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Yogi S, Shirahata T, Sato H, Nishida Y, Inoue K, Niitsu M, Akagami T, Masaki K, Nagata M, Tanaka S, Katsukawa F, Nakamura H. Non-exercise Activity Thermogenesis Correlated With Clinical Parameters in Patients With or At-Risk for Chronic Obstructive Pulmonary Disease (COPD): A Pilot Study. Cureus 2024; 16:e53019. [PMID: 38410298 PMCID: PMC10895206 DOI: 10.7759/cureus.53019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Attention to physical activity has grown in patients with chronic obstructive pulmonary disease (COPD), as it serves as a robust indicator for mortality associated with COPD. Non-exercise activity thermogenesis (NEAT) is the energy expenditure due to physical activities besides active sports-like exercises and resistance training in daily life, and decreased NEAT may be related to physical inactivity in patients with COPD. We examined whether NEAT assessed using a questionnaire reflects clinical parameters in patients with or at risk for COPD. METHODS The study participants consisted of 36 male patients (COPD=28; stage1=6, stage2=14, stage3/4=8, and at-risk for COPD=8) older than 50 years of age. The participants underwent anthropometric measurements, lung function testing, a six-minute walk test, muscle strength testing, and questionnaires, e.g., the COPD assessment test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and Hospital Anxiety and Depression Scale. Image analysis with chest computed tomography (CT) included the number of trunk muscles, bronchial wall thickening, and emphysema (percentage of the lung field occupied by low attenuation area <-950 HU). We evaluated the relationship between these clinical parameters and NEAT questionnaire scores using Pearson correlation analysis and the Tukey-Kramer test. RESULTS The NEAT score was correlated with the severity of airflow limitation and airway wall thickness measured by chest CT, symptoms evaluated by the mMRC dyspnea scale and CAT, and inspiratory muscle strength and pectoralis muscle area assessed by CT. CONCLUSION Our study revealed the significance of NEAT as a valuable indicator in assessing the health status of patients with or at risk for COPD. The NEAT score was correlated with various clinical traits, suggesting that incorporating NEAT assessments using a questionnaire can contribute to a comprehensive understanding of the clinical condition in these patients. Further large-scale studies are warranted to validate and generalize these findings across diverse COPD populations.
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Affiliation(s)
- Sanehiro Yogi
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Toru Shirahata
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Hideaki Sato
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Yuki Nishida
- Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, JPN
- Sports Medicine Research Center, Keio University, Yokohama, JPN
| | - Kaiji Inoue
- Radiology, Saitama Medical University Hospital, Saitama, JPN
| | - Mamoru Niitsu
- Radiology, Saitama Medical University Hospital, Saitama, JPN
| | - Tomoe Akagami
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Kenji Masaki
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Makoto Nagata
- Respiratory Medicine, Saitama Medical University Hospital, Saitama, JPN
| | - Shigeho Tanaka
- Faculty of Nutrition, Kagawa Nutrition University, Saitama, JPN
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Nittari G, Ricci G, Savva D, Gibelli F, Bailo P, Ausania F, De Leo D. Telemedicine in diabetic ulcer management: A pilot study with exploration of medico-legal aspects. Nutr Metab Cardiovasc Dis 2023; 33:2280-2286. [PMID: 37591741 DOI: 10.1016/j.numecd.2023.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/05/2023] [Accepted: 07/15/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND AND AIMS This study aimed to evaluate the quality and efficiency of telemedicine in managing patients with chronic diabetic ulcers and provide an overview of the main medico-legal implications associated with telemedicine management of diabetic foot complications. METHODS AND RESULTS A total of 50 patients with type 2 diabetes mellitus were enrolled from a diabetic foot outpatient clinic in Cyprus between March and May 2022. Participants completed a survey concerning telemedicine services, and the demographic variables and average responses to the PACIC (Patient Assessment of Chronic Illness Care) questions were examined using descriptive analysis. The majority of patients (84%) were male, with a mean age of 60.9 ± 13.05 years. The average PACIC score was 4.42 (min. 2.7 and max. 5.0). Voice calls were the most preferred method of telemedicine delivery, accounting for 53% of all services. CONCLUSION Telemedicine can effectively manage chronic patients, such as those with diabetic ulcers, by reducing the burden on resources and maintaining service quality. However, healthcare professionals must be well-versed in medico-legal implications to adhere to legal and ethical guidelines, protect patient privacy, and maintain high standards of care while using telemedicine for chronic condition treatment.
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Affiliation(s)
- Giulio Nittari
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, 62032, Italy
| | - Giovanna Ricci
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, 62032, Italy
| | - Demetris Savva
- Plastic, Reconstructive and Aesthetic Surgery, Nicosia General Hospital, Nicosia, 2055, Cyprus
| | - Filippo Gibelli
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, 62032, Italy.
