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Journal Club

Journal Club. Nakahori N, Sekine M, Yamada M, Tatsuse T, Kido H, Suzuki M. Socioeconomic status and remaining teeth in Japan: results from the Toyama dementia survey. BMC Public Health. 2019 Jun 4;19(1):691. doi : 10.1186/s12889-019-7068-7.

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Journal Club

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  1. Journal Club Nakahori N, Sekine M, Yamada M, Tatsuse T, Kido H, Suzuki M. Socioeconomic status and remaining teeth in Japan: results from the Toyama dementia survey. BMC Public Health. 2019 Jun 4;19(1):691. doi: 10.1186/s12889-019-7068-7. Hyde PN, Sapper TN, Crabtree CD, LaFountain RA, Bowling ML, Buga A, Fell B, McSwiney FT, Dickerson RM, Miller VJ, Scandling D, Simonetti OP, Phinney SD, Kraemer WJ, King SA, Krauss RM, Volek JS. Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss. JCI Insight. 2019 Jun 20;4(12). pii: 128308. doi: 10.1172/jci.insight.128308. 埼玉医科大学　総合医療センター　内分泌・糖尿病内科 Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University 松田　昌文　 Matsuda, Masafumi 2019年7月11日　8:30-8:55 ４階　カンファレンス室

  2. http://10.52.11.119/x/hospitalclinic/DentalClinicMap_Kawagoe.pdfhttp://10.52.11.119/x/hospitalclinic/DentalClinicMap_Kawagoe.pdf

  3. 1Faculty of Nursing Science, Tsuruga Nursing University, 78-2-1 Kizaki, Tsuruga, Fukui 914-0814, Japan. 2Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan. 3Kiseikai, Kido Clinic, 244 Honoki, Imizu, Toyama 934-0053, Japan. 4Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan. BMC Public Health. 2019 Jun 4;19(1):691. doi: 10.1186/s12889-019-7068-7.

  4. Background: The prevalence of periodontal disease is increasing among elderly individuals in Japan. Reports on the risk factors for tooth loss have included socioeconomic status (SES); however, few studies have addressed the association between remaining teeth and SES by examining whether education and occupation have a synergistic effect on tooth loss. Accordingly, the present study evaluated the association of remaining teeth with the socioeconomic factors of educational and occupational histories in Japanese elderly individuals.

  5. Methods: This retrospective case-control study used data from the Toyama Dementia Survey, Japan. Toyama Prefecture residents aged ≥65 years were randomly selected for the study (sampling rate, 0.5%), and 1303 residents agreed to participate (response rate, 84.8%). Structured interviews with participants and family members (or proxies, if necessary) were conducted. Participants’ lifestyle factors (e.g., smoking and alcohol consumption), medical history, and SES (educational and occupational history) as well as the presence or absence of remaining teeth were assessed. The association between SES and remaining teeth was examined using a logistic regression analysis.

  6. Results: Overall, 275 cases with no remaining teeth and 898 controls with remaining teeth were identified. The odds ratio (OR) for complete tooth loss was higher among less educated participants (≤6 years) than among highly educated participants [age- and sex-adjusted OR, 3.29; 95% confidence interval (CI), 1.90–5.71]; furthermore, it was higher among participants with a blue-collar occupational history than among those with a white-collar occupational history (age- and sex-adjusted OR, 2.16; 95% CI, 1.52–3.06). After adjusting for employment history or educational attainment, the ORs for tooth loss were 2.79–3.07 among less educated participants and 1.89–1.93 among participants with a blue-collar occupational history. A current or former smoking habit and medical history of diabetes and osteoporosis increased the risk of tooth loss. The interaction term of a low level of education and a history of blue-collar occupation with tooth loss was not significant.

