Management of children with obesity at local hospital and impact of COVID-19 pandemic.

This study investigated the status of children with obesity before and after the COVID-19 pandemic, and the effects of lifestyle guidance on weight loss among children in Japan. We analysed the data of patients who visited our hospital after check-ups for obesity and evaluated the efficacy of lifestyle guidance. The patients were divided into groups A, B, and C (year 2011, 2019, and 2021, respectively). There were no differences in body weight, obesity index (OI), blood pressure, or alanine transaminase (ALT) levels between the groups; however, aspartate transaminase (AST) level was the highest in Group C. In Group C, only OI increased between the primary and secondary screenings; however, OI and body mass index (BMI) improved during the second screening and more children in the weight loss group followed lifestyle guidance. OI/BMI did not change over the past decade; however, short-term weight gain was significant owing to the COVID-19 pandemic, and simple guidance was effective in reducing weight. Future challenges include identifying methods to achieve long-term weight loss.

Preventive effects of an intergenerational program on age-related hippocampal atrophy in older adults: The REPRINTS study.

OBJECTIVES: A growing body of literature indicates that social engagements, such as intergenerational programs, are effective strategies to improve a range of cognitive abilities. The present study examined whether the intergenerational program-REPRINTS-prevents age-related hippocampal atrophy. METHODS: After comprehensive baseline assessment, participants were allowed to decide whether to participate in the REPRINTS intervention or in the control group, which required only completion of assessments. REPRINTS participants engaged in group activities that involved reading picture books to children at kindergarten and elementary schools, once every 1 to 2 weeks. A follow-up assessment was conducted after 6 years. Two MRI scans were performed, one immediately after baseline assessment and the other after 6 years. Volumes of the hippocampus, thalamus, and caudate nucleus were derived from automated segmentation. The analysis included 17 REPRINTS and 42 control-group participants. RESULTS: There was no significant difference in any variable of participants' characteristics at baseline between the REPRINTS and control groups. Hippocampal volume significantly declined in the control group but was maintained in the REPRINTS group. No significant differences between groups in thalamus or caudate nucleus volume were observed. Although cognitive function was unaffected by the program, greater decreases in hippocampal volume were significantly correlated with greater decreases in cognitive performance scores. CONCLUSIONS: Our results suggest that the REPRINTS intergenerational program has protective effects on age-related hippocampal atrophy in older adults. These changes precede improvements in cognitive performance, suggesting the validity of the concept of brain plasticity in later life following social engagement.

Long-term effects of an intergenerational program on functional capacity in older adults: Results from a seven-year follow-up of the REPRINTS study.

BACKGROUND: Social engagement activities can help older adults maintain mental and physical functioning levels. This study examined the long-term effects of the intergenerational picture-book reading program "REPRINTS" (Research of Productivity by Intergenerational Sympathy) on older adults. METHODS: After baseline assessment, participants were allowed to decide which condition they wanted to participate in: the REPRINTS intervention or control group involving only assessments. REPRINTS participants participated in group activities that involved playing a hand game and reading picture books to children at kindergartens, elementary schools, and public childcare centers, once every one-two weeks. A follow-up assessment, which focused on functional capacity (i.e., instrumental activities of daily living, intellectual activity, and social function), was conducted after seven years. The analysis included responses from 62 REPRINTS (mean age [SD]=66.2 [5.7]) and 100 control-group participants (mean age [SD]=68.0 [4.7]). RESULTS: A logistic regression analysis examining intervention effects revealed that control-group participants were more likely to reduce intellectual activity and interactions with children compared to REPRINTS participants (p=.013 and .003, respectively). Furthermore, the REPRINTS group maintained greater functional reach compared to the control group (p<.001). However, the REPRINTS group was likely to stay indoors more often, compared to the control group (p=.045). CONCLUSION: The present study indicates that the REPRINTS intergenerational program has long-term, positive effects that help maintain and promote intellectual activity, physical functioning, and intergenerational exchange, although the effect of the increasing amount of physical activity is unclear.

Effects of the Change in Working Status on the Health of Older People in Japan.