| | - Paolo Bailo
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, 62032, Italy
| | - Francesco Ausania
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, Verona, 36134, Italy
| | - Domenico De Leo
- Department of Diagnostic and Public Health, Section of Forensic Medicine, University of Verona, Verona, 36134, Italy
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Shirahata T, Nishida Y, Sato H, Yogi S, Akagami T, Nagata M, Tanaka S, Nakamura H, Katsukawa F. Impact of non-exercise activity thermogenesis on physical activity in patients with COPD. Sci Prog 2022; 105:368504221117064. [PMID: 36082951 PMCID: PMC10450459 DOI: 10.1177/00368504221117064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Physical inactivity is associated with comorbidities and mortality in chronic obstructive pulmonary disease (COPD) patients. Although non-exercise activity thermogenesis (NEAT) is important for evaluating the physical activity level (PAL) of patients with chronic diseases, it has not yet been assessed in COPD patients. This study included male patients with COPD (n = 28) and high risk for COPD (n = 8). Total energy expenditure (TEE) and basal metabolic rate (BMR) were measured using the doubly labeled water (DLW) method and indirect calorimetry, respectively. PAL was calculated as TEE/BMR, while the NEAT was obtained from a questionnaire. Physical activity was also assessed using an accelerometer. The total NEAT score was correlated with PAL (r = 0.534, P < 0.001), while PAL was correlated more strongly with the non-locomotive NEAT score (r = 0.548, P < 0.001) than the locomotive NEAT score (r = 0.278, P = 0.10). Regarding accelerometer-obtained data, this questionnaire mainly reflected steps/day and the duration of light locomotive and non-locomotive daily activities. The NEAT score is a possible option for evaluating PAL in daily clinical practice. The present results indicated that non-locomotive activity may have a greater impact on PAL than locomotive activity in COPD patients.
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Affiliation(s)
- Toru Shirahata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Yuki Nishida
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Sports Medicine Research Center, Keio University, Yokohama, Japan
| | - Hideaki Sato
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Sanehiro Yogi
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoe Akagami
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Makoto Nagata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Shigeho Tanaka
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Faculty of Nutrition, Kagawa Nutrition University, Saitama, Japan
| | - Hidetoshi Nakamura
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
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Burridge K, Christensen SM, Golden A, Ingersoll AB, Tondt J, Bays HE. Obesity history, physical exam, laboratory, body composition, and energy expenditure: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100007. [PMID: 37990700 PMCID: PMC10661987 DOI: 10.1016/j.obpill.2021.100007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is intended to provide clinicians an overview of the clinical and diagnostic evaluation of patients with pre-obesity/obesity. Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS outlines important components of medical, dietary, and physical activity history as well as physical exams, with a focus on specific aspects unique to managing patients with pre-obesity or obesity. Patients with pre-obesity/obesity benefit from the same preventive care and general laboratory testing as those without an increase in body fat. In addition, patients with pre-obesity/obesity may benefit from adiposity-specific diagnostic testing - both generally and individually - according to patient presentation and clinical judgment. Body composition testing, such as dual energy x-ray absorptiometry, bioelectrical impedance, and other measures, each have their own advantages and disadvantages. Some patients in clinical research, and perhaps even clinical practice, may benefit from an assessment of energy expenditure. This can be achieved by several methods including direct calorimetry, indirect calorimetry, doubly labeled water, or estimated by equations. Finally, a unifying theme regarding the etiology of pre-obesity/obesity and effectiveness of treatments of obesity centers on the role of biologic and behavior efficiencies and inefficiencies, with efficiencies more often associated with increases in fat mass and inefficiencies more often associated with decreases in fat mass. Conclusion The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of pre-obesity/obesity.
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Affiliation(s)
- Karlijn Burridge
- Gaining Health, 528 Pennsylvania Ave #708 Glen Ellyn, IL 60137, USA
| | - Sandra M. Christensen
- Integrative Medical Weight Management, 2611 NE 125th St., Suite 100B, Seattle, WA, 98125, USA
| | - Angela Golden
- NP Obesity Treatment Clinic and NP from Home, LLC, PO Box 25959, Munds Park, AZ, 86017, USA
| | - Amy B. Ingersoll
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA
- University of Louisville School of Medicine, USA
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Alexander L, Christensen SM, Richardson L, Ingersoll AB, Burridge K, Golden A, Karjoo S, Cortez D, Shelver M, Bays HE. Nutrition and physical activity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022. OBESITY PILLARS 2021; 1:100005. [PMCID: PMC10661909 DOI: 10.1016/j.obpill.2021.100005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on Nutrition and Physical Activity provides clinicians an overview of nutrition and physical activity principles applicable to the care of patients with increased body fat, especially those with adverse fat mass and adiposopathic metabolic consequences. Methods The scientific information and clinical guidance is based upon referenced evidence and derived from the clinical perspectives of the authors. Results This OMA CPS on Nutrition and Physical Activity provides basic clinical information regarding carbohydrates, proteins, fats (including trans fats, saturated fats, polyunsaturated fats, and monounsaturated fats), general principles of healthful nutrition, nutritional factors associated with improved health outcomes, and food labels. Included are the clinical implications of isocaloric substitution of refined carbohydrates with saturated fats and vice-versa, as well as definitions of low-calorie, very low-calorie, carbohydrate-restricted, and fat-restricted dietary intakes. Specific dietary plans discussed include carbohydrate-restricted diets, fat-restricted diets, very low-calorie diets, the Mediterranean diet, Therapeutic Lifestyle diet, Dietary Approaches to Stop Hypertension (DASH), ketogenic (modified Atkins) diet, Ornish diet, Paleo diet, vegetarian or vegan diet (whole food/plant-based), intermittent fasting/time restricted feeding, and commercial diet programs. This clinical practice statement also examines the health benefits of physical activity and provides practical pre-exercise medical evaluation guidance as well as suggestions regarding types and recommended amounts of dynamic (aerobic) training, resistance (anaerobic) training, leisure time physical activity, and non-exercise activity thermogenesis (NEAT). Additional guidance is provided regarding muscle physiology, exercise prescription, metabolic equivalent tasks (METS), and methods to track physical activity progress. Conclusion This Obesity Medicine Association Clinical Practice Statement on Nutrition and Physical Activity provides clinicians an overview of nutrition and physical activity. Implementation of appropriate nutrition and physical activity in patients with pre-obesity and/or obesity may improve the health of patients, especially those with adverse fat mass and adiposopathic metabolic consequences.
