The existing literature on the temporal stability of cardiovascular ambulatory monitoring data is reviewed. These studies generally show adequate reproducibility across time for blood pressure mean levels. However, the existing data on the reproducibility of blood pressure variability suggest that conventional estimates of 24-hour variability, such as standard deviation, may be very unstable from one monitoring day to the next. Several approaches are suggested for improving the estimate of variability in ambulatory data. Preliminary attempts using these approaches suggest, in contrast to earlier findings, that the temporal stability of ambulatory variability may also be quite good. More studies are recommended that use newer monitors, report heart rate data, employ multiple analytic strategies, and investigate the role of activity and behavior in the temporal stability of ambulatory levels and variability.
{"title":"Temporal Stability of Ambulatory Cardiovascular Monitoring","authors":"Marcia M. Ward, J. Rick Turner, Derek W. Johnston","doi":"10.1093/abm/16.1.3","DOIUrl":"https://doi.org/10.1093/abm/16.1.3","url":null,"abstract":"The existing literature on the temporal stability of cardiovascular ambulatory monitoring data is reviewed. These studies generally show adequate reproducibility across time for blood pressure mean levels. However, the existing data on the reproducibility of blood pressure variability suggest that conventional estimates of 24-hour variability, such as standard deviation, may be very unstable from one monitoring day to the next. Several approaches are suggested for improving the estimate of variability in ambulatory data. Preliminary attempts using these approaches suggest, in contrast to earlier findings, that the temporal stability of ambulatory variability may also be quite good. More studies are recommended that use newer monitors, report heart rate data, employ multiple analytic strategies, and investigate the role of activity and behavior in the temporal stability of ambulatory levels and variability.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Douglas R. Southard, Richard A. Winett, Janet L. Walberg-Rankin, Tamara E. Neubauer, Kathryn Donckers-Roseveare, Paul A. Burkett, Robert A. Gould, David Lombard, John F. Moore
The National Cholesterol Education Program (NCEP) is the cornerstone of primary care efforts to treat hypercholesterolemia. It provides diagnostic criteria and an outline of appropriate assessment and treatment protocols. The initial treatment emphasis is on the Step 1, low-cholesterol, low-fat diet. A review of these guidelines from a behavioral perspective suggests that there may be several areas of concern. These include: (a) the absence of attention given to developing sufficient motivation for behavior change; (b) the limited efficacy of routine dietary education for promoting dietary changes; (c) the apparent need for diets more rigorous than the Step 1 and Step 2 guidelines to substantially lower cholesterol in some individuals; (d) the extensive support such dietary interventions must have from established behavioral change strategies; and (e) the lack of enthusiasm and experience many physicians and other medical personnel have for nutrition interventions. It is suggested that more conceptually-based behavioral assessment procedures, such as those based upon the stages of change model, could broaden the impact of the NCEP. In addition, data are presented which suggest that the NCEP could have greater effectiveness if more exacting behavioral strategies are followed. Interactive, multimedia systems are discussed as one means to facilitate dietary interventions in primary care settings. Finally, the importance of integrating measures designed to enhance long-term maintenance of dietary modifications is emphasized along with the need for more ongoing research within the NCEP.
