Body image evaluations in women smokers.

While body image has been found to be an important predictor for several health behaviors (abnormal dieting. weight regain, exercise), only one study to date has examined body image attitudes in women smokers (Australian sample) with results suggesting that women smokers feel less attractive than nonsmokers. The purpose of the present study was to compare body image in women smokers to normative samples of women. Subjects were 136 women (89.0% White, M age = 39.85, 74% employed. 52% married, body mass index [BMI] = 25.54) entering a randomized clinical smoking cessation trial. Subjects completed the Appearance Evaluation and Fitness Orientation subscales of the Multidimensional Body-Self Relations Questionnaire and the Silhouette Choosing Task. Pooled t-tests showed that subjects scored significantly lower on Appearance Evaluation (t = -6.58, p < .01) and Fitness Orientation (t = -5.55, p < .01) than the normative sample. For the silhouette choosing task, the present sample reported a significantly higher current silhouette (t = 2.29, p < .05) and dissatisfaction score (t = 4.04, p < .01) than the comparative sample. There were no significant differences on the ideal or attraction scores. Results suggest that women smokers may be more dissatisfied with their bodies than women in general. Possible implications include that smoking may adversely affect body image and/or body image concerns may negatively impact cessation attempts.

Predictors of exercise relapse in a college population.

Exercise improves physical and mental health. Nevertheless, most 20-year-olds do not exercise, and approximately 50% of the participants in exercise programs drop out in the first 3 to 6 months. In view of the health benefits of exercise, college health educators and clinicians need to be able to identify factors that predict exercise relapse in a student population. The authors administered questionnaires measuring Prochaska's 10 processes of change for exercise, self-efficacy, and decisional balance to 52 physically active undergraduate students. They assessed baseline exercise levels in October and reassessed them about 8 weeks later. At baseline, relapsers had significantly lower self-efficacy scores than those who maintained their exercise levels. The relapsers also had higher perceived negative views of exercise. These findings provide support for applying the transtheoretical model of behavioral change to a college population.

Body image evaluations in obese females with binge eating disorder.

Dimensions of body image in a sample of obese women diagnosed with binge eating disorder (BED; N=42) were compared with a sample of obese women without BED (non-BED; N=42), matched on age and BMI. Additionally, the relationship between BED, body image and several dimensions of treatment response was examined. Results indicated BED women were more likely to negatively evaluate their global physical appearance and have less satisfaction with specific areas of the body than were non-BED women, even after controlling for depression scores. While BED women were significantly more likely to endorse depressive symptoms, depression scores were negatively correlated with body satisfaction in non-BED women only. BED women did not fare worse in formal weight-loss treatment, as measured by length of time in treatment, group-therapy attendance, or BMI at posttreatment. The role of body image in women with BED seeking weight-loss treatment is discussed relevant to the context of potential impact of BED and negative body image on active weight-loss treatment and maintenance.

Eating self-efficacy and weight cycling: a prospective clinical study.

Previous retrospective studies have not identified global psychosocial consequences of weight cycling. These lack of findings may be due to limitations associated with retrospective research or with using general psychological measures rather than weight-specific measures. This prospective study examined changes in a weight-specific measure, eating self-efficacy, using an obese clinical population who returned to a multidisciplinary weight management program subsequent to weight regain. Subjects did not demonstrate any change in eating self-efficacy despite experiencing weight loss and then weight regain. Individuals returning for treatment may be a select population, thus suggesting that there may not be negative psychological effects of weight cycling for all individuals. Implications for further research are discussed.

Exercise effects on withdrawal and mood among women attempting smoking cessation.

This study investigated both acute and longer term ("chronic") effects of vigorous exercise training on affect, nicotine withdrawal, and cigarette craving among women enrolled in a smoking cessation research study. All subjects participated in a 12-week cognitive behavioral smoking cessation program and were randomly assigned to attend three sessions per week of either a vigorous exercise program or contact control. Measures of positive and negative affect, cigarette craving, and nicotine withdrawal were administered immediately before, and again immediately after the final exercise or contact session each week of the program. Study I enrolled 24 women who had been assigned to the exercise condition. Significant reductions in negative affect, nicotine withdrawal and cigarette craving were observed following exercise most weeks of the program. No significant changes in positive affect were observed. In Study II this protocol was repeated among 62 women (44 exercise, 18 contact control) in two consecutive cohorts of the larger study. Significant reduction were observed in negative affect, nicotine withdrawal and cigarette craving during most weeks of the program among exercise subjects but not contact condition subjects. No chronic (baseline to posttreatment) changes in positive or negative affect, cigarette craving or withdrawal symptoms were observed in either study. Vigorous exercise appears to produce acute improvements in withdrawal symptoms, cigarette craving, and negative affect among sedentary women attempting to quit smoking.

