Journal of International Medical

Research
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Rate of Eating and Body Weight in Patients with Type 2 Diabetes or

Hyperlipidaemia
S Takayama, Y Akamine, T Okabe, Y Koya, M Haraguchi, Y Miyata, T Sakai, H Sakura and T
Sasaki
Journal of International Medical Research 2002 30: 442
DOI: 10.1177/147323000203000413
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The Journal of International Medical Research

2002; 30: 442 444

Rate of Eating and Body Weight in

Patients with Type 2 Diabetes or
Hyperlipidaemia
S TAKAYAMA1, Y AKAMINE1, T OKABE1, Y KOYA1, M HARAGUCHI1, Y MIYATA1,
T SAKAI1, H SAKURA2 AND T SASAKI1
1

Social Insurance Uguisudani Health Care Centre, Tokyo, Japan; 2Diabetes Centre,
Tokyo Womens Medical University School of Medicine, Tokyo, Japan

This preliminary investigation, involving

422 patients, tested the hypothesis that
rate of eating is associated with obesity
in patients with type 2 diabetes or
hyperlipidaemia at all ages. The patients
eating habits were determined using a
questionnaire, and the patients were
classified as quick, normal or slow eaters.
The body mass indices of the three groups
were compared. The body mass indices

of the male patients who ate quickly

(25.4 0.2 kg/m2) were significantly
higher than those of the patients who ate
at a normal rate (24.4 0.3 kg/m2) or
slowly (24.1 0.5 kg/m2). No difference
between body mass indices in the female
groups was found. It was speculated that
rate of eating affects body weight in male
patients with type 2 diabetes or
hyperlipidaemia.

KEY WORDS: TYPE 2 DIABETES; HYPERLIPIDAEMIA; OBESITY; DIETARY

BEHAVIOUR THERAPY; BODY MASS INDEX; RATE OF EATING

THERAPY;

Introduction

lead to poor eating habits. To the authors

Most patients with type 2 diabetes are

significantly overweight, and there is no doubt
that obesity plays a major role in the
pathophysiology of the disease. Obese diabetic
patients have a higher prevalence of
associated vascular conditions, such as arterial
hypertension.1 Clinically, patients with type 2
diabetes or hyperlipidaemia frequently have
problems controlling food intake and, for
example, may feel excessively hungry. This
presents problems, as dietary therapy is a key
element in treating patients with type 2
diabetes. Also, in todays society, many people
have too many work/family commitments,
and meals are often eaten in a hurry; this can

the relationship between rate of eating, body

knowledge, there have been few studies of

weight, age and sex, although Shigeta et al.2
have suggested that the risk of obesity in
quick eaters is higher than that in slow
eaters. This preliminary study aimed to test
the hypothesis that the rate of eating is
associated with obesity in patients with type 2
diabetes or hyperlipidaemia at all ages.

Patients and methods

PATIENTS
Patients included in the study were males
and females with type 2 diabetes or
hyperlipidaemia who attended the Social

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442

S Takayama, Y Akamine, T Okabe et al.

Rate of eating, body weight and type 2 diabetes
Insurance Uguisudani Health Care Centre in
Tokyo, Japan. Participants gave verbal informed
consent to take part in the study, which was
approved by the institutes review board.

characteristics (mean SD): age, 50

10 years; fasting glucose, 126 30 mg/dl;
total cholesterol, 219 43 mg/dl; highdensity lipoprotein cholesterol, 55 28 mg/dl;
and triglycerides, 184 134 mg/dl.

METHOD OF EVALUATION

In the male patients, rate of eating

Details of eating habits were collected using a

questionnaire. Patients were asked to assess if
they ate quickly, normally or slowly compared
with people they ate with, and were grouped
accordingly. The body mass indices (BMIs) and
levels of fasting glucose, total cholesterol,
high-density lipoprotein cholesterol and
triglycerides of the patients were determined.

correlated with age (the distribution of those

eating quickly according to age was: 70.3% of
those aged < 39 years; 60.2% of those aged
40 49 years; 60.6% of those aged 50
59 years; and 47.9% of those aged > 60 years;
2 test, P = 0.015). The BMIs of the male
patients in each group, adjusted for age using
the minimum square average (analysis of
covariance), were compared (Fig. 1). The BMIs

STATISTICAL ANALYSIS
The multiple comparison and tests were
used. P < 0.05 was considered to be
statistically significant.
2

(mean SEM) of the male patients who ate

quickly were significantly higher than those of
the patients who ate normally or slowly (25.4
0.2 kg/m2 versus 24.4 0.3 kg/m2 [P = 0.006]

Results

and 24.1 0.5 kg/m2 [P = 0.01], respectively).

