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Eric Charles Westman

Associate Professor of Medicine
Medicine, General Internal Medicine
Duke Box 3810, Lifestyle Medicine Clinic, Durham, NC 27704
4220 North Roxboro Street, Durham, NC 27704

Selected Publications


Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial.

Journal Article Psychiatry Res · May 2024 The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4-month pilot s ... Full text Link to item Cite

Nutritional aspects

Chapter · January 1, 2023 With evidence pointing to the efficacy of therapeutic carbohydrate restriction (TCR), official protocols for implementation into clinical practice are required. During the metabolic transition from a high-carbohydrate to a TCR diet, clinical considerations ... Full text Cite

Endocrine

Chapter · January 1, 2023 Endocrine dysregulation is the hallmark of modern chronic disease, with insulin resistance (IR) playing a central role. Research surrounding treatments to such disorders are complicated due to complex hormonal regulation of homoeostasis, with the liver pla ... Full text Cite

A review of decision aids to assess cardiovascular risk.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2022 PURPOSE OF REVIEW: Cardiovascular disease remains one of the leading causes of morbidity and mortality today. The major risk factors for cardiovascular disease include type 2 diabetes mellitus, hypertension, tobacco smoking, elevated body mass index, and h ... Full text Link to item Cite

Editorial introductions

Journal Article Current Opinion in Endocrinology, Diabetes and Obesity · October 1, 2022 Full text Cite

Competing paradigms of obesity pathogenesis: energy balance versus carbohydrate-insulin models.

Journal Article Eur J Clin Nutr · September 2022 The obesity pandemic continues unabated despite a persistent public health campaign to decrease energy intake ("eat less") and increase energy expenditure ("move more"). One explanation for this failure is that the current approach, based on the notion of ... Full text Link to item Cite

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients.

Journal Article Front Psychiatry · 2022 BACKGROUND AND HYPOTHESIS: The robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions. STUDY DESIGN: In this ret ... Full text Link to item Cite

The carbohydrate-insulin model: a physiological perspective on the obesity pandemic.

Journal Article Am J Clin Nutr · December 1, 2021 According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focu ... Full text Link to item Cite

Editorial: Carbohydrate restriction: from the 'bedside' to the 'bench'.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2021 Full text Link to item Cite

A case study of overfeeding 3 different diets.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2021 PURPOSE OF REVIEW: Quality or quantity of food has been at the heart of the diet debate for decades and will seemingly continue for many to come unless tightly controlled studies are conducted. To our knowledge, there has never been an overfeeding study co ... Full text Link to item Cite

Carbohydrate-restricted diets and Type 1 diabetes mellitus: research considerations.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2021 PURPOSE OF REVIEW: Type 1 diabetes mellitus (T1DM) is managed via careful control of blood glucose, exogenous insulin, diet, exercise, and other physiologic factors. Interestingly, the dietary recommendations for T1DM have had very little systematic resear ... Full text Link to item Cite

Type 2 Diabetes Mellitus: A Pathophysiologic Perspective.

Journal Article Front Nutr · 2021 Type 2 Diabetes Mellitus (T2DM) is characterized by chronically elevated blood glucose (hyperglycemia) and elevated blood insulin (hyperinsulinemia). When the blood glucose concentration is 100 milligrams/deciliter the bloodstream of an average adult conta ... Full text Link to item Cite

Application of nutrient essentiality criteria to dietary carbohydrates.

Journal Article Nutr Res Rev · December 2020 The purpose of the present review is to describe how human physiology at very low carbohydrate intakes relates to the criteria for nutritional essentiality. Although we did not limit ourselves to one particular type or function of carbohydrates, we did pri ... Full text Link to item Cite

Using a low-carbohydrate diet to treat obesity and type 2 diabetes mellitus.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 2020 PURPOSE OF REVIEW: This study will provide a narrative review of the history of the clinical use of low-carbohydrate diets and give a practical example of how to implement a low-carbohydrate diet, with an emphasis on deprescribing medications. RECENT FINDI ... Full text Link to item Cite

Editorial: Exploring the untapped potential of low-carbohydrate diets.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 2020 Full text Link to item Cite

Low-cost measurement of face mask efficacy for filtering expelled droplets during speech.

Journal Article Sci Adv · September 2020 Mandates for mask use in public during the recent coronavirus disease 2019 (COVID-19) pandemic, worsened by global shortage of commercial supplies, have led to widespread use of homemade masks and mask alternatives. It is assumed that wearing such masks re ... Full text Link to item Cite

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial.

Journal Article Psychiatry Res · May 2024 The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4-month pilot s ... Full text Link to item Cite

Nutritional aspects

Chapter · January 1, 2023 With evidence pointing to the efficacy of therapeutic carbohydrate restriction (TCR), official protocols for implementation into clinical practice are required. During the metabolic transition from a high-carbohydrate to a TCR diet, clinical considerations ... Full text Cite

Endocrine

Chapter · January 1, 2023 Endocrine dysregulation is the hallmark of modern chronic disease, with insulin resistance (IR) playing a central role. Research surrounding treatments to such disorders are complicated due to complex hormonal regulation of homoeostasis, with the liver pla ... Full text Cite

A review of decision aids to assess cardiovascular risk.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2022 PURPOSE OF REVIEW: Cardiovascular disease remains one of the leading causes of morbidity and mortality today. The major risk factors for cardiovascular disease include type 2 diabetes mellitus, hypertension, tobacco smoking, elevated body mass index, and h ... Full text Link to item Cite

Editorial introductions

Journal Article Current Opinion in Endocrinology, Diabetes and Obesity · October 1, 2022 Full text Cite

Competing paradigms of obesity pathogenesis: energy balance versus carbohydrate-insulin models.

