Clinical Manifestation and Management of ADPKD in Western Countries.
Kidney Dis (Basel). 2016 Oct;2(3):120-127
Authors: Sommerer C, Zeier M
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease in Western countries. The prevalence is between 2.4/10,000 and 3.9/10,000. ADPKD represents a systemic disease resulting in deterioration in renal function. Until now, mutations in two genes (PKD1 and PKD2) have been identified. Recently, the European Medicines Agency (EMA) approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency connected with ADPKD in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease. Whereas the EMA approved the release of tolvaptan, the US Food and Drug Administration (FDA) requested further data on side effects and the selection of patient cohorts who may benefit from treatment.
SUMMARY: This review focused on advances in the management and treatment of ADPKD in Western countries.
KEY MESSAGE: ADPKD represents the fourth most common cause of end-stage renal disease (ESRD) in Western countries. ADPKD is a multisystemic disease characterized by the progressive development of bilateral renal cysts, resulting in enlargement of the kidney volume due to cystic formations, hypertension, hematuria, and loss of renal function. ADPKD is associated with high inter- and intrafamilial variability in disease appearance and progression. Patients with PKD1 mutations typically have a more severe phenotype than those with PKD2 mutations. ADPKD is under intensive investigation. Vasopressin and the associated cyclic adenosine monophosphate-related signaling pathways have been demonstrated to be important contributors to cyst growth in ADPKD. Supportive treatments are recommended with the aim of reducing morbidity and mortality associated with disease manifestations. In the past years, several agents have been investigated in ADPKD patients, including mTOR inhibitors, somatostatin analogs, statins, and vasopressin V2 receptor antagonists.
FACTS FROM EAST AND WEST: (1) ADPKD is diagnosed globally by ultrasound detection of kidney enlargement and presence of cysts. Recent analyses of variants of the PKD1 and PKD2 genes by next-generation sequencing in Chinese and Western ADPKD patients might lead to the development of reliable genetic tests. (2) Besides lifestyle changes (low-salt diet, sufficient fluid intake, and no smoking), blood pressure control is the primary nonspecific treatment recommended by Kidney Disease - Improving Global Outcomes (KDIGO) for ADPKD patients. How low the blood pressure target should be and what the means of achieving it are remain open questions depending on the severity of chronic kidney disease and the age of the patients. In a recent Chinese study, diagnostic needle aspiration and laparoscopic unroofing surgery successfully improved infection, pain, and hypertension. Peritoneal dialysis was found to be a feasible treatment for most Chinese ADPKD patients with ESRD. In most Western centers, patients without contraindication are selected for peritoneal dialysis. Kidney transplantation with concurrent bilateral nephrectomy was successful in relieving hypertension and infection in Chinese ADPKD patients. In Western countries, sequential surgical intervention with kidney transplantation after nephrectomy, or the other way round, is preferred in order to reduce risks. (3) The vasopressin 2 receptor antagonist tolvaptan was approved in Europe, Canada, Japan, and Korea to slow down progression of kidney disease in ADPKD patients. Tolvaptan is not yet approved in the USA or in China. mTOR pathway-targeting drugs are currently under evaluation: mTOR inhibitors could slow down the increase in total kidney volume in a cohort of Western and Japanese ADPKD patients. Western studies as well as an ongoing study in China failed to show benefit from rapamycin. A study performed in Italy indicates protective effects of the somatostatin analog octreotide in ADPKD patients. Western and Chinese studies revealed a potential beneficial effect of triptolide, the active substance of the traditional Chinese medicine Tripterygium wilfordii (Lei Gong Teng) to prevent worsening in ADPKD patients.
PMID: 27921039 [PubMed - in process]
Sustaining Effect of Intensive Nutritional Intervention Combined with Health Education on Dietary Behavior and Plasma Glucose in Type 2 Diabetes Mellitus Patients.
Nutrients. 2016 Sep 13;8(9):
Authors: Fan R, Xu M, Wang J, Zhang Z, Chen Q, Li Y, Gu J, Cai X, Guo Q, Bao L, Li Y
Diabetes mellitus is very common in elderly Chinese individuals. Although nutritional intervention can provide a balanced diet, the sustaining effect on at-home dietary behavior and long-term plasma glucose control is not clear. Consequently, we conducted a long-term survey following one month of experiential nutritional intervention combined with health education. Based on the Dietary Guidelines for a Chinese Resident, we found that the food items met the recommended values, the percentages of energy provided from fat, protein, and carbohydrate were more reasonable after one year. The newly formed dietary patterns were "Healthy", "Monotonous", "Vegetarian", "Japanese", "Low energy", and "Traditional" diets. The 2h-PG of female participants as well as those favoring the "Japanese diet" decreased above 12 mmol/L. Participants who selected "Japanese" and "Healthy" diets showed an obvious reduction in FPG while the FPG of participants from Group A declined slightly. "Japanese" and "Healthy" diets also obtained the highest DDP scores, and thus can be considered suitable for T2DM treatment in China. The results of the newly formed dietary patterns, "Japanese" and "Healthy" diets, confirmed the profound efficacy of nutritional intervention combined with health education for improving dietary behavior and glycemic control although health education played a more important role. The present study is encouraging with regard to further exploration of comprehensive diabetes care.
PMID: 27649232 [PubMed - indexed for MEDLINE]
Cultural factors influencing dietary and fluid restriction behaviour: perceptions of older Chinese patients with heart failure.
J Clin Nurs. 2017 Mar;26(5-6):717-726
Authors: Rong X, Peng Y, Yu HP, Li D
AIMS AND OBJECTIVES: To explore the cultural factors related to dietary and fluid restriction behaviours among older Chinese patients.
BACKGROUND: Excess dietary sodium and fluid intake are risk factors contributing to the worsening and rehospitalisation for heart failure in older patients. Managing the complex fluid and diet requirements of heart failure patients is challenging and is made more complicated by cultural variations in self-management behaviours in response to a health threat.
DESIGN: Qualitative study using semi-structured in interviews and framework analysis.
METHODS: The design of this study is qualitative descriptive. Semi-structured in-depth interviews were conducted with 15 heart failure patients. Data were analysed through content analysis.
RESULTS: Seven cultural themes emerged from the qualitative data: the values placed on health and illness, customary way of life, preference for folk care and the Chinese healthcare system, and factors related to kinship and social ties, religion, economics and education.
CONCLUSIONS: Dietary change and management in response to illness, including heart failure, is closely related to individuals' cultural background. Healthcare providers should have a good understanding of cultural aspects that can influence patients' conformity to medical recommendations.
RELEVANCE TO CLINICAL PRACTICE: Heart failure patients need support that considers their cultural needs. Healthcare providers must have a good understanding of the experiences of people from diverse cultural backgrounds.
PMID: 27532343 [PubMed - indexed for MEDLINE]
Comparison of lipid parameters to predict cardiovascular events in Japanese mild-to-moderate hypercholesterolemic patients with and without type 2 diabetes: Subanalysis of the MEGA study.
Diabetes Res Clin Pract. 2016 Mar;113:14-22
Authors: Sone H, Nakagami T, Nishimura R, Tajima N, MEGA Study Group
AIMS: To determine whether specific lipid parameters are better predictors of cardiovascular disease (CVD) in Japanese mild-to-moderate hypercholesterolemic patients with and without diabetes.
METHODS: Mildly or moderately hypercholesterolemic patients with no history of CVD received diet therapy or diet therapy plus pravastatin. In this post-hoc subanalysis, 5-year data from 3170 patients (668 diabetes, 2502 non-diabetes) on diet therapy alone were used to compare lipid parameters as predictors of CVD. We examined the data by tertiles, using hazard ratio (HR) per one-standard deviation (SD) increment (decrease for high-density lipoprotein cholesterol, HDL-C), χ(2) value, receiver operating characteristic curve analysis, and spline analysis.
RESULTS: In mild-to-moderate hypercholesterolemic patients with diabetes, increased total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C and decreased HDL-C were strongly associated with increased incidence of CVD (tertile analysis). In non-diabetes, increased non-HDL-C, and LDL-C/HDL-C were significantly associated with increased incidence of CVD. A one-SD decrease in HDL-C and a one-SD increment in non-HDL-C, TC/HDL-C, and LDL-C/HDL-C were significantly associated with increased HRs for CVD in both diabetes and non-diabetes. Linear CVD risk increases were found for non-HDL-C in diabetes and for non-HDL-C and HDL-C in non-diabetes (spline analysis).
CONCLUSIONS: In mild-to-moderate hypercholesterolemia, CVD risk prediction by stratifications of single or combination of traditional lipid parameter values illustrates various patterns. Parameters including HDL-C are better predictors of cardiovascular risk than only using TC or LDL-C alone. Non-HDL-C could be the most useful lipid parameter to assess CVD risk, considering it is easy to calculate and less affected by food intake.
PMID: 26972955 [PubMed - indexed for MEDLINE]
Gender difference on the association between dietary patterns and metabolic syndrome in Korean population.
Eur J Nutr. 2016 Oct;55(7):2321-30
Authors: Kang Y, Kim J
PURPOSE: Dietary patterns are found to be associated with metabolic risk factors. We explored gender difference on the association between dietary patterns and the risk of metabolic syndrome (MetS) in the general Korean population.
METHOD: A total of 13,410 Korean adults (aged ≥19 years, 5384 men and 8026 women) who participated in the fifth KNHANES were studied. Dietary intake was assessed by the 24-h recall method. MetS was defined by the joint interim statement of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Multivariable-adjusted logistic regression analysis was performed to identify the relationship between dietary pattern and MetS and its components by gender.
RESULTS: Three dietary patterns were derived using factor analysis by sex: traditional, Westernized, and healthy. The traditional pattern was positively associated with hypertriglyceridemia (P for trend = 0.0098), low high-density lipoprotein cholesterol (P for trend = 0.0007), elevated blood pressure (P for trend = 0.0328), and MetS (P for trend = 0.0003) in women only after adjusting for age, body mass index, socioeconomic status, and lifestyle factors. In contrast, the healthy pattern (HP) was negatively associated with abdominal obesity (P for trend = 0.0051) in women. For men, the HP was negatively associated with hypertriglyceridemia (P for trend = 0.0025) after adjustment for potential confounders. The Westernized pattern was not associated with MetS or its components in either men or women.
CONCLUSION: There may be gender differences on the relationship between dietary patterns and metabolic risk factors in Korean population.
PMID: 26659071 [PubMed - indexed for MEDLINE]
The Difference in Nutrient Intakes between Chinese and Mediterranean, Japanese and American Diets.
Nutrients. 2015 Jun 09;7(6):4661-88
Authors: Zhang R, Wang Z, Fei Y, Zhou B, Zheng S, Wang L, Huang L, Jiang S, Liu Z, Jiang J, Yu Y
Across countries, the predominant diets are clearly different and highly related with human health. Therefore, it is necessary to evaluate dietary nutrients between them. This study aimed to evaluate dietary nutrients in China and compare those between Chinese and Mediterranean (Italian), Japanese and American diets. Dietary intakes of 2659 subjects in south-east China, Zhejiang province, from 2010 to 2012, were estimated by three consecutive 24-h dietary recalls. The contribution of carbohydrate to total energy in Chinese subjects was lower than that in Japanese and American subjects, but higher than that in Italian subjects. However, the energy contribution from fat in Chinese subjects was higher than that in Japanese and American subjects, and similar to that in Italian subjects. Moreover, the Chinese diet had lower daily intakes of fiber, calcium, phosphorus, potassium, selenium, vitamin A, vitamin B1, vitamin B2 and vitamin C, compared with the Japanese, American and Italian diets. Nevertheless, intakes of sodium, iron, copper and vitamin E were higher among Chinese people relative to the people of other three countries. The present study demonstrated that the structure of the Chinese diet has been shifting away from the traditional diet toward high-fat, low-carbohydrate and low-fiber diets, and nutrients intakes in Chinese people have been changing even worse than those in American people.
