Validation of questionnaire for assessing perceived benefits and barriers of vegetable consumption in Japanese adults

@#Introduction: This study aimed to develop and validate a diet consultation tool that assesses the perceived benefits and barriers of vegetable consumption attached to the stage of change in Japanese adults. Methods: A web-based survey was conducted among university and vocational school students, medical staffs, and local residents in the Aichi, Osaka, and Kyoto prefectures of Japan between September 2017 and January 2018. Participants comprised of 379 adults aged 20–70 years (mean age: 30.5±12.6 years; men: 21.4%). The scale for decisional balance of vegetable consumption contained 15 benefit items and 15 barrier items. The internal consistency of the scale was examined using Cronbach’s alpha and construct validity was examined using an exploratory factor analysis with Promax rotation. Results: The developed questionnaire had 12 items across two domains for benefits and 12 items across three domains for barriers that were structured with high internal consistencies (Cronbach’s alpha: 0.82, 0.79, 0.82, 0.76 and 0.76, respectively). The intraclass correlation coefficient in the test-retest reliability study was substantial (0.77). We found a very clear association between decreasing barrier score with increasing vegetable consumption and progress in the stage of change. The decisional balance score (benefits score minus barriers score) was positively correlated with the number of vegetable servings as an external parameter (Spearman’s correlation: 0.461; p<0.001). Conclusion: The developed questionnaire was a valid, reliable, and useful tool for diet consultants to assess the perceived benefits and barriers of vegetable consumption in Japanese adults.

Lifestyle intervention might easily improve blood pressure in hypertensive men with the C genotype of angiotensin II type 2 receptor gene

BACKGROUND/OBJECTIVES: Recent studies have reported an association of the angiotensin II type 2 receptor (AT2R) 3123Cytosine/Adenine (3123C/A) polymorphism with essential hypertension and cardiovascular diseases. The purpose of the study was to investigate whether the AT2R 3123C/A polymorphism affects blood pressure for free-living hypertensive men during a 5-month intervention period. SUBJECTS/METHODS: The subjects were free-living hypertensive Japanese men aged 40 to 75 years who agreed to intervention in the period from 2004 to 2011. Detection of the AT2R 3123C/A polymorphism was determined by polymerase chain reaction. The dietary intervention was designed to decrease salt level and to increase potassium level through cooking instructions and self-monitoring of the diet. The exercise session consisted of activities such as stretching, resistance training, and walking. Blood pressure, urinary sodium and potassium excretion, dietary and lifestyle data, and non-fasting venous blood sample were collected at baseline and after the intervention period. RESULTS: Thirty nine subjects were eligible for participation and the follow-up rate was 97.4%. The C allele proportion was 57.9%. AT2R 3123C/A polymorphism was X-chromosome-linked, therefore we analyzed the C and A genotypes. At baseline, no significant differences were observed between the genotype groups. After the intervention, there were no significant differences in lifestyle habit between the groups. Nevertheless, the estimated salt excretion (g/day) was significantly decreased only in the C genotype (13.0-10.3, P = 0.031). No significant change was observed in systolic blood pressure (SBP) (mmHg) in the A genotype, but a significant decrease was observed in the C genotype (150.0-141.5, P = 0.024). CONCLUSTIONS: In the C genotype, it might be easy to improve SBP through lifestyle intervention in free-living hypertensive Japanese men, however generalization could not be achieved by the small sample size.

The relationship between gamma-glutamyltransferase (GGT), bilirubin (Bil) and small dense low-density lipoprotein (sdLDL) in asymptomatic subjects attending a clinic for screening dyslipidaemias

