Antimicrobial activities of piperacillin-tazobactam against Haemophilus influenzae isolates, including beta-lactamase-negative ampicillin-resistant and beta-lactamase-positive amoxicillin-clavulanate-resistant isolates, and mutations in their quinolone resistance-determining regions.

Beta-lactamase-negative ampicillin-resistant (BLNAR) isolates of Haemophilus influenzae have been emerging in some countries, including Japan. The Clinical and Laboratory Standards Institute has only a susceptible MIC breakpoint (< or = 1 microg/ml) for piperacillin-tazobactam and a disclaimer comment that BLNAR H. influenzae should be considered resistant, which was adapted without presentation of data. In addition, fluoroquinolone-resistant H. influenzae isolates have recently been occasionally reported worldwide. To address these problems, we examined susceptibilities to beta-lactams, including piperacillin-tazobactam, and ciprofloxacin by microdilution and disk diffusion (only for piperacillin-tazobactam) methods, against a total of 400 recent H. influenzae clinical isolates, including 100 beta-lactamase-negative ampicillin-susceptible, beta-lactamase-positive ampicillin-resistant, BLNAR, and beta-lactamase-positive amoxicillin-clavulanate-resistant (BLPACR) isolates each. BLNAR and BLPACR isolates were tested by PCR using primers that amplify specific regions of the ftsI gene. We also detected mutations in quinolone resistance-determining regions (QRDRs) by direct sequencing of the PCR products of DNA fragments. Among beta-lactams, piperacillin-tazobactam exhibited potent activity against all isolates of H. influenzae, with all MICs at < or = 0.5 microg/ml (susceptible). A disk diffusion breakpoint for piperacillin-tazobactam of > or = 21 mm is proposed. We confirmed that all BLNAR and BLPACR isolates had amino acid substitutions in the ftsI gene and that the major pattern was group III-like (87.5%). One ciprofloxacin-resistant isolate (MIC, 16 microg/ml) and 31 ciprofloxacin-susceptible isolates (MICs, 0.06 to 0.5 microg/ml) had amino acid changes in their QRDRs. Piperacillin-tazobactam was the most potent beta-lactam tested against all classes of H. influenzae isolates. It is possible that fluoroquinolone-resistant H. influenzae will emerge since several clinical isolates carried mutations in their QRDRs.

Case-control study of green tea consumption and the risk of endometrial endometrioid adenocarcinoma.

OBJECTIVE: To investigate the association between green tea consumption and the risk of endometrial cancer restricted to endometrial endometrioid adenocarcinoma (EEA) using a case-control design in Japan. METHODS: The cases were 152 patients with histopathologically diagnosed EEA, and the controls were 285 healthy women who were matched for age and area of residence with individual cases. The subjects completed a questionnaire regarding health-related lifestyle and reproductive history, and a food frequency questionnaire. Odds ratios (ORs) of EEA for frequency of green tea consumption were calculated by conditional logistic regression analysis. RESULTS: We observed a significant inverse association between green tea consumption and the risk of EEA with a dose-response relationship. The multivariate-adjusted OR of EEA was 0.77 (95% CI: 0.37-1.58) for those in the second quartile of green tea consumption (5-6 cups/week-1 cup/day), 0.61 (0.30-1.23) in the third quartile (2-3 cups/day), and 0.33 (0.15-0.75) in the highest quartile (> or = 4 cups/day), as referenced with those in the lowest quartile (< or = 4 cups/week; p for trend = 0.007). This inverse association was consistently observed regardless of the presence or absence of factors such as obesity and menopause. CONCLUSION: Green tea consumption may be associated with a lower risk of EEA.

No effect of the Trp64Arg variant of the beta3-adrenergic receptor gene on weight loss by diet and exercise intervention among Japanese adults.

