Health Education "Hokenshido" Program Reduced Metabolic Syndrome in the Amagasaki Visceral Fat Study. Three-Year Follow-up Study of 3,174 Japanese Employees

Abstract

Objective The aim of this study was to evaluate the effects of health checkup and the health education "Hokenshido" program based on the concept that visceral fat accumulation causes metabolic syndrome (MetS), leading to cardiovascular disease (CVD). Methods and SubjectsBased on the Japanese definition of metabolic syndrome, in the annual health checkup for general subjects, the measurement of waist circumference and use of "Where am I?" chart on the way to develop atherosclerosis were introduced. The study group comprised 3,174 Japanese employees .2%, 14.4%, p< 0.001) and females (3.0%, 2.2%, 1.9%, p=0.359), respectively. Among subjects with MetS at baseline, the number of subjects with MetS significantly decreased in males (508, 287, 247, p<0.0001) and females (22, 8, 6, p<0.0001), respectively. Mean waist loss was 1.6 cm in males (<0.0001) and 1.5 cm in females (<0.001). Among subjects with metabolic syndrome at baseline, the mean waist loss was 2.5 cm in males (<0.0001) and 3.9 cm in females (<0.05). Fatal atherosclerotic vascular events were not recorded in this study period. Conclusion Health check-up and the "Hokenshido" program reduced the prevalence of the MetS, which might lead to prevention of CVD.

Cross-sectional and longitudinal study of association between circulating thiobarbituric acid-reacting substance levels and clinicobiochemical parameters in 1,178 middle-aged Japanese men - the Amagasaki Visceral Fat Study

“…Table 1 left summarizes the profiles of all participants at baseline. After the health check-up, the medical staff, especially health nurses, provided the individual with annual health promotion program to promote voluntary lifestyle changes (2006 and 2007) [9]. In brief, the program emphasized hazards of visceral fat accumulation and multiple cardiovascular risk factors, with the aim of encouraging a scientific understanding of the concept of metabolic syndrome from visceral fat accumulation to the development of atherosclerotic cardiovascular diseases.…”

“…In brief, the program emphasized hazards of visceral fat accumulation and multiple cardiovascular risk factors, with the aim of encouraging a scientific understanding of the concept of metabolic syndrome from visceral fat accumulation to the development of atherosclerotic cardiovascular diseases. We reported previously that this program should be useful in reducing visceral fat accumulation and consequently decrease number of cardiovascular risks, such as glucose tolerance, dyslipidemia, high blood pressure [10], hypoadiponectinemia [11], and a prevalence of the metabolic syndrome [9], leading to prevention of cardiovascular events [12,13]. …”

Metabolic syndrome and lifestyle modification

“…It is true that there are so far few well-designed randomized controlled trials investigating the effects of these programs in subjects with abdominal obesity rather than general obesity. However, recent observational or single-arm studies including ours suggest that health promotion programs which are based on the concept of the metabolic syndrome and in which visceral adiposity heavily weigh will bring the reduction of visceral fat deposits and the improvement of various metabolic profiles in healthcare practice, seemingly without remarkable adverse effects [51,52] (Table 1). Future well-designed trials will be needed to accurately assess their beneficial effects and potential risks as well as their cost performance, although existing statements by authorities already recommend lifestyle modification as a key strategy for dealing with the metabolic syndrome [34,35].…”

Clinical significance of visceral fat reduction through health education in preventing atherosclerotic cardiovascular disease - Lesson from the Amagasaki Visceral Fat Study: A Japanese perspective

“…Furthermore, the same nurses also explained the results of the medical checkup and the relationship between the subject's lifestyle and the abnormalities recorded in the health check-up, to promote voluntary lifestyle changes. Voluntary lifestyle modification resulted in reductions in accumulated visceral fat (reversible stage) (Figure 1B) [4,5]. Another part of the health education program included inviting the subjects to participate in group discussions or one-to-one discussion with the public health nurses.…”

“…It is anticipated that normalization of visceral fat mass through participation in "Hokenshido" resulted in reductions in the incidence of glucose tolerance, dyslipidemia, hypertension [5] and hypoadiponectinemia [7], as well as the number of obesity-related cardiovascular risk factors [4] and hence help effectively prevent ACVD events [11]. Furthermore, by reducing visceral fat mass, "Hokenshido" prevent ACVD events in patients with the metabolic syndrome.…”