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Affiliation(s)
- Lydia Alexander
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Sandra M. Christensen
- Integrative Medical Weight Management, 2611 NE 125th St, Suite 100B, Seattle, WA, 98125, USA
| | - Larry Richardson
- Family Weight & Wellness, 1230 Rayford Bend, Spring, TX, 77386, USA
| | - Amy Beth Ingersoll
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Karli Burridge
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
- Gaining Health, 528 Pennsylvania Ave #708 Glen Ellyn, IL, 60137, USA
| | - Angela Golden
- NP Obesity Treatment Clinic and NP from Home, LLC, PO Box 25959, Munds Park, AZ, 86017, USA
| | - Sara Karjoo
- Department of Medicine, Johns Hopkins All Children's Hospital, 601 5th Street South Suite 605, St. Petersburg, FL, 33701, USA
| | - Danielle Cortez
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Michael Shelver
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA
- University of Louisville School of Medicine, USA
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Nakanishi S, Shimoda M, Tatsumi F, Kohara K, Obata A, Katakura Y, Sanada J, Fushimi Y, Iwamoto Y, Onishi M, Isobe H, Kusano T, Dan K, Wamata R, Iwamoto H, Mune T, Kaku K, Kaneto H. Effects of sedentary behavior and daily walking steps on body mass index and body composition: Prospective observational study using outpatient clinical data of Japanese patients with type 2 diabetes. J Diabetes Investig 2021; 12:1732-1738. [PMID: 33605026 PMCID: PMC8409876 DOI: 10.1111/jdi.13527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 01/04/2023] Open
Abstract
AIMS/INTRODUCTION This study examined the effect of daily walking steps on glycated hemoglobin, body mass index (BMI) and body composition while taking into consideration sedentary time (ST) in Japanese type 2 diabetes patients over a period of 12 months. MATERIALS AND METHODS Self-administered ST values and information regarding daily walking steps were obtained and analyzed for 236 patients with type 2 diabetes who regularly visited the outpatient clinic. The patients - divided into three categories of daily walking steps: non-step counter user, <7,500 daily walking steps and ≥7,500 daily walking steps (HS) - were prospectively observed considering ST through the monitoring of glycated hemoglobin, BMI waist circumference (WC) and visceral fat accumulation (VFA) for 12 months. RESULTS After 12 months, the participants categorized as the HS group had significantly reduced BMI and VFA independent of ST, as well as significantly reduced WC with high ST. WC and VFA disparities widened significantly at 12 months between the participants categorized as being in the non-step counter user group and the HS group with long ST. However, no difference in glycated hemoglobin levels and BMI were found among the three categories independent of ST. Compared with non-step counter users, the odds ratios with logistic regression models of improvement in BMI and VFA in the <7,500 daily walking steps and HS groups, and WC in the HS group after 12 months were significantly higher only among those with long ST. CONCLUSIONS These results suggest that consideration of sedentary behavior in combination with daily walking steps might be essential for type 2 diabetes management.
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Affiliation(s)
- Shuhei Nakanishi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Masashi Shimoda
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Fuminori Tatsumi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Kenji Kohara
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Atsushi Obata
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Yukino Katakura
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Junpei Sanada
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Yoshiro Fushimi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Yuichiro Iwamoto
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Mana Onishi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Hayato Isobe
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Takashi Kusano
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Kazunori Dan
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Ryo Wamata
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Hideyuki Iwamoto
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Tomoatsu Mune
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Kohei Kaku
- Department of Internal MedicineKawasaki HospitalKawasaki Medical SchoolOkayamaJapan
| | - Hideaki Kaneto
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
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Zhang F, Huang L, Peng L. The Degree of Influence of Daily Physical Activity on Quality of Life in Type 2 Diabetics. Front Psychol 2020; 11:1292. [PMID: 32695043 PMCID: PMC7338712 DOI: 10.3389/fpsyg.2020.01292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/18/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives: This study mainly explored the degree of influence of daily physical activity (PA) on the quality of life (QoL) and then provided a basis for improving PA and QoL in patients with Type 2 diabetes mellitus (T2DM). Methods: Long International PA Questionnaire (IPAQ-L) and Diabetic Mellitus QoL Scale (DMQLS) were used to investigate the daily PA and QoL, respectively, of patients with T2DM. The obtained data were analyzed by SPSS19.0 data analysis software. The correlation between PA and QoL was analyzed by Pearson correlation analysis and the degree of influence of PA on the QoL of patients with T2DM was analyzed by optimal scale regression analysis. Results: The total daily PA of the participants was 1172.79 ± 1266.23 MET-min/week and the overall score of QoL was 149.17 ± 17.16 points. Positive correlation has been found between PA and QoL and all its dimensions (all P < 0.05). It was found in the optimal scale regression that among many influencing factors, PA was significant and ranks first in importance among factors of the patient’s total QoL (importance = 0.432, P < 0.05) and its disease, physiological, psychological, and social dimension. The degrees of influence of PA on sub-dimensions of QoL were in the following order: physiology (0.476), society (0.441), disease (0.388), psychology (0.377), and satisfaction (0.089). Conclusion: The level of daily PA of patients with T2DM in southwestern China was moderate. Among the influencing factors such as gender, age, course of disease, education background, monthly income, BMI, work status, and complications, daily PA is the most important factor for QoL and its physiological, social, psychological, and disease dimension. The degrees of influence of daily PA on sub-dimensions of QoL were (in descending order) as follows: physiology, social, disease, psychology, and satisfaction. Therefore, in view of the importance of daily PA for QoL, more attention should be paid to the daily PA of T2DM patients in the future, including the study on more targeted testing methods, promotion strategies of daily PA, and its more extensive positive effects.
