The differences in the association of objectively measured physical activity with disability between frail and non-frail older adults remain unclear. We (1) evaluated the dose-dependent relationship between daily steps and disability in older adults with and without frailty and (2) examined the interaction between steps and frailty status in relation to the risk of disability. This prospective study used data from 4065 adults aged ≥ 65 years from the Kyoto-Kameoka Study, Japan. The mean daily step count obtained using triaxial accelerometers across ≥ 4 days was recorded. Frailty was evaluated using the validated Kihon Checklist. Disability was identified using the long-term care insurance system's nationally unified database, with data collected until November 30, 2016. Overall, 385 disabilities were recorded during a median follow-up period of 3.32 years (12,855 person-years). After adjusting for confounders, an inverse association was observed between daily step count and disability risk. The disability risk plateaued at 5,000-7,000 steps/day in non-frail people, whereas step counts showed an almost linear inverse relationship with disability risk in frail people. Low step counts (< 5,000 steps) in frail people were more strongly associated with disability risk than were high step counts (≥ 5,000 steps) in non-frail people. The additive interaction between steps and frailty was associated with the relative excess risk of disability in frail people with low step counts (p for interaction = 0.015). The relationship between daily steps and disability differs between older adults with and without frailty, and the adverse effects of frailty on disability risk depend on physical activity.

Abstract

Urban design is the science (not art) of (re)building and (re)arranging the built environment to influence people’s behavior. It can influence stress through several physiological, psychological, and social mechanisms. This interdisciplinary article aims to offer a comprehensive framework on how urban design attributes affect stress through physiological responses. By concentrating on physiological responses, it provides a quantifiable and objective approach to exploring potential relationships between urban design and stress and associated health outcomes. This article presents a focused discussion of relevant literature that supports the development of the proposed framework. It also discusses current gaps and future directions on this topic. The proposed framework considers urban design science’s influence on stress through multiple physiological pathways such as endocrine and nervous responses. It suggests that certain urban design attributes, such as walkability and availability of green spaces, may be associated with influencing urban residents’ stress and mental health.

BACKGROUND: Resistance training is a well-known exercise therapy for preventing and improving lacks of muscle mass, strength, and quality with advances in age; however, its effects on arterial stiffness are not beneficial. Additionally, a higher intake of protein, which is an effective nutrient for muscle health, results in lower arterial stiffness. Whether the combination of moderate to high-intensity resistance training and high-protein intake would improve muscle mass, strength, and quality and cancel the resistance training-induced increase in arterial stiffness in elderly women remains unclear. METHODS: Ninety-three elderly women (67.2 ± 5.3 years) were randomly divided into four groups; sedentary control (CON), higher dietary animal protein intake (HP), resistance training (RT), and combination of RT and HP (RT + HP) groups. Participants in the RT and RT + HP groups completed 12 weeks of resistance training (exercise intensity at 70% of one-repetition maximum (1-RM), three sets with 10 repetitions of leg extension and curls, 3 days/week). In addition to the daily diet, the HP and RT + HP groups consumed steamed chicken breast as a high-protein diet. RESULTS: Percent changes in thickness (indices of muscle mass) and echo intensity (index of muscle quality) in the quadriceps muscle, 1-RM of leg extension and curls (index of muscle strength), and circulating C1q levels (a potential biomarker of muscle fibrosis) in the RT and RT + HP groups significantly improved after both RT and RT + HP interventions (P < 0.05). Percent changes in carotid-femoral pulse wave velocity (cfPWV) and carotid β-stiffness (indices of arterial stiffness), and circulating angiotensin II (a vasoconstrictor peptide hormone) levels via each intervention were significantly higher in the RT group (4.9 ± 12.7%, 13.8 ± 13.5%, 94.9 ± 132.7%, respectively), as compared with the CON group (-2.5 ± 5.9%, 0.2 ± 8.1%, 21.2 ± 79.3%, respectively) (P < 0.05). Of note, no significant differences in the cfPWV, carotid β-stiffness, and circulating angiotensin II levels between the RT + HP (-2.4 ± 9.3%, 2.4 ± 10.3%, -5.7 ± 29.6%, respectively) and CON groups were observed. Furthermore, significant positive relationships between the percent changes in circulating angiotensin II levels, and cfPWV (r = 0.438, P < 0.01) and carotid β-stiffness (r = 0.328, P < 0.01) were observed. CONCLUSIONS: The combination of moderate to high-intensity resistance training and regular intake of steamed chicken breast as a high-protein food could increase muscle mass, strength, and quality and could cancel resistance training-induced increases in arterial stiffness in elderly women.

Objective

Barley, abundant in β-glucan, a soluble dietary fiber, holds promise in obesity prevention. Given the microbial metabolism of dietary fiber in the gastrointestinal tract, we investigated the role of gut microbiota in non-obese individuals consuming high levels of barley.

Methods

Our study enrolled 185 participants from “The cohort study on barley and the intestinal environment (UMIN000033479).” Comprehensive physical examinations, including blood tests, were conducted, along with separate assessments of gut microbiome profiling and dietary intake. Participants were categorized into high and low barley consumption groups based on the median intake, with non-obese individuals in the high intake group identified as barley responders while participants with obesity were designated as non-responders. We compared the relative abundance of intestinal bacteria between these groups and used multivariate analysis to assess the association between intestinal bacteria and barley responders while controlling for confounding factors.

Results and discussion

Among the fermented food choices, responders exhibited notably higher consumption of natto (fermented soybeans) than non-responders. Moreover, after adjusting for confounders, Butyricicoccus and Subdoligranulum were found to be significantly more prevalent in the intestines of responders. Given natto’s inclusion of Bacillus subtilis, a glycolytic bacterium, and the butyrate-producing capabilities of Butyricicoccus and Subdoligranulum, it is hypothesized that fiber degradation and butyrate production are likely to be enhanced within the digestive tract of barley responders.

BACKGROUND: Reports that collect and organize dietary reference intake (DRI) data for military operations in different countries and regions worldwide are limited.This scoping review aimed to collect and organize information on the status of formulating a DRI for military operations in each country. METHODOLOGY: For the information search, we queried PubMed and Google for literature and reports on the DRI for military operations and summarized the content of the adopted literature and reports. RESULTS: The content and rationale for DRI for military operations in Australia, the United Kingdom (UK), the United States of America (USA), and the North Atlantic Treaty Organization (NATO) can be summarized as follows: (1) Energy requirements: Four reports formulated physical activity levels (PALs) and corresponding energy requirements that differed from those for the civilian public. The PAL range for the military was set as high as 1.50-3.20, as opposed to the standard civilian upper PAL set at 1.20-2.20. (2) Protein: Three military reports outside of the UK had different standards than those for the civilian public with an increased intake in accordance with the high PAL while simultaneously preventing excessive intake.In the military, values were formulated 1.2-4.8 times higher than the standards for civilians (45-65 g/day to 55-307 g/day). (3) Macronutrient energy distribution: Four military reports established macronutrient energy distributions that differed from those for the civilian public. The DRI for the Australian and UK militaries was formulated such that as PAL increased, protein decreased, fat decreased or remained unchanged, and carbohydrate increased. (4) Sodium: Considering that military personnel sweat more due to high physical activity and their environment, two Australian and NATO reports were established with sodium levels that were twice as high as that of the civilian public (460-2,300 mg/day to 920-3,200 mg/day). Increasing sodium intake to <4,800 mg/day is recommended for individuals who sweat a lot or are not accustomed to hot environments. CONCLUSIONS: The DRI in Australia, the UK, USA, and NATO consider the physical activity and operating environment of military personnel, differing from those of the civilian population in terms of (1) energy requirements, (2) protein, (3) macronutrient energy distribution, and (4) sodium.

Abstract

Background

Sarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)).

Methods

Subjects were 170 community-dwelling healthy elderly women aged 65–79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m²) and a cutoff of ≥ 25 kg/m² was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m²) to obtain SMI (kg/m²). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively.

Results

When obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups.

Conclusion

Our findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals.

Abstract

Objective:

Water is an essential nutrient for all organisms and is important for maintaining life and health. We aimed to develop a biomarker-calibrated equation for predicting water turnover (WT) and pre-formed water (PW) using the doubly labelled water (DLW) method.

Design:

Cross-sectional study.

Setting:

General older population from the Kyoto–Kameoka Study, Japan.

Participants:

The 141 participants aged ≥ 65 years were divided into a model developing (n 71) and a validation cohort group (n 70) using a random number generation. WT and PW was measured using the DLW method in May–June of 2012. In developing the cohort, equations for predicting WT and PW were developed by multivariate stepwise regression using all data from the questionnaires in the Kyoto–Kameoka study (including factors such as dietary intake and personal characteristics). WT and PW measured using the DLW method were compared with the estimates from the regression equations developed using the Wilcoxon signed-rank test and correlation analysis in validation cohort.

Results:

The median WT and PW for 141 participants were 2·81 and 2·28 l/d, respectively. In the multivariate model, WT (R² = 0·652) and PW (R² = 0·623) were moderately predicted using variables, such as height, weight and fluid intake from beverages based on questionnaire data. WT (r = 0·527) and PW (r = 0·477) predicted that using this model was positively correlated with the values measured by the DLW method.

Conclusions:

Our results showed factors associated with water requirement and indicated a methodological approach of calibrating the self-reported dietary intake data using biomarkers of water consumption.