Controversy remains as to whether the presence of the tryptophan-to-arginine (Trp64Arg) variant of the beta(3)-adrenergic receptor gene impedes the magnitude of body weight loss by diet and exercise intervention. The objectives of the present study were to compare the changes in body weight between carriers and noncarriers of the Trp64Arg variant before and after 6 months of diet and exercise interventions for weight loss. A total of 37 middle-aged Japanese individuals (12 carriers and 25 noncarriers of the Trp64Arg variant) participated in the study. There were no significant differences in body weight between the 2 groups at the baseline. There were significant reductions in body weight both in carriers and noncarriers, but no significant differences between the 2 groups with respect to changes in these variables. The weight changes were -2.52 kg (95% confidence interval [CI], -3.56 to -1.48) among carriers and -1.89 kg (95% CI, -2.65 to -1.13) among noncarriers, and the change in the variant carrier group minus the change in the variant noncarrier group was -0.47 (95% CI, -1.97 to 1.02). These results suggest that the presence of the Trp64Arg variant of the beta(3)-adrenergic receptor gene may not play a major role as a hindrance to weight reduction.

[Malnutrition and the risk of long-term care insurance certification or mortality. A cohort study of the Tsurugaya project].

OBJECTIVE: The purpose of this study was to propose a suitable cut-off point for the serum albumin value to predict which elderly individuals are qualified for long-term care insurance certification and those at risk of death. METHODS: The Tsurugaya Project was a comprehensive geriatric assessment conducted for community-dwelling elderly persons aged 70 years or older in Sendai, Japan. Of those participating, the 832 from whom consent was obtained and who were not qualified for long-term care insurance certification were adopted as subjects. Cut-off points on serum albumin levels were set every 0.1 g/dL from 3.5 g/ dL to 4.0 g/dL. The risk of incident certification of long-term care insurance or death (calculated by the Cox proportional hazards model), the frequency of the subjects, the sensitivity, the specificity and the positive predictive value of the category below each cut-off point were calculated. RESULTS: During 3 years follow-up, a total of 130 subjects either became certificated for long-term care insurance or died. On multivariate analyses, the risk of incident certification of long-term care insurance or death showed significantly increase with all cut-offpoints. The frequencies were 1.3% at 3.5 g/dL, 9.6% at 3.8 g/dL and 29.6% at 4.0 g/dL. The sensitivities were 5.4% at 3.5 g/dL, 18.5% at 3.8 g/ dL and 45.4% at 4.0 g/dL. The specificities were 99.4% at 3.5 g/dL, 92.0% at 3.8 g/dL and 73.4% at 4.0 g/dL. The positive predictive values were 63.6% at 3.5 g/dL, 30.0% at 3.8 g/dL and 24.0% at 4.0 g/dL. When the serum albumin cut-off point was set to 3.8 g/dL and the highest tertile level of the serum albumin value was used as a reference category, the sex- and age-adjusted hazard ratios (95% confidence intervals) were 2.1 (1.1-3.9) in those with serum albumin < or =3.8 g/dL, 1.5 (0.9-2.5) in those with the lowest tertile level and 1.0 (0.6-1.7) in those with the middle tertile level. CONCLUSION: This study suggested that a serum albumin value of 3.8 g/dL is a suitable cut-off point with regard to sensitivity, specificity and positive predictive value.

Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study.

OBJECTIVE: To investigate the association between the sense of "life worth living (ikigai)" and the cause-specific mortality risk. The psychological factors play important roles in morbidity and mortality risks. However, the association between the negative psychological factors and the risk of mortality is inconclusive. METHODS: The Ohsaki Study, a prospective cohort study, was initiated on 43,391 Japanese adults. To assess if the subjects found a sense of ikigai, they were asked the question, "Do you have ikigai in your life?" We used Cox regression analysis to calculate the hazard ratio of the all-cause and cause-specific mortality according to the sense of ikigai categories. RESULTS: Over 7 years' follow-up, 3048 of the subjects died. The risk of all-cause mortality was significantly higher among the subjects who did not find a sense of ikigai as compared with that in the subjects who found a sense of ikigai; the multivariate adjusted hazard ratio (95% confidence interval) was 1.5 (1.3-1.7). As for the cause-specific mortality, subjects who did not find a sense of ikigai were significantly associated with an increased risk of cardiovascular disease (1.6; 1.3-2.0) and external cause mortality (1.9; 1.1-3.3), but not of the cancer mortality (1.3; 1.0-1.6). CONCLUSIONS: In this prospective cohort study, subjects who did not find a sense of ikigai were associated with an increased risk of all-cause mortality. The increase in mortality risk was attributable to cardiovascular disease and external causes, but not cancer.

