RESUMEN
OBJECTIVES: To determine the prevalence and effect of dietary habits on functional constipation in preschool and early elementary school children in Japan. STUDY DESIGN: A total of 3595 children aged 3 to 8 years from 28 nursery schools and 22 elementary schools in Yokohama City, Kanagawa Prefecture, Japan, were evaluated. The subjects were divided into a functional constipation group and a nonfunctional constipation group according to the Rome III criteria. Dietary intake data were collected using a brief-type, self-administered, diet-history questionnaire validated for Japanese preschool-aged children. RESULTS: Of the 3595 subjects evaluated, 718 (20.0%) had functional constipation. The association between functional constipation and gender was not statistically significant (p = 0.617). A decrease in bowel frequency was observed in 15.9% of those with functional constipation. There was no significant difference in the proportion of participants in the constipation group by age (p = 0.112). Binomial logistic regression analysis indicated that only fat per 100 kcal positively correlated with functional constipation [odds ratio = 1.216, 95% confidence interval: 1.0476-1.412]. CONCLUSIONS: Functional constipation is common among children in preschool and early elementary school in urban areas of Japan. Parents should pay attention to constipation-related symptoms other than defecation frequency. A high-fat diet should be avoided to prevent functional constipation.
RESUMEN
BACKGROUND AND OBJECTIVES: To identify dietary practice patterns for Japanese adults and investigate the links between health behaviours and these patterns. METHODS AND STUDY DESIGN: A random sample, stratified according to area, sex, and age, of 4570 adults aged 20-80 years completed a survey conducted in 2011 in a city, in Yamagata Prefecture, Northeast Japan. RESULTS: Cluster analysis of 16 dietary practice items revealed four patterns labelled as: low fat, sugar, or salt; emphasis on nutrition; regular breakfast and staples; and meals not snacks. Findings from multiple linear regression analyses showed that those not engaged in habitual physical exercise had lower scores on low fat, sugar, or salt (beta coefficient -0.22: 95% confidence intervals -0.30, -0.14); emphasis on nutrition (-0.17: -0.25, -0.09); meals not snacks; (-0.38: -0.46, -0.3) that other participants. Current smokers had lower scores than never smokers on low fat, sugar, or salt (-0.23: -0.32, -0.14); emphasis on nutrition (-0.28: -0.37, -0.19); regular breakfast and staples (-0.42: -0.51, -0.33) patterns. Compared with nondrinkers, those who had reduced their consumption of alcohol had higher scores on low fat, sugar, or salt (0.19: 0.09, 0.29) and emphasis on nutrition (0.17: 0.07, 0.27). These relationships were adjusted for other dietary practice patterns, sociodemographic factors, body mass index, and the presence of major illness or pain. CONCLUSIONS: Findings support an integrated and targeted approach as part of public health policy by considering links between dietary practices and other health behaviours, such as habitual exercise and smoking behaviour that may facilitate changes in dietary practices.
Asunto(s)
Dieta , Conductas Relacionadas con la Salud , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Encuestas sobre Dietas , Grasas de la Dieta , Sacarosa en la Dieta , Ejercicio Físico , Conducta Alimentaria , Femenino , Humanos , Japón , Masculino , Comidas , Persona de Mediana Edad , Valor Nutritivo , Fumar , Bocadillos , Adulto JovenRESUMEN
OBJECTIVES: The purpose of this study is (1) to identify obesity-related lifestyle behaviour patterns of diet, physical activity, sedentary and sleep behaviours in preschool children, (2) to examine the association between identified behaviour clusters and overweight/obesity and (3) to investigate differences in children's family environments according to clusters. DESIGN SETTING AND PARTICIPANTS: A cross-sectional study on 2114 preschool children aged 3-6â years who attended childcare facilities (24 nursery schools and 10 kindergartens) in Tsuruoka city, Japan in April 2003 was conducted. MAIN OUTCOME MEASURES: Children's principal caregivers completed a questionnaire on children's lifestyle behaviours (dinner timing, outside playtime, screen time and night-time sleep duration), family environment (family members, maternal employment, mealtime regularity and parents' habitual exercise and screen time) and measurements of weight and height. Cluster analysis was performed using children's 4 lifestyle behaviours based on those non-missing values (n=1545). The χ2 tests and analysis of variance (ANOVA) estimated cluster differences in overweight/obesity and family environments. RESULTS: 6 clusters were identified. Children's overweight/obesity varied across clusters (p=0.007). The cluster with the most screen time, shorter night-time sleep duration, average dinner timing and outside playtime had the highest overweight/obesity prevalence (15.1%), while the cluster with the least screen time, the longest sleep duration, the earliest dinner timing and average outside playtime had the lowest prevalence (4.0%). Family environments regarding mealtime regularity and both parents' screen time also significantly varied across clusters. The cluster having the highest overweight/obesity prevalence had the highest proportion of irregular mealtimes and the most screen time for both parents. CONCLUSIONS: This study suggests that public health approaches to prevent children's overweight/obesity should focus on decreasing screen time and increasing night-time sleep duration. To shape those behaviours, regular mealtimes and decreasing parents' screen time within family environments need to be targeted among family members.