OBJECTIVES: Some studies reported a relationship between life-space mobility (LSM) and frailty assessed by physical aspects; however, a more comprehensive discussion of frailty is underdeveloped. In addition, previous studies have focused only on older Euro-American people. Therefore, we aimed to examine LSM-frailty relationships in community-dwelling older Japanese persons using physical and comprehensive frailty indices. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: We used the data of 8898 older adults from a baseline survey of the Kyoto-Kameoka Study in Japan. METHODS: The validated life-space assessment (LSA) was used to evaluate LSM and categorized it into quartiles. Two validated indices were used to evaluate frailty: the Kihon Checklist (KCL) and the simple Frailty Screening Index (FSI). Multivariable logistic regression was used to determine the relationships between LSM scores and frailty. RESULTS: The mean age (SD) of the participants was 73.4 (6.3) years, and 53.3% were women. The mean LSM score of the study participants was 53.0. The prevalence of frailty by KCL and FSI was 40.7% and 16.8%, respectively. Significant differences between LSM score and frailty prevalence were observed [KCL: Q1, reference; Q2, odds ratio (OR) 0.53, 95% CI 0.45-0.62; Q3, OR 0.30, 95% CI 0.25-0.35; Q4: OR 0.22, 95% CI 0.18-0.26, P for trend <.001; FSI: Q1, reference; Q2, OR 0.57, 95% CI 0.48-0.68; Q3: OR 0.38, 95% CI 0.31-0.46; Q4: OR 0.35, 95% CI 0.28-0.42, P for trend <.001]. Similar results were observed when LSM scores were examined at 10-point intervals, with LSM and frailty exhibiting an L-shaped relationship. The LSM score dose-response curve at which the OR for frailty plateaued among older individuals was approximately 81-90 score. CONCLUSIONS AND IMPLICATIONS: LSM score and frailty prevalence exhibited L-shaped relationships in community-dwelling older persons. This study's findings provide useful data for setting LSM targets for preventing frailty in community-dwelling older persons.

BACKGROUND/OBJECTIVES: While some dietary guidelines have established daily water requirements for adults, those for older adults are not well defined. Factors associated with water turnover (WT), indicating water requirements and preformed water (PW), referring to fluids consumed from food and beverages, remain poorly understood. Therefore, we aimed to investigate these factors in Japanese adults. SUBJECTS/METHODS: This cross-sectional study included 57 participants aged 54-85 years, living in Fukuoka City, Japan. The WT and PW were measured using the doubly labelled water (DLW) methods from August 2015 to September 2015. Dietary intake and physical activity were evaluated using a 3-day dietary record (DR) and a validated triaxial accelerometer, respectively. Fasting blood and urine samples, as well as environmental conditions, were assessed using a validated technique. We evaluated the variables for predicting water consumption by using a multivariate generalised linear model, with forward stepwise selection using these covariates. RESULTS: The median WT and PW were 2842 ml/day and 2227 ml/day, respectively. In the multivariate model, WT (R2 = 0.629) and PW (R2 = 0.621) were moderately predicted by variables such as sex, body weight, moderate-to-vigorous physical activity, water consumption estimated by DR, urinary aldosterone and osmolality, creatinine clearance and wet-bulb globe temperature. The PW estimates from DR were ~40% lower than those from DLW method, despite a significant correlation between the values. CONCLUSIONS: WT and PW are associated not only with lifestyle and environmental factors but also with urinary markers and kidney function. These findings provide useful insights into the differences in each individual's water requirement.

PURPOSE: Body cooling during and after exercise stimulates energy intake (EI). Cooling vests can also reasonably decrease body temperature under various sport occasions. This study examined the acute effects of wearing a cooling vest on EI and appetite after exercise and rest. METHODS: Fifteen healthy young men underwent four trials randomly in a thermoneutral room (~24 °C, ~40% humidity). In two exercise trials, participants performed a 60-minute run at 75% of maximum oxygen uptake and wore a cooling vest (ExC) or thermoneutral vest (ExN) from 1030-1130 h. In two resting trials, participants rested for 60 minutes and wore a cooling vest (RC) or a thermoneutral vest (RN) from 1030-1130 h. From 1130 h, participants consumed a buffet meal until satiety. EI was calculated from the buffet meal. Skin and rectal temperatures were assessed between 0930 h and 1130 h. RESULTS: EI was significantly higher in the ExC trial (1740 ± 642 kcal) than in the ExN trial (1584 ± 604 kcal) and higher in the RC trial (1879 ± 806 kcal) than in the RN trial (1726 ± 806 kcal). Hot foods consumption was significantly higher in the ExC trial than in the ExN trial and higher in the RC trial than in the RN trial. Subjective hunger was significantly higher in the ExC trial than in the ExN trial. Lower rectal temperatures were associated with higher relative EI (β = -8.871, P < 0.001).Conclusions: Wearing a cooling vest increased EI after exercise or rest and increased subjective appetite only after exercise. Increased EI may result from a preference for hot foods altered by a cooling vest.

OBJECTIVES: Poor cardiorespiratory fitness (CRF) and high body mass index (BMI) increased the risk of developing metabolic Syndrome (MetS) mostly in Caucasians. However, the sex-specific combined association of CRF and BMI on MetS considering health-related behaviors has yet to be thoroughly examined in Japanese. This study aims to investigate the sex-specific independent and combined associations of CRF and BMI with MetS in middle-aged Japanese adults. METHODS: 421 participants were included in this cross-sectional study. CRF was estimated using a submaximal cycle ergometer. CRF and BMI were respectively divided into three categories according to tertile distribution. MetS was diagnosed based on five risk factors: waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose. Multivariable logistic regression models were used to estimate independent and combined association of CRF and BMI with MetS. RESULTS: Results showed that 154 (57.5%) and 70 (45.8%) of men and women had MetS, respectively. Compared to men with lower CRF or higher BMI, men with middle and higher CRF or middle and lower BMI were less likely to have MetS. Compared with 'unfit and higher BMI' group, 'unfit and lower BMI', 'fit and higher BMI', and 'fit and lower BMI' groups in men showed statistically significant decreased prevalences of MetS. However, no significant associations were found in women. CONCLUSIONS: This study found significant independent and combined associations of CRF and BMI with MetS only in men, but not in women. However, prospective studies are warranted to confirm sex-specific associations of CRF and BMI with MetS.

BACKGROUND: There are now many different types of activity trackers, including pedometers and accelerometers, to estimate step counts per day. Previous research has extensively examined step-count measurements using activity trackers across various settings while simultaneously wearing different devices.; however, older adults frequently display distinct walking patterns and gait speeds compared to younger adults. This study aimed to compare the step-count between older and younger adults by having them simultaneously wear seven different activity trackers in free-living experiments. METHODS: This study included 35 younger adults (21-43 yrs) and 57 physically independent older adults (65-91 yrs). All participants simultaneously wore one pedometer and six activity trackers: ActiGraph GT3X + Wrist and Hip, Omron Active Style Pro HJA-350IT, Panasonic Actimarker, TANITA EZ-064, Yamasa TH-300, and Yamasa AS-200 for seven days. A regression equation was also used to assess inter-device compatibility. RESULTS: When comparing wrist-worn ActiGraph to the six hip-worn activity trackers, the wrist-worn ActiGraph consistently recorded step counts over 4,000 steps higher than hip-worn activity trackers in both groups (range, 3000-5000 steps). Moreover, when comparing the ActiGraph worn on the wrist to that worn on the hip, the proportion was higher among older adults compared to younger ones (younger: 131%, older: 180%). The Actimarker recorded the highest average step counts among six hip-worn devices, with 8,569 ± 4,881 overall, 9,624 ± 5,177 for younger adults, and 7,890 ± 4,562 for older adults. The difference between the hip-worn ActiGraph and Active Style Pro was just about 70 steps/day overall. The correlation among all devices demonstrated a very high consistency, except for the wrist-worn ActiGraph (r = 0.874-0.978). CONCLUSIONS: Step counts recorded from seven selected consumer-based and research-grade activity trackers and one pedometer, except for the wrist-worn ActiGraph. showed a variation of approximately 1700 steps (range, 1265-2275 steps) steps for both groups, yet maintained a high correlation with each other. These findings will be valuable for researchers and clinicians as they compare step counts across different studies or representative surveys conducted globally.

Abstract

This study investigated the effects of white meat, such as chicken, intake combined with resistance training on muscle mass and strength in the elderly women, and whether the underlying mechanism involves changes in the gut microbiota. Ninety‐three volunteers (age 59–79 years) were randomly allocated to sedentary control with placebo (Sed + PL) or chicken meat (Sed + HP) and resistance training with placebo (RT + PL) or chicken meat (RT + HP). Resistance training sessions were performed 3 d/week for 12 weeks using leg extensions and curls. Boiled chicken meat (110 g, containing 22.5 g protein) was ingested 3 d/week for 12 weeks. Maximal muscle strength and whole‐body lean mass increased significantly in the RT + PL group compared to the Sed + HP group, and the RT + HP group showed a significantly greater increase than the Sed + HP and RT + PL groups. Additionally, the gut microbiota composition did not change before or after the interventions in any of the four groups. Moreover, the individual comparison of gut bacteria using false discovery rate‐based statistical analysis showed no alterations before or after the interventions in the four groups. Resistance training combined with chicken meat intake may effective have increased muscle mass and strength without drastically modifying the gut microbiota composition in elderly women.