Journal Article Eur J Clin Nutr · September 2022 The obesity pandemic continues unabated despite a persistent public health campaign to decrease energy intake ("eat less") and increase energy expenditure ("move more"). One explanation for this failure is that the current approach, based on the notion of ... Full text Link to item Cite

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients.

Journal Article Front Psychiatry · 2022 BACKGROUND AND HYPOTHESIS: The robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions. STUDY DESIGN: In this ret ... Full text Link to item Cite

The carbohydrate-insulin model: a physiological perspective on the obesity pandemic.

Journal Article Am J Clin Nutr · December 1, 2021 According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focu ... Full text Link to item Cite

Editorial: Carbohydrate restriction: from the 'bedside' to the 'bench'.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2021 Full text Link to item Cite

A case study of overfeeding 3 different diets.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2021 PURPOSE OF REVIEW: Quality or quantity of food has been at the heart of the diet debate for decades and will seemingly continue for many to come unless tightly controlled studies are conducted. To our knowledge, there has never been an overfeeding study co ... Full text Link to item Cite

Carbohydrate-restricted diets and Type 1 diabetes mellitus: research considerations.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 1, 2021 PURPOSE OF REVIEW: Type 1 diabetes mellitus (T1DM) is managed via careful control of blood glucose, exogenous insulin, diet, exercise, and other physiologic factors. Interestingly, the dietary recommendations for T1DM have had very little systematic resear ... Full text Link to item Cite

Type 2 Diabetes Mellitus: A Pathophysiologic Perspective.

Journal Article Front Nutr · 2021 Type 2 Diabetes Mellitus (T2DM) is characterized by chronically elevated blood glucose (hyperglycemia) and elevated blood insulin (hyperinsulinemia). When the blood glucose concentration is 100 milligrams/deciliter the bloodstream of an average adult conta ... Full text Link to item Cite

Application of nutrient essentiality criteria to dietary carbohydrates.

Journal Article Nutr Res Rev · December 2020 The purpose of the present review is to describe how human physiology at very low carbohydrate intakes relates to the criteria for nutritional essentiality. Although we did not limit ourselves to one particular type or function of carbohydrates, we did pri ... Full text Link to item Cite

Using a low-carbohydrate diet to treat obesity and type 2 diabetes mellitus.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 2020 PURPOSE OF REVIEW: This study will provide a narrative review of the history of the clinical use of low-carbohydrate diets and give a practical example of how to implement a low-carbohydrate diet, with an emphasis on deprescribing medications. RECENT FINDI ... Full text Link to item Cite

Editorial: Exploring the untapped potential of low-carbohydrate diets.

Journal Article Curr Opin Endocrinol Diabetes Obes · October 2020 Full text Link to item Cite

Low-cost measurement of face mask efficacy for filtering expelled droplets during speech.

Journal Article Sci Adv · September 2020 Mandates for mask use in public during the recent coronavirus disease 2019 (COVID-19) pandemic, worsened by global shortage of commercial supplies, have led to widespread use of homemade masks and mask alternatives. It is assumed that wearing such masks re ... Full text Link to item Cite

Treating binge eating and food addiction symptoms with low-carbohydrate Ketogenic diets: a case series.

Journal Article J Eat Disord · 2020 BACKGROUND: Many patients with obesity and comorbid binge eating symptoms present with the desire to lose weight. Although some studies suggest that dietary restriction can exacerbate binge eating, others show dietary restriction is associated with signifi ... Full text Link to item Cite

Ketogenic Diet for Obesity and Diabetes.

Journal Article JAMA Intern Med · December 1, 2019 Full text Link to item Cite

A lifestyle intervention of weight loss via a low-carbohydrate diet plus walking to reduce metabolic disturbances caused by androgen deprivation therapy among prostate cancer patients: carbohydrate and prostate study 1 (CAPS1) randomized controlled trial.

Journal Article Prostate Cancer Prostatic Dis · September 2019 PURPOSE: The objective of this study was to test a low-carbohydrate diet (LCD) plus walking to reduce androgen deprivation therapy (ADT)-induced metabolic disturbances. MATERIALS AND METHODS: This randomized multi-center trial of prostate cancer (PCa) pati ... Full text Open Access Link to item Cite

Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus.

Journal Article Expert Rev Endocrinol Metab · September 2018 INTRODUCTION: Type 2 diabetes mellitus (T2DM) has reached epidemic proportions in the modern world. For individuals affected by obesity-related T2DM, clinical studies have shown that carbohydrate restriction and weight loss can improve hyperglycemia, obesi ... Full text Link to item Cite

Management of Type 1 Diabetes With a Very Low-Carbohydrate Diet.

Journal Article Pediatrics · June 2018 OBJECTIVES: To evaluate glycemic control among children and adults with type 1 diabetes mellitus (T1DM) who consume a very low-carbohydrate diet (VLCD). METHODS: We conducted an online survey of an international social media group for people with T1DM who ... Full text Link to item Cite

The effects of nicotine and non-nicotine smoking factors on working memory and associated brain function.

Journal Article Addict Biol · July 2016 Smoking abstinence impairs executive function, which may promote continued smoking behavior and relapse. The differential influence of nicotine and non-nicotine (i.e. sensory, motor) smoking factors and related neural substrates is not known. In a fully fa ... Full text Link to item Cite

Weight Loss: A Patient and Physician's Perspective.

Journal Article Adv Ther · June 2016 This article, co-authored by a patient affected by obesity and an obesity medicine specialist, discusses the patient's experience of living with the disease and using many different weight loss approaches until finding a lifestyle program that was appropri ... Full text Link to item Cite

Obesity: Evaluation and treatment essentials

Book · April 19, 2016 Obesity is considered a complex and multifactorial disease. Its treatment, therefore, must also be multimodal and tailored to meet the needs of each patient. Obesity: Evaluation and Treatment Essentials presents a wide spectrum of practical treatment proto ... Cite

Preface

Book · April 19, 2016 Cite

Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: FULL REPORT.

