD 16.8) and self-monitoring and feedback group by 9.0 (SD 11.7) per week. All bar one, feasibility progression criteria were met and this was the return of the indulgence diaries during the intervention period. The study demonstrates the feasibility of a brief intervention to reduce the number of indulgences people ate. The progression criteria were met and areas of improvement are highlighted.


Asunto(s)
Ingestión de Alimentos/psicología , Ingestión de Energía , Conducta Alimentaria , Humanos , Masculino , Estudios Prospectivos , Bocadillos/psicología
4.
Clin Obes ; 8(4): 250-257, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29900680

RESUMEN

An estimated 30% of patients accessing community weight management services experience symptoms of binge eating disorder (BED). Guided self-help (GSH) is the recommended first line of treatment for BED. This study is a preliminary investigation into the effectiveness of GSH delivered by dietitians for patients with binge eating within a weight management service and a consideration of the association between wellbeing, therapeutic relationship and outcomes. The study was conducted as a single group, pre- and post-intervention study with 24 patients reporting symptoms of binge eating who completed the self-help manual with guidance from a trained community dietitian. Primary outcomes were eating disorder psychopathology and behaviours (Eating Disorder Evaluation Questionnaire), depression and anxiety. Principle results showed a significant reduction on all subscales of eating disorder psychopathology, anxiety and depression. There was a reduction in loss of control over eating but the 40% reduction in binge episodes was not statistically significant. Mid-treatment sessional ratings were positively associated with outcome. In conclusion, the GSH intervention was appropriate for dietitian delivery to patients with obesity and binge eating behaviour. This research indicates potential for other dietetic-led weight management services to deliver such interventions and support patients with binge eating accessing their service.


Asunto(s)
Trastorno por Atracón/dietoterapia , Adulto , Trastorno por Atracón/fisiopatología , Trastorno por Atracón/psicología , Redes Comunitarias , Dietética/métodos , Conducta Alimentaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pérdida de Peso , Adulto Joven
5.
Pediatr Obes ; 13(9): 558-566, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29701306

RESUMEN

BACKGROUND: Negative obesity stereotypes and anti-fat attitudes have been observed in children from age three. It is uncertain whether this is specific to fatness or generalizable to other visible differences. OBJECTIVES: To determine whether young children base decisions about qualities in others and friendship choices more on fatness than other visible differences between people. METHODS: Using a personal construct theory approach, 85 children (mean age 5.7, 42 girls) completed a simple repertory grid. The children were asked about differences (constructs) between four illustrations (elements) that showed children as healthy weight, fat, the opposite gender and in a wheelchair. Children were also asked about friendship with the illustrated children and self-image preferences. Their answers were grouped using thematic analysis. RESULTS: The fat, opposite gender and wheelchair-bound characters were equally chosen by children as different to the standard character. When identifying differences, fatness or body shape was referred to significantly less than gender or being in a wheelchair. Children were more likely to reject an opposite gender character as a friend, or as someone they would like to be, than to reject the fat character. Only one child, themselves overweight, voiced strong anti-fat attitudes. CONCLUSIONS: Apparent negativity towards fatness is fostered by failure to consider other visible differences and by children's 'like me' peer preferences. It was less desirable in the eyes of most 5-year old girls to be a boy than to be fat. This offers some reassurance to those working to improve children's health literacy in obesity.


Asunto(s)
Amigos/psicología , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud/estadística & datos numéricos , Obesidad Infantil/psicología , Autoimagen , Tamaño Corporal , Niño , Preescolar , Inglaterra , Femenino , Humanos , Relaciones Interpersonales , Masculino
6.
Diabet Med ; 35(7): 972-979, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29608221

