Excretion and Perception of a Characteristic Odor in Urine after Asparagus Ingestion: a Psychophysical and Genetic Study

The urine of people who have recently eaten asparagus has a sulfurous odor, which is distinct and similar to cooked cabbage. Using a 2-alternative forced-choice procedure, we examined individual differences in both the production of the odorants and the perception of this asparagus odor in urine. We conclude that individual differences exist in both odorant production and odor perception. The biological basis for the inability to produce the metabolite in detectable quantities is unknown, but the inability to smell the odor is associated with a single nucleotide polymorphism (rs4481887) within a 50-gene cluster of olfactory receptors

The Effect of a Computerized Cognitive-Behavioral Stress Management Intervention On Psychological Factors and Diabetes Management

Diabetes is associated with increased psychological distress which, in turn, is associated with poorer diabetes outcomes. This study examined the impact of a nine-week Internet based cognitive-behavioral therapy intervention that targeted stress and mood in people with diabetes. It was hypothesized that the intervention would decrease psychological distress and improve diabetes outcomes and adherence to diabetes treatment regimens. Participants with type 1 and type 2 diabetes were randomly assigned to the intervention (n = 103) or a waiting-list control group (n = 74). ANCOVAs demonstrated significant group effects for the reduction of perceived generalized stress (F (1, 105) = 7.06, p = .01; d = .84), diabetes-related distress (F (1, 105) = 13.45, p \u3c .01; d = .54), depression (F (1, 90) = 7.06, p \u3c .01; d = .40), anxiety (F (1, 89) = 6.78, p = .01; d = .41), and negative affect (F (1, 103) = 13.02, p \u3c .01; d = .56). There were also significant group effects for the reduction of psychological fatigue (F (1, 98) = 7.34, p = .01; d = .40), cognitive symptoms (F (1,95) = 6.40, p = .01; d = .48), hyperglycemic symptoms (F(1, 95) = 11.16, p \u3c.01; d = .41) and hypoglycemic symptom (F(1, 98) = 6.16, p= .02; d= .53). Further, there were significant indirect effects of the intervention on the above diabetes symptoms, through psychological distress. There was no effect of the intervention on hemoglobin A1c (F(1.43) = 0.28, p= .60), though this analysis was underpowered. The intervention also had no effect on adherence to diabetes treatment regimen. This study provides evidence of a convenient and effective way to reduce psychological distress and improve symptoms in those with diabetes. It also provides evidence of reduced psychological distress as a mechanism for improving diabetes outcomes

The Inflammatory Consequences of Stress and Adiposity

The inflammatory process is important in protecting the body against the invasion of pathogens, but recent research has suggested that a long-term inflammatory response may lead to chronic diseases (e.g., Black, 2003; Wu, Dorn, Donahue, Sempos, & Trevisan, 2002). Two factors that have been implicated in the inflammatory and disease processes are stress and obesity (Black, 2003). While their individual lines of research continue to grow, few researchers have attempted to integrate these factors into one model to explain their effects on inflammation. This study aimed to replicate previous findings suggesting relationships between stress, obesity and inflammation and test an integrated model of stress and obesity by examining a possible interaction between the effects of stress and obesity on inflammation. Socioeconomic Status (SES) and depression were employed to examine the association between stress and the inflammatory marker, c-reactive protein (CRP). The study utilized the data resulting from the National Health and Nutrition Examination Survey (NHANES; National Center for Health Statistics, 2006). Included in the dataset are 4998 adults (2416 males and 2582 females) ranging in age from 18 years to over 85 years (M = 47.13, SD = 20.86). A subsample (N = 589) completed the Major Depression module of the Composite International Diagnostic Interview (CDCI). The results indicate that body mass index, waist circumference, income, education, and depression symptoms significantly predict CRP. The data also suggest an interaction between the adiposity variables and the SES variables. This supports the hypothesis that the inflammatory effect of stress on an individual is moderated by adiposity

The Effect of a Computerized Cognitive-Behavioral Stress Management Intervention On Psychological Factors and Diabetes Management