PMID: 26066014 [PubMed - indexed for MEDLINE]
Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach.
BMC Med. 2015 May 21;13:120
Authors: Greenhalgh T, Clinch M, Afsar N, Choudhury Y, Sudra R, Campbell-Richards D, Claydon A, Hitman GA, Hanson P, Finer S
BACKGROUND: Diabetes in pregnancy is common in South Asians, especially those from low-income backgrounds, and leads to short-term morbidity and longer-term metabolic programming in mother and offspring. We sought to understand the multiple influences on behaviour (hence risks to metabolic health) of South Asian mothers and their unborn child, theorise how these influences interact and build over time, and inform the design of culturally congruent, multi-level interventions.
METHODS: Our sample for this qualitative study was 45 women of Bangladeshi, Indian, Sri Lankan, or Pakistani origin aged 21-45 years with a history of diabetes in pregnancy, recruited from diabetes and antenatal services in two deprived London boroughs. Overall, 17 women shared their experiences of diabetes, pregnancy, and health services in group discussions and 28 women gave individual narrative interviews, facilitated by multilingual researchers, audiotaped, translated, and transcribed. Data were analysed using the constant comparative method, drawing on sociological and narrative theories.
RESULTS: Key storylines (over-arching narratives) recurred across all ethnic groups studied. Short-term storylines depicted the experience of diabetic pregnancy as stressful, difficult to control, and associated with negative symptoms, especially tiredness. Taking exercise and restricting diet often worsened these symptoms and conflicted with advice from relatives and peers. Many women believed that exercise in pregnancy would damage the fetus and drain the mother's strength, and that eating would be strength-giving for mother and fetus. These short-term storylines were nested within medium-term storylines about family life, especially the cultural, practical, and material constraints of the traditional South Asian wife and mother role and past experiences of illness and healthcare, and within longer-term storylines about genetic, cultural, and material heritage - including migration, acculturation, and family memories of food insecurity. While peer advice was familiar, meaningful, and morally resonant, health education advice from clinicians was usually unfamiliar and devoid of cultural meaning.
CONCLUSIONS: 'Behaviour change' interventions aimed at preventing and managing diabetes in South Asian women before and during pregnancy are likely to be ineffective if delivered in a socio-cultural vacuum. Individual education should be supplemented with community-level interventions to address the socio-material constraints and cultural frames within which behavioural 'choices' are made.
PMID: 25998551 [PubMed - indexed for MEDLINE]
[The role of fractional nitric oxide in exhaled breath (FeNO) in clinical practice of asthma].
Rinsho Byori. 2014 Dec;62(12):1226-33
Authors: Nagase H
The measurement of FeNO (fractional nitric oxide concentration in exhaled breath) is a noninvasive method to assess airway inflammation. The elevated level of FeNO in asthma patients was first reported in 1993, and measurement has been covered by insurance in Japan since April 2013. NO is generated through the conversion of L-arginine to L-citrulline by the action of nitric oxide synthase (NOS) and iNOS is highly expressed in asthmatic airways. FeNO is expiratory flow-ependent, and measurement at 50 mL/s is recommended. As a nitrate-rich diet and the contamination of nasal NO increase, and smoking and spirometry decrease FeNO, these factors should be avoided or taken into account when measuring FeNO. For clinical application, FeNO may be used for the diagnosis or as a guide to treat asthma. Although FeNO correlates well with eosinophilic airway inflammation, it is not present in all asthma patients, and eosinophilic bronchitis or a part of COPD also shows eosinophilic inflammation. Thus, FeNO may be used as an adjunct for asthma diagnosis, and in ATS guideline, it is recommended to use FeNO for the diagnosis of eosinophilic airway inflammation and determining the likelihood of responsiveness to steroids. Several studies attempted to use FeNO to determine the dose of ICS (inhaled corticosteroids) and compared FeNO with traditional guideline-based management. The results were inconsistent, and the Cochrane review found that FeNO-based treatment did not lead to a reduction in the ICS dose or improved asthma outcomes. Nevertheless, a study of a pregnant woman showed reduced exacerbations with a refined algorithm, and further research will shed light on the appropriate application of FeNO measurement for asthma management. In this paper, the mechanism of NO generation, background and method of FeNO measurement, and clinical application will be reviewed and an outline of the official ATS clinical practice guideline will be introduced.
PMID: 25823239 [PubMed - indexed for MEDLINE]
Evidence-based clinical practice guidelines for functional dyspepsia.
J Gastroenterol. 2015 Feb;50(2):125-39
Authors: Miwa H, Kusano M, Arisawa T, Oshima T, Kato M, Joh T, Suzuki H, Tominaga K, Nakada K, Nagahara A, Futagami S, Manabe N, Inui A, Haruma K, Higuchi K, Yakabi K, Hongo M, Uemura N, Kinoshita Y, Sugano K, Shimosegawa T, Japanese Society of Gastroenterology
General interest in functional gastrointestinal disorders is increasing among Japanese doctors as well as patients. This increase can be attributed to a number of factors, including recent increased interest in quality of life and advances in our understanding of the pathophysiology of gastrointestinal disease. Japan recently became the world's first country to list "functional dyspepsia" as a disease name for national insurance billing purposes. However, recognition and understanding of functional dyspepsia (FD) remain poor, and no standard treatment strategy has yet been established. Accordingly, the Japanese Society of Gastroenterology (JSGE) developed an evidence-based clinical practice guideline for FD, consisting of five sections: concept, definition, and epidemiology; pathophysiology; diagnosis; treatment; and prognosis and complications. This article summarizes the Japanese guideline, with particular focus on the treatment section. Once a patient is diagnosed with FD, the doctor should carefully explain the pathophysiology and benign nature of this condition, establish a good doctor-patient relationship, and then provide advice for daily living (diet and lifestyle modifications, explanations, and reassurance). The proposed pharmacological treatment is divided into two steps: initial treatment including an acid inhibitory drug (H2RA or PPI) or prokinetics, (strong recommendation); second-line treatment including anxiolytics, antidepressants, and Japanese traditional medicine (weak recommendation). H. pylori eradication, strongly recommended with a high evidence level, is positioned separately from other treatment flows. Conditions that do not respond to these treatment regimens are regarded as refractory FD. Patients will be further examined for other organic disorders or will be referred to specialists using other approaches such as psychosomatic treatment.
PMID: 25586651 [PubMed - indexed for MEDLINE]
The experiences and needs of Chinese-Canadian stroke survivors and family caregivers as they re-integrate into the community.
Health Soc Care Community. 2015 Sep;23(5):523-31
Authors: Yeung EH, Szeto A, Richardson D, Lai SH, Lim E, Cameron JI
Stroke is a leading cause of adult disability and community re-integration is a priority for stroke rehabilitation. In North America, we have a growing population of individuals whose first language is not English. Little is known about the experiences of visible minorities living in North America as they re-integrate into the community post stroke or how these experiences change over time. Specifically, this research aimed to explore the experiences and needs of Chinese stroke survivors and family caregivers as they return to community living using the Timing it Right Framework as a conceptual guide. We recruited Cantonese-speaking stroke survivors and family caregivers from outpatient rehabilitation programmes. Using qualitative interviews conducted in Cantonese or English, we examined their experiences and needs as they return to community living and explored the influence of culture and time on their experiences. The interviews were transcribed and translated, and then analysed using framework analysis. Using framework analysis, we coded the data corresponding to the phases of the Timing it Right framework to determine the influence of time on the themes. We interviewed five Cantonese-speaking stroke survivors and 13 caregivers in 2009. We identified two main themes: (i) Participants' education and support needs change over time and (ii) Chinese resources are needed across care environments. These resources include access to care in their preferred language, traditional Chinese medicine, and Chinese food during their recovery and rehabilitation. To optimise Chinese stroke survivors' and caregivers' community re-integration, healthcare professionals should provide timely and accessible education and be aware of the role of Chinese diet and traditional medicine in stroke survivors' rehabilitation.
PMID: 25443438 [PubMed - indexed for MEDLINE]
Pulverized konjac glucomannan ameliorates oxazolone-induced colitis in mice.
Eur J Nutr. 2015 Sep;54(6):959-69
Authors: Onitake T, Ueno Y, Tanaka S, Sagami S, Hayashi R, Nagai K, Hide M, Chayama K
PURPOSE: Pulverized konjac glucomannan (PKGM) is a natural biologically active compound extracted from konjac, a Japanese traditional food. In the present study, we investigated the role of PKGM in intestinal immunity in a mouse model of oxazolone (OXA)-induced colitis.
METHODS: C57BL/6(B6) mice were fed PKGM or control food from 2 weeks before the induction of OXA colitis. Body weight change, colon length, and histological change in the colon were examined. The mononuclear cells were purified from colon and stimulated with PMA/ionomycin. The levels of TNF-α, interferon (IFN)-γ, interleukin (IL)-4, and IL-13 from the supernatant were measured by ELISA.
RESULTS: Oral administration of PKGM prevented the body weight loss and shortening of colon length associated with OXA-induced colitis. Histological analysis revealed that the colonic inflammation was improved by the administration of PKGM. The levels of IL-4 and IL-13, the critical inflammatory cytokines in OXA colitis, derived from mononuclear cells from the lamina propria of the colon were significantly suppressed by PKGM administration. PKGM-fed mice showed a significantly lower IL-4/IFN-γ ratio in the colonic lamina propria compared with that in control-fed mice. Fluorescence-activated cell sorting analysis revealed that natural killer (NK) 1.1(+) T cells in the liver were significantly decreased in PKGM-fed mice. Finally, the preventive role of PKGM in OXA-induced colitis was not observed in invariant natural killer T cell-deficient mice.
CONCLUSIONS: PKGM ameliorated OXA-induced colitis in mice. This effect is associated with a decreased population of NK1.1(+) T cells and induction of Th1-polarized immune responses.
PMID: 25253162 [PubMed - indexed for MEDLINE]
The effect of 'sleep high and train low' on weight loss in overweight Chinese adolescents: study protocol for a randomized controlled trial.
Trials. 2014 Jun 25;15:250
Authors: Wang R, Liu D, Wang X, Xiao W, Wu N, Gao B, Chen P
BACKGROUND: Exercise and diet are the cornerstones for the treatment of obesity in obese children and adolescents. However, compensatory changes in appetite and energy expenditure elicited by exercise and dieting make it hard to maintain a reduced weight over the longterm. The anorexic effect of hypoxia can be potentially utilized to counteract this compensatory increase, thereby enhancing the success of weight loss. The purpose of the study is to assess the effectiveness of four week intermittent hypoxia exposure added to a traditional exercise and diet intervention on inducing short- and longterm weight loss in obese adolescents.
METHODS/DESIGN: In this randomized parallel group controlled clinical trial, 40 obese adolescents (20 boys and 20 girls, 11 to 15-years-old), will be recruited from a summer weight loss camp at the Shanghai University of Sport, China. Participants will be stratified by gender and randomly assigned to either the control group or the hypoxia group. During the four-week intervention period, both groups will exercise and eat a balanced diet. Additionally, the control group will sleep in normal conditions, while the hypoxia group will sleep in a normobaric hypoxia chamber (sleep high and train low). The primary outcome will be body composition and the main secondary outcomes will be the circulating levels of appetite regulatory gastrointestinal hormones. All the outcome measures will be assessed at baseline, after the four-week intervention, and at two months follow-up.
DISCUSSION: Our study will be the first to evaluate the effectiveness of 'sleep high and train low' on short- and longterm weight loss among obese adolescents. A potential mechanism for the appetite regulatory effect of hypoxia will also be explored. The results of the study will provide an evidence-based recommendation for the use of hypoxia in a weight loss intervention among obese children and adolescents. Furthermore, the clarification of mechanisms leading to weight loss in 'sleep high and train low' might provide information for the development of new strategies in combating obesity.