RESUMEN

AIMS: To measure total 25-hydroxyvitamin D levels in women in mid-pregnancy who participated in the Belfast centre of the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) observational study, and to investigate the associations between levels of 25-hydroxyvitamin D and markers of gestational diabetes mellitus and lipid biomarkers. METHODS: A total of 1585 pregnant women had serum samples available for measurement. Participants were recruited from the Royal Jubilee Maternity Hospital, Belfast, Northern Ireland, at 24-32 weeks' gestation, as part of the HAPO study. 25-hydroxyvitamin D concentrations were measured using liquid chromatography tandem mass spectrometry. Glucose, C-peptide and lipid levels were previously analysed in a central laboratory. Statistical analysis was performed. RESULTS: The median (interquartile range) 25-hydroxyvitamin D concentration during pregnancy was 38.6 (24.1-60.7) nmol/l, with 65.8% of women being vitamin D-deficient (≤50 nmol/l). In regression analysis, the association between maternal 25-hydroxyvitamin D and fasting plasma glucose levels approached significance [regression coefficient -0.017 (95% CI -0.034 to 0.001); P=0.06], and a significant positive association was observed between maternal 25-hydroxyvitamin D and ß-cell function [1.013 (95% CI 1.001 to 1.024); P=0.031]. Maternal 25-hydroxyvitamin D level was positively associated with HDL [0.047 (95% CI 0.021 to 0.073) P≤ 0.001] and total cholesterol [0.085 (95% CI 0.002 to 0.167); P=0.044] in regression analysis. CONCLUSIONS: These results indicate a high prevalence of vitamin D deficiency during pregnancy, which requires identification and treatment; however, only weak associations were observed between 25-hydroxyvitamin D level and markers of glucose and insulin metabolism. This would suggest that these are of doubtful clinical significance.


Asunto(s)
Glucemia/metabolismo , Péptido C/metabolismo , Colesterol/metabolismo , Diabetes Gestacional/metabolismo , Complicaciones del Embarazo/metabolismo , Deficiencia de Vitamina D/metabolismo , Vitamina D/análogos & derivados , 25-Hidroxivitamina D 2/metabolismo , Adolescente , Adulto , Calcifediol/metabolismo , Cromatografía Liquida , Diabetes Gestacional/epidemiología , Dieta , Femenino , Humanos , Irlanda del Norte , Embarazo , Complicaciones del Embarazo/epidemiología , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Espectrometría de Masas en Tándem , Vitamina D/metabolismo , Deficiencia de Vitamina D/epidemiología , Población Blanca , Adulto Joven
7.
Eur J Clin Nutr ; 71(5): 625-630, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-27966566

RESUMEN

BACKGROUND/OBJECTIVES: The relationship between food craving and dieting is mixed and uncertain, with little evidence during active weight management. Accordingly, the frequency and nature of food cravings were investigated in people attending a commercial weight management programme. SUBJECTS/METHODS: An online survey was completed by 2932 participants (97% female, mean age=43.0 years, mean body mass index=31.6 kg/m2). Assessments included the Control of Eating Questionnaire, measuring the frequency, intensity, specificity and behaviour following food cravings. Others included body weight, dietary restraint, perceived success of dieting and mood. Forty-two per cent of the sample completed a second survey 7 weeks later. RESULTS: Cross-sectional analysis showed those currently dieting to lose weight (55% of sample) had significantly fewer, less intense and more resisted food cravings than those watching what they ate so as not to gain weight (35% of sample). Cravings were fewer for chocolate and other sweet foods. Longitudinally, food cravings decreased over the period of weight loss (2.0 kg). Fewer foods were craved and the cravings were less intense, easier to resist and to control. Eating in response to food cravings was a significant predictor of weight change. CONCLUSIONS: People with obesity and recent experience of resisting eating in response to food cravings lost more weight over the next 7 weeks. Feeling in control of eating was also associated with greater weight loss. This suggests it is the behaviour that follows food cravings rather than simply their frequency or intensity that contributes to successful weight management. This has implications for interventions to help address food cravings.