Body mass index and cardiovascular disease mortality in Japan: the Ohsaki Study.

OBJECTIVE: Although there is a clear positive association between obesity and the incidence and severity of cardiovascular disease, the association between underweight and cardiovascular disease is unclear. The objective of this study was to examine the relation between body mass index (BMI) and cardiovascular disease in Japan, where the proportion of the population that is underweight is relatively high. METHOD: A total of 43,916 Japanese adults (21,003 men and 22,913 women) aged 40 to 79 years who had no history of cancer, ischemic heart disease (IHD), or stroke participated in the baseline survey in 1994. Hazard ratios (HR) and their 95% confidence intervals (CIs) for death due to total cardiovascular disease, all strokes, ischemic stroke, hemorrhagic stroke, and IHD were calculated according to BMI by using Cox's proportional hazards regression models. The 22.5-24.9 kg/m(2) BMI category was used as the reference category in all analyses. RESULTS: There were U-shaped associations between BMI and total cardiovascular disease, all stroke, hemorrhagic stroke, and IHD mortality, and a J-shaped association between BMI and ischemic stroke mortality. Participants with a BMI <18.5 kg/m(2) had a significantly increased risk of total cardiovascular disease, all stroke, hemorrhagic stroke, and IHD mortality, and the multivariate HR (95% CI) was 1.62 (1.19-2.19), 1.50 (1.02-2.21), 2.11 (1.07-4.17), 1.83 (1.11-3.01), respectively. CONCLUSION: Underweight was substantially associated with hemorrhagic stroke and IHD mortality in Japan, while obesity was associated with increased risk of total cardiovascular disease mortality and mortality from individual cardiovascular diseases.

[Fish intake and the risk of prostate cancer in Japan: a prospective cohort study].

OBJECTIVE: Fish intake may reduce the risk of prostate cancer. However, the results of previous prospective cohort studies have been inconsistent, and almost all have been undertaken in Western countries, where total fish intake is low. We therefore investigated the association between fish intake and the risk of prostate cancer in a prospective cohort study in Japan. PARTICIPANTS AND METHODS: We delivered a self-administered questionnaire including items on dietary intake (40-item food frequency questionnaire [FFQ]), and various lifestyle habits, between October and December 1994 to all male National Health Insurance (NHI) beneficiaries aged 40-79 years in Japan. Usable questionnaires were returned from 24,895 (94%) of the participants. We divided the participants into quartiles based on their self-reported fish intake. We used the Cox proportional hazards model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of prostate cancer incidence according to fish intake, after adjustment for potential confounders. RESULTS: We identified 95 prostate cancer cases during 7 years of follow-up, to the end of December 2001. An inverse association was observed between fish intake and the risk of prostate cancer. The multivariate HRs (95% CI) of prostate cancer across increasing quartiles of fish intake were 1.00, 0.92 (0.48-1.76), 0.73 (0.42-1.28), and 0.72 (0.40-1.33) (P for trend = 0.23). Among participants aged 40-69 years, the multivariate HRs (95% CI) of prostate cancer across increasing quartiles of fish intake were 1.00, 1.26 (0.51-3.11), 0.86 (0.38-1.94), and 1.01 (0.43-2.34) (P for trend = 0.83). On the other hand, among participants aged 70 years or older, the corresponding multivariate HRs (95% CI) were 1.00, 0.63 (0.23-1.69), 0.60 (0.27-1.30), and 0.44 (0.18-1.11) (P for trend = 0.08). CONCLUSIONS: The risk of prostate cancer tended to decrease among those aged 70 years or older although it was not significant. The relation was not seen in those aged 40-69 years old.

