Correction: The Smart Life Stay (SLS) program: effects of a lifestyle intervention program in combination with health tourism and health guidance for type 2 diabetes.

Following publication, the authors asked to add the following institution to the affiliations of author Madoka Matsushita: Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine Both the PDF and HTML versions of the Article have been updated accordingly.

The Smart Life Stay (SLS) program: effects of a lifestyle intervention program in combination with health tourism and health guidance for type 2 diabetes.

BACKGROUND: The aim of this study was to determine the effectiveness of the Smart Life Stay (SLS) program, which is an experience-oriented stayover program, in combination with health tourism and mandatory health guidance on glucose metabolism after 2 years. METHODS: The participants of the SLS program (n = 792) were recruited from a database of 23 medical insurers. They underwent a mandatory health examination termed Specific Health Checkups in 2014. The participants were included if they had diabetes or were at a high risk of diabetes and if they satisfied the following inclusion criteria: (1) body mass index (BMI; kg/m2) > 25, or (2) waist circumference (WC; cm) > 85 for men and > 90 for women, or (3) hemoglobin A1c (HbA1c; %) > 5.6, or (4) fasting plasma glucose (FPG; mg/dl) > 100. Individuals who corresponded to one or more items were included as study participants. The control subjects (n = 3645) were nonparticipants of the program who were selected from the database and met the inclusion criteria. The lifestyle changes and changes in mean BMI, WC, FPG, and HbA1c in both groups from baseline to 2-year follow-up were compared by inverse probability weighting of a propensity score. RESULTS: The percentage of people who exercised regularly increased significantly in the SLS group compared with the control group. In the SLS group, BW, BMI, and WC significantly decreased by 1.75 kg, 0.60 kg/m2, and 1.45 cm, respectively, whereas in the control group, WC, FPG, and HbA1c increased significantly by 0.38 cm, 3.37 mg/dl, and 0.12%, respectively. The comparison between groups revealed that the BW, BMI, WC, FPG, and HbA1c improved significantly in the SLS group. CONCLUSIONS: The SLS program is suggested to help improve glucose metabolism. This program could be a feasible option as a lifestyle intervention program for diabetes.

Cross-calibration of pencil-beam (DPX-NT) and fan-beam (QDR-4500C) dual-energy X-ray absorptiometry for sarcopenia.

Sarcopenia, defined as the loss of muscle mass accompanied by weakness, is an important factor leading to frailty and is a growing concern in the aging Japanese society. Muscle mass can be calculated by dual-energy X-ray absorptiometry (DXA), but results differ between devices produced by different manufactures. Thus, cross-calibration is needed to compare body composition results in multicenter trials or when scanners are replaced. The purpose of this study was to perform an in vivo calibration of total body scans between pencil-beam (DPX-NT, GE Healthcare) and fan-beam (QDR-4500C, Hologic Inc.) DXA units. A total 30 subjects (15 women, 15 men, mean age = 35 years, range 22-49 years) were recruited. The lumbar bone mineral density (BMD), femoral neck BMD, appendicular fat and lean body mass, and the appendicular skeletal muscle mass index (ASMI) were highly correlated (r = 0.979-0.993, r(2) = 0.889-0.977). The conversion formulas were as follows: lumbar BMD, Y = -0.08 + 1.16X (X = QDR-4500C, Y = DPX-NT), femoral neck BMD, Y = -0.015 + 1.11X, and ASMI Y = 0.92 + 0.90X. There is excellent comparability between the DPX-NT and the QDR-4500C DXA units. However, cross-calibration equations are required to assess muscle volume, fat, and ASMI in multicenter studies investigating sarcopenia.

Three percent weight reduction is the minimum requirement to improve health hazards in obese and overweight people in Japan.

OBJECTIVE: Adequate goal-setting is important in health counselling and treatment for obesity and overweight. We tried to determine the minimum weight reduction required for improvement of obesity-related risk factors and conditions in obese and overweight Japanese people, using a nationwide intervention programme database. METHODS: Japanese men and women (n=3480; mean age±standard deviation [SD], 48.3±5.9 years; mean body mass index±SD, 27.7±2.5kgm(-2)) with "Obesity Disease" or "Metabolic Syndrome" participated in a 6-month lifestyle modification programme (specific health guidance) and underwent follow-up for 6 months thereafter. The relationship between percent weight reduction and changes in 11 parameters of obesity-related diseases were examined. RESULTS: Significant weight reduction was observed 6 months after the beginning of the programme, and it was maintained for 1 year. Concomitant improvements in parameters for obesity-related diseases were also observed. One-third of the subjects reduced their body weight by ≥3%. In the group exhibiting 1% to <3% weight reduction, plasma triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), haemoglobin A1c (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-glutamyl transpeptidase (γ-GTP) decreased significantly, and high-density lipoprotein cholesterol (HDL-C) increased significantly compared to the control group (±1% weight change group). In addition to the improvements of these 7 parameters (out of 11), significant reductions in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG) and uric acid (UA) (total 11 of 11 parameters) were observed in the group with 3% to <5% weight reduction. In the group with ≥5% weight reduction, the same 11 parameters also improved as those in the group with 3% to <5% weight reduction. CONCLUSION: The 6-month lifestyle modification programme induced significant weight reduction and significant improvement of parameters of obesity-related diseases. All the measured obesity-related parameters were significantly improved in groups with 3% to <5% and ≥5% weight reduction. Based on these findings, the minimum weight reduction required for improvement of obesity-related risk factors or conditions is 3% in obese and overweight (by WHO classification) Japanese people.