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This study aimed to explore the association of breakfast (BF) dietary patterns with physical activity (PA) and fitness in elementary school children. This study enrolled 242 school children of 5th and 6th grade. BF dietary patterns were evaluated by questionnaires on whether the child consumes the following food categories: staple, main dish, side dish, soup, milk or dairy products, and fruit. Individual PA levels were categorized into high and low PA groups using a PA scale for children. The measured 8 assessments of physical fitness scores were converted to Z-scores normalized for sex, age and height as previously reported. High PA group had significantly higher scores in running and muscle strength as well as in the total score of physical fitness. The frequency of eating BF (with or without BF omission) and the level of PA were not significantly related in both sexes. However, in girl children, BF, including staple, main dish, side dish, and soup, was significantly more prevalent in high PA group than low PA group (55.9% vs. 32.1%; χ2 = 5.638, p = 0.018). A similar tendency was observed in girls who had BF, including staple, main dish, and side dish (49.0% vs. 31.1%; χ2 = 3.720, p = 0.054). No associations between dietary patterns and PA were observed in boys. The results suggested that the frequency of eating BF was not associated with PA levels, which was significantly related to physical fitness in Japanese 5th and 6th grade elementary school children. In contrast, the results indicated that a high-quality BF dietary pattern, such as a meal including staple, main dish, side dish, and soup, might be associated with a physically active girl child.
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This study aimed to examine characteristics of physical functions, physical activity, and cognitive functions among community-dwelling older people who stopped driving automobiles. Participants were 589 community-dwelling older people (age: 65–89, 71.4 ± 5.1 years; 403 men, 186 women). The participants underwent nine physical assessments—hand grip strength, knee extension strength, timed up-and-go test, chair stand, one leg standing with open eyes, functional reach, vertical jump, preferred gait speed, maximal gait speed—and were evaluated for physical activity; and five cognitive assessments—the Mini-Mental State Examination (MMSE), Logical Memory I and II (WMS-R LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and Trail Making Test A and B (TMT-A, TMT-B). They were divided into current driver (379 men, 169 women) and driving cessation (24 men, 17 women) groups. Among men, the driving cessation group had poorer vertical jump, TMT-A, and TMT-B results, while women had poorer hand grip strength, one leg standing with open eyes, WMS-R LM-II, and LM-II results, and longer inactivity time, compared with the current driver group and adjusted for covariates (P < 0.05 for all). The findings suggest driving cessation among community-dwelling older people is significantly associated with poorer physical functions, physical activity, and cognitive functions compared with those in current drivers.
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OBJECTIVES@#To assess the vitamin D status in postmenopausal women with osteoporotic fractures, determine its concentration by fracture site at the clinical setting, and compare the proportion of vitamin D deficiency with that reported in literature.@*METHODS@#The prospective study included 317 postmenopausal women with osteoporotic fractures who were treated consecutively from 2016 to 2018. After obtaining informed consent for participation in the seamless treatment of osteoporosis against fractures study, which is our initiative to prevent secondary osteoporotic fractures, we registered the patients, examined bone mineral density (BMD) at the unfractured femoral neck and lumbar spine, serum 25-hydroxyvitamin D (25(OH)D) concentration, blood chemistry, and bone turnover markers.@*RESULTS@#The mean age of the patients was 80.7 years. Moreover, 78% of patients of all fractures had 25(OH)D concentration < 20 ng/mL, whereas 12% of patients had 25(OH)D concentration ≥ 30 ng/mL 25(OH)D concentration in hip fractures was significantly lower than that in vertebral or distal radius fractures (P < 0.05). Multiple regression analysis revealed that 25(OH)D concentration is significantly associated with femoral neck BMD (β = 0.16; 95% confidence interval [CI], 0.78–12.17, P = 0.03) and serum albumin concentration (β = 0.21; 95% CI, 0.62–2.96, P < 0.001) in patients with 25(OH)D concentration < 30 ng/mL.@*CONCLUSIONS@#The results of this study show that the proportion of postmenopausal women with osteoporotic fractures who had vitamin D deficiency was higher than the proportion in previous reports that examined general postmenopausal women (35.2%–52.0%).