Personality and body mass index: a cross-sectional analysis from the Miyagi Cohort Study.

OBJECTIVE: Obesity is an increasingly prevalent public health problem worldwide, and is associated with a higher risk of developing various noncommunicable diseases. To further examine the association between personality and overweight, obesity, or underweight, we conducted a cross-sectional analysis in Japan. We hypothesized that extraversion and psychoticism would have a positive association with overweight, and that neuroticism and lie would have an inverse association with overweight, whereas the association between personality and underweight would be the reverse image of overweight. METHODS: In 1990, 30,722 subjects (40-64 years of age) completed a self-administered questionnaire including body weight and height and the Japanese version of the Eysenck Personality Questionnaire-Revised Short Form. Multivariate logistic regression analysis was used to calculate odds ratios for overweight [body mass index (BMI)> or =25.0 kg/m2] or underweight (BMI<18.5) relative to each category on the personality subscale. RESULTS: In men and women, extraversion and psychoticism had positive associations with overweight, whereas neuroticism had an inverse association. Lie had an inverse association with overweight in men. In men and women, only extraversion had an inverse association with underweight and neuroticism had a positive association with underweight. CONCLUSION: Our findings indicate that personality is associated with both overweight and underweight. These results may provide clues to devising more effective measures for preventing overweight, obesity, or underweight or for weight control intervention.

Alcohol consumption and suicide mortality among Japanese men: the Ohsaki Study.

The risk of suicide is well known to be increased among heavy alcohol drinkers. However, whether the risk is increased or decreased among light drinkers is still under debate. We investigated this association in a population-based sample of men in Japan. The Ohsaki Study was a population-based, prospective cohort study among Japanese adults aged from 40 to 79 years. Between October and December, 1994, 22,804 men in Miyagi Prefecture, Japan, completed a questionnaire on various health-related lifestyles, including alcohol drinking. During the subsequent 7 years follow-up, 73 participants committed suicide. We used the Cox proportional hazards regression model to estimate the hazard ratio (HR) for suicide mortality according to the quantity of alcohol consumed daily, with adjustment for potential confounders. There was a statistically significant positive and linear association between the amount of alcohol consumed and the risk of suicide: the multivariate HRs in reference to nondrinkers (95% confidence interval) were 1.2 (0.5-2.7), 1.5 (0.7-3.4), and 2.4 (1.2-4.6) in current drinkers who consumed /=45.6g of alcohol per day, respectively (P-trend=.016). Even after the early death cases were excluded, a significant linear association was observed between alcohol consumption and the risk of suicide, with the risk of suicide also being nonsignificantly higher among the light drinkers than among nondrinkers (multivariate HR=1.7). This prospective cohort study indicated a positive linear association between alcohol consumption and the risk of suicide, and the suicide risk among the light drinkers was not decreased as compared with that in nondrinkers.

Survival prediction of patients with advanced cancer: the predictive accuracy of the model based on biological markers.

To determine whether the addition of biological markers to performance status (PS) and physical symptoms would improve survival prediction among patients with advanced cancer, we developed two prediction models with a scoring system based on 294 consecutive patients with advanced cancer (training set), and then tested its validity on another 93 patients (testing set). We assessed the predictive accuracy of the models using receiver-operating characteristic analysis. Albumin (ALB), lactate dehydrogenase (LDH), and lymphocyte percentage (Lymp%) were significantly and independently associated with survival length. For prediction of 60-day survival, the predictive accuracy of Model 2, based on the above biological markers in addition to PS and symptoms, was significantly better than that of Model 1, based on PS and symptoms alone (area under the curve [AUC] for Model 2, 0.80+/-0.03; AUC for Model 1, 0.69+/-0.04; P<0.001). Addition of ALB, LDH, and Lymp% to PS and physical symptoms improved prediction accuracy, especially for longer survival.

Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study.

BACKGROUND: Although ecological observations suggest that the Japanese diet may reduce the risk of cardiovascular disease (CVD), the impact of a Japanese dietary pattern upon mortality due to CVD is unclear. METHODS: We prospectively assessed the association between dietary patterns among the Japanese and CVD mortality. Dietary information was collected from 40 547 Japanese men and women aged 40-79 years without a history of diabetes, stroke, myocardial infarction or cancer at the baseline in 1994. RESULTS: During 7 years of follow-up, 801 participants died of CVD. Factor analysis (principal component) based on a validated food frequency questionnaire identified three dietary patterns: (i) a Japanese dietary pattern highly correlated with soybean products, fish, seaweeds, vegetables, fruits and green tea, (ii) an 'animal food' dietary pattern and (iii) a high-dairy, high-fruit-and-vegetable, low-alcohol (DFA) dietary pattern. The Japanese dietary pattern was related to high sodium intake and high prevalence of hypertension. After adjustment for potential confounders, the Japanese dietary pattern score was associated with a lower risk of CVD mortality (hazard ratio of the highest quartile vs the lowest, 0.73; 95% confidence interval: 0.59-0.90; P for trend = 0.003). The 'animal food' dietary pattern was associated with an increased risk of CVD, but the DFA dietary pattern was not. CONCLUSION: The Japanese dietary pattern was associated with a decreased risk of CVD mortality, despite its relation to sodium intake and hypertension.

Coffee consumption and the risk of colorectal cancer: a prospective cohort study in Japan.

An inverse association between coffee consumption and the risk of colorectal cancer has been reported in several case-control studies, but results from prospective cohort studies have been inconclusive. We conducted a prospective cohort study among a Japanese population to clarify the association between coffee consumption and the risk of colorectal cancer incidence. We used data from the Miyagi Cohort Study for this analysis. Usable self-administered questionnaires about coffee consumption were returned from 22,836 men and 24,769 women, aged 40-64 years, with no previous history of cancer. We used the Cox proportional-hazard regression model to estimate hazard ratios and 95% confidence intervals. During 11.6 years of follow-up (425,303 person-years), we identified 457 cases of colorectal cancer. Coffee consumption was not associated with the incidence of colorectal, colon or rectal cancer. The multivariate-adjusted hazard ratio (95% confidence interval) of colorectal cancer incidence for 3 or more cups of coffee per day as compared with no consumption was 0.95 (0.65-1.39) for men and women (p for trend = 0.55), 0.91 (0.56-1.46) for men (p for trend = 0.53) and 1.16 (0.60-2.23) for women (p for trend = 0.996). Coffee consumption was also not associated with incidence of either proximal or distal colon cancer. We conclude that coffee consumption is not associated with the incidence risk of colorectal cancer in the general population in Japan.

Lower risk of death from gastric cancer among participants of gastric cancer screening in Japan: a population-based cohort study.

OBJECTIVE: This study aimed to investigate the association between gastric cancer screening and mortality from gastric cancer. METHODS: In 1990, 47,605 Japanese subjects were recruited and completed a questionnaire about participation in gastric cancer screening and life-style. We followed up their vital status through December 2001. In this cohort, 41,394 subjects without a history of cancer were allocated to the screened group or the unscreened group according to their response to the question about gastric cancer screening. We estimated the relative risk (RR) of death from gastric cancer, death from any cause except gastric cancer, and incidence of gastric cancer with adjustment for potential confounding variables. RESULTS: The risk of death from gastric cancer among the screened group was significantly lower than that among the unscreened group. The multivariate RR of death from gastric cancer for screened individuals compared with those not screened was 0.54 (95% confidence interval [CI]: 0.38, 0.77). The RR of death from any cause except gastric cancer was 0.83 (95% CI: 0.77, 0.90), and the RR of incidence of gastric cancer was 0.94 (95% CI: 0.79, 1.13). CONCLUSION: Our data suggest that gastric cancer screening or factors associated with it may be associated with lower mortality from gastric cancer.

