Association of the National Health Guidance Intervention for Obesity and Cardiovascular Risks With Health Outcomes Among Japanese Men

Fukuma, Shingo; Iizuka, Toshiaki; Ikenoue, Tatsuyoshi; Tsugawa, Yusuke

doi:10.1001/jamainternmed.2020.4334

Cited by 59 publications

(64 citation statements)

References 21 publications

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“…The reason for stagnation in MetS prevalence in Japan is thought to be low participation in the Specific Health Guidance program. [8][9][10]12 In our study, although the questionnaire was not an established one and the data were not shown, 50% of the participants felt that it was easy to follow LOCABO, while 68% found it easier to follow it compared to other dietary approaches they had previously attempted. These findings suggest that LOCABO is a suitable method for improving participation in the Specific Health Guidance program.…”

Section: Discussionmentioning

confidence: 73%

“…9 Although preliminary evaluation studies have reported that the participants of the Specific Health Guidance program achieved body weight reduction (on average, 1.98 kg for men and 2.25 kg for women) and improvement in plasma glucose, blood pressure, and lipid profile; 10 , 11 a recent large-scale evaluation revealed no association between the Specific Health Guidance and clinically meaningful weight loss or improvement of other cardiovascular risk factors. 12 The Specific Health Guidance involves lifestyle interventions such as energy restriction and encouragement of physical activity, which are perceived as troublesome and difficult to maintain. 13 , 14 This suggests that novel methods of effective implementation are needed.…”

Section: Introductionmentioning

confidence: 99%

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Changes in Body Weight, Dysglycemia, and Dyslipidemia After Moderately Low-Carbohydrate Diet Education (LOCABO Challenge Program) Among Workers in Japan

Yamada¹,

Inoue²,

Ooyane³

et al. 2021

DMSO

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Purpose It is theorized that the prevalence of obesity has not decreased owing to poor adherence to implemented programs addressing metabolic syndrome, obesity, and diabetes in Japan. Therefore, we intended to evaluate the influence of a moderately low-carbohydrate diet on improving markers of metabolic syndrome among workers in Japan. Patients and Methods Participants with metabolic syndrome or obesity were recruited based on the eligibility criteria for the Specific Health Guidance program and educated on a moderately low-carbohydrate diet between spring 2016 and fall 2018. The participants were then made to report their food intake and body weight once a week for the next 12 weeks and were counselled on maintaining a moderately low-carbohydrate diet. HbA1c levels, lipid profile, body weight, and sleep quality were evaluated. The normality of the data was evaluated using the Skewness/Kurtosis test. Each variable was compared before and after the intervention using the Wilcoxon signed-rank test. Further, a subgroup analysis of the data from the participants whose variables were abnormal at baseline was performed. Results Among the 101 enrolled participants, a decrease in the median weight (from 82.5 to 79.7 kg, p<0.001, n=46), body mass index (from 27.3 to 26.9 kg/m 2 , p<0.001, n=46), and apnea-hypopnea index (from 24.1 to 17.1, p<0.01, n=39) was observed. Subgroup analysis of participants with abnormal baseline values revealed changes in HbA1c (from 6.7% to 5.8%, p<0.001, n=34), total cholesterol (from 220 to 209 mg/dL, p<0.01, n=54), low-density lipoprotein cholesterol (from 133 to 120 mg/dL, p<0.001, n=31), high-density lipoprotein cholesterol (from 35 to 40 mg/dL, p<0.01, n=31), triglycerides (from 242 to 190 mg/dL, p<0.01, n=57), and deep sleep percentage (from 10.4% to 18.2%, p<0.05, n=7). Conclusion A moderately low-carbohydrate diet may be considered a potential intervention for improving the markers of metabolic syndrome, obesity, and diabetes.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Changes in Body Weight, Dysglycemia, and Dyslipidemia After Moderately Low-Carbohydrate Diet Education (LOCABO Challenge Program) Among Workers in Japan

Yamada¹,

Inoue²,

Ooyane³

et al. 2021

DMSO

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“…In Japan, a nationwide screening program was introduced to identify the subjects with obesity (BMI ≥ 25.0 kg/m 2 ) and risk factors of cardiovascular disease and to provide health guidance to prevent the development and progression of metabolic disorders and cardiovascular disease among the working-age population in 2008 [ 31 ]. However, Fukuma S. et al have reported that the national health guidance intervention was not associated with the reduction of cardiovascular risk such as diabetes [ 32 ]. Further research is needed to specify the subjects at high risk of metabolic disorders with or without obesity.…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors for Development of Type 2 Diabetes: Panasonic Cohort Study 4