<p><b>INTRODUCTION</b>Gamma-glutamyltransferase (GGT), bilirubin (Bil) and small dense low-density lipoprotein (sdLDL) particles are each known to be risk markers for cardiometabolic diseases which are characterised by oxidative stress conditions. These markers are connected with the oxidative milieu; however, the association between GGT, Bil, and sdLDL has been hardly examined. This hospital-based study investigated the association between GGT and sdLDL, as well as the association between Bil and sdLDL, in asymptomatic subjects.</p><p><b>MATERIALS AND METHODS</b>Cardiometabolic variables, GGT, Bil and the mean LDL particle size were measured in 100 asymptomatic subjects attending a clinic for screening dyslipidaemias (36 men and 64 women, mean age 64 years). Correlation analyses of the association between the mean LDL particle size and other variables, such as GGT and Bil, were performed.</p><p><b>RESULTS</b>The mean (standard deviation) levels of GGT, Bil, and the mean LDL particle size were found to be 21.7 (8.3) IU/L, 14.0 (4.3) μmol/L, and 26.7 (0.6) nm, respectively. An univariate correlation test showed both a significant inverse correlation between the mean LDL particle size and GGT (r = - 0.33, P <0.01) and a significant positive correlation between the mean LDL particle size and Bil (r = 0.32, P <0.01). A multiple regression analysis revealed similarly significant results of their correlations, independent of the other cardiometabolic variables.</p><p><b>CONCLUSION</b>These results suggest that the correlation of GGT and sdLDL, as well as that of Bil and sdLDL, may be cooperatively associated with cardiometabolic processes. Further research is warranted in order to confirm the observed association.</p>

A Study about “YARIGAI” : What Makes Work Worth Doing for the Community Pharmacists Who Participated in a Workshop of the COMPASS Project / 社会薬学

Objective : By extracting and modeling the component factors that community pharmacists have for “YARIGAI”—a Japanese colloquial expression commonly defined as “something worthwhile doing”—and by re-defining “YARIGAI,” we sought to help improve the quality of work lives of community pharmacists. Methods : All of 139 employee pharmacists participated in a workshop of the COMPASS Project (May 2011) were surveyed using a self-administered questionnaire. Responses were collected on the scene. The seventeen, 6-point-scale questions focused on the “patient-pharmacist relationship,” which may be related to “YARIGAI.” Then “YARIGAI” factors were extracted using factor analysis, and modeled using covariance structure analysis. IBM SPSS (ver. 20) and Amos 5.0J were used for the analyses. Results : To the item “I feel ‘YARIGAI’ with pharmacy work,” 12.2% of the 139 respondents said, “Strongly agree”, followed by “Agree” (41.0%) and “Somewhat agree” (33.8%). A factor analysis extracted three factors related to “YARIGAI” (knowledge, patient counseling management, and sense of personal growth). After modeling (AGFI : 0.903, RMSEA : 0.048) with these factors as latent variables and items in them as observable variables, a positive correlation was indicated for all the following factor pairs : “knowledge” and “patient counseling management”, “knowledge” and “sense of personal growth”, and “sense of personal growth” and “patient counseling management” (standardized points of estimate : 0.71, 0.55, and 0.42, respectively). Standardized coefficients for all latent and observable variables were 0.7 or higher, showing a good fit. Conclusion : “YARIGAI” of pharmacists employed by community pharmacies can consist of “knowledge,” “patient counseling management,” and “sense of personal growth”. Our results suggest that the improvement of communication skills and knowledge can lead to improvement of “YARIGAI” of pharmacists working for community pharmacies.

Association between angiotensin II type 2 receptor gene A/C3123 polymorphism and high-density lipoprotein cholesterol with hypertension in asymptomatic women

The present study investigated the association between the angiotensin II type 2 receptor [AT2R] gene adenine/cytosine [A/C]-3123 polymorphism and cardiometabolic variables in subjects with and without hypertension. Cardiometabolic variables, in addition to genotyping by an allele-specific DNA assay, were measured in 161 asymptomatic community-dwelling Japanese women [age range 30-83 years]. They were divided into hypertensive [n = 82, age 50-81 years] and nonhypertensive [n = 79, age 30-83 years] subjects. The A-allele carriers [n = 53] showed significantly lower high-density lipoprotein cholesterol [HDL-C] levels than the non-A-allele carriers [n = 26] among nonhypertensive subjects [1.45 +/- 0.38 vs. 1.66 +/- 0.33 mmol/l, p = 0.02]. Even when multiple-adjusted analyses were performed, the HDL-C levels continued to differ significantly and independently of other variables, including the body mass index and insulin resistance index, between A-allele and non-A-allele carriers. However, this association was not observed among hypertensive subjects. The present study demonstrated that A-allele carriers had significantly lower HDL-C levels than did non-A-allele carries among nonhypertensive women, while this association was not observed among hypertensive women. This indicates that the A/C3124 polymorphism may be a marker associated with HDL metabolism by hypertension. This was a small study, so further research is warranted to confirm the observed association