{"title":"Increasing the Effectiveness of the National Cholesterol Education Program: Dietary and Behavioral Interventions for Clinical Settings","authors":"Douglas R. Southard, Richard A. Winett, Janet L. Walberg-Rankin, Tamara E. Neubauer, Kathryn Donckers-Roseveare, Paul A. Burkett, Robert A. Gould, David Lombard, John F. Moore","doi":"10.1093/abm/14.1.21","DOIUrl":"https://doi.org/10.1093/abm/14.1.21","url":null,"abstract":"The National Cholesterol Education Program (NCEP) is the cornerstone of primary care efforts to treat hypercholesterolemia. It provides diagnostic criteria and an outline of appropriate assessment and treatment protocols. The initial treatment emphasis is on the Step 1, low-cholesterol, low-fat diet. A review of these guidelines from a behavioral perspective suggests that there may be several areas of concern. These include: (a) the absence of attention given to developing sufficient motivation for behavior change; (b) the limited efficacy of routine dietary education for promoting dietary changes; (c) the apparent need for diets more rigorous than the Step 1 and Step 2 guidelines to substantially lower cholesterol in some individuals; (d) the extensive support such dietary interventions must have from established behavioral change strategies; and (e) the lack of enthusiasm and experience many physicians and other medical personnel have for nutrition interventions. It is suggested that more conceptually-based behavioral assessment procedures, such as those based upon the stages of change model, could broaden the impact of the NCEP. In addition, data are presented which suggest that the NCEP could have greater effectiveness if more exacting behavioral strategies are followed. Interactive, multimedia systems are discussed as one means to facilitate dietary interventions in primary care settings. Finally, the importance of integrating measures designed to enhance long-term maintenance of dietary modifications is emphasized along with the need for more ongoing research within the NCEP.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140314878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Studies of reactivity to stressors have generally focused only on men. Women may react to stressors with a different adrenergic and hormonal response, however one cannot be sure that this reflects biological differences or differences in task interpretation across the sexes. Men appear to respond to behavioral stressors with a greater increase in systolic blood pressure (BP). Hemodynamic reactivity (i.e. heart rate and BP) is probably not altered by phase of menstrual cycle. Hormonal and receptor responses to stressors may well be influenced by phase of menstrual cycle; the luteal phase of the cycle may be a time of greater adrenergic responsiveness. Type A behavior and various aspects of hostility have been studied extensively as possible coronary-prone behaviors in men. However, there are very few large-scale prospective studies of such variables in women. Depressed mood has also been recognized as a potential cardiovascular risk factor, although it has received less attention than either Type A or hostility. Studies on men have reported that depression is associated with elevated cardiovascular risk even decades later, suggesting that the depression is not merely a prodrome of underlying cardiac disease. Such studies have generally not been performed on women, despite the fact that women have twice the rate of depression as men.
对压力反应的研究通常只针对男性。女性可能会对压力源做出不同的肾上腺素能和荷尔蒙反应，但我们无法确定这是否反映了两性之间的生理差异或任务解读差异。男性对行为压力源的反应似乎是收缩压（BP）升高更多。血液动力学反应（即心率和血压）可能不会因月经周期的阶段而改变。荷尔蒙和受体对压力源的反应很可能受月经周期阶段的影响；月经周期的黄体期可能是肾上腺素能反应更强的时期。作为可能导致男性冠心病的行为，A 型行为和各方面的敌意已被广泛研究。然而，很少有针对女性此类变量的大规模前瞻性研究。抑郁情绪也被认为是一种潜在的心血管风险因素，尽管它受到的关注比 A 型行为或敌意行为都要少。对男性的研究报告显示，抑郁与心血管风险的升高有关，甚至在几十年后也是如此，这表明抑郁不仅仅是潜在心脏疾病的前兆。尽管女性患抑郁症的比例是男性的两倍，但此类研究一般不针对女性。
{"title":"Coronary Heart Disease in Women: Personality and Stress-Induced Biological Responses","authors":"Joel E. Dimsdale","doi":"10.1093/abm/15.2-3.119","DOIUrl":"https://doi.org/10.1093/abm/15.2-3.119","url":null,"abstract":"Studies of reactivity to stressors have generally focused only on men. Women may react to stressors with a different adrenergic and hormonal response, however one cannot be sure that this reflects biological differences or differences in task interpretation across the sexes. Men appear to respond to behavioral stressors with a greater increase in systolic blood pressure (BP). Hemodynamic reactivity (i.e. heart rate and BP) is probably not altered by phase of menstrual cycle. Hormonal and receptor responses to stressors may well be influenced by phase of menstrual cycle; the luteal phase of the cycle may be a time of greater adrenergic responsiveness. Type A behavior and various aspects of hostility have been studied extensively as possible coronary-prone behaviors in men. However, there are very few large-scale prospective studies of such variables in women. Depressed mood has also been recognized as a potential cardiovascular risk factor, although it has received less attention than either Type A or hostility. Studies on men have reported that depression is associated with elevated cardiovascular risk even decades later, suggesting that the depression is not merely a prodrome of underlying cardiac disease. Such studies have generally not been performed on women, despite the fact that women have twice the rate of depression as men.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
