Clinical trial for introduction of the preventive measures against Lifestyle-related diseases with Specific Health checkups and Specific counseling guidance in Brunei Darussalam / 国際保健医療

  In Brunei Darussalam, obesity and diabetes mellitus are serious national health challenges, and there is an urgent, nationwide need to develop measures against these diseases. This project provides training in various efforts unique to Japan aimed at preventing lifestyle-related diseases mainly through specific medical check-ups and health guidance. The objective of this project is to form a basis for introducing a Japanese-style system in Brunei Darussalam.  In this training program, the Bruneian staff learned specific medical check-ups, strategies for applying the results of these check-ups, actual and detailed contents of the specific counselling guidance, and so forth. We can reasonably expect that implementation of these practices and the skills acquired in Brunei will enable the Bruneian staff to more effectively prevent and control diabetes and obesity.  Moreover, this project not only contributes to health promotion for Bruneian citizens, but can also be expected to have a spillover effect on neighboring Muslim countries with similar problems (e.g., Malaysia and Indonesia). The prevalence of obesity and diabetes mellitus is increasing globally in both developed and developing countries, and preventive measures are urgently needed worldwide. It seems that recognition and introduction of the efforts made in Japan are extremely meaningful and important for solving international issues.

Changes in Air Temperature and Its Relation to Ambulance Transports Due to Heat Stroke in All 47 Prefectures of Japan / 예방의학회지

OBJECTIVES: Changes in air temperature and its relation to ambulance transports due to heat stroke in all 47 prefectures, in Japan were evaluated. METHODS: Data on air temperature were obtained from the Japanese Meteorological Agency. Data on ambulance transports due to heat stroke was directly obtained from the Fire and Disaster Management Agency, Japan. We also used the number of deaths due to heat stroke from the Ministry of Health, Labour and Welfare, Japan, and population data from the Ministry of Internal Affairs and Communications. Chronological changes in parameters of air temperature were analyzed. In addition, the relation between air temperature and ambulance transports due to heat stroke in August 2010 was also evaluated by using an ecological study. RESULTS: Positive and significant changes in the parameters of air temperature that is, the mean air temperature, mean of the highest air temperature, and mean of the lowest air temperature were noted in all 47 prefectures. In addition, changes in air temperature were accelerated when adjusted for observation years. Ambulance transports due to heat stroke was significantly correlated with air temperature in the ecological study. The highest air temperature was significantly linked to ambulance transports due to heat stroke, especially in elderly subjects. CONCLUSIONS: Global warming was demonstrated in all 47 prefectures in Japan. In addition, the higher air temperature was closely associated with higher ambulance transports due to heat stroke in Japan.

Relationship Between Cigarette Smoking and Muscle Strength in Japanese Men / 예방의학회지

OBJECTIVES: To investigate the link between cigarette smoking and muscle strength in Japanese men. METHODS: We used data on 4249 Japanese men, aged 43.3+/-13.9 years, in this cross-sectional investigation study. Grip strength and leg strength were measured as indicators of overall muscle strength. Meanwhile, subjects' cigarette smoking habits were recorded by trained medical staff. The effect of cigarette smoking on muscle strength was evaluated. RESULTS: A total of 1618 men (38.1%) were smokers and 1481 men (34.9%) exercised regularly. Significant differences in muscle strength were noted between men with and without a Brinkman index of 400 or greater, after adjusting for age. After adjusting for age, height, body weight and exercise habits, associations between the Brinkman index and leg strength and the ratio of leg strength to body weight were attenuated. CONCLUSIONS: Cigarette smoking might be negatively associated with muscle strength, especially grip strength in Japanese men.

Translating from 23METs-h/wk as physical activity reference value for Japanese to daily step counts / 体力科学

A physical activity reference value for health promotion, 23 METs-h/week was established by the Ministry of Health, Welfare, and Labour in Japan in 2006. The purpose of this study was to determine the daily step counts (steps/day) that classify adults as meeting the 23 METs-h/week reference value by using objective measurements. Objectively measured physical activity levels of 1837 Japanese adults aged from 23 - 69 yrs from both urban and rural Japanese cohorts were provided. Amount of physical activity and daily step counts were assessed using a triaxial accelerometer (Actimarker EW4800; Panasonic Electric Works). Receiver operating characteristics (ROC) curve analysis determined the optimal daily step counts (steps/day) that discriminated adults who met the reference value from those who did not. Approximately 48 % of Japanese adults met the 23 METs-h/week of physical activity reference value. ROC curve analysis found that 9341 steps/day produced 77.1 % of sensitivity and 79.5 % of specificity in all subject. When the analysis was performed in each cohort, 9980 steps/day and 8640 steps/day were indicated as the optimal daily step counts for them to meet 23 METs-h/week in urban and rural cohort, respectively. These data suggest that Japanese adults are likely to meet 23 METs-h/week of physical activity reference value if they accumulate between 8500 and 10,000 steps/day of daily step counts.