Asunto(s)
Ansia/fisiología , Ingestión de Alimentos/psicología , Obesidad/psicología , Pérdida de Peso , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Peso Corporal , Estudios Transversales , Dieta Reductora , Femenino , Preferencias Alimentarias/psicología , Conductas Relacionadas con la Salud , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Obesidad/terapia , Encuestas y Cuestionarios , Adulto Joven
8.
Pediatr Obes ; 11(6): 500-505, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26913477

RESUMEN

BACKGROUND AND OBJECTIVES: Variation in the existing literature on the psychosocial benefits of weight loss in obese youth results, in part, from methodological limitations and modest weight loss. Accordingly, this research assessed perceived self-competence and low self-esteem during an intensive weight loss programme in a large sample of obese youth and related these to starting weight, gender and weight loss. METHODS: Over 4 years, 303 obese male and female adolescents (body mass index [BMI] 34.3 kg m-2 , BMI standard deviation score 2.99; 14.7 years) attended a residential weight loss camp for a mean duration of 31 d. Outcome variables included dimensional self-esteem (Harter) and weight change over the camp. RESULTS: At the start of camp, obese youth scored highest on social acceptance and lowest on physical appearance and athletic competence. Global self-worth and most domains of self-competence improved significantly over the intervention. The proportion with low global self-worth reduced from 35% to 16%, but there was little change in the proportion reporting high self-competence (23%). Mean weight loss was -5.5 kg (BMI standard deviation scores -0.25) with boys and those heaviest at the start losing most. Weight loss was significantly correlated with improved physical appearance (r = 0.13) and athletic competence (r = 0.19), but not global self-worth. CONCLUSIONS: This intensive weight loss intervention yielded significant psychological benefit, especially in self-competence and among individuals achieving most weight loss. The weak association with weight loss suggests the influence of other contributing environmental or social features that should be the focus of further research.


Asunto(s)
Obesidad Infantil/psicología , Autoimagen , Programas de Reducción de Peso/métodos , Adolescente , Índice de Masa Corporal , Peso Corporal , Femenino , Humanos , Masculino , Obesidad Infantil/terapia , Pérdida de Peso
9.
Chem Commun (Camb) ; 52(19): 3750-3, 2016 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-26800518

RESUMEN

The porosity of a glass formed by melt-quenching a metal-organic framework, has been characterized by positron annihilation lifetime spectroscopy. The results reveal porosity intermediate between the related open and dense crystalline frameworks ZIF-4 and ZIF-zni. A structural model for the glass was constructed using an amorphous polymerization algorithm, providing additional insight into the gas-inaccessible nature of porosity and the possible applications of hybrid glasses.

10.
J Hum Nutr Diet ; 29(3): 281-9, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26400798

RESUMEN

BACKGROUND: Cravings in pregnancy are considered to alter dietary intake; however, the nutritional consequences are unknown. The present study aimed to investigate the prevalence of food cravings in pregnancy, and their contribution, as a potentially modifiable determinant of weight gain and the development of obesity in pregnancy. METHODS: Healthy pregnant women were participants in the Belfast cohort of the Hyperglycaemia and Adverse Pregnancy Outcome study (HAPO), a prospective observational study examining maternal glycaemia and pregnancy outcome. Diet was assessed at an average of 29 weeks of gestation using a self-administered validated food frequency questionnaire over the previous 2 weeks that included questions on food cravings experienced at any time during pregnancy. Clinical measurements collected included, height, weight, blood glucose and neonatal outcomes. Mean daily nutrient intakes were analysed with appropriate software. RESULTS: Food cravings were reported by 39% (n = 635) of women, with sweet foods, fruit and dairy products most frequently consumed. Those who craved foods had a higher mean (SD) energy intake [9721 (3016) kJ] (P = 0.002) even when under-reporters were removed [10131 (2875) kJ] (P = 0.008). However, no differences were found in nutrient or food intake between groups when adjusted for energy. Similarly, no differences were observed between groups and glycaemic control, anthropometric measurements or offspring outcome measures. CONCLUSIONS: Cravings commonly occur in pregnancy and contributed to a small increase in energy intake; however, this did not impact on overall dietary intake, nor was it associated with excessive gestational weight gain, maternal glycaemia or offspring outcome measurements.