  7. Conclusions: In Japan, a low SES is a risk factor for tooth loss. A low level of education is a more important predictor of tooth loss than a blue-collar occupation. Keywords: Remaining teeth, Socioeconomic status, Educational attainment, Occupation

  8. Message 　対象となったのは、富山県認知症高齢者実態調査の対象となった65歳以上の高齢者のうち、同意を得られた1,303人。さらに今回の研究では、残存歯のない275人と、残存歯がある898人の計1,173人を対象に、残存歯の有無と、教育歴や生活習慣病等との関連性を調査した。 　その結果、喫煙、糖尿病、骨粗鬆症は、歯の喪失リスクを増加させることが明らかになった。また、短い教育歴や肉体労働の職歴も、歯の喪失リスクと関連することが分かった。 https://dm-net.co.jp/calendar/2019/029281.php

  9. 2017/10/12JC ？ Lancet. 2017 Aug 28. pii: S0140-6736(17)32252-3. doi: 10.1016/S0140-6736(17)32252-3.

  10. Original ArticleWeight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet Israel, Germany, Boston Iris Shai, R.D., Ph.D., Dan Schwarzfuchs, M.D., Yaakov Henkin, M.D., Danit R. Shahar, R.D., Ph.D., Shula Witkow, R.D., M.P.H., Ilana Greenberg, R.D., M.P.H., Rachel Golan, R.D., M.P.H., Drora Fraser, Ph.D., ArkadyBolotin, Ph.D., HilelVardi, M.Sc., OsnatTangi-Rozental, B.A., Rachel Zuk-Ramot, R.N., Benjamin Sarusi, M.Sc., DovBrickner, M.D., Ziva Schwartz, M.D., EinatSheiner, M.D., Rachel Marko, M.Sc., Esther Katorza, M.Sc., Joachim Thiery, M.D., Georg Martin Fiedler, M.D., Matthias Blüher, M.D., Michael Stumvoll, M.D., Meir J. Stampfer, M.D., Dr.P.H., for the Dietary Intervention Randomized Controlled Trial (DIRECT) Group In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non–restricted-calorie. Shai I et al. N Engl J Med 2008;359:229-241

  11. Weight Changes during 2 Years According to Diet Group Shai I et al. N Engl J Med 2008;359:229-241

  12. Changes in Cholesterol and Triglyceride Biomarkers According to Diet Group during the Maximum Weight-Loss Phase (1 to 6 Months) and the Weight-Loss Maintenance Phase (7 to 24 Months) of the 2-Year Intervention Shai I et al. N Engl J Med 2008;359:229-241

  13. Changes in Biomarkers According to Diet Group and Presence or Absence of Type 2 Diabetes • Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets • The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions Shai I et al. N Engl J Med 2008;359:229-241

  14. Difference in Mean Weight Loss Across Diets With 95%Credible Intervals The values above the named diets (blue boxes) correspond to the difference in mean weight lost between the columns and row at 12 months (eg, the difference in average weight lost between the Ornish diet and no diet at 12 months is 6.55 kg). The values below the diet classes correspond to the difference in mean weight lost between the row and the column at 6 months (eg, the difference in average weight lost between the Ornish diet and no diet at 6 months is 9.03 kg). LEARN indicates Lifestyle, Exercise, Attitudes, Relationships, and Nutrition. JAMA. 2014;312(9):923-933.

  15. JCI Insight. 2019 Jun 20;4(12). pii: 128308. doi: 10.1172/jci.insight.128308.

  16. Graphical abstract

  17. BACKGROUND. Metabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS.

  18. METHODS. Individuals who were obese with a diagnosis of MetS were fed three 4-week weight-maintenance diets that were low, moderate, and high in carbohydrate. Protein was constant and fat was exchanged isocalorically for carbohydrate across all diets.

