Changes on the Physiological Lactonase Activity of Serum Paraoxonase 1 by a Diet Intervention for Weight Loss in Healthy Overweight and Obese Women

Low caloric diet (LCD) is used for weight loss. Paraoxonase 1 (PON-1) is associated with the antioxidant functions of high-density lipoprotein (HDL). Among limited data on the relationships between obesity and PON-1, there has been no study on the effects of a stand-alone LCD on the physiological lactonase activity of PON-1. We investigated the prospective effects of LCD intervention (2 months) for weight loss on serum PON-1 activities (lactonase, arylesterase [mono-esterase] and tri-esterase) and HDL cholesterol (HDL-C), and their association with low-density lipoprotein cholesterol (LDL-C) in overweight and non-morbidly obese but otherwise healthy women (n = 30; mean age, 50.3 years; mean body mass index [BMI], 28.5 kg/m2). In addition to the data such as BMI, blood pressure, blood glucose and lipids, PON-1 activities were examined between pre- and post-intervention. The intervention reduced all metabolic outcomes, and PON-1 lactonase activity (determined with 5-[thiobutyl]butyrolactone) significantly decreased by 6.1%, paralleled by arylesterase (by 7.3%) and tri-esterase (by 7.8%). In multiple regression analysis, the percent change of PON-1 lactonase was significantly, positively and independently correlated to that of LDL-C (β = 0.51), HDL-C (β = 0.40), and BMI (β = 0.37). Our results showed that the solo diet treatment on weight loss might reduce serum PON-1 lactonase activity with reduced HDL-C and LDL-C. The relationship between the lactonase and LDL-C may be adaptive, plausibly hypothesizing less need for PON-1 activity as an antioxidant property to protect lipoproteins. Further research is needed to confirm this prediction

Dietary intake in Japanese outpatients with type 2 diabetes: 2-year follow up study

【目的】食事療法は2型糖尿病患者の自己管理に必須であるが、その経年的な実践状況についての検討は不足している。そこで本研究では、2型糖尿病患者における2年間の食事摂取状況の実態把握を行った。【方法】外来に通院する2型糖尿病患者60名 (平均年齢：66.8歳, 男性比率：65.0%) について、食物摂取頻度調査法を用い2014年とその2年後に把握した食品群・栄養素摂取状況を経年的に比較した。【結果】対象者の調査開始時の平均値は、罹病期間：10.2 ± 6.6 年，HbA1c：7.4 ± 1.1 %，BMI（Body Mass Index）：23.6 ± 4.4 kg/m2 であった。2年後は、BMI や血糖、血中脂質に有意差はみられず、収縮期血圧のみ調査開始時より高値であった(137.3 ± 13.6 vs. 132.8 ± 14.7 mmHg, p=0.031)。食事摂取状況は、2年間でエネルギー摂取量に有意差はみられなかったが、脂質エネルギー比が増加し(25.8 ± 5.3 vs. 27.3 ± 6.2 %, p= 0.030)、食物繊維摂取量が低下した(13.8 ± 4.6 vs.12.5 ± 3.6 g, p= 0.030)。食品群別では、野菜総量は摂取量が低下し(280 ± 132 vs. 229 ± 114 g, p=0.004)、肉類摂取量が増加した(45 ± 31 vs. 57 ± 48 g, p= 0.029)。調査開始時のHbA1c 値とBMI による層別解析では、HbA1c＜7%群で食物繊維と野菜類の総量摂取量が2年後に低値となり(p=0.048, 0.001)、HbA1c≧7%群で脂質摂取量が高値であるが( p= 0.042)、脂質エネルギー比でみると有意差は認められなかった。BMI 25kg/m2 未満群では、脂質エネルギー比が2年間で増加し(p= 0.043)、食物繊維と野菜類の総量摂取量が低下し(p= 0.003, 0.003)、乳類の摂取量が増加した(p= 0.022)。BMI 25kg/m2 以上群は、エネルギーや三大栄養素摂取に有意差は認められず、食品群別で、緑黄色野菜のみ2 年後の摂取量が低値となった(p= 0.008)。【結論】外来2型糖尿病患者の2年間の食事摂取状況の変化が明らかとなった。糖尿病療養状況を考慮した、各患者の食事摂取状況の経時的な把握を行う必要性が示唆された。Objective: The dietary intake across the ages of patients with type 2 diabetes is sparse though nutritional therapy is essential for self-managing for diabetes. We aimed to clarify 2-year dietary intake among Japanese individuals with type 2 diabetes from a community hospital-based registry. Methods: This study was analyzed in 60 patients with type 2 diabetes (Men%:65.0%, Age: 66.8y, BMI: 23.6kg/m2, HbA1c:7.4%) using the food frequency questionnaire based on food groups using paired t-test and Wilcoxon signed-rank test. Results: BMI, HbA1c, and serum lipid revels did not show significant difference over 2 years. Systolic blood pressure level in 2 years was significantly high than the value of baseline (137.3±13.6 vs. 132.8±14.7mmHg, p= 0.031). There was no significant difference in mean energy intake and proportions of protein and carbohydrate comprising total energy intake over 2 years. The proportion of fat intake increased (25.8±5.3 vs. 27.3±6.2%, p=0.030) and the fiber intake decreased in the 2 years (13.8±4.6 vs. 12.5±3.6g, p=0.030). As a dietary intake by food groups, vegetable intake was decreased (280±132 vs. 229±114g, p=0.004) and meat intake increased (45±31 vs. 57±48g, p= 0.029) in the 2 years. In addition, among patients who had HbA1c <7%, the intake of fiber and vegetable intakes in 2 years decreased compared with those at baseline (p= 0.048, 0.001), and patients with HbA1c ≥7% had higher fat intake value in 2 years than that of baseline (p= 0.043), though the proportion of fat intake did not show significant difference over 2 years. According to BMI, patients without overweight (BMI< 25kg/m2)raised the proportion of fat intake and milk/milk products intakes (p= 0.043 and 0.022, respectively) and reduced fiber and vegetable intakes (p= 0.003 and 0.003, respectively) in 2 years. The patients with overweight show higher green vegetable intake in 2 years, but the intakes of other nutrients and food group did not significantly changed. Conclusion: Our study clarified the characteristics and change of dietary intake of Japanese outpatients with type 2 diabetes and considering the treatment status would be useful for understanding each dietary intake of each patients with type 2 diabetes

