Hitoshi Nishizawa

Background/Objectives: Patterns or biases in food preferences are thought to influence eating behavior. However, their associations with obesity remain unclear. We aimed to identify obesity-related food preference characteristics in the general population. Methods: We analyzed a nationwide web-based survey of adults in Japan (7,971 men and 7,524 women). Preferences for carbohydrates, fat, protein, and dietary fiber were assessed using the Japan Food Preference Questionnaire (JFPQ). Associations between food preference scores and BMI were evaluated in individuals with a BMI ≥18.5 kg/m². Moreover, food preference scores were compared between individuals with normal weight (BMI 18.5 to 2) and those with obesity (BMI ≥25.0 kg/m²), stratified by time since the last meal (<3 vs. ≥3 h). Results: A higher BMI was associated with a greater preference for non-sweet fat and soft drinks and with a lower preference for dietary fiber, particularly vegetables, in both genders. Compared with individuals with normal weight, meal-timing-related differences in food preference scores were less apparent in individuals with obesity, accompanied by higher carbohydrate, fat, and protein preference scores at <3 h after the last meal. Conclusions: Obesity was associated with distinct self-reported food preference patterns that may influence food choices and weight gain. Food preference profiling could be useful for identifying individuals at risk of future obesity and for guiding nutritional counseling in weight management.

Obesity and type 2 diabetes mellitus (T2DM) are growing global health burdens, with dietary patterns, particularly high intake of carbohydrate- and fat-rich foods, contributing to disease progression. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), is effective for both lowering blood glucose and reducing weight; however, its effects on food preferences for specific macronutrients remain unclear. In this retrospective observational study, we enrolled 32 obese subjects with T2DM who were hospitalized for glycemic control, including 20 who started semaglutide treatment (the Sema group) and 12 who did not receive GLP-1RA therapy. Eating behaviors were assessed using the Dietary Behavior Questionnaire from the Japan Society for the Study of Obesity (JASSO-DBQ), and food preferences for carbohydrates, fat, protein, and dietary fiber were quantitatively evaluated using the Japan Food Preference Questionnaire (JFPQ). Thirteen subjects in the Sema group and eight in the Non-GLP-1 group completed 6-months of follow-up. The Sema group showed significant decreases in HbA1c levels (–1.1%) and body weight (–5.7 kg), with fat loss exceeding skeletal muscle loss. Significant decreases were observed in eating behavior scores for “Eating Motives,” “Way of Eating,” and “Dietary Content.” Notably, semaglutide significantly reduced preferences for sweet and non-sweet carbohydrates and non-sweet fats, without changing protein or dietary fiber preferences. In particular, significant reductions were observed in preferences for Japanese staple foods (e.g., white rice and udon/soba) and high-fat snacks. The Non-GLP-1 group showed no significant changes in food preferences for any of the nutrient categories. In summary, semaglutide treatment in obese subjects with T2DM facilitated weight loss, in part by altering food preferences, which potentially contributed to its metabolic benefits.

Aims: Identifying habitual patterns of eating behaviour underlying obesity is essential for effective weight loss interventions. This study aimed to clarify differences in eating behaviours among obese individuals in a large‐scale Japanese population. Materials and Methods: We analysed data from an online survey completed by 17 766 individuals aged 20–69 years. Eating behaviours were assessed using the Dietary Behaviour Questionnaire from the Japan Society for the Study of Obesity. Differences in the seven eating behaviour domains were examined by sex (Wilcoxon rank‐sum test), age (Steel test with the 20s as the reference), and BMI category (Steel–Dwass test), classified as normal weight (18.5 to 2 ), overweight (25 to 2 ), or obese (≥30 kg/m ² ). Results: Among the normal‐weight subjects, females scored higher than males in all domains except ‘Way of Eating’ and ‘Dietary Content’, whereas the eating behaviour scores declined with age across all of the domains in both sexes. Across the BMI categories, scores for all of the domains significantly increased with increasing obesity levels in both sexes. Particularly in males, significant differences were also observed between overweight and obese subjects. Additionally, age‐related declines in scores were less pronounced among obese individuals. Furthermore, significant positive correlations between scores for all domains and BMI were observed in both sexes, even after adjusting for age. Conclusions: Our findings revealed significant differences in a wide range of eating behaviours across sex, age, and obesity levels. These results may contribute to the development of evidence‐based strategies for the treatment of obesity disease.

