Lifestyle-related disease is a generic term for disease caused by the continuation of physically stressful lifestyles such as an unbalanced diet, lack of exercise, stress, smoking, and excessive drinking. In particular, the three diseases of hypertension, diabetes, and hyperlipidemia are called silent killers. They are often left untreated because of few subjective symptoms, and they become the cause of atherosclerosis, and thereby ischemic heart disease and cerebral infarction. We introduce here clinical trials that play a crucial role in secondary prevention by the early detection and treatment of lifestyle-related disease. These lifestyle-related diseases are not independent of each other. Visceral fat obesity is the cause of the disease, and the state in which a variety of diseases are likely to appear due to visceral fat obesity is called metabolic syndrome. A medical check-up on metabolic syndrome and health care instructions will become mandatory in Japan in April 2008. New developments in clinical examination such as ISO 15189, the clinical laboratory certification system, and point of care testing (POCT) are introduced.
The screening technique developed by the authors for lifestyle-related diseases in children is composed of 3 elements involving 18 items, and the evaluation criteria of their gradient score and total score out of 100. With the aim of expanding this technique, a survey was conducted using 6, 385 school pupils as subjects, and another survey together with a blood test was conducted using 107 obese children as subjects from whom informed consent was obtained to examine the adequacy of the 3 elements and the validity of our technique. With regard to the 18 items and the gradient score, 17 items and 15 items were respectively demonstrated to be correlated with the need for medical examination by the χ2 test and by multidimensional scaling based on the 6, 385 children. A high correct classification rate of approximately 70% was demonstrated for the evaluation criteria between the screening evaluation results and logistic discriminant analysis of the blood test results for the 106 obese children. These results confirmed the adequacy of our technique composed of 3 elements and the validity of its application in the field. The application of our technique in a regional field study showed that 274 (4.3%) were screened in our population of 6, 385 children, and that 155 (56.6% of those screened and 2.4% of the total population) were found to require medical examination. The proposed screening procedure makes it possible to identify those children who require medical examination, enabling the burden on school children and the budget involved in a mass medical examination to be reduced. The results suggest that our technique is both simple and effective.
The basal metabolic rate (BMR) of Japanese females in their twenties (F2006) was compared with that of females of the same age measured in the 1950s (F1950; Nagamine and Suzuki, 1964). The subjects measured during 2004-2006 were 83 females (F2006) with no exercise habits. BMR was measured by using indirect calorimetry, and the body composition was assessed by dual-energy X-ray absorptiometry (DXA). While the height and weight of F2006 were respectively significantly higher and heavier than those of F1950, BMR of F2006 (1, 110±112kcal/day) was not significantly different from that of F1950 (1, 132kcal/day). In addition, there was no difference in lean body mass (LBM) between the two groups. On the other hand, BMR per body weight of F2006 (21.5±2.1kcal/kg/day) was significantly lower than that of F1950 (23.1kcal/kg/day). BMR per body weight of F2006 was correlated with LBM per body weight (%LBM, r=0.51, p<0.001), although BMR per LBM of F2006 was not different from that of F1950. These data suggest that BMR per body weight of the current young females of Japan is lower than that of the young females of the same age measured in the 1950s, during which data for establishing the BMR reference value in “Dietary Reference Intakes for Japanese, 2005” was obtained. Furthermore, the difference in BMR per body weight between the two groups can be explained by the difference in %LBM.
L-Arabinose is a natural, poorly absorbed pentose that selectively inhibits intestinal sucrase activity. Rats were fed for 4 weeks on a 20% sucrose diet containing 1% L-arabinose. Experiment 1 was carried out to investigate the effects of L-arabinose feeding on the intestinal microflora and weights of the cecum, cecal contents and fat pad. In experiment 1, the cecal contents in 5% glucose containing 3% skim milk were frozen at -80°C until needed for incubation, while the cecal contents in experiment 2 were incubated immediately after dissection. The body weights of the rats fed on the 1% L-arabinose diet were not significantly different from those fed on the control diet. The weight of the fat pad tended to be less in the L-arabinose group than in the control group, while the weight of the cecum and amount of ammonia in the cecal contents were significantly higher with L-arabinose ingestion. The amount of total organic acids tended to be highest in the cecal contents of the L-arabinose group. Bifidobacteria were observed in the L-arabinose group in experiments 1 and 2, but not in the control group. The viable count of bifidobacteria was not influenced by preserving the cecal contents at -80°C. The results suggest that L-arabinose feeding influenced the intestinal microflora and induced the production of bifidobacteria.