Unstable bodyweight and incident type 2 diabetes mellitus: A meta-analysis

Aims/IntroductionThe present meta-analysis aimed to clarify the association of unstable bodyweight with the risk of type 2 diabetes mellitus, an association that has been controversial among longitudinal studies.Materials and MethodsAn electronic literature search using EMBASE and MEDLINE was followed up to 31 August 2016. The relative risks (RRs) of type 2 diabetes mellitus in individuals with unstable bodyweight were pooled using the inverse variance method.ResultsEight studies were eligible for the meta-analysis. The median duration of measurements of weight change and follow-up years for ascertaining type 2 diabetes mellitus were 13.5 and 9.4 years, respectively. The pooled RR for the least vs most stable category was 1.33 (95% confidence interval 1.12–1.57). Between-study heterogeneity was statistically significant (P = 0.048). Whether type 2 diabetes mellitus was ascertained by blood testing explained 66.0% of the variance in the logarithm of RR (P = 0.02). In three studies in which blood testing was carried out, type 2 diabetes mellitus risk was not significant (RR 1.06, 95% confidence interval 0.91–1.25). Furthermore, publication bias that inflated type 2 diabetes mellitus risk was statistically detected by Egger\u27s test (P = 0.09).ConclusionsUnstable bodyweight might be modestly associated with the elevated risk of type 2 diabetes mellitus; although serious biases, such as diagnostic suspicion bias and publication bias, made it difficult to assess this association

Quantitative Relationship Between Cumulative Risk Alleles Based on Genome-Wide Association Studies and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

Many epidemiological studies have assessed the genetic risk of having undiagnosed or of developing type 2 diabetes mellitus (T2DM) using several single nucleotide polymorphisms (SNPs) based on findings of genome-wide association studies (GWAS). However, the quantitative association of cumulative risk alleles (RAs) of such SNPs with T2DM risk has been unclear. The aim of this meta-analysis is to review the strength of the association between cumulative RAs and T2DM risk. Systematic literature searches were conducted for cross-sectional or longitudinal studies that examined odds ratios (ORs) for T2DM in relation to genetic profiles. Logarithm of the estimated OR (log OR) of T2DM for 1 increment in RAs carried (1-ΔRA) in each study was pooled using a random-effects model. There were 46 eligible studies that included 74,880 cases among 249,365 participants. In 32 studies with a cross-sectional design, the pooled OR for T2DM morbidity for 1-ΔRA was 1.16 (95% confidence interval [CI], 1.13–1.19). In 15 studies that had a longitudinal design, the OR for incident T2DM was 1.10 (95% CI, 1.08–1.13). There was large heterogeneity in the magnitude of log OR (P < 0.001 for both cross-sectional studies and longitudinal studies). The top 10 commonly used genes significantly explained the variance in the log OR (P = 0.04 for cross-sectional studies; P = 0.006 for longitudinal studies). The current meta-analysis indicated that carrying 1-ΔRA in T2DM-associated SNPs was associated with a modest risk of prevalent or incident T2DM, although the heterogeneity in the used genes among studies requires us to interpret the results with caution

Changes in Selected Food Groups Consumption and Quality of Meals in Japanese School Children during the COVID-19 Pandemic