Alcohol consumption is associated with an increased risk of distal colon and rectal cancer in Japanese men: the Miyagi Cohort Study.

The association between alcohol consumption and the risk of cancer of the proximal or distal colon or rectum remains controversial. We examined this association in a large population-based cohort of Japanese men. In 1990, a self-administered questionnaire on alcohol drinking and other health habits was delivered to 25,279 Japanese men aged 40 to 64 years of age. After exclusion of subjects who gave incomplete responses on alcohol drinking or prevalent cancer cases at the baseline, a total of 21,199 men remained. Of these, 307 men were diagnosed as having colorectal cancer after 11 years of follow-up. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustments made for potential confounders. Compared with never drinkers, past and current drinkers had multivariate HRs of 1.1 (95% CI, 0.6-1.9) and 1.6 (95% CI, 1.1-2.2) for colorectal cancer, respectively. A dose-response relationship with current volume of alcohol drinkers was observed for cancer of the distal colon and rectum, but not for proximal colon. The multivariate HRs for distal colon and rectal cancer among current heavy drinkers (45.6 g or more ethanol per day) as compared with never drinkers were 4.2 (1.6-10.7; p for trend=0.0002) and 1.8 (1.1-3.2; p for trend=0.04), respectively. In contrast, no significant linear association was found for proximal colon cancer (p for trend=0.2). These data indicate that alcohol consumption in Japanese men is associated with a statistically significant increased risk of cancer of the distal colon and rectum, but not cancer of the proximal colon.

Impact of non-dietary nutrients intake on misclassification in the estimation of nutrient intake in epidemiologic study.

BACKGROUND: Few previous epidemiologic studies have evaluated the effects of non-dietary nutrient intake, such as supplements, over the counter (OTC) drugs, and prescription drugs containing vitamins or minerals, in examining the relationship between dietary factors and health outcomes. METHODS: To examine the influence of the non-dietary intake of vitamins and calcium on the estimation of nutrient intake, we conducted a cross-sectional study with 1,168 community-dwelling Japanese subjects aged 70 years or older in 2002. The subjects were asked to bring their non-dietary nutrient sources to the examining site. The dietary and non-dietary intakes of vitamins B1, C, E and calcium were obtained and the subjects were grouped into quartiles according to their dietary intake and their dietary plus non-dietary intake. The degree of agreement between these two classifications was examined to estimate the degree of misclassification. RESULTS: Among the subjects who were classified into the highest intake category for vitamin E with dietary intake plus non-dietary nutrient intake, 34.2 % were misclassified into lower category with dietary intake alone. Similarly, intake of vitamin B(1), vitamin C and calcium were misclassified 28.8%, 18.8 %, 6.2 %, respectively. CONCLUSIONS: Our data suggest that estimation of vitamin intake from dietary sources alone would yield a maximum misclassification of one-third, which would lead to misleading conclusions being drawn from epidemiologic studies. In contrast, the degree of misclassification for calcium may be relatively small.

Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: the Ohsaki study.