BACKGROUND: Although oral frailty is independently associated with an increased risk of mortality, evidence for the usefulness of screening tools for oral frailty is less than that for physical frailty screening tools. We aimed to investigate the relationship between oral frailty and mortality in older adults. METHODS: This prospective cohort study included 11,374 adults aged ≥65 years, who provided valid responses to a baseline mail survey questionnaire from the Kyoto-Kameoka study. Oral frailty status was evaluated using the Oral Frailty Index-8 (range, 0 [best] to 10 [worst]). Participants were classified into four categories according to the Oral Frailty Index-8: robust (score, 0-2), oral pre-frailty (score, 3), oral frailty (score, 4-6), and oral severe frailty (score ≥ 7). Physical and psychological frailty were evaluated using the validated frailty-screening index and defined as a score of ≥3 out of a possible 5 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. RESULTS: During the 5.3-year median follow-up period (57,157 person-years), 1184 deaths were recorded. After adjusting for confounders, including physical and psychological frailty, medical history, and lifestyle, in comparison with a robust oral status, oral pre-frailty (HR, 1.29; 95 % confidence interval [CI], 1.02-1.63), oral frailty (HR, 1.22; 95 % CI, 1.01-1.48), and oral severe frailty (HR, 1.43; 95 % CI, 1.16-1.76) were associated with higher HRs of mortality (p for trend = 0.002). CONCLUSION: Oral frailty is associated with mortality independent of physical and psychological frailty in older adults. The Oral Frailty Index-8 may be useful for identifying individuals at high risk of mortality.

Objectives National policies to promote physical activity and exercise have been formulated by several ministries and agencies in Japan. This study aimed to examine the formulation and implementation of such policies in municipalities by administrative sector and population size.Methods After stratifying all municipalities in Japan at the population level, we randomly selected 272 municipalities. We collected 1,632 cases in six sectors (health, sports, education, urban planning, transportation, and environment) within these municipalities. A questionnaire survey on the status of policy formulation, implementation, and coordination among departments was conducted as a cross-sectional study. Differences between groups of municipalities were statistically analyzed using Fisher's exact test. The survey period was from September 2018 to March 2019.Results A total of 616 responses were collected (response rate 37.7%). The response rates for health and education were lower than those for the other sectors. The rate of policy formulation to promote physical activity was extremely high in the health and sports sectors, and there was slight variation by population size. In contrast, formulation rates were generally low in the urban planning, transportation, and environment sectors, especially in smaller municipalities. In the sectors mentioned above, physical activity promotion projects mainly involved the development of exercise and sports infrastructures. Health, sports, and education were the primary sectors that used those environments. Regarding interdepartmental coordination in policy implementation, a cooperative relationship existed among the health, sports, and education sectors and between the urban planning and transportation sectors. However, smaller municipalities were found to have fewer opportunities for such collaboration and tended to implement policies independently.Conclusion This study clarifies the policy formulation and implementation for promoting physical activity in municipalities at the national level in Japan. In addition, their characteristics were identified based on different administrative sectors and population size. These results are expected to be used in future local government policies.

Abstract

Objective

This study aimed to determine the effects of different energy loads on the gut microbiota composition and the rates of energy and nutrient excretion via feces and urine.

Methods

A randomized crossover dietary intervention study was conducted with three dietary conditions: overfeeding (OF), control (CON), and underfeeding (UF). Ten healthy men were subjected to each condition for 8 days (4 days and 3 nights in nonlaboratory and laboratory settings each). The effects of dietary conditions on energy excretion rates via feces and urine were assessed using a bomb calorimeter.

Results

Short‐term energy loads dynamically altered the gut microbiota at the α‐diversity (Shannon index), phylum, and genus levels (p &lt; 0.05). Energy excretion rates via urine and urine plus feces decreased under OF more than under CON (urine −0.7%; p &lt; 0.001, urine plus feces −1.9%; p = 0.049) and UF (urine −1.0%; p &lt; 0.001, urine plus feces −2.1%; p = 0.031). However, energy excretion rates via feces did not differ between conditions.

Conclusions

Although short‐term overfeeding dynamically altered the gut microbiota composition, the energy excretion rate via feces was unaffected. Energy excretion rates via urine and urine plus feces were lower under OF than under CON and UF conditions.

BACKGROUND & AIMS: The differences in the association of body mass index (BMI) with mortality between older adults with and without frailty remain unclear. This study investigated this association in community-dwelling older adults with and without frailty. METHODS: This prospective study included 10,912 adults aged ≥65 years who provided valid responses to a baseline mail survey questionnaire in the Kyoto-Kameoka Study in Japan. The BMI was calculated based on self-reported height and body weight and classified into four categories: <18.5, 18.5-21.4, 21.5-24.9, and ≥25.0 kg/m2. Frailty was evaluated using the validated Kihon Checklist and defined as a score of 7 or higher out of a possible 25 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. RESULTS: During the 5.3 year median follow-up period (54,084 person-years), 1352 deaths were recorded. After adjusting for confounders, including lifestyle and medical history, compared with participants with a BMI of 21.5-24.9 kg/m2, those in the lower BMI category had a higher mortality HR, while those with a higher BMI displayed an inverse association with mortality (<18.5 kg/m2: HR: 1.85, 95% confidence interval [CI]: 1.58-2.17; 18.5-21.4 kg/m2: HR: 1.38, 95% CI: 1.21-1.58; and ≥25.0 kg/m2: HR: 0.80, 95% CI: 0.67-0.96). In a model stratified by frailty status, the BMI range with the lowest HR for mortality was 23.0-24.0 kg/m2 in non-frail older adults; however, in frail older adults, a higher BMI was inversely associated with mortality. CONCLUSIONS: The relationship between BMI and mortality varies between individuals with and without frailty, with those experiencing frailty potentially benefiting from a higher BMI compared to those without frailty. This study suggests that frailty should be assessed when considering the optimal BMI for the lowest mortality risk among older adults.

AIMS: High non-fasting triglycerides (TG) concentration is linked to the development of atherosclerosis, and physical activity is commonly recommended to reduce postprandial TG concentration and cardiovascular diseases. Previous studies have demonstrated that acute whole-body (walking and running) or lower-body (leg cycling) aerobic exercise reduces postprandial TG. However, it is unclear whether upper-body exercise (i.e. arm-cranking) with sufficient energy expenditure lowers postprandial TG. Therefore, this study aimed to evaluate the effects of energy-matched upper- and lower-body exercises on postprandial TG concentrations the next day in healthy young men. METHOD AND MATERIALS: Fifteen healthy young men (age 22.5 ± 1.7 years, height 173.8 ± 5.7 cm, body mass 68.2 ± 8.5 kg, peak oxygen uptake 48.0 ± 5.5 mL/min/kg and physically active) participated in a three-arm crossover trials: 1) arm-cranking, 2) leg-cycling exercise at 70% of mode-specific peak oxygen uptake to induce a net energy expenditure of 1,255 kJ, or 3) rested between 16:00 and 17:00 h on day 1 and consumed two standardised meals for breakfast (10:00 h) and lunch (13:00 h) on day 2. The mean macronutrient content of the breakfast was 44.9 ± 5.6 g fat, 104.8 ± 13.0 g carbohydrate, and 29.4 ± 3.6 g protein, which provided 3.95 ± 0.49 MJ energy (43% fat, 45% carbohydrate, and 12% protein), and that of the lunch was 45.2 ± 5.6 g fat, 106.7 ± 13.2 g carbohydrate, and 33.9 ± 4.2 g protein, which provided 4.06 ± 0.50 MJ energy (42% fat, 44% carbohydrate, and 14% protein). RESULTS: Time-averaged postprandial serum TG concentrations over 8 h differed among trials (main effect of trial p < 0.001) and were lower in the upper- and lower-body exercise trials than in the control trial (1.46 ± 0.54 vs. 1.50 ± 0.69 vs. 1.79 ± 0.83 mmol/L, respectively). The incremental TG area under the curve (AUC) (main effect of trial, p = 0.012) was 39% and 37% higher in the control trial than in the upper- and lower-body exercise trials (p = 0.025 and p = 0.033, respectively). There were no significant differences in incremental TG AUC between the upper- and lower-body exercise trials. CONCLUSION: An acute bout of energy-matched upper- and lower-body exercises similarly lowered postprandial TG concentrations the following day in healthy young men.Trial registration number: UMIN000045449.Date of registration: 10 September 2021.

Objective: In epidemiological studies, physical activity is objectively assessed using pedometers and activity monitors. Understanding the types, features, and accuracies of these devices is crucial for interpreting the results of studies conducted on different devices. This study aimed to systematically collect and organize information on the step-detection methods, step cancellation functions, and memory functions of pedometers and activity monitors from major Japanese manufacturers, with the goal of facilitating their practical application.

<Br>Methods: Three domestic manufacturers were selected: Omron, Yamasa, and Tanita. From each manufacturer’s website, we collected information on the price, weight, placement, step detection methods, and the presence or absence of filter and memory functions, including their duration.

<Br>Results: Of the 34 models tested (six from Omron, eight from Yamasa, and 20 from Tanita), three models (two from Yamasa and one from Tanita) used a spring-levered pendulum mechanism and were worn on the waist. The remaining 31 models used accelerometers. All accelerometer models included step cancellation functions, but the setting conditions varied by manufacturer: Omron set it at 4 seconds, Yamasa at 10 stepshows, and Tanita at 7 seconds.

<Br>Conclusion: This study shows notable differences in step detection methods, filter functions, and memory functions depending on the manufacturer and device. When conducting research that measures step counts, implementing health guidance, and interpreting the results of measurements using different devices, it is essential to systematically consider the specific characteristics of pedometers and activity monitors.