BACKGROUND: Working at old ages is regarded as a good way to keep one's health according to the idea of productive aging. However, there is not enough evidence yet whether retirement is good or bad, or the kind of effects it has on the health of older adults aged 65 and over. We examined it by using a recent data of Wako city, a suburb area near Tokyo in Japan. METHODS: One thousand seven hundred sixty-eight participants answered to 3 waves of survey questionnaires: 2008, 2010, and 2012, successively. We considered 3 indicators of health; self-rated health, mental health (GDS15) and HLFC (Higher-Level Functional Capacity: TMIG-IC). In cross-sectional analysis, we compared these 3 indicators by three groups: full-time worker, part-time worker, and non-worker. In longitudinal analysis, we compared these three indicators by two groups: subjects who successively worked in 2008, 2010, 2012, and subjects who worked in 2008 but retired before 2010. We used one-way and two way repeated measures ANCOVA for these analyses, respectively. RESULTS: It was significantly clear that retirement worsened both mental health and HLFC in people aged 65 years and over; especially, mental health worsened rapidly and HLFC gradually. However, these indicators didn't worsen in subjects who changed from full-time jobs to part-time jobs. Quitting from part-time jobs deteriorated mental health gradually and HLFC moderately compared to full-time jobs. CONCLUSION: The results support the activity theory that older adults who quit from full-time jobs deteriorated both mental health and HLFC, though at different speeds. If they make a transit to part-time jobs, the deterioration would be moderate. It shows that working is an effective way of social participation for older people aged 65 years and over in Japan.

[An initiative to develop a new employment support facility for older job seekers in metropolitan areas].

OBJECTIVES: This study examined the possibility and necessity for expansion and diffusion of a new employment support facility for older job seekers in metropolitan areas based on health and welfare measures. This longitudinal study assessed questionnaire responses from older job seekers at a new facility established in Ota ward in the Tokyo metropolitan area as a compliment to the conventional system comprised of Hello Work and the Silver Human Resources Center. METHODS: We offered questionnaires to job seekers at their first facility visit and asked them to return them by mail (baseline survey). Follow-up surveys of the same respondents were conducted after 2, 4, 8, and 12 weeks, with questions about demographics, personal status, social activities, mental health, and job search status. The surveys were administered from January 2013 to March 2014. RESULTS: We obtained 128 responses (average respondent age: 63.8 years) from 180 baseline survey questionnaires. The respondents included 82 males and 46 females. The response rates were over 90% for all follow-up surveys. Among respondents, 71.4% had less than a senior high school level of education. The average annual household income was less than 3 million yen and less than 1 million yen for 68.0% and 16.0% of the participants, respectively. The life circumstances were "hard" or "very hard" for 56.3% of respondents. Among respondents, 78.9% indicated that they were seeking employment for economic reasons. Women and those over 65 years of age were more likely to search for jobs for their well-being than men and respondents less than 65 years of age. The majority of respondents indicated that they wanted to make use of their abilities or experience and many hoped to work as garbage collectors, cooks, or apartment caretakers. CONCLUSION: We found that the main objective of older job seekers living at this facility was economic acquisition. Men and those less than 65 years of age were at particular risk for economic distress, poor mental health, and were more likely to be searching for regular employment. A relatively higher proportion of women and respondents over 65 years of age were seeking jobs for their well-being; a need for social relationships that may be more pronounced among women in this study population.

The effect of intergenerational programs on the mental health of elderly adults.

OBJECTIVES: The aim of this study was to clarify the effect of an intergenerational program on elderly persons' symptoms of depressive mood and in improving their sense of coherence, which is an element for successful coping with stressors. METHOD: We evaluated an intervention research project (Research of Productivity by Intergenerational Sympathy [REPRINTS]), in which volunteers >65 years old read picture books to children in a school setting. The intervention group (REPRINTS) was recruited through intensive weekly training seminars for three months. The no-contact control group members were also recreated to participate in health checks and surveys for data collection purposes. Eventually, 26 participants in the intervention group and 54 in the control group were included for data analysis. RESULTS: The age or gender was not significantly different between the intervention and control groups. A two-way repeated-measures ANOVA shows a time × group significant interaction effects. Analyses of the simple main effects showed that sense of meaningfulness significantly increased for members of the intervention group at all terms, with no changes in the control group over time. Multiple mediation analysis revealed that participation in the intergenerational program was associated with a sense of manageability which was also significantly related to depressive mood. CONCLUSION: Intergenerational programs could serve as key health promoters among elderly people by decreasing the risk of social isolation and loneliness due to the greater sense of meaningfulness. However, given our limited sample size, generalizability was restricted and studies with larger cohorts are required to further validate our findings.

Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk.

BACKGROUND: Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls. METHODS: Three groups of adults, young-old (age, 60-74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18-35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study. RESULTS: Thirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers. CONCLUSIONS: Older adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls.

[The influences of exercise fulfillment on mental and physical functions of targeted older adults and the effect of a physical exercise intervention].

OBJECTIVES: To investigate the influence of the differences in exercise fulfillment on mental and physical functions and the effects of exercise intervention on community-dwelling older adults. METHODS: Participants in this study included 260 community-dwelling older adults (mean age +/- SD, 70.4 +/- 6.0 years) who participated in the exercise intervention study (intervention and control groups). Exercise fulfillment levels (low or high), physical activity levels (low or high), mental health (WHO-5 scores), health-related QOL (SF-8 score), and physical abilities of these adults were measured during a baseline health checkup. Based on the status of the 3 exercise fulfillment groups, multivariate analysis of variance (MANOVA), which was adjusted for age, sex, and physical activity levels, was performed to compare the results of the outcome measures among the 3 groups. The intervention group (n = 88, aged 70.3 +/- 6.2 years) was divided into 2 subgroups: the deterioration subgroup (participants with low-exercise fulfillment after the intervention) and the improvement subgroup (participants with high-exercise fulfillment after the intervention). Subsequently, the intervention effects were assessed by repeated measurements of the analysis of variance (ANOVA) between the 2 subgroups. RESULTS: MANOVA analysis revealed that body mass index, grip strength, maximum walking speed, the WHO-5 score, and the SF-8 subscale (8 items) score differed significantly amongst the groups. The high-exercise fulfillment group demonstrated better results for these variables than the low-exercise fulfillment group. Similar results were obtained for each group with respect to the physical activity levels. The repeated-measures ANOVA revealed that time had an important effect on lower physical functions and the SF-8 subscale (1 item) score; it also revealed the important effects of body mass index, the WHO-5 score, the SF-8 subscale (6 items) score, and psychological independence on the group. CONCLUSION: Older adults with higher exercise fulfillment demonstrated better mental and psychological health, regardless of their physical activity levels. Older adults with low-exercise fulfillment could potentially improve their physical abilities; however, their mental and psychological health significantly differed from that of older adults with medium- or high-exercise fulfillment after exercise intervention. These findings provide preliminary evidence, which indicates that exercise can provide sufficient fulfillment and contribute to the promotion and improvement of health in older adults. Moreover, performing adequate tests on exercise fulfillment may aid in assessing the effects of intervention programs in regional healthcare systems.

[A randomized controlled trial of the effects of a comprehensive intervention program for community-dwelling older adults].

AIM: The objective of this study was to evaluate the effects of a comprehensive intervention program named SPRING, which utilizes a hot spring facility, in community-dwelling older adults in a randomized controlled trial. METHODS: A total of 60 community-dwelling elderly people (mean age, 72.7±6.0 years) participated in this program. After baseline investigation, participants were randomly assigned to an intervention group (n=31) or a control group (n=29). The intervention group participated in a comprehensive intervention program (including exercise classes, nutrition classes and bathing) twice a week for 3 months. After 3 months and 6 months, we evaluated the effects of the intervention. RESULTS: The attendance rate of the intervention group was 76%, and there were no accidents or injuries associated with this program. After 3 months, grip strength and one-leg standing with eyes-open scores significantly improved among the intervention group, compared with the control group (p=0.028; p=0.003, respectively). On follow-up, grip strength, one-leg standing with eyes-open scores and the World Health Organization Well-Being Index (WHO-5) scores were statistically significantly maintained or had improved in the intervention group (p=0.001; p=0.024; p=0.027, respectively). CONCLUSION: The comprehensive intervention program SPRING may improve physical function among community-dwelling older adults. In addition, SPRING may have long-term beneficial effects for older adults.