Asunto(s)
Ansia/fisiología , Dieta/psicología , Alimentos , Fenómenos Fisiologicos Nutricionales Maternos/fisiología , Aumento de Peso , Adulto , Glucemia/análisis , Registros de Dieta , Ingestión de Energía , Femenino , Humanos , Hiperglucemia/complicaciones , Irlanda del Norte , Obesidad/complicaciones , Obesidad/psicología , Embarazo , Complicaciones del Embarazo , Resultado del Embarazo , Estudios Prospectivos , Encuestas y Cuestionarios , Población Blanca
11.
Pediatr Obes ; 11(5): 418-24, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-26493156

RESUMEN

BACKGROUND: While research has investigated negative stereotyping of fat body shapes, little has focused on young children's understanding of the mechanisms, motivations and consequences of weight change. OBJECTIVES: To investigate children's understanding of how weight change is achieved, people's motivation for weight change, and the consequences of weight loss or weight gain. METHODS: One hundred children (mean age 5.2, 38 girls) read a book in which one of the main characters (male/female according to the child's sex) was either healthy weight or overweight. Afterwards, this character was described as gaining or losing weight, and drawings which depicted the child in the story as either healthy weight or overweight were presented to the child and discussed. An audio-recorded semi-structured interview followed and transcripts were analysed using thematic analysis. RESULTS: Nearly all children described the weight/shape change and attributed this to food more frequently than exercise. Weight loss was viewed positively and both motivations and consequences grouped under two master themes (physical and social reasons). No clear gender differences were observed in these responses. CONCLUSIONS: Talking with 5-year-olds showed them to be observant and knowledgeable, especially about motivations for and consequences of weight change. For those working to improve children's health literacy, this suggests receptiveness to early and fact-based education.


Asunto(s)
Imagen Corporal/psicología , Peso Corporal , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud/estadística & datos numéricos , Sobrepeso/psicología , Índice de Masa Corporal , Niño , Preescolar , Ejercicio Físico , Femenino , Humanos , Masculino , Motivación , Aumento de Peso
12.
Br J Radiol ; 88(1049): 20140670, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25710283

RESUMEN

OBJECTIVE: To analyse imaging features of subtypes of Castleman disease (CD), emphasizing differentiating features from lymphoma. METHODS: Institutional review board-approved, Health Insurance Portability and Accountability Act compliant, retrospective study examined 30 patients with CD. 30 patients (females, 20; mean age, 46 years; range, 22-87 years) with histopathologically confirmed CD and pre-treatment imaging formed the analytic cohort. Imaging at presentation in all patients [CT, 30; positron emission tomography (PET)/CT, 5; MR, 4; ultrasound, 3] and subsequent imaging in three cases that developed lymphoma was reviewed by two radiologists in consensus. RESULTS: Subtypes: hyaline-vascular (n = 18); multicentric not otherwise specified (NOS) (n = 6); human herpesvirus 8 associated (n = 2); mixed unicentric (n = 2); pure plasma-cell variant (n = 1); and unicentric NOS (n = 1). Distribution: unicentric (n = 17); and multicentric (n = 13). Nodal sites-unicentric: 13 thoracic, 3 abdominal and 1 cervical; multicentric: 9 abdominal, 8 thoracic, 6 cervical, 5 inguinal, 4 axillary and 4 supraclavicular. On CT, differentiating features from lymphoma were calcification (n = 8; 26.7%) and heterogeneous enhancement (n = 5; 19.2%). No association between CD subtype, degree or enhancement pattern, or calcification was noted. On PET/CT (n = 5), nodes were typically fluorine-18 fludeoxyglucose avid (n = 4). On ultrasound (n = 3), nodes were hypoechoic, homogeneous with posterior acoustic enhancement. On MR (n = 4), nodes were hypointense (n = 2) to isointense (n = 2) on T1 weighted images and isointense (n = 1) to hyperintense (n = 3) on T2 weighted images. All (n = 4) demonstrated homogeneous enhancement. Three cases developed non-Hodgkin's lymphoma, two of the three had larger spleens, and these cases had effusions/ascites. CONCLUSION: CD can be unicentric or multicentric and involve nodes above and below the diaphragm. Patients with CD can develop lymphoma. ADVANCES IN KNOWLEDGE: Assessing individual risk of developing lymphoma in patients with CD is difficult, although the findings of splenomegaly, pleural effusion and ascites may be suggestive.