Multi-kinase inhibitors (MKIs), such as lenvatinib, have been approved for the treatment of various malignancies. Although hypertension and hypothyroidism are well-recognized adverse events, primary adrenal insufficiency (PAI) remains underrecognized. Herein, we present a case series of 3 patients who developed mild PAI during treatment with lenvatinib and pembrolizumab for advanced cancer. Several months after treatment initiation, plasma ACTH levels increased and remained elevated despite normal serum cortisol levels. In 1 patient, plasma ACTH levels improved during treatment interruption but increased again after resumption. All patients were suggested to have mild or subclinical PAI based on a reduced cortisol response to a 250 μg ACTH stimulation test. Based on clinical features, PAI is likely attributed to lenvatinib, although a potential contribution from pembrolizumab cannot be ruled out. All patients were asymptomatic but were initiated on hydrocortisone. To date, detailed reports on MKI-related PAI are limited to a few studies with small sample sizes. Consequently, many cases of MKI-related PAI may remain undiagnosed because of a lack of awareness of the disease. Therefore, it is essential to recognize the potential for MKI-related PAI and closely monitor adrenal function during MKI treatment for early diagnosis and appropriate management.

Aims: The effect of uric acid (UA)-lowering therapy with xanthine oxidoreductase (XOR) inhibitors on the development of cardiovascular disease requires further investigation. This study aimed to evaluate the long-term effects of febuxostat on arterial stiffness, focusing on liver function.Methods: The PRIZE study involved random assignment of patients with asymptomatic hyperuricemia to receive either add-on febuxostat treatment (febuxostat group) or non-pharmacological treatment (control group). Of the 514 participants, 23 and 14 patients in the febuxostat and control groups, respectively, underwent assessment of arterial stiffness using the cardio-ankle vascular index (CAVI). The participants in each group were further grouped on the basis of their baseline alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels (above or below the media value or 30 U/L). The primary endpoint was the change in the CAVI from baseline to 12 and 24 months.Results: Overall, no significant differences were found between the control and febuxostat groups in the least-squares mean estimates of changes in CAVI at 24 months (mean between-group difference, −0.41 [95% CI, −1.05 to 0.23]; p=0.204). However, there were significant differences in participants with higher baseline ALT or AST levels above 30 U/L at 24 months (mean between-group difference, −1.12 [95% CI, −2.23 to −0.01]; p=0.048 for ALT ≥ 30 U/L and −1.08 [95% CI, −2.13 to −0.03]; p=0.044 for AST ≥ 30 U/L).Conclusions: Two-year treatment with febuxostat demonstrated a beneficial effect on CAVI in patients with hyperuricemia and liver dysfunction.

Blood levels of hypoxanthine (HX) have been suggested as potential biomarkers associated with intramuscular metabolic dynamics in response to exercise. This pilot randomized crossover trial (UMIN000036520) aimed to investigate the changes in plasma HX after whole-body vibration exercise (WBVE) and their relationships with body composition and muscle-related parameters, enrolling eighteen healthy male volunteers. In the WBVE-alone intervention, the study subjects performed 20-min of WBVE. In the OGTT → WBVE intervention, a 75-g oral glucose load (OGL) was administered 30 min prior to the start of the WBVE intervention. Blood samples were collected before the start and 10 min after the end of WBVE in both interventions. WBVE resulted in a significant increase in plasma HX levels, which was accompanied by increased blood ammonia, pyruvic acid, and lactic acid levels. The HX increase following WBVE was suppressed by prior OGL. In the WBVE-alone intervention, there were no significant correlations between the post-WBVE changes in plasma HX (ΔHX) levels and any of the clinical parameters. On the other hand, in the OGTT → WBVE intervention, ΔHX showed significant negative correlations with muscle mass (ρ = –0.62, p = 0.01), strength (ρ = –0.71, p = 0.005), and muscle quality (ρ = –0.81, p = 0.0007) in the legs. In conclusion, these findings suggest possible associations between post-WBVE increases in plasma HX levels and muscle status, particularly under the glucose-supplemented condition. The measurement of plasma HX concentrations following WBVE may have clinical applications in the identification of high-risk populations for sarcopenia.

Background/Objectives: Understanding food preferences is important for weight management. However, methods for assessing food preferences are not well established, especially in Japan. This study aimed to examine detailed food preferences and their associations with actual food intake in non-obese and abdominal-obese subjects using a newly developed questionnaire tailored for the Japanese population. Methods: We developed the Japan Food Preference Questionnaire (JFPQ) to evaluate food preferences across four nutrient groups based on nutritional evidence: carbohydrate, fat, protein, and dietary fiber. A total of 38 non-obese and 30 abdominal-obese participants completed both the JFPQ and the Food Frequency Questionnaire (FFQ). Food preferences for each nutrient were compared between the two groups, and correlations between food preferences (assessed by the JFPQ) and food intake (assessed by the FFQ) were analyzed. Results: Compared with the non-obese group, the abdominal-obese group showed significantly greater preferences for carbohydrates, fat, and protein, with no significant difference in dietary fiber after adjusting for age and sex. Furthermore, in the abdominal-obese group, positive correlations were found between actual intake and preference for high-fat and high-carbohydrate foods. Conclusions: Our findings from this pilot study demonstrated that abdominal-obese individuals had greater preferences for fat and carbohydrates, which were linked to actual fat and carbohydrate intake and possibly contributed to the development of obesity.