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Wednesday, April 29, 2009
Sadrivaan A and B (The Hilton Istanbul Hotel )
[Background] The national health project for lifestyle-related disease control with particular emphasis on metabolic syndrome (central obesity, impaired glucose tolerance, hypertension, dyslipidaemia) was inaugurated in April 2008. However, this project was introduced before its methodologies were adequately established; therefore, an evidence-based health policy is now desired.
[Purpose] We carried out a pilot study in 2007 prior to the implementation of public health measures, developed a health guidance program in which community-based nutritional and exercise guidance is incorporated, carried out the program as a trial, and evaluated the program in terms of its validity and feasibility.
[Methods] The participants of this program consisted of 311 local residents (135 males and 176 females; mean age, 61.4) with impaired glucose tolerance. A nutritional guidance program, including guidance on such items as suppression of total calories consumed per day, energy from fat of 25% or less, 10 g of salt or less, and 25 g of fiber per day or more, was developed considering the physique of the Japanese and was implemented by the participants. Regarding exercise guidance, they were instructed to walk more than 10,000 steps/day as determined using a pedometer. This comprehensive program was carried out for six months.
[Results] After the program’s completion, the participants’ mean weight decreased from 63.8 to 62.1 kg (p<0.001), abdominal circumference from 91.6 to 89.5 cm (p<0.001), and HbA1c level from 5.42 to 5.25% (p<0.001). The percentage of participants whose satisfaction level was either “very satisfactory” or “satisfactory” reached 96.8%.
[Discussion] Our comprehensive health guidance program incorporating community-based nutritional and exercise guidance had a significant impact and its feasibility was demonstrated. We obtained our results of the program’s evaluation six months after its implementation; long-term analyses of the effect of the program will be necessary in the future.
[Purpose] We carried out a pilot study in 2007 prior to the implementation of public health measures, developed a health guidance program in which community-based nutritional and exercise guidance is incorporated, carried out the program as a trial, and evaluated the program in terms of its validity and feasibility.
[Methods] The participants of this program consisted of 311 local residents (135 males and 176 females; mean age, 61.4) with impaired glucose tolerance. A nutritional guidance program, including guidance on such items as suppression of total calories consumed per day, energy from fat of 25% or less, 10 g of salt or less, and 25 g of fiber per day or more, was developed considering the physique of the Japanese and was implemented by the participants. Regarding exercise guidance, they were instructed to walk more than 10,000 steps/day as determined using a pedometer. This comprehensive program was carried out for six months.
[Results] After the program’s completion, the participants’ mean weight decreased from 63.8 to 62.1 kg (p<0.001), abdominal circumference from 91.6 to 89.5 cm (p<0.001), and HbA1c level from 5.42 to 5.25% (p<0.001). The percentage of participants whose satisfaction level was either “very satisfactory” or “satisfactory” reached 96.8%.
[Discussion] Our comprehensive health guidance program incorporating community-based nutritional and exercise guidance had a significant impact and its feasibility was demonstrated. We obtained our results of the program’s evaluation six months after its implementation; long-term analyses of the effect of the program will be necessary in the future.
Learning Objectives: 1. Know national health project for lifestyle-related disease control with particular emphasis on metabolic syndrome of Japan as a trial of developed countries. 2. Apply to your community the methodology of our program to facilitate prevention of type 2 diabetes in a patient with impaired glucose tolerance. 3. Discuss that our comprehensive health guidance program incorporating community-based nutritional and exercise guidance will allow effective prevention for type 2 diabetes in patients with impaired glucose tolerance.
Sub-Theme: Public Health and Research: Evidence Based Policy on Health