Asunto(s)
Estilo de Vida , Obesidad/epidemiología , Peso Corporal , Niño , Preescolar , Análisis por Conglomerados , Computadores , Estudios Transversales , Dieta , Ejercicio Físico , Composición Familiar , Femenino , Conductas Relacionadas con la Salud , Humanos , Japón/epidemiología , Masculino , Comidas , Conducta Sedentaria , Sueño , Encuestas y Cuestionarios , TelevisiónRESUMEN
OBJECTIVE: Various eating behaviors have been linked with body weight management. However, combined effects of major eating behaviors are not fully understood. This study aimed to clarify the association of the combination of eating quickly (EQ), late evening meals (LEM), and skipping breakfast (SB) with being overweight. METHOD: A cross-sectional study with standardized questions for EQ, LEM, and SB was conducted. Stratified random sampling of 5% of residents aged 20 to 80years was surveyed in a city in northeast Japan in 2011, and 4249 (84.9%) residents were analyzed. Association of combinations of eating behaviors on being overweight (BMI (kg/m(2)≥25.0)) was estimated by using logistic analysis, and odds ratio (OR) and 95% confidential interval were calculated after adjustment for potential covariates. RESULTS: LEM, SB, or a combination of LEM and SB was not significantly associated with being overweight. However, the combination of EQ or only EQ was significantly associated with being overweight. As the number of eating behavior practices increased, there was a linear increase in OR for being overweight. The OR of all three combined eating behaviors was higher than that of any combined two behaviors or of each behavior. DISCUSSION: This study result supports the evidence that EQ increases the risk of being overweight whether by itself or in combinations with LEM and/or SB. However, only LEM or only SB did not increase the risk of being overweight.
Asunto(s)
Desayuno/psicología , Ingestión de Alimentos/psicología , Conducta Alimentaria/psicología , Sobrepeso/psicología , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Desayuno/fisiología , Estudios Transversales , Ingestión de Alimentos/fisiología , Conducta Alimentaria/fisiología , Femenino , Humanos , Japón/epidemiología , Masculino , Comidas/fisiología , Comidas/psicología , Persona de Mediana Edad , Sobrepeso/epidemiología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Practicing healthy lifestyle behaviors is a means to prevent metabolic syndrome (MetS), but the effect of changes of various behaviors over a short period is not fully understood. The purpose of this study was to elucidate the influence of changes in 12 behaviors on the development of MetS during 1 year. METHODS AND RESULTS: Of 10,442 workers who received a periodic health checkup in a health center in Tokyo in 2008, 3,137 workers aged 30-69, without MetS, who received another health checkup in 2009 were analyzed. Smoking, amounts and frequency of alcohol drinking, sleeping, exercise, walking duration and speed, late-night dinners, bedtime snacking, breakfast, eating speed, and weight control were classified into 4 groups according to change from 2008 to 2009. To examine the influence of behavioral changes on developing MetS, multiple logistic analysis was conducted after adjustment for sex, baseline age and MetS components. Changes from healthy to unhealthy behaviors in exercise, walking duration and speed, daily drinking, and weight control were significant in developing MetS compared with maintaining healthy behaviors. Those risks were higher than keeping unhealthy behaviors. Unhealthy to healthy behavior in smoking increased the risk while healthy to unhealthy behavior in eating speed decreased the risk of developing MetS. CONCLUSIONS: To prevent developing MetS during 1 year, healthy behaviors regarding physical activity, drinking, and weight management should be maintained.
