Perspective of Small-Molecule AdipoR Agonist for Type 2 Diabetes and Short Life in Obesity

Obesity associated with unhealthy diet and lack of exercise is shown to contribute to the onset and/or aggravation of the metabolic syndrome and diabetes, thus placing affected individuals at increased risk of cardiovascular disease and cancer. Plasma adiponectin levels are decreased in obesity, which causes insulin resistance and diabetes. Therefore, we identified adiponectin receptors (AdipoRs) as the therapeutic target. It was suggested that, similarly to caloric restriction and exercise, activation of the AdipoRs may have the potential not only to improve lifestyle-related diseases but to contribute to prolonged the shortened lifespan on a high caloric unhealthy diet. To this end, we have identified "AdipoRon" as an adiponectin receptor agonist. Indeed, AdipoRon ameliorated diabetes associated with obesity as well as to increase exercise endurance, thus prolonging shortened lifespan of obese mice fed on a high fat diet. Additionally, we have recently determined the crystal structures of the human AdipoRs. The seven-transmembrane helices of AdipoRs are structurally distinct from those of G-protein coupled receptors. It is expected that these findings will contribute not only to the elucidation of the AdipoR-related signal transduction but to the development and optimization of AdipoR-targeted therapeutics for obesity-related diseases such as diabetes.

Methodological issues for a large-scale intervention trial of lifestyle modification: Interim assessment of the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study

<p><b>OBJECTIVE</b>To clarify the methodological issues for the High-risk and population Strategy for Occupational Health Promotion Study (HIPOP-OHP study), which is a 4-year non-randomized control trial, an interim assessment of male participants was performed 3 years after the baseline survey.</p><p><b>METHODS</b>We had approximately 2,500 and 4,000 participants in the intervention and control groups, respectively. The population measures and prevalence of risk factors at each year, and between the baseline and 4th examinations were compared between the two groups. The personal trends of returning participants who were in the study at the 1(st) and 4(th) examinations were also evaluated.</p><p><b>RESULTS</b>During the 3 years, an increase in serum HDL cholesterol (2.7 mg/dl), and a reduction in the prevalence of hypertriglycemia detected with fasting blood samples (3.6%) and current smokers (5.4%) were observed in the intervention group. The mean HDL cholesterol level was significantly higher in the intervention group than in the control group at the 4th examination, reversed from the baseline survey. The serum non-HDL cholesterol level was significantly increased only in the control group. There was also a significant increase in the prevalence of hypertriglycemia nad high plasma glucose detected with fasting blood samples in the control group. The return participation rate after 3 years was 72.2% for the intervention group and 74.9% for the control group. The above-mentioned changes for risk factors were mainly due to returning participants at each examination.</p><p><b>CONCLUSION</b>These interventional methods may be effective in improving overall cardiovascular risk factors in the population. However, the low return participation rate will dilute the effect of the intervention.</p>

The evaluation of materials to provide health-related information as a population strategy in the worksite: The high-risk and population strategy for occupational health promotion (HIPOP-OHP) study

<p><b>OBJECTIVE</b>To examine the effectiveness of newly developed materials for providing health-related information to the worksite population, we compared the amount of attention that employees paid to the materials.</p><p><b>METHODS</b>Study subjects were 2,361 employees in six companies participating in an intervention program between 2002 and 2003. Three kinds of media were used as tools for providing health information: [1] Point Of Purchase advertising menus (POP menus) were placed on all tables in company restaurants, [2] posters were put on walls and [3] leaflets were distributed at health-related events. One year or more after the introduction of these media, we compared the amount of attention paid to each type of medium.</p><p><b>RESULTS</b>Amongst the three types of media, the POP menu drew the most attention, although results were not consistent in all gender and company groups. Every piece of information provided by the POP menus was "always" or "almost always" read by 41% of the men and 51% of the women surveyed. The corresponding rate for posters was 30% in men and 32% in women. For leaflets, only 16% of men and 22% of women read almost all of the leaflets. More attention was paid to the POP menu when the sample was women, older, and ate at the company restaurant at least three times a week.</p><p><b>CONCLUSION</b>The POP menu may provide health-related information to a broader range of people than posters and leaflets, therefore, it is an effective material for population strategy.</p>

Effectiveness of annual interventions for smoking cessation in an occupational setting in Japan

