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10. Exam Practice Answers D

The document presents two studies: one on the effects of a low-glycemic load diet on energy expenditure and heart disease risk factors during weight loss, and another comparing spinal manipulation, medication, and home exercise for neck pain. The first study found that a low-glycemic load diet resulted in less decrease in resting energy expenditure and improved cardiovascular risk factors compared to a low-fat diet. The second study indicated that spinal manipulation was more effective than medication for neck pain, while home exercise showed similar outcomes at most time points.

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6 views

10. Exam Practice Answers D

The document presents two studies: one on the effects of a low-glycemic load diet on energy expenditure and heart disease risk factors during weight loss, and another comparing spinal manipulation, medication, and home exercise for neck pain. The first study found that a low-glycemic load diet resulted in less decrease in resting energy expenditure and improved cardiovascular risk factors compared to a low-fat diet. The second study indicated that spinal manipulation was more effective than medication for neck pain, while home exercise showed similar outcomes at most time points.

Uploaded by

Harnavjot Kaur
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Exam Practice Answers: D

Use the following Abstract to answer Questions 1 to 6

Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors
during weight loss’

Context: Weight loss elicits physiological adaptations relating to energy intake and expenditure that
antagonize ongoing weight loss.

Objective: To test whether dietary composition affects the physiological adaptations to weight loss,
as assessed by resting energy expenditure.

Design, Study, and Participants: A randomized control trial of 39 overweight or obese young adults
aged 18 to 40 years who received an energy-restricted diet, either low-glycemic load or low-fat.
Participants were studied in the General Clinical Research Centers of the Brigham and Women's
Hospital and the Children's Hospital, Boston, Mass, before and after 10% weight loss. The study was
conducted from January 4, 2001, to May 6, 2003.

Main Outcome Measure: Resting energy expenditure measured in the fasting state by indirect
calorimetry, body composition by dual-energy x-ray absorptiometry, cardiovascular disease risk
factors, and self-reported hunger.

Results: Resting energy expenditure decreased less with the low-glycemic load diet than with the
low-fat diet, expressed in absolute terms (mean [SE], 96 [24] vs. 176 [27] kcal/d; p = 0.04) or as a
proportion (5.9% [1.5%] vs. 10.6% [1.7%]; p = 0.05). Participants receiving the low-glycemic load diet
reported less hunger than those receiving the low-fat diet (p = 0.04). Insulin resistance (p = 0.01),
serum triglycerides (p = 0.01), C-reactive protein (p = 0.03), and blood pressure (p = 0.07 for both
systolic and diastolic) improved more with the low-glycemic load diet. Changes in body composition
(fat and lean mass) in both groups were very similar (p = 0.85 and p = 0.45, respectively).

Conclusions: Changes in dietary composition within prevailing norms can affect physiological
adaptations that defend body weight. Reduction in glycemic load may aid in the prevention or
treatment of obesity, cardiovascular disease, and diabetes mellitus.

Reference: Pereira MA, Swain J, Goldfine AB, Rifai N and Ludwig DS (2004) ‘Effects of a low-glycemic
load diet on resting energy expenditure and heart disease risk factors during weight loss’, Journal of
the American Medical Association, 292(20):2482–90, doi:10.1001/jama.292.20.2482

1. What is the research design being used?

a. RCT.
b. Cohort.
c. Case-study.
d. Case-control.

HBS108 Health Information and Data, Trimester 1, 2023 Page 1 of 4


2. What is the independent variable?

a. Dietary composition.
b. Resting energy expenditure.
c. Low-glycemic load diet.
d. Low-fat diet.
e. None of the above.

3. What is the dependent variable?

a. Dietary composition.
b. Resting energy expenditure.
c. Low-glycemic load diet.
d. Low-fat diet.
e. None of the above.

4. True or False? Blood pressure improved more for participants on the low-glycemic load diet than
those on the low fat diet.

a. True.
b. False.

5. True or False? This was a statistically significant result.

a. True.
b. False.

6. What exhibited the best results in terms of aiding the prevention or treatment of obesity,
cardiovascular disease and diabetes mellitus?

a. Dietary composition.
b. Resting energy expenditure.
c. Low-glycemic load diet.
d. Low-fat diet.
e. None of the above.

HBS108 Health Information and Data, Trimester 1, 2023 Page 2 of 4


Use the following Abstract to answer Questions 7 to 10

Spinal Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain

Background: Mechanical neck pain is a common condition that affects an estimated 70% of persons
at some point in their lives. Little research exists to guide the choice of therapy for acute and
subacute neck pain.

Objective: To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and
home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.

Design: Randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00029770)

Setting: 1 university research center and 1 pain management clinic in Minnesota.

Participants: 272 persons aged 18 to 65 years who had nonspecific neck pain for 2 to 12 weeks.

Intervention: 12 weeks of SMT, medication, or HEA.

Measurements: The primary outcome was participant-rated pain, measured at 2, 4, 8, 12, 26, and 52
weeks after randomization. Secondary measures were self-reported disability, global improvement,
medication use, satisfaction, general health status (Short Form-36 Health Survey physical and mental
health scales), and adverse events. Blinded evaluation of neck motion was performed at 4 and 12
weeks.

Results: For pain, SMT had a statistically significant advantage over medication after 8, 12, 26, and 52
weeks (p ≤ 0.010), and HEA was superior to medication at 26 weeks (p ≤ 0.02). No important
differences in pain were found between SMT and HEA at any time point. Results for most of the
secondary outcomes were similar to those of the primary outcome.

Limitations: Participants and providers could not be blinded. No specific criteria for defining clinically
important group differences were pre-specified or available from the literature.

Conclusion: For participants with acute and subacute neck pain, SMT was more effective than
medication in both the short and long term. However, a few instructional sessions of HEA resulted in
similar outcomes at most time points.

Reference: Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y and Grimm RH (2012) ‘Spinal
Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain’, Annals
of Internal Medicine, 156:1–10, doi:10.7326/0003-4819-156-1-201201030-00002

7. What is the research design being used?

a. Cross-sectional.
b. Case-control.
c. RCT.
d. Cohort.
e. Case-study.

HBS108 Health Information and Data, Trimester 1, 2023 Page 3 of 4


8. What was the independent variable in this study?

a. Randomised controlled trial.


b. A series of therapies.
c. Randomisation.
d. Acute and sub-acute neck pain.

9. What was the dependent variable in this study?

a. A series of therapies.
b. Cohort study.
c. Randomization.
d. Acute and sub-acute neck pain.

10. What was/were the important result(s) of the study?

a. That SMT was superior to medication.


b. That SMT was superior to HEA.
c. There was little difference between the efficacy of SMT and HEA upon acute and
subacute neck pain.
d. a. and c. are correct.

HBS108 Health Information and Data, Trimester 1, 2023 Page 4 of 4

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