糖尿病とメタボリックシンドロームの予防

Visceral fat accumulation plays a central role in the onset and progression of type ２ diabetes and metabolic syndrome. It has been pointed out that Japanese are more likely to have visceral fat accumulation even if their BMI is less than２５kg/m２. Lifestyle-related interventions aimed at weight loss significantly reduce the onset of type ２ diabetes and metabolic syndrome. Visceral fat is characterized by a tendency to decrease from an early stage of weight loss, and a decrease in visceral fat can be expected by a few percent weight loss. It has been reported that weight loss of ３ to ５％ from the current body weight improves hyperglycemia, dyslipidemia, high blood pressure, hyperuricemia, and NAFLD, which are the components of metabolic syndrome. The diet is required to maintain adequate total energy intake, limit energy ratio of lipid, and reduce the amount of saturated fatty acids. In addition to exercising, increasing daily physical activity and reducing sedentary time are also effective for weight loss. The preventive effect of metabolic syndrome can be obtained by combining short-term exercises even if they are not continuous. On the other hand, it is known that being low body weight in the elderly person increase the risk of death. Until middle and old age, prevention of obesity is important because metabolic syndrome consisting of hypernutrition and obesity causes lifestyle-related diseases such as diabetes and dyslipidemia, increasing the risk of death. Since weight loss can reduce skeletal muscle mass as well as fat mass in the elderly, it is important to take measures against undernutrition so as not to limit energy intake too much. Furthermore, in the elderly, it is necessary to combine multiple types of exercise not only to prevent metabolic syndrome and diabetes, but also to prevent sarcopenia and frailty.