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<p>High fat diet consumption induces fat accumulation in the liver. An understanding of when liver fat accumulation begins is important for exploring the mechanisms underlying fatty liver. The aim of this study was to investigate the processes of fat accumulation in the liver during high fat diet consumption with or without exercise using computed tomography (CT). Male 6 week old C57BL/6J mice were randomly assigned to the normal diet or high fat diet group. After 6 weeks, mice in the high-fat diet group were further divided into voluntary wheel exercise (HFD+Ex) and no exercise (HFD) groups. We measured body weight, food intake and locomotor activity in all mice. Liver fat accumulation was measured by CT scan weekly. Blood and tissue sampling was performed at the end of the experimental period. Following the 6 week exercise period, total body, mesenteric fat and liver weight in the HFD+Ex group were significantly lower than those in the HFD group. Alanine aminotransferase levels improved in HFD+Ex mice compared with those of HFD mice. The hounsfield unit value in HFD mice decreased between 3 and 8 weeks, suggesting that liver fat accumulation accelerated during this period. In contrast this decrease was not observed one week after exercise in HFD+Ex mice. These results suggest that liver fat accumulation estimated by CT was not observed until the 3rd week of high fat feeding while the effects of voluntary wheel exercise appeared immediately.</p>
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<p>This study evaluates the pertinent cutoffs of Timed Up and Go (TUG) and Chair Stand (CS) tests for detecting cognitive impairment risk in Japanese elderly. Subjects were community-dwelling adults aged 65 or older (N = 455, 129 men and 326 women). Cognitive function was examined using Urakami’s test for Alzheimer’s disease; physical function was examined by TUG and CS. The maximum score for cognitive function was 15; impairment was defined as 12 or less. Receiver operating characteristic (ROC) analyses were performed to find an appropriate cutoff of TUG and CS for cognitive impairment. Furthermore, the sensitivity and specificity of the combined use of these measures independently distinguishing between subjects with and without a risk for cognitive impairment were determined. Fifty-four subjects (12%) scored as impaired on Urakami’s test. The optimal TUG cutoff for cognitive impairment was 6 seconds and 9 seconds for CS. The combined use of TUG and CS, based on a subject being positive on at least one measure, yielded sensitivity of 78% and specificity of 50%. Area under the ROC curve of TUG and CS were respectively 0.67 and 0.66. When divided into two groups according to the TUG cutoff value, the odds ratio of cognitive impairment in the slower group was 2.1 (95% confidence interval 1.25-3.37). For CS cutoff, the slower-group odds ratio was 3.57 (95% confidence interval 2.20-5.81). For TUG and CS combined, the slower-group odds ratio was 2.11 (95% confidence interval 1.03-4.34). TUG and CS are thus potent predictors for cognitive impairment among elderly adults.</p>
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<p>This study examined whether physical and cognitive function was independently associated with risk of Musculoskeletal Ambulation Disorder Symptom Complex (MADS) in community-dwelling older people. We examined 640 older people (315 men, 325 women; 65–89 years). We assessed physical performance by one-leg standing with eyes open, timed up and go (TUG), muscle strength, muscle power, and gait speed. Cognition was assessed using Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Trail-Making Tests (TMT) A and B. We divided participants by physical function into “MADS” (one-leg standing < 15s or TUG ≥ 11s) and “non-MADS”, and identified cognitive impairment if MMSE was < 27 and CDR ≥ 0.5. We also grouped by sex and age (younger-old: 65–74 years and older-old: 75–89 years), and controlled for age, Body Mass Index, education and steps. Physical and cognitive function was significantly worse in the MADS groups. The younger-old men had poorer muscle strength, muscle power and TMT-A. The younger-old women had poorer muscle power, gait speed, MMSE and TMT-B. Older-old men had poorer muscle strength, and older-old women poorer gait speed (P < 0.05). The MADS groups also had significantly higher adjusted odds ratio (OR) for cognitive impairment (younger-old men: OR: 4.62; 95% confidence interval [CI]: 1.08–19.8; younger-old women: OR: 6.09; 95% CI: 1.03–35.9; P < 0.05). This study suggested that poorer physical and cognitive function was significantly associated with the risk of MADS, and these associations may be differ with sex and age.</p>
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<b>Objective: </b>Many patients in Kagawa University Hospital are administered medicines prepared by the simple suspension method. Pharmacists in charge of these patients receive inquiries from doctors and nurses regarding the suitability of medicines for the simple suspension method. Answering these inquiries is complicated and time-consuming as multiple data sources need to be searched. In order to simplify these complicated procedures, we herein attempted to develop a novel database to provide valuable information that could contribute to the safe performance of the simple suspension method, and evaluated its usefulness.<br><b>Method: </b>The specifications of the database were determined by analyzing previously answered inquiries. To evaluate the usefulness of the database, we used test prescriptions and compared the amount of time required to gather information using the database and the conventional method, i.e., using books alone. We also analyzed previous prescriptions with the database in order to determine what kinds of problems could be detected.<br><b>Results: </b>The investigation of previous prescriptions indicated that some medicines needed to be examined not only for their suitability for the simple suspension method, but also their incompatibility. Therefore, we added a feature regarding the incompatibility of medicines to the database. The time required to gather the information needed to answer the test prescription was shorter with our database than with the conventional method. Furthermore, the database improved the detection of medicines that require particular attention for their properties including incompatibility. An analysis of previous prescriptions using our database indicated the possibility of incompatibility in half of the previous prescriptions examined.<br><b>Conclusion: </b>Our database could rapidly provide information related to the simple suspension method, including the incompatibility of medicines.
