The Japan Functional Food Research Association (JAFRA), a non-profit organization (NPO), held Health Forum 2008 at Tosho Hall (Marunouchi, Tokyo) on September 21, 2008. The forum was sponsored by the NPO Self-Medication Advocacy Council, Japan Preventive Association of Life-style related Disease (JPALD), and CMP Japan Co., Ltd.
Under the theme “Metabolic syndrome - appropriate understanding and measures for control”, four representatives from this field gave lectures. Daiwa pharmaceuticals, a company that has worked cooperatively with the JAFRA as a full company member since its inception, also gave complete backing to this event, including administration.
“Lifestyle-related diseases and metabolic syndrome”
Dr. Yoshio Ikeda, president of JPALD, gave a lecture entitled “Lifestyle-related diseases and metabolic syndrome”. The number of individuals in the population who suffer from obesity (BMI ? 125, Age ? 18), an underlying cause of metabolic syndrome, has now reached 13 million males and 10 million females. He warned that obesity with visceral adiposity predisposes to hypertension, diabetes mellitus, and serum hyperlipidemia in both males and females middle aged or older, and that the combination of these factors results in metabolic syndrome. Since obesity with manifestations of metabolic syndrome is associated with lifestyle-related diseases that can lead directly to death, including myocardial infarction and stroke, as well as to chronic kidney disease (CKD), hyperuricemia (gout), fatty liver, and further to the development of some cancers, he strongly emphasized the importance of nationwide primary prevention efforts mainly targeting metabolic syndrome.
He expressed concern for the current situation in which diet is perceived simply as a means to reduce bodyweight, rather than being used as part of “dietary therapy” or “therapy of food reduction,” to achieve a “desirable dietary lifestyle”, based on its original Greek word “diata (lifestyle)”.
His long-advocated theory of “Stop first, secondly reduce, and thirdly increase” was emphasized as key lifestyle to preventing metabolic syndrome: “Stop first” is to stop smoking; “Secondly reduce” is to eat and drink moderately (stop eating before feeling full, and to reduce intake of alcohol to within 20g even for alcohol-resistant people); “thirdly increase” is to enhance movement (actively exercise), rest (enough relaxation and sleep), and communication (increased contact with people, activities and objects to develop beneficial hobbies and to live a creative life).
Currently, most of the more than 700 products approved as Food for Specified Health Use (FOSHU) are related to dietary fibers, lactobacillus, and oligosaccharides. However, Dr. Ikeda expressed his expectation that foods with possible health claims related to blood pressure, blood glucose, body fat, cholesterol, and neutral fat are continuously being developed and may be useful in the primary prevention of lifestyle-related diseases like metabolic syndrome, if used effectively as a routine dietary addition.
"Dietary therapy for metabolic syndrome"
The lecture given by Dr. Takaho Watayo, director of Towarm Coedo Hospital, was entitled “Dietary therapy for metabolic syndrome”. Metabolic syndrome, the incidence of which is dramatically increasing worldwide, is a serious pathologic condition characterized by visceral adiposity, leading to diabetes mellitus, hypertension, dyslipidemia and, finally, to severe arteriosclerosis, and eventually the development of angina and myocardial or cerebral infarction. Based on an analysis of the current situation, he indicated that metabolic syndrome is strongly associated with excessive food intake and obesity when viewed from the perspective of nutrition and diet. Therefore, improvement of dietary habits and lifestyle may contribute to successful improvements in health, and there is a growing number of such examples, he explained.
The relationship between the duo of salt and fat and metabolic syndrome and arteriosclerosis was also covered. First, intake of salt increases blood osmolarity, leading to the development of hypertension, as well as increased osmolarity of lymph, increasing visceral lymphatic flow. In addition, a fatty diet leads to extensive absorption of lipolytic products such as chylomicrons through the small intestinal mucosa into the lymph channel, resulting in hyperlipidemia, he explained. Adipocytes that have become enlarged by visceral adiposity have compromised adiponectin secretory capacity and secrete tumor necrosis factor (TNF), which impairs the insulin sensitivity of skeletal muscles and causes hyperglycemia. Further, vascular wall macrophages that are mobilized to eliminate excessive oxidized low-density lipoprotein (LDL), which is toxic in hyperlipidemia, become foam cells and die after ingesting LDLs, and are then deposited as atheroma on the vascular wall. Based on this data, Dr. Watayo suggested that a diet high in salt and fat is a factor contributing to the risk of hyperlipidemia with visceral adiposity, diabetes mellitus, hypertension, and arteriosclerosis.