The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial.

BACKGROUND: Smoking prevalence rates among women are declining at a slower rate than among men. OBJECTIVE: To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation. METHODS: Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group-based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively). RESULTS: Compared with control subjects (n = 147), exercise subjects (n = 134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P = .03) and 3 months (16.4% vs 8.2%, P=.03) and 12 months (11.9% vs 5.4%, P=.05) following treatment. Exercise subjects had significantly increased functional capacity (estimated VO2 peak, 25+/-6 to 28+/-6, P<.01) and had gained less weight by the end of treatment (3.05 vs 5.40 kg, P = .03). CONCLUSIONS: Vigorous exercise facilitates short- and longer-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program. Vigorous exercise improves exercise capacity and delays weight gain following smoking cessation.

Weight control smoking among sedentary women.

This study examined characteristics associated with weight control smoking among 281 sedentary women enrolled in a smoking cessation trial. A series of regression models were developed to identify predictors of weight control smoking as measured by the Smoking Situations Questionnaire. Predictor variables included demographic variables, dietary intake, weight gain following previous quit attempts, dietary restraint, self-efficacy for weight management, smoking behavior, exercise behavior, negative affect and psychological constructs relevant to smoking cessation, and exercise adoption. In the final predictor model, anticipation of weight gain in the current quit attempt, higher dietary restraint, younger age, greater Fagerstrom scores, greater number of pounds gained in previous quit attempts, and lower levels of self-efficacy to manage weight in negative affect situations were associated with smoking for weight control. Treatment implications for women who smoke for weight control reasons are discussed.

History of depression and subsyndromal depression in women smokers.

While Major Depressive Disorder (MDD) is associated with difficulty quitting smoking, few studies have examined the role of subsyndromal depression (SubD). We examined pretreatment differences in smoking, weight concerns, and negative affect among three groups of women (N = 281) enrolling in a smoking cessation program who responded to a self-report questionnaire about the lifetime presence of MDD symptoms: self-report positive for MDD, self-report positive for SubD, and self-report negative for depression (fulfilling either DSM-III-R symptom or duration criteria, but not both). Compared to MDD Subjects (Ss), SubD Ss were more likely to report eating disordered behaviors. Compared to Non-Depressed (Non-Dep) Ss, SubD Ss initiated smoking earlier, and reported greater previous withdrawal symptoms, more eating disordered behaviors, and higher anxiety, depression, and stress. Compared to Non-Dep Ss, MDD Ss reported a greater smoking rate during their heaviest usage period, greater previous withdrawal symptoms, lower self-efficacy to manage food intake (especially during negative affect situations), and greater depression and anxiety. Many of these significant differences disappeared when SubD Ss were combined with Non-Dep Ss and compared with MDD Ss as is done traditionally. SubD does not appear to be on a continuum with Non-Dep and MDD groups, but rather warrants further investigation as a discrete subset of smokers. The implications for assessment and treatment are discussed.

Rationale, design, and baseline data for Commit to Quit: an exercise efficacy trial for smoking cessation among women.

BACKGROUND: The Commit to Quit trial was designed to address the methodological problems of prior studies that have examined the contribution of exercise to smoking cessation. METHODS: This paper provides an overview of the study design and describes the sample of women who participated in this trial (N = 281). Interrelationships among eating, exercise, and smoking behavior are examined. RESULTS: Subjects randomized into the study compared with the sample of women who completed the initial assessment but were not randomized were more likely to be white, to have at least a high school education, and to smoke fewer cigarettes per day. Overall, the most frequent ineligibility criteria were health-related issues and scheduling conflicts. On average, participants in this study smoked more cigarettes per day than national samples of women smokers. Significant interrelationships include the positive association of motivational readiness for quitting smoking and enhanced levels of dietary restraint and the positive association of motivational readiness for exercise adoption and high levels of weight concern. CONCLUSIONS: This study represents the first adequately powered randomized controlled clinical trial comparing the relative efficacy of a cognitive-behavioral smoking cessation treatment plus vigorous exercise with the same treatment plus contact control.

