Differential Impact of Calcium and Vitamin D on Body Composition Changes in Post-Menopausal Women Following a Restricted Energy Diet and Exercise Program.

Vitamin D and calcium supplementation have been posited to improve body composition and different formulations of calcium may impact bioavailability. However, data are lacking regarding the combinatorial effects of exercise, diet, and calcium and/or vitamin D supplementation on body composition changes in post-menopausal women. Herein, 128 post-menopausal women (51.3 ± 4.5 years, 36.4 ± 5.7 kg/m2, 46.2 ± 4.5% fat) were assigned to diet and supplement groups while participating in a supervised circuit-style resistance-training program (3 d/week) over a 14-week period. Diet groups included: (1) normal diet (CTL), (2) a low-calorie, higher protein diet (LCHP; 1600 kcal/day, 15% carbohydrates, 55% protein, 30% fat), and (3) a low-calorie, higher carbohydrate diet (LCHC; 1600 kcal/day, 55% carbohydrates, 15% protein, 30% fat). Supplement groups consisted of: (1) maltodextrin (PLA), (2) 800 mg/day of calcium carbonate (Ca), and (3) 800 mg/day of calcium citrate and malate and 400 IU/day of vitamin D (Ca+D). Fasting blood samples, body composition, resting energy expenditure, aerobic capacity, muscular strength and endurance measures were assessed. Data were analyzed by mixed factorial ANOVA with repeated measures and presented as mean change from baseline [95% CI]. Exercise training promoted significant improvements in strength, peak aerobic capacity, and blood lipids. Dieting resulted in greater losses of body mass (CTL -0.4 ± 2.4; LCHC -5.1 ± 4.2; LCHP -3.8 ± 4.2 kg) and fat mass (CTL -1.4 ± 1.8; LCHC -3.7 ± 3.7; LCHP -3.4 ± 3.4 kg). When compared to LCHC-PLA, the LCHC + Ca combination led to greater losses in body mass (PLA -4.1 [-6.1, -2.1], Ca -6.4 [-8.1, -4.7], Ca+D -4.4 [-6.4, -2.5] kg). In comparison to LCHC-Ca, the LCHC-Ca+D led to an improved maintenance of fat-free mass (PLA -0.3 [-1.4, 0.7], Ca -1.4 [-2.3, -0.5], Ca+D 0.4 [-0.6, 1.5] kg) and a greater loss of body fat (PLA -2.3 [-3.4, -1.1], Ca -1.3 [-2.3, -0.3], Ca+D -3.6 [-4.8, -2.5]%). Alternatively, no significant differences in weight loss or body composition resulted when adding Ca or Ca+D to the LCHP regimen in comparison to when PLA was added to the LCHP diet. When combined with an energy-restricted, higher carbohydrate diet, adding 800 mg of Ca carbonate stimulated greater body mass loss compared to when a PLA was added. Alternatively, adding Ca+D to the LCHC diet promoted greater% fat changes and attenuation of fat-free mass loss. Our results expand upon current literature regarding the impact of calcium supplementation with dieting and regular exercise. This data highlights that different forms of calcium in combination with an energy restricted, higher carbohydrate diet may trigger changes in body mass or body composition while no impact of calcium supplementation was observed when participants followed an energy restricted, higher protein diet.

Effects of Adherence to a Higher Protein Diet on Weight Loss, Markers of Health, and Functional Capacity in Older Women Participating in a Resistance-Based Exercise Program.