Diabetes is associated with increased psychological distress which, in turn, is associated with poorer diabetes outcomes. This study examined the impact of a nine-week Internet based cognitive-behavioral therapy intervention that targeted stress and mood in people with diabetes. It was hypothesized that the intervention would decrease psychological distress and improve diabetes outcomes and adherence to diabetes treatment regimens. Participants with type 1 and type 2 diabetes were randomly assigned to the intervention (n = 103) or a waiting-list control group (n = 74). ANCOVAs demonstrated significant group effects for the reduction of perceived generalized stress (F (1, 105) = 7.06, p = .01; d = .84), diabetes-related distress (F (1, 105) = 13.45, p \u3c .01; d = .54), depression (F (1, 90) = 7.06, p \u3c .01; d = .40), anxiety (F (1, 89) = 6.78, p = .01; d = .41), and negative affect (F (1, 103) = 13.02, p \u3c .01; d = .56). There were also significant group effects for the reduction of psychological fatigue (F (1, 98) = 7.34, p = .01; d = .40), cognitive symptoms (F (1,95) = 6.40, p = .01; d = .48), hyperglycemic symptoms (F(1, 95) = 11.16, p \u3c.01; d = .41) and hypoglycemic symptom (F(1, 98) = 6.16, p= .02; d= .53). Further, there were significant indirect effects of the intervention on the above diabetes symptoms, through psychological distress. There was no effect of the intervention on hemoglobin A1c (F(1.43) = 0.28, p= .60), though this analysis was underpowered. The intervention also had no effect on adherence to diabetes treatment regimen. This study provides evidence of a convenient and effective way to reduce psychological distress and improve symptoms in those with diabetes. It also provides evidence of reduced psychological distress as a mechanism for improving diabetes outcomes

Depression and Hemoglobin A1c in Type 1 and Type 2 Diabetes: The Role of Self-Efficacy

Aims: To examine a self-efficacy explanation of the finding that depression is related to hemoglobin A1c (A1c) level in people with type 1 but not type 2 diabetes. Methods: Cross-sectional design involving 124 participants with type 1 (n = 32) and type 2 (n = 92) diabetes. Participants completed measures of depression and diabetes-related self-efficacy. A1c was obtained from medical records. Results: Replicating prior findings, A1c was significantly correlated with depression in type 1 participants (r = .51, p \u3c .01), but not in type 2 participants (r = .11, ns). As hypothesized, A1c was significantly correlated with self-efficacy among type 1 participants (r = −.42, p \u3c .05) but not among type 2 participants (r = −.01, ns). Self-efficacy also mediated the effect of A1c on depression among the type 1 participants (Z = 2.21, p \u3c .05). Conclusion: In people with type 1, but not type 2 diabetes, A1c levels are related to diabetes adherence mastery (self-efficacy), which mediates the link between A1c and depression. Results are discussed with regard to the proposal that perceptions of ineffective control over one\u27s health play a role in the development of depression (a consequence model of depression in diabetes)

Educational Attainment Moderates the Effect of a Brief Diabetes Intervention

Aims: Those with less education are at increased risk for developing diabetes and have a poorer prognosis. Intensive diabetes self-care interventions have been more effective at improving glycemic control in those with lower educational attainment. Due to limited resources, the focus has shifted to brief, cost-effective health interventions. This study examined whether educational attainment moderates the effect of a brief, telephone delivered self-care intervention on glycemic control in people with type 2 diabetes. Methods Randomized clinical trial. Participants (N = 62) were assigned to receive treatment as usual or treatment as usual plus a brief telephone intervention. The primary outcome measure was hemoglobin A1c. Results: A significant education by intervention group interaction effect indicated that participants with higher educational attainment had greater improvement in glycemic control (A1c) than those with less educational attainment; whereas, educational attainment was unrelated to change in glycemic control (A1c) within the control group. Conclusions: People with higher educational attainment may benefit to a greater extent from brief self-care interventions for diabetes, while those with lower educational attainment may require more intensive treatment

Pain and Functional Impairment as Mediators of the Link between Medical Symptoms and Depression in Type 2 Diabetes

Background: Among people with diabetes, depression is more common and is associated with greater morbidity and mortality. A better understanding of mechanisms underlying the link between poor health and depression is needed. Pain and functional impairment may account for the effect of poor health on depression in diabetes. Purpose: The purpose of the study was to examine whether pain and functional impairment mediate the association between diabetes-related medical symptoms and depression in type 2 diabetes. Method: Adults diagnosed with type 2 diabetes (N = 77) completed the following measures: Patient Health Questionnaire (PHQ), Diabetes Symptom Checklist (DSC), and Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Body mass index (BMI) was computed using height and weight data from medical records. Mediation and linear regression analyses were conducted. Results: Pain and functional impairment made significant, independent contributions to depression. Functional impairment mediated the link between diabetes-related medical symptoms and depression. Pain mediated the association between higher BMI and depression. Conclusion: Pain and functional impairment appear to play important, independent roles in depression in type 2 diabetes. Mediation analyses suggest the following: 1. diabetes-related medical problems increase functional impairment, which in turn leads to greater depression; and 2. the burden of carrying greater body mass (higher BMI) increases pain, which leads to increased depression