A total of 422 patients with type 2 diabetes or

hyperlipidaemia were evaluated. There were
372 males and 50 females with the following

In comparison, there was no difference in BMI

between the female patients who ate quickly,
normally or slowly.

P = 0.01
P = 0.006

27

BMIs (kg/m2)

26
25
24
23
22
21
20
0

Quick

Normal

Slow

Rate of eating
FIGURE 1: A comparison of the body mass indices (BMIs) (mean SEM) for the three
groups of males who eat quickly, normally and slowly. The BMIs of patients in each
group, adjusted for age using the minimum square average (analysis of covariance),
were compared statistically. P < 0.05 is statistically significant

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443

S Takayama, Y Akamine, T Okabe et al.

Rate of eating, body weight and type 2 diabetes

Discussion
From these results, it is speculated that rate of
eating affects body weight in male patients
with type 2 diabetes or hyperlipidaemia. The
lack of association found in female patients
may be due to the limited numbers in the
female sample.
The cornerstone of treatment for type 2
diabetes is weight loss, continued weight
control through diet and increased physical
activity. Weight loss in patients with type 2
diabetes is associated with both improved
glycaemic control and reduced cardiovascular
disease risk factors.3 5 A previous study
reported that quick eaters have a risk of
obesity 1.8 times that of slow eaters, and a 1.5fold risk for insulin resistance.2 Behavioural
therapy significantly reduces over-eating in
obese patients.6 Ookuma et al.7 reported that
recording chewing habits is effective in the

reduction and maintenance of body weight.

The degree of mastication greatly influences
the rate of eating, and the combination of
mastication and taste can induce changes in
gastric motility in humans.8
The patients self-evaluated their rate of
eating, and the method did not consider
other factors, such as how often meals were
eaten and the nutritional content of the
meals. In light of the trends noted in this
preliminary study, the investigation will
be developed further. Further studies to
examine
the
relationship
between
mastication, rate of eating and body weight
are planned.

Acknowledgement
Part of this study was presented at the 11th
KoreaJapan Symposium on Diabetes
Mellitus, Pusan, Korea, 2001.

Received for publication 7 March 2002 Accepted 8 May 2002

2002 Cambridge Medical Publications
References
1 Scheen AJ: Treating obesity rather than diabetes:
a valuable option for the management of the
obese diabetic patient. Int Diabetes Monitor 1999;
11: 2 4.
2 Shigeta H, Shigeta M, Nakazawa A, Nakamura
N, Yoshikawa T: Lifestyle, obesity, and insulin
resistance. Diabetes Care 2001; 24: 608.
3 Maggio CA, Pi-Sunyer FX: The prevention and
treatment of obesity. Application to type 2
diabetes. Diabetes Care 1997; 20: 1744 1766.
4 Bosello O, Armellini F, Zamboni M, Fitchet M: The
benefits of modest weight loss in type 2 diabetes.
Int J Obesity 1997; 21 (Suppl 1): S10 S13.
5 Wing RR, Blair EH, Bononi P, Marcus MD,
Watanabe R, Bergman RN: Caloric restriction

per se is a significant factor in improvements in

glycemic control and insulin sensitivity during
weight loss in obese NIDDM patients. Diabetes
Care 1994; 17: 30 36.
6 Fujimoto K, Sakata T, Etou H: Charting of daily
weight pattern reinforces maintenance of
weight reduction in moderately obese patients.
Am J Med Sci 1992; 303: 145 150.
7 Ookuma K, Yoshimatsu H, Sakata T, Adachi K:
The effect of chewing chart recording in the
treatment of obesity. Jpn J Psychosom Med 2000;
40: 247 253.
8 Takayama S, Sakura H, Kaiho T, Iwamoto Y:
The combination of mastication and tasting
induces changes in gastric motility (abstract).
Euro J Physiol 2001; 441 (Suppl): R184.

Address for correspondence

Dr S Takayama
Social Insurance Uguisudani Health Care Centre, 2-19-19 Negishi, Taito-ku,
Tokyo 110-0003, Japan.
E-mail: s-taka@ceres.dti.ne.jp
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