Journal Article J Clin Lipidol · 2016 Bariatric procedures often improve lipid levels in patients with obesity. This 2 part scientific statement examines the potential lipid benefits of bariatric procedures and represents the contributions from authors representing the National Lipid Associati ... Full text Link to item Cite

Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: EXECUTIVE SUMMARY.

Journal Article J Clin Lipidol · 2016 Bariatric procedures often improve lipid levels in patients with obesity. This 2-part scientific statement examines the potential lipid benefits of bariatric procedures and represents contributions from authors representing the National Lipid Association, ... Full text Link to item Cite

Lipids and bariatric procedures Part 2 of 2: scientific statement from the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and Obesity Medicine Association (OMA).

Journal Article Surg Obes Relat Dis · 2016 Bariatric procedures generally improve dyslipidemia, sometimes substantially so. Bariatric procedures also improve other major cardiovascular risk factors. This 2-part Scientific Statement examines the lipid effects of bariatric procedures and reflects con ... Full text Link to item Cite

Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.

Journal Article Nutrition · January 2015 The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonl ... Full text Link to item Cite

Nicotine and non-nicotine smoking factors differentially modulate craving, withdrawal and cerebral blood flow as measured with arterial spin labeling.

Journal Article Neuropsychopharmacology · November 2014 Smoking cessation results in withdrawal symptoms such as craving and negative mood that may contribute to lapse and relapse. Little is known regarding whether these symptoms are associated with the nicotine or non-nicotine components of cigarette smoke. Us ... Full text Link to item Cite

Meclizine enhancement of sensorimotor gating in healthy male subjects with high startle responses and low prepulse inhibition.

Journal Article Neuropsychopharmacology · February 2014 Histamine H1 receptor systems have been shown in animal studies to have important roles in the reversal of sensorimotor gating deficits, as measured by prepulse inhibition (PPI). H1-antagonist treatment attenuates the PPI impairments caused by either block ... Full text Link to item Cite

Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity.

Journal Article Obesity (Silver Spring) · December 2011 There is a perception that phentermine pharmacotherapy for obesity increases blood pressure and heart rate (HR), exposing treated patients to increased cardiovascular risk. We collected data from phentermine-treated (PT) and phentermine-untreated (P0) pati ... Full text Link to item Cite

Comparison of a reduced carbohydrate and reduced fat diet for LDL, HDL, and VLDL subclasses during 9-months of weight maintenance subsequent to weight loss.

Journal Article Lipids Health Dis · June 1, 2010 OBJECTIVES: This study compared LDL, HDL, and VLDL subclasses in overweight or obese adults consuming either a reduced carbohydrate (RC) or reduced fat (RF) weight maintenance diet for 9 months following significant weight loss. METHODS: Thirty-five (21 RC ... Full text Open Access Link to item Cite

Reinforcing effects of nicotine and non-nicotine components of cigarette smoke.

Journal Article Psychopharmacology (Berl) · May 2010 RATIONALE: Nicotine and non-nicotine components of cigarette smoke contribute to its reinforcing effects; however, the specific role of each component in maintaining behavior has not yet been elucidated. OBJECTIVES: To assess the reinforcing effects of nic ... Full text Link to item Cite

A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.

Journal Article Arch Intern Med · January 25, 2010 BACKGROUND: Two potent weight loss therapies, a low-carbohydrate, ketogenic diet (LCKD) and orlistat therapy combined with a low-fat diet (O + LFD), are available to the public but, to our knowledge, have never been compared. METHODS: Overweight or obese o ... Full text Link to item Cite

Low glycemic diet for weight loss in hypertriglyceridemic patients attending a lipid clinic.

Journal Article J Clin Lipidol · 2010 PURPOSE: To assess the effectiveness of low glycemic dietary counseling for weight loss among moderately hypertriglyceridemic patients in an academic referral lipid clinic. METHODS: During 1998 to 2000, weight loss advice followed traditional guidelines. B ... Full text Link to item Cite

Reply

Journal Article Clinical Gastroenterology and Hepatology · January 1, 2010 Full text Cite

Carbohydrate-restricted diets for obesity and related diseases: an update.

Journal Article Curr Atheroscler Rep · November 2009 Basic, clinical, and epidemiologic research on carbohydrate-restricted dietary patterns continues to grow, evaluating the impact of this way of eating on weight loss, obesity-associated comorbidities, and development of any adverse effects. Randomized, con ... Full text Link to item Cite

Precessation treatment with nicotine patch significantly increases abstinence rates relative to conventional treatment.

Journal Article Nicotine Tob Res · September 2009 INTRODUCTION: Previous studies have reported that smoking abstinence rates are increased when nicotine skin patch treatment is initiated prior to the target quit smoking date, as compared with conventional treatment beginning on the quit date. We hypothesi ... Full text Link to item Cite

A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome.

Journal Article Clin Gastroenterol Hepatol · June 2009 BACKGROUND & AIMS: Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) anecdotally report symptom improvement after initiating a very low-carbohydrate diet (VLCD). This study prospectively evaluated a VLCD in IBS-D. METHODS: Participants wi ... Full text Link to item Cite

The effects of varying dietary carbohydrate and fat content on survival in a murine LNCaP prostate cancer xenograft model.

