This article presents harm reduction, which was recently developed in response to the expansion of injection drug use and the HIV/AIDS epidemic. The authors describe the essence of harm reduction, proposing that harm reduction is a pragmatic strategy from a public health perspective to deal with injection drug use. Also, how harm reduction complements the traditional strategies to eradicate illicit drug use based on abstinence (so called, War on Drugs, or Just Say NO) is discussed. By describing key principles of harm reduction, such as low-threshold programs, non-judgmental attitudes, priority of immediate goals, and balancing costs and benefits, the authors introduce major harm reduction programs, which include needle/syringe exchange, outreach, counseling and education, supervised injection sites, and substitution treatment. Substantial evidence demonstrates harm reduction is effective in preventing the spread of HIV. Although international bodies, such as UNAIDS and WHO, advocate harm reduction strategies for the better prevention from the spread of HIV/AIDS, and some countries have adopted national harm reduction policies, United States discourages harm reduction policies in fighting the global HIV/AIDS pandemic. Finally, the authors address the effectiveness of harm reduction from the public health perspectives to deal with AIDS epidemic among injection drug users and the necessity of comprehensive understanding and multifaceted application of harm reduction. They also present the need to rethink Japanese government policies and social programs to meet drug users' health needs.

BACKGROUND/OBJECTIVES: Mulberry leaves contain quercetin derivatives, which have the effects of reducing obesity and improving lipid and glucose metabolism in mice with obesity. It is not clear whether or not mulberry leaves can directly affect metabolic disorders, in the presence of obesity, because of the interaction between obesity and metabolic disorders. The aim of the current study was to assess the direct action of quercetin derivatives on metabolic disorders in non-obese conditions in short-term high-fat diet fed mice. MATERIALS/METHODS: C57BL/6N mice were fed a high-fat diet, supplemented with either 0% (control), 1%, or 3% mulberry leaf powder (Mul) or 1% catechin powder for five days. Anthropometric parameters and blood biochemistry were determined, and hepatic gene expression associated with lipid and glucose metabolism was analyzed. RESULTS: Body and white fat weights did not differ among the four groups. Plasma triglycerides, total cholesterol, and free fatty acids in the 1%, 3% Mul and catechin groups did not differ significantly from those of the controls, however, plasma glucose and 8-isoprostane levels were significantly reduced. Liver gene expression of gp91phox, a main component of NADPH oxidase, was significantly down-regulated, and PPAR-alpha, related to beta-oxidation, was significantly up-regulated. FAS and GPAT, involved in lipid metabolism, were significantly down-regulated, and Ehhadh was significantly up-regulated. Glucose-metabolism related genes, L-PK and G6Pase, were significantly down-regulated, while GK was significantly up-regulated in the two Mul groups compared to the control group. CONCLUSIONS: Our results suggest that the Mul quercetin derivatives can directly improve lipid and glucose metabolism by reducing oxidative stress and enhancing beta-oxidation. The 1% Mul and 1% catechin groups had similar levels of polyphenol compound intake (0.4 x 10(-5) vs 0.4 x 10(-5) mole/5 days) and exhibited similar effects, but neither showed dose-dependent effects on lipid and glucose metabolism or oxidative stress.
Adipose Tissue, White ; Animals ; Biochemistry ; Blood Glucose ; Catechin ; Cholesterol ; Diet, High-Fat ; Fatty Acids, Nonesterified ; Gene Expression* ; Glucose* ; Lipid Metabolism ; Liver ; Metabolism* ; Mice* ; Morus* ; NADPH Oxidase ; Obesity ; Oxidative Stress ; Plasma ; Quercetin* ; Triglycerides ; Weights and Measures