Minority women and tobacco: implications for smoking cessation interventions.

Quitting smoking is the single most important preventive health behavior a woman can perform to significantly reduce her chances of morbidity and premature mortality. Minority women are an extremely important population to target for smoking cessation intervention. Rates and risk factors for cardiovascular diseases and cancer are markedly higher among women of certain minority groups. In addition, smoking prevalence rates in women of some ethnic groups are elevated relative to the majority population of women, and specific groups have displayed slower rates of decline in smoking. Furthermore, minority women tend to have less access and appear to be less responsive to smoking cessation programs aimed at the majority culture. Thus, consideration of the practical and cultural needs of ethnic minority women is imperative when designing smoking intervention programs. This article describes the smoking behaviors of African-American, American Indian and Native Alaskan, Asian and Pacific Islander, and Hispanic women smokers, in order to gain a greater understanding of the treatment needs of these women. Information on prevalence rates and smoking patterns, barriers to quitting, and findings from intervention studies within each population are reviewed as well as recommendations for smoking cessation treatment.

Perceived changes in sexual functioning and body image following weight loss in an obese female population: a pilot study.

This study assessed perceived changes in sexual behavior and body image after weight loss in a clinically obese population. Thirty-two women enrolled in a hospital-based multidisciplinary weight management program completed retrospective questionnaires about their sexual functioning and body image before and after weight loss. Subjects reported significant increases in the frequency of their sexual activity. Subjects also perceived significant improvements in their body image. These findings suggest that obese people experience positive changes in sexual functioning and body image after weight loss.

Theories and techniques for promoting physical activity behaviours.

The primary goal of this article is to review theoretical models utilised in designing physical activity interventions for healthy adults. Physical activity offers numerous benefits for improved physical and psychological health. However, the majority of the population is sedentary and therefore at increased risk for morbidity and mortality. Many techniques have been developed for intervening with physical activity behaviours, some of which are based on theoretical models. While some of these models show more promise than others, no model is sufficient to thoroughly explain exercise behaviours or how to best intervene. In the final section, recommendations for future research are presented, and promising areas of development in physical activity interventions are discussed. This is not an exhaustive review of theoretical models but rather focuses on models most commonly applied to physical activity.

Cognitive-behavioral mediators of changing multiple behaviors: smoking and a sedentary lifestyle.

BACKGROUND: A significant percentage of the U.S. population has multiple poor health behaviors. Understanding the relationship among these behavioral risk factors is important for designing effective multiple risk factor interventions. While there is some evidence suggesting that participation in physical exercise may have a positive impact on smoking cessation, there is much to be learned about the relationships between cognitive-behavioral (self-efficacy, decisional-balance) and motivational mechanisms (stage of change) which have been shown to mediate changes in both exercise and smoking behavior. METHODS: The sample comprised 332 smokers employed at two workplaces-a government agency and a medical center-recruited as part of a larger worksite health promotion project and who completed questionnaires on their smoking and exercise behaviors. RESULTS: The results revealed significant relationships between smoking variables and exercise variables. Smokers who rated as important the positive benefits of smoking also rated as important the costs associated with increased physical activity. Similarly, the negative consequences of smoking were significantly associated with the positive benefits of physical activity. Self-efficacy for one behavior was significantly associated with self-efficacy for the other. Significant differences by exercise and smoking stage of change were found on the cross-behavior sets of variables (self-efficacy, pros, cons). Smokers who were contemplating a more active lifestyle reported the negative consequences of smoking to be significantly more important to them than smokers who were not considering adoption of a more active lifestyle. Smokers who were exercising regularly reported significantly more confidence in their ability to refrain from smoking than smokers not exercising regularly. Finally, smokers preparing for quitting reported less confidence in their ability to exercise than smokers who had already taken action to change their smoking behavior. CONCLUSIONS: The cognitive mechanisms associated with changes in smoking behavior are related to the cognitive variables which have been shown to predict changes in exercise behavior. Significant relationships in mediating mechanisms including decisional balance and self-efficacy between smoking and exercise provide preliminary information on how change in one risk behavior may relate to change in another. These associations have implications for future intervention research and for methods research on multiple risk factors interactions.