Asunto(s)
Consumo de Bebidas Alcohólicas , Estilo de Vida , Síndrome Metabólico , Actividad Motora , Fumar , Adulto , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/fisiopatología , Femenino , Humanos , Masculino , Síndrome Metabólico/epidemiología , Síndrome Metabólico/etiología , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Fumar/efectos adversos , Fumar/fisiopatología , TokioRESUMEN
OBJECTIVES: We investigated the antihypertensive mechanism of long-term Miso soup consumption in Dahl salt-sensitive (Dahl S) rats with salt-induced hypertension. MATERIAL AND METHODS: Female Dahl S rats fed a low-salt (0.3% NaCl) diet were divided into three groups: (1) six rats given water, (2) six rats given 0.65% (w/v) saline solution or (3) eight rats given 5% (w/v) Miso soup containing 0.65% (w/v) saline solution. They were followed for 12 weeks. Variables in the plasma or 24-h urine were determined. Systolic blood pressure (SBP) was measured by the tail-cuff method. RESULTS: The SBP increased in an age-dependent manner in Dahl S rats drinking saline solutions. The elevation of SBP was significantly attenuated in Dahl S rats given Miso soup although the ultimate cumulative salt loading was much greater in the Miso group than those given the saline solutions. This SBP reduction in the Miso group was associated with an increase in fractional excretion of Na (FENa) and free water clearance in the kidney. Urinary dopamine excretions were increased in the Miso group compared with that in the saline group. The increase in urinary dopamine excretions was associated with a decrease in brain oxidative stress. Urinary dopamine excretions were an independent predictor of SBP in the Miso group. CONCLUSIONS: Long-term consumption of Miso soup attenuated blood pressure elevation in Dahl salt-sensitive rats with salt-induced hypertension. The blood pressure reduction was due to, at least in part, constituent(s) of the Miso that increase natriuresis and diuresis and enhance dopaminergic nervous activity in the kidney.
Asunto(s)
Presión Sanguínea/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Natriuresis/efectos de los fármacos , Cloruro de Sodio Dietético/farmacología , Alimentos de Soja , Animales , Antihipertensivos/farmacología , Diuresis/fisiología , Dopamina/metabolismo , Femenino , Humanos , Hipertensión/fisiopatología , Hipotensión/tratamiento farmacológico , Japón , Ratas Endogámicas Dahl , Sodio/metabolismoRESUMEN
OBJECTIVE: Perceived neighborhood environment (NE) is considered a determinant of daily physical activity (PA). However, evidence concerning differences among types of PA, gender, and age is limited. The study purpose was to clarify the association between NE and walking time (WT) or habitual exercise (HE) across gender, age, and employment status in a community-dwelling population of Japan. METHODS: A questionnaire mail survey with a stratified random 7,515 sampling was conducted in a northeast city in January 2007. Multiple logistic analysis was conducted to examine the associations between seven NE indices and WT or HE across gender, age, and employment status: 20-39 (young-employed), 40-59 (middle-employed), and 60-79 (old-employed or old-unemployed) after adjustment for age and means of transportation. RESULTS: A total of 3,806 residents (52.4 % females) completed the survey. Traffic and crime safety in old-unemployed males and proximity to service facilities and traffic and crime safety in middle-employed females were significantly associated with a low risk of insufficient WT. Proximity to service facilities in old-employed males, number of service facilities, places for walking, and good view in middle-employed females, and density of dwelling and proximity to service facilities in old-unemployed females were significantly associated with a low risk of non-HE. CONCLUSIONS: The association between NE and WT or HE differed across type of PA, gender, age, and employment status, and was observed mainly in middle- and old-aged females. The middle- and old-aged female residents' PA possibly were more influenced by their NE, and NE would contribute to promote active living.