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Affiliation(s)
- Feng Zhang
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
| | - Li Huang
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
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Nakanishi S, Hirukawa H, Shimoda M, Tatsumi F, Kohara K, Obata A, Okauchi S, Katakura Y, Sanada J, Fushimi Y, Nishioka M, Kan Y, Tomita‐Mizoguchi A, Isobe H, Iwamoto H, Takahashi K, Mune T, Kaku K, Kaneto H. Impact of physical activity and sedentary time on glycated hemoglobin levels and body composition: Cross-sectional study using outpatient clinical data of Japanese patients with type 2 diabetes. J Diabetes Investig 2020; 11:633-639. [PMID: 31756287 PMCID: PMC7232284 DOI: 10.1111/jdi.13185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/05/2019] [Accepted: 11/19/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION This study examined the association among sedentary time (ST), physical activity (PA), glycated hemoglobin and body composition in Japanese type 2 diabetes patients. MATERIALS AND METHODS Patients with type 2 diabetes who visited the outpatient clinic at Kawasaki Medical School Hospital, Okayama, Japan, comprised the study's participants. Self-administered International Physical Activity Questionnaire short forms were obtained and analyzed for 1,053 patients, including 158 patients for whom waist circumference and visceral fat accumulation were measured. From the questionnaire, three categorical data (low, moderate, high) and continuous data (METs/h/week) regarding PA and ST (min/day), respectively, were obtained. RESULTS The patients categorized as having low PA had significantly higher body mass index than those categorized as having high levels, after adjustment was made for confounders. Continuous data of PA were negatively associated with waist circumference and visceral fat accumulation. ST was positively associated with body mass index. After dividing the participants into four groups according to medians of ST and PA, the following categories were established: long ST and low PA, long ST but high PA, short ST but low PA and short ST and high PA. In terms of body mass index, short ST and high PA measured significantly lower than long ST and low PA. For waist circumference and visceral fat accumulation, short ST but low PA and short ST and high PA measured significantly lower than long ST and low PA and long ST but high. CONCLUSIONS These results imply that the combination of avoiding sedentary behavior and increasing PA might be important in the prevention bodyweight gain and in the avoidance of central obesity, respectively, in Japanese type 2 diabetes patients.
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Affiliation(s)
- Shuhei Nakanishi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Hidenori Hirukawa
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Masashi Shimoda
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Fuminori Tatsumi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Kenji Kohara
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Atsushi Obata
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Seizo Okauchi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Yukino Katakura
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Junpei Sanada
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Yoshiro Fushimi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Momoyo Nishioka
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Yuki Kan
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | | | - Hayato Isobe
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Hideyuki Iwamoto
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Kaio Takahashi
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Tomoatsu Mune
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
| | - Kohei Kaku
- Department of Internal MedicineKawasaki HospitalKawasaki Medical SchoolOkayamaJapan
| | - Hideaki Kaneto
- Division of Diabetes, Metabolism and EndocrinologyKawasaki Medical SchoolOkayamaJapan
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Štotl I, Kambič T, Hadžić V, Zdolšek A. Different Types of Physical Activity and Metabolic Control in People With Type 1 Diabetes Mellitus. Front Physiol 2019; 10:1210. [PMID: 31607950 PMCID: PMC6769065 DOI: 10.3389/fphys.2019.01210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/05/2019] [Indexed: 12/26/2022] Open
Abstract
Background The aim of presented cross-sectional study was to determine the association of different types of physical activity (PA) with metabolic control in people with type 1 diabetes. Materials and Methods A total of 109 adult subjects with type 1 diabetes were asked to complete the non-exercise activity thermogenesis (NEAT) questionnaire, the hypoglycemia questionnaire, and the World Health Organization Global PA Questionnaire (GPAQ) which was used to assess moderate PA (MPA) and vigorous PA (VPA). Results NEAT score (p < 0.001) and total duration of work as assessed with GPAQ (p = 0.007) were positively associated with chronic glycemic control when controlled for sex, BMI, and continuous glucose monitoring system (CGMS) use. We could not confirm such association with total leisure time PA (LTPA) assessed with GPAQ (p = 0.443), though. Multivariate regression model controlled for sex showed positive effects of HbA1 c (p = 0.011) and age (p = 0.035), and negative effect of NEAT score (p = 0.001) on BMI. Systolic blood pressure was positively associated with duration of MPA (p = 0.009) and VPA (p = 0.012), but not with NEAT score (p = 0.830) when controlled for sex and BMI. NEAT score and VPA were positively associated with HDL levels when controlled for sex and BMI. Controlled for sex and BMI, higher values of VPA were significantly associated with lower levels of total cholesterol (p = 0.009) and LDL (p = 0.005). Conclusion Higher levels of NEAT are associated with some favorable metabolic effects in adult people with type 1 diabetes, but may also present an additional burden for them with more challenging environment regarding glycemic control.