TRIAL REGISTRATION: This trial was registered on 10 January 2014 at the Chinese Clinical Trial Registry with the registration number: ChiCTR-TRC-14004106.
PMID: 24962246 [PubMed - indexed for MEDLINE]
Miso (Japanese soybean paste) soup attenuates salt-induced sympathoexcitation and left ventricular dysfunction in mice with chronic pressure overload.
Fukuoka Igaku Zasshi. 2014 Feb;105(2):48-56
Authors: Ito K, Hirooka Y, Sunagawa K
The hypothalamic mineralocorticoid receptor (MR)-angiotensin II type 1 receptor (AT1R) pathway is activated in mice with chronic pressure overload (CPO). When this activation is combined with high salt intake, it leads to sympathoexcitation, hypertension, and left ventricular (LV) dysfunction. Salt intake is thus an important factor that contributes to heart failure. Miso, a traditional Japanese food made from fermented soybeans, rice, wheat, or oats, can attenuate salt-induced hypertension in rats. However, its effects on CPO mice with salt-induced sympathoexcitation and LV dysfunction are unclear. Here, we investigated whether miso has protective effects in these mice. We also evaluated mechanisms associated with the hypothalamic MR-AT1R pathway. Aortic banding was used to produce CPO, and a sham operation was performed for controls. At 2 weeks after surgery, the mice were given water containing high NaCl levels (0.5%, 1.0%, and 1.5%) for 4 weeks. The high salt loading in CPO mice increased excretion of urinary norepinephrine (uNE), a marker of sympathetic activity, in an NaCl concentration-dependent manner; however, this was not observed in Sham mice. Subsequently, CPO mice were administered 1.0% NaCl water (CPO-H) or miso soup (1.0% NaCl equivalent, CPO-miso). The expression of hypothalamic MR, serum glucocorticoid-induced kinase-1 (SGK-1), and AT1R was higher in the CPO-H mice than in the Sham mice; however, the expression of these proteins was attenuated in the CPO-miso group. Although the CPO-miso mice had higher sodium intake, salt-induced sympathoexcitation was lower in these mice than in the CPO-H group. Our findings indicate that regular intake of miso soup attenuates salt-induced sympathoexcitation in CPO mice via inhibition of the hypothalamic MR-AT1R pathway.
PMID: 24908908 [PubMed - indexed for MEDLINE]
Daikenchuto stimulates colonic motility after laparoscopic-assisted colectomy.
Hepatogastroenterology. 2014 Jan-Feb;61(129):85-9
Authors: Yaegashi M, Otsuka K, Itabashi T, Kimura T, Kato K, Fujii H, Koeda K, Sasaki A, Wakabayashi G
BACKGROUND/AIMS: Paralytic ileus after laparoscopic-assisted surgery often occurs. We investigated whether daikenchuto (DKT), a traditional Japanese herbal medicine, improves intestinal motility in patients undergoing laparoscopic-assisted colectomy for colon cancer.
METHODOLOGY: Fifty-four patients who underwent colectomy at Iwate Medical University Hospital between October 2010 and March 2012 were randomized to either the DKT group (7.5 g/day, p.o.) or the control group (lactobacillus preparation, 3g/day, p.o.). Primary endpoints included time to first flatus, bowel movement, and tolerance of diet after extubation. Secondary endpoints were WBC count, C-reactive protein (CRP) level, length of hospital stay, and postoperative ileus. Colonic transit time was measured using radiopaque markers and abdominal radiographs.
RESULTS: Fifty-one patients (DKT, 26 vs. control, 25) were included in the per-protocol analysis. The DKT group had significantly faster time until first flatus (67.5 +/- 13.6h vs. 77.9 +/- 11.8h, P < 0.01) and bowel movement (82.9 +/- 17.8h vs. 99.5 +/- 18.9h, P < 0.01) and colonic transit time (91.9 +/- 19.8h vs. 115.2 +/- 12.8 h, P < 0.05). There were no significant intergroup differences in secondary endpoints and adverse events.
CONCLUSIONS: DKT accelerates colonic motility in patients undergoing laparoscopic-assisted colectomy for colon cancer.
PMID: 24895799 [PubMed - indexed for MEDLINE]
TU-100 (Daikenchuto) and ginger ameliorate anti-CD3 antibody induced T cell-mediated murine enteritis: microbe-independent effects involving Akt and NF-κB suppression.
PLoS One. 2014;9(5):e97456
Authors: Ueno N, Hasebe T, Kaneko A, Yamamoto M, Fujiya M, Kohgo Y, Kono T, Wang CZ, Yuan CS, Bissonnette M, Chang EB, Musch MW
The Japanese traditional medicine daikenchuto (TU-100) has anti-inflammatory activities, but the mechanisms remain incompletely understood. TU-100 includes ginger, ginseng, and Japanese pepper, each component possessing bioactive properties. The effects of TU-100 and individual components were investigated in a model of intestinal T lymphocyte activation using anti-CD3 antibody. To determine contribution of intestinal bacteria, specific pathogen free (SPF) and germ free (GF) mice were used. TU-100 or its components were delivered by diet or by gavage. Anti-CD3 antibody increased jejunal accumulation of fluid, increased TNFα, and induced intestinal epithelial apoptosis in both SPF and GF mice, which was blocked by either TU-100 or ginger, but not by ginseng or Japanese pepper. TU-100 and ginger also blocked anti-CD3-stimulated Akt and NF-κB activation. A co-culture system of colonic Caco2BBE and Jurkat-1 cells was used to examine T-lymphocyte/epithelial cells interactions. Jurkat-1 cells were stimulated with anti-CD3 to produce TNFα that activates epithelial cell NF-κB. TU-100 and ginger blocked anti-CD3 antibody activation of Akt in Jurkat cells, decreasing their TNFα production. Additionally, TU-100 and ginger alone blocked direct TNFα stimulation of Caco2BBE cells and decreased activation of caspase-3 and polyADP ribose. The present studies demonstrate a new anti-inflammatory action of TU-100 that is microbe-independent and due to its ginger component.
PMID: 24857966 [PubMed - indexed for MEDLINE]
[Scientific statement] Report of the Salt Reduction Committee of the Japanese Society of Hypertension(2) Goal and strategies of dietary salt reduction in the management of hypertension.
Hypertens Res. 2013 Dec;36(12):1020-5
Authors: Miura K, Ando K, Tsuchihashi T, Yoshita K, Watanabe Y, Kawarazaki H, Matsuura H, Kusaka M, Kai H, Kawamura M, Kawano Y
In this section of the Report of the Salt Reduction Committee of the Japanese Society of Hypertension, the target level of dietary salt reduction and its scientific evidence, present status of salt consumption in Japan, salt-reducing measures/guidance methods in individuals and population strategies to reduce salt intake are introduced. In the Dietary Reference Intake for the general population in Japan (2010 version), the target levels of salt restriction in men and women were established as less than 9.0 per day and 7.5 g per day, respectively. The Japanese Society of Hypertension Guidelines for the Management of Hypertension 2009 recommended the target level of dietary salt restriction in patients with hypertension as less than 6 g per day. However, the National Health and Nutrition Survey of Japan in 2010 reported that the mean salt intake in adults was 10.6 g per day (men: 11.4 g per day and women: 9.8 g per day). To effectively decrease salt intake in Japan, it is necessary to reduce the consumption of high-salt foods (especially traditional foods) and replace high-salt seasonings (soy sauce and so on) with low-salt alternatives. Health-care professionals must effectively perform salt-reduction guidance for hypertensive patients in hospitals/administrative organizations. To promote population strategies for salt reduction in the whole society of Japan, social strategies, such as administrative policies, companies' cooperation and educational staff's cooperation, are necessary.
PMID: 24152612 [PubMed - indexed for MEDLINE]
Blood pressure reduction by Japanese traditional Miso is associated with increased diuresis and natriuresis through dopamine system in Dahl salt-sensitive rats.
Clin Exp Hypertens. 2014;36(5):359-66
Authors: Du DD, Yoshinaga M, Sonoda M, Kawakubo K, Uehara Y
OBJECTIVES: We investigated the antihypertensive mechanism of long-term Miso soup consumption in Dahl salt-sensitive (Dahl S) rats with salt-induced hypertension.
MATERIAL AND METHODS: Female Dahl S rats fed a low-salt (0.3% NaCl) diet were divided into three groups: (1) six rats given water, (2) six rats given 0.65% (w/v) saline solution or (3) eight rats given 5% (w/v) Miso soup containing 0.65% (w/v) saline solution. They were followed for 12 weeks. Variables in the plasma or 24-h urine were determined. Systolic blood pressure (SBP) was measured by the tail-cuff method.
RESULTS: The SBP increased in an age-dependent manner in Dahl S rats drinking saline solutions. The elevation of SBP was significantly attenuated in Dahl S rats given Miso soup although the ultimate cumulative salt loading was much greater in the Miso group than those given the saline solutions. This SBP reduction in the Miso group was associated with an increase in fractional excretion of Na (FENa) and free water clearance in the kidney. Urinary dopamine excretions were increased in the Miso group compared with that in the saline group. The increase in urinary dopamine excretions was associated with a decrease in brain oxidative stress. Urinary dopamine excretions were an independent predictor of SBP in the Miso group.
CONCLUSIONS: Long-term consumption of Miso soup attenuated blood pressure elevation in Dahl salt-sensitive rats with salt-induced hypertension. The blood pressure reduction was due to, at least in part, constituent(s) of the Miso that increase natriuresis and diuresis and enhance dopaminergic nervous activity in the kidney.
PMID: 24047246 [PubMed - indexed for MEDLINE]
[Challenges for the future of psychiatry and psychiatric medical care].
Seishin Shinkeigaku Zasshi. 2013;115(1):76-83
Authors: Higuchi T
In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up:  The persistently high number of suicides.  The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals.  The absolute shortage of child psychiatrists.  Little progress with the transition from hospitalization-centered to community-centered medical care.  The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the situation, is the fact that the "psychiatry exception" system (unbalanced ratio of staff to psychiatric patients) is still present today. (2) To reach a fundamental solution, the policy of low fees for psychiatric services has to be abolished. (3) Multi-disciplinary medical teams, as practiced in other developed countries, is not yet adequately applied in Japan. From the aspect of medical fees, it is not adequately encouraged either. The only place where team medicine is actually practiced is in the "forced hospitalization" ward, but, as stated in the supplementary resolution of the Japanese diet (national assembly), high-quality medicine should not only be practiced in the "forced hospitalization" ward, but also in general psychiatry. (4) The policy of transition from hospitalization-centered to community-centered medical care, which was initiated a long time ago by the Japanese government, is not proceeding in reality, and it is time that we put our heads together and find ways to overcome this problem. It is significant that "psychiatric disorders" have been included as one of the "five diseases," (a system adopted by the government concerning community health care), and now we have the best opportunity to improve community-centered psychiatric care.
PMID: 23691798 [PubMed - indexed for MEDLINE]
[Cognitive behavioral therapy for obesity].
Nihon Rinsho. 2013 Feb;71(2):329-34
Authors: Nozaki T, Sawamoto R, Sudo N
A change in the traditional Japanese diet to include foods from other countries and increased reliance on motorized transportation has resulted in higher-caloric intake and lower energy expenditure. In consequence, the number of obese patients has grown rapidly, as has the number of patients with type 2 diabetes, hyperlipidemia, hyperuricemia, hypertension and coronary vascular disease. These have come to be called lifestyle-related diseases because changes in lifestyle are deeply associated with their onset and development. In the U.S. and Europe, lifestyle modification and medication are considered important to the treatment of such diseases. Cognitive behavioral therapy plays a central role in lifestyle modification. We here focus on our cognitive behavioral therapy for obesity.
PMID: 23631216 [PubMed - indexed for MEDLINE]
Association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population.
Biomed Environ Sci. 2012 Aug;25(4):373-82
Authors: He YN, Feskens E, Li YP, Zhang J, Fu P, Ma GS, Yang XG
OBJECTIVE: To study the association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population.