Journal Article Cancer Prev Res (Phila) · June 2009 PURPOSE: Numerous dietary factors elevate serum levels of insulin and insulin-like growth factor I (IGF-I), both potent prostate cancer mitogens. We tested whether varying dietary carbohydrate and fat, without energy restriction relative to comparison diet ... Full text Link to item Cite

Comparison of weight-loss diets.

Journal Article N Engl J Med · May 21, 2009 Full text Link to item Cite

Rethinking dietary saturated fats

Journal Article Lipid Technology · May 1, 2009 A re-evaluation of the diet/heart disease hypothesis is occurring, and the link between dietary fat and heart disease is not as conclusive as once was thought. A re-evaluation of assessment of cardiometabolic risk is also occurring - from serum low density ... Full text Cite

Effects of two weight-loss diets on health-related quality of life.

Journal Article Qual Life Res · April 2009 PURPOSE: To compare the effects of two diets on health-related quality of life (HRQOL). METHODS: Overweight volunteers (n = 119) were randomized to follow a low-carbohydrate, ketogenic diet (LCKD) or a low-fat diet (LFD) for 24 weeks. HRQOL was measured ev ... Full text Link to item Cite

Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: a case report and review of the literature.

Journal Article Nutr Metab (Lond) · February 26, 2009 We report the unexpected resolution of longstanding schizophrenic symptoms after starting a low-carbohydrate, ketogenic diet. After a review of the literature, possible reasons for this include the metabolic consequences from the elimination of gluten from ... Full text Link to item Cite

Rethinking Dietary Saturated Fat

Journal Article Food Technology · February 1, 2009 The discussion initiated in a scientific program session during the 2008 IFT Annual Meeting & Food Expo┬« and some possible industry ramifications of the nutritional debate is presented. The session included presentations by David Klurfeld, a Human Nutritio ... Cite

The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus.

Journal Article Nutr Metab (Lond) · December 19, 2008 OBJECTIVE: Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate ... Full text Link to item Cite

Clinical experience using appetite suppressants and SSRIs.

Journal Article J Okla State Med Assoc · August 2008 The use of sympathomimetic appetite suppressants and serotonin-selective reuptake inhibitors (SSRIs) has been questioned due to anecdotal reports of serotonin syndrome. This survey of bariatric physicians using these medications in clinical practice did no ... Link to item Cite

Protein, weight management, and satiety.

Journal Article Am J Clin Nutr · May 2008 Obesity, with its comorbidities such as metabolic syndrome and cardiovascular diseases, is a major public health concern. To address this problem, it is imperative to identify treatment interventions that target a variety of short- and long-term mechanisms ... Full text Link to item Cite

Has carbohydrate-restriction been forgotten as a treatment for diabetes mellitus? A perspective on the ACCORD study design.

Journal Article Nutr Metab (Lond) · April 9, 2008 Prior to the discovery of medical treatment for diabetes, carbohydrate-restriction was the predominant treatment recommendation to treat diabetes mellitus. In this commentary we argue that carbohydrate-restriction should be reincorporated into contemporary ... Full text Link to item Cite

Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal.

Journal Article Nutr Metab (Lond) · April 8, 2008 Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluati ... Full text Link to item Cite

Acid-base analysis of individuals following two weight loss diets.

Journal Article Eur J Clin Nutr · December 2007 OBJECTIVE: To examine the effects of low-carbohydrate, ketogenic (LCKD) and low-fat (LFD) diets on acid-base status. DESIGN: Prospective analysis of volunteers from two clinical trials. PARTICIPANTS: Subset of 39 volunteers from a randomized trial comparin ... Full text Link to item Cite

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program.

Journal Article Nutr J · November 1, 2007 BACKGROUND: Recent evidence suggests that a low carbohydrate (LC) diet may be equally or more effective for short-term weight loss than a traditional low fat (LF) diet; however, less is known about how they compare for weight maintenance. The purpose of th ... Full text Link to item Cite

Low-carbohydrate nutrition and metabolism.

Journal Article Am J Clin Nutr · August 2007 Featured Publication The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this thematic review is carbohydrate restriction. Recent stud ... Full text Link to item Cite

The effects of foods, beverages, and other factors on cigarette palatability.

Journal Article Nicotine Tob Res · April 2007 While smokers commonly report that various foods and beverages worsen or enhance the taste of cigarettes, the prevalence and diversity of these phenomena have not been studied. We administered an open-ended questionnaire to 209 smokers asking for reports o ... Full text Link to item Cite

The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study.

Journal Article Dig Dis Sci · February 2007 Nonalcoholic fatty liver disease is an increasingly common condition that may progress to hepatic cirrhosis. This pilot study evaluated the effects of a low-carbohydrate, ketogenic diet on obesity-associated fatty liver disease. Five patients with a mean b ... Full text Link to item Cite

The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms.

Journal Article Obesity (Silver Spring) · January 2007 OBJECTIVE: To investigate the effects of weight loss diets on mood, food cravings, and other self-reported symptoms. RESEARCH METHODS AND PROCEDURES: Mood and other symptoms were evaluated by participant self-report using the Atkins Health Indicator Test ( ... Full text Link to item Cite

Transdermal nicotine attenuates depression symptoms in nonsmokers: a double-blind, placebo-controlled trial.

Journal Article Psychopharmacology (Berl) · November 2006 RATIONALE: Despite established links between nicotine dependence and depression, little research has examined the effects of nicotine on depression symptoms. OBJECTIVE: This study evaluated the acute and chronic effects of transdermal nicotine in nonsmoker ... Full text Link to item Cite

Low carbohydrate diets in family practice: what can we learn from an internet-based support group.

Journal Article Nutr J · October 2, 2006 The Active Low-Carber Forums (ALCF) is an on-line support group started in 2000 which currently has more than 86,000 members. Data collected from posts to the forum and from an on-line survey were used to determine the behavior and attitudes of people on l ... Full text Link to item Cite

A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms.