Saijo

Okada

Hamaguchi

et al. 2022

IJERPH

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(1) Background: As no study has evaluated the risk factors contributing to the development of type 2 diabetes according to body weight mass (BMI) categories in a large cohort and over a long period in a Japanese population, we aimed to assess them in 46,001 Japanese individuals; (2) Methods: This long-term retrospective cohort study included individuals who participated in a medical health checkup program at Panasonic Corporation from 2008 to 2018. In total, 3,208 participants developed type 2 diabetes. The BMI at 2008 were divided into 3 groups: BMI < 22 kg/m2, 22 ≤ BMI < 25 kg/m2, and BMI ≥ 25 kg/m2 to evaluate the risk factors for type 2 diabetes; (3) Results: Cox regression analyses revealed that the significant risk factors were age, BMI, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting plasma glucose, current smoking status, and alcohol consumption in populations with BMI ≥ 25.0 kg/m2. The risk factors in the population with 22 ≤ BMI < 25 kg/m2 were identical to that of BMI ≥ 25.0 kg/m2 excluding systolic blood pressure, low-density lipoprotein cholesterol, and skipping breakfast. However, in the population with BMI < 22.0 kg/m2, no association was found as to BMI, SBP, LDL cholesterol level, and triglycerides; (4) Conclusions: The risk factors for developing diabetes were quite different between the population with BMI < 22 kg/m2 and the population with 22 ≤ BMI < 25 kg/m2 or BMI ≥ 25 kg/m2 in a Japanese population.

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“…However, it was reported that most subjects eligible for the guidance/intervention program did not attend the program [ 19 , 20 ], and only approximately 10% of the eligible subjects completed the program [ 21 ]. Furthermore, although the intervention program itself was shown to be sufficiently effective in eliciting behavioral modifications and improving abdominal obesity [ 19 ], a recent study reported that this intervention program was not associated with clinically meaningful weight loss or improvement of other CV risk factors [ 22 ]. Although the present study did not evaluate this particular program, our real-world results would add to these previous findings.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Annual Health Checkups with the Subject’s Subsequent Behavior of Cardiovascular Risk Management in a Real-World Setting in Japan: A Retrospective Cohort Study on Changes in Antihypertensive Drug Prescription and Blood Pressure from 2015 to 2017

Higa

Yoichi

Nozawa

et al. 2021

Drugs - Real World Outcomes

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Background In Japan, workers receive a health checkup annually, and based on the results, a follow-up health guidance or intervention is provided when deemed necessary. However, it remains unclear whether the current real-world health checkup and guidance programs in Japan successfully lead to behavioral changes or improvement of clinical outcomes in individuals who require cardiovascular (CV) risk management. Objective This study aimed to explore the association between health checkup and the subsequent behavior change in CV risk management in subjects with uncontrolled blood pressure (BP) without antihypertensive drug prescription, who can have increased risk of CV events. Patients and Methods This was a retrospective cohort study that used health-checkup and claims data from a Japanese healthcare database managed by MinaCare Co., Ltd. Of those aged 20–74 years with available data on systolic and diastolic BP from 2015 to 2017, data from individuals with uncontrolled BP who were not prescribed antihypertensive drugs within 6 months before their baseline health checkup in 2015 were extracted and analyzed. The primary outcome measures were changes in antihypertensive drug prescription and BP control status based on health-checkup results from the baseline year (2015) to 2017. CV risk-management behavior was also assessed using body mass index (BMI) and smoking status, as these are the major modifiable CV risk factors. Results Among 39,242 subjects with uncontrolled BP without antihypertensive drug prescription at baseline, 88.9% remained without prescription in 2016. Of the subjects without prescription, 62.9% continued to have uncontrolled BP. Both statuses of the major modifiable CV risk factors remained unchanged in 2016: 92.1% of obese subjects (BMI ≥ 25 kg/m 2 ) at baseline remained obese, and 93.8% of smokers at baseline aged ≥ 40 years continued to smoke. Logistic regression analysis revealed that age 60–69 years (vs. 40–49 years), hypertension (HT) stage II (vs. stage I), HT stage III (vs. stage I), and BMI ≥ 25.0 kg/m 2 (vs. < 25.0 kg/m 2 ) were factors associated with uncontrolled BP in 2016 (subsequent year), regardless of antihypertensive drug prescription. Conclusions Untreated HT for years increases the risk of CV events. These results suggest that current health-checkup and guidance programs are inadequately effective for behavioral change. Further practices for committing to lifestyle modifications and seeking medical advice based on their health-checkup results need to be undertaken to improve health behavior. Supplementary Information The online version contains supplementary material available at 10.1007/s40801-020-00224-5.

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Association of the National Health Guidance Intervention for Obesity and Cardiovascular Risks With Health Outcomes Among Japanese Men

Cited by 59 publications

References 21 publications

Changes in Body Weight, Dysglycemia, and Dyslipidemia After Moderately Low-Carbohydrate Diet Education (LOCABO Challenge Program) Among Workers in Japan

Changes in Body Weight, Dysglycemia, and Dyslipidemia After Moderately Low-Carbohydrate Diet Education (LOCABO Challenge Program) Among Workers in Japan

The Risk Factors for Development of Type 2 Diabetes: Panasonic Cohort Study 4

Relationship of Annual Health Checkups with the Subject’s Subsequent Behavior of Cardiovascular Risk Management in a Real-World Setting in Japan: A Retrospective Cohort Study on Changes in Antihypertensive Drug Prescription and Blood Pressure from 2015 to 2017

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