DEVELOPMENT OF VO_2max PREDICTION MODELS FROM 3-MINUTE WALK TEST / 体力科学

The purpose of the study was to develop new VO_2max prediction models for Japanese men using a 3-minute walk test. One hundred and twenty-seven Japanese men aged from 20 to 69 years were recruited as subjects of the present study. Maximal oxygen uptake (VO_2max) was measured with a maximal incremental test on a bicycle ergometer. The prediction models were derived using data of age, 3-minute walking distance (3MWD), and either BMI, waist circumference (WC), or %Fat. This data was cross-validated by using PRESS cross-validation procedures. 3MWD was significantly related to VO_2max (<i>r</i> = 0.54, P<0.001). The multiple correlation coefficients for the BMI, WC, and %Fat models, respectively, were 0.81, 0.82, and 0.85. The standard error of estimate (SEE) was 4.5, 4.4, and 4.1 ml·kg^-1·min^-1, respectively, for the BMI, WC, and %Fat models. All regression models demonstrated a high level of cross-validity supported by the minor shrinkage of the coefficient of determination and increment of SEE in the PRESS procedure. This study demonstrated that 3MWD was useful for predicting VO_2max accurately using VO_2max prediction models for Japanese men. The new non-exercise prediction equations derived in this study are applicable to estimating VO_2max in Japanese adult men.

Relationship between changes in body weight and waist circumference in Japanese

<p><b>OBJECTIVES</b>We investigated the correlation between changes in body weight and body composition parameters.</p><p><b>METHODS</b>We used the data of 2635 Japanese (40.2±12.2 years) at baseline and at 1-year follow-up from a database of 13522 subjects, which is available at the Okayama Southern Institute of Health in Okayama prefecture, Japan. Body weight, waist circumference at the umbilical level, hip circumference, and body fat percentage were used in the analyses.</p><p><b>RESULTS</b>Body composition parameters were significantly reduced after 1 year. Changes in body weight significantly correlated with changes in waist circumference, changes in hip circumference, and changes in body fat percentage. A decrease in body weight of 3 kg corresponded to a 3.45 cm decrease in waist circumference in men and a 2.83 cm decrease in that in women.</p><p><b>CONCLUSION</b>A decrease in body weight of 3 kg corresponded to an almost 3 cm decrease in waist circumference at the umbilical level in Japanese men and women.</p>

Relationship between Changes in Body Weight and Waist Circumference in Japanese

Objectives: We investigated the correlation between changes in body weight and body composition parameters. Methods: We used the data of 2635 Japanese (40.2±12.2 years) at baseline and at 1-year follow-up from a database of 13522 subjects, which is available at the Okayama Southern Institute of Health in Okayama prefecture, Japan. Body weight, waist circumference at the umbilical level, hip circumference, and body fat percentage were used in the analyses. Results: Body composition parameters were significantly reduced after 1 year. Changes in body weight significantly correlated with changes in waist circumference, changes in hip circumference, and changes in body fat percentage. A decrease in body weight of 3 kg corresponded to a 3.45 cm decrease in waist circumference in men and a 2.83 cm decrease in that in women. Conclusion: A decrease in body weight of 3 kg corresponded to an almost 3 cm decrease in waist circumference at the umbilical level in Japanese men and women.

LONG-TERM EFFECTS OF LIFESTYLE PHYSICAL ACTIVITY INTERVENTION AND STRUCTURED EXERCISE INTERVENTION / 体力科学

To promote habitual participation in physical activity, a 3-month program for lifestyle physical activity intervention (L group) and structured exercise intervention (E group) was carried out in a community in Okayama Prefecture. One year later, we compared the two intervention groups in terms of cost-effectiveness and behavioral change in habitual physical activity. A total of 250 subjects voluntarily participated in the lifestyle physical activity intervention ; and a total of 42 subjects participated in the structured exercise intervention. The number of participants decreased to 115 (46%) and 21 (50%), respectively, one year later. However, the proportion of subjects who practice endurance exercise increased significantly in both L and E groups ; and an additional 35 subjects (30%) started to practice endurance exercise in L group and 5 (24%) in E group after the interventions. The cost-effectiveness for a person newly starting the endurance exercise practice in the L group intervention was 29,206 yen ; and the E group intervention was 124,731 yen, a ratio of 1/4.3. The study suggests that the cost-effectiveness for the lifestyle physical activity intervention was 4 times better than the structured exercise intervention.

Bone status assessment in Japanese subjects using speed of sound along the tibia / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To explore the potential use of ultrasound measurement (SoundScan 2000 Compact, Myriad Ultrasound Systems Ltd., Rehovot, Israel), and to assess both quantitative and qualitative properties of bone.</p><p><b>METHODS</b>The speed of sound waves (SOS; m/s) propagating along the cortical bone was determined at the tibial shaft. The performance, reliability, validity, and clinical application of this system were evaluated in Japanese subjects.</p><p><b>RESULTS</b>In phantom experiments, validity of this system was 0.04 (%), coefficient variation (CV: %) in same-day tests was 0.12, in five-separate-day tests was 0.13, and in independent operators was 0.11, respectively. In experiments with Japanese subjects, CV in same-day tests was 0.38, in five-separate-day tests was 0.99, and in independent operators was 0.90, respectively. In addition, cortical bone status of 1176 Japanese subjects (372 males, 804 females) was clinically evaluated by SoundScan 2000 Compact. SOS was negatively correlated with body fat percentage (%), body fat (kg) and waist hip ratio in females and subjects with higher weight bearing index (leg strength/body weight; WBI) have higher SOS in females under the age of forty.</p><p><b>CONCLUSIONS</b>These findings indicate that the SoundScan 2000 Compact is a highly reliable and valid method for determining cortical bone status and body composition and WBI are closely related to cortical bone status in Japanese females.</p>