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Dietary intake and physical activity in Japanese patients with type 2 diabetes: the Japan Diabetes Complication and its Prevention prospective study (JDCP study 8)

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Abstract

Medical nutrition therapy and exercise therapy are the cornerstones of treatment for patients with type 2 diabetes; however, there has not been a nationwide study on the actual dietary intake and physical activity status of patients since the 2000s. We aimed to clarify this in Japanese patients with type 2 diabetes using data from the Japan Diabetes Complication and its Prevention prospective (JDCP), a nationwide study launched in 2007. A total of 1992 patients with type 2 diabetes, aged 40–75 years, completed either the Brief-type, self-administered Diet History Questionnaire (1643 patients) or International Physical Activity Questionnaire (1834 patients), and their data were analyzed in this study. Mean daily energy intake for all participants was 1686.8 kcal/day, and the mean proportions of carbohydrate, protein, and fat comprising total energy intake were 60.2, 16.2, and 23.6%, respectively. The patients in this study had similar energy and nutrient intake status to patients in the 1996 Japan Diabetes Complications Study; however, Japanese patients still had higher carbohydrate and lower fat consumption than patients with diabetes in Western countries. The physical activity questionnaire reported that 31.0% of patients did not have exercise habits; this was particularly noticeable in female patients and patients under the age of 65. BMI increased from 22.7 to 24.1 kg/m2 in men and 23.2 to 24.8 kg/m2 in women from 1996 to 2007, respectively. Further research is required to investigate how dietary intake and physical activity associates with the risk of developing complications in type 2 diabetes patients.

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Acknowledgements

We thank all the patients, staff and the diabetologists all over Japan for their long-standing collaboration in this study. We thank Satoshi Sasaki, M.D., Ph.D., Professor in the Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, for helpful nutritional advice. Thanks are also extended to Ms. Mami Haga, Niigata University, for their excellent secretarial assistance.

JDCP Study Investigators JDCP Study Working Groups (representatives shown with an asterisk [*]). Nephropathy: Kazunori Utsunomiya, Daisuke Koya, Kenichi Shikata*. Retinopathy: Shigehiko Kitano*, Yukihiro Sato, Hidetoshi Yamashita, Satoshi Kato (2021–). Neuropathy: Jiro Nakamura*, Masayuki Baba. Macrovascular disease: Hitoshi Shimano, Yoshimitsu Yamasaki*, Naruhito Yoshioka. Diet therapy: Satoshi Sasaki, Jo Sato, Kinsuke Tsuda*. Exercise therapy: Yoshiharu Oshida, Hirohito Sone*. Epidemiology/statistics: Kazuo Izumi, Hideki Origasa, Rimei Nishimura*, Yasuaki Hayashino. Periodontal disease: Kouji Inagaki*, Fusanori Nishimura, Hidetoshi Noguchi. JDCP Study Regional Leaders: Hokkaido Chapter: Naruhito Yoshioka. Tohoku Chapter: Jo Sato. Kanto-Koshinetsu Chapter: Rimei Nishimura (Principal Investigator). Chubu Chapter: Jiro Nakamura. Kinki Chapter: Nobuya Inagaki. Chugoku-Shikoku Chapter: Yukio Tanizawa. Kyushu Chapter: Eiichi Araki. JDCP Study Coordination Committee: Objective: To make key decisions relating to the research project to ensure appropriate and smooth conduct of the study. Members of the Committee: Eiichi Araki, Kazuo Izumi, Nobuya Inagaki, Kohjiro Ueki, Hirohito Sone, Naoko Tajima, Yukio Tanizawa Rimei Nishimura*, Mitsuhiko Noda, Yasuaki Hayashino. JDCP Study Steering Committee (SSC): Objective: To provide guidance on key issues in the conduct of the study, with the committee set up within the JDS; to receive reports from the SCC; to make recommendations to the SCC as required; and to assess the progress of the study as well as its outcomes and report to the JDS as to whether the study is being conducted appropriately. Members of the Committee: (First-termers, 2009–2012): Yasuhiko Iwamoto, Masato Kasuga, Kishio Nanjo (Chair), Masakazu Haneda, Nigishi Hotta. (Second-termers, 2013–2017): Masato Kasuga (Chair), Yasuhiro Iso, Hiroshi Kiyohara, Masakazu Haneda, Toshimasa Yamauchi, Tsutomu Yamazaki. (Third-termers, 2018–2022): Eiichi Araki (Chair), Jiro Nakamura, Yasuhiro Iso, Hiroshi Kiyohara, Toshimasa Yamauchi, Tsutomu Yamazaki.

Funding

Funding to support this study was received from Japan Diabetes Society.