Objective: The results of the National Health and Nutrition Survey regarding exercise habits and step counts are utilized to set targets and monitor Japan’s health policy. A comprehensive understanding of the evolution of survey methodologies is thus essential for the effective formulation of policies within the realm of physical activity. This study aims to systematically categorize survey items pertaining to exercise habits, step counts, anthropometric measurements and physical fitness surveyed from 1946 to 2019.
<Br>Methods: This study encompasses surveys conducted from 1946 to 2019, comprising all years. Information pertaining to survey items related to exercise habits, step counts, and anthropometric measurements and physical fitness was gathered from the summaries and reports of each survey year. The data underwent systematic organization of the items, incorporating details on survey methods and any alterations made.
<Br>Results: Exercise habit is consistently defined as engagement in 30 minutes or more of exercise at least twice a week for a duration of one year or more. In this study, it was investigated through face-to-face surveys conducted by researchers since 1986. Since 1989, the pedometer from Yamasa Tokei Keiki Co., Ltd., worn at the waist, has been employed to measure daily step counts for November, excluding Sundays and holidays. The survey encompassed not only exercise habits and step counts but also delved into broader aspects, such as general physical activity, exercise, sports participation, frequency, duration, motivation, grip strength, and anthropometric measurements, and it was adapted to societal contexts.
<Br>Conclusion: The above definition of exercise habit and the pedometer to quantify step counts have been utilized consistently since the survey’s inception. Consequently, it was deemed feasible to utilize the National Health and Nutrition Survey to assess temporal variations in exercise habits and step counts.

Sports science focuses on enhancing athletes' performance, requiring a multifaceted approach. It is evolving from a purely muscle-centred approach to an interdisciplinary one. This paper investigates built environment design science, a dimension less explored in relation to enhancing athlete performance in sports science. The discussion is divided into three categories: athlete-centric training built environment design, enhanced fan and community engagement, and improved integrative accessibility. The study also identifies future research directions, including evidence of the relative impact of the built environment, financial aspects, and performance evaluation methods. Collaboration between sports scientists and scholars in urban design, parks, transportation, landscape architecture and environmental psychology is necessary to advance this topic further.

AIM: The gut microbiota has emerged as a new intervention target for sarcopenia. Prior studies in humans have focused on the association between gut microbiota and skeletal muscle quantity, while the evidence on muscle function and quality is lacking. This study aimed to identify gut microbiota genera associated with skeletal muscle function, quantity, and quality in a general population of Japanese adults. METHODS: This cross-sectional study included 164 participants aged 35-80 years, women and men recruited from urban areas of Japan. Fecal samples were collected and analyzed using 16S rRNA gene amplicon sequencing. Skeletal muscle function was measured using handgrip strength and leg extension power (LEP), while skeletal muscle mass was estimated using bioelectrical impedance analysis. Phase angle was used as a measure of skeletal muscle quality. Multivariate linear regression analysis stratified by age group was used to examine the association between the dominant genera of the gut microbiota and skeletal muscle variables. RESULTS: A significant association was found between Bacteroides and Prevotella 9 with LEP only in the ≥60 years group. When both Bacteroides and Prevotella 9 were included in the same regression model, only Bacteroides remained consistently and significantly associated with LEP. No significant associations were observed between skeletal muscle mass, handgrip strength, and phase angle and major gut microbiota genera. CONCLUSIONS: In this study, we observed a significant positive association between Bacteroides and leg muscle function in older adults. Further studies are required to elucidate the underlying mechanisms linking Bacteroides to lower-extremity muscle function. Geriatr Gerontol Int 2023; ••: ••-••.

Abstract

DNA methylation-based age estimators (DNAm aging clocks) are currently one of the most promising biomarkers for predicting biological age. However, the relationships between objectively measured physical fitness, including cardiorespiratory fitness, and DNAm aging clocks are largely unknown. We investigated the relationships between physical fitness and the age-adjusted value from the residuals of the regression of DNAm aging clock to chronological age (DNAmAgeAcceleration: DNAmAgeAccel) and attempted to determine the relative contribution of physical fitness variables to DNAmAgeAccel in the presence of other lifestyle factors. DNA samples from 144 Japanese men aged 65–72 years were used to calculate first- (i.e., DNAmHorvath and DNAmHannum) and second- (i.e., DNAmPhenoAge, DNAmGrimAge and DNAmFitAge) generation DNAm aging clocks. Various surveys and measurements were conducted, including physical fitness, body composition, blood biochemical parameters, nutrients intake, smoking, alcohol consumption, disease status, sleep status, and chronotype. The peak oxygen uptake (VO_2peak) per kg body weight had a significant negative correlation with GrimAgeAccel (r= -0.222,p= 0.008). A comparison of the tertile groups showed that the GrimAgeAccel of the highest VO_2peakgroup was decelerated by 1.6 years compared to the lowest group (p= 0.035). Multiple regression analysis suggested that rather than physical fitness, serum triglycerides, carbohydrate intake, and smoking status, were significantly associated with DNAmAgeAccel. In conclusion, the contribution of cardiorespiratory fitness to DNAmAgeAccel was relatively low compared to lifestyle factors such as smoking. However, this study reveals a negative relationship between cardiorespiratory fitness and DNAmAgeAccel in older men.

BACKGROUND: Physical activity or biomarker-calibrated energy intake (EI) alone is associated with mortality in older adults; the interaction relationship between the combined use of both factors and mortality has not been examined. We evaluated the relationship between mortality and calibrated EI and step counts in older adults. METHODS: This prospective study included 4,159 adults aged ≥65 years who participated in the Kyoto-Kameoka study in Japan and wore a triaxial accelerometer between 1 April and 15 November 2013. The calibrated EI was calculated based on a previously developed equation using EI biomarkers. The step count was obtained from the accelerometer ≥ 4 days. Participants were classified into the following four groups: low EI (LEI)/low step counts (LSC) group (EI: <2,400 kcal/day in men and <1,900 kcal/day in women; steps: <5,000 /day), n = 1,352; high EI (HEI)/LSC group (EI: ≥2,400 kcal/day in men and ≥1,900 kcal/day in women; steps: <5,000 /day), n = 1,586; LEI/high step counts (HSC) group (EI: <2,400 kcal/day in men and < 1,900 kcal/day in women; steps: ≥5,000 /day), n = 471; and HEI/HSC group (EI: ≥2,400 kcal/day in men and ≥1,900 kcal/day in women; steps: ≥5,000 /day), n = 750. Mortality-related data were collected until 30 November 2016. We performed a multivariable Cox proportional hazard analysis. RESULTS: The median follow-up period was 3.38 years (14,046 person-years), and 111 mortalities were recorded. After adjusting for confounders, the HEI/HSC group had the lowest all-cause mortality rate compared to other groups (LEI/LSC: reference; HEI/LSC: hazard ratio [HR]: 0.71, 95% confidence interval [CI]: 0.41-1.23; LEI/HSC: HR: 0.59, 95% CI: 0.29-1.19; and HEI/HSC: HR: 0.10, 95% CI: 0.01-0.76). No significant interaction was observed between the calibrated EI and steps with mortality. The spline model showed that 35-42 kcal/100 steps/day of EI/100 steps was associated with the lowest mortality risk. CONCLUSIONS: HR mortality risk was lowest at 35-42 kcal/100 steps/day, suggesting that very high (≥56 kcal) or low (<28 kcal) EI/100 steps are not inversely associated with mortality. Adherence to optimal EI and adequate physical activity may provide sufficient energy balance to explain the inverse association with mortality among older Japanese adults.

Abstract

Background

Although water is essential to the maintenance of health and life, standard values for human water requirements are yet to be determined. This study aimed to evaluate the distribution of water turnover (WT) according to sex and age, estimated using a prediction equation, in Japanese adolescents and adults.

Methods

This cross-sectional study used data from the 2016 National Health and Nutrition Survey, Japan. Data were obtained from electronically available aggregated reports in the survey’s official website. Participants aged between 15 and 80 years (10,546 men, 12,355 women) were selected using stratified random sampling. WT was calculated considering lifestyle and environmental factors, and using an equation (coefficient of determination = 0.471) previously developed by the international doubly labelled water (DLW) database group. As data on physical activity levels (PAL) were not collected in the survey, we used two evaluation methods: (1) energy intake assessed by dietary records and (2) total energy expenditure measured by the DLW method reported in previous Japanese studies, divided by basal metabolic rate predicted using the equation. We evaluated the relationship between WT and age using a restricted cubic spline model.

Results

The average WT for the 15–19, 20–29, 30–39, 40–49, 50–59, 60–69, and ≥ 70 years was 3291, 3151, 3213, 3243, 3205, 3104, and 2790 ml/day, respectively in men, and 2641, 2594, 2741, 2739, 2753, 2707, and 2482 ml/day, respectively in women. In the spline model, WT showed an inverse association with age in men older than 50 years, whereas women showed a reverse U-shaped relationship between WT and age (p for non-linearity &lt; 0.001), although results differed with body weight adjustment. Similar results were found for both PAL evaluation methods, and the range of WT per body weight was 45–56 ml/day for both sexes.

Conclusions

We determined the standard values of WT in Japanese population using a prediction equation and national large-scale survey data. These findings may be useful for setting water requirements for dietary guidelines in future.