METHODS: Data about 20 717 subjects aged 45-59 years from the cross-sectional 2002 China National Nutrition and Health Survey were analyzed. High fat-low carbohydrate diet was scored according to the energy of carbohydrate, fat, and protein.
RESULTS: Of the 20 717 subjects, 1 332 were diagnosed with hyperglycemia and 662 were newly diagnosed with type 2 diabetes. Multivariate adjusted analysis showed that the highest score of type 2 diabetes patients was 2.75 (95% CI: 2.09-3.61). The score of type 2 diabetes patients was 1.87 (95% CI: 1.35-2.58) after further adjustment for their socioeconomic status and physical activity. No significant difference was found in the odds ratio after further adjustment for BMI, blood pressure, lipid level, and energy intake. No evidence was observed for the relation between high fat-low carbohydrate-diet score in type 2 diabetes patients due to high family income, less education, physical activity, overweight, hypertension, high TG, or low HDL level.
CONCLUSION: High fat-low carbohydrate diets, far different from traditional Chinese diets, are associated with the high incidence of type 2 diabetes in Chinese population.
PMID: 23026516 [PubMed - indexed for MEDLINE]
Therapeutic effect of Yokukansan on social isolation-induced aggressive behavior of zinc-deficient and pair-fed mice.
Brain Res Bull. 2012 Apr 10;87(6):551-5
Authors: Takeda A, Iwaki H, Ide K, Tamano H, Oku N
In patients with dementia including Alzheimer's disease, hallucinations, agitation/aggression and irritability are known to frequently occur and as distressing behavioral and psychological symptoms of dementia (BPSD). On the basis of the evidence on clinical efficacy and safety of Yokukansan, a traditional Japanese herbal medicine, on BPSD, in the present study, Yokukansan was examined in the therapeutic effects on social isolation-induced aggressive behavior of zinc-deficient and pair-fed mice. Yokukansan was p.o. administered for 7 days as a drinking water to isolated mice fed a zinc-deficient diet for 10 days, which exhibited aggressive behavior, and isolated pair-fed mice fed a control diet of the amount consumed by zinc-deficient mice for 10 days, which exhibited aggressive behavior. Aggressive behavior was evaluated by the resident-intruder test. Yokukansan (312 mg/kg/day) attenuated both aggressive behaviors of zinc-deficient and pair-fed mice. Because Yokukansan can suppress abnormal glutamatergic neuron activity, MK-801, an N-methyl-D-aspartate (NMDA) receptor blocker, and aminooxyacetic acid (AOAA), a γ-amino butyric acid (GABA) transaminase blocker, were also examined in the effects on social isolation-induced aggressive behavior. MK-801 (0.1 mg/kg) or AOAA (23 mg/kg) was i.p. injected into isolated aggressive mice. Thirty minutes later, the resident-intruder test was performed to evaluate the effect of the drugs. Both drugs attenuated aggressive behavior of zinc deficient mice, but not that of pair-fed mice. These results suggest that Yokukansan ameliorates social isolation-induced aggressive behavior of zinc-deficient and pair-fed mice through the action against glutamatergic neurotransmitter system and other neurotransmitter systems.
PMID: 22373913 [PubMed - indexed for MEDLINE]
Japanese traditional miso soup attenuates salt-induced hypertension and its organ damage in Dahl salt-sensitive rats.
Nutrition. 2012 Sep;28(9):924-31
Authors: Yoshinaga M, Toda N, Tamura Y, Terakado S, Ueno M, Otsuka K, Numabe A, Kawabata Y, Uehara Y
OBJECTIVE: We investigated the effects of long-term miso soup drinking on salt-induced hypertension in Dahl salt-sensitive (Dahl S) rats.
METHODS: Dahl S rats were divided into four groups that consumed 1) water, 2) a 0.9% NaCl solution, 3) a 1.3% sodium NaCl solution, or 4) miso soup containing 1.3% NaCl. They were followed for 8 wk. Systolic blood pressure and hypertensive organ damage were determined.
RESULTS: Systolic blood pressure increased in an age- and dose-dependent manner in Dahl S rats drinking salt solutions. The systolic blood pressure increase was significantly less in the Dahl S rats that drank miso soup, although the ultimate cumulative salt loading was greater than that in the Dahl S rats given the 1.3% NaCl solution. This blood pressure decrease was associated with a morphologic attenuation of glomerular sclerosis in the kidney and collagen infiltration in the heart. Urinary protein excretions were less in the miso group than in the rats given the 1.3% NaCl solution. The fractional excretion of sodium was increased and that of potassium was decreased in Dahl S rats given the 1.3% NaCl solution, and these effects were reversed in rats given miso soup toward the values of the control.
CONCLUSION: We found that long-term miso soup drinking attenuates the blood pressure increase in salt-induced hypertension with organ damage. This may be caused by a possible retardation of sodium absorption in the gastrointestinal tract or by the direct effects of nutrients in the miso soup from soybeans. The decrease was associated with decreases in cardiovascular and renal damage.
PMID: 22261579 [PubMed - indexed for MEDLINE]
Alogliptin as an initial therapy in patients with newly diagnosed, drug naïve type 2 diabetes: a randomized, control trial.
Endocrine. 2012 Jun;41(3):435-41
Authors: Kutoh E, Ukai Y
The objectives of this study is to evaluate the efficacy and safety of alogliptin versus very low fat/calorie traditional Japanese diet (non-inferiority trial) as an initial therapy for newly diagnosed, drug naïve subjects with type 2 diabetes (T2DM). Study design was prospective, randomized, non-double-blind, controlled trial. The study was conducted at outpatient units of municipal hospital. Patients were newly diagnosed, drug naïve patients who visited the outpatient units. The patients randomly received 12.5-25 mg/day alogliptin (n = 25) or severe low calorie traditional Japanese diet (n = 26). The procedure of this trial was assessed by the consolidated standards of reporting trials statement. The primary end point was the change of HbA1c at 3 months. Secondary end points included the changes of fasting blood glucose, insulin, homeostasis model assessment-R (HOMA-R), HOMA-B, body mass index (BMI), and lipid parameters. Similar, significant reductions of HbA1c levels were observed in both groups (from 10.51 to 8.74% for alogliptin and from 10.01 to 8.39% for traditional Japanese diet) without any clinically significant adverse events. In the alogliptin group, some subjects (16%) had mild hypoglycemic evens which could be managed by taking glucose drinks by themselves. HOMA-B significantly increased in both groups with varying degrees, whereas HOMA-R significantly decreased only in the Japanese diet group. Atherogenic lipids, such as, total cholesterol, non-high density lipoprotein cholesterol, and low density lipoprotein cholesterol levels significantly decreased in both groups. BMI had no change in the alogliptin group, whereas it significantly decreased in the Japanese diet group. (1) Concerning its glycemic efficacy, alogliptin is effective and non-inferior to traditional Japanese diet as an initial therapeutic option for newly diagnosed T2DM. However, regarding the reductions of body weight and insulin resistance, traditional Japanese diet is superior. (2) Both alogliptin and traditional Japanese diet have favorable effects on atherogenic lipid profiles.
PMID: 22249941 [PubMed - indexed for MEDLINE]
Aqueous extract of Gleditsia sinensis Lam. fruits improves serum and liver lipid profiles and attenuates atherosclerosis in rabbits fed a high-fat diet.
J Ethnopharmacol. 2011 Oct 11;137(3):1061-6
Authors: Lai P, Du JR, Zhang MX, Kuang X, Li YJ, Chen YS, He Y
ETHNOPHARMACOLOGICAL RELEVANCE: Gleditsia sinensis Lam. has been used in the traditional Chinese medicine as a chief ingredient of many polyherbal formulations for the treatment of obesity and thrombosis.
AIM OF THE STUDY: To evaluate the effects of Gleditsia sinensis Lam. fruit aqueous extract (GAE) on hyperlipidemia and atherosclerosis in Japanese white rabbits on a high fat diet.
MATERIALS AND METHODS: Rabbits were divided into four groups: the normal control with a normal diet, and high-fat diet-fed model group and GAE-treated groups supplemented with GAE (6 or 12 mg/kg/day, p.o.), respectively. The groups fed high-fat diets were given i.v. with bovine serum albumin (BSA) on the 4th week to induce atherosclerosis. The serum lipid profile, including triglycerides (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), was determined on the 0th, 4th, 8th and 14th week, respectively. And the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) were measured simultaneously. At the end of the experiment, the rabbits were sacrificed, and the atherosclerotic plaques as well as the histopathological changes of aorta and liver were assessed by oil-red or HE staining, respectively, and the aorta and liver lipid profiles were also assayed.
RESULTS: Results showed that the prophylactic treatment with GAE could significantly decrease the lipid levels of serum, aorta and liver, attenuate aortic atherosclerosis and improve aortic remodeling without the significant liver and muscle toxicity.
CONCLUSION: The present findings suggest that GAE can effectively attenuate the atherosclerotic at least through anti-hyperlipidemic activity and thus has the therapeutic potential in treating hyperlipidemia-related cardiovascular diseases.
PMID: 21718773 [PubMed - indexed for MEDLINE]
[Dietary therapy for prevention and treatment of atherosclerosis from the perspective of anti-inflammation].
Nihon Rinsho. 2011 Jan;69(1):110-8
Authors: Tada N
Recently, many data link inflammation and atherosclerotic events and systemic inflammation are increasingly recognized as an important mediator of coronary artery disease (CAD). Indeed, experimental and epidemiological studies indicate that eating patterns, such as the traditional Mediterranean diets reduce inflammation and cardiovascular risk. These anti-inflammatory diets should be considered for the primary and secondary prevention of CAD. We must also recognize that even a transient increase in free radicals derived from inadequate food intake acutely triggers atherogenic changes including inflammation, endothelial dysfunction, hypercoagulability. Here in this review, the evidence supporting a causal link between dietary factors related to inflammatory modulators and CAD are summarized and dietary strategies for improving obesity, dyslipidemia, insulin resistance, and cardiovascular health are discussed.
PMID: 21226270 [PubMed - indexed for MEDLINE]
Protective effects of Kurozu and Kurozu Moromimatsu on dextran sulfate sodium-induced experimental colitis.
Dig Dis Sci. 2011 May;56(5):1387-92
Authors: Shizuma T, Ishiwata K, Nagano M, Mori H, Fukuyama N
BACKGROUND: Kurozu, a traditional Japanese black vinegar made from unpolished rice, and Kurozu Moromimatsu (Kurozu-M), its sediment, are both consumed in Japan as health foods or supplements. However, it is not known whether they have anti-colitis activity.
AIMS: We examined the protective effects of Kurozu and Kurozu-M in an animal model of dextran sulfate sodium (DSS)-induced colitis.
METHODS: DSS-induced colitis was induced in C57 black 6 mice by orally administering 3.5% DSS solution for 12 days. The control group received basal CE-2 diet (n = 10), the Kurozu group received CE-2 containing Kurozu (n = 10), the Kurozu-M group received CE-2 containing Kurozu-M (n = 10), and the acetic acid group received CE-2 containing acetic acid (n = 10), starting a week before DSS administration. Changes of body weight and bloody stool frequency were monitored. At 12 days after DSS administration, mice were killed for pathological examination and measurement of nitrotyrosine levels in rectal tissues.
RESULTS: Kurozu significantly inhibited body weight loss during 6-12 days after DSS administration and reduced bloody stool frequency during 2-12 days, and also significantly decreased nitrotyrosine levels at 12 days, compared to the control group. Kurozu-M significantly inhibited body weight loss during 6-8 days after DSS administration and reduced bloody stool frequency during 2-12 days, but tissue nitrotyrosine level was not significantly different from the control. Acetic acid had no ameliorating effect on DSS-induced colitis compared to the control group.
CONCLUSIONS: Kurozu and Kurozu-M have protective effects against DSS-induced colitis. Kurozu has anti-oxidative and anti-nitration activity.