LDL particle size and reactive oxygen metabolites in dyslipidemic patients

Small dense low density lipoprotein [sdLDL] which has a small LDL particle size with greater susceptibility to oxidation is regarded as a risk marker for cardiovascular disease. The diacron reactive oxygen metabolites [d ROMs] test has recently been introduced as an oxidative stress related marker in the clinic. The aim of the present study was to investigate the correlation between the mean LDL particle size and the oxidative stress status as evaluated by the d ROMs in dyslipidemic patients. The study included 278 dyslipidemic patients [121 male and 157 female, mean age, 60 years]. Clinical data including the conventional atherosclerotic risk factors in addition to the mean LDL particle size measured with the gel electrophoresis and the d ROMs were collected. Male patients had a significantly smaller mean LDL particle size than females [262.2 +/- 7.5 [SD] vs. 264.3 +/- 6.7 A, P<0.05], while female patients had a significantly higher d ROMs level than males [318 +/- 68 vs. 350 +/- 72 U. Carr., P<0.01]. A multiple regression analysis revealed that there was an independent, significant, and inverse correlation between the mean LDL particle size and the d ROMs [beta=?0.19, P<0.05]. These findings of the co existence of both markers suggest that sdLDL and oxidative stress can be cooperative in atherogenesis, possibly leading to the incidence of CVD, in dyslipidemic patients

Effect of ezetimibe on remnant-like particle cholesterol in subjects with metabolic syndrome

To investigate the influence of ezetimibe monotherapy on remnant-like particle cholesterol [RLP-C] in subjects with metabolic syndrome [MetS]. Ezetimibe [10 mg/daily] was prescribed over a 12-week period for hypercholesterolemic subjects divided into groups with MetS [n = 28; male/female = 13/15; mean age 67 years] and without MetS [n = 22; male/female = 9/13; mean age 66 years]. In the pre- and post-treatment phases, BMI, blood pressure and fasting blood levels of glucose, lipid panels and RLP-C were measured. The group with MetS showed significantly higher RLP-C levels than the group without MetS [median level: 0.18 vs. 0.12 mmol/l [7.1 vs. 4.4 mg/dl], p < 0.01] in the pre-treatment phase. In the post-treatment phase, the low-density lipoprotein cholesterol levels were significantly reduced in both groups to a similar level [p < 0.001 in both], while there was a significantly greater reduction in RLP-C in the group with MetS than the group without MetS [median level: 0.12 vs. 0.11 mmol/l [4.8 vs. 4.1 mg/dl], p < 0.05]. This difference in RLP-C remained significant after adjusting for confounding factors. Ezetimibe monotherapy may be associated with a greater reduction in RLP-C levels in subjects with MetS than in those without MetS

White blood cells, neutrophils, and reactive oxygen metabolites among asymptomatic subjects

Chronic inflammation and oxidative stress are associated with health and the disease status. The objective of the present study was to investigate the association among white blood cell [WBC] counts, neutrophil counts as a WBC subpopulation, and diacron reactive oxygen metabolites [d-ROMs] levels in an asymptomatic population. The clinical data, including general cardiovascular risk variables and high-sensitivity C-reactive protein [hs-CRP], were collected from 100 female subjects [mean age, 62 years] in outpatient clinics. The correlation of the d-ROMs with hs-CRP, WBC, and neutrophil counts was examined. The mean/median levels were WBC counts 5.9 x 10[9]/L, neutrophil counts 3.6 x 10[9]/L, hs-CRP 0.06 mg/dL, and d-ROMs 359 CURR U. A simple correlation analysis showed a significant positive correlation of the d-ROMs with the WBC counts, neutrophil counts, or hs-CRP levels. The correlation between d-ROMs and neutrophil counts [beta = 0.22, P < 0.05], as well as that between d-ROMs and hs-CRP [beta = 0.28, P < 0.01], remained significant and independent in a multiple linear regression analysis adjusted for other variables. A multiple linear regression analysis showed that WBC counts had only a positive correlation tendency to the d-ROMs. Neutrophils may be slightly but more involved in the oxidative stress status, as assessed by d-ROMs, in comparison to the overall WBC. Further studies are needed to clarify the biologic mechanism[s] of the observed relationship

Leptin:Adiponectin Ratio and Metabolic Syndrome in the General Japanese Population / 대한진단검사의학회지

