Journal of International Medical Research 2002 Takayama 442 4

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The Journal of International Medical Research

2002; 30: 442 444

442

Rate of Eating and Body Weight in

Patients with Type 2 Diabetes orHyperlipidaemia

S TAKAYAMA1, Y AKAMINE1, T OKABE1, Y KOYA1, M HARAGUCHI1, Y MIYATA1,T SAKAI1, H SAKURA2 AND T SASAKI1

1Social Insurance Uguisudani Health Care Centre, Tokyo, Japan; 2Diabetes Centre,Tokyo Womens Medical University School of Medicine, Tokyo, Japan

This preliminary investigation, involving

422 patients, tested the hypothesis that

rate of eating is associated with obesity

in patients with type 2 diabetes or

hyperlipidaemia at all ages. The patients

eating habits were determined using a

questionnaire, and the patients were

classified as quick, normal or slow eaters.

The body mass indices of the three groupswere compared. The body mass indices

of the male patients who ate quickly

(25.4 0.2 kg/m2) were significantly

higher than those of the patients who ate

at a normal rate (24.4 0.3 kg/m2) or

slowly (24.1 0.5 kg/m2). No difference

between body mass indices in the female

groups was found. It was speculated that

rate of eating affects body weight in male

patients with type 2 diabetes orhyperlipidaemia.

KEY WORDS: TYPE 2 DIABETES; HYPERLIPIDAEMIA; OBESITY; DIETARY THERAPY;

BEHAVIOUR THERAPY; BODY MASS INDEX; RATE OF EATING

Introduction

Most patients with type 2 diabetes are

significantly overweight, and there is no doubt

that obesity plays a major role in the

pathophysiology of the disease. Obese diabetic

patients have a higher prevalence of

associated vascular conditions, such as arterial

hypertension.1 Clinically, patients with type 2

diabetes or hyperlipidaemia frequently have

problems controlling food intake and, for

example, may feel excessively hungry. This

presents problems, as dietary therapy is a key

element in treating patients with type 2

diabetes. Also, in todays society, many people

have too many work/family commitments,

and meals are often eaten in a hurry; this can

lead to poor eating habits. To the authors

knowledge, there have been few studies of

the relationship between rate of eating, body

weight, age and sex, although Shigeta et al.2

have suggested that the risk of obesity in

quick eaters is higher than that in slow

eaters. This preliminary study aimed to test

the hypothesis that the rate of eating is

associated with obesity in patients with type 2

diabetes or hyperlipidaemia at all ages.

Patients and methods

PATIENTS

Patients included in the study were males

and females with type 2 diabetes or

hyperlipidaemia who attended the Social

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Insurance Uguisudani Health Care Centre in

Tokyo, Japan. Participants gave verbal informed

consent to take part in the study, which was

approved by the institutes review board.

METHOD OF EVALUATION

Details of eating habits were collected using a

questionnaire. Patients were asked to assess if

they ate quickly, normally or slowly compared

with people they ate with, and were grouped

accordingly. The body mass indices (BMIs) and

levels of fasting glucose, total cholesterol,

high-density lipoprotein cholesterol and

triglycerides of the patients were determined.

STATISTICAL ANALYSIS

The multiple comparison and 2 tests were

used. P < 0.05 was considered to be

statistically significant.

Results

A total of 422 patients with type 2 diabetes or

hyperlipidaemia were evaluated. There were

372 males and 50 females with the following

characteristics (mean SD): age, 50

10 years; fasting glucose, 126 30 mg/dl;

total cholesterol, 219 43 mg/dl; high-

density lipoprotein cholesterol, 55 28 mg/dl;

and triglycerides, 184 134 mg/dl.

In the male patients, rate of eating

correlated with age (the distribution of those

eating quickly according to age was: 70.3% of

those aged < 39 years; 60.2% of those aged

40 49 years; 60.6% of those aged 50

59 years; and 47.9% of those aged > 60 years;

2 test, P = 0.015). The BMIs of the male

patients in each group, adjusted for age usingthe minimum square average (analysis of

covariance), were compared (Fig. 1). The BMIs

(mean SEM) of the male patients who ate

quickly were significantly higher than those of

the patients who ate normally or slowly (25.4

0.2 kg/m2 versus 24.4 0.3 kg/m2 [P= 0.006]

and 24.1 0.5 kg/m2 [P= 0.01], respectively).