PMID: 20936352 [PubMed - indexed for MEDLINE]
Dietary acid load and rapid progression to end-stage renal disease of diabetic nephropathy in Westernized South Asian people.
J Nephrol. 2011 Jan-Feb;24(1):11-7
Authors: van den Berg E, Hospers FA, Navis G, Engberink MF, Brink EJ, Geleijnse JM, van Baak MA, Gans RO, Bakker SJ
Diabetic nephropathy is now the most common cause of end-stage renal failure in many countries of the world. Despite increasing implementation of preventive treatment, the chance that an individual diabetic patient will reach end-stage renal failure has been increasing rather than decreasing during recent decades. Current dietary habits in The Netherlands and the rest of the Western world are slowly shifting from relatively alkalinizing (e.g., potatoes and vegetables) toward more acidifying (e.g., rice and meat). Moreover, immigrants who consumed traditional diets in their homelands, usually adapt to Western dietary habits. This phenomenon of diet acculturation could, for instance, be involved in the up to 40 times higher chance of development of end-stage renal failure in association with diabetes in South-Asian immigrants compared with whites, in Western countries. High ingestion of nonvolatile acids with food increases susceptibility for progression to end-stage renal failure. These high dietary acid loads lead to compensatory increases in renal acid excretion and ammoniagenesis. The price paid for maintenance of acid-base homeostasis is renal tubulointerstitial injury, with subsequent decline in renal function and induction of hypertension. The tendency for metabolic acidosis that results from the changing dietary habits could be corrected by a shift toward more alkalinizing food. We hypothesize that promoting such a shift can prevent the epidemic of end-stage renal failure in diabetes.
PMID: 20872351 [PubMed - indexed for MEDLINE]
Ameliorative effect of Yokukansan on social isolation-induced aggressive behavior of zinc-deficient young mice.
Brain Res Bull. 2010 Nov 20;83(6):351-5
Authors: Tamano H, Kan F, Oku N, Takeda A
Yokukansan, a traditional Japanese medicine has been used to cure neuropsychological disorders. In the present study, the effect of Yokukansan on social isolation-induced aggressive behavior was examined in zinc-deficient mice, which were fed a zinc-deficient diet and a drinking water containing Yokukansan for 2 weeks. In the resident-intruder test, the rate of mice that exhibited aggressive behavior in zinc-deficient mice, which was significantly higher than that in the control mice, was significantly decreased by administration of Yokukansan. The basal level of serum glucocorticoid, which was significantly higher in zinc-deficient mice, was lowered by administration of Yokukansan. On the other hand, serum glucocorticoid levels after the resident-intruder test were almost the same between the control and zinc-deficient mice. However, administration of Yokukansan to zinc-deficient mice significantly increased serum glucocorticoid level after the resident-intruder test and the significant difference in the rate of serum corticosterone level after the test to the basal level between the control and zinc-deficient mice was abolished. Dietary zinc deficiency increases the basal levels of serum glucocorticoid, while may insufficiently increase serum glucocorticoid levels in the resident-intruder test. The concentrations of glutamate and GABA (γ-aminobutyric acid) in the brain were significantly higher in zinc-deficient mice, while Yokukansan ameliorated the significant increases. These results indicate that Yokukansan ameliorates social isolation-induced aggressive behavior of zinc-deficient mice, probably via amelioration of abnormal glucocorticoid secretion. The ameliorative effect seems to be linked to the modification of glutamatergic neuron activity after administration of Yokukansan.
PMID: 20813168 [PubMed - indexed for MEDLINE]
Controlling energetic intake based on a novel logistic regression model for the metabolic syndrome in a Chinese population.
Br J Nutr. 2011 Jan;105(2):256-62
Authors: Yangmei L, Yanxia M, Liangmei Q, Jinhui Z, Yu H, Minwen Z
The present study was designed to develop a novel method of energy calculation for controlling energetic intake in patients with the metabolic syndrome. Demographics and dietary data were recorded for 2582 obese subjects. Nutritional education was applied to all the patients. One year later, the data on age, sex, activity intensity coefficient, waistline, environmental temperature and BMI in subjects who lost ≥ 5% body weight were entered into a multivariate logistic regression analysis model. Energy requirement was calculated from the results of multivariate logistic regression. Four hundred and thirty-four metabolic syndrome patients were then randomly divided into the treated group (216) and the control group (218). The energetic intake in the experimental group was controlled based on the new energy requirement model. The traditional energy exchange method was used in the control group. The independent factors predicting metabolic syndrome prognosis, such as age, sex, activity intensity coefficient, waistline, environmental temperature and BMI, were identified by multivariate logistic regression analysis. The energy requirement model was then constructed by logistic regression analysis. After 6 months of energetic intake control based on the new model, the parameters of the experimental group were significantly different from those of the controls (all P < 0·05): waistline, 89·65 (SD 5·54) v. 91·97 (SD 4·78) cm; BMI, 24·67 (SD 3·54) v. 25·87 (SD 2·65) kg/m2; fasting blood glucose, 6·9 (SD 3·6) v. 8·7 (SD 4·6) mmol/l; 2 h PG, 8·7 (SD 5·7) v. 10·7 (SD 4·5) mmol/l; HbA1c, 7·7 (SD 1·6) v. 8·9 (SD 2·6) %; homoeostasis model insulin resistance index, 3·14 (SD 1·62) v. 4·32 (SD 2·25). The new energy requirement model can effectively improve the clinical outcomes of controlling energetic intake in metabolic syndrome patients.
PMID: 20807463 [PubMed - indexed for MEDLINE]
Enhancement of anti-allergic effects mediated by the Kampo medicine Shoseiryuto (Xiao-Qing-Long-Tang in Chinese) with lysed Enterococcus faecalis FK-23 in mice.
Asian Pac J Allergy Immunol. 2010 Mar;28(1):59-66
Authors: Shimada T, Kondoh M, Motonaga C, Kitamura Y, Cheng L, Shi H, Enomoto T, Tsuruta D, Ishii M, Kobayashi H
Kampo is a traditional Japanese medicine originating from ancient Chinese medicine which included the administration of herbal prescription, lifestyle advice and acupuncture. Orally administered Kampo prescriptions are believed to be influenced by diet and intestinal microbiota. However, reports on the Kampo administration effects are still limited. Shoseiryuto (TJ-19), which has anti-allergic and anti-inflammatory properties, is a Kampo prescription used clinically for the treatment of allergic bronchial asthma. We examined whether Shoseiryuto administration is affected by a probiotic product, lysed Enterococcus faecalis FK-23 (LFK). BALB/c mice were sensitized with cedar pollen allergen, and the peritoneal accumulation of eosinophils was induced. During a sensitization period of 21 days, varying amounts of Shoseiryuto (and saline as a control) were administered to the mice. The accumulation of eosinophils was significantly reduced by 30 mg/day doses of Shoseiryuto but not by 3 or 9 mg/day doses. Similarly, 3 mg/day Shoseiryuto, 30 mg/day LFK, 3 mg/day of Shoseiryuto co-administered with 30 mg/day of LFK, and saline control were compared. A significant reduction in the accumulation of eosinophils was observed at 3 mg/day Shoseiryuto co-administered with 30 mg/day of LFK. These results suggest that Shoseiryuto-mediated anti-allergic effects are enhanced by the probiotic (LFK). Although not significant statistically, serum allergen-specific and total IgE levels in the treatment group exposed to the mixed agent (ie. Shoseiryuto and LFK) were generally lower than those receiving either one alone. The results indicate a synergistic effect of a Kampo medicine (Shoseiryuto, Xiao-Qing-Long-Tang in Chinese) and lysed Enterococcus faecalis FK-23 on allergic responses in mice.
PMID: 20527518 [PubMed - indexed for MEDLINE]
Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study.
BMC Geriatr. 2010 Jun 01;10:31
Authors: Monma Y, Niu K, Iwasaki K, Tomita N, Nakaya N, Hozawa A, Kuriyama S, Takayama S, Seki T, Takeda T, Yaegashi N, Ebihara S, Arai H, Nagatomi R, Tsuji I
BACKGROUND: Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly.
METHODS: We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake.
RESULTS: Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture.
CONCLUSIONS: The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.
PMID: 20513246 [PubMed - indexed for MEDLINE]
Equol improves menopausal symptoms in Japanese women.
J Nutr. 2010 Jul;140(7):1386S-9S
Authors: Aso T
It has been well documented that the frequency of vasomotor menopausal symptoms, such as hot flashes and night sweats, of Japanese menopausal women is less than that of Western women. High intake of soy isoflavones in the traditional Japanese diet has been postulated as the possible explanation of the difference. Epidemiological studies have reported that the content of equol, which is a biologically active metabolite of the isoflavone, daidzein, is lower in the women who complain of severe vasomotor symptoms. To investigate the involvement of equol in the manifestation of menopausal symptoms, especially vasomotor symptoms, and the possible therapeutic role of a supplement containing equol (natural S-equol developed by Otsuka Pharmaceutical) on the menopausal symptoms of Japanese women, 3 randomized clinical trials were conducted. The studies indicated that a daily dose of 10 mg of natural S-equol improved menopausal symptoms. In the confirmation study, menopausal women who were equol nonproducers who consumed 10 mg/d of natural S-equol for 12 wk had significantly reduced severity and frequency of hot flashes as well as a significant reduction in the severity of neck or shoulder stiffness. The equol-ingesting group also showed trends of improvement in sweating and irritability and a significant improvement in the somatic category symptoms. Thus, it is concluded that the supplement containing natural S-equol, a novel soybean-derived functional component, has a promising role as an alternative remedy in the management of menopausal symptoms.
PMID: 20484552 [PubMed - indexed for MEDLINE]
Anti-obesity effect on rodents of the traditional Japanese food, tororokombu, shaved Laminaria.
Biosci Biotechnol Biochem. 2009 Oct;73(10):2326-8
Authors: Miyata M, Koyama T, Kamitani T, Toda T, Yazawa K
Tororokombu is a traditional Japanese food made from edible kelp. The way to make tororokombu is characterized by shaving kelp very thinly. It was found that tororokombu decreased the serum triglyceride level induced by oil administration to rats and had an anti-obesity effect on obese mice induced by a high-fat diet. These effects were more powerful than those of non-shaved kelp.
PMID: 19809171 [PubMed - indexed for MEDLINE]
Effects of yokukansan, a traditional Japanese medicine, on memory disturbance and behavioral and psychological symptoms of dementia in thiamine-deficient rats.
Biol Pharm Bull. 2009 Oct;32(10):1701-9
Authors: Ikarashi Y, Iizuka S, Imamura S, Yamaguchi T, Sekiguchi K, Kanno H, Kawakami Z, Yuzurihara M, Kase Y, Takeda S
Effects of yokukansan (TJ-54) on memory disturbance and behavioral and psychological symptoms of dementia (BPSD) were investigated in thiamine-deficient (TD) rats which were produced by feeding a TD diet for 37 d. Daily oral administration of TJ-54 (0.5, 1.0 g/kg) ameliorated the memory disturbance, anxiety-like behavior, the increase in aggressive behaviors, the decrease in social behaviors, and several neurological symptoms including opisthotonus observed in TD rats, in a dose-dependent manner. In addition, histopathological examinations showed that TJ-54 inhibited the degeneration of neuronal and astroglial cells in the brain stem, hippocampus and cortex in TD rats. Microdialysis experiments showed that TJ-54 inhibited extracellular glutamate rise in the ventral posterior medial thalamus in TD rats. These results suggest that TJ-54 possesses the preventive or progress inhibitive effect against the development of memory disturbance and BPSD-like behaviors induced by the degeneration of neuronal and astroglial cells resulting from TD. TJ-54 may inhibit glutamate-mediated excitotoxicity as one of mechanisms.
PMID: 19801831 [PubMed - indexed for MEDLINE]
Oral administration of Yokukansan inhibits the development of atopic dermatitis-like lesions in isolated NC/Nga mice.