Author information

Authors and Affiliations

  1. Department of Health and Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, 471 Ebigase, Higashi-ku, Niigata, 950-8680, Japan

    Chika Horikawa

  2. Tezukayama Gakuin University Faculty of Human Sciences, 4-2-2, Harumidai, Minami-ku, Sakai-shi, Osaka, 590-0013, Japan

    Kinsuke Tsuda

  3. Medical Checkup Center, Minami Seikyo Hospital, 2-204 Minamiohdaka, Midori-ku, Nagoya, 459-8540, Japan

    Yoshiharu Oshida

  4. Tohoku Medical and Pharmaceutical University, Wakabayashi Hospital, 2-29-1, Yamatomachi, Wakabayashi-ku, Sendai, Miyagi, 984-8560, Japan

    Jo Satoh

  5. Department of Endocrinology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan

    Yasuaki Hayashino

  6. Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Naoko Tajima

  7. Division of Diabetes, Department of Internal Medicine, Metabolism and Endocrinology, Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Rimei Nishimura

  8. Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuoh-ku, Niigata, 951-8510, Japan

    Hirohito Sone

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  1. Chika Horikawa
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  8. Hirohito Sone
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Consortia

JDCP Study Group

  • Daisuke Koya
  • , Kenichi Shikata
  • , Shigehiko Kitano
  • , Yukihiro Sato
  • , Hidetoshi Yamashita
  • , Satoshi Kato
  • , Jiro Nakamura
  • , Masayuki Baba
  • , Hitoshi Shimano
  • , Yoshimitsu Yamasaki
  • , Naruhito Yoshioka
  • , Satoshi Sasaki
  • , Jo Sato
  • , Kinsuke Tsuda
  • , Yoshiharu Oshida
  • , Hirohito Sone
  • , Kazuo Izumi
  • , Hideki Origasa
  • , Rimei Nishimura
  • , Yasuaki Hayashino
  • , Kouji Inagaki
  • , Fusanori Nishimura
  • , Hidetoshi Noguchi
  • , Naruhito Yoshioka
  • , Jo Sato
  • , Rimei Nishimura
  • , Jiro Nakamura
  • , Nobuya Inagaki
  • , Yukio Tanizawa
  • , Eiichi Araki
  • , Eiichi Araki
  • , Kazuo Izumi
  • , Nobuya Inagaki
  • , Kohjiro Ueki
  • , Hirohito Sone
  • , Naoko Tajima
  • , Yukio Tanizawa Rimei Nishimura
  • , Mitsuhiko Noda
  • , Yasuaki Hayashino
  • , Yasuhiko Iwamoto
  • , Masato Kasuga
  • , Kishio Nanjo
  • , Masakazu Haneda
  • , Nigishi Hotta
  • , Masato Kasuga
  • , Yasuhiro Iso
  • , Hiroshi Kiyohara
  • , Masakazu Haneda
  • , Toshimasa Yamauchi
  • , Tsutomu Yamazaki
  • , Eiichi Araki
  • , Jiro Nakamura
  • , Yasuhiro Iso
  • , Hiroshi Kiyohara
  • , Toshimasa Yamauchi
  •  & Tsutomu Yamazak.

Corresponding author

Correspondence to Hirohito Sone.

Ethics declarations

Conflict of interest

Jo Satoh received honoraria from Boehringer Ingelheim, Eli Lilly and Company, MSD, Ono Pharmaceutical Co., Ltd., Sanofi, and Sumitomo Dainippon Pharma Co., Ltd. Yasuaki Hayashino received a research grant from Ono Pharmaceutical Co., Ltd. Rimei Nishimura received honoraria from Sanofi, Medtronic Japan Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Takeda Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., MSD, and Astellas Pharma lnc., and received subsidies or donations from Taisho Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Ltd., and Nippon Boehringer Ingelheim Co., Ltd. Hirohito Sone received a research grant from Novo Nordisk Pharma Ltd., and reports endowed departments by commercial entities from Novo Nordisk Pharma Ltd., Eisai Co., Ltd., Kyowa Kirin Co., Ltd. Astellas Pharma Inc., Taisho Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., and Takeda Pharmaceutical Co., Ltd. Chika Horikawa, Kinsuke Tsuda, Yoshiharu Oshida, and Naoko Tajima declare that they have no conflict of interest.

Ethical considerations

The protocol for the study, which is in accordance with the Declaration of Helsinki and the Ethical Guidelines for Clinical/Epidemiological Studies of the Japanese Ministry of Health Labor and Welfare, received ethical approval from the institutional review boards of the Japan Diabetes Society Research Ethics Committee and all of the participating institutes, and was registered with the UMIN Clinical Trial Registry (Registry ID UMIN000016519).

Informed consent

Written informed consent was obtained from all patients enrolled to protect their rights and welfare, and to protect them against any potential harm and risk associated with the conduct of the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The members of the JDCP Study Group are listed in Acknowledgements.

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Horikawa, C., Tsuda, K., Oshida, Y. et al. Dietary intake and physical activity in Japanese patients with type 2 diabetes: the Japan Diabetes Complication and its Prevention prospective study (JDCP study 8). Diabetol Int 13, 344–357 (2022). https://doi.org/10.1007/s13340-022-00575-0

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