[Indirect effects of school volunteering by senior citizens on parents through the "REPRINTS" intergenerational health promotion program].

BACKGROUND AND PURPOSE: We have launched a new intervention study, called "REPRINTS" (Research of productivity by intergenerational sympathy), in which senior volunteers aged 60 years and over are engaged in reading picture books to school children, regularly visiting public elementary schools since 2004. METHODS: So far, no repeated cross-sectional studies to demonstrate indirect effects on parents have been reported, although reciprocal effects on senior volunteers and children have been demonstrated. The purpose of this study was to examine the changes of evaluation of "REPRINTS" program by parents of school children during the 2 years. SUBJECTS & SETTING: Four to six volunteers as a group visited an elementary school in a suburb of Kawasaki city twice a week to read picture books. A baseline survey was conducted one month after launching the volunteer activity. First to fourth follow-up surveys were conducted every 6 months after baseline surver. Of 368 parents, 230 whose children were in 1st-4th grade were analyzed. MEASUREMENTS: School grade of children, gender, emotional image scale of older adults by the SD (Semantic Differential) method (13 items), parents' evaluation of activity of "REPRINTS" volunteers such as promotion of reading for children, or children's respect for older adults, appreciation, familiarity with older adults, indirect effects on promotion of safety in the community, and reducing parent's physical and psychological burdens of volunteer service for school. Repeated cross-sectional analyses by ANCOVA, adjusted for confounding factors, were conducted in order to compare changes in responses between parents of 1st-2nd grade children (lower-grade children) with those of 3rd-4th grade-children (middle-grade children). We examined experiences of being read with picture books, greeting and having conversations with volunteers among all of 330 students of 1st-4th grade. These three items were examined using Chi-squared test to compare longitudinal change between parents of lower-grade and middle-grade children. RESULTS: Evaluation of children's familiarity with older adults significantly declined among parents of middle-grade children, but was maintained among those of lower-grade children during the 2 years. Physical burdens of volunteer service for school were lower among parents' of lower-grade children at baseline, and were significantly reduced among parents' of all grades. Promotion of reading for children, indirect effects on promotion of safety in the community, and frequency of hearing episodes of "REPRINTS" volunteers from children were higher among parents' of lower-grade children at baseline. Psychological burdens were reduced and level of knowledge of "REPRINTS" volunteers was increased among parents' of all grades. In terms of parents' emotional image scale of older adults in general, no significant difference was found among the grades of school children and number of surveys for all the subscales of 'socialization', 'activity', and 'cheerfulness'. CONCLUSION: The level of knowledge and a number of items of evaluation of "REPRINTS" volunteers were significantly increased among parents of both lower-grade and middle-grade children during the 2-year intervention. This study indicates that the "REPRINTS" program can contribute to establishing trust and reliance between generations of older adults and parents of school children with the children as mediators.

Obesity screening for young Japanese males and females using skin fold measurements: the classification revisited.

Anthropometric assessment is a simple, safe, and cost-efficient method to examine the health status of individuals. The Japanese obesity classification based on the sum of two skin folds (Sigma2SF) was proposed nearly 40 years ago, therefore its applicability to Japanese living today is unknown. The current study aimed to determine Sigma2SF cut-off values that correspond to percent body fat (%BF) and BMI values using two datasets from young Japanese adults (233 males and 139 females). Using regression analysis, Sigma2SF and height-corrected Sigma2SF (HtSigma2SF) values that correspond to %BF of 20, 25, and 30% for males and 30, 35, and 40% for females were determined. In addition, cut-off values of both Sigma2SF and HtSigma2SF that correspond to BMI values of 23 kg/m2, 25 kg/m2 and 30 kg/m2 were determined. In comparison with the original Sigma2SF values, the proposed values are smaller by about 10 mm at maximum. The proposed values show an improvement in sensitivity from about 25% to above 90% to identify individuals with > or =20% body fat in males and > or =30% body fat in females with high specificity of about 95% in both genders. The results indicate that the original Sigma2SF cut-off values to screen obese individuals cannot be applied to young Japanese adults living today and modification is required. Application of the proposed values may assist screening in the clinical setting.