J Dermatol Sci. 2009 Oct;56(1):37-42
Authors: Jiang J, Yamaguchi T, Funakushi N, Kuhara T, Fan PS, Ueki R, Suto H, Kase Y, Ikeda S, Ogawa H
BACKGROUND: Increasing evidence suggests that stress can trigger and exacerbate atopic dermatitis (AD). Psychotherapy is becoming more important in the treatment of AD patients. Yokukansan (YKS, Yi-Gan San in Chinese), a traditional Japanese medicine, has been widely utilized in the treatment of neurosis, insomnia and anxiety especially in Asian countries. Furthermore, it was reported that YKS inhibited skin lesions in socially isolated mice but not in group-housed mice. Therefore, in the present study it was investigated whether or not YKS was effective in the treatment of AD using socially isolated NC/Nga mice.
OBJECTIVE: The present study was designed to assess the effect of YKS on the development of AD-like lesions in socially isolated NC/Nga mice to obtain information about its usefulness in the treatment of AD.
METHODS: Ten-week-old male NC/Nga mice were socially isolated under conventional conditions. YKS was administered orally to mice at the dose of 0.5% or 1.0% together with diet. The efficacy of YKS was evaluated by assessing skin lesion severity, scratching behaviors, skin hydration, and infiltration of inflammatory cells in the skin. Grooming behaviors evoked by social isolation stress and serum corticosterone levels were also measured.
RESULTS: Oral administration of YKS to socially isolated NC/Nga mice resulted in the inhibition of exacerbation of AD-like skin lesions. It seemed that the inhibition of exacerbation of AD-like skin lesions observed in NC/Nga mice might be due to suppression of the scratching and grooming behaviors, inhibition of the infiltration of mast cells and eosinophils, and retention of humidity in the skin. Serum corticosterone levels were also significantly inhibited in the 1%-YKS-treated mice as compared with those of the control mice. There were no significant differences in the levels of serum total IgE and nerve growth factor (NGF) between the YKS-treated mice and the non-treated control mice.
CONCLUSION: YKS inhibited the development of AD-like skin lesions in socially isolated NC/Nga mice by suppressing scratching and infiltration of inflammatory cells in the skin. These results indicate that YKS possesses an anti-itching property, and its anti-itching may be partly through attenuation on social isolation stress. It is expected that YKS might provide an effective alternative therapy for AD in human patients.
PMID: 19647983 [PubMed - indexed for MEDLINE]
Risk factors for stroke and lipid-lowering effect of pravastatin on the risk of stroke in Japanese patients with hypercholesterolemia: analysis of data from the MEGA Study, a large randomized controlled trial.
J Neurol Sci. 2009 Sep 15;284(1-2):72-6
Authors: Uchiyama S, Nakaya N, Mizuno K, Ohashi Y, Tajima N, Kushiro T, Teramoto T, Nakamura H, MEGA Study Group
BACKGROUND: The aims of this study were to clarify the risk factors for stroke, and to investigate the effect of low-density lipoprotein cholesterol (LDL-C) lowering with pravastatin on the risk of stroke, in Japanese mild-to-moderately hypercholesterolemic patients enrolled in the MEGA Study.
METHODS: Multivariate Cox proportional hazard model was used to determine the baseline risk factors for stroke. The proportion of treatment effect (PTE) explained by on-treatment LDL-C levels was estimated.
RESULTS: In 7832 patients at risk, a total of 99 strokes were observed during the 5-year follow-up period. Significant relationships were observed between stroke and traditional risk factors such as male sex, advanced age, low high-density lipoprotein cholesterol (HDL-C), high lipoprotein(a) (Lp[a]), hypertension, diabetes, obesity, and smoking. In the pravastatin group, hazard ratio (HR) for stroke adjusted by on-treatment lipid level was lower than the unadjusted value versus control (HR [95%CI], 0.48 [0.26-0.87] and 0.59 [0.38-0.92], respectively)--giving a negative PTE of -38.6% and suggesting that the risk reduction could not be explained by LDL-C lowering alone.
CONCLUSIONS: Male sex, aging, hypertension, diabetes, low HDL-C, high Lp(a), obesity, and smoking were determined as risk factors for stroke in Japanese patients with hypercholesterolemia, and the observed risk reduction could not be explained by pravastatin's LDL-C-lowering effect alone, suggesting pleiotropic effects.
PMID: 19423132 [PubMed - indexed for MEDLINE]
Saltiness enhancement by the characteristic flavor of dried bonito stock.
J Food Sci. 2008 Aug;73(6):S321-5
Authors: Manabe M
There is a pressing need for the development of ways of preparing palatable salt-reduced foods to reduce the salt intake of the Japanese population. The salt-reducing effect of the characteristic flavors other than umami of dried bonito stock, which is widely used in everyday Japanese food, was examined by sensory evaluation. In the 1st sensory evaluation, the effect was evaluated in a model solution. The saltiness of 0.80% NaCl solution was equivalent to that of 0.12% monosodium glutamate (MSG) solution containing 0.81% NaCl and dried bonito stock containing 0.68% NaCl. Saltiness enhancement could not be found when MSG solution was used, but was found with 6% dried bonito stock. The 2nd evaluation examined whether the effect was valid for 2 everyday Japanese foods--traditional Japanese clear soup (sumashi-jiru) and steamed egg custard (tamagodoufu). Although enhancement of saltiness by dried bonito stock could not be clearly demonstrated in the soup, a change in NaCl concentration within 15% did not affect the palatability of the soup. However, dried bonito stock not only enhanced the saltiness but also improved the palatability of steamed egg custard. These findings are expected to be useful for improving the palatability of salt-reduced food.
PMID: 19241577 [PubMed - indexed for MEDLINE]
Natto and viscous vegetables in a Japanese style meal suppress postprandial glucose and insulin responses.
Asia Pac J Clin Nutr. 2008;17(4):663-8
Authors: Taniguchi A, Yamanaka-Okumura H, Nishida Y, Yamamoto H, Taketani Y, Takeda E
Naturally viscous vegetables and natto, made by fermenting soybeans, are very palatable and considered to be healthy foods in Japan. The objective was to assess whether the consumption of natto and viscous vegetables as part of a traditional Japanese breakfast based on high-glycemic index white rice affects glycemic, insulinemic, lipidemic and satiety responses in healthy subjects. Eleven healthy subjects consumed the reference, control and test meals in a randomized cross-over design. The test meal, comprising 200 g of boiled white rice with viscous meal (50 g natto, 60 g Japanese yams and 40 g okras), and the control meal, comprising 200 g of white rice with non-viscous boiled soybeans, potatoes and broccoli, contained comparable amounts of carbohydrate, fat, protein and fiber. In addition, whiter rice was used as a reference meal. Blood samples over 180 min were analyzed for glucose, insulin, non-esterified free fatty acid and triacylglyceride. Peak glucose and insulin concentrations after the test meal (6.0 mmol/L and 262 pmol/L) were significantly lower than after the control meal (6.8 mmol/L and 360 pmol/L). The incremental areas under the curve for glucose and insulin over 0-120 min after the test meal were also significantly reduced as compared with the control meal (28 and 27%). The consumption of naturally viscous vegetables with white rice reduced acute glycemia and insulinemia. This practical dietary combination would ensure compliance and favorably alter the risk for diabetes and cardiovascular diseases.
PMID: 19114406 [PubMed - indexed for MEDLINE]
Protease-resistant fraction of smoked, dried bonito alleviates atopic dermatitis-like skin lesions in NC/Nga mice.
J Nutr Sci Vitaminol (Tokyo). 2007 Oct;53(5):451-6
Authors: Matsumoto J, Ishikawa S, Doi M, Kishida T, Ebihara K
The effect of smoke-dried bonito undigested fraction remaining after microbial protease treatment (SDBR) on a spontaneously occurring mouse model of atopic dermatitis was studied in male 5-wk-old, NC/Nga mice. Smoke-dried bonito, Katsuobushi, is a traditional Japanese food. SDBR contains 2 major components: bonito oil and protease-undigested proteins. Mice were fed a casein diet containing corn oil (C diet) or a diet containing SDBR (SDBR diet) for 18 wk. In comparison with the C diet, the SDBR diet alleviated the increase in skin severity score and plasma IgE concentration in a time-dependent manner, and lowered leucotriene B(4) (LTB(4))-releasing ability upon calcium ionophore A23187 stimulation. The SDBR diet did not affect scratching time. These results demonstrate that SDBR diet alleviates atopic dermatitis-like skin lesions in NC/Nga mice.
PMID: 18079614 [PubMed - indexed for MEDLINE]
Effects of agar and pectin on gastric emptying and post-prandial glycaemic profiles in healthy human volunteers.
Clin Exp Pharmacol Physiol. 2007 Nov;34(11):1151-5
Authors: Sanaka M, Yamamoto T, Anjiki H, Nagasawa K, Kuyama Y
1. Dietary fibre, such as pectin, delays gastric emptying and may enhance post-prandial glucose tolerance. Agar, which is high in fibre content, is widely used in the traditional Japanese diet. Although long-term diet therapy with agar decreases fasting plasma glucose levels in diabetes, knowledge is lacking about the acute effects of agar on gastric emptying and the post-prandial glycaemic profiles. The present study was designed to investigate the acute effects of agar. 2. Ten healthy male volunteers were studied on three occasions with three different test meals (450 kcal/500 mL): (i) a fibre-free meal; (ii) a meal with 2.0 g agar; or (iii) a meal with 5.2 g pectin. On each occasion, participants underwent a [(13)C]-acetate breath test along with serial blood sampling. To quantify gastric emptying, the half [(13)CO(2)] excretion time (t((1/2)b)) and the time for maximal [(13)CO(2)] excretion rate (t(lag)) were determined. The post-prandial glycaemic response was expressed as an incremental change from the fasting value at each sampling time. Data were analysed using repeated-measures analysis of variance (anova), followed by a post hoc paired Student's t-test with Bonferroni adjustment. 3. The time-course for respiratory [(13)CO(2)] excretion differed significantly among the three test meals (P = 0.0004, anova). Compared with the control meal, [(13)CO(2)] excretion was significantly lower following consumption of the agar meal (between 40 and 105 min post-prandially; P < 0.025, Student's t-test) and the pectin meal (between 40 and 180 min post-prandially; P < 0.025, Student's t-test). Among the three meals, significant differences were found in t((1/2)b) (P = 0.002, anova) and t(lag) (P = 0.011, anova). Compared with the control meal, the agar and pectin meals exhibited a significantly prolonged t((1/2)b) (P = 0.007 and P < 0.0001, respectively, Student's t-test) and t(lag) (P = 0.006 and P = 0.002, respectively, Student's t-test). Neither the agar nor pectin meal affected the post-prandial glucose profile. 4. In healthy adults, agar and pectin delay gastric emptying but have no impact on the post-prandial glucose response.
PMID: 17880369 [PubMed - indexed for MEDLINE]
Hypocholesterolemic effect of katsuobushi, smoke-dried bonito, prevents ovarian hormone deficiency-induced hypercholesterolemia.
J Nutr Sci Vitaminol (Tokyo). 2007 Jun;53(3):225-31
Authors: Matsumoto J, Enami K, Doi M, Kishida T, Ebihara K
The purpose of this study was to examine whether katsuobushi, smoked-dried bonito (KB), which is a traditional Japanese food, prevents ovarian hormone deficiency-induced hypercholesterolemia. In experiment 1, ovariectomized rats (OVX-rats) were fed a purified diet containing casein or KB. Compared with the casein diet, the KB diet reduced the plasma cholesterol concentration and apparent protein digestibility, and increased the fecal dry weight and fecal bile acid excretion. In experiment 2, OVX-rats were fed one of the following four diets: casein diet containing corn oil or fish oil (CA/CO or CA/FO), or a diet containing the digested or undigested fraction of KB after treatment with microbial protease (KBE or KBR). KBR contains mainly two components: oil and protease-undigested protein of KB origin. In comparison with the CA/CO diet, the KBE diet did not affect the plasma and liver lipids concentrations, apparent protein digestibility nor fecal bile acid excretion. However, the KBR and CA/FO diets reduced the plasma cholesterol and triacylglycerol (TAG) concentrations and the liver total lipid and TAG concentrations, but increased the liver total and esterified cholesterol concentrations. The KBR diet increased fecal bile acid excretion and fecal dry weight, whereas the CA/FO diet did not. Thus, the preventive effect of KB on the ovarian hormone deficiency-associated increase in plasma cholesterol concentration appears to be mediated by an increase in bile acid excretion through a promoted secretion of bile acids by the binding of bile acids to resistant proteins.
