Recent Topic of Saturated Fatty Acid (SFA) for Atherosclerotic Diseases

Whether saturated fatty acid (SFA) has a clinical influence on atherosclerotic cardiovascular disease (ASCVD) or not has been disputed. Prospective Urban Rural Epidemiology (PURE) study was recently summarized from 21 countries with about 150 thousand data. Dairy intake was negatively correlated with the prevalence of metabolic syndrome and the incidence of diabetes and hypertension. To increase the intake of dairy products would be easy and inexpensive to continue for treatment. Polyunsaturated fatty acid (PUFA) and monounsaturated fatty acid (MUFA) may reduce atherosclerotic diseases with beneficial effects. Clinical evidence of SFA will be hopefully accumulated for practice and research in the future

Unsaturated Fatty Acid for Preventive Cardiovascular Disease

Obesity and metabolic syndrome have lipids intake problems including Monounsaturated Fatty Acid (MUFA) and Polyunsaturated Fatty Acid (PUFA). For decreasing the Atherosclerotic Cardiovascular Disease (ASCVD) risk, to replace of Saturated Fatty Acid (SFA) with PUFA and/or MUFA would be adequate. Finn Study including 2200 cases showed that Odd Ratio (OR) for obesity was SFAs: 1.28, MUFAs: 1.38, PUFAs: 0.70, Linoleic Acid (LA): 0.67 and DHA: 0.75. In Norwegian study with 3706 cases, higher LA levels were significantly associated with lower values of LDL-C, triglycerides, blood glucose, body mass index, blood pressure and eGFR. These current data are useful for practice

Up-To-Date Perspectives for Hyperuricemia, Cardiorenal Influence and Urate-Lowering Therapy (ULT)

Hyperuricemia is a clinical important problem and its prevalence has been increased. Latest topics are described. The guideline adequately managing gout was published from American College of Rheumatology (ACR). Various optimal uses of urate-lowering therapy (ULT) were presented. The cardiorenal effects of hyperuricemia have been investigated for years. Regarding the patients on chronic kidney disease (CKD) and high risk of progression, ULT with allopurinol did not show the decline in eGFR compared to the control. Recently, dotinurad that is a new selective urate reabsorption inhibitor (SURI) would be applied to medical practice. Low-dose dotinurad showed satisfactory pharmacological efficacy

Recent Perspectives on Social Frailty and Related Issue for the Elderly

Current situation has brought many people less physical and social activities across the world. Consequently, there has been some concern about the exacerbation of frailty, especially in the elderly. The problems for the elderly have oral frailty (OF), social frailty (SF) and physical frailty (PF). PF subdomains are slow gait speed, weakness, exhaustion, low activity and weight loss. Social frailty criteria have 7 factors including living alone, no education, absence of confidence, infrequent contact, infrequent social activities, financial difficulty, and socioeconomic deprivation. As useful index for social frailty, Social Frailty Index (SFI) and Tilburg Frailty Indicator (TFI) will be recommended

Effective Proposal of Food Pyramid for Understanding of Low Carbohydrate Diet (LCD)

There have been several types of dietary approaches, such as low-fat diet (calorie restriction, CR), Mediterranean diet, and low carbohydrate diet (LCD). LCD was started by Atkins and Bernstein, and LCD in Japan was initiated by authors and collaborators. We proposed petite-LCD, standard-LCD and super-LCD for practical use through the activity of Japan LCD promotion association (JLCDPA). Furthermore, seven golden rules for LCD and food pyramid for LCD were presented, which were also beneficial for patients and usual people for providing educational information. Our experience would be hopefully to become some reference for future practice

Medical Practice and Research in Primary Care with the Philosophy of Hinohara-ism and Oslerism

In the 1960s, there was some dissatisfaction for the medical situation. They included increased depersonalization of medicine and fragmentation of care. Millis Report of 1966 was presented the recommendation for new medical system, which focuses not upon individual organs and systems but upon the whole man. After that, primary care medicine and family medicine were developed. On the other hand, in Japan, we have had a most respectable and well-known physician, Dr. Shigeaki HINOHARA (1911-2017). He had been working in St. Luke’s International Hospital, Tokyo, and been abroad in US. Then he came to know Sir Osler / Oslerism, and modern medicine at that time. After coming back Japan, he has changed the medicine in Japan. He has firstly introduced and developed in Japan, such as primary care medicine, annual medical checkups, health education system for many people, problem-oriented system (POS) for medical chart, education system for nurse and co-medicals, life style related disease, music therapy, New Elderly Association (NEA) movement and so on. Consequently, he has been called “The Father of Primary Care” and “The Father of Music therapy”. He lived up to 105 years with continuous activity, and his remarkable achievements have still lead many people. The author has majored in primary care medicine, music therapy, psychosomatic medicine, sports medicine, life style related disease and developed these activities with Dr. Hinohara for long. Recently, we have broaden Oslerism and Hinohara-ism through NEA and other opportunities. The author has been 1) physician, 2) pianist, 3) athlete, 4) essayist with more than 40 books and 2000 publications. In the key note speech, a variety of contents would be presented such as primary care, music therapy, anti-aging medicine, low carbohydrate diet (LCD), sports activities and others for the beneficial and positive effects for healthier body/soul/mind/spirit

Several Effective Measures for Minus Excess Mortality of COVID-19 in Japan Including Mutual Interrelationships and Long-Term Care Facilities (LTCF)

The impact of COVID-19 can be shown by life expectancy, excess death and total years of life lost (YLL). United States showed life expectancy minus 1.67 years, excess deaths 375,235 and total YLL 7,362,555. The excess death of Japan has remained minus value for long, in which long-term care facilities (LTCF) may contribute. LTCF has characteristic points as i) mutual interrelationships between hospitals, medical societies and prefectural offices, ii) rapid communication channels for regulatory official authorities, iii) high degree of citizenship and cooperation of all Japanese people for daily life and iv) mild lockdown without any punishment with declaration

Beneficial and Therapeutic Potential of Ketone Bodies (KB) in Clinical Practice

Various discussion exists concerning ketone bodies (KB) for beneficial effects. In 2021, the American College of Cardiology (ACC) has presented the therapeutic potential of KB for cardiovascular (CV) disease. KB cover 10-15% of cardiac production of ATP, elevation of cardiac energetics, and reduction of cardiac remodeling, inflammation, and oxidative stress

Dual Action Mechanism of Insulin Resistance and Insulin Secretion by Imeglimin for Diabetic Treatment

Imeglimin (Twymeeg) is novel oral hypoglycemic agent (OHA) developed in the glimin category. It has dual action mechanisms of reducing insulin resistance and increasing insulin secretion. Trials of imeglimin for efficacy and safety 1 (TIMES 1), TIMES 2 and TIMES 3 were performed with significant clinical efficacy. Among them, HbA1c decrease for 52 weeks showed single imeglimin -0.46%, combined therapy of dipeptidyl peptidase-4i (DPP-4i)-0.92%, Glucagon-like peptide-1 receptor agonists (GLP-1RA)-0.12% and insulin -0.63%. From physiological and pharmacological points of view, the mechanism may include the enhancement action of glucose-stimulated insulin secretion (GSIS). For GSIS progress, transient receptor potential melastatin 2 (TRPM2) channel is activated