Anthropometric and Clinical Findings in Obese Japanese: The Saku Control Obesity Program (SCOP)

The associations of eating behavior and dietary intake with metabolic syndrome in Japanese: Saku cohort baseline study

Background

The prevention of metabolic syndrome (MetS) is a major public health concern in Japan. The effects of the relationship between eating behavior and nutritional intake on MetS remained unclear.

To evaluate nutrition’s role in preventing or exacerbating MetS, we examined the associations among eating behavior, nutritional intake, and MetS for the baseline study in the cohort subjects undergone health checkups.

Methods

Four thousand and four hundred forty-seven Japanese men and women were enrolled at the Saku Central Hospital. They received an anthropometric and clinical examination and were assessed for present illness, lifestyle factors such as physical activity, smoking, drinking, and dietary habits at the enrollment. Eating behavior was analyzed by the Sakata’s Eating Behavior Questionnaire. Dietary assessment was made using a brief self-administered diet history questionnaire. Two thousand and six hundred two men and 1844 women aged more than 20 were analyzed.

Results

The mean age in men and women were 59.2 and 58.4 years old and the mean body mass index (BMI) were 23.7 and 22.3 kg/m², respectively. The percentages of MetS were 20.6 in men and 6.1 in women. In some nutrients, significantly higher energy-adjusted intakes in subjects without MetS than with Mets appeared both in men and women after age adjustment. After adjusting by age, energy-adjusted intake beverages in men and cereals in women were significantly higher in subjects with MetS than those without MetS. The scores of all the categories in eating behavior were significantly worse in subjects with MetS than those without MetS.

Conclusions

The differences in dietary intake between subjects with Mets and without Mets were relatively small. The scores of all the categories in eating behavior were worse in subjects with MetS than without MetS. It was suggested that the problem lay in the quality of diet, not in the quantity, caused by bad eating habits. The potential influence of eating behavior and nutritional intake on MetS was presented in men and women.

Preproghrelin gene polymorphisms in obese Japanese: Association with diabetes mellitus in men and with metabolic syndrome parameters in women

SUMMARY

Preproghrelin gene polymorphisms (SNPs) are possible predisposing factors to obesity and metabolic syndrome. We analysed SNPs in obese Japanese individuals and studied the correlation with diabetes and metabolic syndrome. We recruited 235 subjects (BMI > 28.3) from individuals undergoing periodic medical check-up at Saku Central Hospital. Their SNPs were genotyped using PCR-RFLP method. Frequencies of 5 SNPs in the preproghrelin gene -1500C>G (rs3755777), -1062G>C (rs26311), -994C>T (rs26312), Leu72Met (+408C>A) (rs696217), and +3056T>C (rs2075356) were compared with healthy individuals (data from HapMap Project or Asian population studies). Associations between these SNPs and clinical parameters were investigated. The phenotypes evidently differed between men and women. In men, higher fasting glucose and HbA1c values were observed in the +3056C/C minor homozygotes without leptin or insulin accumulation. The +408C -- +3056C haplotype was more frequent in the diabetic subgroup, in which diagnosis was based on fasting glucose, 75gOGTT, and HbA1c values, than normal subgroup. In contrast, in women, a significant correlation was observed between fat metabolism and obesity. The -1062C/C minor homozygotes had higher values of C-peptide, insulin, total and visceral fat area, waist circumference and BMI. The 72Met/Met minor homozygotes showed reduced leptin, total, HDL and LDL cholesterol concentrations and increased value of visceral fat area. Further, in the other SNPs, the minor homozygotes showed a similar trend, and the heterozygotes had intermediate values. Preproghrelin gene polymorphisms in obese Japanese may be predisposing factors to diabetes mellitus in men and to obesity via aberrant fat metabolism in women.:

Reduction in adiposity, β-cell function, insulin sensitivity, and cardiovascular risk factors: a prospective study among Japanese with obesity

Background

A reduction in adiposity may be associated with an improvement in insulin sensitivity and β-cell function as well as cardiovascular disease (CVD) risk factors; however, few studies have investigated these associations in a longitudinal setting.

Methods

To investigate these associations over a 1-year period, we conducted an observational analysis of 196 Japanese subjects with obesity in the Saku Control Obesity Program. We investigated the relations between changes in adiposity (body mass index [BMI], waist circumference, subcutaneous fat area [SFAT], and visceral fat area [VFAT]) and changes in HbA1c, fasting plasma glucose (FPG), insulin sensitivity index (ISI), the homeostasis model assessment β cell function (HOMA-β), lipids, and blood pressure.

Results

All adiposity changes were positively associated with HbA1c and FPG changes. Reductions in BMI and VFAT were associated with HOMA-β reduction. Reductions in all adiposity measures were associated with an improvement in the ISI. Changes in most adiposity measures were positively associated with changes in blood pressure and lipid levels, except for LDL.

Conclusion

The present findings provide additional supportive evidence indicating that a reduction in adiposity may lead to an improvement in insulin sensitivity and the reduction of CVD risk factors in obese individuals.