PMID: 17874827 [PubMed - indexed for MEDLINE]
Diet and the risk of gastric cancer: review of epidemiological evidence.
Gastric Cancer. 2007;10(2):75-83
Authors: Tsugane S, Sasazuki S
There are geographic and ethnic differences in the incidence of gastric cancer around the world as well as with its trends for each population over time. The incidence patterns observed among immigrants change according to where they live. All of these factors serve to indicate the close association of gastric cancer with modifiable factors such as diet. This review presents epidemiological evidence on the association between dietary factors and gastric cancer based on previous systematic reviews and subsequent updates. Infection with Helicobacter pylori is a strong and established risk factor of gastric cancer but is not a sufficient cause for its development. Substantial evidence from ecological, case-control, and cohort studies strongly suggests that the risk may be increased with a high intake of various traditional salt-preserved foods and salt per se and decreased with a high intake of fruit and vegetables, particularly fruit. However, it remains unclear which constituents in fruit and vegetables play a significant role in gastric cancer prevention. Among them, vitamin C is a plausible candidate supported by a relatively large body of epidemiological evidence. Consumption of green tea is possibly associated with a decreased risk of gastric cancer, although the protective effects have been, for the most part, identified in Japanese women, most of whom are nonsmokers. In contrast, processed meat and N-nitroso compounds may be positively associated with the risk of gastric cancer. In conclusion, dietary modification by reducing salt and salted food intake, as well as by increasing intake of fruit and vitamin C, represents a practical strategy to prevent gastric cancer.
PMID: 17577615 [PubMed - indexed for MEDLINE]
Kazakhstan: a folate-deficient area?
Eur J Clin Nutr. 2006 Sep;60(9):1141-3
Authors: Akilzhanova A, Takamura N, Zhaojia Y, Aoyagi K, Karazhanova L, Yamashita S
OBJECTIVE: In the Republic of Kazakhstan, located in central Asia, the traditional diet consists mainly of meat, and vegetable intake tends to be deficient. This eating lifestyle may contribute to folate deficiency, which is closely linked to abnormal homocysteine (HCY) metabolism.
SUBJECTS AND METHODS: In order to evaluate current folate status in the healthy Kazakh population, we screened serum folate and plasma HCY in 50 healthy Kazakh adults aged 20-65 years (KZH) and 60 healthy Japanese control subjects aged 27-65 years (JPN).
RESULTS: Serum levels of folate were significantly lower in KZH than in JPN (3.1 vs 10.0 ng/ml, P<0.01). Fifty of 61 (82.0%) subjects in KZH but none in JPN showed low concentrations of folate (<3.6 ng/ml). Plasma levels of HCY were significantly higher in KZH than in JPN (13.2 vs 7.8 nmol/ml, P<0.01).
CONCLUSIONS: Our findings strongly suggest that owing to the insufficient intake of vegetables, folate deficiency exists in Kazakhstan. Furthermore, hyperhomocysteinemia was observed in this group, probably owing to the secondary effects of folate deficiency.
PMID: 16622445 [PubMed - indexed for MEDLINE]
Phytoestrogens derived from red clover: an alternative to estrogen replacement therapy?
J Steroid Biochem Mol Biol. 2005 Apr;94(5):499-518
Authors: Beck V, Rohr U, Jungbauer A
The benefits of plant extracts from soy and red clover as alternatives to conventional hormone replacement therapy (HRT) have been debated in the past. Here, an attempt has been made to summarize the biochemical and pharmacological data in the light of clinical aspects. Red clover and soy extracts contain isoflavones, which have a high affinity to estrogen receptor alpha (ERalpha), estrogen receptor beta (ERbeta), progesterone receptor (PR) and androgen receptor (AR). The higher affinity to ERbeta compared to ERalpha has been used as an explanation why red clover extracts function as food additives to treat menopausal disorders and may reduce risk of breast cancer. Biochemical analysis shows that these representatives of phytoestrogens have multiple actions beside selective estrogen receptor modulator (SERM)-activity. They act as selective estrogen enzyme modulators (SEEMs), have antioxidant activity and interact with transcription factors such as NF-kappaB. Furthermore, it is indicated that they have protective effects on osteoporosis and the cardiovascular system. Currently 40-50mg of isoflavones (biochanin A, daidzein, formononetin and genistein) are recommended as daily dose. This recommendation is based on the daily intake of phytoestrogens in a traditional Japanese diet.
PMID: 15876415 [PubMed - indexed for MEDLINE]
Diet and Japanese herbal medicine for recalcitrant atopic dermatitis: efficacy and safety.
Drugs Exp Clin Res. 2004;30(5-6):197-202
Authors: Kobayashi H, Mizuno N, Teramae H, Kutsuna H, Ueoku S, Onoyama J, Yamanaka K, Fujita N, Ishii M
We have been utilizing Kampo, a Japanese herbal medicine, together with lifestyle advice, for recalcitrant atopic dermatitis. To estimate the safety and efficacy of the treatment, we administered Kampo formulas to patients in whom conventional treatment failed to improve symptoms, along with dietary advice recommending traditional Japanese food. The therapeutic effects of Kampo formulas were assessed in 95 patients with recalcitrant atopic dermatitis who consulted our clinic from January to June, 2000. The overall result was 'markedly effective" in 19 patients (20%), "moderately effective" in 33 (35%), "slightly effective" in 36 (38%) and "ineffective" in four (4%). Three patients dropped out of the study. No adverse reactions in laboratory data were noted in examined patients. The most commonly used formula was Hochu-ekki-to containing Astragalus root, liquorice, jujube, ginseng, white Atractylodes rhizome, fresh ginger and Chinese Angelica root. Diet and Japanese herbal medicine are thought to be useful as an alternative therapy of intractable atopic dermatitis.
PMID: 15700746 [PubMed - indexed for MEDLINE]
Effects of agar (kanten) diet on obese patients with impaired glucose tolerance and type 2 diabetes.
Diabetes Obes Metab. 2005 Jan;7(1):40-6
Authors: Maeda H, Yamamoto R, Hirao K, Tochikubo O
AIM: The aim of this study was to evaluate the efficacy of agar diet in combination with a conventional diet (traditional Japanese food) for obese patients with impaired glucose tolerance and type 2 diabetes.
METHODS: After a 4-week run-in period on their habitual diets, 76 patients were randomly assigned to have conventional diet or conventional diet with agar. Both groups were on these diets for 12 weeks. Body weight, body mass index (BMI), glycaemic control, blood pressure, insulin resistance, total body fat, fat distribution and lipids were assessed before and after the experimental period.
RESULTS: In both groups, after 12 weeks, mean body weight, BMI, fasting glucose levels, homeostasis model assessment-insulin resistance, and systolic and diastolic blood pressures had decreased significantly from their baseline values. HbA(1)c, visceral fat area, subcutaneous fat area, total body fat, insulin area under the curve after oral glucose tolerance test and total cholesterol decreased significantly in the agar-diet group. After 12 weeks, mean changes of body weight (-2.8 +/- 2.7 kg vs. -1.3 +/- 2.3 kg, p = 0.008), BMI values (-1.1 +/- 1.1 kg/m(2) vs. -0.5 +/- 0.9 kg/m(2), p = 0.009) and total cholesterol (-7.6 +/- 27.5 mg/dl vs. + 2.4 +/- 23.4 mg/dl, p = 0.036) were significantly greater in the agar-diet group than in the conventional diet group.
CONCLUSIONS: The agar diet resulted in marked weight loss due to the maintenance of reduced calorie intake and to an improvement in metabolic parameters.
PMID: 15642074 [PubMed - indexed for MEDLINE]
Diet instruction for Japanese traditional food in therapy for atopic dermatitis.
Adv Exp Med Biol. 2004;546:281-96
Authors: Kobayashi H, Mizuno N, Teramae H, Kutsuna H, Nanatsue M, Hirai K, Ishii M
PMID: 15584382 [PubMed - indexed for MEDLINE]
Effects of Dai-saiko-to (Da-Chai-Hu-Tang) on plasma lipids and atherosclerotic lesions in female heterozygous heritable Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits.
Pharmacol Res. 2004 Sep;50(3):223-30
Authors: Yoshie F, Iizuka A, Komatsu Y, Matsumoto A, Itakura H, Kondo K
We investigated the antihypercholesterolemic effects of traditional Japanese herbal medicine Dai-saiko-to (Da-Chai-Hu-Tang in Chinese) in female heritable Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits. The plasma total cholesterol levels increased for up to 12 weeks after beginning a diet containing 0.1% cholesterol then reached a plateau of about 603 mg dl(-1). Dai-saiko-to was administered at doses of 0.5-1.0 g kg(-1) per day or pravastatin 10 mg kg(-1) per day for 24 weeks. Plasma total cholesterol levels were significantly decreased in the groups administered Dai-saiko-to 1.0 g kg(-1) per day or pravastatin for 4-24 weeks, whereas there were no change with plasma phospholipid and triglyceride levels. However, Dai-saiko-to 1.0 g kg(-1) per day significantly decreased plasma LDL cholesterol levels, but had no effect on either VLDL- or HDL-cholesterol levels. Moreover, LDL-receptor mRNA levels in the liver were significantly increased in the Dai-saiko-to 1.0 g kg(-1) per day group compared with those of animals receiving the 0.1% cholesterol diet. In addition, both groups receiving Dai-saiko-to 1.0 g kg(-1) per day and pravastatin showed a significantly reduced percentage of intimal surface area of thoracic aorta involved with atheromatous plaques in the thoracic aorta at 24 weeks. These results indicated that Dai-saiko-to 1.0 g kg(-1) per day significantly decreased the plasma cholesterol levels and atheromatous plaque area due to expression of the LDL mRNA gene in the liver.
PMID: 15225663 [PubMed - indexed for MEDLINE]
Phyto-oestrogens and prostatic growth.
Natl Med J India. 2004 Jan-Feb;17(1):22-6
Authors: Vij U, Kumar A
The incidence of and mortality from prostatic cancer in the West is higher than that in Asian countries. Migrants from Asia to western countries, who maintain their traditional diet, do not have an increased risk of prostatic cancer. This has been attributed in part to 'phyto-oestrogens' in vegetarian Asian diets. Prostatic cancer is a hormone-dependent disease and oestrogens retard the growth of prostatic tumours by interfering with the action of testosterone. Oestrogen increases the level of sex hormone-binding globulin that binds testosterone, resulting in lower free testosterone levels, thereby decreasing androgenic stimulation of the prostate. Oestrogens used to retard the growth of prostatic cancer are associated with certain undesirable side-effects. Phyto-oestrogens have weak oestrogenic potency and anticancer effects. Thus, these phytochemicals have a possible role in the prevention of hormone-dependent diseases such as prostatic cancer. Although the relative potencies of various phyto-oestrogens compared with oestradiol are low, the oestrogen receptor (ER) complexes formed byoestradiol and isoflavones have functional similarities. Also, phyto-oestrogens have a higher affinity to bind to ER-beta than ER-alpha. They are antiproliferative and inhibit tyrosine and other protein kinases which play a key role in tumorigenesis, and also inhibit the production of the potent androgen 5alpha dihydrotestosterone in the prostate. Since prostatic cancer cells usually multiply slowly and the development of this cancer can take many years before symptoms appear, the latent period provides a chemopreventive opportunity for natural therapy with phyto-oestrogens. Although phyto-oestrogens have not yet been used in long-term trials to evaluate their ability to reduce the risk of prostate carcinoma, the evidence thus far suggests that they have a protective effect against the growth of prostate tumours.