Journal Article Dig Dis Sci · August 2006 Obese patients with gastroesophageal reflux disease (GERD) may experience resolution of symptoms utilizing a very low-carbohydrate diet. The mechanism of this improvement is unknown. This studied aimed to prospectively assess changes in distal esophageal a ... Full text Link to item Cite

Effect of a low-carbohydrate, ketogenic diet program compared to a low-fat diet on fasting lipoprotein subclasses.

Journal Article Int J Cardiol · June 16, 2006 BACKGROUND: Low-carbohydrate, ketogenic diets (LCKD) are effective for weight loss, but concerns remain regarding cardiovascular risk. The purpose of this study was to determine the effect of an LCKD program on serum lipoprotein subclasses. METHODS: This w ... Full text Link to item Cite

Precessation treatment with nicotine skin patch facilitates smoking cessation.

Journal Article Nicotine Tob Res · February 2006 Nicotine replacement therapy (NRT) is a well-established treatment to aid smoking cessation, and current products recommend using NRT only after quitting smoking. However, theoretical arguments and previous data support the hypothesis that precessation use ... Full text Link to item Cite

Dietary treatment of diabetes mellitus in the pre-insulin era (1914-1922).

Journal Article Perspect Biol Med · 2006 Featured Publication Before the discovery of insulin, one of the most common dietary treatments of diabetes mellitus was a high-fat, low-carbohydrate diet. A review of Frederick M. Allen's case histories shows that a 70% fat, 8% carbohydrate diet could eliminate glycosuria amo ... Full text Link to item Cite

The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study.

Journal Article Nutr Metab (Lond) · December 16, 2005 BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, hyperinsulinemia, and insulin resistance. Because low carbohydrate diets have been shown to reduce insuli ... Full text Link to item Cite

A low-carbohydrate, ketogenic diet to treat type 2 diabetes.

Journal Article Nutr Metab (Lond) · December 1, 2005 BACKGROUND: The low-carbohydrate, ketogenic diet (LCKD) may be effective for improving glycemia and reducing medications in patients with type 2 diabetes. METHODS: From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for ... Full text Link to item Cite

Is a low-carb, low-fat diet optimal?

Journal Article Arch Intern Med · May 9, 2005 Full text Link to item Cite

Outcomes from an outpatient smoking-cessation clinic.

Journal Article Pharmacotherapy · February 2005 STUDY OBJECTIVES: To determine the success of an outpatient smoking-cessation clinic by assessing smoking abstinence rates and factors associated with lower abstinence rates. We also sought to determine whether smoking abstinence rates differed among vario ... Full text Link to item Cite

Prenatal and postpartum smoking abstinence a partner-assisted approach.

Journal Article Am J Prev Med · October 2004 BACKGROUND: A partner's provision of support and smoking status has been consistently associated with women's likelihood of smoking cessation during pregnancy and relapse in postpartum. DESIGN: A three-group randomized controlled intervention trial was con ... Full text Link to item Cite

Update on smoking cessation

Journal Article Patient Care · October 1, 2004 It is no surprise to physicians that the Surgeon General's latest report states that smoking affects every organ system. The tobacco cessation guideline from the USPHS that recommends nicotine replacement therapy or bupropion for nearly all patients who sm ... Cite

Diet therapy for narcolepsy.

Journal Article Neurology · June 22, 2004 The effects of a low-carbohydrate, ketogenic diet (LCKD) on sleepiness and other narcolepsy symptoms were studied. Nine patients with narcolepsy were asked to adhere to the Atkins' diet plan, and their symptoms were assessed using the Narcolepsy Symptom St ... Full text Link to item Cite

The effects of controlled deep breathing on smoking withdrawal symptoms in dependent smokers.

Journal Article Addict Behav · June 2004 This study was designed to assess the effect of controlled deep breathing on smoking withdrawal symptoms. In two laboratory sessions, dependent smokers refrained from smoking for 4 h. During a deep breathing session, participants were instructed to take a ... Full text Link to item Cite

Does binge eating disorder impact weight-related quality of life?

Journal Article Obes Res · June 2004 OBJECTIVES: To determine whether binge eating disorder (BED) impacts weight-related quality of life in obese individuals seeking weight loss treatment and to investigate the role of psychological symptoms, BMI, and demographic variables in the relationship ... Full text Link to item Cite

A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial.

Journal Article Ann Intern Med · May 18, 2004 Featured Publication BACKGROUND: Low-carbohydrate diets remain popular despite a paucity of scientific evidence on their effectiveness. OBJECTIVE: To compare the effects of a low-carbohydrate, ketogenic diet program with those of a low-fat, low-cholesterol, reduced-calorie die ... Full text Link to item Cite

Binge eating, quality of life and physical activity improve after Roux-en-Y gastric bypass for morbid obesity.

Journal Article Obes Surg · March 2004 BACKGROUND: Severe obesity has been associated with disordered eating, impaired quality of life (QoL), and decreased physical activity. This study examines changes in these variables 6 months after Roux-en-Y gastric bypass (RYGBP). METHODS: 40 morbidly obe ... Full text Link to item Cite

Clinical experience of a carbohydrate-restricted diet for the metabolic syndrome.

Journal Article Metab Syndr Relat Disord · 2004 BACKGROUND: Our objective was to analyze a restricted carbohydrate dietary approach compared to a standard low-fat diet plus medication plan as treatment for weight loss and the metabolic syndrome. METHODS: This was a retrospective analysis of patients att ... Full text Link to item Cite

The Effects of a Low-Carbohydrate Regimen on Glycemic Control and Serum Lipids in Diabetes Mellitus

Journal Article Metabolic Syndrome and Related Disorders · December 1, 2003 The Diabetes Complications and Control Trial (DCCT) established that diabetic complications could be reduced by improvement in glycemic control. The ideal diabetes treatment protocol would maintain blood glucose levels in normal ranges without resulting in ... Full text Cite

A review of low-carbohydrate ketogenic diets.