Escherichia coli harboring polyketide synthase (pks+ E. coli) has been suggested to contribute to colorectal cancer development. Physical activity is strongly associated with lower colorectal cancer risks, but its effects on pks+ E. coli remain unclear. The aim of this study was to investigate the association between pks+ E. coli prevalence and physical activity. A cross-sectional study was conducted on 222 Japanese adults (27-79-years-old, 73.9% female). Triaxial accelerometers were used to measure light-intensity physical activity, moderate-to-vigorous intensity physical activity, the physical activity level, step-count, and time spent inactive. Fecal samples collected from participants were used to determine the prevalence of pks+ E. coli. Multivariate logistic regression analysis and restricted cubic spline curves were used to examine the association between pks+ E. coli prevalence and physical activity. The prevalence of pks+ E. coli was 26.6% (59/222 participants). The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the highest tertile with reference to the lowest tertile of physical activity variables were as follows: light-intensity physical activity (OR 0.63; 95% CI 0.26-1.5), moderate-to-vigorous intensity physical activity (OR 0.85; 95% CI 0.39-1.87), physical activity level (OR 0.69; 95% CI 0.32-1.51), step-count (OR 0.92; 95% CI 0.42-2.00) and time spent inactive (OR 1.30; 95% CI 0.58-2.93). No significant dose-response relationship was found between all physical activity variables and pks+ E. coli prevalence. Our findings did not suggest that physical activity has beneficial effects on the prevalence of pks+ E. coli. Longitudinal studies targeting a large population are needed to clarify this association.

A cross-sectional study involving 224 healthy Japanese adult females explored the relationship between ramen intake, gut microbiota diversity, and blood biochemistry. Using a stepwise regression model, ramen intake was inversely associated with gut microbiome alpha diversity after adjusting for related factors, including diets, Age, BMI, and stool habits (β = −0.018; r = −0.15 for Shannon index). The intake group of ramen was inversely associated with dietary nutrients and dietary fiber compared with the no-intake group of ramen. Sugar intake, Dorea as a short-chain fatty acid (SCFA)-producing gut microbiota, and γ-glutamyl transferase as a liver function marker were directly associated with ramen intake after adjustment for related factors including diets, gut microbiota, and blood chemistry using a stepwise logistic regression model, whereas Dorea is inconsistently less abundant in the ramen group. In conclusion, the increased ramen was associated with decreased gut bacterial diversity accompanying a perturbation of Dorea through the dietary nutrients, gut microbiota, and blood chemistry, while the methodological limitations existed in a cross-sectional study. People with frequent ramen eating habits need to take measures to consume various nutrients to maintain and improve their health, and dietary management can be applied to the dietary feature in ramen consumption.

Introduction

The gut microbiome plays a fundamental role in host homeostasis through regulating immune functions, enzyme activity, and hormone secretion. Exercise is associated with changes in gut microbiome composition and function. However, few studies have investigated the gut microbiome during training periodization. The present study aimed to investigate the relationship between training periodization and the gut microbiome in elite athletes.

Methods

In total, 84 elite athletes participated in the cross-sectional study; and gut microbiome was determined during their transition or preparation season period. Further, 10 short-track speed skate athletes participated in the longitudinal study, which assessed the gut microbiome and physical fitness such as aerobic capacity and anaerobic power in the general and specific preparation phase of training periodization. The gut microbiome was analyzed using 16S rRNA sequencing.

Results

The cross-sectional study revealed significant differences in Prevotella, Bifidobacterium, Parabacteroides, and Alistipes genera and in enterotype distribution between transition and preparation season phase periodization. In the longitudinal study, training phase periodization altered the level of Bacteroides, Blautia, and Bifidobacterium in the microbiome. Such changes in the microbiome were significantly correlated with alternations in aerobic capacity and tended to correlate with the anaerobic power.

Discussion

These findings suggest that periodization alters the gut microbiome abundance related to energy metabolism and trainability of physical fitness. Athlete's condition may thus be mediated to some extent by the microbiota in the intestinal environment.

Fat-free mass (FFM) is a heterogeneous compartment comprising body cell mass (BCM), intracellular water (ICW), extracellular solids, and extracellular water (ECW). The BCM/FFM and ECW/ICW ratios vary among individuals and decrease with age. This study aimed to determine whether BCM/FFM and ECW/ICW ratios are predictors of maximal oxygen uptake (V̇O2peak) independently of age, sex, and objectively measured physical activity (PA). A total of 115 Japanese males and females, aged 55.3 ± 8.0 years (mean ± standard deviation), were included in the study. Anthropometry, explosive leg muscle power, and V̇O2peak were measured, and BCM, FFM, ICW, and ECW were estimated. Step count and PA were objectively measured using a triaxial accelerometer. Blood flow volume was assessed using ultrasonography. BCM and ICW were negatively correlated with age, whereas FFM and ECW were not significantly correlated with age. FFM, ICW/ECW, BCM/FFM, step counts, moderate and vigorous PA, and leg muscle power were positively correlated with V̇O2peak, even after adjusting for age and sex (P<0.05). Multiple regression analysis indicated that either BCM/FFM or ECW/ICW, leg power, and objectively measured PA were associated with V̇O2peak independent of age, sex, and FFM. Blood flow volume was significantly correlated with ECW (P<0.05), but not with BCM. The BCM/FFM and ECW/ICW ratios were significant predictors of VO2peak, independent of age, sex, FFM, leg power, and objectively measured PA.

BACKGROUND: Barley, a grain rich in soluble dietary fiber β-glucan, is expected to lower blood pressure. Conversely, individual differences in its effects on the host might be an issue, and gut bacterial composition may be a determinant. METHODS: Using data from a cross-sectional study, we examined whether the gut bacterial composition could explain the classification of a population with hypertension risks despite their high barley consumption. Participants with high barley intake and no occurrence of hypertension were defined as "responders" (n = 26), whereas participants with high barley intake and hypertension risks were defined as "non-responders" (n = 39). RESULTS: 16S rRNA gene sequencing revealed that feces from the responders presented higher levels of Faecalibacterium, Ruminococcaceae UCG-013, Lachnospira, and Subdoligranulum and lower levels of Lachnoclostridium and Prevotella 9 than that from non-responders. We further created a machine-learning responder classification model using random forest based on gut bacteria with an area under the curve value of 0.75 for estimating the effect of barley on the development of hypertension. CONCLUSIONS: Our findings establish a link between the gut bacteria characteristics and the predicted control of blood pressure provided by barley intake, thereby providing a framework for the future development of personalized dietary strategies.

Abstract

This study aimed to identify the modifiable cardiovascular risk factors associated with longitudinal changes, which are nine functional and structural biological vascular aging indicators (BVAIs), to propose an effective method to prevent biological vascular aging. We conducted a longitudinal study of 697 adults (a maximum of 3636 BVAI measurements) who were, at baseline, aged between 26 and 85 years and whose BVAIs were measured at least twice between 2007 and 2018. The nine BVAIs were measured using vascular testing and an ultrasound device. Covariates were assessed using validated questionnaires and devices. During the mean follow-up period of 6.7 years, the average number of BVAI measurements ranged from 4.3 to 5.3. The longitudinal analysis showed a moderate positive correlation between the common carotid intima-media thickness (IMT) and chronological age in both men (r = 0.53) and women (r = 0.54). In the multivariate analysis, BVAIs were associated with factors such as age, sex, residential area, smoking status, blood clinical chemistry test levels, number of comorbidities, physical fitness, body mass, physical activity, and dietary intake. The IMT is the most useful BVAI. Our findings suggest that modifiable cardiovascular risk factors are associated with longitudinal changes in BVAI as represented by IMT.

OBJECTIVES: Frailty has been shown to be a mediator of the risk of excess death due to depression in older adults, although this relationship has not been sufficiently investigated. Our objective was to evaluate this relationship. METHODS: We used data from 7,913 Japanese people aged≥65 years who participated in the Kyoto-Kameoka prospective cohort study and who provided valid responses to the Geriatric Depression Scale-15 (GDS-15) and the World Health Organization-Five Well-Being Index (WHO-5) in mail-in surveys. Depressive status was assessed using the GDS-15 and WHO-5. Frailty was evaluated using the Kihon Checklist. Data on mortality were collected from February 15, 2012, to November 30, 2016. We evaluated the relationship between depression and all-cause mortality risk using a Cox proportional-hazards model. RESULTS: The prevalence of depressive status assessed by GDS-15 and WHO-5 was 25.4% and 40.1%, respectively. In total, 665 deaths were recorded during a median follow-up period of 4.75 years (35,878 person-years). After adjusting for confounders, we found that depressive status assessed by the GDS-15 had a higher risk of mortality than those without it (hazard ratio [HR] 1.62, 95% confidence interval [CI] 1.38-1.91). This association was moderately weaker when adjusted for frailty (HR 1.46, 95% CI 1.23-1.73). Similar results were observed when depression was assessed with the WHO-5. CONCLUSION: Our findings suggest that the risk of excess death due to depressive status in older adults may be partially explained by frailty. This indicates a need to focus on improving frailty besides conventional depression treatments.