PMID: 15115228 [PubMed - indexed for MEDLINE]
[A comparison of the efficacy of conservative therapies for obese patients with osteoarthritis of the knee].
Ryumachi. 2002 Oct;42(5):795-800
Authors: Toda Y
Two hundred and five obese women with osteoarthritis of the knee (knee OA) were treated with one of the following interventions for six weeks: A nonsteroidal anti-inflammatory drug (NSAID) alone (Control, n = 16), NSAID combined with walking (n = 16), NSAID with non-weight bearing exercises (n = 16), NSAID with intra-articular hyaluronan injections (NH, n = 16), NSAID with supplement foods, glucosamine and condroitin (NS, n = 15), traditional shoe inserts, wedged insoles (NT, n = 20), NSAID with a novel insole with an elastic subtalar strapping (NN, n = 25), an energy restriction diet plus the NSAID (ND, n = 32), a diet combined with the NSAID and exercises (NDE, n = 25), and the diet combined with the NSAID and walking (NDW, n = 24). The Lequesne index was employed to obtain remission percentages, which were then compared between the ten groups. Compared with all but the NDW group, the NDE group showed a significant improvement. The NDW group also demonstrated a significant improvement, compared with all but the NDE and NN groups. The NN group showed a significant improvement compared with the control, NS and ND groups. However, for patients in the NDE and NDW groups, it was difficult to maintain body composition, even with these intervention methods. In this regard, the use of the insole with the elastic subtalar strapping was a simple and convenient method to maintain the body composition effect of the intervention method for knee OA patients.
PMID: 12462019 [PubMed - indexed for MEDLINE]
Protective effects of Saiko-ka-ryukotsu-borei-to (Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) against atherosclerosis in Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits.
Pharmacol Res. 2001 May;43(5):481-8
Authors: Yoshie F, Iizuka A, Kubo M, Komatsu Y, Matsumoto A, Itakura H, Takeda H, Matsumiya T, Kondo K
We investigated the protective effects of the traditional Japanese herbal medicine Saiko-ka-ryukotsu-borei-to (Chai-Hu-Jia-Long-Gu-Mu-Li-Tang in Chinese) (SRBT) against hypercholesterolemia and atherosclerotic lesions. We focused on atherosclerosis using female heterozygous Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits. The total plasma cholesterol levels increased for up to 12 weeks after beginning a diet containing 0.1% cholesterol and then reached a plateau of about 600 mg dl(-1). When SRBT was administered at a dose of 1.0 g kg(-1)per day for 24 weeks, total plasma cholesterol levels were significantly decreased after 20-24 weeks. On the other hand, pravastatin at a dose of 10 mg kg(-1)per day produced a significant decrease in total plasma cholesterol levels from 4 to 24 weeks (about 105-130 mg dl(-1)). Moreover, 1.0 g kg(-1)per day of SRBT significantly decreased plasma low density lipoprotein (LDL) cholesterol levels but did not change either very low density lipoprotein (VLDL), or high density lipoprotein (HDL) cholesterol levels. Animals that received pravastatin had significantly decreased LDL cholesterol levels and VLDL cholesterol levels after 8 weeks and at 24 weeks. We also examined the expression of apoB, E and LDL receptor mRNA levels in the liver at 24 weeks after beginning the administration of 1.0 g kg(-1)per day of SRBT. Both apoE and LDL receptor mRNA levels were significantly increased compared with those in rabbits receiving the 0.1% cholesterol diet. SRBT at a dose of 1.0 g kg(-1)per day significantly depressed the intimal surface area of the thoracic aortae involved with atheromatous plaques. The present results suggest that SRBT may protect against hypercholesterolemia and atheromatous lesions by affecting apoE and LDL receptor mRNA gene expression in the liver.
PMID: 11394941 [PubMed - indexed for MEDLINE]
Diet therapy and food exchange lists for diabetic patients.
Diabetes Res Clin Pract. 1994 Oct;24 Suppl:S233-40
Authors: Kitamura S
The present situation of diet therapy for diabetes in Japan is described in this chapter. The diabetic diet in Japan is based on Japanese traditional food and eating habits. So far, it has effectively contributed to the treatment of diabetes. The aim of diet therapy for the diabetic regimen in Japan is, as in other countries, firstly, to supply energy for maintaining adequate body weight and healthy social activities, and secondly, to attain glycemic control as close as possible to that of a non-diabetic person to prevent the occurrence of diabetic complications. The Japan Diabetes Society has elucidated the following principles of diet therapy for the accomplishment of the above purposes. (1) The proper amount of daily energy intake means the amount which affords physical activities. (2) The proportion of the 3 main nutrients should be: 60% as carbohydrate, 15-20% protein and 20-25% fat. (3) As to vitamins and minerals, an appropriate amount to meet the average requirement should be supplied daily. (4) It is recommended that a proper amount of fiber be taken. Furthermore, with regard to patient education, which is the most important aspect of adhering to diet therapy, an outline of the latest (1993) edition of the 'Food Exchange Lists', having been first edited in 1965 by the Japan Diabetes Society, is introduced together with its use.
PMID: 7859612 [PubMed - indexed for MEDLINE]
[Effect of traditional Chinese medicine (dai-saiko-to) on experimental calcinosis].
Nihon Yakurigaku Zasshi. 1994 Aug;104(2):85-9
Authors: Goto M, Hayashi M, Seyama Y, Yamashita S
To clarify the anti-calcinosis actions of traditional Chinese medicine (Dai: Dai-saiko-to) and estradiol benzoate (E2), 7-week or retired (about 6-months-old) female rats were treated with Vit. D2 (1.75 x 10(5) I.U./kg b.w./day) for 4 days, and then were fed a basal diet containing Dai (at ten times the medical dose in humans) or were injected i.p. with E2 (at the medical dose in humans) for 6 weeks. The following results were obtained: 1) Dai did not improve Ca and P metabolism in experimental calcinosis of 7-week female rats; 2) in retired female rats, Dai decreased both P in the heart and the ratio of Ca to P in bone, similar to the treatment with E2. Dai, as well as E2, seemed to nomalize Ca and P metabolism disturbed by Vit. D2 treatment.
PMID: 7927072 [PubMed - indexed for MEDLINE]
[Effects of traditional Chinese medicines (dai-saiko-to, sho-saiko-to and hachimi-zio-gan) on spontaneously diabetic rat (WBN/Kob) with experimentally induced lipid and mineral disorders].
Nihon Yakurigaku Zasshi. 1992 Oct;100(4):353-8
Authors: Goto M, Hayashi M, Todoroki T, Seyama Y, Yamashita S
To clarify the therapeutic effects of several traditional Chinese medicines to improve disorders of carbohydrate, lipid and mineral metabolism, spontaneously diabetic rats (WBN/Kob) were treated with Vit. D2, 1 x 10(5) I.U./kg b.w./day, for 4 days, and then fed a hyperlipidemic diet containing traditional Chinese medicines for 6 weeks. The following results were obtained: 1) In the diabetic rats, the 3 traditional Chinese medicines further decreased the blood glucose level at 120 min after glucose loading in the glucose tolerance test. 2) The drugs increased the inorganic phosphate in the liver and normalized mineral metabolic disorder. 3) Hachimi-zio-gan decreased the cholesterol content in the kidney, and Sho-saiko-to decreased the cholesterol content in the elastin fraction (elastin-cholesterol) of the kidney. Such experimental results suggest that traditional Chinese medicines may be effective against the pathological conditions of diabetes mellitus that involve disorders of lipid and mineral metabolism.
PMID: 1446886 [PubMed - indexed for MEDLINE]
Japanese dietary intake of salt and protein--relating to the strategy of salt restriction.
Tohoku J Exp Med. 1990 Dec;162(4):293-302
Authors: Sakata S, Moriyama M
The high level of Japanese salt intake, which has been the major risk factor for cerebrovascular disease and hypertension, has decreased since World War II, and reached a steady level. In the present study, the dietary salt intake in Tohoku (once the district of highest sodium intake) and that in Kyushu (once the district of median or low sodium intake) were studied in relation to nutritional status by the analysis of sodium and urea-nitrogen excretion in 24-hr urine samples collected from 305 healthy Japanese. When the amount of urinary creatinine and urea-nitrogen were adjusted, the mean value of urinary sodium in females was significantly larger in Tohoku than in Kyushu, but not significantly in males. The regional difference of salt intake still remains, although it seems to be disappearing. Traditionally, Japanese high intake of salt was accompanied by poor nutritional status. In the present study, however, a significant positive correlation was observed between sodium and urea-nitrogen. The excess of protein intake would cause the excess of salt intake. Therefore, the strategy of further salt restriction should be directed to not only traditional salty foods but also nutritional status such as protein intake.
PMID: 2102562 [PubMed - indexed for MEDLINE]
Effect of shosaikoto, daisaikoto and sannoshashinto (traditional Japanese and Chinese medicines) on experimental hyperlipidemia in rats.
J Ethnopharmacol. 1989 Oct;26(3):255-69
Authors: Umeda M, Amagaya S, Ogihara Y
Effect of Sannoshashinto, Shosaikoto and Diasaikoto, Japanese and Chinese traditional medicinal mixtures (kampohozai), on cholesterol-induced hypercholesterolemia, aging-induced hyperlipidemia and cholesterol turnover were studied in rats. Sannoshashinto, Shosaikoto and Daisaikoto reduced the hypercholesterolemia induced by a high cholesterol diet and Sannoshashinto and Daisaikoto improved the atherogenetic index. Liver total cholesterol as increased by a high cholesterol diet was reduced by all three kampohozai. Furthermore, the increases of serum and liver triglyceride were also inhibited. In an experiment using untreated aging rats, both serum total cholesterol and serum triglyceride levels were increased. The aging-induced increases of serum total cholesterol were inhibited by Sannoshashinto and Daisaikoto and the increases of serum triglyceride were reduced by all three kampohozai. These drugs showed no effect on cholesterol biosynthesis in liver. Sannoshashinto, however, appeared to accelerate the disappearance of cholesterol from blood, while Daisaikoto inhibited the cholesterol absorption from the intestine.
PMID: 2615406 [PubMed - indexed for MEDLINE]
[Comparative effects of traditional Chinese medicines (dai-saiko-to, hatimi-zio-gan and byakko-ka-ninzin-to) on experimental diabetes and hyperlipidemia].
Nihon Yakurigaku Zasshi. 1989 Mar;93(3):179-86
Authors: Goto M, Inoue H, Seyama Y, Yamashita S, Inoue O, Yumioka E
In order to clarify the anti-hyperglycemic and anti-hyperlipidemic actions of traditional Chinese medicines, experiments were carried out with experimentally diabetic rats induced by cyproheptadine treatment. The following results were obtained: 1) Dai-saiko-to decreased the blood glucose level at 30, 60 and 120 min after glucose loading in the tolerance test; and the drug tended to increase serum insulin level and increased the ratio (glucose/insulin) at 120 min after the glucose loading. A significant decrease in serum total cholesterol was observed in the high fat diet-treated rats. 2) Hatimi-zio-gan also decreased the blood glucose level at 30 and 120 min after glucose loading. The drug did not lower the serum insulin, but rather increased the glucagon level at 120 min after the loading. The serum lipid level was not reduced by the drug. 3) Byakko-ka-ninzin-to also increased serum glucagon at 120 min, but no change of glucose and lipid in the sera under the above experimental conditions was observed. Such experimental results suggest that Dai-saiko-to might exert an effect that can improve the pathological conditions of diabetes mellitus.
PMID: 2659456 [PubMed - indexed for MEDLINE]