CONTEXT: Green tea polyphenols have been extensively studied as cardiovascular disease and cancer chemopreventive agents in vitro and in animal studies. However, the effects of green tea consumption in humans remain unclear. OBJECTIVE: To investigate the associations between green tea consumption and all-cause and cause-specific mortality. DESIGN, SETTING, AND PARTICIPANTS: The Ohsaki National Health Insurance Cohort Study, a population-based, prospective cohort study initiated in 1994 among 40,530 Japanese adults aged 40 to 79 years without history of stroke, coronary heart disease, or cancer at baseline. Participants were followed up for up to 11 years (1995-2005) for all-cause mortality and for up to 7 years (1995-2001) for cause-specific mortality. MAIN OUTCOME MEASURES: Mortality due to cardiovascular disease, cancer, and all causes. RESULTS: Over 11 years of follow-up (follow-up rate, 86.1%), 4209 participants died, and over 7 years of follow-up (follow-up rate, 89.6%), 892 participants died of cardiovascular disease and 1134 participants died of cancer. Green tea consumption was inversely associated with mortality due to all causes and due to cardiovascular disease. The inverse association with all-cause mortality was stronger in women (P = .03 for interaction with sex). In men, the multivariate hazard ratios of mortality due to all causes associated with different green tea consumption frequencies were 1.00 (reference) for less than 1 cup/d, 0.93 (95% confidence interval [CI], 0.83-1.05) for 1 to 2 cups/d, 0.95 (95% CI, 0.85-1.06) for 3 to 4 cups/d, and 0.88 (95% CI, 0.79-0.98) for 5 or more cups/d, respectively (P = .03 for trend). The corresponding data for women were 1.00, 0.98 (95% CI, 0.84-1.15), 0.82 (95% CI, 0.70-0.95), and 0.77 (95% CI, 0.67-0.89), respectively (P<.001 for trend). The inverse association with cardiovascular disease mortality was stronger than that with all-cause mortality. This inverse association was also stronger in women (P = .08 for interaction with sex). In women, the multivariate hazard ratios of cardiovascular disease mortality across increasing green tea consumption categories were 1.00, 0.84 (95% CI, 0.63-1.12), 0.69 (95% CI, 0.52-0.93), and 0.69 (95% CI, 0.53-0.90), respectively (P = .004 for trend). Among the types of cardiovascular disease mortality, the strongest inverse association was observed for stroke mortality. In contrast, the hazard ratios of cancer mortality were not significantly different from 1.00 in all green tea categories compared with the lowest-consumption category. CONCLUSION: Green tea consumption is associated with reduced mortality due to all causes and due to cardiovascular disease but not with reduced mortality due to cancer.

Dietary intakes and plasma 8-iso-prostaglandin F2alpha concentrations in community-dwelling elderly Japanese: the Tsurugaya project.

We examined the association between dietary intakes and oxidative stress status in elderly Japanese. We analyzed cross-sectional data from a community-based Comprehensive Geriatric Assessment conducted in 2002. The subjects included 961 Japanese subjects aged 70 years or older who were non-daily antioxidant supplements users. We measured plasma total 8-iso-prostaglandin (PG)F(2alpha) concentrations, a measurable lipid peroxidation biomarker, using a specific enzyme immunoassay kit. Dietary intakes were assessed through a food frequency questionnaire. Subjects were divided into three groups according to their dietary intake frequencies. Logistic regression was applied to calculate the odds ratios (ORs) for being in the highest tertile of plasma 8-iso-PGF(2alpha) concentration. Frequent intake of orange or other citrus fruits, or persimmon, strawberry, or kiwi fruit was associated with lower plasma 8-iso-PGF(2alpha) concentrations, respectively. After adjustment for potential confounders, the ORs and 95% confidence intervals (CIs) for orange or other citrus fruits were 1.00 (reference), 0.66 (0.47, 0.92), and 0.58 (0.39, 0.87) (p for trend, 0.009). Intake of persimmon, strawberry, or kiwi fruit showed similar results. These associations were partly explained by vitamin C intake. Other dietary intakes had no association. Intake of fruits may have a beneficial effect against oxidative stress in elderly Japanese.

Obesity and depressive symptoms in elderly Japanese: the Tsurugaya Project.

OBJECTIVE: The aim of this study is to examine the association between obesity and depressive symptoms in Japan. METHODS: We conducted a cross-sectional study of 1128 community-dwelling elderly Japanese aged 70 years or older in 2002. We calculated the body mass index [BMI=weight (kg)/height (m)2] from measured weight and height and evaluated depressive symptoms using the 30-item Geriatric Depression Scale (GDS 30), with a cut-off point of 11. RESULTS: In men, no apparent association was observed between BMI and depressive symptoms. An inverse linear trend was observed in women overall, but stratified analysis of chronic medical conditions, such as stroke or cancer, showed an inverse association was evident only among women with the conditions. Among women without these chronic conditions, no apparent association was evident. CONCLUSION: No apparent association was observed in men overall or in apparently healthy women. An inverse trend was observed only in women with chronic medical conditions.

