Effects of a lifestyle modification programme to reduce the number of risk factors for metabolic syndrome: a randomised controlled trial.

OBJECTIVE: To determine the effectiveness of a personal support lifestyle education programme (PSMetS) for reducing risk factors in individuals with metabolic syndrome (MetS). DESIGN: A two-arm randomised controlled trial. SETTING: Companies in metropolitan Tokyo, Japan. SUBJECTS: Male workers with diagnosed MetS or a high risk for MetS according to the Counselling Guidance Program, Japan (n 193). RESULTS: The reduction in the number of risk factors for MetS (as defined according to the criteria published by the Japanese Ministry of Health, Labor and Welfare in April 2007 (MHLW-MetS)) in the PSMetS group was not significantly different from that in the usual care group by van Elteren's test (baseline-adjusted P=0·075) for intention-to-treat (ITT), while it was significant (baseline-adjusted P=0·038) for per-protocol set (PPS). The proportion of MHLW-MetS was significantly different between groups by van Elteren's test (baseline-adjusted P=0·031). Two components of MHLW-MetS showed significant reductions in the PSMetS group: waist circumference (baseline-adjusted P=0·001) and BMI (baseline-adjusted P=0·002). PPS and ITT analyses showed similar results. CONCLUSIONS: For male workers with MHLW-MetS or a high risk of MHLW-MetS, PSMetS reduced the number of risk factors for MHLW-MetS.

[The association between subjective symptoms and lifestyle habits among junior high school students a cross-sectional survey in Kumamoto, Japan].

OBJECTIVES: This study aimed to examine the association between subjective symptoms and lifestyle habits among junior high school students by using a cross-sectional survey. METHODS: The survey was conducted during May-November 2012. The study subjects were 1229 adolescents (527 boys and 702 girls, age 12-13 years) from 10 junior high schools in Kumamoto Prefecture, Japan. Data from 1182 students (500 boys and 682 girls; response rate 96.2%) were used for the analyses. School nurses measured students' body weights and heights. A self-administered questionnaire examining dietary intake (FFQW82), subjective symptoms (12 items), lifestyle habits (18 items), and diet- and health-related topics (9 items) was used. The 4 categories of each of the 12 subjective symptoms were classified into dichotomous variables (1=always or sometimes; 0=occasionally or never). The subjective symptom score was calculated as a total score by summing up the dichotomous variables for the 12 subjective symptoms. Associations were examined using a chi-square test, Student's t-test, Wilcoxon rank sum test, and a stepwise regression model. The structure of factors was examined by factor analysis (varimax rotation) and associations among the question items were examined by principal component analysis. A significance level of 5% (two-sided) was applied and SAS ver. 9.3 software was used for the analyses. RESULTS: Students' body weights and heights were mostly at or near national averages. The ratio of energy intake at breakfast, lunch, and dinner for the 1-day total energy intake (kcal) was respectively 2:3:4, indicating decreased energy intake at breakfast. The percent energy (%E) from fat of the 1-day total energy intake was 29%E for boys and 30%E for girls. Using regression models, we found that the following lifestyle factors were significantly related to fewer subjective symptoms: "balanced diet," and "sleeping 6 hours or more per day" were for boys and girls, "regularly eating three meals a day," "strong appetite," and "having relaxation time" for girls. However, the following factors were significantly related to more subjective symptoms: "eating hurriedly," and "2 hours or more of watching television or playing video games" were for boys and girls, "cooking meals or sweets" for boys, "eating snacks and nighttime meals," and "eating dinner after 9 p.m.," and "preparing bento (boxed lunches)" for girls. Dietary intake was not significantly related to subjective symptoms. CONCLUSION: Findings from this study suggest that subjective symptoms are associated with lifestyle habits among junior high school students.

Validity and reproducibility of the FFQ (FFQW82) for dietary assessment in female adolescents.

OBJECTIVE: To assess the validity and reproducibility of a self-administered FFQ with eighty-two food items (FFQW82) for assessing the habitual diet in female adolescents. DESIGN: The validity of the FFQW82 for assessment of nutrient intake was evaluated by comparison with a 7 d weighed food record (7d-FRRI) reported as 'gold standard'. Reproducibility of the FFQW82 was assessed at an interval of 1 month (test-retest method). The first survey (FFQW82 and 7d-FRRI) was conducted in April 2007 and the second FFQW82 survey was conducted in May 2007. Daily consumption of energy from eleven food groups and nine nutrients were calculated from both instruments for breakfast, lunch, dinner and the whole day. Crude and energy-adjusted Pearson correlation coefficients were calculated using log-transformed data. SETTING: Middle school, Tokyo, Japan. SUBJECTS: Female adolescents aged 12-13 years. RESULTS: Sixty-three female adolescents completed both surveys. The relative difference between the energy intake calculated by the FFQW82 and the 7d-FRRI for the whole day, breakfast, lunch and dinner was 8 %, 10 %, 15 % and 10 %, respectively. As for validity, the correlation coefficient of total energy intake for the whole day was 0·31. The result for breakfast was relatively higher (0·59) compared with that for lunch (0·40) and dinner (0·32). For macronutrients, the energy-adjusted correlation coefficient ranged from 0·28 (carbohydrates) to 0·53 (protein). Reproducibility of total energy intake was 0·62 and ranged from 0·46 (fat) to 0·69 (carbohydrate) for macronutrients. CONCLUSIONS: These results suggest that the FFQW82 has proved to have some potential with regard to reproducibility among our study population.

Randomized controlled trial of a new dietary education program to prevent type 2 diabetes in a high-risk group of Japanese male workers.

OBJECTIVE: The aim of this study was to assess the effectiveness of a new dietary education (NDE) program in reducing plasma glucose (PG) levels in Japanese male workers at high risk for type 2 diabetes through a randomized controlled trial. RESEARCH DESIGN AND METHODS: We randomly assigned 173 high-risk men (mean age, 55 years) to either the NDE or the control (conventional dietary education) group. Each subject in the NDE group received two individualized interventions especially aimed at reducing total energy intake at dinner by modifying dietary intake. The control group received conventional group counseling. An "overintake/underintake fraction" for total energy intake was used to measure the status of dietary intake. Our hypothesis was that the NDE group would have a 10% decrease in 2-h PG 1 year after the start of the education. Outcome measures were compared with ANCOVA by adjusting for baseline values. RESULTS: The NDE group had a significantly lower total energy intake at dinner and daily than the control group. The adjusted differences in changes from baseline in the absolute value of the 'overintake/underintake fraction' were -15.3% (95% CI -24.6 to -6.0%, P = 0.002) for dinner and -6.0% (-9.8 to -2.2%, P = 0.002) for daily [corrected]. The NDE group had a decreased 2-h PG after 1 year, whereas that value was increased in the control group. The adjusted difference in the percent change of 2-h PG was significant (-15.2%, -22.0 to -8.4%, P < 0.001). CONCLUSIONS: The NDE was shown to reduce glucose levels in high-risk subjects for type 2 diabetes.