Asunto(s)
Enfermedad de Castleman/diagnóstico , Imagen Multimodal , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad de Castleman/patología , Diagnóstico Diferencial , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
13.
J Minim Invasive Gynecol ; 22(6S): S117, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-27678611
14.
J Appl Microbiol ; 117(6): 1614-33, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25196092

RESUMEN

AIMS: Decontamination and remediation of a site contaminated by the accidental or intentional release of fully virulent Bacillus anthracis spores are difficult, costly and potentially damaging to the environment. Development of novel decontamination strategies that have minimal environmental impacts remains a high priority. Although ungerminated spores are amongst the most resilient organisms known, once exposed to germinants, the germinating spores, in some cases, become susceptible to antimicrobial environments. We evaluated the concept that once germinated, B. anthracis spores would be less hazardous and significantly easier to remediate than ungerminated dormant spores. METHODS AND RESULTS: Through in vitro germination and sensitivity assays, we demonstrated that upon germination, B. anthracis Ames spores and Bacillus thuringiensis Al Hakam spores (serving as a surrogate for B. anthracis) become susceptible to environmental stressors. The majority of these germinated B. anthracis and B. thuringiensis spores were nonviable after exposure to a defined minimal germination-inducing solution for prolonged periods of time. Additionally, we examined the impact of potential secondary disinfectant strategies including bleach, hydrogen peroxide, formaldehyde and artificial UV-A, UV-B and UV-C radiation, employed after a 60-min germination-induction step. Each secondary disinfectant employs a unique mechanism of killing; as a result, germination-induction strategies are better suited for some secondary disinfectants than others. CONCLUSIONS: These results provide evidence that the deployment of an optimal combination strategy of germination-induction/secondary disinfection may be a promising aspect of wide-area decontamination following a B. anthracis contamination event. SIGNIFICANCE AND IMPACT OF THE STUDY: By inducing spores to germinate, our data confirm that the resulting cells exhibit sensitivities that can be leveraged when paired with certain decontamination measures. This increased susceptibility could be exploited to devise more efficient and safe decontamination measures and may obviate the need for more stringent methods that are currently in place.


Asunto(s)
Bacillus anthracis/fisiología , Bacillus thuringiensis/fisiología , Descontaminación/métodos , Bacillus anthracis/efectos de los fármacos , Bacillus anthracis/efectos de la radiación , Bacillus anthracis/ultraestructura , Bacillus thuringiensis/efectos de los fármacos , Bacillus thuringiensis/efectos de la radiación , Bacillus thuringiensis/ultraestructura , Desinfectantes/farmacología , Desinfección , Formaldehído/farmacología , Humanos , Peróxido de Hidrógeno/farmacología , Esporas Bacterianas/efectos de los fármacos , Esporas Bacterianas/crecimiento & desarrollo , Esporas Bacterianas/efectos de la radiación , Esporas Bacterianas/ultraestructura , Rayos Ultravioleta
15.
Pregnancy Hypertens ; 4(3): 235, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26104624