Intellectual activity and likelihood of subsequently improving or maintaining instrumental activities of daily living functioning in community-dwelling older Japanese: a longitudinal study.

OBJECTIVE: To test the a priori hypothesis that increase or maintenance of the level of cognitive activity would be independently associated with a subsequent beneficial impact (i.e. improvement or maintenance) on instrumental activity of daily living (IADL) functioning. METHODS: Observational study using 4-year longitudinal data from 1477 community-dwelling Japanese who were 66 years and older and living in Yoita town, a rural community located in the northwest along the Sea of Japan. Baseline assessment occurred in November 2000. Intellectual Activity and IADL were evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. RESULTS: Increase or maintenance of exposure to intellectual activities over a period of 2 years was associated with increased likelihood of better IADL functioning trajectory (i.e. improvement or stability) over the subsequent 2 years (OR: 1.63; 95% CI: 1.03-2.56; p = 0.035), even after adjustment for major confounders. CONCLUSION: This study documented a longitudinal, independent association of exposure to intellectual activities with better IADL functioning over time. These findings provide preliminary support for promotion of exposure to intellectual activities among older adults as an opportunity to prevent disability in the older segment of the population. Assessment of public health programs targeting such an opportunity is warranted.

Predictors of improvement or decline in instrumental activities of daily living among community-dwelling older Japanese.

BACKGROUND: To explore predictors of functional improvement or decline in instrumental activities of daily living (IADL) among community-dwelling older people. METHODS: Of all the residents (>or=65 years, n = 1,673) living in Yoita town, Niigata prefecture, Japan, in 2000, 1,544 subjects who participated in the baseline interview survey (T1) were followed up until 2002 (T2). A wide range of variables obtained in T1 was entered into the model predicting functional improvement or decline in IADL. RESULTS: Among 1,274 individuals who participated in both T1 and T2, 105 subjects showed improvement, 194 decline, and the remaining 975 showed stability in IADL. Multiple logistic regression analyses indicated that good self-rated health and cognitive function (MMSE >or=24) at T1 were good predictors of both improvement and protection against decline in IADL. Independence in basic activities of daily living predicted improvement in IADL. Advanced age and poor walking ability predicted decline in IADL. CONCLUSIONS: Good self-rated health and cognitive function predicted both improvement and protection against decline in IADL. Thus, intervention programs aiming at maintaining both good self-rated health and cognitive function should be able to improve IADL.

[Regulatory factors for images of the elderly among elementary school students assessed through secular trend analyses by frequency of inter-exchange with "REPRINTS" senior volunteers].

BACKGROUND AND PURPOSE: We have launched a new intervention study, called "REPRINTS" (Research of productivity by intergenerational sympathy) in which senior volunteers aged 60 years and over engage in reading picture books to school children, regularly visiting public elementary schools since 2004. The purpose of this study was to clarify characteristics of images of older people held by elementary school children and factors associated with such images, as well as to examine changes in images through intervention by "REPRINTS" senior volunteers (volunteers) for the initial one year period. SUBJECTS & SETTING: Four to six volunteers as a group visited A elementary school in a suburb Kawasaki city (470 students) twice a week to read picture books. The baseline survey was conducted one month after launching the volunteer activity. First and second follow-up surveys were conducted at 6 month intervals after the baseline survey. MEASUREMENTS: Grade, gender, short version of emotional-like image scale of older adults assessed by the SD (Semantic Differential) method (6 items in the subscale for "evaluation" and 4 items in the subscale for "potency/activity"), experience of living with grandparents, experience of interchange with older people, frequency of interchange with volunteers and the social desirability scale for children. RESULT: Related variables for a higher score in the subscale for "evaluation" included lower grade and abundant experience of interchange with older people such as grandparents. Those for "potency/ activity" included lower grade, male gender, and a higher social desirability scale for children in the multiple logistic regression model. Students were divided into two groups in terms of frequency of interchange with volunteers (low and high-frequency groups) through three surveys. In the subscale for "evaluation", the general linear model demonstrated a significant interaction between the group and number of surveys adjusted for confounding factors. CONCLUSION: Although emotional images of older people significantly decline with advancing grade, those of students with a high frequency of interchange with volunteers were here found to be maintained more positively over one year compared to those with a low frequency.