Asunto(s)
Ejercicio Físico , Características de la Residencia , Caminata , Adulto , Factores de Edad , Anciano , Ciudades , Empleo , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Factores Sexuales , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Education and income are important socioeconomic indicators that reflect different aspects of social hierarchy. However, only a few studies have explicitly examined how different the relationship between education and health behaviour is from that between income and health behaviour. According to the human capital theory of health investment, education would reflect knowledge assets that allow an efficient investment in health, while income would relate to the value of healthy days and/or the time cost of health investment. Since time cost and the relative price of health would differ across age strata, we examined the significance of effect modification by age strata to distinguish the effects of education on habitual exercise from the effects of income. A cross-sectional survey was conducted using a self-administered questionnaire in a rural city in northern Japan in January 2007 (n = 3385). Logistic regression analyses were conducted to assess the association of educational attainment and household income with habitual exercise. Interaction terms of these socioeconomic indicators with age strata (<60 years versus ≥60 years) were included to test the distinctive association across age, followed by a stratified analysis. As theoretically predicted, higher income was significantly associated with habitual exercise among those aged 25-59 years, while the association was null or negative among those aged 60 and above. Education was significantly associated with habitual exercise regardless of the age groups. These results suggest that the effects of socioeconomic factors on health behaviours vary according to which socioeconomic indicators are analysed, and which age group is selected. We conclude that studies on the socioeconomic disparity of health behaviours should carefully choose socioeconomic indicators to explain specific health behaviours to reveal underlying mechanisms and provide relevant policy implications, based on explicit behavioural models.
Asunto(s)
Escolaridad , Ejercicio Físico/fisiología , Población Rural , Clase Social , Adulto , Estudios Transversales , Femenino , Conductas Relacionadas con la Salud , Humanos , Japón , Modelos Logísticos , Masculino , Persona de Mediana EdadRESUMEN
AIM: The purpose of the study was to determine the sensitive cutoff values of waist circumference (WC) in relation to the body mass index (BMI) for detecting the clustering of cardiovascular risk factors (CCRF) in Japanese men and women. METHODS: The study population included 2,476 male and female residents who participated in a ward health examination in Tokyo, Japan. The CCRF were defined according to the Japanese Committee of the Criteria for Metabolic Syndrome. Receiver Operating Characteristics (ROC) analysis was conducted within each BMI category. RESULTS: The percentage of study participants in the normal BMI category was around 70% for both men and women. The sensitive cutoff values for the largest WC with at least 80% sensitivity were 81 cm for normal and 89 cm for overweight men. The corresponding values for women were 79 cm and 86 cm, respectively. The WC with maximized sensitivity plus specificity was 80 cm for normal and 89 cm for overweight men, and the sensitivity was 88.7% and 83.0%, respectively. The corresponding values for women were 78 and 94 cm, respectively, and the sensitivity was 91.5% and 57.6%, respectively. CONCLUSIONS: For the early detection and management of clusters of cardiovascular risk factors, we concluded that a BMI-specific WC cutoff value of 80 cm for normal weight in both men and women and 89 cm for overweight men and 86 cm for overweight women should be discriminate cutoff values.
Asunto(s)
Índice de Masa Corporal , Enfermedades Cardiovasculares/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/fisiopatología , Diagnóstico Precoz , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Curva ROC , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: The purpose of this study was to determine the discriminate gender-specific cutoff values of waist circumference (WC) for detecting the clustering of cardiovascular risk factors (CCRF), which reflects the intra-abdominal visceral fat area (VFA) using a large Japanese population. METHODS AND RESULTS: The study population consisted of 6,736 men and women who underwent a periodic health check-up and had a computed tomography scan for VFA measurement at the PL Tokyo Health Care Center in Tokyo, Japan. The CCRF was defined according to the Japanese Committee of the Criteria for Metabolic Syndrome. The discriminate values for detecting the CCRF were tested using receiver operating characteristics analysis. The discriminate values of VFA were 103.0 cm(2) with 68.7% sensitivity and 61.8% specificity for men and 69.0 cm(2) with 80.8% sensitivity and 70.0% specificity for women. The WC values corresponding to the VFA were 89.1 cm for men and 86.3 cm for women. The discriminate values of VFA and WC were not substantially different between people with or without raised blood pressure. CONCLUSIONS: For the early detection and management of the CCRF and VFA in the primary screening setting, the discriminate and convenient gender-specific WC criteria would be 90 cm for men and 85 cm for women.