  19. Controlled feeding and dietary intervention formulation. Specific 7-day rotational menus were developed for the 3 diet treatments: LC, MC, and HC using typical food items. Each menu was designed using a caloric intake base of 2,500 kcal and to allow for scaling options for various caloric intakes. Although individual differences in absolute intakes of food occurred, this approach allowed for relative macronutrient and micronutrient proportions to be constant between participants. Participants’ caloric needs were preliminarily determined via indirect calorimetry and the Harris-Benedict equation. At the initiation of the run-in diet, participants were fed an MC diet at a caloric intake level estimated to match energy expenditure. Any changes in body mass were monitored and caloric intake adjusted accordingly to maintain weight stability. Once body mass stabilized, no further adjustments to caloric intake were made across the interventions. All food was prepared and provided to subjects during the experimental period. All food, drinks, and seasonings were weighed to the nearest 0.1 g and prepared in a metabolic kitchen located at The Ohio State University. In order to minimize intercompany and interproduct variations, every product utilized in the trial was maintained throughout the entirety of the study. All food was prepared by baking, boiling, or sautéing and all juices were collected in order to minimize nutrient loss. Participants were instructed to eat/drink meals in their entirety, including consumption of any residual oils that may be in the containers. Adherence was tracked by the receipt of empty food containers. Detailed nutrient composition was completed a priori via Nutritionist Pro (Axxya Systems) for every meal to ensure accurate macro-/micronutrient composition. Mean nutrient intakes for the diet periods are reported in Supplemental Table 2. All 3 investigational diets were isocaloric, isonitrogenous, and contained a scalable amount of cheese (Cheddar and Gouda) that approximated 6 oz/day of full-fat cheese per 2,500 kcal. The MC diet was created to be comparable to the standard American diet with approximately one-third energy from fat and half from carbohydrate. It was high in potatoes and a mix of whole and processed grains, with at least 5 servings of fruits and vegetables every day. For the HC diet, we cut out fat primarily from animal products (except cheese) and scaled carbohydrate proportionately with at least 5 servings of fruits and vegetables per day. For the LC diet, we did the opposite. Because the primary vector for saturated fat was provided in the form of full-fat cheese products, polyunsaturated fat was relatively low for all diets. The main sources of polyunsaturated fat came from fatty meats, nuts, and condiments such as mayonnaise.

  20. Figure 3. A eucaloric weight-stable LC diet rapidly reverses MetS in individuals who are obese, independent of weight loss. (A) Individual diagnosis of MetS after LC, MC, and HC diets. Women are represented as pink figures and men are in blue. All data n = 16.

  21. Figure 3. A eucaloric weight-stable LC diet rapidly reverses MetS in individuals who are obese, independent of weight loss. (B) Change in criteria for MetS relative to baseline after LC, MC, and HC diets. Circles represent individual participants, the thick line is the mean, and thin lines are 95% CIs. P value from 3-way (LC, MC, HC) repeated-measures ANOVA. Values not sharing a common letter are different (P < 0.05). All data n = 16.

  22. RESULTS. Despite maintaining body mass, low-carbohydrate (LC) intake enhanced fat oxidation and was more effective in reversing MetS, especially high triglycerides, low HDL-C, and the small LDL subclass phenotype. Carbohydrate restriction also improved abnormal fatty acid composition, an emerging MetS feature. Despite containing 2.5 times more saturated fat than the high-carbohydrate diet, an LC diet decreased plasma total saturated fat and palmitoleate and increased arachidonate.

  23. CONCLUSION. Consistent with the perspective that MetS is a pathologic state that manifests as dietary carbohydrate intolerance, these results show that compared with eucaloric high-carbohydrate intake, LC/high-fat diets benefit MetS independent of whole-body or fat mass. TRIAL REGISTRATION. ClinicalTrials.gov Identifier: NCT02918422. FUNDING. Dairy Management Inc. and the Dutch Dairy Association.

  24. Message 　研究チームは4ヵ月をかけて、エネルギー消費量が同じになるように調整した、▼低炭水化物、▼中炭水化物、▼高炭水化物の食事を参加者に摂ってもらい、それぞれの間に2週間の休みを入れた。 　参加者が食事を食べる順序はランダムに割り当てられた。3つの食事パターンはすべて20%のタンパク質を含み、▼低炭水化物ダイエット(炭水化物6%、脂肪74%)、▼中炭水化物ダイエット(炭水化物32%、脂肪48%)、▼高炭水化物ダイエット(炭水化物57%、脂肪23%)という内容だった。 　その結果、低炭水化物ダイエットを1ヵ月続けた場合、さまざまな検査値が改善することが明らかになった。中性脂肪値は低下し、コレステロール値も改善した。 SGLT2阻害薬が効果があるのも当然か。基本的に低炭水化物食の効果というより仮説は「dietary carbohydrate intolerance (i.e., the inability to process carbohydrate in a healthy manner) rather than obesity per se is a fundamental feature of MetS.」なのだが。 https://dm-net.co.jp/calendar/2019/029294.php

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