[Association between depressive symptoms and cerebrovascular lesions on MRI in community-dwelling elderly individuals].

AIM: We conducted a community-based study to verify relationships between cerebrovascular lesions (CVL) on magnetic resonance imaging and depressive symptoms (DS) in elderly individuals, and the validity of Krishnan's MRI-defined vascular depression (MRI-VD). METHODS: MRI was performed in 196 community-dwelling elderly individuals (mean age, 72.3 +/- 1.7 years; range, 70-75 years) with a Mini Mental State (MMS) score of 22 or more who participated in the comprehensive geriatric assessment. The DS (+) group consisted of 41 subjects with Geriatric Depression Scale (GDS) score of 15 or more. The DS (-) group consisted of 141 subjects with a GDS score of 9 or less. Hyperintensities of deep white matter and subcortical gray matter were scored according to the modified Fazekas criteria. The CVL score was defined as the higher of the two scores, and 3 grades were defined as scores of 0, 1, or 2 or more. According to Krishnan's MRI-VD, a CVL score of 2 or more was defined as CVL (+). Logistic regression analyses were used to test associations between CVL and DS, and univariate analyses were used to examine differences in clinical features between CVL (+) and CVL (-) within the DS (+) group; RESULTS: Logistic regression analysis adjusting for age, sex, cognitive function, educational level, instrumental activities of daily life (IADL) and subjective healthiness, CVL scores of 1 and 2 or more displayed significant associations with DS compared with a score of 0. However, no significant differences in DS were found between CVL (+) and CVL (-). Within the DS (+) group, no significant differences were noted between CVL (+) and CVL (-) in MMS, IADL, subjective healthiness, sleeping symptoms, alcohol-related problem or suicidal ideation. CONCLUSION: CVL was associated with DS independent of various confounders. However, clarification of clinical profiles is required to define MRI-VD as an independent clinical entity.

Green tea consumption and cognitive function: a cross-sectional study from the Tsurugaya Project 1.

BACKGROUND: Although considerable experimental and animal evidence shows that green tea may possess potent activities of neuroprotection, neurorescue, and amyloid precursor protein processing that may lead to cognitive enhancement, no human data are available. OBJECTIVE: The objective was to examine the association between green tea consumption and cognitive function in humans. DESIGN: We analyzed cross-sectional data from a community-based Comprehensive Geriatric Assessment (CGA) conducted in 2002. The subjects were 1003 Japanese subjects aged > or =70 y. They completed a self-administered questionnaire that included questions about the frequency of green tea consumption. We evaluated cognitive function by using the Mini-Mental State Examination with cutoffs of <28, <26, and <24 and calculated multivariate-adjusted odds ratios (ORs) of cognitive impairment. RESULTS: Higher consumption of green tea was associated with a lower prevalence of cognitive impairment. At the <26 cutoff, after adjustment for potential confounders, the ORs for the cognitive impairment associated with different frequencies of green tea consumption were 1.00 (reference) for < or =3 cups/wk, 0.62 (95% CI: 0.33, 1.19) for 4-6 cups/wk or 1 cup/d, and 0.46 (95% CI: 0.30, 0.72) for > or =2 cups/d (P for trend = 0.0006). Corresponding ORs were 1.00 (reference), 0.60 (95% CI: 0.35, 1.02), and 0.87 (95% CI: 0.55, 1.38) (P for trend = 0.33) for black or oolong tea and 1.00 (reference), 1.16 (95% CI: 0.78, 1.73), and 1.03 (95% CI: 0.59, 1.80) (P for trend = 0.70) for coffee. The results were essentially the same at cutoffs of <28 and <24. CONCLUSION: A higher consumption of green tea is associated with a lower prevalence of cognitive impairment in humans.