The purpose of this project was to design a concise weight loss and exercise program that could be incorporated into a typical family physician's office utilizing routine personnel and physician time commitments. The program was developed to include caloric restriction, diet instructions, behavioral modification, and patient education. It also included outlining an exercise program that was specific enough to allow patients to have a concrete amount of exercise to do but flexible enough to be applicable to all patients. The accompanying manual can serve as a general guide to all physicians who wish to instruct patients on weight loss and exercise. Where the physicians did not agree with the specific information offered in the manual they could substitute their own information but still follow the same general guidelines for use in handling patients. If used properly this program could be quite helpful for handling a very difficult and common problem for the busy family practitioner.

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Questionnaires were constructed to measure dieter's beliefs in their abilities to (1) adhere to a diet in eating situations, (2) perform various dieting behaviors, and (3) reach their dieting goals. The three questionnaires were called the Situation-, Behavior-, and Goal-Based Dieting Self-Efficacy Scales. / Preliminary work examined the reliability of the three scales. The Situtation-Based scale demonstrated a high level of test-retest reliability over a two to four week period in the two college samples. Examination of scale intercorrelations in the clinical sample indicated that the scales were correlated at only a low level, suggesting that the scales measure different aspects of the construct of dieting self-efficacy. / Results of the laboratory studies demonstrated that the Situation-Based scale was a significant predictor of how much dieters ate in response to two different types of challenges to their diets, high calorie preloads and a depressed mood induction. / The ability of the three scales to predict weight changes was examined in the clinical sample. Only the Goal-Based scale was found to predict weight change. / In summary, the present study adds to the body of literature supporting goal-based dieting self-efficacy as a significant predictor of weight change during dieting attempts. Suggestions were offered about ways to apply this finding to clinical practice, in the areas of patient selection and treatment prescription. / The present research was limited in the following ways. The laboratory studies were limited by the narrow range of subjects, and the artificiality of the eating situation. Future research should extend this finding with other populations, as well as methodologies for examining the relation between dieting self-efficacy and eating in real-life situations. The clinical study was limited by the absence of a follow-up assessment. Future research must examine the ability of dieting self-efficacy to predict weight change over longer periods of time. Finally, suggestions were made concerning the importance of future research attempting to clarify the construct of dieting self-efficacy, particularly research aimed at determining the relation between responses to these questionnaires and the actual cognitive processes engaged in by dieters in eating situations, and over the course of their weight control efforts. (Abstract shortened with permission of author.)

Our first objective was to compare deuterium incorporation and mass isotopomer distribution analysis in the measurement of in vivo cholesterol biosynthesis in humans. Twelve healthy subjects were recruited to participate in a 24 h stable isotope infusion study which mimicked temporal conditions typical of both deuterium incorporation and mass isotopomer distribution analysis techniques. Data suggest both deuterium incorporation and mass isotopomer distribution analysis accurately define cholesterol synthesis in humans when measured over a period of 24 h. / Our second objective was to examine the effects of weight loss through energy restriction upon human in vivo circulating cholesterol concentrations and synthesis using the deuterium incorporation methodology. Seven overweight subjects with a mean BMI of 30.6 +/- 1.6 kg·m-2 were recruited into a 2-phase prospective clinical trial including 3 mo on a weight stable American Heart Association Step I diet and 6 mo on an energy-reduced American Heart Association Step I diet. Data suggest that deuterium incorporation and mass isotopomer distribution analysis are equally effective methods for measuring cholesterol biosynthesis in humans, and that energy restriction resulting in modest weight loss effectively reduces endogenous cholesterol synthesis thus decreasing the risk of CVD development in obese and overweight men. (Abstract shortened by UMI.)

The purpose of this study was to determine effects of diet composition and exercise on the loss and maintenance of loss of body weight and body fat; and the protection of muscle in obese subjects. Ten subjects who were members of the Ball State University (BSU) Adult Fitness Program and/or the BSU Weight Management Program, and who were at least 120 percent of ideal body weight, participated in the one-year study.Three-day diet records collected at four-month intervals were assessed using the Nutriplanner computer data base to determine energy and nutrient composition of subjects' diets. Measures of weight, triceps skinfolds (TSF), and arm circumference were collected at three-month intervals to assess changes in weight, arm fat area (AFA), and arm muscle area (AMA). Adherence to exercise was reported by participants.The findings of this study showed that obese subjects who consumed low-fat, high-carbohydrate diets while adhering to an exercise program lost, or tended to lose, more weight and arm fat area, while experiencing an increase in arm muscle area. Further studies in this area of research are needed to assess the effects of diet composition, exclusive of exercise, on changes in fat and muscle area. In addition, work is needed to develop more reliable means of assessing food intake over an extended period of time.

Twelve highly trained collegiate wrestlers were studied to determine if performance of a six-minute arm crank task can be maintained by feeding a hypocaloric, high percentage carbohydrate diet to athletes during a four day weight loss period. Subjects were placed on a hypocaloric, low percentage (41.9%) carbohydrate diet (LC) and a hypocaloric, high percentage (65.9%) carbohydrate diet (HC) during two separate weight loss periods. The reduction in work performed during six minutes of arm cranking from pre- to post-weight loss was 0.9% and 8.2% for HC and LC treatments, respectively. Post exercise lactate measures were significantly lower and pH values were significantly higher pre- and post-weight loss under the LC treatment as compared to the HC treatment. Pre-exercise glycerol values were significantly higher post weight loss as compared to pre weight loss under both diet treatments. Profile of Mood State (POMS) scores indicate a negative effect of weight loss on psychological well being of the subjects. This negative effect is exacerbated during weight loss under the LC as compared to HC treatment. These data indicate a significant reduction in performance following a four day weight loss of 6.1% under the LC treatment, while performance is maintained following the HC treatment. / Department of Biology

Thesis (Ph. D.)--University of Rhode Island, 2005. / Typescript. Includes bibliographical references (leaves 120-130).

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