In 2020, a state of emergency was declared to control the devastating impact of coronavirus, leading to temporary school closures in Japan, meaning that school lunches were not provided to the majority of schoolchildren. Using questionnaires completed by participants’ guardians, we examined the relationship between household income and the quality of meals in Japanese schoolchildren before, during, and after the state of emergency. Participants (1111 children, 10–14 years old) were chosen to form a nationally representative sample of the Japanese population. “Well-balanced dietary intake” was defined as the intake of (i) meat, fish, or eggs and (ii) vegetables. The desired prevalence was defined as equal to or more than twice a day. Household income was divided into quartiles. “Well-balanced dietary intake” was lower in all households during the state of emergency compared with before. The proportion of those with a “well-balanced dietary intake” at least twice a day was notably low in both Q3 and Q4 during the state of emergency compared with before the declared state of emergency; relative risk increase (95% CI) were Q1: −19.0% (−19.6% to −18.4%), p &lt; 0.001, Q2: −21.3% (−22.1% to −20.6%) p &lt; 0.001, Q3: −25.4% (−26.1% to −24.7%), p &lt; 0.001, and Q4: −34.8% (−35.6% to −34.0%), p &lt; 0.001. The interaction p (vs. Q1) of Q2, Q3, and Q4 were all &lt;0.001. Guardians from low-income households had significantly higher rates of having less: time, psychological room, and financial position to prepare meals during the state of emergency. Our results suggest that schoolchildren’s quality of meals worsened during the state of emergency, especially in low-income households, because school lunches were not provided

A Music Therapy System for Patients with Dementia who Repeat Stereotypical Utterances

Some patients with dementia repeat stereotypical utterances and/or scream in agitation for several hours. Music therapy is a method known to alleviate the symptoms of dementia. Altshuler explained that a music therapist should first play music that matches the current mood of a patient according to the iso-principle, principle of music therapy. We thought that if certain types of music can calm patients down, a music therapy system that is usable for musical novices could be useful in nursing homes. Therefore, we present a music therapy system, "MusiCuddle," that automatically plays a short musical phrase (tune) in response to a caregiver's simple key entry. This music overlaps with patients' utterances and/or screaming. The first note of the tune is same as the fundamental pitch (F0) of the patient's utterances. We compiled four types of tunes (chords, cadences, Japanese school songs, and phrases created from the patients' utterances) into a database. The cadences were selected from established music scores and began with an unsteady or/and agitated chord in order to resonate with the patient's mental instability. We conducted a case study to investigate how MusiCuddle changes a patient's behaviors. In the case study, the pitches extracted from the patient's utterances were varied and wide-ranging. We thought her level of agitation might be reflected in her pitches. Pitch differences in the first note affect and change the entire mood of the music. Therefore, it may be said that the MusiCuddle can play music to resonate with his/her mood by extracting pitch from her utterance in accordance with the iso-principle. Moreover, we recorded the patient's utterances and compared them with vs. without using MusiCuddle to estimate the influence of MusiCuddle. The results suggested that tunes presented by MusiCuddle may give patients an opportunity to stop repeating stereotypical utterances

Towards a System that Relieves Psychological Symptoms of Dementia by Music

MusiCuddle is a system to calm the symptoms of patients with mental instability who repeat stereotypical utterances. The system presents a short musical phrase whose first note is the same as the fundamental pitch (F0) of a patient’s utterances. We performed a case study to investigate how a patient’s behaviors changed with MusiCuddle. The results suggested that the phrases presented by MusiCuddle may provide patients with an opportunity to stop repeating stereotypical utterances. Then, we added a vocoder function to MusiCuddle so that patients would be able to attend to the music more. We examined whether the mood of university students changed or not according to music presented with the vocoder function. We found significant differences between major harmonies and minor harmonies for the “cheerful” and “negative” moods. Namely, when a person’s voice is combined with cheerful sounds, he/she can become cheerful. However, when we conducted a case study to expect a patient’s repetitive utterances changed or stoped by the sound from the MusiCuddle with the vocoder, the participant’s utterances did not change. We discussed reasons of the result from an aspect of characteristic of a patient according to a cause disease of dementia

Association between Low Protein Intake and Mortality in Patients with Type 2 Diabetes

The aim of this study was to investigate the association between protein intake and mortality risk in patients with type 2 diabetes. We analyzed a pooled data of 2494 diabetic patients from two prospective longitudinal studies. Nutritional intake was assessed using a Food Frequency Questionnaire at baseline. Protein intake per body weight (kg) per day was categorized into quartile groups. Adjusted hazard ratios (HRs) and 95% confidence interval (CI) were calculated using Cox regression analysis. During the six-year follow-up, there were 152 incidents of all-cause mortality. The HR for mortality in the lowest quartile of protein intake per body weight compared with the highest quartile was 2.26 (95% CI: 1.34–3.82, p = 0.002) after adjustment for covariates. Subgroup analyses revealed significant associations between low protein intake and mortality in patients aged over 75 years or under 65 years. After further adjustment of the total energy intake, a significant association between protein intake and mortality remained in patients aged ≥ 75 years, whereas the association was attenuated in those aged < 65 years. Our results suggest that adequate protein intake is necessary in older diabetic patients over 75 years, whereas with diabetes, whereas whole optimal total energy intake is required in younger patients with type 2 diabetes