Objective Previous studies have shown that relative handgrip strength, handgrip measure divided by body mass index (BMI), affects the future onset of diabetes and prediabetes. However, fat free mass (FFM) has been suggested to adjust for this effect better than BMI. In this study, we examined applicability of models that adjusted handgrip-diabetes relationship with either BMI or FFM. Results Of 1940 participants (56.2% male, average (SD) age, 57.2 [11.2] years), 267 (13.8%) had diabetes (DM) and 912 (47.0%) had prediabetes (pre-DM). The average handgrip measure for men was 40.0 kg (tertile measures, 37.4 kg and 42.5 kg) and for women 24.2 kg (tertile measures, 22.6 kg and 25.7 kg). Among both sexes, the percentage of people unaffected by DM or pre-DM was highest in the strong handgrip group and lowest in the weak handgrip group. Analysis using binary logistic models showed that an increase in handgrip measure was associated with a decrease in the chance of having either pre-DM or DM. This effect was detected by both BMI models and FFM models, even after adjustment for medical and lifestyle factors. Either or both should be used depending on the research aims, setting and methods.

BACKGROUND: Long-term weight loss is difficult to maintain, but recently cognitive behavioral therapy has been shown to be effective for long-term weight loss and maintenance. METHODS:The 119 participants, who had been assigned to program to lose weight, were interviewed by dieticians regarding their motivation for weight loss and psychological status and self-corrected problems with their eating activities and exercises, following recognition of problems, discussing solutions, and devising personal dietary plans and exercise plan to loose weight at 1.0-2.0 kg per month. RESULTS: In women, the prevalence of motivation to resolve the situation (n = 44, 84.6%) was significantly higher than that of men (n = 33, 67.3%; p < 0.05). In men, awareness of the need to keep healthy by oneself was significantly associated with the motivation to resolve the situation (p = 0.002) and the availability of support from others (p = 0.004). Thirty problems and 29 dietary goals were set by participants. The percentages of intake of alcohol (p < 0.05) and intake of sweets (p < 0.01) as the problems and decrease of intake in specified foods (p < 0.01) and snacks (p = 0.05) as dietary goals were significantly different between men and women. Women with BMI over 31 kg/m 2 set fewer additional steps as exercise goals than those with BMI under 29 kg/m 2 (p < 0.05). CONCLUSIONS:The characters of subjects such as psychological status and the problems and the target recognized by participants were different between gender and the degree of obesity.Obesity is increasing in prevalence in Japan, and it represents a major risk not only for metabolic syndromes, such as type 2 diabetes, ischemic heart disease, hypertension, gout, and dyslipidemias, but also some cancers.1) Loss of 10% of starting weight is thought to be associated with amelioration of risk factors such as hypertension, hypercholesterolemia, and hyperglycemia.2) Traditional dietary treatment of obesity consists of an energy-reduced diet prescribed by dietitians to achieve weight loss in a short period. 3) Long term evaluations of obesity interventions indicate that weight loss accomplished through changes in diet and physical activity is rarely maintained. 4) Since Stuart first applied behavior therapy to weight loss in the obese, 5) more than 100 papers have been published in the field. The goal of behavioral treatment is for participants themselves to choose to reduce caloric intake and increase energy expenditures based on alternatives provided by professionals, such as the dietitians.Recently, cognitive behavioral treatment has been applied to weight loss in the obese. Cognitive behavioral treatment (therapy) is a methodology for systematically modifying eating and activity habits, other behaviors, or negative thoughts that appear to contribute to obesity using a combination of selfmonitoring, goal setting, stimulus control, cognitive restructuring, stress management, and social support. The cognitive behavioral treatment can be applied in an individual or group setting to a...