Preproghrelin gene polymorphisms in obese Japanese women. Minor homozygotes are light eaters, do not prefer protein or fat, and apparently have a poor appetite

Preproghrelin gene single-nucleotide polymorphisms are possible predisposing factors to obesity and other metabolic syndromes. To study the correlation between genotypes and obesity, we recruited 117 obese Japanese women (BMI, 25.0-41.1; average, 31.1). Minor homozygotes for five preproghrelin gene polymorphisms, namely, -1500C>G (rs3755777), -1062G>C (rs26311), -994C>T (rs26312) (promoter region), Leu72Met (rs696217) (exon 2), and +3056T>C (rs2075356) (intron 2), had high values of total and visceral fat areas, waist circumference, and BMI, indicating significant correlation of the polymorphisms with obesity and fat metabolism. Here, we studied the relationship between the genotypes and dietary tendency. Self-administered Diet History Questionnaire showed that total food intake, sugar, and dairy product intake were low in +3056C/C women. Their energy, protein, fat, and meat intake was also low. Energy balance calculation showed considerably reduced fat and protein consumption. Dietary habits were surveyed using Sakata's Questionnaire on Eating Behavior. Of the genotypes, -1062C/C women showed low scores for "motivation for eating" and "eating because of stress or something else." Thus, surprisingly, it was revealed that minor homozygotes for preproghrelin gene polymorphisms were light eaters, did not prefer fat or protein, and apparently had a poor appetite, although they were predisposed to obesity.

Dietary glycemic index and glycemic load in relation to HbA1c in Japanese obese adults: a cross-sectional analysis of the Saku Control Obesity Program

BACKGROUND

Dietary glycemic index or load is thought to play an important role in glucose metabolism. However, few studies have investigated the relation between glycemic index (GI) or load (GL) and glycemia in Asian populations. In this cross-sectional analysis of a randomized controlled trial, the Saku Control Obesity Program, we examined the relation between the baseline GI or GL and glycemia (HbA1c and fasting plasma glucose [FPG] levels), insulin resistance (HOMA-IR), β-cell function (HOMA-β), and other metabolic risk factors (lipid levels, diastolic and systolic blood pressure, and adiposity measures).

METHODS

The participants were 227 obese Japanese women and men. We used multiple linear regression models and logistic regression models to adjust for potential confounding factors such as age, sex, visceral fat area, total energy intake, and physical activity levels.

RESULTS

After adjustments for potential confounding factors, GI was not associated with HbA1c, but GL was positively associated with HbA1c. For increasing quartiles of GI, the adjusted mean HbA1c were 6.3%, 6.7%, 6.4%, and 6.4% (P for trend = 0.991). For increasing quartiles of GL, the adjusted mean HbA1c were 6.2%, 6.2%, 6.6%, and 6.5% (P for trend = 0.044). In addition, among participants with HbA1c ≥ 7.0%, 20 out of 28 (71%) had a high GL (≥ median); the adjusted odds ratio for HbA1c ≥ 7.0% among participants with higher GL was 3.1 (95% confidence interval [CI] = 1.2 to 8.1) compared to the participants with a lower GL (

CONCLUSIONS

Our findings suggest that participants with poor glycemic control tend to have a higher GL in an obese Japanese population.

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Affiliation(s)

Maki Goto Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.
Akemi Morita
Atsushi Goto
Satoshi Sasaki
Naomi Aiba
Takuro Shimbo
Yasuo Terauchi
Motohiko Miyachi
Mitsuhiko Noda
Shaw Watanabe

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Obese Japanese adults with type 2 diabetes have higher basal metabolic rates than non-diabetic adults

Several cross-sectional studies in Pima Indians and Caucasians have indicated that obese individuals with type 2 diabetes have a higher basal metabolic rate (BMR) than healthy, obese individuals. However, no study has investigated this comparison in Japanese subjects, who are known to be susceptible to type 2 diabetes due to genetic characteristics. Thirty obese Japanese adults with pre-type 2 diabetes (n=7) or type 2 diabetes (n=13) or without diabetes (n=10) participated in this study. BMR was measured using indirect calorimetry. The relationships between residual BMR (calculated as measured BMR minus BMR adjusted for fat-free mass, fat mass, age, and sex) and biomarkers including fasting glucose, glycosylated hemoglobin (HbA(1c)), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-R), triglycerides, and free fatty acids were examined using Pearson's correlation. BMR in diabetic subjects adjusted for fat-free mass, fat mass, age, and sex was 7.1% higher than in non-diabetic subjects. BMR in diabetic subjects was also significantly (p<0.05) higher than in non-diabetic subjects. There was a significant correlation between residual BMR and fasting glucose (r=0.391, p=0.032). These results indicate that in the Japanese population, obese subjects with type 2 diabetes have higher BMR compared with obese non-diabetic subjects. The fasting glucose level may contribute to these differences.

Relation of body composition to daily physical activity in free-living Japanese adult women

The objective of the present study was to investigate the relationship between the indices of body size such as BMI, fat-free mass index (FFMI, FFM/height2), fat mass index (FMI, FM/height2), and body fat percentage (%BF), and physical activities assessed by the doubly-labelled water (DLW) method and an accelerometer in free-living Japanese adult women. We conducted a cross-sectional study in 100 female subjects ranging in age from 31 to 69 years. Subjects were classified in quartiles of BMI, FFMI, FMI and %BF. Daily walking steps and the duration of light to vigorous physical activity were simultaneously assessed by an accelerometer for the same period as the DLW experiment. Only physical activity-related energy expenditure (PAEE)/FFM and PAEE/body weight (BW) decreased in the highest quartile of BMI. Physical activity level, PAEE/FFM and PAEE/BW decreased in the highest quartile of FMI and %BF, whereas they were not different among quartiles of FFMI. Daily walking steps and the duration of moderate- and vigorous-intensity physical activities decreased or tended to decrease in the highest quartile of FMI and %BF, but did not differ among quartiles of FFMI and BMI. These results clearly showed that Japanese adult women with higher fat deposition obviously had a low level of physical activities assessed by both the DLW method and accelerometry, but those with larger BMI had lower PAEE/FFM and PAEE/BW only. Our data suggest that the relationship between obesity and daily physical activities should be discussed using not only BMI but also FMI or %BF.