BACKGROUND: Circulating leptin:adiponectin ratio (L:A) is a potential surrogate marker for cardiometabolic diseases; however, the relationship of the L:A with the occurrence of metabolic syndrome (MetS) has not yet been fully explored in the general Japanese population. METHODS: We enrolled 678 Japanese subjects (208 men and 470 women, mean age: 58.8+/-14.4 [SD] yr; mean body mass index: 23.6+/-3.3 kg/m2) in this study, and determined their MetS status by using the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) recommendations with minor modifications for the Japanese population. Biochemical markers such as leptin and adiponectin present in blood were measured. The statistical analyses performed were gender-based. RESULTS: A in subjects with MetS was significantly higher than that in subjects without MetS, regardless of gender. The L:A also showed a significant and gradual increase corresponding to the increase in the number of components of MetS present in both the genders (trend P<0.01). The cut-off level of the L:A to detect MetS was 0.59 (sensitivity: 0.72, specificity: 0.70) in men and 1.04 (sensitivity: 0.72, specificity: 0.69) in women. CONCLUSIONS: These results suggest that the L:A can serve as a clinically useful marker for detecting MetS characteristics in the general Japanese population. The clinical application of this laboratory index for detecting MetS should be assessed in future studies.

Leptin:Adiponectin Ratio and Metabolic Syndrome in the General Japanese Population / 대한진단검사의학회지

BACKGROUND: Circulating leptin:adiponectin ratio (L:A) is a potential surrogate marker for cardiometabolic diseases; however, the relationship of the L:A with the occurrence of metabolic syndrome (MetS) has not yet been fully explored in the general Japanese population. METHODS: We enrolled 678 Japanese subjects (208 men and 470 women, mean age: 58.8+/-14.4 [SD] yr; mean body mass index: 23.6+/-3.3 kg/m2) in this study, and determined their MetS status by using the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) recommendations with minor modifications for the Japanese population. Biochemical markers such as leptin and adiponectin present in blood were measured. The statistical analyses performed were gender-based. RESULTS: A in subjects with MetS was significantly higher than that in subjects without MetS, regardless of gender. The L:A also showed a significant and gradual increase corresponding to the increase in the number of components of MetS present in both the genders (trend P<0.01). The cut-off level of the L:A to detect MetS was 0.59 (sensitivity: 0.72, specificity: 0.70) in men and 1.04 (sensitivity: 0.72, specificity: 0.69) in women. CONCLUSIONS: These results suggest that the L:A can serve as a clinically useful marker for detecting MetS characteristics in the general Japanese population. The clinical application of this laboratory index for detecting MetS should be assessed in future studies.

Influence of smoking habits on the GA/HbA1c ratio in patients with type 1 diabetes mellitus

To assess the influence of smoking on glycated albumin [GA] to hemoglobin A1c [HbA1c] ratio among type 1 diabetes mellitus [T1DM] patients. Eighty-one T1DM patients [49 females, 32 males, mean age 48 +/- 18 years] were recruited, and data concerning GA/HbA1c ratio and smoking were collected. The median levels of GA and HbA1c were 23.3 and 7.4%, respectively. Independent of age, sex and/or body mass index, the GA/HbA1c ratio in smokers was significantly lower than that in nonsmokers [3.0 vs. 3.3, p < 0.05]. The data suggest that smoking might affect the GA/HbA1c ratio among T1DM patients

The Successful Treatment of a Case of Anorexia Nervosa with Anchu-san / 日本東洋医学雑誌

We present here an interesting case of anorexia nervosa that was well controlled by Ancyu-san, a traditional Japanese herbal medicine. A 17-year-old student was re-admitted to our department in December of 1990, because of anorexia and eating disorders. She had lost approximately 12kg body weight during 3 months. She was 154cm tall and weighed 26kg. Her blood pressure was 75/40mmHg, her pulse rate was 30beats/min, and her body temparature was 34.4°C. She was extremely emaciated and hyperactive. On oriental examination, a shallow complexion, a cold feeling in the limbs, postprandial headaches, and a feeling of obstruction of the external ear. Her pulse was slow and feeble. Abdominal examination revealed that the abdominal strength was reduced to 2/5 with Inai-teisui (abdominal water and gas retention). Based on these findings, this case was diagnosed as Deficient Spleen and Stomach due to Deficient Ki and Blood combined with Stagnated Ki, and therefore a candidate for the Kampo formula Ancyu-san. The patient began medication in January 1991. Her appetite improved gradually and her body weight increased from 26kg to 47kg in two months.