Depression, smoking, activity level, and health status: pretreatment predictors of attrition in obesity treatment.

Consistent predictors of attrition in obesity treatment have not been identified. This study examined whether pretreatment psychological and health behavior variables would predict attrition from a 26 week clinical multidisciplinary VLCD and behavior therapy program. Higher levels of depression, current smoking, being sedentary, and having nontreated high blood pressure were associated with treatment attrition. Thus, a biopsychosocial assessment which evaluates medical and psychiatric status may help clinicians to identify individuals at high risk for attrition.

History of sexual abuse and obesity treatment outcome.

In this study, clinical data from 22 obese women who reported a history of sexual abuse were compared to clinical data from 22 obese women who denied a history of sexual abuse. Subjects were matched for body mass index (BMI), sex, and age. All subjects were enrolled in a multidisciplinary outpatient hospital-based very-low-calorie diet (VLCD) weight-management program. Subjects completed a structured clinical interview, the Beck Depression Inventory (BDI), and the Weight Efficacy Life-Style Questionnaire (WEL). Subjects with a history of sexual abuse lost significantly less weight and reported more episodes of nonadherence. Possible explanations for these findings include both psychiatric distress and low weight self-efficacy. The difference between the groups in self-efficacy was greatest in situations involving negative affect or physical discomfort.

Variability of arterial PO2 in hospitalized patients: implications for clinical practice and research.

The effects of position and ventilation on variability of PO2 in hospitalized patients were studied using a cross-over design. Arterial blood gases were obtained for 51 patients while they were lying and while they were sitting, and after five deep breaths (lying). The PO2 generally increased after five deep breaths but was not systematically changed by sitting up. Nineteen patients (37%) had changes in PO2 greater than or equal to 10 mm Hg. The patient's mean PO2 and respiratory rate influenced these differences. Among patients with a mean PO2 less than 85 mm Hg whose respiratory rates were greater than 20/min, only 11% had a change in PO2 greater than or equal to 10 mm Hg. In contrast, among patients with a mean PO2 greater than 85 mm Hg and a respiratory rate less than 20/min, 60% had a change in PO2 greater than or equal to 10 mm Hg. Considerable variability in PO2 is introduced by commonly encountered changes in position and ventilation. These conditions must be standardized when serial blood gas results are used to assess changes in a patient's condition.

Human alveolar macrophages produce leukotriene B4.

Human alveolar macrophages obtained by bronchoalveolar lavage were labeled overnight with [3H]arachidonic acid. The cells were stimulated with calcium ionophore A23187, and the 20:4 oxygenated metabolites released into the culture medium were identified by reverse-phase HPLC. Leukotriene B4 was the major 20:4 metabolite produced by these cultures. Leukotriene B4 was identified by its reverse-phase HPLC elution time, its UV spectrum, and its chemotactic and chemokinetic activities for neutrophils. In addition, the macrophage- and neutrophil-derived leukotriene B4 free acids and methyl esters were found to have identical HPLC retention times.

Diffusing capacity in idiopathic scoliosis and its interpretation regarding alveolar development.

We measured lung volumes, diffusing capacity by the single breath method (DL), membrane permeability (DM), and capillary blood volume (Vc) in 22 subjects with idiopathic scoliosis (mean angle of curvature, 66 degrees). Compared with an age-matched group, vital capacity, total lung capacity, and functional residual capacity were respectively, 21% (p less than 0.0001), 18% (p less than 0.01), and 15% (p less than 0.05) lower. The DL was 17% lower (p less than 0.01), but specific DL (DL divided by alveolar volume = DLVA) was the same. For both groups, DLVA was inversely correlated with VA. The same qualitative relationship existed between DM, Vc, their specific values, and VA except for a larger spread of Vc in the scoliotic group. The data show that DL and its components, DM and Vc, are normal in idiopathic scoliosis when reduced lung volumes are allowed for. These findings are consistent with partial failure of alveolar enlargement as a result of the thoracic deformity rather than any atrophy of the alveoli or pulmonary vasculature. Thus scoliosis results in a delay of lung development, such that in a group of symptomatic patients with moderate degrees of deformity (mean angle of curvature, 66 degrees), lung volumes and DL are about 80% of that of an age-matched control group; the alveolar characteristics of a 12-yr-old with scoliosis are therefore similar to those of a 9-yr-old normal child.