Journal Article Curr Atheroscler Rep · November 2003 Featured Publication In response to the emerging epidemic of obesity in the United States, a renewal of interest in alternative diets has occurred, especially in diets that limit carbohydrate intake. Recent research has demonstrated that low-carbohydrate ketogenic diets can le ... Full text Link to item Cite

Pharmacologic and sensorimotor components of satiation in cigarette smoking.

Journal Article Pharmacol Biochem Behav · September 2003 To examine mechanisms underlying satiation in cigarette smoking, 18 smokers received intravenous (i.v.) nicotine, alone or in combination with denicotinized cigarette smoke. Nicotine was administered using programmed presentations of either pulsed injectio ... Full text Link to item Cite

Mecamylamine acutely increases human intravenous nicotine self-administration.

Journal Article Pharmacol Biochem Behav · September 2003 Previous studies of human cigarette smoking have shown that administration of the nicotinic acetylcholine receptor antagonist mecamylamine produces acute increases in smoking behavior. In contrast, studies of intravenous nicotine self-administration in ani ... Full text Link to item Cite

Clinical use of a carbohydrate-restricted diet to treat the dyslipidemia of the metabolic syndrome.

Journal Article Metab Syndr Relat Disord · September 2003 BACKGROUND: The metabolic syndrome is characterized by an atherogenic dyslipidemia identifiable using lipoprotein subclass analysis. This study assesses the effect of a carbohydrate-restricted diet on the dyslipidemia of the metabolic syndrome in a clinica ... Full text Link to item Cite

Residential smoking therapy.

Journal Article J Gen Intern Med · April 2003 OBJECTIVE: To evaluate a pilot 4-day residential smoking treatment program for smokers who had relapsed after participation in an outpatient smoking program. DESIGN: A single-arm clinical trial. Participants stayed in a supportive, smoke-free environment f ... Full text Link to item Cite

PET studies of the influences of nicotine on neural systems in cigarette smokers.

Journal Article Am J Psychiatry · February 2003 OBJECTIVE: The effects of acute nicotine administration and smoking on brain function were investigated in two studies, with the primary goal of identifying neural systems that mediate these effects. METHOD: In study 1, 18 healthy volunteer cigarette smoke ... Full text Link to item Cite

Very-low-carbohydrate weight-loss diets revisited.

Journal Article Cleve Clin J Med · November 2002 Much scientific and anecdotal data demonstrate favorable metabolic responses to very-low-carbohydrate diets. We believe that very-low-carbohydrate diets merit further study for weight loss, and that criticisms of these diets lack scientific evidence. ... Full text Link to item Cite

Relationship between obesity and health-related quality of life in men.

Journal Article Obes Res · October 2002 OBJECTIVE: Few studies examining the relationship between obesity and health-related quality of life (HRQOL) have used a medical outpatient population or demonstrated a relationship in men. Furthermore, most studies have not adequately considered comorbid ... Full text Link to item Cite

Effect of 6-month adherence to a very low carbohydrate diet program.

Journal Article Am J Med · July 2002 To determine the effect of a 6-month very low carbohydrate diet program on body weight and other metabolic parameters.Fifty-one overweight or obese healthy volunteers who wanted to lose weight were placed on a very low carbohydrate diet (<25 g/d), with no ... Full text Link to item Cite

Asthma exacerbation after administration of nicotine nasal spray for smoking cessation.

Journal Article Pharmacotherapy · June 2002 A 58-year-old man experienced an asthma exacerbation after administration of nicotine nasal spray for smoking cessation. His medical history was significant for asthma, chronic obstructive pulmonary disease, hypertension, and tobacco use when he was prescr ... Full text Link to item Cite

Is dietary carbohydrate essential for human nutrition? [4] (multiple letters)

Journal Article American Journal of Clinical Nutrition · January 1, 2002 Full text Cite

Oral nicotine solution for smoking cessation: a pilot tolerability study.

Journal Article Nicotine Tob Res · November 2001 This study was conducted to determine the preliminary tolerability of an oral nicotine solution with minimal behavioral intervention for smoking cessation. Twenty-five healthy volunteers who smoked at least 10 cigarettes per day and were motivated to quit ... Full text Link to item Cite

Use of bupropion SR in a pharmacist-managed outpatient smoking-cessation program.

Journal Article Pharmacotherapy · May 2001 We administered bupropion sustained-release (SR) in a pharmacist-managed outpatient smoking-cessation program. Patients were referred to the program by their primary care physician. All patients completed initial visit questionnaires, received behavioral c ... Full text Link to item Cite

Individual differences in smoking reward from de-nicotinized cigarettes.

Journal Article Nicotine Tob Res · May 2001 Most studies of cigarette smoking and smoking cessation have focused on the psychopharmacological effects of nicotine; relatively few have explored the role of sensory aspects of cigarette smoke. Sensory aspects of cigarette smoke play a role in the mainte ... Full text Link to item Cite

Acute effects of nicotine and mecamylamine on tobacco withdrawal symptoms, cigarette reward and ad lib smoking.

Journal Article Pharmacol Biochem Behav · February 2001 Separate and combined effects of nicotine and the nicotinic antagonist mecamylamine were studied in 32 healthy volunteer smokers after overnight abstinence from smoking. Subjects participated in three sessions (3 h each), during which they wore skin patche ... Full text Link to item Cite

Improvement of gastroesophageal reflux disease after initiation of a low-carbohydrate diet: five brief case reports.