In comparison, there was no difference in BMI

between the female patients who ate quickly,

normally or slowly.

443

S Takayama, Y Akamine, T Okabe et al.

Rate of eating, body weight and type 2 diabetes

FIGURE 1:A comparison of the body mass indices (BMIs) (mean SEM) for the threegroups of males who eat quickly, normally and slowly. The BMIs of patients in eachgroup, adjusted for age using the minimum square average (analysis of covariance),were compared statistically. P < 0.05 is statistically significant

20

21

22

2324

25

26

27

BMIs(kg/m

2)

Rate of eating

NormalQuick

P= 0.01

P= 0.006

Slow0



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Address for correspondenceDr S Takayama

Social Insurance Uguisudani Health Care Centre, 2-19-19 Negishi, Taito-ku,

Tokyo 110-0003, Japan.

E-mail: [email protected]

Discussion

From these results, it is speculated that rate of

eating affects body weight in male patients

with type 2 diabetes or hyperlipidaemia. The

lack of association found in female patients

may be due to the limited numbers in the

female sample.

The cornerstone of treatment for type 2

diabetes is weight loss, continued weight

control through diet and increased physical

activity. Weight loss in patients with type 2

diabetes is associated with both improved

glycaemic control and reduced cardiovasculardisease risk factors.3 5 A previous study

reported that quick eaters have a risk of

obesity 1.8 times that of slow eaters, and a 1.5-

fold risk for insulin resistance.2 Behavioural

therapy significantly reduces over-eating in

obese patients.6 Ookuma et al.7 reported that

recording chewing habits is effective in the

reduction and maintenance of body weight.

The degree of mastication greatly influences

the rate of eating, and the combination of

mastication and taste can induce changes in

gastric motility in humans.8

The patients self-evaluated their rate of

eating, and the method did not consider

other factors, such as how often meals were

eaten and the nutritional content of the

meals. In light of the trends noted in this

preliminary study, the investigation will

be developed further. Further studies to

examine the relationship betweenmastication, rate of eating and body weight

are planned.

Acknowledgement

Part of this study was presented at the 11th

KoreaJapan Symposium on Diabetes

Mellitus, Pusan, Korea, 2001.

444

S Takayama, Y Akamine, T Okabe et al.

Rate of eating, body weight and type 2 diabetes

References1 Scheen AJ: Treating obesity rather than diabetes:

a valuable option for the management of theobese diabetic patient. Int Diabetes Monitor 1999;11: 2 4.

2 Shigeta H, Shigeta M, Nakazawa A, NakamuraN, Yoshikawa T: Lifestyle, obesity, and insulinresistance. Diabetes Care 2001; 24: 608.

3 Maggio CA, Pi-Sunyer FX: The prevention and

treatment of obesity. Application to type 2diabetes. Diabetes Care 1997; 20: 1744 1766.

4 Bosello O, Armellini F, Zamboni M, Fitchet M: Thebenefits of modest weight loss in type 2 diabetes.Int J Obesity1997; 21 (Suppl 1): S10 S13.

5 Wing RR, Blair EH, Bononi P, Marcus MD,Watanabe R, Bergman RN: Caloric restriction

per se is a significant factor in improvements inglycemic control and insulin sensitivity duringweight loss in obese NIDDM patients. DiabetesCare 1994; 17: 30 36.

6 Fujimoto K, Sakata T, Etou H: Charting of dailyweight pattern reinforces maintenance ofweight reduction in moderately obese patients.Am J Med Sci 1992; 303: 145 150.

7 Ookuma K, Yoshimatsu H, Sakata T, Adachi K:

The effect of chewing chart recording in thetreatment of obesity.Jpn J Psychosom Med2000;40: 247 253.

8 Takayama S, Sakura H, Kaiho T, Iwamoto Y:The combination of mastication and tastinginduces changes in gastric motility (abstract).Euro J Physiol 2001; 441 (Suppl): R184.

Received for publication 7 March 2002 Accepted 8 May 20022002 Cambridge Medical Publications


Journal of International Medical Research 2002 Takayama 442 4

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