2.1 Recruitment
metabolic syndrome, heart failure, hypertension, hypertriglyceridemia
RECRUITMENT, UNSTABLE ANGINA, HEART FAILURE, HYPERTRIGLYCERIDEMIA, METABOLIC SYNDROME, FOOD ALLERGY, HYPERTENSION
The participants of the current study are the employees in the NISSIN Foods Holdings Co., Ltd (Tokyo, Japan) working at that company's main office (Shinjuku, Tokyo) and at the company's research center (Hachioji, Tokyo). The NISSIN Foods Holdings Co., Ltd had no conflict of interest to this study. Subject recruitment criteria included: those with the ages of 20 to 74 and with BMI≥25 and/or waist circumstance ≥85 cm for men and ≥90 cm for women (consistent with the diagnostic criteria of metabolic syndrome in Japan). The exclusion criteria were those who needed special dietary therapy such as protein restriction and/or severe food allergy, those with severe hypertension (systolic blood pressure ≥160 mmHg and diastolic blood pressure ≥110 mmHg), those with severe hypertriglyceridemia (≥1000 mg/dl), those who required exercise restriction (e.g., those with heart failure and/or unstable angina), those who were pregnant, planning to become pregnant, or were breastfeeding, and those who the researchers judged difficult to participate in the program (e.g., those who were going to be absent due to a long trip). Based on the most recent health checkup data, employees who met the criteria were invited to participate in this study via e-mails from the staffs of the company. After signing the informed consent, participants were randomly divided into two groups: the weekly group, who attended four weekly classes; and the bi-weekly group, who attended four classes every other week. We employed a stratified randomization method which controlled for age, sex, BMI, and working place (The current study was approved by the Institutional Ethics Review Board of Osaka University Hospital (approved number 21335) and informed consent was obtained from all participants.