Journal Article Altern Ther Health Med · 2001 The 5 individuals described in these case reports experienced resolution of GERD symptoms after self-initiation of a low-carbohydrate diet. Their observations suggest that carbohydrate restriction may have contributed to their symptom relief. However, this ... Link to item Cite

Dissociating nicotine and nonnicotine components of cigarette smoking.

Journal Article Pharmacol Biochem Behav · September 2000 To dissociate the sensorimotor aspects of cigarette smoking from the pharmacologic effects of nicotine, smokers rated the subjective effects of nicotine-containing or denicotinized cigarettes, and intravenous (IV) nicotine or saline infusions. Three groups ... Full text Link to item Cite

Combining the nicotine inhaler and nicotine patch for smoking cessation

Journal Article American Journal of Health Behavior · January 1, 2000 Objective: To assess the combination of the nicotine inhaler and nicotine patch for smoking cessation. Methods: Thirty healthy volunteers were enrolled into this open-label clinical trial of the combined use of nicotine inhalers and patches (15mg/16hr) for ... Full text Cite

Arterial nicotine kinetics during cigarette smoking and intravenous nicotine administration: implications for addiction.

Journal Article Drug Alcohol Depend · September 1, 1999 An understanding of drug addiction requires knowledge of the effective drug concentrations to which receptors in the nervous system are exposed. It has often been thought that smoking of abused substances such as nicotine or cocaine produces much higher dr ... Full text Link to item Cite

Factors influencing morning report case presentations.

Journal Article South Med J · August 1999 BACKGROUND: One of the most widely accepted didactic conferences among residency training programs is morning report. This study examines several factors that may influence the content of case presentations at morning report. METHODS: This prospective surv ... Full text Link to item Cite

Naltrexone blockade of nicotine effects in cigarette smokers.

Journal Article Psychopharmacology (Berl) · April 1999 RATIONALE: The role of endogenous opiate systems in cigarette smoking remains unclear. In laboratory animals, opiate antagonists block many of the effects of nicotine, but in humans they do not consistently alter smoking behavior. OBJECTIVE: This study exp ... Full text Link to item Cite

Blockade of smoking satisfaction using the peripheral nicotinic antagonist trimethaphan.

Journal Article Pharmacol Biochem Behav · January 1999 The present study was conducted to investigate the role of peripheral nicotinic receptors in mediating the rewarding effects of cigarette smoking. Twelve cigarette smokers rated cigarettes after intravenous infusion of the short-acting peripheral nicotinic ... Full text Link to item Cite

Integrating transdermal nicotine therapy into nicotine fading treatments: Effects on salivary cotinine levels

Journal Article Psychology of Addictive Behaviors · January 1, 1999 Many stop-smoking programs wean smokers off nicotine by using nicotine fading procedures and nicotine replacement products. It has not been clear how best to integrate these 2 weaning methods. This study measured salivary cotinine levels produced by nicoti ... Full text Cite

Safety of Zyban in patients with co-existing medical and/or psychiatric conditions

Journal Article Journal of Investigative Medicine · January 1, 1999 Zyban has been shown to be an effective agent for smoking cessation. However prior studies have primarily involved generally healthy smokers. The purpose of this study was to describe our experience with using Zyban in smokers who have co-existing medical ... Cite

Implementing a patient's bill of rights with the personal health organizer

Journal Article American Journal of Health Behavior · January 1, 1999 Objective: The objective of this study was to assess the effect of a personal health organizer on continuity of care and patient responsibility. Methods: In this six-month observational study, 42 medical patients were recruited by their physicians to use a ... Full text Cite

You're my father, not my patient

Journal Article Wisconsin Medical Journal · January 1, 1999 Cite

Nicotine-mecamylamine treatment for smoking cessation: the role of pre-cessation therapy.

Journal Article Exp Clin Psychopharmacol · August 1998 The nicotinic antagonist mecamylamine was evaluated in a randomized smoking cessation trial. Four groups of participants (n = 20 per group) received nicotine plus mecamylamine, nicotine alone, mecamylamine alone, or no drug for 4 weeks before cessation. Af ... Full text Link to item Cite

Commentary

Journal Article Evidence-Based Medicine · January 1, 1998 Cite

Smoking behavior on the first day of a quit attempt predicts long-term abstinence.

Journal Article Arch Intern Med · February 10, 1997 BACKGROUND: The nicotine patch has been widely used for smoking cessation, but not all smokers quit using the patch. Knowing which smokers are likely to succeed with the nicotine patch may improve the efficiency of nicotine patch use. OBJECTIVE: To identif ... Link to item Cite

The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease.

Journal Article N Engl J Med · December 12, 1996 BACKGROUND: Transdermal nicotine therapy is widely used to aid smoking cessation, but there is uncertainty about its safety in patients with cardiac disease. METHODS: In a randomized, double-blind, placebo-controlled trial at 10 Veterans Affairs medical ce ... Full text Link to item Cite

Airway sensory replacement as a treatment for smoking cessation

Journal Article Drug Development Research · December 1, 1996 Although nicotine may be a necessary component of the smoking addiction, it is obvious even to the non-expert that there is far more to smoking than the delivery of nicotine alone. Among the many aspects of smoking that smokers find pleasurable, 60% of smo ... Full text Cite

Dissociating the nicotine and airway sensory effects of smoking.