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This study aimed to examine the effects of an 8-week physical activity program, which mainly comprised home-based bench-stepping exercise training at the intensity of lactate threshold (LT), on mental health (MH), health-related quality of life (HRQOL), and physical fitness in Japanese returnees from China. Thirty Japanese returnees (63 ± 9 y) participated in the exercise program. Another six subjects were enrolled as the control group. The subjects performed 212 ± 57 min of training, and their daily step counts were increased. Aerobic capacity (LT: 4.5 ± 0.8 vs. 5.5 ± 1.1 METs), lower limb strength (30-s chair stand test [CS-30]: 19.1 ± 5.5 vs. 21.3 ± 5.1 times), and sit-and-reach flexibility (sitting-posture body anteflexion: 36.1 ± 9.4 vs. 39.0 ± 8.4 cm) were significantly increased after the intervention compared with before the intervention. Furthermore, MH, as assessed by the total score of the GHQ-28 (3.4 ± 4.4 vs. 0.3 ± 0.8 points), and the mental component score (MCS) of HRQOL, as evaluated by the SF-36v2 (55.1 ± 11.4 vs. 58.5 ± 10.0), were significantly changed in a positive manner. However, a two-way repeated measures ANOVA (group × period) showed significant interactions for LT and MCS (p<0.05), and a tendency for interactions of CS-30 (p=0.063) and the total score of the GHQ-28 (p=0.098). These results indicate that this bench-stepping exercise program could become a useful health support program for improving physical fitness, as well as MH and HRQOL, in Japanese returnees.
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Recent health guidelines suggest that children should accumulate 60 minutes of physical activity (PA) of moderate to vigorous intensity every day. The purpose of this study was to assess PA on weekdays, in addition to physical fitness, in elementary school children during short-term extracurricular activities (EA). Children from an elementary school (n=160) who carried out EA were assigned to the EA group, and children from the neighboring elementary school (n=210) comprised the non-EA group. A physical fitness test was applied to evaluate physical fitness in pupils. Moreover, 48 children (EA, n=24; non-EA, n=24) wore a pedometer with a uniaxial accelerometer to determine the amount of PA and time spent in moderate- to vigorous-intensity PA. The PA of EA was evaluated with the exception of the short program (10 min). Jogging distance of the EA was 1357 ± 333 m, average speed was 170 ± 42 m/min. The estimated energy consumption of jogging was 55 ± 19 kcal. Multiple items of the physical fitness test scored significantly higher in the EA group than in non-EA subjects. Total step counts were 15485 ± 1915 steps/day for the EA group and 12363 ± 2464 steps/day for the non-EA group on weekdays (p<0.001). Time spent in moderate- to vigorous-intensity PA on weekdays was 61.6 ± 10.0 min/day for EA children and 46.5 ± 12.9 min/day for non-EA children (p<0.001). In addition, the extent of PA in the EA group was higher than the amount recommended for children in general. This study suggested that short-term EA are related to both the fitness and PA levels of elementary school children.