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Affiliation(s)
- Iztok Štotl
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tim Kambič
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.,Department for Research and Education, General Hospital Murska Sobota, Murska Sobota, Slovenia
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Anže Zdolšek
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Umegaki H, Makino T, Uemura K, Shimada H, Hayashi T, Cheng XW, Kuzuya M. Association between insulin resistance and objective measurement of physical activity in community-dwelling older adults without diabetes mellitus. Diabetes Res Clin Pract 2018; 143:267-274. [PMID: 30056188 DOI: 10.1016/j.diabres.2018.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/10/2018] [Accepted: 07/23/2018] [Indexed: 12/11/2022]
Abstract
AIMS The main objective of this study was to determine the association between objectively measured physical activity (PA) and cardiometabolic risk factors, particularly insulin resistance (IR), in Japanese community-dwelling older adults without diabetes mellitus. METHODS Daily PA was measured by accelerometers in 388 community-dwelling older adults. IR was determined using homeostasis model assessment of insulin resistance (HOMA-IR). Regression analyses adjusted by age and sex were performed to determine the association of light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), or total steps per day with cardiometabolic risk factors. Then, multiple regression analysis was performed with HOMA-IR as an independent variable and those factors with p < 10% in the regression analysis as explanatory variables. RESULTS Objectively measured LPA was negatively associated with systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, and triglyceride (TG) and positively associated with high-density lipoprotein cholesterol (HDL-C). LPA was also negatively associated with IR. Total steps per day also had significant association with IR. MVPA was associated with TG, HDL-C, and IR. Multiple regression analysis showed that the association between LPA and IR was independent of other covariates, whereas that between MVPA and IR was lost after adjustment for other covariates. CONCLUSION IR was associated with LPA or total steps, but not with MVPA, in community-dwelling older adults without diabetes mellitus.
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Affiliation(s)
- Hiroyuki Umegaki
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan.
| | - Taeko Makino
- Institute of Innovation for Future Society, Nagoya University, Aichi, Japan
| | - Kazuki Uemura
- Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Toyama, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takahiro Hayashi
- Institute of Innovation for Future Society, Nagoya University, Aichi, Japan
| | - Xian Wu Cheng
- Institute of Innovation for Future Society, Nagoya University, Aichi, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan; Institute of Innovation for Future Society, Nagoya University, Aichi, Japan
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Yanai H, Adachi H, Masui Y, Katsuyama H, Kawaguchi A, Hakoshima M, Waragai Y, Harigae T, Hamasaki H, Sako A. Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. J Clin Med Res 2018; 10:365-369. [PMID: 29581797 PMCID: PMC5862082 DOI: 10.14740/jocmr3382w] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 01/01/2023] Open
Abstract
To achieve excellent glycemic control in patients with type 2 diabetes, an adequate prescription of exercise therapy is required. The meta-analyses proposed that high-intensity training improves metabolic parameters in patients with pre-diabetes or type 2 diabetes and low physical activity is associated with an increased risk of incident type 2 diabetes. Here, we would introduce literatures about effects of physical activity on mortality, cardiovascular events, and metabolic parameters, to encourage understanding of exercise therapy, and then describe how to prescribe exercise therapy for patients with type 2 diabetes. We also show the usefulness of non-exercise activity thermogenesis for diabetic patients who cannot perform volitional sporting-like exercise because of diabetic complication and/or comorbidity, by presenting results of our previous studies.
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Affiliation(s)
- Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hiroki Adachi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoshinori Masui
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akiko Kawaguchi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Mariko Hakoshima
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoko Waragai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Tadanao Harigae
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
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12
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Energy expenditure after spinal cord injury in people with motor-complete tetraplegia or motor-complete paraplegia. Spinal Cord 2017; 56:274-283. [DOI: 10.1038/s41393-017-0024-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/29/2017] [Accepted: 10/04/2017] [Indexed: 11/08/2022]
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Benfato ID, Moretto TL, de Carvalho FP, Barthichoto M, Ferreira SM, Costa Júnior JM, Lazzarin MC, de Oliveira F, Martinez C, Prado de França Carvalho C, de Oliveira CAM. Spontaneous physical activity and mediators of energy homeostasis in the hypothalamus of mice from 4 to 10 months of age. Exp Physiol 2017; 102:1524-1534. [PMID: 28786537 DOI: 10.1113/ep086265] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 08/04/2017] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Is the initial decline of spontaneous physical activity (SPA) in mice related to impaired insulin and leptin signalling or brain-derived neurotrophic factor expression in the hypothalamus? What is the main finding and its importance? We showed that SPA started to decline at an early stage, concomitantly with an impairment of hypothalamic leptin signalling. Consequently, energy expenditure decreased and glucose tolerance worsened. Our results demonstrate the need to counteract the initial decline in SPA to avoid metabolic impairments and indicate the possible involvement of central leptin in the reduction in SPA with age. The biological control of physical activity is poorly understood. Age decreases insulin, leptin and brain-derived neurotrophic factor (BDNF) signalling in the hypothalamus, and all have been shown to modulate spontaneous physical activity (SPA). We investigated the age at which SPA starts to decline and whether this is associated with the emergence of hypothalamic insulin and leptin resistance and reduced BDNF expression. Spontaneous physical activity (and other parameters of locomotion) and energy expenditure were determined monthly in mice from the 4th to the 10th month of age. Metabolic and hypothalamic analyses were performed in 4-, 6- and 10-month-old mice. Spontaneous physical activity, distance travelled and speed of locomotion started to decrease in 6-month-old mice. The reduction in SPA became more evident from 8 months of age. Energy expenditure decreased from the 8th month. Hypothalamic BDNF protein expression and insulin signalling did not change throughout the time span studied. Leptin signalling decreased at 6 and 10 months compared with 4 months. Also, compared with 4 months, 6- and 10-month-old mice were glucose intolerant. In conclusion, SPA begins to decline in parallel with reduced hypothalamic leptin signalling. Metabolic impairment also manifests as SPA decreases, highlighting the need to understand the regulation of SPA in order to combat its decline.
