Table 20. Step 5 Lifestyle items to be improved.

Smoking cessation: No smoking is mandatory. Prevent passive smoking.

Weight control:

Weigh yourself regularly.

If BMI ＜25, maintain an appropriate weight.

If BMI ≥ 25, reduce energy intake to less than energy expenditure to lose weight.

Dietary management

Consume an adequate amount of energy and a good balance of the three macronutrients (protein, fat, and carbohydrates), vitamins, and minerals.

Avoid excessive intake of saturated fats and cholesterol.

Avoid trans fatty acids.

Increase intake of n‐3 polyunsaturated fatty acids.

Increase fiber intake.

Reduce salt intake, aiming for less than 6 g/day.

Physical Activity and Exercise

Perform exercise habitually, mainly aerobic exercise of moderate or greater intensity ＊ (aim for a total of at least 30 minutes daily).

Remind them to reduce sedentary behavior＊＊ and stay active in their daily lives.

In addition to aerobic exercise, resistance and flexibility exercises should be performed.

Drinking

Alcohol consumption should be limited to 25 g＊＊＊ of ethanol per day or less. Establish a day off from drinking.

^＊Moderate or greater means intensity of 3 METs or greater, where METs is a unit of activity intensity that indicates the number of times the resting metabolic rate. ^＊＊Sedentary behaviors are all arousalbehaviors with an energy expenditure of 1.5 METs or less in the sitting and lying positions. ^＊＊＊ Equivalent to approximately 1 cup of sake, 1 medium beer bottle, half cup of shochu, doublewhiskey/brandy, or 2 glasses of wine.