Journal Article Pharmacol Biochem Behav · February 1996 This study examined the subjective and cardiovascular effects of two of the components of cigarette smoking when given separately: nicotine and airway sensations. Using a within-subjects design, six healthy volunteer smokers, age 18-45 years, who smoked at ... Full text Link to item Cite

Nicotine/mecamylamine combination treatment for smoking cessation

Journal Article Drug Development Research · January 1, 1996 Pharmacotherapies for smoking cessation that can be used in a minimal behavioral intervention setting are urgently needed. The studies described in this article show that the nicotinic antagonist mecamylamine is efficacious when administered in combination ... Full text Cite

Curriculum survey of substance abuse teaching

Journal Article Journal of Investigative Medicine · January 1, 1996 Substance abuse is the leading cause of preventable death in our society. In this project we surveyed the faculty at one university medical school to describe the substance abuse curriculum. We employed a two-stage mail survey: of 1340 surveys mailed, 754 ... Cite

Accuracy and reliability of apical S3 gallop detection.

Journal Article J Gen Intern Med · August 1995 This study assessed physician performance in detecting the apical S3 gallop using a cardiology patient simulator. Six physicians (two cardiology fellows, two medicine residents, and two attending physicians) performed two sets of 24 cardiac examinations th ... Full text Link to item Cite

Does smokeless tobacco cause hypertension?

Journal Article South Med J · July 1995 This article reviews the literature regarding the cardiovascular effects of smokeless tobacco use. Articles were identified using a MEDLINE search of the English-language literature from 1966 to 1992 and a manual search of bibliographies of identified arti ... Full text Link to item Cite

Airway sensory replacement combined with nicotine replacement for smoking cessation. A randomized, placebo-controlled trial using a citric acid inhaler.

Journal Article Chest · May 1995 STUDY OBJECTIVE: This study was conducted to determine if the combination of airway sensory replacement and nicotine replacement improves 10-week smoking abstinence rates over nicotine replacement alone. DESIGN: Double-blind, randomized, placebo-controlled ... Full text Link to item Cite

Nicotine as a therapeutic drug.

Journal Article N C Med J · January 1995 Current evidence about the therapeutic potential of nicotine is strongest for ulcerative colitis. The role, if any, of nicotine therapy in Parkinson's or Alzheimer's diseases is not clear, but further research appears warranted. We need more information ab ... Link to item Cite

Should physicians screen for oral disease? A physical examination study of the oral cavity.

Journal Article J Gen Intern Med · October 1994 OBJECTIVE: To assess how well primary care clinicians select patients needing early referral to a dentist based on an oral cavity examination. DESIGN: Prospective comparison of the screening oral cavity examinations performed by primary care clinicians wit ... Full text Link to item Cite

Mecamylamine combined with nicotine skin patch facilitates smoking cessation beyond nicotine patch treatment alone.

Journal Article Clin Pharmacol Ther · July 1994 OBJECTIVE: To evaluate concurrent administration of mecamylamine (nicotine antagonist) with nicotine skin patch treatment for smoking cessation. METHODS: This was a randomized, double-blind, placebo-controlled trial. Forty-eight healthy smokers who smoked ... Full text Link to item Cite

Nicotine skin patch treatment increases abstinence, decreases withdrawal symptoms, and attenuates rewarding effects of smoking.

Journal Article J Clin Psychopharmacol · February 1994 A variety of studies have shown that nicotine skin patches are effective in promoting smoking cessation. This study replicated this effect, in addition, nicotine skin patches were found to decrease a variety of withdrawal effects, including craving for cig ... Link to item Cite

Combined Effects of Nicotine and Mecamylamine in Attenuating Smoking Satisfaction

Journal Article Experimental and Clinical Psychopharmacology · January 1, 1994 Separate and combined effects of nicotine and the nicotinic antagonist mecamylamine were studied. Twelve smokers rated test cigarettes after administration of mecamylamine versus placebo capsules and nicotine versus nonnicotine preload. Smoking withdrawal ... Full text Cite

Resident recognition of open-angle glaucoma: effects of an educational intervention.

Journal Article J Gen Intern Med · September 1993 To test an educational intervention's effect on improving detection of glaucoma by direct ophthalmoscopy, 14 medicine residents examined five patients, two with ophthalmoscopic changes of glaucoma and three with normal fundi. The residents observed a stand ... Full text Link to item Cite

The nicotine patch in smoking cessation. A randomized trial with telephone counseling.

Journal Article Arch Intern Med · August 23, 1993 BACKGROUND: This study was conducted to determine the efficacy of the nicotine patch in smoking cessation when combined with self-help materials, three brief visits, and telephone counseling. METHODS: One hundred fifty-nine healthy volunteers who smoked at ... Link to item Cite

Treatment of acute myocardial infarction.

Journal Article N Engl J Med · August 5, 1993 Full text Link to item Cite

Smokeless tobacco use in an outpatient veteran population.

Journal Article South Med J · August 1993 Smokeless tobacco use is a significant health risk for carcinoma of the oropharynx, and has a high prevalence in the southern United States. To evaluate the potential demand for a smokeless tobacco cessation program, we surveyed patients attending the Gene ... Full text Link to item Cite

The effect of sleeved arms on oscillometric blood pressure measurement.

Journal Article J Gen Intern Med · June 1993 The authors measured the blood pressures of 36 subjects who had bare and sleeved arms to determine the effect of wearing sleeves on automatic oscillometric blood pressure measurements. They found no statistically significant effect of sleeves on the measur ... Full text Link to item Cite

Pharmacokinetics of a transdermal nicotine patch compared to nicotine gum

Journal Article Drug Development and Industrial Pharmacy · January 1, 1993 A new transdermal nicotine delivery system (TBS-NCT)was investigated in laboratory and clinical studies with healthy cigarette smokers. Plasma nicotine concentration time profiles were characterized during and after 24-hr application of three doses of TBS- ... Full text Cite

Licorice, tobacco chewing, and hypertension.

Journal Article N Engl J Med · March 22, 1990 Full text Link to item Cite