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Recent studies indicate that exercise with a low muscle glycogen state enhances exercise-induced metabolic adaptation. However, it is unclear whether metabolic adaptation is involved with muscle glycogen depletion level. In this study, we investigated the effects of prior muscle glycogen depletion level on metabolic response during acute continuous exercise. Seven men completed two experimental trials consisting of two exercise sessions per day. During the first session, participants performed either intermittent exercise (IE) at VO<sub>2</sub>max (the IE-CE trial) or continuous exercise (CE) at lactate threshold (the CE-CE trial). During the second session, participants performed 60 minutes of CE at lactate threshold. During this second session, fatty acid oxidation (FAO) was calculated. To determine muscle glycogen content and PGC-1α and PDK-4 mRNA abundance, muscle biopsies were taken at rest after the first session and 2 hours after the second session. After the first session, muscle glycogen content was significantly lower in the IE-CE trial (38.1±5.0 mmol/kg w.w.) than in the CE-CE trial (56.7±10.2 mmol/kg w.w.), <i>P</i><0.05. FAO was higher in the IE-CE trial than the CE-CE trial at baseline and 15 minutes after the second session (both <i>P</i><0.05). PGC-1α mRNA abundance increased after exercise (IE-CE, 5.9±2.5; CE-CE, 2.6±1.3-fold; <i>P</i><0.1). PDK-4 mRNA abundance increased significantly after exercise (IE-CE, 22.2±8.8; CE-CE, 31.5±10.6-fold; <i>P</i><0.05). PGC-1α and PDK-4 mRNA were not significantly different between the trials. In conclusion, continuous exercise with a slightly muscle glycogen-depleted state induced similar level of PGC-1α and PDK-4 mRNA expression, but attenuated FAO, compared to exercise with a moderate muscle glycogen-depleted state.
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It is well known that decreased physical performance induces the decreased activity of daily living and increment of mortality rate in elderly subjects. On the other hand, a prolonged heart rate corrected-QT (QTc) interval is associated with an increased risk of cardiac sudden death and cardiac autonomic dysfunction. We investigated the associations between physical performance and QTc interval in elderly subjects. The subjects included 605 elderly persons (274 men and 331 women, age; 71.2±4.7 years) without a history of cardiovascular disease and taking cardioactive drugs. Resting 12-leads electrocardiography was measured after more than 5 minutes of rest. The QTc interval was calculated according to Bazett’s formula. The physical fitness test was performed to determine the physical performance (muscle strength, balance and walking abilities). The subjects were divided into four categories, which were defined as equally quantile distributions of QTc interval. The physical performance levels were significantly lower in the longest QTc interval group compared to the shortest QTc interval group in both men and women (p<0.05, respectively). Moreover, after adjusting for the age, the physical performance levels were significantly lower in the longest QTc interval group compared to the shortest QTc interval group, especially, this relationship was observed in late-stage elderly group (p<0.05, respectively). These results suggest that decreased physical performance levels were also associated with prolonged QTc interval in elderly subjects.
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Since the effect of the submaximal aerobic exercise on bone had been controversial, the aim of this study was to elucidate the effect of the bench step (BS), that seemed to deliver higher mechanical load on bone than any other aerobic exercises, on the total bone mineral content (BMC) and the bone metabolism of menopausal women. Sixteen menopausal women (65 ± 9 years old) as the exercise group (ExG) and 28 pre-menopausal women (43 ± 3 years old) as the control group (CG) were studied. ExG carried out BS training with the exercise intensity at lactate threshold (LT) for 21 weeks. In ExG, BMC was measured by dual energy X-ray absorptiometry (DXA) at one year before the intervention (A year before), pre-intervention (Pre) and post-intervention (Post). Serum osteocalcin (OC) as the marker of bone formation and serum type I collagen cross-linked N-telopeptide (NTx) as the marker of bone absorption at Pre, 11th week of the intervention and Post. In CG, BMC was measured annually without the intervention. In ExG, OC was not changed, but NTx was significantly decreased by intervention (<i>p</i><0.05). The decreased amount of annual change in BMC between a year before and Pre (T1) was significantly higher compared to that between Pre and Post (T2) (<i>p</i><0.01) and CG (<i>p</i><0.001). There was no significant difference between T2 and CG. In conclusion, BS with LT could prevent decreasing BMC in menopausal women, and maintain the same level of BMC in pre-menopausal women by suppressing the bone absorption.
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Evaluation of the physical fitness level of children and adolescents must include consideration of individual growth rates. This study evaluates the relationship between height and physical fitness in a large sample of 6-17 yr students. Physical fitness test scores were calculated for every 1 cm height group and used to generate quadratic regression equations. Physical fitness data reported by the Ministry of Education, Culture, Sports, Science and Technology in Japan (MEXT) were compared with estimated values obtained using our regression equations. The differences between the values reported by MEXT and our estimated values were very small. Comparison of physical fitness T-scores calculated based on school grade averages with T-scores based on means calculated using our regression equations indicated that shorter height students had lower T-scores if school grade averages were used for the calculation. In conclusion, in elementary and junior high school students, it is important to evaluate physical fitness level relative to individual physical growth.