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Affiliation(s)
- Izabelle Dias Benfato
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo, Santos, SP, Brazil
| | - Thaís Ludmilla Moretto
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo, Santos, SP, Brazil
| | | | - Marcela Barthichoto
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo, Santos, SP, Brazil
| | - Sandra Mara Ferreira
- Department of Structural and Functional Biology, Biology Institute, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - José Maria Costa Júnior
- Department of Structural and Functional Biology, Biology Institute, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | - Mariana Cruz Lazzarin
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo, Santos, SP, Brazil
| | - Flávia de Oliveira
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo, Santos, SP, Brazil
| | - Carolina Martinez
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo, Santos, SP, Brazil
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Energy expenditure in people with motor-complete paraplegia. Spinal Cord 2017; 55:774-781. [DOI: 10.1038/sc.2017.27] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 01/27/2017] [Accepted: 02/09/2017] [Indexed: 11/08/2022]
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15
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Hamasaki H, Kawashima Y, Yanai H. The association between hand grip strength and non-exercise activity thermogenesis in patients with type 2 diabetes. DIABETES & METABOLISM 2016; 43:284-286. [PMID: 27816619 DOI: 10.1016/j.diabet.2016.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
Affiliation(s)
- H Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan.
| | - Y Kawashima
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - H Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
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16
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Hamasaki H. Daily physical activity and type 2 diabetes: A review. World J Diabetes 2016; 7:243-51. [PMID: 27350847 PMCID: PMC4914832 DOI: 10.4239/wjd.v7.i12.243] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/05/2016] [Accepted: 05/07/2016] [Indexed: 02/05/2023] Open
Abstract
Physical activity improves glycemic control and reduces the risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes (T2D). Moderate to vigorous physical activity is recommended to manage T2D; however, patients with T2D can be physically weak, making it difficult to engage in the recommended levels of physical activity. Daily physical activity includes various activities performed during both occupational and leisure time such as walking, gardening, and housework that type 2 diabetic patients should be able to perform without considerable physical burden. This review focuses on the association between daily physical activity and T2D. Walking was the most common form of daily physical activity, with numerous studies demonstrating its beneficial effects on reducing the risk of T2D, CVD, and mortality. Walking for at least 30 min per day was shown to reduce the risk of T2D by approximately 50%. Additionally, walking was associated with a reduction in mortality. In contrast, evidence was extremely limited regarding other daily physical activities such as gardening and housework in patients with T2D. Recent studies have suggested daily physical activity, including non-exercise activity thermogenesis, to be favorably associated with metabolic risks and mortality. However, well-designed longitudinal studies are warranted to elucidate its effects on overall health.
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Hamasaki H, Ezaki O, Yanai H. Nonexercise Activity Thermogenesis is Significantly Lower in Type 2 Diabetic Patients With Mental Disorders Than in Those Without Mental Disorders: A Cross-sectional Study. Medicine (Baltimore) 2016; 95:e2517. [PMID: 26765475 PMCID: PMC4718301 DOI: 10.1097/md.0000000000002517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/09/2015] [Accepted: 12/18/2015] [Indexed: 12/15/2022] Open
Abstract
Physical activity improves health in patients with mental disorders. Nonexercise activity thermogenesis (NEAT) represents energy expenditure due to daily physical activities other than volitional exercise. We aimed to evaluate NEAT in type 2 diabetic patients with and without accompanying mental disorders.Between September 2010 and September 2014, we studied 150 patients with type 2 diabetes, 50 of whom also had a diagnosis of mental disorder, such as schizophrenia or mood disorder. We evaluated their NEAT in structured interviews using a validated questionnaire, and investigated differences in NEAT score and metabolic parameters between patients with and without mental disorders.The NEAT score was significantly lower in patients with mental disorders than in those without (56.3 ± 9.9 vs 61.9 ± 12.1; P = 0.005). Patients with mental disorders had significantly higher triglyceride (184.5 ± 116.3 vs 146.4 ± 78.4 mg/dL; P = 0.02) and insulin levels (18.7 ± 20.1 vs 11.2 ± 8.5 μU/mL; P = 0.006), and significantly lower B-type natriuretic peptide (12.1 ± 13.3 vs 26.3 ± 24.8 pg/mL; P < 0.001) and brachial-ankle pulse wave velocity levels (1501 ± 371 vs 1699 ± 367 cm/s; P = 0.003) than patients without mental disorders. In patients with schizophrenia, specifically, NEAT showed a negative correlation with hemoglobin A1c levels (β = -0.493, P = 0.031), and a positive correlation with high-density lipoprotein cholesterol (β = 0.519, P = 0.023) and B-type natriuretic peptide levels (β = 0.583, P = 0.02).Our results suggest that NEAT may be beneficial for the management of obesity, insulin sensitivity, and lipid profiles in patients with mental disorders. Incorporating NEAT into interventions for type 2 diabetes in patients with mental disorders, especially schizophrenia, shows promise and warrants further investigation.