RESUMEN

UNLABELLED: Dietary cravings alter food intake however the nutritional and anthropometric consequences are unknown. This study aimed to assess the prevalence and types of foods craved during pregnancy and secondly to compare the anthropometric, clinical characteristics and nutritional intakes of women with and without food cravings. METHODS: Healthy pregnant women were participants in the Belfast cohort of Hyperglycaemic and Adverse Pregnancy Outcome study (HAPO), a prospective observational study examining maternal glycaemia and pregnancy outcome. Diet was assessed using a validated semi-quantitative food frequency questionnaire at 29weeks gestation which included subjective questions on food cravings. Mean daily nutrient intakes were analysed using Q Builder nutritional software (Tinuviel Software, UK) and SPSS Version 20. RESULTS: Data were available for 1639 women, mean age 30 (SD 5.5) years; mean BMI at booking (<16weeks gestation) 25.6kg/m(2) (range 16.5-50.8) of which 39% (n=635) experienced food cravings. Women who craved foods had a higher mean daily energy intake (9721kJ+3016) (p=0.002) and gained more weight (9.55kg+5.4) (p=0.049) throughout pregnancy than those who did not experience food cravings (9256kJ+2786 and 8.95kg+5.4 respectively). Women who were overweight (30%) or obese (16%) at booking, did not differ in their likelihood of reporting cravings to those who were under- or normal weight at booking. CONCLUSION: Cravings occur commonly in pregnancy and those women who craved foods had a higher mean energy intake and gained more weight throughout pregnancy than those who did not crave foods. This study was supported by a grant from Sugar Nutrition UK.

16.
Clin Obes ; 4(6): 324-32, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25826162

RESUMEN

Primary care referral to commercial weight loss programmes that follow best practice is included in current UK guidance on the management of adult obesity. This study investigated whether such a programme was cost-effective compared with usual care. A decision-analytical Markov model was developed to estimate the lifetime costs and benefits of the referral programme compared with usual care and enable a cost-utility analysis. The model cohort transited between body mass index classifications and type 2 diabetes, stroke and myocardial infarction (MI) with risk, cost and effect parameter values taken from published literature. The cost per incremental quality-adjusted life year (QALY) was calculated. Extensive deterministic and scenario sensitivity analyses and probabilistic sensitivity analyses (PSA) were conducted. At 12 months, the incremental cost-effectiveness ratio was £6906, indicating that programme referral was cost-effective. Over a lifetime, referral to the commercial programme was dominant as it led to a cost saving of £924 and conferred incremental benefit (0.22 QALY) over usual care. Model simulations estimated lower lifetime rates of type 2 diabetes, stroke and MI as a result of the weight loss achieved. The results were robust to extensive sensitivity analyses. The PSA indicated that programme referral had a 68% chance of being cost-effective at a willingness to pay per incremental QALY threshold of £20,000. Referral to the programme dominated usual care, being both cheaper and more effective. These results compare favourably with economic evaluations of other obesity interventions and add to a growing evidence base on the cost-effectiveness of commercial weight loss providers and practices.


Asunto(s)
Obesidad/economía , Atención Primaria de Salud/economía , Derivación y Consulta/economía , Programas de Reducción de Peso/economía , Adulto , Estudios de Cohortes , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Obesidad/terapia , Calidad de Vida , Pérdida de Peso
17.
Clin Obes ; 4(3): 136-42, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25826768

RESUMEN

Food cravings are common post-bariatric surgery, suggested as predictors of relapse and weight regain, but relatively unstudied, especially in the longer term. The present study investigated the frequency and nature of food craving experiences after gastric surgery in comparison with non-surgical control participants. Participants were 21 women, 4-38 months post-surgery (mean age = 44 years, 9 following gastric banding, 12 after Roux-en-Y gastric bypass), and two comparison samples of 39 overweight dieters and 33 normal weight non-dieters. They completed a food craving record after every food craving, a daily mood assessment and a food diary over a 7-day period. Over the 299 craving episodes, savoury foods were the most commonly craved (40% of craving events), followed by chocolate (31%). Post-bariatric patients reported more and stronger cravings than normal weight non-dieters but at a similar frequency and strength to overweight dieters. Neither hunger nor negative mood distinguished the food cravings of post-bariatric patients from those of comparison participants, nor did the proportion that led to eating (58%). Food cravings should be anticipated post-bariatric surgery but no more so at 12 months post-surgery than by other overweight or obese individuals. Food cravings are not the product of extreme hunger nor do they have the connection with negative mood seen in disordered eating. In addition, the ability to fulfil cravings by eating the craved food is reduced by the surgery itself, although the duration of surgical restraint is uncertain.


