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Japan wants fight against obesity to fit the Bill

Daily Yomiuri/ANN
TOKYO, May 24: Twenty million middle-aged Japanese have a problem with visceral fat, and the government wants to do something about it.
The health, labour and welfare ministry has made so-called metabolic syndrome a subject of legislation on health care reform that is being discussed at the Diet.
Metabolic syndrome, in which fat accumulates around organs, causes heart attacks and strokes. People in this country began to enjoy a richer but less healthy diet after World War II and exercise less as automobile use spread, leading more and more to become fat. Attention is now on diagnostic criteria and therapeutic approaches for the ailment.
The Japanese Society of Internal Medicine and other organisations set the diagnostic criteria for metabolic syndrome in April 2005. Men and women with a waist size of more than 85cm and 90cm, respectively, are judged to possibly have the syndrome. In addition, patients have two of the following three problems; systolic blood pressure over 130 mmHg, or minimal blood pressure over 85 mmHg; blood-sugar level over 110 mg/dL when hungry; and neutral fat in blood over 150 mg/dL, or high-density lipoprotein cholesterol below 40 mg/dL.
According to the health ministry, metabolic syndrome sufferers number 9.4 million among those aged between 40 and 74, and incipient sufferers are estimated to be 10.2 million in this particular age group. One in two men and one in five women in this group are at risk of the syndrome, according to the estimate.
The syndrome is regarded as dangerous because it has been learned that visceral fat can cause diabetes, high blood pressure, and hyperlipemia. What makes it more dangerous is that obesity and the three diseases, when combined together, greatly elevates the probability that a person will suffer a heart attack or stroke.
A research group of the ministry found in 2001 that people with two of the health problems listed above are 5.8 times more likely to develop heart disease than those who have none. The probability is 35.8 times higher for those with metabolic syndrome, which means having three or all of the four problems.
The ministry mapped out measures for metabolic syndrome, as a pillar of a program aimed at preventing life-style related diseases, in a package of Bills concerning health care program reforms now under deliberation in the current Diet session.
The measures include stronger promotion for health checkups and more frequent health guidance by public health nurses and dietitians for people aged 40 and over. A target also was set to reduce the number of cases and incipient cases by 25 per cent by
fiscal 2015. It seems appropriate to take notice of metabolic syndrome when trying to prevent heart disease. But the size of the problem becomes evident when one considers that half of middle-aged men are at risk of suffering from the syndrome. The criteria for the syndrome are much tighter in Japan than in the USA, as is seen in the difference of the waist size standard. The USA sets the obesity threshold at 102cm for men, while the US standard is stricter for women than in Japan, at 88cm.
The Japanese criteria are based on domestic research studying the link between the amount of visceral fat found to be present by diagnostic imaging and risk factors such as high blood pressure and hyperlipemia.
Tokai University Prof. Yoichi Ogushi pointed out that the data were inadequate as visceral fat was measured when a person had only one risk factor, but to study metabolic syndrome a person with multiple risk factors should be surveyed