While abundant scientific evidence documents the risks of untreated hypercholesterolemia, long-term cholesterol-lowering could also be associated with adverse health effects. This article discusses potential connections between reduced serum cholesterol levels and three specific adverse outcomes: (a) cancer, (b) hemorrhagic stroke, and(c) death from non-illness related causes (suicide, accident, or violence). Included are data from epidemiologic studies of both serum cholesterol and dietary fat consumption, and evidence from randomized, clinical trials of cholesterol lowering with either dietary or pharmacologic treatment. While some evidence links reduced serum cholesterol with each of these three illnesses or events, the inconsistencies and limitations of the available evidence presently preclude conclusions regarding either the safety or dangers of cholesterol-lowering treatments.
{"title":"Health Through Cholesterol Reduction: Are there Unforeseen Risks?","authors":"Matthew F. Muldoon, Stephen B. Manuck","doi":"10.1093/abm/14.2.101","DOIUrl":"https://doi.org/10.1093/abm/14.2.101","url":null,"abstract":"While abundant scientific evidence documents the risks of untreated hypercholesterolemia, long-term cholesterol-lowering could also be associated with adverse health effects. This article discusses potential connections between reduced serum cholesterol levels and three specific adverse outcomes: (a) cancer, (b) hemorrhagic stroke, and(c) death from non-illness related causes (suicide, accident, or violence). Included are data from epidemiologic studies of both serum cholesterol and dietary fat consumption, and evidence from randomized, clinical trials of cholesterol lowering with either dietary or pharmacologic treatment. While some evidence links reduced serum cholesterol with each of these three illnesses or events, the inconsistencies and limitations of the available evidence presently preclude conclusions regarding either the safety or dangers of cholesterol-lowering treatments.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140311132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rheumatoid arthritis (RA) is a chronic, painful, and debilitating disease which affects approximately 1% of the adult population. A great deal of literature suggests that psychological factors are important to patient outcomes in RA. This article discusses these factors and then reviews the cognitive-behavioral treatment literature for this population. Although cognitive-behavioral treatments appear to assist RA patients in managing their pain, additional findings are inconsistent and methodological limitations in the literature preclude firm conclusions. A final section of this paper presents suggestions to improve the design of future studies evaluating cognitive-behavioral treatments for these patients.
{"title":"Cognitive-Behavioral Treatment of Rheumatoid Arthritis: A Preliminary Review of Efficacy and Methodology","authors":"Lance M. McCracken","doi":"10.1093/abm/13.2.57","DOIUrl":"https://doi.org/10.1093/abm/13.2.57","url":null,"abstract":"Rheumatoid arthritis (RA) is a chronic, painful, and debilitating disease which affects approximately 1% of the adult population. A great deal of literature suggests that psychological factors are important to patient outcomes in RA. This article discusses these factors and then reviews the cognitive-behavioral treatment literature for this population. Although cognitive-behavioral treatments appear to assist RA patients in managing their pain, additional findings are inconsistent and methodological limitations in the literature preclude firm conclusions. A final section of this paper presents suggestions to improve the design of future studies evaluating cognitive-behavioral treatments for these patients.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140314808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helen C. Gift, Barbara Gerbert, Gerald C. Kress, Susan T. Reisine
This article reviews issues which serve as the basis for future research in the area of the oral health care delivery system. The review is presented within the context of the larger health care and social environment and includes assessments of structure and organization, participants, access and utilization, professional training, and science transfer. The major trends in the sociodemographics of the U.S. population, changes in oral health status, and abilities to alter disease processes through prevention and treatment strategies are among the challenges addressed. The conclusions of the review illustrate the complexity of the oral health care delivery system as a research opportunity for behavioral and social scientists.
