High saturated fatty acid intake induces insulin secretion by elevating gastric inhibitory polypeptide levels in healthy individuals.

Insulin resistance is central to the etiology of the metabolic syndrome cluster of diseases. Evidence suggests that a high-fat diet is associated with insulin resistance, which may be modulated by dietary fatty acid composition. We hypothesized that high saturated fatty acid intake increases insulin and gastric inhibitory polypeptide (GIP) secretion. To clarify the effect of ingested fatty acid composition on glucose levels, we conducted an intervention study to investigate the insulin and plasma GIP responses in 11 healthy women, including a dietary control. Subjects were provided daily control meals (F-20; saturated fatty acids/monounsaturated fatty acids/polyunsaturated fatty acids [S/M/P] ratio, 3:4:3) with 20 energy (E) % fat, followed by 2 isoenergetic experimental meals for 7 days each. These meals comprised 60 E% carbohydrate, 15 E% protein, and 30 E% fat (FB-30; high saturated fatty acid meal; S/M/P, 5:4:1; F-30: reduced saturated fatty acid meal; S/M/P, 3:4:3). On the second day of the F-20 and the last day of F-30 and FB-30, blood samples were taken before and 30, 60, and 120 minutes after a meal tolerance test. The plasma glucose responses did not differ between F-20 and FB-30 or F-30. However, insulin levels were higher after the FB-30 than after the F-20 (P < .01). The GIP response after the FB-30 was higher than that after the F-30 (P < .05). In addition, the difference in the incremental GIP between FB-30 and F-30 correlated significantly and positively with that of the insulin. These results suggest that a high saturated fatty acid content stimulates postprandial insulin release via increased GIP secretion.

[Relationships between the changes in eating behavior and alleviation of symptoms observed in high and low risk groups of metabolic syndrome].

BACKGROUND: Eating behavior change (EBC) is essential to remedy metabolic syndrome (MetS). We carried out our clinic-based health and nutrition intervention informed by the transtheoretical model (TTM) to promote EBC. In particular, we aimed to foster EBC among individuals who were in the cognitive stage (C-level stage) of their health behavior, in contrast to the model positing that those in C-level stage are less likely to adopt EBC than those in the behavioral stage (B-level stage). The degree of each one's risk for MetS was also examined. SUBJECTS: The study population comprised 108 adults (38 males aged 58 +/- 10.8 SD and 70 females aged 60 +/- 6.6). METHODS: SUBJECTS were given instruction and support for over a 3-month period. MetS diagnostic criteria values, dietary intake and TTM were measured before and/or after the intervention. On the basis of their MetS and TTM scores, subjects were classified into two groups according to risk (high or low) and stage (C or B). Multiple linear regression analysis was performed. RESULTS: In both risk groups, EBC stage scores advanced in many subjects, progressing from C to B-level stage. Reduction in abdominal circumference and improvement of the MetS criteria values were also observed particularly in the high-risk group and those in the B-level stage. Stage-specific improvements in physical characteristics, the MetS criteria values and energy intake were likewise seen in both risk groups. Abdominal circumference reduction was negatively and positively correlated with EBC stage scores and fat energy ratio, respectively. CONCLUSION: From the results, it was proved that improvements of MetS criteria values concomitantly occurred with reduction of eating energy intake, especially fat energy, as well as advance of EBC from C to B-level stage. In addition, we found it effective to let the participants recognize their degrees of risk for MetS.

The prevalence of diabetes mellitus and impaired fasting glucose/glycaemia (IFG) in suburban and rural Nepal-the communities--based cross-sectional study during the democratic movements in 1990.