Asunto(s)
Pueblo Asiatico , Enfermedades Cardiovasculares/etiología , Grasa Intraabdominal/diagnóstico por imagen , Síndrome Metabólico/diagnóstico por imagen , Obesidad/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Circunferencia de la Cintura/etnología , Adulto , Anciano , Pueblo Asiatico/estadística & datos numéricos , Presión Sanguínea , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/etnología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/etnología , Hipertensión/fisiopatología , Japón , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/etnología , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/etnología , Valor Predictivo de las Pruebas , Curva ROC , Factores de Riesgo , Sensibilidad y Especificidad , Factores SexualesRESUMEN
OBJECTIVE: Previous studies on the association between physical activity (PA) and neighborhood environments (NE) focused on either objectively measuring the NE or the residents' perception of NE. Here, we investigate which actual or perceived NE is associated with residents' PA in Japan. METHODS: Two regions with an objectively assessed high and low residential density, land use mix-diversity, and street connectivity, respectively, were identified in one city. The subjects were selected using a stratified random sampling method by sex and age in each region. The NE of the subjects was objectively measured using the Geographic Information System (GIS), and the subjects' perception of the NE was assessed using a questionnaire. The daily total number of walking steps was measured with an accelerometer, and walking and cycling time were assessed by a questionnaire. RESULTS: For the female subjects, the mean cycling time, subjectively assessed as a means of transport, was significantly longer in the group with a high GIS score for the number of land use types, while the score for total number of walking steps was significantly higher among those who were aware of places to walk to, and cycling time for transport was longer for those who perceived an accessibility to post offices, banks/credit unions, gymnasiums/fitness facilities, and amusement facilities in their neighborhood. For the male subjects, the score for walking time for leisure was longer for those who perceived aesthetics and an accessibility to parks, and the score for total walking steps was significantly higher for those who perceived an accessibility to bookstores or rental video stores in their neighborhood. CONCLUSIONS: The results to this study demonstrate that daily PA was high among female subjects living in a NE with land use mix-diversity, and who had an awareness of places to walk to and the accessibility to facilities for daily necessities in their neighborhood. For male subjects, daily PA was high among those who perceived the aesthetics of and accessibility to facilities for pleasure in their neighborhood. Further research is needed to determine the association between PA and NE on the basis of sex differences.
