Eating behavior is more difficult to change than other health related behaviors. This article introduces how to promote changes in eating behavior after a health check, based on the characteristics of eating behavior.

 First, their eating lifestyle from the behavioral perspective should be examined. Two ideas, which promote positive eating behavior, include food and behavioral perspectives. They are both needed for promoting behavioral change; if only food perspective is addressed, the client may use the common complaint "I know but I can't". Habitual eating behavior is part of a behavioral chain. If you imagine the client's behavior as part of a larger behavioral chain, you may understand how to cut the chain and can advise better on how to achieve their goals.

 Second, information that would increase the client's confidence should be provided. Readiness to change behavior is explained by the constructs of "importance" and "confidence". A person who has high levels of "importance" but low "confidence", may return to "I know but I can't" behavior. It is more important to raise "confidence" among these clients. It could be useful to implement strategies that would prevent people from giving into their "temptations," which are situations where they cannot act according to their target behaviors.

 Lastly, when giving advice related to food, it is better to give dish or meal information rather than nutritional or food information. There are five kinds of food information: nutrition, food, dish, meal, and behavior. It is often difficult to evaluate how much people act on food and nutritional advice.

 The time after a health check is limited; therefore, it could be valuable to utilize a standard questionnaire and listen to the clients about their behavior and give them appropriate information, which they feel they can act upon.

 Health literacy in an important basic skill supporting the voluntary and autonomous adoption of healthy behaviors. This skill can be categorized into dimensions such as "accessing", "understanding", "appraising", and "applying" health information. We can also examine the effects of different levels of skill in each of these dimensions on healthy behavior. This can enable provision of more effective health guidance. Health literacy is also an important skill for information distributors, because they are required to enable people with insufficient health literacy to understand, appraise and apply health information. However, people with high levels of health literacy levels do not always use healthy behaviors. There is a big barrier between "understanding" or "appraising", and "applying" that information on a personal level.

 It is therefore important to explore how to support and lead people who recognize healthy behaviors, but do not adopt them. Complicated goals or dull content is unlikely to persuade people. To appeal to people's emotions, and affect behavior, other characteristics are required. Our randomized controlled trial found that there were fewer withdrawals during the intervention period in the group that were given support to make exercise more enjoyable than in the group given support to help them understand the outcomes of exercise. We often tend to focus on the results or outcomes of health behavior, and try to encourage people by emphasizing those. However, it may be better to provide support by increasing opportunities to have fun while exercising to encourage behavioral change. Further studies are needed on how to combine supporting behavioral change by harnessing motivation, with improving health literacy.

 Lipid levels such as LDL cholesterol, triglyceride (TG), HDL cholesterol levels are measured for evaluating the event risk of arteriosclerotic cardiovascular diseases, their cutoff values ​​are based on many epidemiological data. Evaluation in LDL and HDL cholesterol levels are useful for assessing arteriosclerotic cardiovascular events because they had direct correlations with the number of LDL and HDL particles, but fasting TG levels vary widely and different lipoprotein profiles have significantly different risk status even though they had similar TG values. Accumulation of TG-containing remnant lipoprotein exists in the background of arteriosclerotic cardiovascular disease risk of hypertriglyceridemia. The remnant cholesterol level (RLP-C or RemL-C) is usually measured for evaluating remnant lipoproteins, we independently developed a measurement system for apo (lipoprotein) B-48 concentration that reflects the accumulation of chylomicron remnant derived from the small intestine. The fasting apo B-48 level concentration was lower in healthy subjects (reference interval; 0.74-5.65 µg/mL, upper limit of reference value; 5.7 µg/mL) than other apolipoproteins and it was high in patients with the accumulation of remnant lipoproteins, such as those with type III hyperlipidemia, metabolic syndrome and chronic kidney disease. Furthermore, fasting apo B-48 concentration was positively correlated with carotid intima-intima thickness in patients with high but normal fasting TG concentrations (100-150 mg/dL) and with the prevalence of the coronary stenosis in consecutive cases of coronary artery catheterization, the de novo coronary stenosis after stent implantation and the cerebral infarction of large arteries. Thus, the measurement of fasting apo B-48 concentration could be established as an independent evaluation method for atherosclerotic risk factors reflecting the chylomicron remnant accumulation. The measurement of TG level is still important for health examination, but detection of lipoprotein abnormality is important for estimating atherosclerotic disease risk, and lipoprotein profile analysis such as apo B-48 concentration measurement should be utilized.

 To determine the long-term trend of hypertriglyceridemia prevalence, 259,935 subjects who had undergone Ningen Dock at the Jikei University Hospital for 31 years from 1988 were analyzed. The annual prevalence of triglycerides of ≥150mg/dL and the adherence rate of lipid-improving drugs were investigated.

 In men, the trend of hypertriglyceridemia prevalence was downward in all age groups. Women showed a downward trend in the prevalence of hypertriglyceridemia in all age groups except for those in their 30s, but the rate of decrease was slightly more than that in men.

 The use of anti-hypertriglyceridemia drugs increased year by year. The prevalence of hypertriglyceridemia in the non-use group showed the same downward trend overall. Being overweight and alcohol consumption elevate triglyceride levels. BMI increased in men and decreased in women. Alcohol consumption decreased for the last three decades. Thus, decreased alcohol consumption was a possible reason for the reduced prevalence of hypertriglyceridemia.

 The effect of weight loss on hypertriglyceridemia was more effective with greater weight loss, but the effect weakened at ≥300mg/dL of triglyceride. Total bilirubin, a potent antioxidant, was reduced at ≥400mg/dL triglycerides. In the comprehensive risk chart, subjects with ≥500mg/dL triglycerides are diagnosed with hypertriglyceridemia, indicated as a referral to a lipid specialist, but only 0.4% of the patients who underwent the health screening were referred. In future health screenings, it is advisable to change the cutoff value needed to consult a lipid specialist from 500 to 400mg/dL. Lifestyle improvement is useful for subjects with 150-399mg/dL triglycerides.