A rising prevalence of Type 2 diabetes and impaired fasting glucose/glycaemia (IFG) was recently reported in the urban areas of Nepal by Singh and Bhattarai [D.L. Singh, M.D. Bhattarai, High prevalence of diabetes and impaired fasting glycaemia in urban Nepal, Diabet. Med. 20 (2003) 170-171] in the first population-based study based on the revised diagnostic criteria of ADA-1997 and WHO-1998. In comparison with our community-based survey done in 1990 in suburban and rural areas of Nepal, the current data show a surprisingly rapid increase in the prevalence of diabetes in the Nepalese population. In our 1990 study, diabetes and IFG, respectively, were present in 1.4 and 2.5% of people > or =20 years old in suburban village (Bhadrakali) compared with 0.3 and 0.7% in a rural village (Kotyang). In a short communication, Singh and Bhattarai found the rates to be 14.6 and 9.1% in urban areas, and 2.5 and 1.3% in rural areas. This phenomena appears to have been influenced more by rapid urbanization and changes in lifestyles after the ongoing democratic movements that have taken place since 1990 in Nepal. Moreover, our new analysis of the data provide baseline features for the planning of health care policy and establishment of medical priorities in modern day Nepal.

Irregular patterns in the daily weight chart at night predict body weight regain.

This study examined whether charting daily weight patterns can predict weight regain in obese patients. The subjects were 98 moderately obese Japanese women aged 23 to 66 years who were obliged to precisely record their daily weights during the initial 4-month education period, but not thereafter. The patients were followed up at 8, 12, and 16 months. Abdominal fat areas and blood samples were assessed in the outpatient clinic at 0, 4, and 16 months. The standard deviations (SDs) of the differences in body weight between "after waking up" and "after breakfast" (SDa), "after dinner" (SDb), and "before going to bed" (SDc) were calculated, which were parameters reflecting the fluctuations in the daily weight patterns during the first 4 months. SDc, but not SDa or SDb, was correlated positively with weight regain at 8, 12, and 16 months (P = 0.049, P = 0.002, and P = 0.001, respectively). There were significant differences in temporal change in body weight and abdominal visceral fat between the small SDc group (SDc 75th percentile), but not for subcutaneous abdominal fat or the serum concentrations of glucose, insulin, or lipids. The results indicate that fluctuation of body weight immediately before going to bed is useful for predicting the rebound in body weight.

Bancroftian filariasis in Nepal: a survey for circulating antigenemia of Wuchereria bancrofti and urinary IgG4 antibody in two rural areas of Nepal.

Serum and urine samples were randomly collected from residents in two rural areas at different altitudes in Nepal, and were examined for Wuchereria bancrofti antigens and antibodies (IgG4) to filarial antigens, respectively. In Judigaun, located at 900 m in altitude, 25.2% of 238 serum samples were positive for antigen, and 50.8% of 244 urine samples were positive for antibody. The level of IgG4 antibodies was higher among antigen positive individuals than among the antigen negatives. In Kotyang, located at 1100-1300 m, the prevalence of antigenemia was 15.4% of 117 serum samples.

Estimated protein intake and blood pressure in a screened cohort in Okinawa, Japan.

We examined the relation between protein intake and blood pressure in a screened cohort in Okinawa, Japan. A total of 1,299 screened subjects, 885 men and 414 women, were examined at the Okinawa General Health Maintenance Association. Daily intake of sodium (Na) and potassium (K) was estimated from Na, K, and creatinine excretion by the method of Kawasaki et al., and daily protein intake was estimated by the method of Maroni et al. as the estimated daily urinary excretion of urea nitrogen. Mean (SD) daily protein intake was 71.8 (18.6) g in men and 54.0 (13.5) g in women, and the mean (SD) daily protein intake per unit kg body weight was 1.1 (0.2) g/kg in men and 1.0 (0.2) g/kg in women. In men, both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in those with lower protein intake (LP; < 1.0 g/kg/day) than in those with higher protein intake (HP; > or = 1.0 g/kg/day) (p < 0 .05 for DBP). In women, both SBP and DBP were higher in those with LP than in those with HP, but these differences were not statistically significant. However, urinary excretion of both Na and K was lower in those with LP than in those with HP, respectively, both in men and women (p < 0.0001). In summary, estimated daily protein intake was about 1.1 g/kg in men and 1.0 g/kg in women. Despite the higher urinary excretion of Na, both SBP and DBP tended to be lower in those with higher daily protein intake, particularly in men.