Applicability of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) and the Attention to Body Shape scale (ABS) in Japanese males and females.

OBJECTIVES: To determine applicability of the Japanese-translated versions of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) and the Attention to the Body Shape Scale (ABS) in Japanese males and females. METHODS: The translated questionnaires were administered to Japanese living in Japan (84 males, 139 females) and also to 68 Japanese males living in Australia. The results were compared with 72 Australian males using the English version and also with previous results using Australian females. RESULTS: Alpha levels from the two questionnaires ranged 0.70 to 0.87. Japanese groups showed significant (p<0.05) differences in the scores obtained from the BAQ compared to Australian males. The inter-subscale correlations for the BAQ were comparable regardless of ethnicity. Both questionnaires also correlated with the 26-item Eating Attitudes Test scores (p<0.01). DISCUSSION: The current study suggests that both BAQ and ABS are adequate for use in Japanese males and females to assess their body attitudes.

[An intergenerational health promotion program involving older adults in urban areas. "Research of Productivity by Intergenerational Sympathy (REPRINTS)": first-year experience and short-term effects].

OBJECTIVE: We have launched a new intervention study, called "Research of Productivity by Intergenerational Sympathy (REPRINTS)" in which senior volunteers engage in reading picture books to children. The "REPRINTS" program consistently involves social roles and intellectual activity, two higher-level functional capacities. This study reported findings and problems experienced through "REPRINTS" during the first year, ascertained potential effectiveness of social activity, and proposed methods for continued activity. METHODS: Basic concepts of "REPRINTS"program include "contribution to society", "life-long learning", and "group activity." Sixty seven volunteers and 74 controls, all aged 60 years and over living in three areas, ie., Chuo-ku, central Tokyo, Kawasaki city, suburb of Tokyo and Nagahama city, a local city, participated in a baseline health check-up in June, 2004. After completion of 3-month training seminars (once a week, 2 hr per session), volunteers visited public elementary schools and kindergartens in groups of 6-10 persons for 6 months. They were assessed again by follow-up health check-up in March, 2005. RESULTS: At baseline, the proportion of those who had no grand children (41.8% vs. 20.3%, P= 0.006), average school years (13.4 +/- 2.5 vs. 12.3 +/- 2.5 years, P= 0.008), having any experience of volunteer activities (79.1% vs. 52.7%, P=0.001), and an usual walking speed (86.7 +/- 12.3 vs. 81.3 +/- 12.9 m/min, P=0.012) were significantly higher in volunteers than in controls. There was no significant difference in other baseline characteristics between the two groups. At follow-up, social network scores for 56 volunteers were significantly improved: frequency of contact with grandchildren and others around neighborhood and size of circles of friends and acquaintances were increased, as compared to controls. Social support scores for the volunteers significantly decreased in the receiving aspect, while increased in the giving aspect. In addition, consciousness of loving community and self-rated health were significantly enhanced and hand-grip strength showed significantly less decline in volunteers than in controls. CONCLUSIONS: Through engaging in the intergenerational and intellectual volunteer programs for 9 months, subjective health, social support and network, consciousness of loving community and some aspects of physical performance were significantly promoted in senior volunteers. Coordination of existing administrative services enabled us to establish this "REPRINTS" health promotion program for community-dwelling older adults.

Differences in nutrient intakes and physical activity levels of Japanese and Australian Caucasian males living in Australia and Japanese males living in Japan.