RESUMEN
SUMMARY: Recently, food intake pattern analysis associated with body weight has been conducted instead of traditional dietary analysis focusing on a single nutrient or food group, but there have been few studies examining the association between change in food intake patterns and body weight loss. In this study, short- and long-term relationships between changes in food intake patterns and body weight loss were examined. Subjects were 506 overweight/obese men and women who participated in a 12-week health promotion program and a follow-up check 9 months later. Diet was assessed with a FFQ and food intake patterns named "Plant foods and seafood" and "Sweets, meats, dairy products and alcohol" were derived by cluster analysis using the intake of 17 food groups at the baseline. During the program, body weight loss of the subjects changed pattern from "Sweets, meats, dairy products and alcohol" to "Plant foods and seafood" (SP group) was significantly larger than that of the subjects who showed an opposite pattern change (PS group) or the subjects who maintained "Sweets, meats, dairy products and alcohol" pattern after adjusting for age, sex, body weight at the baseline, changes in energy intake and exercise habit. Body weight loss of the SP group was also significantly greater than that of the PS group during the follow-up period. Changes in food intake patterns were related to body weight loss and changing the pattern from "Sweets, meats, dairy products and alcohol" to "Plant foods and seafood" was most effective for short- and long-term body weight loss.:
RESUMEN
The purpose of this study was to determine effective cut-off values of waist circumference (WC) to detect the clustering of cardiovascular risk factors (CCRF) in a Japanese population. The subjects were 2,476 men and women who participated in a health examination in Tokyo. The CCRF was defined according to the International Diabetes Federation (IDF) and the Japanese Committee of the Criteria for Metabolic Syndrome (JCCMS). The effective (accurate and sensitive) values were tested using the receiver operating characteristics analysis. The accurate (maximised sensitivity plus specificity) values were 81 cm and 80 cm using the IDF and JCCMS criteria for men, and 82 cm for both criteria for women. From the ROC curve, 85 cm was identified as an effective value for men. Thus, the effective cut-off value of WC for the Japanese should be approximately 85 cm for men and approximately 82 cm for women.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Síndrome Metabólico/complicaciones , Relación Cintura-Cadera/normas , Adulto , Anciano , Anciano de 80 o más Años , Pueblo Asiatico , Composición Corporal , Enfermedades Cardiovasculares/epidemiología , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
The patterns of food intake change which are effective for weight loss have not been clearly researched yet. The objective of this study was to examine the correlation between food intake change patterns and body weight loss. One hundred and two overweight women completed a 2-day dietary record before and after a 12-week weight-reduction program, and 28 food groups were classified. Patterns of food intake change were derived by cluster analysis, and compared with the changes of physical measurements and nutrition intake. As a result, decreasing Japanese foods pattern (DJP), increasing healthy foods pattern (IHP) and changing staple foods pattern (CSP) were classified. DJP and CSP mainly changed staple food intake. IHP decreased sugars, oils, beans except soybeans and meat intake, and increased fruits and seafood intake. DJP decreased fat and carbohydrate intake most but CSP showed least change. IHP also decreased fat and carbohydrate intake but maintained protein intake. Although no significant differences were seen in the change of energy intake between IHP and DJP or CSP, subjects of IHP showed the largest reduction in mean body weight, BMI, %body fat, waist circumference and serum triacylglycerol after adjusting for age and baseline values. Body weight, BMI and %body fat maintained their significance further adjusting for changes in energy intake and the number of walking steps. Food intake change patterns affected the magnitude of body weight loss independent of energy intake. In addition to energy intake, assessment of food intake change patterns could be useful for effective weight loss.:
RESUMEN
OBJECTIVE: The purpose of this study is to delineate the association between residents' perception of the neighborhood's environments and walking time in objectively different regions in Japan. METHODS: Two regions were selected as high and low walkable regions on the basis of differences in their residential density, mixed land use and street connectivity. The subjects in this study were participants in a health promotion program focused on walking sponsored by local governments. A questionnaire was sent to the participants asking about how their perception of the neighborhood's environment related to walking, and the time spent walking per week. There were 237 residents from the high walkable region and 195 from the low walkable region who completed the study survey. RESULTS: The high walkable region had a larger residential density, a high mixed land use and a higher street connectivity than the low walkable region. Walking time, and the scores of the perception of the neighborhood's environment for the high walkable region residents were significantly higher than those for the low walkable region residents. Thus, residents' perception of the neighborhood's environment generally reflected the actual physical environmental characteristics. Residents in the high walkable region whose scores for accessibility and aesthetics were high, spent significantly more walking time. Residents in the low walkable region whose scores for accessibility, safety, convenience and aesthetics were high, spent significantly more walking time. CONCLUSION: The study results suggested that the neighborhood's environment may influence daily walking time. The perceptions of the neighborhood's environmental factors that correlate with walking times differ between the different regional physical environments. Therefore, to promote physical activity, the consideration of environmental factors unique to residents' neighborhood's environments is needed.