BACKGROUND: Physical activity (PA) and sedentary behavior (SB) have been affected by the COVID-19 pandemic and its restrictive environments, such as social distancing and lockdown measures. However, regional differences in the changes in domain-specific PA and SB in response to the COVID-19 pandemic are not clearly understood. OBJECTIVE: This study aimed to examine regional differences in domain-specific PA and SB, as well as sleeping time in response to the COVID-19 pandemic in Japan. METHODS: A web-based cross-sectional nationwide survey and an accelerometer-based longitudinal observation were conducted. In the web-based survey, we recruited 150 Japanese men and 150 Japanese women for each of the following age groups: 20s, 30s, 40s, 50s, 60s, and 70s (n=1800). A total of 1627 adults provided valid responses to web-based surveillance from June to July 2020. Participants were recruited from urban (Greater Tokyo Area, n=1028), urban-rural (regional core cities, n=459), or rural (regional small and medium cities, n=140) areas. They answered sociodemographic and health-related questions and retrospectively registered the PA data of their average day before and during the COVID-19 pandemic in a web-based PA record system. In the accelerometer-based observation, PA and step count data were obtained using a triaxial accelerometer on people living in urban (n=370) and rural (n=308) areas. RESULTS: Before the COVID-19 pandemic, there were no significant differences between these 3 regions in the time spent sleeping, staying at home, working or studying, and exercising (P>.05). By contrast, people living in urban areas had a longer duration of SB and transportation and a shorter duration of moderate-to-vigorous PA and lying or napping time compared with people living in rural areas (P>.05). During the COVID-19 pandemic, a significant decrease was observed in transportation time in urban (-7.2 min/day, P<.001) and urban-rural (-2.0 min/day, P=.009) areas but not in rural (-0.4 min/day, P=.52) areas. The moderate-to-vigorous PA was decreased in urban (-31.3 min/day, P<.001) and urban-rural (-30.0 min/day, P<.001) areas but not in rural areas (-17.3 min/day, P=.08). A significant increase was observed in time spent sleeping in urban (+22.4 min/day, P<.001) and urban-rural (+24.2 min/day, P<.001) but not in rural areas (+3.9 min/day, P=.74). Lying or napping was increased in urban (+14.9 min/day, P<.001) but not in rural areas (-6.9 min/day, P=.68). PA and step count obtained using an accelerometer significantly decreased in urban (P<.05) but not in rural areas (P>.05). CONCLUSIONS: The effect of the COVID-19 pandemic on PA and SB was significantly dependent on living area, even in a single country. The effects of PA and SB were greater in the Greater Tokyo Area and regional core cities but were not observed in regional small and medium cities in Japan.

Aerobic capacity is a fitness measure reflecting the ability to sustain whole-body physical activity as fast and long as possible. Identifying the distribution of aerobic capacity in a population may help estimate their health status. This study aimed to estimate standard values of aerobic capacity (peak oxygen uptake [Formula: see text] and anaerobic threshold [AT]/kg) for the Japanese population stratified by sex and age using a meta-analysis. Moreover, the comparison of the estimated standard values of the Japanese with those of other populations was performed as a supplementary analysis. We systematically searched original articles on aerobic capacity in the Japanese population using PubMed, Ichushi-Web, and Google Scholar. We meta-analysed [Formula: see text] (total: 78,714, men: 54,614, women: 24,100) and AT (total: 4,042, men: 1,961, women: 2,081) data of healthy Japanese from 21 articles by sex and age. We also searched, collected and meta-analysed data from other populations. Means and 95% confidence intervals were calculated. The estimated standard values of [Formula: see text] (mL/kg/min) for Japanese men and women aged 4-9, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years were 47.6, 51.2, 43.2, 37.2, 34.5, 31.7, 28.6, and 26.3, and 42.0, 43.2, 33.6, 30.6, 27.4, 25.6, 23.4, and 23.1, respectively. The AT/kg (mL/kg/min) for Japanese men and women aged 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years were 21.1, 18.3, 16.8, 15.9, 15.8, and 15.2, and 17.4, 17.0, 15.7, 15.0, 14.5, and 14.2, respectively. Herein, we presented the estimated standard values of aerobic capacity according to sex and age in a Japanese population. In conclusion, aerobic capacity declines with ageing after 20-29 years of age. Additionally, aerobic capacity is lower in the Japanese population than in other populations across a wide range of age groups. Standard value estimation by meta-analysis can be conducted in any country or region and for public health purposes.

PURPOSE: Whether the association between objectively assessed physical activity and mortality differs between adults with versus those without frailty is unclear. We investigated this association in community-dwelling older adults. METHODS: This prospective study used the data of 4165 older adults aged 65 years or older from the Kyoto-Kameoka study in Japan who wore a triaxial accelerometer (EW-NK52). The number of steps was classified by quartiles using the average daily value of data obtained from the accelerometer across four or more days. Frailty was evaluated using the validated Kihon Checklist. We evaluated the association between mortality and daily steps using a multivariable Cox proportional hazards analysis and restricted spline model. RESULTS: The average daily steps for the first, second, third, and fourth quartiles were 1786, 3030, 4452, and 7502, respectively. In total, 113 deaths were recorded during a median follow-up of 3.38 years (14061 person-years). After adjusting for confounders, the top quartile was associated with a lower hazard ratio (HR) for mortality than the bottom quartile (HR: 0.39, 95% confidence interval: 0.18-0.85). In a stratified model by frailty status, the daily step count dose-response curve at which the HR for mortality plateaued among non-frail individuals was approximately 5000-7000 steps per day. In contrast, the daily step count showed an inverse relationship with mortality at approximately 5000 steps or more per day in frail individuals. CONCLUSIONS: The relationship between daily steps and mortality is different between those with and those without frailty, and people with frailty may require more daily steps than those with non-frailty to achieve the inverse relationship with mortality. These findings may be useful for informing future physical activity guidelines.

Factors associated with dynamic changes in the objectively measured physical activity have not been well understood. We aimed to 1) evaluate the longitudinal change in the physical activity trajectory according to sex which is associated with age and to 2) determine the factors associated with the dynamic change in physical activity-related variables across a wide age range among Japanese adults. This longitudinal prospective study included 689 Japanese adults (3914 measurements) aged 26-85 years, whose physical activity data in at least two surveys were available. Physical activity-related variables, such as intensity (inactive, light [LPA; 1.5 to 2.9 metabolic equivalents (METs)], moderate-to-vigorous [MVPA; ≥3.0 METs]), total energy expenditure (TEE), physical activity level (PAL), and step count, were evaluated using a validated triaxial accelerometer. Statistical analysis involved the latent growth curve models and random-effect panel data multivariate regression analysis. During a mean follow-up period of 6.8 years, physical activity was assessed an average of 5.1 times in men and 5.9 times in women. The profiles for the inactive time, LPA (only men), MVPA, step count, PAL, and TEE showed clear curvature, indicating an accelerated rate of change around the age of 70. In contrast, other variables exhibited minimal or no curvature over the age span. The MVPA trajectory was positively associated with alcohol consumption, hand grips, leg power, and trunk flexibility and negatively associated with age, local area, body mass index (BMI), comorbidity score, and heart rate over time. Our results indicated that the physical activity trajectory revealed clear curvature, accelerated rate of change around the age of 70, and determined physical health and fitness and BMI as dynamic factors associated with physical activity changes. These findings may be useful to help support populations to achieve and maintain the recommended level of physical activity.

[Purpose] Very few studies have been conducted on the benefits of water exercise for older adults with sarcopenic obesity. Whether the water exercise intervention is effective for improving sarcopenia and/or obesity remains unclear. This study aimed to investigate the effects of water exercise on body composition and components of metabolic syndrome in older females with sarcopenic obesity. [Participants and Methods] Participants (aged ≥60 years) were divided into a water exercise group and a control group. Water-based strength and endurance exercises were performed three times a week for 12 weeks. Lean soft tissue mass, fat mass, and body fat percentage were measured by dual-energy x-ray absorptiometry. [Results] Two-way analysis of variance revealed significant interactions (time × group) for total body fat percentage and leg body fat percentage. In the exercise group, leg body fat percentage significantly decreased after the intervention, but no significant change was observed in the control group. The components of metabolic syndrome showed no significant interactions in either group (time × group). [Conclusion] No significant changes were observed in the components of metabolic syndrome. However, 12-week water exercise may be effective for reducing fat mass in females with sarcopenic obesity.

AIMS: This study determined the relationship between intra-individual variability in day-to-day nutrition-related lifestyle behaviors (meal timing, eating window, food intake, movement behaviors, sleep conditions, and body weight) and glycemic outcomes under free-living conditions in adults without type 2 diabetes. METHODS: We analyzed 104 adults without type 2 diabetes. During the 7-day measurement period, dietary intake, movement behaviors, sleep conditions, and glucose outcomes were assessed. Daily food intake was assessed using a mobile-based health application. Movement behaviors and sleep conditions were assessed using a tri-axial accelerometer. Meal timing was assessed from the participant's daily life record. Blood glucose levels were measured continuously using a glucose monitor. Statistical analyses were conducted using a linear mixed-effects model, with mealtime, food intake, body weight, movement behaviors, and sleep conditions as fixed effects and participants as a random effect. RESULTS: Dinner time and eating window were positively significantly correlated with mean (dinner time, p=0.003; eating window, p=0.001), standard deviation (SD; both at p<0.001), and maximum (both at p<0.001) blood glucose levels. Breakfast time was negatively associated with glucose outcomes (p<0.01). Sedentary time was positively significantly associated with blood glucose SD (p=0.040). Total sleep time was negatively significantly correlated with SD (p=0.032) and maximum (p=0.035) blood glucose levels. Total daily energy intake (p=0.001), carbohydrate intake (p<0.001), and body weight (p<0.05) were positively associated with mean blood glucose levels. CONCLUSION: Intra-individual variations in nutrition-related lifestyle behaviors, especially morning and evening body weight, and food intake, were associated with mean blood glucose levels, and a long sedentary time and total sleep time were associated with glucose variability. Earlier dinner times and shorter eating windows per day resulted in better glucose control.

