Improvement of BMI, Body Composition, and Body Fat Distribution With Lifestyle Modification in Japanese Americans With Impaired Glucose Tolerance

  1. David Liao, MD1,
  2. Pamela J. Asberry, RN1,
  3. Jane B. Shofer, MS1,
  4. Holly Callahan, BS2,
  5. Colleen Matthys, RD2,
  6. Edward J. Boyko, MD, MPH34,
  7. Donna Leonetti, PHD5,
  8. Steven E. Kahn, MB, CHB14,
  9. Melissa Austin, PHD6,
  10. Laura Newell, PHD5,
  11. Robert S. Schwartz, MD7 and
  12. Wilfred Y. Fujimoto, MD1
  1. 1Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, Washington
  2. 2General Clinical Research Center, University of Washington, Seattle, Washington
  3. 3Division of General Internal Medicine, University of Washington, Seattle, Washington
  4. 4VA Puget Sound Health Care System, Seattle, Washington
  5. 5Department of Anthropology, University of Washington, Seattle, Washington
  6. 6Department of Epidemiology, University of Washington, Seattle, Washington
  7. 7Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, Washington


    OBJECTIVE—To determine whether diet and endurance exercise improved adiposity-related measurements in Japanese Americans with impaired glucose tolerance (IGT).

    RESEARCH DESIGN AND METHODS—This study compared the effects of an American Heart Association (AHA) step 2 diet (<30% of total calories as fat, <7% saturated fat, 55% carbohydrate, and < 200 mg cholesterol daily) plus endurance exercise for 1 h three times a week (treatment group) with an AHA step 1 diet (30% of total calories as fat, 10% saturated fat, 50% carbohydrate, and <300 mg cholesterol) plus stretching exercise three times a week (control group) on BMI, body composition (% fat), and body fat distribution at 6 and 24 months of follow-up in 64 Japanese American men and women with IGT, 58 of whom completed the study.

    RESULTS—At 6 months, the treatment group showed significantly greater reduction in percent, body fat (−1.4 ± 0.4 vs. −0.3 ± 0.3%); BMI (−1.1 ± 0.2 vs. −0.4 ± 0.1 kg/m2); subcutaneous fat by computed tomography at the abdomen (−29.3 ± 4.2 vs. −5.7 ± 5.9 cm2), thigh (−13.2 ± 3.6 vs. −3.6 ± 3.0 cm2), and thorax (−19.6 ± 3.6 vs. −8.9 ± 2.6 cm2); and skinfold thickness at the bicep (−2.0 ± 0.6 vs. 1.1 ± 0.6 mm) and tricep (−3.7 ± 0.8 vs. −0.9 ± 0.6 mm), which continued despite moving to home-based exercise for the last 18 months.

    CONCLUSIONS—Diet and endurance exercise improved BMI, body composition, and body fat distribution and, thus, may delay or prevent type 2 diabetes in Japanese Americans with IGT.


    • Address correspondence and reprint requests to David Liao, MD, Department of Medicine, Box 356426, University of Washington, Seattle, WA 98195. E-mail: liao_dave{at}

      Received for publication 25 January 2002 and accepted in revised form 10 May 2002.

      A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

      See accompany editorial on p. 1650.

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