Oriental medicine classifies obesity based on physique, “stomach heat,” and “splenic deficiency.” This study investigated the relationship between these constitutions and the fat mass and obesity-associated (FTO) genotype for body mass index (BMI), health, and dietary habits. The participants were 415 residents of Japan aged between 20–69 years (239 women); 27 participants (6.5%) were underweight, 309 (74.5%) were in the normal range, and 79 (19.0%) were overweight. The median BMI (interquartile range) of the participants was 21.8 (4.6) kg/m². The prevalence of the FTO gene variant in the oriental medical constitution was positively related to BMI for spleen deficiency (25.5%), non-stomach heat/spleen deficiency (33.8%), and stomach heat constitution (39.3%) (Trend test p=0.015); there were no differences in BMI by FTO genotype in stomach heat and spleen deficiency. However, the BMI by FTO genotype was strongly associated with the genotype in non-stomach/spleen deficiency; particularly, wild-type 20.6 kg/m² and variant 23.6 kg/m² (p<0.001). Specifically, the non-stomach heat/spleen deficiency BMI of variant carriers was the highest among other combination types. Regarding stomach heat, the prevalence of smoking was high (p=0.022), and preference for eating a full dinner (adjusted odds ratio [aOR]: 2.51, 95% confidence interval [95%CI]: 1.54-4.10) and salty food (aOR: 1.89, 95%CI: 1.17-3.05) were extracted as onset factors. For spleen deficiency, tiring easily (p=0.004) and avoiding ingesting fats (p=0.020), and being female (aOR: 2.23, 95%CI: 1.29-3.88) were onset factors. Regarding non-stomach/spleen deficiency, being physically healthy but consuming a high amount of margarine frequently with the variant type (p=0.028) were onset factors. These results suggest that stomach heat regardless of FTO genotype has risks associated with obesity and hypertension. Those with spleen deficiency, regardless of FTO genotype, should focus on symptoms like stress and tiredness as well as the decrease in BMI. Furthermore, non-stomach heat/spleen deficiency with FTO variant may lead to an increase in BMI due to the preference for high-energy foods.

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In order to suppress postprandial elevation of blood glucose, inhibitory substances toward α-glucosidase are attracting attention. Among them, 1-deoxynojirimycin (1-DNJ), one of iminosugars that exists in mulberry leaf, has a potent inhibitory activity. In this review, we outline the inhibition of α-glucosidase by iminosugars and the effect of intake of mulberry leaf powder on postprandial elevation of blood glucose.

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