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The decrease of muscle glycogen may be useful for the improvement of endurance performance. Intense anaerobic exercise requires a high rate of glycogen utilization, but consecutive intense anaerobic exercises induce a pronounced decline of external power and muscle glycogen consumption. We hypothesized that a long rest period between consecutive intense anaerobic exercises may aid in sustaining external power and glycogen consumption. Secondly, we hypothesized that active rest (AR) during the long resting period may be more effective than passive rest (PR).Six subjects performed four 30-second Wingate tests (WAnT) with a 4-minute recovery between each bout (Consecutive method). The subjects also performed a similar exercise procedure, but with a 30-minute seated resting period after the second bout (PR method).The other six male subjects performed four 30-second WAnTs with a 4-minute recovery between each bout, with 30-minutes of cycling at 40% VO<sub>2</sub>max after the second bout (AR method). The subjects also performed PR method.The total work during the third and fourth bouts was greatest under the AR condition, followed by the PR condition, and finally the Consecutive method (p<0.05 for all comparisons). Blood lactate concentration during resting period was significantly lower, while muscle glycogen consumption was greater AR method than PR method (p<0.05 for both).A long resting period between consecutive intense anaerobic exercises may prevent the decline in external power and work. Additionally, AR has more favorable effects on muscle glycogen consumption, resulting in very low muscle glycogen levels, even with a small total amount of exercise.
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<b>Background:</b> Although previous reports have shown a lower proportion of the ACTN3 XX genotype (R577X nonsense polymorphism) in sprint/power athletes compared with controls, possibly attributed to the importance of skeletal muscle function associated with alpha-actinin-3 deficiency, the findings on association between endurance athlete status and R577X genotype are equivocal. <b>Purpose:</b> The present study was undertaken to examine association of <i>ACTN3</i> R577X genotype with elite Japanese endurance athlete status. <b>Subjects and Methods:</b> Subjects comprised 79 elite Japanese endurance runners (E) who participated in competition at national level and 96 Japanese controls (C). We divided endurance runners into two groups, i.e., 42 national level runners (E-N) and 37 international level runners (E-I) who had represented Japan in international competition. R577X genotype (rs1815739) was analyzed by direct sequencing. Frequency differences of polymorphisms between athletes and controls were examined by Chi-square tests. <b>Result:</b> The R allele frequency tended to be higher in E group than in C group (P=0.066). When we divided E into two groups, the R allele frequency in E-I group was significantly higher than that in C group (P=0.046); whereas there were no significant differences between E-N and C groups (p=0.316). Then, the three genetic models were tested. In the additive genetic model (RR>RX>XX), there were significantly differences between E-I and C (P=0.038), but not the dominant (RR vs. RX+XX) and the recessive (RR+RX vs. XX) genetic models. <b>Conclusion:</b> R allele of the R577X genotype in the <i>ACTN3</i> gene was associated with elite Japanese endurance athlete status.
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This study sought to determine whether aerobic exercise training affects cognitive functioning among semi-independent (> 75 years) and independent elderly people. Seventy-six semi-independent and independent elderly subjects were divided into the following groups: semi-independent control (n = 16); semi-independent training (n = 13); independent control (n = 22); independent training (n = 25). During the 12-week intervention, subjects in both training groups performed a bench-stepping exercise at the intensity of the lactate threshold. Subjects were assessed at baseline and post-intervention using the Frontal Assessment Battery test (FAB), the Modified Mini-Mental State Exam (3MS), and a bench-stepping test of aerobic capacity. During the intervention, FAB scores improved only in the semi-independent training group (<i>p</i> = .002), while 3MS and MMSE scores improved in both the semi-independent training (<i>p</i> = .032 and <i>p</i> = .004) and independent training groups (<i>p</i> = .001 and <i>p</i> = .013). FAB and 3MS scores were higher in the semi-independent training (<i>p</i> = .001 and <i>p</i> = .002) compared with the semi-independent control group after the intervention. Finally, post-intervention scores for FAB, and 3MS in the semi-independent training group almost reached the baseline levels of the independent control and independent training groups. These results indicate that moderate intensity bench-stepping exercise training can improve cognitive and frontal lobe functioning in semi-independent elderly people, almost to the level exhibited by independent elderly people.