The aim of the study was to determine the nutritional status and nutrient intakes of young Japanese males living in Australia and compared with Japanese males living in Japan and Australian Caucasian males. Four-day dietary records were obtained from 65 Japanese living in Australia (JA), 81 Japanese living in Japan (JJ), and 70 Australian Caucasian males (AA) aged 18-30 years old, together with body composition and physical activity level assessments using anthropometry and the questionnaire. Australian males were significantly taller and heavier than the Japanese counterparts and also showed a greater percent body fat (%BF) and height-corrected sum of skinfolds compared with Japanese males living in Japan (%BF: JJ = 16.6 +/- 5.2, AA = 18.7 +/- 5.6; height corrected sum of skinfolds: JJ = 78.8 +/- 37.3, AA = 96.0 +/- 39.5) (P<0.05). A greater proportion of Australian Caucasian males (98.6%) were involved in vigorous physical exercise than Japanese males (JA = 72.3%; JJ = 85.2%). The JA group consumed a greater amount of energy from protein and fat sources as well as greater calcium, iron, dietary fibre and niacin equivalents intakes than the JJ group (P<0.05). The results suggest that Japanese males living in Australia consumed more energy-dense westernised diet than Japanese males living in Japan. Because of lower physical activity level than Australian males, consumption of energy-dense diet may increase the risk of weight gain among Japanese males who stay in Australia for a long-term.

Differences in the relationship between BMI and percentage body fat between Japanese and Australian-Caucasian young men.

This cross-sectional study aimed to determine ethnic and environmental influences on the relationship between BMI and percentage body fat, using a sample of 144 Japanese and 140 Australian-Caucasian men living in Australia, and eighty-eight Japanese men living in Japan. Body composition was assessed by anthropometry using standard international methods (International Society for the Advancement of Kinanthropometry protocol). Body density was predicted using Durnin and Womersley's (1974) equation, and percentage body fat was calculated from Siri's (1961) equation. Significant (P<0.05) ethnic differences in stature, body mass and BMI were observed between Japanese and Australian men, but no ethnic differences were observed in their percentage body fat and height-corrected sum of skinfold thicknesses. No differences were found in the BMI-percentage body fat relationship between the Japanese subjects living in Australia and in Japan. Significant (P<0.05) ethnic differences in the BMI-percentage body fat relationship observed from a comparison between pooled Japanese men (aged 18-40 years, BMI range 16.6-32.8 kg/m2) and Australians (aged 18-39 years, BMI range 16.1-31.4 kg/m2) suggest that Japanese men are likely to have a greater percentage body fat than Australian men at any given BMI value. From the analyses, the Japanese men were estimated to have an equivalent amount of body fat to the Australian men at BMI values that were about 1.5 units lower than those of the Australians (23.5 kg/m2 and 28.2 kg/m2, respectively). It was concluded that Japanese men have greater body fat deposition than Australian-Caucasians at the same BMI value. Japanese men may therefore require lower BMI cut-off points to identify obese individuals compared with Australian-Caucasian men.

Relationships between brachial-ankle pulse wave velocity and conventional atherosclerotic risk factors in community-dwelling people.

BACKGROUND: A simple instrument has been developed to measure brachial-ankle pulse wave velocity (baPWV). The aim of the present study was to use this instrument to study the relationship between baPWV and conventional atherosclerotic risk factors. METHODS: Community-dwelling Japanese (632) living in a rural area (234 men and 398 women) participated in a municipal medical health survey that included baPWV measurement and a traditional clinical examination, conducted in June, 2002. RESULTS: Men had a significantly higher baPWV than women. No interaction between gender and age on baPWV was identified. Multiple linear regression analysis indicated that age, hemodynamic factors (diastolic blood pressure, pulse pressure, and heart rate), hemoglobinA1c, current drinking and smoking status, and mild retinal changes had significant independent influences on higher baPWV. CONCLUSIONS: In this rural population, age, gender, and hemodynamic factors were independently associated with baPWV, along with traditional atherosclerotic risk factors, although no significant associations between baPWV and histories of atherosclerotic diseases or subclinical atherosclerosis except for mild retinal changes were demonstrated.