Resistance training and maintenance of a higher protein diet have been recommended to help older individuals maintain muscle mass. This study examined whether adherence to a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition, markers of health, and/or functional capacity in older females in comparison to following a traditional higher carbohydrate diet or exercise training alone with no diet intervention. In total, 54 overweight and obese females (65.9 ± 4.7 years; 78.7 ± 11 kg, 30.5 ± 4.1 kg/m², 43.5 ± 3.6% fat) were randomly assigned to an exercise-only group (E), an exercise plus hypo-energetic higher carbohydrate (HC) diet, or a higher protein diet (HP) diet. Participants followed their respective diet plans and performed a supervised 30-min circuit-style resistance exercise program 3 d/wk. Participants were tested at 0, 10, and 14 weeks. Data were analyzed using univariate, multivariate, and repeated measures general linear model (GLM) statistics as well as one-way analysis of variance (ANOVA) of changes from baseline with [95% confidence intervals]. Results revealed that after 14 weeks, participants in the HP group experienced significantly greater reductions in weight (E -1.3 ± 2.3, [-2.4, -0.2]; HC -3.0 ± 3.1 [-4.5, -1.5]; HP -4.8 ± 3.2, [-6.4, -3.1]%, p = 0.003), fat mass (E -2.7 ± 3.8, [-4.6, -0.9]; HC -5.9 ± 4.2 [-8.0, -3.9]; HP -10.2 ± 5.8 [-13.2, ⁻7.2%], p < 0.001), and body fat percentage (E -2.0 ± 3.5 [-3.7, -0.3]; HC -4.3 ± 3.2 [-5.9, -2.8]; HP -6.3 ± 3.5 [-8.1, -4.5] %, p = 0.002) with no significant reductions in fat-free mass or resting energy expenditure over time or among groups. Significant differences were observed in leptin (E -1.8 ± 34 [-18, 14]; HC 43.8 ± 55 [CI 16, 71]; HP -26.5 ± 70 [-63, -9.6] ng/mL, p = 0.001) and adiponectin (E 43.1 ± 76.2 [6.3, 79.8]; HC -27.9 ± 33.4 [-44.5, -11.3]; HP 52.3 ± 79 [11.9, 92.8] µg/mL, p = 0.001). All groups experienced significant improvements in muscular strength, muscular endurance, aerobic capacity, markers of balance and functional capacity, and several markers of health. These findings indicate that a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition compared to a higher carbohydrate diet in older females.

MODERATING EFFECT OF HYPNOTIZABILITY ON HYPNOSIS FOR HOT FLASHES IN BREAST CANCER SURVIVORS.

The objective of this study was to examine the potential role of hypnotizability as a moderator of effectiveness of a hypnosis intervention for reducing hot flashes in breast cancer survivors. Sixty women were randomized into either five weekly sessions of hypnosis or a wait list control condition. Nine of the participants dropped out of the study and 24 were randomized to the control condition. There were 27 participants who completed the hypnosis intervention and for whom hypnotizability was assessed. The frequency and severity of hot flashes were measured by daily diaries completed for one week at baseline and at the end of treatment. Hypnotizability was assessed by the Stanford Hypnotic Clinical Scale. Hot flash scores were reduced by 68% on average at the end of treatment. Sequential multiple regression was used to test whether hypnotizability moderated the effect of initial hot flash scores on post-test hot flash scores. The results suggest that the hypnosis intervention was more effective for participants who scored higher on measured hypnotizability. The moderating role of hypnotizability may be useful to consider in treatment of hot flashes with the hypnosis intervention. While this study was limited to breast cancer survivors it may clarify some of the complexity of the response to hypnosis.

Perceived stress among nursing and administration staff related to accreditation.

BACKGROUND: Nurses in hospital administration and management positions may experience workplace stress, which can have important consequences on the health and well-being. PURPOSE: The aim of this study was to examine the effects of perceived stress on nursing hospital management and administrative employees of a large health care organization before and after a review by The Joint Commission on the Accreditation of Healthcare Organizations. METHODS: A total of 100 hospital employees were randomly selected to complete questionnaires assessing their perception of stress and its effect on their well-being before and after the site review. They were also asked to rate their subjective experience of sleep, anxiety, depression, and job satisfaction. RESULTS: Perceived stress was significantly related to employees' increased health concerns, symptoms of depression and anxiety, interpersonal relationships, and job satisfaction (p = .003). CONCLUSIONS: Hospital accreditation reviews may increase perceived stress and appears to be related to emotional and physical well-being. APPLICATION: The implications include evidence there is a need for organizations to initiate corrective action to help nurses in administrative roles to cope with increased levels of job strain, minimize potential psychological and physiological consequences, and preserve job satisfaction.

Preferences for hypnotic imagery for hot-flash reduction: a brief communication.

The purpose of this brief report is to identify imagery preferences of women receiving hypnotherapy to alleviate hot flashes. As part of a larger study, 51 breast cancer survivors were asked to identify their own personal preferences for imagery for reducing hot flashes. Most of the participants identified personal imagery associated with coolness; none of the participants selected imagery for warmth or heat. The most widely used was imagery involving water associated with coolness (27.0%). It is recommended that clinicians using hypnosis for reduction of hot flashes attend to patients' preferences as specific imagery may moderate the effectiveness of hypnosis for hot flashes.