[Individualized health education with sports gym use and dietary advice for overweight and obese persons in a community. Kokuho Health-up model Program in Chikusei-shi (former Kyowa town)].

OBJECTIVE: We aimed to evaluate the effect of a community-based health educational program for overweight or obesity persons, as the Kokuho Health-up model Program in Kyowa area of Chikusei-shi. METHODS: The subjects were men and women aged 35 to 60 years who participated in annual health check-ups from 1998 to 2003 and were living in Chikusei-shi (Former Kyowa town) Ibaraki prefecture, had a body mass index > or = 25.0 kg/m2 at baseline, and agreed to a 6-month intervention. The participants were divided into 59 persons for the intense intervention group (health checkups, dietary advice, monthly individual health education, and exercise in sports facilities three times/ week), 62 persons for the moderate intervention group (health checkups, dietary advice, monthly individual health education, and exercise in sports facilities or at home once/week), and 34 persons for the control group (only health checkups). Criteria for the metabolic syndrome were those published by the Japanese 8 committee. RESULT: During the 6-month intervention, the follow-up rate was 86%. At the baseline, there were no differences in physical status or lifestyles among the intervention and control groups. The frequency of use of sports facilities was 6.4 times/month for the intense intervention group and 1.9 times/month for the moderate intervention group. Mean body weight did not change in the control group (70.6 kg to 70.9 kg, P = 0.84) but decreased in the intense intervention group (71.4 kg to 69.5 kg, P < 0.001) and moderate intervention group (69.5 kg to 66.7 kg, P < 0.001). Mean abdominal circumference increased in the control group (91.0 cm to 93.9 cm, P = 0.001) but did not change in intense intervention group (90.1 cm to 90.0 cm, P = 0.29) or moderate intervention group (90.4 cm to 88.7 cm, P = 0.39). The prevalence of metabolic syndrome increased in the control group (18.2% to 40.0%, P = 0.01) but did not change in either of the intervention groups. CONCLUSIONS: We found a significant reduction of body weight and an attenuation of the increase of metabolic syndrome in both intensive and moderate intervention groups. The present community-based educational program may be effective for health promotion with overweight or obese middle-aged adults.