Affiliations 

  • 1 Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Department of Health Care Administration & Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: yunfei.li90@gmail.com
  • 2 Department of Health Care Administration & Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • 3 Health Administration Program, Faculty of Business & Management, Universiti Teknologi MARA, Selangor, Malaysia. Electronic address: azizabduls.jamal@gmail.com
  • 4 Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan
  • 5 Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
  • 6 National Center for Medicine and Technology Assessment, China National Health Development Research Center, Beijing, China
  • 7 Shanghai Jiao Tong University, School of Nursing, Shanghai, China
  • 8 Department of Human Genetics, University of Chicago, Chicago, IL, USA
  • 9 School of Medicine & Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
Soc Sci Med, 2022 Dec;314:115468.
PMID: 36327638 DOI: 10.1016/j.socscimed.2022.115468

Abstract

Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.