<p><b>OBJECTIVE</b>To examine the effectiveness of a small-scale smoking cessation intervention program conducted annually for ten years in an occupational setting in Japan.</p><p><b>METHODS</b>We conducted an annual intervention program promoting smoking cessation in male smokers from 1993 to 2002 in an occupational setting in Hyogo, Japan. Trends in smoking prevalence in this worksite were compared with a control group from two similar worksites of the same company. The intervention program was carried out by medical students (the fourth year of a six-year course) who received training on the protocol prior to the intervention. This protocol consisted of one initial group session, followed by periodical correspondence for two months. Successful cessation of smoking was determined by self-declaration of abstinence for longer than four weeks after intervention, confirmed by an expiratory carbon monoxide concentration of less than nine ppm. Smoking prevalence was determined by a self-administered questionnaire provided at the annual health checkup.</p><p><b>RESULTS</b>The proportion of smokers who participated in the program was 3.47% on average. Abstinence rates following each intervention ranged from 13.3% to 60.0%, with the prevalence of male smokers at the intervention worksite decreasing from 56.2% in 1993 to 47.0% in 2002. In contrast, the smoking prevalence of the control worksites remained largely unchanged, being 60.2% in 1995 and 57.6% in 2002. At the end of the study, the intervention worksite had a significantly lower prevalence of smokers in either the crude or age-adjusted rate.</p><p><b>CONCLUSION</b>A small-scale but repeated smoking cessation intervention program at a worksite can reduce smoking prevalence more efficiently than the natural trends.</p>

Effectiveness of Annual Interventions for Smoking Cessation in an Occupational Setting in Japan

Objective: To examine the effectiveness of a small-scale smoking cessation intervention program conducted annually for ten years in an occupational setting in Japan. Methods: We conducted an annual intervention program promoting smoking cessation in male smokers from 1993 to 2002 in an occupational setting in Hyogo, Japan. Trends in smoking prevalence in this worksite were compared with a control group from two similar worksites of the same company. The intervention program was carried out by medical students (the fourth year of a six-year course) who received training on the protocol prior to the intervention. This protocol consisted of one initial group session, followed by periodical correspondence for two months. Successful cessation of smoking was determined by self-declaration of abstinence for longer than four weeks after intervention, confirmed by an expiratory carbon monoxide concentration of less than nine ppm. Smoking prevalence was determined by a self-administered questionnaire provided at the annual health checkup. Results: The proportion of smokers who participated in the program was 3.47% on average. Abstinence rates following each intervention ranged from 13.3% to 60.0%, with the prevalence of male smokers at the intervention worksite decreasing from 56.2% in 1993 to 47.0% in 2002. In contrast, the smoking prevalence of the control worksites remained largely unchanged, being 60.2% in 1995 and 57.6% in 2002. At the end of the study, the intervention worksite had a significantly lower prevalence of smokers in either the crude or age-adjusted rate. Conclusion: A small-scale but repeated smoking cessation intervention program at a worksite can reduce smoking prevalence more efficiently than the natural trend.

The Evaluation of Materials to Provide Health-Related Information as a Population Strategy in the Worksite: The High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study

Objective: To examine the effectiveness of newly developed materials for providing health-related information to the worksite population, we compared the amount of attention that employees paid to the materials. Methods: Study subjects were 2,361 employees in six companies participating in an intervention program between 2002 and 2003. Three kinds of media were used as tools for providing health information: [1] Point Of Purchase advertising menus (POP menus) were placed on all tables in company restaurants, [2] posters were put on walls and [3] leaflets were distributed at health-related events. One year or more after the introduction of these media, we compared the amount of attention paid to each type of medium. Results: Amongst the three types of media, the POP menu drew the most attention, although results were not consistent in all gender and company groups. Every piece of information provided by the POP menus was “always” or “almost always” read by 41% of the men and 51% of the women surveyed. The corresponding rate for posters was 30% in men and 32% in women. For leaflets, only 16% of men and 22% of women read almost all of the leaflets. More attention was paid to the POP menu when the sample was women, older, and ate at the company restaurant at least three times a week. Conclusion: The POP menu may provide health-related information to a broader range of people than posters and leaflets, therefore, it is an effective material for population strategy.

Methodological Issues for a Large-Scale Intervention Trial of Lifestyle Modification: Interim Assessment of the High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study

Objective: To clarify the methodological issues for the High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP study), which is a 4-year non-randomized control trial, an interim assessment of male participants was performed 3 years after the baseline survey. Methods: We had approximately 2,500 and 4,000 participants in the intervention and control groups, respectively. The population measures and prevalence of risk factors at each year, and between the baseline and 4th examinations were compared between the two groups. The personal trends of returning participants who were in the study at the 1st and 4th examinations were also evaluated. Results: During the 3 years, an increase in serum HDL cholesterol (2.7 mg/dl), and a reduction in the prevalence of hypertriglycemia detected with fasting blood samples (3.6%) and current smokers (5.4%) were observed in the intervention group. The mean HDL cholesterol level was significantly higher in the intervention group than in the control group at the 4th examination, reversed from the baseline survey. The serum non-HDL cholesterol level was significantly increased only in the control group. There was also a significant increase in the prevalence of hypertriglycemia and high plasma glucose detected with fasting blood samples in the control group. The return participation rate after 3 years was 72.2% for the intervention group and 74.9% for the control group. The above-mentioned changes for risk factors were mainly due to returning participants at each examination. Conclusion: These interventional methods may be effective in improving overall cardiovascular risk factors in the population. However, the low return participation rate will dilute the effect of the intervention.