BACKGROUND/OBJECTIVES: Mulberry leaves contain quercetin derivatives, which have the effects of reducing obesity and improving lipid and glucose metabolism in mice with obesity. It is not clear whether or not mulberry leaves can directly affect metabolic disorders, in the presence of obesity, because of the interaction between obesity and metabolic disorders. The aim of the current study was to assess the direct action of quercetin derivatives on metabolic disorders in non-obese conditions in short-term high-fat diet fed mice. MATERIALS/METHODS: C57BL/6N mice were fed a high-fat diet, supplemented with either 0% (control), 1%, or 3% mulberry leaf powder (Mul) or 1% catechin powder for five days. Anthropometric parameters and blood biochemistry were determined, and hepatic gene expression associated with lipid and glucose metabolism was analyzed. RESULTS: Body and white fat weights did not differ among the four groups. Plasma triglycerides, total cholesterol, and free fatty acids in the 1%, 3% Mul and catechin groups did not differ significantly from those of the controls, however, plasma glucose and 8-isoprostane levels were significantly reduced. Liver gene expression of gp91phox, a main component of NADPH oxidase, was significantly down-regulated, and PPAR-alpha, related to beta-oxidation, was significantly up-regulated. FAS and GPAT, involved in lipid metabolism, were significantly down-regulated, and Ehhadh was significantly up-regulated. Glucose-metabolism related genes, L-PK and G6Pase, were significantly down-regulated, while GK was significantly up-regulated in the two Mul groups compared to the control group. CONCLUSIONS: Our results suggest that the Mul quercetin derivatives can directly improve lipid and glucose metabolism by reducing oxidative stress and enhancing beta-oxidation. The 1% Mul and 1% catechin groups had similar levels of polyphenol compound intake (0.4 x 10(-5) vs 0.4 x 10(-5) mole/5 days) and exhibited similar effects, but neither showed dose-dependent effects on lipid and glucose metabolism or oxidative stress.
Adipose Tissue, White ; Animals ; Biochemistry ; Blood Glucose ; Catechin ; Cholesterol ; Diet, High-Fat ; Fatty Acids, Nonesterified ; Gene Expression* ; Glucose* ; Lipid Metabolism ; Liver ; Metabolism* ; Mice* ; Morus* ; NADPH Oxidase ; Obesity ; Oxidative Stress ; Plasma ; Quercetin* ; Triglycerides ; Weights and Measures

The anti-obesity effects of a hot water extract from wasabi (Wasabia japonica Matsum.) leaves (WLE), without its specific pungent constituents, such as allyl-isothiocyanate, were investigated in high fat-diet induced mice. C57J/BL mice were fed a high-fat diet (control group) or a high-fat diet supplemented with 5% WLE (WLE group). Physical parameters and blood profiles were determined. Gene expression associated with lipid metabolism in liver and white adipose tissue were analyzed. After 120 days of feeding, significantly lower body weight gain, liver weight and epididymal white adipose tissue weight was observed in the WLE group compared to the control group. In liver gene expression within the WLE group, PPARalpha was significantly enhanced and SREBP-1c was significantly suppressed. Subsequent downstream genes controlled by these regulators were significantly suppressed. In epididymal white adipose tissue of the WLE group, expression of leptin, PPARgamma, and C/EBPalpha were significantly suppressed and adiponectin was significantly enhanced. Acox, related to fatty acid oxidization in adipocytes, was also enhanced. Our results demonstrate that the WLE dietary supplement induces mild suppression of obesity in a high-fat diet induced mice, possibly due to suppression of lipid accumulation in liver and white adipose tissue.
Adipocytes ; Adiponectin ; Adipose Tissue, White ; Animals ; Body Weight ; Diet, High-Fat ; Dietary Supplements ; Gene Expression ; Leptin ; Lipid Metabolism ; Liver ; Mice ; Obesity ; PPAR alpha ; PPAR gamma ; Sterol Regulatory Element Binding Protein 1 ; Water

The purpose of this study was to investigate the consciousness among young people (n = 1016) on training body part(s), using a questionnaire-based survey showing participants a picture of a single-joint exercise. The participants were shown a picture of knee-extension exercise (KNEE-EXT), and were asked to identify the body part(s) they felt were being trained. On seeing the picture, more than 90% of the participants felt that KNEE-EXT can train the anterior thigh part. However, more than 90% of the participants who had no experience doing KNEE-EXT felt that the exercise trained not only the anterior thigh part but also other parts, including the trunk, the posterior thigh, and the upper limb. Among those participants who had performed KNEE-EXT without the experience of strength-training under professional supervision, approximately 80% felt that the exercise was appropriate to train not only the anterior thigh but also other parts. These results suggest that performing exercises by referring to only a picture may result in the individuals not properly understanding how the body part(s) should be trained during exercise, even in single-joint exercises. Appropriate supervision is of even greater importance especially for strength-training beginners. Furthermore, even among participants who had an experience of exercise under professional supervision, approximately 60% had a similar response. Therefore, to enhance the benefits of exercises, individuals (even those who have had experience in training under professional supervision) should always be instructed under appropriate supervision on the correct technique and knowledge about the exercises.