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. 2021 Sep 21:14:3935-3943.
doi: 10.2147/RMHP.S323444. eCollection 2021.

Efficacy of Additional Intervention to the Specific Health Guidance in Japan: The Takahata GENKI Project

Nao Enomoto  1 , Sho Nakamura  2   3   4 , Satoru Kanda  3   4   5 , Hiroko Endo  1 , Emiko Yamada  1 , Sachiyo Kobayashi  1 , Miki Kido  1 , Rina Inoue  4 , Junko Shimakura  6 , Hiroto Narimatsu  2   3   4   7
Affiliations

Efficacy of Additional Intervention to the Specific Health Guidance in Japan: The Takahata GENKI Project

Nao Enomoto et al. Risk Manag Healthc Policy. .

Abstract

Purpose: A tailored approach to individual risk factors for developing lifestyle-related diseases would help induce behavioral changes toward intervention acceptability. The addition of preventive healthcare programs to nationwide specific health guidance in Japan is adapted in a given region.

Patients and methods: We conducted a prospective parallel-group comparison study on 195 eligible residents from Takahata, Japan, with a high risk of lifestyle-related diseases from 2014 to 2017 to examine whether such an intervention could improve the body mass index (BMI) and estimated glomerular filtration rate (eGFR).

Results: Of the 195 enrolled residents, 117 were assigned to the control group and 78 to the intervention group. They were ≤65 years old and had a BMI ≥25 kg/m2 and an eGFR ≤90 mL/kg/1.73 m2. We conducted certain interventions for each group, including additional blood testing, regular health guidance, and specific health guidance. After one year, neither BMI (intervention: 26.7 ± 2.17 kg/m2 vs control: 27.3 ± 2.12 kg/m2, p = 0.076) nor eGFR (intervention: 72.2 ± 11.1 mL/kg/1.73 m2 vs control: 73.1 ± 10.5 mL/kg/1.73 m2, p = 0.608) differed significantly between groups. However, after three years, the BMI in the intervention group (26.4 ± 2.05 kg/m2) was significantly reduced compared to that in the control group (27.4 ± 2.26 kg/m2; p = 0.005).

Conclusion: The additional interventions might have contributed to a reduction in metabolic syndrome.

Trial registration: This study was registered in the UMIN-Clinical Trials Registry (ID:000013581). More information: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000015868. The registration date was 31/03/2014.

Keywords: body mass index; estimated glomerular filtration rate; medical cost; personalized preventive medicine.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Intervention program. Black font indicates common universal program in Japan. Red font indicates additional intervention. In the common universal program, subjects with a waist circumference ≥85 cm (men)/ ≥90 cm (women) with at least two of the following:1 impaired glucose tolerance (fasting blood glucose ≥100 mg/dL or hemoglobin A1c ≥5.6%), 2 dyslipidemia (triglyceride ≥150 mg/dL or HDL-cholesterol <40 mg/dL), 3 high blood pressure (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg) are considered at high risk. Subjects with a waist circumference <85 cm (men)/<90 cm (women) and body mass index ≥25 kg/m2, with all of these three factor are also considered at high risk. The subjects at moderate risk comprise those with a waist circumference ≥85 cm (men)/ ≥90 cm (women) with one of the three risk factors or those with a waist circumference <85 cm (men)/<90 cm (women) a body mass index ≥25 kg/m2 and having one or two of the three risk factors. The intervention did not include pharmacological treatment.
Figure 2
Figure 2
CONSORT flowchart.
Figure 3
Figure 3
Follow-up flowchart of the participants.
Figure 4
Figure 4
Trends of body mass index (BMI) (A), estimated glomerular filtration rate (eGFR) (B), and medical costs (C).
See this image and copyright information in PMC

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