{"title":"Social, Economic, and Professional Dimensions of the Oral Health Care Delivery System","authors":"Helen C. Gift, Barbara Gerbert, Gerald C. Kress, Susan T. Reisine","doi":"10.1093/abm/12.4.161","DOIUrl":"https://doi.org/10.1093/abm/12.4.161","url":null,"abstract":"This article reviews issues which serve as the basis for future research in the area of the oral health care delivery system. The review is presented within the context of the larger health care and social environment and includes assessments of structure and organization, participants, access and utilization, professional training, and science transfer. The major trends in the sociodemographics of the U.S. population, changes in oral health status, and abilities to alter disease processes through prevention and treatment strategies are among the challenges addressed. The conclusions of the review illustrate the complexity of the oral health care delivery system as a research opportunity for behavioral and social scientists.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140315198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The hypothesis that specific disorders arise from specific psychosocial circumstances has received little attention in the last couple of decades. Recently developed measurements of stress, specifically the Life Events and Difficulties Schedule (LEDS), allow a more focused perspective on the differing psychosocial pathways to psychiatric and physical disorder. This is the result of the level of measurement employed by the LEDS, whereby specific qualities of distress, such as losses, dangers, frustrations, and so on, can be distinguished from each other within the overall category of distressing/unpleasant experience. Studies of depression, anxiety, schizophrenia, abdominal pain, appendectomy, menorrhagia, secondary amenorrhea, and myocardial infarction using the LEDS suggest that the specific qualities of the stressors involved in the onset of each condition may parallel similar predisposing vulnerabilities in the personalities of those becoming ill, and corresponding psychiatric conditions between stressor and somatic onset. An overall framework is outlined within which disorders are typified as more or less disengaged/overengaged, and suggestions are offered for future research.
{"title":"Life Stress and Illness: The Question of Specificity","authors":"Tirril Harris","doi":"10.1093/abm/13.4.211","DOIUrl":"https://doi.org/10.1093/abm/13.4.211","url":null,"abstract":"The hypothesis that specific disorders arise from specific psychosocial circumstances has received little attention in the last couple of decades. Recently developed measurements of stress, specifically the Life Events and Difficulties Schedule (LEDS), allow a more focused perspective on the differing psychosocial pathways to psychiatric and physical disorder. This is the result of the level of measurement employed by the LEDS, whereby specific qualities of distress, such as losses, dangers, frustrations, and so on, can be distinguished from each other within the overall category of distressing/unpleasant experience. Studies of depression, anxiety, schizophrenia, abdominal pain, appendectomy, menorrhagia, secondary amenorrhea, and myocardial infarction using the LEDS suggest that the specific qualities of the stressors involved in the onset of each condition may parallel similar predisposing vulnerabilities in the personalities of those becoming ill, and corresponding psychiatric conditions between stressor and somatic onset. An overall framework is outlined within which disorders are typified as more or less disengaged/overengaged, and suggestions are offered for future research.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article reviews common, reasonable therapies and questionable nutritional remedies for diseases and conditions that have dietary implications. Standard and questionable dietary remedies are defined and distinguished from other types of therapies, such as experimental or investigational Reasons for concern about questionable remedies are summarized. Some of the possible causes of their popularity are briefly reviewed. Several disorders are discussed to illustrate general points and concerns about the use of unproven remedies in clinical practice. The article concludes with remarks about some collaborative efforts between nutritionists and behavior therapists that are likely to be helpful to patients.