RESUMEN
A new controlled-release isosorbide-5-mononitrate (CR-ISMN) preparation has been developed to meet the requirement for a low nitrate concentration interval in order to avoid nitrate tolerance. We conducted a randomized, double-blind, placebo-controlled study in 31 Japanese patients with stable effort angina pectoris to investigate the efficacy and safety of CR-ISMN. Patients were randomly assigned to either CR-ISMN (40 mg once daily) or placebo groups for 2 weeks after two consecutive symptom-limited treadmill exercise tests using the Bruce protocol to ascertain the reproducibility of exercise tolerance during the placebo run-in period. Exercise tests were repeated at 5, 12, and 24 hours after administration on the final day. No significant difference in exercise time to moderate angina was identified between the CR-ISMN and placebo groups at 5, 12, or 24 hours after administration. However, the changes in exercise were prolonged at 5 hours but not shortened at 24 hours in the CR-ISMN group. The results of subgroup analysis suggested that the concomitant use of insulin might lead to confounding results. Although headache was the most frequent adverse effect in the CR-ISMN group, all symptoms were mild and at self-limiting levels. The plasma concentrations of CR-ISMN maintained therapeutic levels at 5 and 12 hours, and gradually decreased to less than the minimum therapeutic concentration (100 ng/mL) at 24 hours after administration. This study demonstrates that CR-ISMN improves exercise tolerance during the daytime and is well-tolerated in Japanese patients with stable effort angina pectoris without increasing the number of serious adverse effects.
Asunto(s)
Angina de Pecho/tratamiento farmacológico , Dinitrato de Isosorbide/análogos & derivados , Vasodilatadores/administración & dosificación , Anciano , Angina de Pecho/fisiopatología , Preparaciones de Acción Retardada , Método Doble Ciego , Tolerancia a Medicamentos , Prueba de Esfuerzo , Tolerancia al Ejercicio , Femenino , Humanos , Dinitrato de Isosorbide/administración & dosificación , Dinitrato de Isosorbide/sangre , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Resultado del Tratamiento , Vasodilatadores/sangreRESUMEN
OBJECTIVES: To examine the effects of ß(3)-adrenergic receptor gene polymorphism on body weight change during a weight reduction program for middle-aged, overweight women with careful consideration of their energy intake and expenditure. DESIGN: Intervention study of weight reduction for 12 weeks in a community setting. SUBJECTS: Eighty overweight middle-aged women who completed the individualized lifestyle modification program. MEASUREMENTS: ß(3)-adrenergic receptor gene polymorphism was identified by polymerase chain reaction and consecutive restriction fragment-length polymorphism analysis. Anthropometrical parameters, lifestyle factors, blood lipid and glucose levels, physical activity level and energy intake were measured before and at the end of the program. RESULTS: The numbers of subjects with the Trp64Trp, Trp64Arg, and Arg64Arg genotypes were 45, 30 and 5, respectively. Baseline characteristics among subjects with the 64Arg allele had significantly smaller decrease in body weight and energy intake than those without the 64Arg allele. The change of other clinical characteristics did not differ between the two groups. After adjusting for the %change of energy intake, the %change of body weight did not differ between the two groups. CONCLUSION: The 64Arg allele of the ß(3)-AR gene is not likely to be the factor determining the difficulty in losing body weight in Japanese middle-aged, overweight women. Lifestyle factors, such as the decrease in energy intake, might mask the effect of the 64Arg allele on body weight loss. Specific considerations for the management of energy intake would be needed to promote body weight loss for those with the 64Arg allele.
RESUMEN
Incidence rate of sudden death differs depending on the definition of the sudden death, survey method, and characteristic of the study population. Death certificate survey of the regional population revealed the incidence rate of 1 to 2 per 1000 population per year (definition: natural death occurring within 24 hours of the symptom onset). When the medical records were reviewed in addition to the death certificate and those with malignant neoplasm or bedridden condition were excluded, the rate decreased to 0.4. Meta-analysis of cohort studies of the rural area and work-site, the incidence rate was reported to be 0.42 in men and 0.09 in women (age 40 to 69 years). The work-site cohort studies showed smaller incidence rate of 0.16 to 0.22 (age less than 60 years) in men due to healthy worker's effect.