Water is essential for survival, but one in three individuals worldwide (2.2 billion people) lacks access to safe drinking water. Water intake requirements largely reflect water turnover (WT), the water used by the body each day. We investigated the determinants of human WT in 5604 people from the ages of 8 days to 96 years from 23 countries using isotope-tracking (2H) methods. Age, body size, and composition were significantly associated with WT, as were physical activity, athletic status, pregnancy, socioeconomic status, and environmental characteristics (latitude, altitude, air temperature, and humidity). People who lived in countries with a low human development index (HDI) had higher WT than people in high-HDI countries. On the basis of this extensive dataset, we provide equations to predict human WT in relation to anthropometric, economic, and environmental factors.

Dietary plant lignans are converted inside the gut to enterolignans enterodiol (ED) and enterolactone (EL), which have several biological functions, and health benefits. In this study, we characterized the gut microbiome composition associated with enterolignan production using data from a cross-sectional study in the Japanese population. We identified enterolignan producers by measuring ED and EL levels in subject's serum using liquid chromatography-tandem mass spectrometry. Enterolignan producers show more abundant proportion of Ruminococcaceae and Lachnospiraceae than non-enterolignan producers. In particular, subjects with EL in their serum had a highly diverse gut microbiome that was rich in Ruminococcaceae and Rikenellaceae. Moreover, we built a random forest classification model to classify subjects to either EL producers or not using three characteristic bacteria. In conclusion, our analysis revealed the composition of gut microbiome that is associated with lignan metabolism. We also confirmed that it can be used to classify the microbiome ability to metabolize lignan using machine learning approach.

The phase angle (PhA), measured via bioelectrical impedance analysis, is considered an indicator of cellular health, where higher values reflect higher cellularity, cell membrane integrity, and better cell function. This study aimed to examine the relationship between PhA and exercise habits or objectively measured physical activity. We included 115 people aged 32-69 years. The body composition and PhA were measured using a bioelectrical impedance device. Physical activity and sedentary behavior (SB) were assessed using a triaxial accelerometer. Exercise habits were also obtained through structured interviews, and participants were categorized into the no exercise habit (No-Ex), resistance training exercise habit (RT), or aerobic training exercise habit (AT) groups. Objectively measured moderate-to-vigorous physical activity or step count significantly correlated with PhA, independent of age, sex, height, percent body fat, body cell mass, and leg muscle power. In contrast, SB was not significant determinants of PhA. People who exercised regularly (RT or AT) had significantly higher PhA values than did those in the No-Ex group. Furthermore, the PhA was not significantly different between the RT and AT groups. Regularly engaging in exercise with moderate-to-vigorous intensity may improve or maintain muscle cellular health and muscle quality.

Background/Objective: The 2020 Tokyo Olympics and Paralympic was held in 2021, although postponed due to the spread of COVID-19. This event might have an impact on physical activity (PA) of children and adolescents, but the national data on PA during the pandemic were not available. Therefore, the goal of the 2022 Japan Report Card on Physical Activity for Children and Youth (The 2022 Japan Report Card) is to assess and track levels of health behaviors related to PA, and health outcomes in Japanese children and adolescents, and environments and government strategy for PA just before the pandemic. Methods: The 2022 Japan Report Card consists of health behaviors and outcomes (8 indicators), and influences on health behaviors (4 indicators). Nationally representative data were used to score the indicators. Results: The key five health behaviors and outcomes (Overall PA: B-; Organized Sport: B-; Active Transportation: A-; Physical fitness: B, Weight status: A) were favorable. Sedentary Behavior and Sleep received C- and D- grades, respectively. Active Play could not be graded (INC). In the influences domain, Family and Peers was graded as C-, while School (B+), Community and Environment (B), and Government (B) were favorable. Conclusions: The 2022 Japan Report Card shows that Japanese children and adolescents had favorable levels of overall PA, active transportation to and from school, and weight status, and there was a generally favorable environment for PA and health, though sedentary behavior and sleep were unfavorable. Future nationally representative surveys on active play are needed.

BACKGROUND: Whether sleep quality and duration-combination assessed from multiple domains are strongly associated with mortality risk in older adults remains unelucidated. We aimed to clarify these relationships. METHODS: We enrolled 7,668 older (age ≥65) Japanese adults in the Kyoto-Kameoka prospective cohort study who provided valid responses to the Pittsburgh Sleep Quality Index (PSQI) in a mail-in survey. Sleep quality and duration were classified into six groups using previously validated PSQI: short sleep duration (SSD: <360 min/day)/sleep disturbance (SD: ≥5.5 PSQI points), n=701; SSD/non-sleep disturbance (NSD: <5.5 PSQI points), n=100; optimal sleep duration (OSD: 360-480 min/day)/NSD, n=1863; OSD/SD, n=2113; long sleep duration (LSD: >480 min/day)/NSD, n=1972; LSD/SD, n=919. Mortality data were collected from February 15, 2012, to November 30, 2016. We evaluated the relationship between all-cause mortality risk and sleep quality and duration-combination using a multivariable Cox proportional hazards model that included baseline covariates. RESULTS: The median follow-up period was 4.75 years (34,826 person-years), with a total of 616 deaths. After adjusting for confounders, compared with other groups, SSD/SD and LSD/SD had the highest hazard ratio (HR) of mortality [SSD/SD: HR, 1.56 (95% confidence interval [CI]: 1.10-2.19); SSD/NSD: HR, 1.27 (95%CI: 0.47-3.48); OSD/NSD: reference; OSD/SD: HR, 1.20 (95%CI: 0.91-1.59); LSD/NSD: HR, 1.35 (95%CI: 1.03-1.77); LSD/SD: HR, 1.83 (95%CI: 1.37-2.45)]. However, mortality risk was not associated with the interaction between sleep quality and duration. CONCLUSIONS: Older adults with sleep disturbances involving SSD and LSD have a strong positive association with mortality risk, suggesting an additive effect between sleep quality and duration.

PURPOSE: To examine how physical activity (PA) and sitting time (ST) are associated with mortality in older Japanese adults. METHODOLOGY: We used the data of 10 233 older Japanese adults aged ≥65 years who provided valid responses to the International Physical Activity Questionnaire-Short Form (IPAQ-SF) by a mail survey. Both PA and ST were assessed using the IPAQ-SF. The results were classified into high or low categories using ≥3.0 metabolic equivalent PA (150 min/week) and ST (300 min/day) into the following four groups: High PA (HPA)/Low ST (LST), HPA/High ST (HST), Low PA (LPA)/LST, and LPA/HST. Mortality data were collected from July 30, 2011, to November 30, 2016. We assessed the interaction of PA and ST status with the risk of all-cause mortality using the multivariable Cox proportional-hazards model. RESULTS: A total of 1014 people were recorded to have died during a median follow-up period of 5.3 years (51 553 person-years). After adjustment for confounders, the risk of mortality was higher in the LPA/HST group than in all other groups (HPA/LST: reference; HPA/HST group: hazard ratio [HR] 0.86 (95% confidence interval [CI]: 0.66 to 1.12); LPA/LST group: HR 1.09 (95% CI: 0.88 to 1.35); LPA/HST group: HR 1.36 (95% CI: 1.10 to 1.67); and multiplicative interaction: HR 1.44 (95% CI: 1.07 to 1.94)). CONCLUSIONS: The risk of mortality associated with LPA/HST depends on the level of PA, duration of ST, and their interaction with each other. Our results may be useful in ameliorating the adverse effects leading to mortality in individuals with lower PA, by reducing ST.

BACKGROUND: Protein supplementation augments muscle strength gain during resistance training. Although some studies focus on the dose-response relationship of total protein intake to muscle mass or strength, the detailed dose-response relationship between total protein intake and muscle strength increase is yet to be clarified, especially in the absence of resistance training. OBJECTIVE: We aimed to assess the detailed dose-response relationship between protein supplementation and muscle strength, with and without resistance training. DESIGN: Systematic review with meta-analysis. DATA SOURCES: PubMed and Ichushi-Web (last accessed on March 23, 2022). ELIGIBILITY CRITERIA: Randomized controlled trials investigating the effects of protein intake on muscle strength. SYNTHESIS METHODS: A random-effects model and a spline model. RESULTS: A total of 82 articles were obtained for meta-analyses, and data from 69 articles were used to create spline curves. Muscle strength increase was significantly augmented only with resistance training (MD 2.01%, 95% CI 1.09-2.93) and was not augmented if resistance training was absent (MD 0.13%, 95% CI - 1.53 to 1.79). In the dose-response analysis using a spline model, muscle strength increase with resistance training showed a dose-dependent positive association with total protein intake, which is 0.72% (95% CI 0.40-1.04%) increase in muscle strength per 0.1 g/kg body weight [BW]/d increase in total protein intake up to 1.5 g/kg BW/d, but no further gains were observed thereafter. CONCLUSION: Concurrent use of resistance training is essential for protein supplementation to improve muscle strength. This study indicates that 1.5 g/kg BW/d may be the most appropriate amount of total protein intake for maintaining and augmenting muscle strength along with resistance training.

We aimed to verify the combined use of two frailty tools in predicting mortality in older adults. We used the data of 10,276 Japanese older adults (aged ≥ 65 years) who provided valid responses to two frailty assessment tools in a mail survey in Japan's Kyoto‒Kameoka Prospective cohort study. Frailty status was categorized into four groups depending on the validated frailty screening index and Kihon Checklist, respectively: Non-frailty (n = 5960), Physical frailty (n = 223), Comprehensive frailty (n = 2211), and Combination (n = 1882) groups. Mortality data were collected between July 30, 2011, and November 30, 2016. We assessed the relationship between frailty status and all-cause mortality risk using multivariate Cox proportional hazards models. During a median follow-up of 5.3 years, we recorded 1257 deaths. After adjusting for confounders, the Combination group had the highest mortality risk compared with the other groups [Non-frailty: reference; Physical frailty: hazards ratio [HR], 0.99 (95% confidence interval [CI] 0.58 to 1.70); Comprehensive frailty: 1.91 (1.63 to 2.23); Combination: 2.85 (2.44 to 3.22)]. People who are positive for frailty in both instruments have a higher risk of death than those who are positive to one model.