{"title":"Nutritional Remedies: Reasonable and Questionable","authors":"Johanna T. Dwyer","doi":"10.1093/abm/14.2.120","DOIUrl":"https://doi.org/10.1093/abm/14.2.120","url":null,"abstract":"This article reviews common, reasonable therapies and questionable nutritional remedies for diseases and conditions that have dietary implications. Standard and questionable dietary remedies are defined and distinguished from other types of therapies, such as experimental or investigational Reasons for concern about questionable remedies are summarized. Some of the possible causes of their popularity are briefly reviewed. Several disorders are discussed to illustrate general points and concerns about the use of unproven remedies in clinical practice. The article concludes with remarks about some collaborative efforts between nutritionists and behavior therapists that are likely to be helpful to patients.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140311303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article suggests that the inconsistent ability of social support interventions to enhance treatment outcomes in weight loss and smoking cessation studies is a result of inadequate theoretical conceptualization and operational definition of social support. Family systems theory is proposed as a theoretical framework which capitalizes on the salience of patient-partner interactions in producing long-term behavior change. A model is presented which outlines how this alternative conceptualization of social support would alter previous interventions. Preliminary evidence in favor of the proposed model is presented in the form of retrospective analysis of previous studies. Based on a desire to resolve the inconsistency of previous research, a call is made for the consideration of systems theory in future social support intervention studies.
{"title":"Does Social Support Aid in Weight Loss and Smoking Interventions? Reply from a Family Systems Perspective","authors":"Jason B. Lassner","doi":"10.1093/abm/13.2.66","DOIUrl":"https://doi.org/10.1093/abm/13.2.66","url":null,"abstract":"This article suggests that the inconsistent ability of social support interventions to enhance treatment outcomes in weight loss and smoking cessation studies is a result of inadequate theoretical conceptualization and operational definition of social support. Family systems theory is proposed as a theoretical framework which capitalizes on the salience of patient-partner interactions in producing long-term behavior change. A model is presented which outlines how this alternative conceptualization of social support would alter previous interventions. Preliminary evidence in favor of the proposed model is presented in the form of retrospective analysis of previous studies. Based on a desire to resolve the inconsistency of previous research, a call is made for the consideration of systems theory in future social support intervention studies.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article reviews research on the relationship between cardiovascular disease (CVD) and obesity. A preponderance of evidence strongly suggests that obesity is causally related to elevated blood pressure, elevated cholesterol, and glucose intolerance, all of which are primary risk factors for CVD. Nevertheless, data linking obesity to CVD itself are less consistent. While some studies show a positive and graded relationship between obesity and CVD incidence and mortality, others show no effect or even an inverse relationship. Possible reasons for these conflicting findings are discussed. These include heterogeneity of obesities, particularly central versus peripheral obesity; misclassification of individuals due to use of inaccurate obesity indices; analytic difficulties in estimating the contributions of obesity as a single variable in a complex chain of causation; and the presence of confounders such as cigarette smoking that lower weight, but are themselves a cause of CVD.
{"title":"Is Obesity a Risk Factor for Cardiovascular Disease?","authors":"Robert W. Jeffery","doi":"10.1093/abm/14.2.109","DOIUrl":"https://doi.org/10.1093/abm/14.2.109","url":null,"abstract":"This article reviews research on the relationship between cardiovascular disease (CVD) and obesity. A preponderance of evidence strongly suggests that obesity is causally related to elevated blood pressure, elevated cholesterol, and glucose intolerance, all of which are primary risk factors for CVD. Nevertheless, data linking obesity to CVD itself are less consistent. While some studies show a positive and graded relationship between obesity and CVD incidence and mortality, others show no effect or even an inverse relationship. Possible reasons for these conflicting findings are discussed. These include heterogeneity of obesities, particularly central versus peripheral obesity; misclassification of individuals due to use of inaccurate obesity indices; analytic difficulties in estimating the contributions of obesity as a single variable in a complex chain of causation; and the presence of confounders such as cigarette smoking that lower weight, but are themselves a cause of CVD.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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