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Angiotensin I converting enzyme (ACE) gene Insertion/Deletion (I/D) polymorphism was first shown as a genetic factor which influences human physical performance in 1998. Since then, various gene polymorphisms which influence physical performance and trainability have been reported. ACE is a key enzyme which produces angiotensin II in the renin-angiotensin system, and its activity was determined by I/D polymorphism. Many studies indicate that the I/I genotype is frequently found in elite endurance athletes, while the D/D genotype is frequently found in power-oriented elite athletes. Longitudinal studies show that the D/D genotype may contribute to enhanced strength trainability. However, it is still unclear whether the I/I genotype enhances endurance trainability. Therefore, the ACE gene I/D polymorphism can be a genetic factor which influences human physical performance.
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The purpose of the present investigation was to examine the usefulness of the stepping rate for assessing the time spent in moderate to vigorous intensity physical activity (MVPA). In the present investigation, 11 young men wore two pedometers (LIFECORDER EX ; KZ, Walking Style ; WS) during controlled walking and jogging, as well as during free-living conditions for 3 days. In addition to the number of steps, the KZ determined the time spent in physical activity based on the intensity of the physical activity (light intensity physical activity (LPA); below 3 METs, and MVPA ; above 3 METs), and the stepping rate (≧60, ≧80, or ≧100 steps·min<sup>-1</sup>). In contrast, the WS was defined as the physical activity for a stepping rate of 60 steps·min<sup>-1</sup> or more, continuously for longer than 10 min as the time spent in physical activity. Regarding the results, under continuous walking/jogging, the KZ-assessed LPA and MVPA well reflected the intensity of the physical activity. On the other hand, the WS accumulated the time spent in physical activity for longer than 90% of the actual exercise duration, regardless of the walking speed. Furthermore, the stepping rate corresponding to 3 METs was 102 steps·min<sup>-1</sup>. Under free-living conditions, however, the KZ-detected MVPA differed significantly in comparison to the time of the physical activity as determined by the other algorithms, except for the time spent in a stepping rate of 80 or higher steps·min<sup>-1</sup>. In conclusion, these results indicate that 100 steps·min<sup>-1</sup> is a useful stepping rate for the assessment of MVPA. However, under free living conditions, the stepping rate should be determined at a higher frequency than a one minute interval length in order to improve the accuracy of the MVPA assessment.
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The purpose of present study was to examine validity of accelerometer (Lifecorder ; LC) and to assess the free-living physical activity (PA) in Japanese elementary school students used by LC method. Firstly, to examine validity of LC, twelve children, aged 11.2±1.0 years, were measured total energy expenditure (TEE) by doubly labeled water method and resting energy expenditure (REE) by the expired gas analysis. Physical activity energy expenditure (PAEE) is calculated as 0.9 TEE minus REE. At the same time, PA was evaluated by both daily walk count (WC) and vigorous activity time (LC7-9) using LC method. PAEE per 1 kg body weight significantly correlated with WC (r=0.785, p<0.005) and LC7-9 (r=0.828, p<0.001). Secondly, 140 boys and 167 girls, aged 8-11 years were measured PA by LC method. WC and LC7-9 each were 13000-18000 counts and 16-32 minutes in week-day, and 8000-12500 counts and 8-18 minutes in week-end. PA analyzed by MANOVA were significantly higher in boys than in girls, and lower in week-end than in week-day, and decreased in proportion as grade. Present study suggests that LC method is a good measure of PA in free-living condition for elementary school students.
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The purpose of this study is to discuss the effects of aging and exercise on aerobic capacity in the elderly and the procedure for encouraging sedentary elderly to engage in a health promotion program based on aerobic exercise. Regular proper aerobic exercise training, even when started as an elder, induces an increase in maximal oxygen intake and lactate threshold (or ventilatory threshold) by enhancing ventricular diastolic function and oxidative capacity in muscle ; and reduces the risk factors of lifestyle related diseases. There was a need for a simple test for determining aerobic capacity and exercise prescriptions in community-dwelling elderly. We recommended two methods for this purpose : one is to determine DPBP and the other is to estimate work rate at a certain concentration (rest plus 0.1 mmol /l ) of the blood lactate based on it just after 2 A stage step exercise. Both work rate can be used not only for evaluation of the aerobic fitness level, but also a safer and effective exercise intensity to elucidate the benefit of aerobic exercise. These tests were very simple and can determine 5 to 10 people simultaneously.