Relationship between changes in serum leptin levels and blood pressure after weight loss.

Insulin resistance is thought to raise blood pressure. Recently, a significant positive relationship between mean blood pressure and plasma leptin levels, but there have been no reports dealing with the relationship between blood pressure and either insulin resistance or serum leptin levels after weight loss. In the present work, we attempted to clarify the relationship between changes in blood pressure and either the serum leptin level or the insulin level in 102 moderately obese females (mean body mass index (BMI), 29.5 +/- 0.5 kg/m2; age, 47.0 +/- 0.9) during a 3 month period. No differences in age, fat-mass, homeostasis model assessment (HOMA), the summation of insulin (sigmaIRI), plasma renin activity (PRA) or 24 h norepinephrine excretion (24hU-NE) were observed between the hypertensive (HT) group (n = 31) and normotensive (NT) group (n = 71) before weight loss, but the basal serum leptin was significantly higher in the HT (16.8 +/- 1.1 ng/ml) than in the NT group (15.2 +/- 0.8 ng/ml), after adjusting for abdominal total fat. After a 3 month weight reduction program, the total abdominal fat, serum leptin and sigmaIRI significantly decreased in both groups. The systolic blood pressure (SBP)/diastolic blood pressure (DBP) significantly decreased from 144/84 to 130/77 mmHg only in the HT but not in the NT group. The PRA decreased in both groups, while the 24hU-NE significantly decreased only in the HT group. The changes in the leptin level were significantly correlated with the changes in both sigmaIRI and HOMA after weight loss in the two groups, respectively. Finally, a statistically significant positive correlation was observed between the changes in the leptin and the changes in the mean blood pressure (MBP) (r = 0.412, p < 0.05) only in the HT group. Multiple regression analysis revealed that the changes in MBP were independently associated with the changes in 24hU-NE and the changes in either sigmaIRI or HOMA in all subjects. However, a statistically significant positive correlation was observed between the changes in MBP and the changes in leptin levels even after adjusting for the total abdominal fat, 24hU-NE and either sigmaIRI or HOMA (both expressed as a percentage of the baseline value) in a multiple regression analysis only in the HT group. These results suggest that leptin may play a role in the pathophysiology of obese hypertension.

[Antihypertensive effect and safety evaluation of vegetable drink with peptides derived from sardine protein hydrolysates on mild hypertensive, high-normal and normal blood pressure subjects].

