INTRODUCTION: Energy expenditure (EE) associated with physical activity is negatively correlated with prevalence of obesity and related diseases, and exercise plays a major role in prevention and treatment of these diseases. We determined baseline daily step-count and physical activity-related energy expenditure (PAEE) in 230 obese subjects (40-64 years old) participating in the Saku Control Obesity Program. The secondary purpose of this study was to determine the association between abdominal fat and amount of physical activity.
METHODS: Daily step-count and PAEE were measured using a uniaxial accelerometer. The subjects wore the uniaxial accelerometer on their belt from the time they woke up until going to bed for 2 weeks. Adjusted PAEE (METs·h/day) was calculated based on daily PAEE and body weight.
RESULTS AND CONCLUSIONS: Daily step-count, PAEE, and adjusted PAEE were 7,815±3,211 (mean±SD) steps/day, 258±115 kcal/day, and 3.09±1.38 METs·h/day, respectively. There were no significant differences in daily step-count or adjusted PAEE between men and women. Daily step-count and adjusted PAEE were somewhat lower than the reference values for the quantity of physical activity for health promotion (8,000-10,000 steps/day and 3.3 METs·h/day) established by the Ministry of Health, Labour, and Welfare of Japan. BMI, visceral fat area, and abdominal circumference were negatively and weakly correlated with daily step-count and adjusted PAEE (r=−0.13 to −0.19, P<0.05 to 0.01). These results suggest that the amount of physical activity assessed by uniaxial accelerometry is partially associated with not only systemic obesity but also abdominal obesity.

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BACKGROUND: We planed a moderate-intensity lifestyle intervention program for overweight Japanese populations, the Saku Control Obesity Program (SCOP), a clinic-based, open randomized, cross-over trial. The purpose of the present article describes the baseline dietary characteristics of the study subjects.
METHODS: Dietary intake at baseline was assessed using a validated self-administered diet history questionnaire in overweight subjects (mean body mass index: 30.8kg/m²) in the intervention and the control groups (n = 119 and 116, respectively).
RESULTS: Mean value of energy intakes was not significantly different between the intervention and the control groups (2485 and 2426 kcal/day, respectively). Mean intake of nutrients and foods was generally similar between the groups although higher intake of potassium, calcium, phosphorus, riboflavin, and dairy product and lower intake of pulses and seaweeds in the intervention than in the control groups were observed.
CONCLUSIONS: Mean dietary intake level of energy, nutrients, and foods at baseline was similar between the intervention and the control groups although small significant difference was observed for a few dietary variables. These results suggest the success of randomization in the present study at least regarding dietary intake.

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BACKGROUND: Japan has entered the epidemic of obesity. To clarify the contributing factors to the development of metabolic syndrome triggered by visceral fat obesity and to investigate the effectiveness of a weight-loss program, we launched a new intervention program for obese people.
METHODS: Japanese subjects with high body mass index (BMI > 28.3 kg/m²) were selected for a weight-loss program from those who had undergone a medical checkup at the Saku Central Hospital. The baseline anthropometric and clinical findings of the participants were analyzed.
RESULTS: At baseline, 235 subjects (116 men and 119 women) participated in this program. The mean weight, waist circumference, and visceral fat area were 86.4 ± 11.8 kg, 101.5 ± 8.7 cm, and 159.0 ± 54.1 cm² in men and 75.2 ± 9.5 kg, 103.7 ± 8.3 cm, and 129.8 ± 47.0 cm² in women, respectively. Using the Japanese diagnostic criteria, the prevalence of metabolic syndrome was 62.9% in men and 51.3% in women. Leptin, c-peptide, and insulin levels tended to increase with increasing numbers of metabolic risk factors in men. In women, c-peptide and free fatty acid levels tended to increase with increasing numbers of these factors, but adiponectin decreased dose-dependently with increasing numbers of factors.
CONCLUSIONS: More than half the subjects were founded to meet the criteria for metabolic syndrome. Immediate intervention to lose weight and to improve other risk factors of metabolic syndrome is necessary in such seriously obese people.

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BACKGROUND: Large errors may occur when predicting basal metabolic rate (BMR) based on physical characteristics in obese people. In addition, the contribution of abdominal visceral fat to BMR remains controversial. This study examined the accuracy of several predictive equations for BMR and the contribution of abdominal fat distribution to BMR in obese Japanese participants in the Saku Control Obesity Program (SCOP).
METHODS: BMR was determined using a mask and Douglas bag in adult males (n = 12) and females (n = 11). We measured abdominal subcutaneous and visceral fat areas using computerized tomography.
RESULTS: All the equations, with the exception of Bernstein’s, overestimated BMR in obese males. Some equations, including the Japan-Dietary Reference Intakes and the Food and Agriculture Organization of the United Nations/World Health Organization/United Nations University (FAO/WHO/UNU) equations, overestimated BMR in obese females, while the Harris-Benedict and Henry equations provided relatively accurate predictions of BMR in obese females. We found no correlation between abdominal visceral fat area and BMR when adjusted for sex, fat-free mass, and abdominal subcutaneous fat area (partial r =−0.022). Abdominal subcutaneous fat area correlated significantly with BMR when adjusted for sex, fat-free mass, and abdominal visceral fat area (partial r = 0.732), although this correlation was no longer significant after adjustment for total fat mass (partial r = 0.266).
CONCLUSIONS: In obese Japanese subjects, most the predictive equations overestimated BMR in males, whereas some equations were relatively accurate for females. Our findings indicate abdominal fat distribution may not be independently related with BMR.

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AIMS: This study is aimed to elucidate the effect of aerobic walking using watch-type pedometers with or without a heart rate checker, which may support to keep moderate exercise intensity.
METHODS: Thirty one healthy subjects (mean age, 59.1 ± 5.0, 17 men and 14 women) were divided into 2 groups: the study group of 15 subjects (8 men and 7 women) using a pedometer with a heart rate checker and the control group of 16 subjects (9 men and 7 women) using a common pedometer checking heart rates by themselves. All participants tried aerobic walking exercises alone for 8 weeks, 5 days a week, for 45 minutes a day with an instructed exercise intensity 40 to 60%. The subjects underwent height, weight, body fat percentage, blood pressure, and hematological and blood chemistry tests before and after the study. In addition, all participants completed an aging and QOL questionnaire before and after the study.
RESULTS: A decrease of systolic blood pressure (before-study value 140.2 ± 23.2 mmHg) by 3.7% and an increase of estrogen levels (by 37%) in women were observed in both groups. In a comparative study of the 2 groups, the study group showed significant improvements in “lethargy”, “tinnitus”, “early satiety”, “constipation” and “arthralgia” as physical symptoms and in “difficulty in falling asleep” and “pessimism” as mental symptoms.
CONCLUSIONS: Aerobic walking with a heart rate checker may help to maintain the exercise intensity within the range of 40% to 60% of maximum, thus resulted more desirable data than walking with self heart rate checking at one’s own pace.

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