SMOKING WITHDRAWL EFFECTS ON ENERGY BALANCE

戒烟对能量平衡的影响

• 批准号: 6121723
• 负责人: DOUGLAS E JORENBY
• 金额: $ 3.35万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6121723
• 关键词: basal metabolism; behavioral habituation /sensitization; bioenergetics; body weight; caloric dietary content; calorimetry; female; human subject; nicotine replacement; nutrient intake activity; nutrition related tag; smoking cessation; transdermal drug delivery

Smokers weigh less than nonsmokers, and typically gain 5-10 pounds upon quitting smoking, yet the mechanisms by which nicotine influences body weight remain unclear. Seventy-five smokers will be randomly assigned to one of three groups (stratified on the basis of a restrained eating score): 42 mg nicotine replacement, 21 mg nicotine replacement, or placebo. Subjects will receive transdermal therapy for eight weeks and intensive group counseling for sixteen weeks. Resting metabolic rate (RMR), thermic response to food, withdrawal ratings, three-day dietary records, nicotine/cotinine levels, and activity will be assessed in an overnight (twelve hour) calorimetry session prior to smoking cessation, and in 24-hour calorimetry sessions one, four, eight and sixteen weeks post-cessation. If the 42 mg nicotine dose is sufficient to maintain pre-smoking cessation set-point, at one and four weeks post-quit the 42 mg group should have a higher RMR and lower caloric intake than the other groups. The 21 mg group should weigh more than the 42 mg group by week 16. Decline in RMR should be strongly associated with increased withdrawal severity, and those subjects with restrained eating styles should show the greatest increases in caloric intake, weight, and decline in RMR. In addition to providing a powerful test of two theories (regulatory versus effector), this research also has great clinical significance. It may help to identify those smokers at greatest risk for weight gain, and suggest optimal strategies for managing weight gain related to smoking cessation. As fear of weight gain deters many smokers from attempting to quit, this information could provide significant health benefits.

吸烟者的体重比不吸烟者轻，戒烟后通常会增加5-10磅，但尼古丁影响体重的机制尚不清楚。75名吸烟者将被随机分为三组（根据节制饮食评分分层）：42毫克尼古丁替代品，21毫克尼古丁替代品或安慰剂。受试者将接受为期8周的透皮治疗和为期16周的强化小组咨询。静息代谢率（RMR）、对食物的热反应、戒断评分、三天饮食记录、尼古丁/可替宁水平和活动将在戒烟前的夜间（12小时）量热仪和戒烟后1、4、8和16周的24小时量热仪中进行评估。如果42毫克的尼古丁剂量足以维持戒烟前的设定点，那么在戒烟后1周和4周，42毫克组的RMR应该比其他组高，热量摄入应该比其他组低。到第16周，21毫克组的体重应该超过42毫克组。RMR的下降应该与戒断严重程度的增加密切相关，那些饮食方式克制的受试者在热量摄入、体重和RMR的下降方面应该表现出最大的增加。除了对两种理论（调控与效应）提供有力的检验外，本研究还具有重要的临床意义。它可能有助于识别那些体重增加风险最大的吸烟者，并提出控制与戒烟相关的体重增加的最佳策略。由于对体重增加的恐惧使许多吸烟者不敢尝试戒烟，这一信息可能对健康有重大好处。