Objective. To evaluate the effectiveness of the Life Style Modification Program for Physical Activity and Diet (LiSM-PAN) in comparison to a conventional healthcare program.
Method. Subjects with risk factor(s) for chronic disease were allocated as a cluster to the LiSM group (n=92) or the Control group (n=85). The LiSM-PAN program consisted of counseling plus social and environment support, and the Control program consisted of written feedback for changing physical activity and dietary practice. Intervention was conducted for 6 months during 2001-2002 and with data analysis during 20032004 in Tokyo, Japan. The main outcomes were leisure time exercise energy expenditure (L.E.E.E.), maximum oxygen uptake (VO(2)max), dietary habits, body mass index (BMI), blood pressure, blood glucose, and lipid parameters.
Results. The LiSM group showed a significantly greater increase in L.E.E.E. than the Control group at the end of the intervention (mean intergroup difference: 400.6 kcal/week, 95% CI: 126.1, 675.0 kcal/week). No significant mean inter-group differences were observed in dietary habits. The LiSM group showed significantly greater decreases in BMI, systolic blood pressure, and LDL-cholesterol than the Control group.
Conclusion. The LiSM-PAN program produced greater positive changes in L.E.E.E., dietary habits, and risk factors for cardiovascular diseases in high-risk middle-aged male workers compared to the Control program. (C) 2007 Elsevier Inc. All rights reserved.

Objective: This study compared the effects of a behavioral approach program（BAP）and a knowledge-oriented program（KOP）to promote physical activity and healthy dietary habits in community-dwelling middle-aged Japanese. Both programs were designed to have the same intervention protocol in terms of duration and frequency. Methods: One hundred subjects（81 females）, 57.4 ± 8.3 years of age（mean ± SD）, were randomly assigned to either the BAP or KOP group. The subjects in both groups participated in 2-hr monthly group sessions over a 4 month period. The BAP was based on learning theory and social cognitive theory, and comprised of behavioral strategies（e.g., goal setting, self-monitoring, rewards, and social support）and group discussions. The KOP was based on a conventional health education program, and comprised of lectures on lifestyle-related diseases, physical exercise, and nutrition, followed by group discussions. The primary outcomes included: 1）changes in the number of walking steps, 2）total energy expenditure for exercise and leisure-time physical activities calculated by a self-reported questionnaire, 3）total energy intake of foods, fats, and vegetables, and 4）self-efficacy in physical exercise.Results: A significant inter-group difference existed in the change in number of daily walking steps between the BAP and KOP groups（+226 steps vs. －968 steps, P=0.02）. There were significant improvements in fat and vegetable intake in both the BAP and KOP groups, but there were no significant differences between the two groups. There was no significant change in exercise self-efficacy in either group. The change in exercise selfefficacy positively correlated with the change in leisure-time physical activity in the BAP group（r=0.35, P=0.02）. Conclusion: These findings suggest that the behavioral approach program promoted greater improvement in physical activity than the conventional health education program in community-dwelling middle-aged Japanese adults.

The purpose of this study was to explore the fundamental factors for the development of a prevention program for life-style related diseases using a health examination and follow-up services in primary care setting for community health.The research subjects were 22 persons（4 males and 18 females）who had any factors for life-style related diseases in a health examination carried out in the 2001 fiscal year in a city. They included five persons（who judged as to be needed a lifestyle improvement by a medical doctor）, five public-health-service participants, and twelve members of self-promotion group in the community. For six months from October, 2001 to March, 2002, the program was provided through a regular （once a month）health learning class for 90 minutes per session. After the health examination, subjects were selected as a life-style related disease high-risked population. The health status was assessed by a self-reported questionnaire and a fitness test before and after the class. They set up the goal for change in behaviors individually with having the support from the health staffs. The program repeated practice of goal behavior, the target revision by individual consultation, and the group work in the classes. They consulted the health examination one year after. In the class, the participant learned how to exercise at home and self-monitoring method for exercise and dietary practices by receiving lectures and instructions concerning exercise and diet in daily life.The utility was evaluated by the implementation and the process of the program. The implementation was assessed by a participating rate（defined as the number of persons consulted the two health examinations divided by the numbers of the subjects）, an attendance rate（defined as the attendance times divided by six times）, and a submit rate（defined as the number of submitted sheets divided by five sheets）and an entry rate（defined as the number of entering days divided by one hundred forty days）of the self-monitoring sheets. The process was assessed by an attending rate（defined as the monthly number of attendants divided by the number of the subjects）, a collecting rate of the self-monitoring sheets（defined as the monthly number of the sheets collected divided by the number of the subjects）, and self-monitoring for exercise（daily average number of steps）. The effectiveness was assessed by the changes in behaviora（l the exercise and diet stage of change）, physical（the 3-minute walk distance）, and medical indices（the life-style instruction category）. The results obtained as follows:1 ）The participating rate was 100％, mean（standard deviation）of the attendance rate was 82.6（20.9）％.2 ）The submit rate and the entry rate of the self-monitoring sheets was 83.6（14.7）％ and 67.3（18.0）％, respectively.3 ）The attending rate was 81.8％ at the first, 90.9％ at the second, 81.8％ at the third, 90.9％ at the fourth, 72.7％ at the fifth, and 77.3％ at the sixth class. The collecting rate was 90.9％ at the first, 95.5％ at the second, 100％ at the third, 81.8％ at the fourth, and 50.0％ at the fifth month. The mean（standard deviation）of daily average number of steps was 6784（2582）before the intervention, 8,198（2732）at the first, 6798（2121） at the second, 7171（2599）at the third, 7294（2140）at the fourth, and 7900（2760）at the fifth month. The main effect of time was not significant.4 ）Those who improved the exercise and diet stage of change between before and after the intervention were three and seven subjects, respectively. There were no significant changes both in exercise（p=0.83）and in diet （p=0.29）behavior.5 ）The 3-minute walk distance significantly increased after the intervention both in male（24m, p<0.01）and in female（20m, p=0.05）.(View PDF for the rest of the abstract.)