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Affiliation(s)
- Hidetaka Hamasaki
- From the Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan (HH and HY); and the Institute of Women's Health Science, Showa Women's University, Tokyo, Japan (OE)
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Hamasaki H, Kawashima Y, Adachi H, Moriyama S, Katsuyama H, Sako A, Yanai H. Associations between lower extremity muscle mass and metabolic parameters related to obesity in Japanese obese patients with type 2 diabetes. PeerJ 2015; 3:e942. [PMID: 26175963 PMCID: PMC4499465 DOI: 10.7717/peerj.942] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/16/2015] [Indexed: 12/25/2022] Open
Abstract
Background. Age-related loss of muscle mass (sarcopenia) increases the incidence of obesity in the elderly by reducing physical activity. This sarcopenic obesity may become self-perpetuating, increasing the risks for metabolic syndrome, disability, and mortality. We investigated the associations of two sarcopenic indices, the ratio of lower extremity muscle mass to body weight (L/W ratio) and the ratio of lower extremity muscle mass to upper extremity muscle mass (L/U ratio), with metabolic parameters related to obesity in patients with type 2 diabetes and obesity. Methods. Of 148 inpatients with type 2 diabetes treated between October 2013 and April 2014, we recruited 26 with obesity but no physical disability. Daily physical activity was measured by a triaxial accelerometer during a period of hospitalization, and which was also evaluated by our previously reported non-exercise activity thermogenesis questionnaire. We measured body composition by bioelectrical impedance and investigated the correlations of L/W and L/U ratios with body weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), visceral fat area, subcutaneous fat area, serum lipid profile, and daily physical activity. Results. The L/W ratio was significantly and negatively correlated with BMI, WC, WHR, body fat mass, body fat percentage, subcutaneous fat area, and serum free fatty acid concentration, was positively correlated with daily physical activity: the locomotive non-exercise activity thermogenesis score, but was not correlated with visceral fat area. The L/U ratio was significantly and positively correlated with serum high-density lipoprotein cholesterol. Conclusions. High L/W and L/U ratios, indicative of relatively preserved lower extremity muscle mass, were predictive of improved metabolic parameters related to obesity. Preserved muscle fitness in obesity, especially of the lower extremities, may prevent sarcopenic obesity and lower associated risks for metabolic syndrome and early mortality.
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Affiliation(s)
- Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan ; General Internal Medicine, Community Healthcare Studies, Jichi Medical University Graduate School , Tochigi , Japan
| | - Yu Kawashima
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan
| | - Hiroki Adachi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan
| | - Sumie Moriyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan
| | - Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital , Chiba , Japan
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Villablanca PA, Alegria JR, Mookadam F, Holmes DR, Wright RS, Levine JA. Nonexercise activity thermogenesis in obesity management. Mayo Clin Proc 2015; 90:509-19. [PMID: 25841254 DOI: 10.1016/j.mayocp.2015.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 02/01/2015] [Accepted: 02/03/2015] [Indexed: 02/07/2023]
Abstract
Obesity is linked to cardiovascular disease. The global increase in sedentary lifestyle is an important factor contributing to the rising prevalence of the obesity epidemic. Traditionally, counseling has focused on moderate- to vigorous-intensity exercise, with disappointing results. Nonexercise activity thermogenesis (NEAT) is an important component of daily energy expenditure. It represents the common daily activities, such as fidgeting, walking, and standing. These high-effect NEAT movements could result in up to an extra 2000 kcal of expenditure per day beyond the basal metabolic rate, depending on body weight and level of activity. Implementing NEAT during leisure-time and occupational activities could be essential to maintaining a negative energy balance. NEAT can be applied by being upright, ambulating, and redesigning workplace and leisure-time environments to promote NEAT. The benefits of NEAT include not only the extra calories expended but also the reduced occurrence of the metabolic syndrome, cardiovascular events, and all-cause mortality. We believe that to overcome the obesity epidemic and its adverse cardiovascular consequences, NEAT should be part of the current medical recommendations. The content of this review is based on a literature search of PubMed and the Google search engine between January 1, 1960, and October 1, 2014, using the search terms physical activity, obesity, energy expenditure, nonexercise activity thermogenesis, and NEAT.
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Affiliation(s)
- Pedro A Villablanca
- Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY.
| | | | - Farouk Mookadam
- Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ
| | - David R Holmes
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - R Scott Wright
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
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Significance of exercise in nonalcoholic fatty liver disease in men: a community-based large cross-sectional study. J Gastroenterol 2015; 50:230-7. [PMID: 24748332 DOI: 10.1007/s00535-014-0959-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/04/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a risk factor for diabetes and cardiovascular disease that could progress to nonalcoholic steatohepatitis, cirrhosis, and liver failure. We aimed to assess the relationship between NAFLD and lifestyle habits. METHODS Using a community-based, cross-sectional design, the records of 11,094 Japanese subjects who had undergone at least 1 annual health checkup were reviewed. RESULTS Of the 6,370 subjects who qualified for enrolment, 1,346 met the diagnostic criteria for NAFLD. The prevalence rate (PR) of NAFLD increased significantly to 36.6, 41.5, and 41.1 % with no snacking, snacking less than once/day, and snacking ≥2 times/day, respectively, in men (P = 0.0495) and to 10.8, 11.7, and 15.3 %, respectively, in women (P = 0.002). In men, the NAFLD PR decreased significantly to 48.8, 36.9, and 29.9 % with no exercise, exercise consciousness, and periodical exercise, respectively (P < 0.001). In women, the NAFLD PR decreased significantly to 19.3, 13.5, 11, and 8 % with sleep durations of ≤4, 5-6, 7-8, and ≥9 h, respectively (P = 0.003). Periodical exercise was identified as an independent factor associated with NAFLD in men (odds ratio 0.707, 95 % confidence interval 0.546-0.914; P = 0.008). CONCLUSIONS Performing regular exercise was associated with a reduced risk for NAFLD in men. Men with a high risk for NAFLD can be identified using questionnaires on exercise in an outpatient setting. Disease progression and further complications may be prevented by educating high-risk NAFLD patients about the importance of exercise.