Asunto(s)
Ansia , Obesidad/psicología , Obesidad/cirugía , Sobrepeso/psicología , Sobrepeso/cirugía , Adulto , Anciano , Apetito , Cirugía Bariátrica , Femenino , Preferencias Alimentarias , Humanos , Hambre , Persona de Mediana Edad , Obesidad/fisiopatología , Sobrepeso/fisiopatología , Estudios Prospectivos , Autoinforme
18.
Br J Pharmacol ; 170(3): 679-92, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23902406

RESUMEN

BACKGROUND AND PURPOSE: Epilepsy is the most prevalent neurological disease and is characterized by recurrent seizures. Here, we investigate (i) the anticonvulsant profiles of cannabis-derived botanical drug substances (BDSs) rich in cannabidivarin (CBDV) and containing cannabidiol (CBD) in acute in vivo seizure models and (ii) the binding of CBDV BDSs and their components at cannabinoid CB1 receptors. EXPERIMENTAL APPROACH: The anticonvulsant profiles of two CBDV BDSs (50-422 mg·kg(-1) ) were evaluated in three animal models of acute seizure. Purified CBDV and CBD were also evaluated in an isobolographic study to evaluate potential pharmacological interactions. CBDV BDS effects on motor function were also investigated using static beam and grip strength assays. Binding of CBDV BDSs to cannabinoid CB1 receptors was evaluated using displacement binding assays. KEY RESULTS: CBDV BDSs exerted significant anticonvulsant effects in the pentylenetetrazole (≥100 mg·kg(-1) ) and audiogenic seizure models (≥87 mg·kg(-1) ), and suppressed pilocarpine-induced convulsions (≥100 mg·kg(-1) ). The isobolographic study revealed that the anticonvulsant effects of purified CBDV and CBD were linearly additive when co-administered. Some motor effects of CBDV BDSs were observed on static beam performance; no effects on grip strength were found. The Δ(9) -tetrahydrocannabinol and Δ(9) -tetrahydrocannabivarin content of CBDV BDS accounted for its greater affinity for CB1 cannabinoid receptors than purified CBDV. CONCLUSIONS AND IMPLICATIONS: CBDV BDSs exerted significant anticonvulsant effects in three models of seizure that were not mediated by the CB1 cannabinoid receptor and were of comparable efficacy with purified CBDV. These findings strongly support the further clinical development of CBDV BDSs for the treatment of epilepsy.


Asunto(s)
Anticonvulsivantes/farmacología , Encéfalo/efectos de los fármacos , Cannabinoides/farmacología , Cannabis , Extractos Vegetales/farmacología , Convulsiones/prevención & control , Animales , Anticonvulsivantes/metabolismo , Encéfalo/metabolismo , Encéfalo/fisiopatología , Cannabidiol/farmacología , Cannabinoides/metabolismo , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Fuerza de la Mano , Masculino , Ratones , Ratones Endogámicos DBA , Actividad Motora/efectos de los fármacos , Ruido/efectos adversos , Pentilenotetrazol , Fitoterapia , Pilocarpina , Extractos Vegetales/metabolismo , Plantas Medicinales , Unión Proteica , Ratas , Ratas Endogámicas WKY , Receptor Cannabinoide CB1/efectos de los fármacos , Receptor Cannabinoide CB1/metabolismo , Convulsiones/etiología , Convulsiones/metabolismo , Convulsiones/fisiopatología
19.
Int J Obes (Lond) ; 37(3): 468-72, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22584456