Objective: the effects of regular exercise over 5 years on mortality and ADL impairment were evaluated in elderly people.
Design: intervention study.
Setting: Tsuru City Yamanashi prefecture, Japan.
Methods: the subjects of this study were 245 elderly people living at home. Of these individuals, 155 (56 males aged 76.5+/-4.2 years at the baseline level; 99 females aged 76.2+/-4.8 years) who voluntarily participated in our original health-promoting programme were regarded as an intervention group. The remaining 90 (29 males aged 77.6+/-5.2 years at the baseline level; 61 females aged 77.3+/-5.1 years) were regarded as a control group. The programme was a 5-year intervention consisting of collective sessions given six times a year every 2 months. The intervention was a combination of an exercise programme based on theories of exercise physiology and a support programme based on health education theories. The relative risks of death and ADL impairment adjusted for age, presence or absence of cardiovascular or musculo-skeletal disorders, and functional fitness level at the baseline were calculated using logistic regression analysis.
Results: the rates of participant compliance per year were 67.7% in the first year of the intervention period and gradually decreased thereafter to 43.9% in the last year. Amongst female subjects the percentage of those who exercised habitually at the end of the study period was the same as that in the baseline in the intervention group but was significantly lower at the end of the study in the control group (chi(2)=10.576, P&lt;0.01). The relative risk of death in the intervention group was 1.0 (95% CI 0.22-4.51) amongst the males and 0.16 (95% CI 0.03-0.81) amongst the females. Relative risk of ADL impairment was 0.22 (95% CI 0.03-1.42) amongst the males and 0.36 (95% CI 0.13-1.02) amongst the females.
Conclusion: These findings suggest that the improved mortality and state of independence in the female portion of the intervention group occurred as a result of increased physical exercise levels in daily fife. However, validation of our results must await research that employs a randomized control trial to avoid various biases and confounding factors between the intervention and the control groups.

We measured functional fitness in older subjects and performed a follow-up survey for 6 years to clarify whether the level of functional fitness at a given point contributes to prediction of the subsequent occurrence of impairment of functions necessary for independent living. The longitudinal data were obtained for 391 persons aged 60 years or over, who were independently living in the community. Four items of functional fitness, i.e. the ability to perform standing/sitting movements, ability to perform traveling movements, ability to perform housekeeping movements, and ability to perform personal grooming activities, were assessed. The relationship between functional fitness and the risk of the occurrence of impairment of independence in daily living was evaluated using a binomial logistic regression model. In males, all the 4 items of functional fitness were significantly related to the risk of impairment of activities of daily living (ADL). In females, however, none of the items was significantly related to the risk of ADL impairment. In conclusion, functional fitness appears to be valid as a predictive parameter of future occurrence of ADL impairment in relatively healthy and independent elderly males. However, its validity in elderly females needs further evaluation.

The purpose of this study was to investigate the effect of moderate intensity exercise on gastric emptying and absorption using positron emission tomography（PET）with oral 18F-fluoro-deoxy-glucose（18FFDG） intake. Seven healthy subjects aged 20～28 years volunteered to participate in this study. Each subject exercised on a bicycle ergometer for 30 minutes at 60％ maximal oxygen uptake（Exercise trial）. A control trial（without exercise）was also performed by the subjects. Immediately before starting exercise， 300ml of water containing 18F-FDG was orally administered. 18F-FDG accumulation in the alimentary tract was measured with 3D PET after the end of exercise. Regions of interest were drawn on visually defined stomach and small intestine. To measure blood glucose, plasma radioactivity, and plasma CCK, blood was sampled 4 times every 10 minutes throughout the exercise. Percent contents of remaining radioactivity in stomach in exercise trial was higher than that in control. Significant change in blood glucose level due to exercise was showed. Plasma CCK level in exercise trial was higher than that in control at the end of exercise. The effect of exercise on ％contents of remaining radioactivity in the total alimentary tract or change in plasma radioactivity level was not significant.These findings suggest that cycling exercise for 30 minutes at moderate intensity has a depressive effect on gastric emptying of fluid intake partially influenced by CCK, but no marked effect on absorption of 18F-FDG from the intestine in normal human subjects.