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Hamasaki H, Noda M, Moriyama S, Yoshikawa R, Katsuyama H, Sako A, Mishima S, Kakei M, Ezaki O, Yanai H. Daily Physical Activity Assessed by a Triaxial Accelerometer Is Beneficially Associated with Waist Circumference, Serum Triglycerides, and Insulin Resistance in Japanese Patients with Prediabetes or Untreated Early Type 2 Diabetes. J Diabetes Res 2015; 2015:526201. [PMID: 26064983 PMCID: PMC4441997 DOI: 10.1155/2015/526201] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/27/2015] [Accepted: 03/30/2015] [Indexed: 12/14/2022] Open
Abstract
AIM To investigate the association between daily physical activity and metabolic risk factors in Japanese adults with prediabetes or untreated early type 2 diabetes (T2D). METHODS Daily physical activity level was measured using a triaxial accelerometer. We assessed correlations between physical activity level and waist circumference, blood pressure, fasting levels of plasma glucose, serum triglycerides, and insulin and homeostasis model assessment-insulin resistance (HOMA-IR). RESULTS A total of 80 patients were studied. After adjustment for age and body mass index, in all subjects, physical activity level was negatively associated with waist circumference (β = -0.124, P = 0.018) and fasting serum triglycerides (β = -0.239, P = 0.035), insulin (β = -0.224, P = 0.022). In men, physical activity level was negatively associated with systolic blood pressure (β = -0.351, P = 0.044), fasting plasma glucose (β = -0.369, P = 0.025) and insulin (β = -0.362, P = 0.012), and HOMA-IR (β = -0.371, P = 0.011). No significant associations were found between physical activity level and metabolic risk factors in women. CONCLUSION Objectively measured daily physical activity is beneficially associated with waist circumference, serum triglycerides, and insulin resistance in individuals with prediabetes or untreated early T2D. (This trial is registered with UMIN000015774.).
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Affiliation(s)
- Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
- General Internal Medicine, Community Healthcare Studies, Jichi Medical University Graduate School, Tochigi 329-0498, Japan
- *Hidetaka Hamasaki:
| | - Mitsuhiko Noda
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Sumie Moriyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
| | - Reo Yoshikawa
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
| | - Shuichi Mishima
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
| | - Masafumi Kakei
- General Internal Medicine, Community Healthcare Studies, Jichi Medical University Graduate School, Tochigi 329-0498, Japan
| | - Osamu Ezaki
- Department of Human Health and Design, Faculty of Human Life and Environmental Sciences, Showa Women's University, Tokyo 154-8533, Japan
| | - Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan
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Hamasaki H, Yanai H, Kakei M, Noda M, Ezaki O. The validity of the non-exercise activity thermogenesis questionnaire evaluated by objectively measured daily physical activity by the triaxial accelerometer. BMC Sports Sci Med Rehabil 2014; 6:27. [PMID: 25075310 PMCID: PMC4114431 DOI: 10.1186/2052-1847-6-27] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 07/01/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Physical inactivity is a major cardiovascular risk factor. Recently, we showed that non-exercise activity thermogenesis (NEAT) assessed by the self-reported questionnaire is favorably associated with metabolic risks in patients with type 2 diabetes. The purpose of the present study was to examine the validity of the questionnaire by comparing with objectively measured daily physical activity (PA) by using the triaxial accelerometer. METHODS Daily physical activity level (PAL) of 51 participants (24 men and 27 women) with type 2 diabetes was measured by the triaxial accelerometer. At the same time, we evaluated their NEAT score using our original questionnaire modified from a compendium of physical activities. RESULTS The NEAT score was significantly and positively correlated with PAL measured by the triaxial accelerometer (r = 0.604, P < 0.001). PAL was also significantly and positively correlated with both the locomotive NEAT score and the non-locomotive NEAT score (r = 0.444, P = 0.001 and r = 0.526, P < 0.001, respectively). CONCLUSIONS The NEAT score measured by the self-reported questionnaire was highly correlated with PAL measured by the triaxial accelerometer. Our original NEAT questionnaire may be useful for evaluation of daily PAL in clinical practices.
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Affiliation(s)
- Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan ; Division of Complementary Medicine, First Department of General Medicine, Saitama Medical Center, Jichi Medical University School of Medicine, Saitama, Japan
| | - Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Masafumi Kakei
- Division of Complementary Medicine, First Department of General Medicine, Saitama Medical Center, Jichi Medical University School of Medicine, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Osamu Ezaki
- Department of Human Health and Design, Faculty of Human Life and Environmental Sciences, Showa Women's University, Tokyo, Japan
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Tsuda K, Tsuda Y, Sato Y, Ishihara A. Exercise therapy in diabetic patients. THE JOURNAL OF PHYSICAL FITNESS AND SPORTS MEDICINE 2014. [DOI: 10.7600/jpfsm.3.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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24
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Hamasaki H, Yanai H, Kakei M, Ezaki O, Noda M. Non-exercise activity thermogenesis is associated with markers for diabetic microangiopathy in Japanese female patients with type 2 diabetes. Int J Cardiol 2013; 168:4836-7. [PMID: 23859256 DOI: 10.1016/j.ijcard.2013.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan; General Internal Medicine, Community Healthcare Studies, Jichi Medical University Graduate School, Tochigi, Japan
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