Attenuated age-impact on systemic inflammatory markers in the presence of a metabolic burden.

BACKGROUND: The overall burden of chronic disease, inflammation and cardiovascular risk increases with age. Whether the relationship between age and inflammation is impacted by presence of an adverse metabolic burden is not known. METHODS: We determined inflammatory markers in humans (336 Caucasians and 224 African Americans) and in mice, representing a spectrum of age, weight and metabolic burden. RESULTS: In humans, levels of inflammatory markers increased significantly with age in subjects without the metabolic syndrome, (P=0.009 and P=0.037 for C-reactive protein, P<0.001 and P=0.001 for fibrinogen, P<0.001 and P=0.005 for serum amyloid-A, for Caucasians and African Americans, respectively). In contrast, trend patterns of inflammatory markers did not change significantly with age in subjects with metabolic syndrome in either ethnic group, except for fibrinogen in Caucasians. A composite z-score for systemic inflammation increased significantly with age in subjects without metabolic syndrome (P=0.004 and P<0.006 for Caucasians and African Americans, respectively) but not in subjects with metabolic syndrome (P=0.009 for difference in age trend between metabolic syndrome and non-metabolic syndrome). In contrast, no similar age trend was found in vascular inflammation. The findings in humans were paralleled by results in mice as serum amyloid-A levels increased across age (range 2-15 months, P<0.01) and were higher in ob/ob mice compared to control mice (P<0.001). CONCLUSIONS: Presence of a metabolic challenge in mice and humans influences levels of inflammatory markers over a wide age range. Our results underscore that already at a young age, presence of a metabolic burden enhances inflammation to a level that appears to be similar to that of decades older people without metabolic syndrome.

Weight Loss and Improvement of Metabolic Syndrome by Interventional Program Based on Health Education / 日本農村医学会雑誌

A cluster of insulin resistance, dyslipidemia and hypertension has been labeled as a metabolic syndrome. Asians have a lower rate of obesity than Caucasians, but have recently become increasingly prone to obesity and the metabolic syndrome, especially in rural communities in Japan. Although weight loss has been considered to be effective for improvement of the metabolic syndrome, most data are based on studies in Western countries with only limited information derived from Japanese populations. We conducted a study of 188 subjects who participated in our interventional program for obesity based on health education and self-determination in 2000-2003. The intervention induced significant decreases in caloric intakes and increases in physical activity in the participants, and then resulted in a significant 1.3kg reduction in weight on the average. Weght-loss was significantly associated with indexes of obesity, values of total cholesterol, triglyceide and HDL cholesterol levels, but was not related with blood pressure and LDL cholesterol, which were significantly decreased by our intervention. Furthermore a simple regression analysis was carried out to verify whether weight loss and metabolic syndrome parameters were related. Weight loss was determinantsexplaining less than a total of 10% of the variance in triglyceride and total cholesterol for the participants. Future studies of weight loss for metabolic syndrome should incorporate Asian ethnic factors, such as dietary habits and genetic influences.

Development and Evaluation of Interventional Program for Obesity Based on Health Education and Self-Dertermination / 日本農村医学会雑誌

To arrest the prevalence of obesity in Japanese rural communities, we have conducted to develop an interventional program for the prevention of obesity based on health education and self-dertermination since 2000. We adopted the behavioral program to strengthen self-control of diet and exercise based on learning principles. The objectives of the 3-month program were to lose weight by 3.0kg, to reduce metabolic measurement values by 10% in terms of dietary caloric intake and to keep taking over 7, 000 steps a day. Subjects were 140 residents with Body Mass Index of 24.8±3.0, aged 35-70 years, in Izumo City and Sada Town, Shimane Prefecture, who were interested in the prevention of overweight and obesity-associated diseases, voluntarily participated in the behavioral program conducted in 2000-2002. The rate of dropout from the program was 2.9%(4/140). The behavioral intervention induced significant decreases in intakes of energy, protein and fat, and increases in the number of steps per day taken by the participants. The intervention induced a significant difference in weightloss (-1.0kg in 2001 and -1.8kg in 2002). Significant differences of anthropometric parameters were found in body weight, BMI, waist and hip circumferences, blood pressure and lipid profiles, such as total cholesterol, LDL-cholesterol, and HDL-cholesterol, by the intervention in 2001 and 2002. Since our program is based on the participants' awareness and autonomous improvement of behavior, it would be easier to continue for a long term compared to complying with specialist's complicated prescription of behavioristic modification.

Comprehensive Evaluation of Risk Factors for Atherosclerosis among Workers in a Rural Community and a Local City / 日本農村医学会雑誌

In the 1990's, a metabolic syndrome associated with obesity, insulin resistance, hyperlipidemia and hypertension began to capture the attention of Japanese investigators as on ominous predictor of myocardial infarction. As there is few information of the metabolic syndrome in rural communities, we conducted a cross-sectional survey of the prevalence of the metabolic syndrome for 1, 084 workers aged 20-59 years in a rural community, Sada Town, and a neighboring local city, Izumo City, Shimane Prefecture. The number of risk factors for atherosclerosis was increased with age and was higher in males than in females. Men in their 50's in the rural community were at higher risk than their counterparts in the city. Most of the workers had one or two risk factors, and those who had three and more risk factors accounted for a little less than 7%. The rate of males aged 40-59 years in the rural community having over two risk factors among obesity, hyperlipidemia, hypertension and diabetes was significantly higher than that of the same age group in the city. The metabolic syndrome among males living in the rural community was related to obesity, hypo-HDL cholesterolemia, and hypertension. Males in the rural community had higher body mass index (BMI), than males in the city, but there was no significant difference in BMI between female groups. The prevalence of obesity in males in the rural community was linked with drinking habit and a decline in physical activities. In order to prevent the metabolic syndrome in the rural communities, a health policy based on a population-based strategy should be implemented to change the healthy lifestyle of workers, to promote health education and establish a health supportive environment.

The Occurrence of Bovine Spongiform Encephalopathy (BSE) in Japan from the Viewpoint of Political Science / 日本農村医学会雑誌

The Japanese government's response to the recent discovery of dairy cows suffering from bovine spongiform encephalopathy (BSE) in this country was analyzed from the viewpoint of policy science with reference to the policy in the United Kingdom and other EU countries. The results of investigation into the causative agent (s) androutes of infection of BSE that affected a total of seven cows were reviewed and the points at issue during the course of the epidemiological survey were given. Despite repeated warnings from the UK, EU and WHO, adequate countermeasures were not taken by the government offices concerned-the Ministry of Agriculture, Forestry and Fishery and the Ministry of Health, Welfare and Labor. They failed to prevent the occurrence of BSE and the resultant panic among consumers. The present review brought to lighta lack of a sense of urgency and risk management system in the government, the moral hazard in the food industry and market, the blunder of the government officials and the absence of an adequate food safety surveillance system. At the same time, we presented some proposals as to what the future food safety policy should be.