Overview of Japanese Workplace Health Promotion for Obesity and preliminary Evaluation of the Japanese National Project: Specialized Health Screenings and Health Guidance for Metabolic Syndrome

Introduction
The national project to reduce medical costs through the intervention program incorporating specialized health screenings(SHS) and health guidance(SHG) for metabolic syndrome (MetS) was begun from 2008 in Japan. But only few studys was conducted for evaluation of this project.

Methods
To show a preliminary evaluation of this national project, we showed medical status of 23,092 SHG subjects in an outsourcing health guidance company during 2008, assessed the relation between MetS risks and various lifestyle factors by cross-sectional design and evaluated preliminary efficacy for body weight and waist circumference reduction, behavior change by pre-post design.

Results
Subjects included male 16067 vs female 7025, 13950 subjects of motivational support, 40min face-to-face health guidance by PHN or dietitian vs 9142 subjects of active support, 6 months follow-up programs. Average age, weight, BMI, waist circumference was 58.5 years old, 70.1kg, 26.0, 91.2cm. About 4.6% of subjects had very high risk for hypertension, dislipidemia, diabetes or serious medical complications. The subjects with MetS were characterized by over eating and lipid intake, late dinner, eating out, eating rapidly, skip breakfast, lack of vegetables, sleep and daily physical activity. Preliminary evaluation by pre-post design showed the mean weight reduction rate was -3.4% at active support vs -2.4% at motivational support. The follow-up rate after 6 months was 85% at active support vs 90% at motivational support. The rates of Action and Maintenance stage of Prochaska's transtheoretical model increased from 29.5% to 70.2%.

Discussion
Though there were several limitations, we found some positive impact through our interventions based on the national project. But to keep this follow-up rate we must make great effort such as many remainder phone call. For the success of the national countermeasure for MetS prevention, we must consider revising stratification system for SHG, and integration of high risk & population approach including workplace health promotion.