RESUMEN

This paper reports the final 24-month outcomes of a randomized controlled trial evaluating the effect of additional therapeutic contact (ATC) as an adjunct to a community-based weight-management program for overweight and obese 13-16-year-olds. ATC involved telephone coaching or short-message-service and/or email communication once per fortnight. Adolescents were randomized to receive the Loozit group program-a two-phase behavioral lifestyle intervention with (n=73), or without (n=78), ATC in Phase 2. Adolescents/parents separately attended seven weekly group sessions (Phase 1), followed by quarterly adolescent sessions (Phase 2). Assessor-blinded, 24-month changes in anthropometry and metabolic health included primary outcomes body mass index (BMI) z-score and waist:height ratio (WHtR). Secondary outcomes were self-reported psychosocial and lifestyle changes. By 24 months, 17 adolescents had formally withdrawn. Relative to the Loozit program alone, ATC largely had no impact on outcomes. Secondary pre-post assessment of the Loozit group program showed mean (95% CI) reductions in BMI z-score (-0.13 (-0.20, -0.06)) and WHtR (-0.02 (-0.03, -0.01)) in both arms, with several metabolic and psychosocial improvements. Adjunctive ATC did not provide further benefits to the Loozit group program. We recommend that further work is needed to optimize technological support for adolescents in weight-loss maintenance. Australian New Zealand Clinical Trials Registry Number ACTRNO12606000175572.


Asunto(s)
Terapia Conductista/métodos , Consejo Dirigido/métodos , Obesidad/terapia , Teléfono , Programas de Reducción de Peso/métodos , Adolescente , Conducta del Adolescente , Servicios de Salud del Adolescente , Australia/epidemiología , Índice de Masa Corporal , Femenino , Humanos , Estilo de Vida , Masculino , Obesidad/epidemiología , Obesidad/psicología , Envío de Mensajes de Texto , Pérdida de Peso
20.
Br J Pharmacol ; 167(8): 1629-42, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22970845

RESUMEN

BACKGROUND AND PURPOSE: Phytocannabinoids in Cannabis sativa have diverse pharmacological targets extending beyond cannabinoid receptors and several exert notable anticonvulsant effects. For the first time, we investigated the anticonvulsant profile of the phytocannabinoid cannabidivarin (CBDV) in vitro and in in vivo seizure models. EXPERIMENTAL APPROACH: The effect of CBDV (1-100 µM) on epileptiform local field potentials (LFPs) induced in rat hippocampal brain slices by 4-aminopyridine (4-AP) application or Mg(2+) -free conditions was assessed by in vitro multi-electrode array recordings. Additionally, the anticonvulsant profile of CBDV (50-200 mg·kg(-1) ) in vivo was investigated in four rodent seizure models: maximal electroshock (mES) and audiogenic seizures in mice, and pentylenetetrazole (PTZ) and pilocarpine-induced seizures in rats. The effects of CBDV in combination with commonly used antiepileptic drugs on rat seizures were investigated. Finally, the motor side effect profile of CBDV was investigated using static beam and grip strength assays. KEY RESULTS: CBDV significantly attenuated status epilepticus-like epileptiform LFPs induced by 4-AP and Mg(2+) -free conditions. CBDV had significant anticonvulsant effects on the mES (≥100 mg·kg(-1) ), audiogenic (≥50 mg·kg(-1) ) and PTZ-induced seizures (≥100 mg·kg(-1) ). CBDV (200 mg·kg(-1) ) alone had no effect against pilocarpine-induced seizures, but significantly attenuated these seizures when administered with valproate or phenobarbital at this dose. CBDV had no effect on motor function. CONCLUSIONS AND IMPLICATIONS: These results indicate that CBDV is an effective anticonvulsant in a broad range of seizure models. Also it did not significantly affect normal motor function and, therefore, merits further investigation as a novel anti-epileptic in chronic epilepsy models. LINKED ARTICLES: This article is part of a themed section on Cannabinoids. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.167.issue-8.


Asunto(s)
Anticonvulsivantes/uso terapéutico , Cannabinoides/uso terapéutico , Cannabis , Fitoterapia , Convulsiones/tratamiento farmacológico , Animales , Anticonvulsivantes/farmacología , Cannabinoides/farmacología , Modelos Animales de Enfermedad , Femenino , Hipocampo/efectos de los fármacos , Hipocampo/fisiología , Técnicas In Vitro , Masculino , Ratones , Ratones Endogámicos DBA , Ratones Endogámicos ICR , Actividad Motora/efectos de los fármacos , Pentilenotetrazol , Pilocarpina , Ratas , Ratas Endogámicas WKY , Convulsiones/inducido químicamente , Convulsiones/fisiopatología
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