A randomized double-blind placebo-controlled study was conducted on 63 subjects to determine the antihypertensive effect of a vegetable drink in which sardine protein hydrolysates containing a dipeptide, Valyl-Tyrosine (VY), were incorporated. The subjects, consisting of people with mild hypertension, high-normal blood pressure and normal blood pressure, were randomly divided into test (male/female = 25/6, average age 50.1 +/- 10.4 years old) and control groups (26/6, 49.0 +/- 5.0). Each subject in the test group was given 195 g of the vegetable drink containing 0.5 g of sardine peptides (sardine protein hydrolysates) with 0.4 mg of VY (test drink) once a day for 13 weeks in a row, and subjects in the control group were given the same amount of the vegetable drink without sardine peptides (control drink) in the same manner. In the test group, 40 subjects with mild hypertension or high-normal blood pressure (130 mmHg < or = systolic blood pressure (SBP) < 160 mmHg and/or 80 mmHg < or = diastolic blood pressure (DBP) < 100 mmHg) showed a significant decrease in SBP, from 142.0 +/- 10.3 mmHg at the start of the test to 134.4 +/- 11.1 mmHg during the first week of the test period, after which similar values were seen throughout the test period (13 weeks). Compared to the control group, the difference in SBP from baseline was statistically significant in the test group throughout the intake period. DBP also decreased significantly from 88.0 +/- 7.9 mmHg at baseline to 83.5 +/- 8.6 mmHg after 13 weeks. In the control group, SBP and DBP were 140.8 +/- 8.4 mmHg and 90.5 +/- 6.6 mmHg respectively at the start of the test, and neither decreased during the test period. In subjects with normal blood pressure, neither those in the test group nor those in the control group showed a significant change in SBP and DBP during the test period. An excessive ingestion test was performed on 25 subjects with hypertension, mild hypertension, high-normal blood pressure, and normal blood pressure by giving 585 g (3 times the recommended amount of intake) of the test drink for 14 days in a row. As a result, a significant decrease of blood pressure was observed in the hypertension, mild hypertension and high-normal blood pressure groups, but no excessive decline in blood pressure or any side-effects were associated with any subjects during the test period. In the groups with normal blood pressure, the excessive ingestion of the test drink did not affect blood pressure. In these two studies, physical check-ups and biochemical analyses of blood and urine were also conducted in all subjects, and no abnormalities were observed. These results suggest that the test drink containing sardine protein hydrolysates exhibited the antihypertensive effect in only the subjects with mild hypertension or high-normal blood pressure. No adverse effects were observed in either hypertensive or normotensive subjects.

Urinary excretion of sodium and potassium in a screened cohort in Okinawa, Japan.

Information regarding daily intake of sodium (Na) is useful for both normotensive and hypertensive subjects. We measured urinary excretion of sodium (U-Na) and urinary excretion of potassium (U-K) to estimate daily salt intake in a cohort of health screening subjects in Okinawa, Japan. Urine samples were obtained from 2,411 subjects (1,554 men and 857 women) who were examined on a half-day dry-doc at the Okinawa General Health Maintenance Association (OGHMA). Four hundred and one subjects were examined twice, once between September and November in 1997, and once between September and November in 1998. The mean U-Na was 182 mEq/day for men and 176 mEq/day for women. The mean U-K was 54 mEq/day for men and 50 mEq/day for women. U-Na was higher in young men, and U-K was lower in young women. In both men and women, smokers had a significantly lower Na excretion compared to nonsmokers. Subjects treated for hypertension had a significantly lower Na excretion (173 mEq/day) compared to subjects not treated for hypertension (192 mEq/day). Our findings suggest that Na excretion in screened subjects in Okinawa is lower than the national average. Sodium excretion, however, was higher in young men than in elderly subjects, and K excretion was lower in young women than in elderly subjects. Both trends are disadvantageous for controlling hypertension.

Effects of a 1 day fast on biohumoral variables associated with human circadian rhythmicity.

1. The aim of the present study was to investigate the effects of a short (1 day) fast by testing biohumoral variables associated with the human circadian rhythm. 2. Fifteen clinically healthy male volunteers (32 +/- 8 years old) participated in the study. Subjects were fed a control diet for 7 days. The last day was a control day and the following 8th day was the fasting day. Each subject was asked to collect urine seven times over a 24 h period. Chemical and hormonal variables were measured in each fractionated urine specimen. The time- qualified urinary excretion rates were biometrically analysed using conventional and chronobiological methods. 3. During fasting, significant incremental changes were detected in the urinary excretion rates of potassium, aldosterone, 17-hydroxycorticosteroids and adrenaline and significant decremental changes were detected in the excretion rates of sodium, chloride, creatinine, urea nitrogen, uric acid, 17-ketosteroids, noradrenaline and dopamine. The circadian rhythmicity of the variables was well preserved and remained almost stable throughout the fasting phase. 4. Fasting affected the mean oscillatory levels and oscillatory amplitudes of variables, suggesting that nutrients may have played roles as tonic and phasic modulators on the mechanisms that physiologically regulate ircadian rhythmicity.