Dietary improvement was cited as the most effective treatment for metabolic syndrome, and Gerson therapy was introduced as an example. The essential factors of this therapy are limitation of salt and animal (four-legged) fat or protein, with a natural diet, specifically high intake of vegetable and fruit juice (potassium and polyphenol), beans and potatoes (vitamins, etc.), seaweed (iodine), various digestive enzyme ingredients (diastase, pancreatin, and proteolytic or lipolytic enzymes contained in fruits). The therapy normalizes nutrient absorption and metabolism in humans, and leads to spontaneous recovery by enhancing immunomodulatory activity. In his experience of over ten years with this therapy, the effectiveness has been confirmed in more than 60% of patients with advanced cancer, and in approximately 80% of patients with autoimmune disease such as rheumatism and ulcerative colitis, and metabolic syndrome.
There is an increasing global trend towards use of nutritional metabolic therapy in intractable diseases, including cancer and autoimmune diseases, as well as metabolic syndrome, with findings that a considerable percentage of patients are able to move toward a cure through improvement of diet and lifestyle. Referring to successful experience in the United States in reducing cancer-related deaths with the introduction of the “Designer Foods Project” since 1992, he concluded that deliberate routine medical care and detailed lifestyle guidance are expected to provide a therapeutic effect.
"Metabolic syndrome from the perspective of gastric and intestinal features"
Dr. Kazutoshi Kaketani, director of the Hanzomon Gastrointestinal Clinic, gave a lecture entitled “Metabolic syndrome from the perspective of gastric and intestinal features”. He introduced the concept of “gastric and intestinal features” advocated by Dr. Hiromi Shinya, professor of Albert Einstein College of Medicine, indicating that the stomach and bowel have features (face) unique to the individual, like every person has a difference face. Through his experience of gastrointestinal endoscopic examination of over 100 thousand patients, he has found that gastric and intestinal features are closely related to human health, and he has found that poor gastric and intestinal features are strongly associated with cardiovascular disease.
Detrimental lifestyle habits practiced over a prolonged period, such as excessive intake of meat (animal proteins), excessive eating and drinking, alcohol drinking, and smoking may, especially in combination with stress, induce gastric mucosal injury or hypoactivity by increasing gastric and intestinal load, resulting in poor gastric feature. Intestinal feature is also compromised by bad lifestyle habits, he pointed out.
He has encountered some patients who completely recovered after resection of gastric or intestinal carcinoma but who then died unexpectedly. In most of these cases the cause of death was cardiovascular disease including myocardial infarction and stroke, he mentioned.
Considering that patients with poor gastric and intestinal features tend to develop metabolic syndrome as well as carotid sclerosis, causing stroke or ischemic heart disease, he speculated on the relationship between the gastric and intestinal features and cardiovascular disease, based on his clinical experience. As a result of a complete medical check of the subjects and an investigation of correlations, large intestinal disease, including polyps and diverticulosis, sticky fatty mucus, and fecal fluid caked on intestinal wall were found. He indicated that those with very poor intestinal feature (28.5% of all patients) are predisposed to metabolic syndrome (77%).
Several supplements for the prevention of thrombosis are on the market and some of these have proven effect and efficacy. He stated that, in spite of a number of hurdles in terms of the evidence of both efficacy and safety that will be required in the future, supplementary products may play an important role in the management of metabolic syndrome.
"Prevention of thrombosis"
“Prevention of thrombosis” was the title of the lecture given by Dr. Masahito Hitosugi, assistant professor, Department of Legal Medicine, Dokkyo University School of Medicine. It was proposed that, since thrombosis is a cause of ischemic heart disease and stroke, being involved in 30% of deaths in Japan, the elucidation of its pathology and the promotion of preventive measures are a major and important challenge for modern society.
So-called economy class syndrome (travelers' thrombosis), the thrombosis that occurs immediately after long travel in airplanes, is mainly caused by remaining in a sitting position for a long time. Those with risk factors, such lifestyle-related diseases, including obesity and diabetes mellitus, cardiac disease, trauma, thrombosis or history of a surgical operation, should make special efforts to avoid this condition, he pointed out. Referring to reports on travelers' thrombosis, he stated that more than 90% of patients had some other risk factors, and he advised that where it is necessary to remain in a sitting position for a long time, frequent movement of the feet is essential to maintain good venous return.
It was emphasized that the best way to prevent thrombosis is to maintain good blood flow by paying attention to daily lifestyle factors, especially dietary habits, and that the Japanese traditional food natto is effective for this purpose.