OBJECTIVES: We aimed to examine the relationship between the fat-free mass index (FFMI; FFM/height2) and appendicular skeletal muscle mass index (ASMI; ASM/height2), measured using both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), and investigate the effects of age and obesity. We also evaluated the suitability of BIA-measured FFMI as a simple surrogate marker of the ASMI and calculated the optimal FFMI cutoff value for low muscle mass screening to diagnose sarcopenia. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: This study included 1313 adults (women, 33.6%) aged 40-87 years (mean age, 55 ± 10 years) from the XXXX Study. METHODS: Body composition was measured using multifrequency BIA and DXA. Low muscle mass was defined according to the criteria of the Asian Working Group for Sarcopenia 2019. RESULTS: BIA-measured FFMI showed strong positive correlations with both BIA- (r = 0.96) and DXA-measured (r = 0.95) ASMIs. Similarly, in the subgroup analysis according to age and obesity, the FFMI was correlated with the ASMI. The areas under the receiver operating characteristic curve for screening low muscle mass defined by DXA-measured ASMI using BIA-measured FFMI values were 0.95 (95% CI 0.93-0.97) for men and 0.91 (95% CI 0.87-0.94) for women. The optimal BIA-measured FFMI cutoff values for screening low muscle mass defined by DXA-measured ASMI were 17.5 (sensitivity 89%, specificity 88%) for men and 14.6 (sensitivity 80%, specificity 86%) for women. CONCLUSIONS AND IMPLICATIONS: The FFMI showed a strong positive correlation with BIA- and DXA-measured ASMIs, regardless of age and obesity. The FFMI could be a useful simple surrogate marker of the ASMI for low muscle mass screening in sarcopenia in community settings. The suggested FFMI cutoff values for predicting low muscle mass are <18 in men and <15 in women.

Abstract

The gut microbiome is an important determinant in various diseases. Here we perform a cross-sectional study of Japanese adults and identify the Blautia genus, especially B. wexlerae, as a commensal bacterium that is inversely correlated with obesity and type 2 diabetes mellitus. Oral administration of B. wexlerae to mice induce metabolic changes and anti-inflammatory effects that decrease both high-fat diet–induced obesity and diabetes. The beneficial effects of B. wexlerae are correlated with unique amino-acid metabolism to produce S-adenosylmethionine, acetylcholine, and l-ornithine and carbohydrate metabolism resulting in the accumulation of amylopectin and production of succinate, lactate, and acetate, with simultaneous modification of the gut bacterial composition. These findings reveal unique regulatory pathways of host and microbial metabolism that may provide novel strategies in preventive and therapeutic approaches for metabolic disorders.

BACKGROUND: The Olympic Games represent an opportunity to create a 'physical activity legacy' that promotes physical activity at the population level in the host nations and cities. However, previous studies showed little increase in population-level physical activity following the Olympics. The upsurge of public interest in sports and physical activity participation before the Olympics may diminish rapidly following the Games. We examined the pre-Games effects of the Olympics on Japanese population-level physical activity after the announcement of Tokyo's successful bid for the 2020 Olympic and Paralympic Games in September 2013. METHODS: We used publicly available data from serial cross-sectional surveys conducted with nationally or regionally representative samples in Japan seven years before and after the announcement (from 2006-2020). The outcomes were 1) daily step counts and 2) exercise habit prevalence (≥ 30 min/day, ≥ 2 days/week, and over a year) from the National Health and Nutrition Surveys Japan (NHNS-J; 14 time points; aggregated data); and 3) sports participation (at least once a week) from the National Sports-Life Survey conducted every two years (NSLS; eight time points; individual-level data of 18,867 adults) and from the Public Opinion Survey on Sports Participation of Tokyo Residents (POSSP; eight time points; aggregated data). Age- and gender-adjusted regression models were used to estimate changes in the outcomes before and after the announcement. RESULTS: There were no significant pre-Games effects of the Olympics on national-level physical activity participation among Japanese adults. Sports participation (56.4% and 57.5%, respectively; P = 0.518), daily steps (6,535 and 6,686 steps/day; P = 0.353), and exercise habit (30.7% and 29.1%, P = 0.309) did not change significantly before and after the announcement. Although an increase in sports participation among Tokyo residents was not found in the NSLS (61.5% and 59.3%, P = 0.227), it was observed in the POSSP (49.1% and 57.7%, P = 0.019). Nonetheless, this increase might not be related to the pre-Games effects since the trend diminished following the announcement. CONCLUSIONS: Population-level physical activity did not show significant changes until 2020. Realising the physical activity legacy of an Olympics may require strategic promotion and cross-agency partnership implementation in the pre- and post-event period.

BACKGROUND: Many activity trackers have been developed, but steps can still be inconsistent from one monitor to another. RESEARCH QUESTION: What are the differences and associations between the steps of 13 selected consumer-based and research-grade wearable devices during 1 standardized day in a metabolic chamber and 15-day free-living trials? METHODS: In total, 19 healthy adults between 21 and 50 years-old participated in this study. Participants were equipped with 12 accelerometer-based active trackers and one pedometer (Yamasa) in order to monitor the number of steps per day. The devices were worn on the waist (ActiGraph, Omron, Actimarker, Lifedorder, Withings, and Yamasa) or non-dominant wrist (Fitbit, Garmin, Misfit, EPSON, and Jawbone), or placed in a pocket (Omron CaloriScan, and TANITA). Participants performed structured activities over a 24 h period in a chamber (Standardized day), and steps were monitored in the same participants in free-living trials for 15 successive days using the same monitors (free-living days). RESULTS: When the 13 monitors were ranked by their steps, waist-worn ActiGraph was located at the center (7th) of the monitors both in the Standardized (12,252 ± 598 steps/day, mean ± SD) and free-living days (9295 ± 4027 steps/day). The correlation between the accelerometer-based devices was very high (r = 0.87-0.99). However, the steps of Yamasa was significantly lower in both trials than ActiGraph. The wrist-worn accelerometers had significantly higher steps than other devices both trials (P < 0.05). The differences between ActiGraph and Actimarker or Lifecorder was less than 100 steps/day in the Standardized day, and the differences between ActiGraph and Active Style Pro was less than 100 steps/day in the free-living days. Regression equation was also performed for inter-device compatibility. SIGNIFICANCE: Step obtained from the wrist-worn, waist-worn, and pocket-type activity trackers were significantly different from each other but still highly correlated in free-living conditions.

BACKGROUND: The term "frailty" might appear simple, but the methods used to assess it differ among studies. Consequently, there is inconsistency in the classification of frailty and predictive capacity depending on the frailty assessment method utilised. We aimed to examine the diagnostic accuracy of several screening tools for frailty defined by the phenotype model in older Japanese adults. METHODS: This cross-sectional study included 1,306 older Japanese adults aged ≥ 65 years who underwent physical check-up by cluster random sampling as part of the Kyoto-Kameoka Study in Japan. We evaluated the diagnostic accuracy of several screening instruments for frailty using the revised Japanese version of the Cardiovascular Health Study criteria as the reference standard. These criteria are based on the Fried phenotype model and include five elements: unintentional weight loss, weakness (grip strength), exhaustion, slowness (normal gait speed), and low physical activity. The Kihon Checklist (KCL), frailty screening index (FSI), and self-reported health were evaluated using mailed surveys. We calculated the non-parametric area under the receiver operating characteristic curve (AUC ROC) for several screening tools against the reference standard. RESULTS: The participants' mean (standard deviation) age was 72.8 (5.5) years. The prevalence of frailty based on the Fried phenotype model was 12.2% in women and 10.3% in men. The AUC ROC was 0.861 (95% confidence interval: 0.832-0.889) for KCL, 0.860 (0.831-0.889) for FSI, and 0.668 (0.629-0.707) for self-reported health. The cut-off for identifying frail individuals was ≥ 7 points in the KCL and ≥ 2 points in the FSI. CONCLUSIONS: Our results indicated that the two instruments (KCL and FSI) had sufficient diagnostic accuracy for frailty based on the phenotype model for older Japanese adults. This may be useful for the early detection of frailty in high-risk older adults.

OBJECTIVES: Some epidemiological studies of older American adults have reported a relationship between life-space mobility (LSM) and mortality. However, these studies did not show a dose-response relationship and did not include individuals from other countries. Therefore, we evaluated the dose-response relationship between LSM and mortality in older adults. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: We used the data of 10,014 older Japanese adults (aged ≥65 years) who provided valid responses to the Life-Space Assessment (LSA) in the Kyoto-Kameoka study in Japan. METHODS: LSM was evaluated using the self-administered LSA consisting of 5 items regarding life-space from person's bedroom to outside town. The LSM score was calculated by multiplying life-space level by frequency score by independence score, yielding a possible range of 0 (constricted life-space) to 120 (broad life-space). These scores were categorized into quartiles (Qs). Mortality data were collected from July 30, 2011 to November 30, 2016. A multivariate Cox proportional hazards model that included baseline covariates were used to evaluate the relationship between LSM score and mortality risk. RESULTS: A total of 1030 deaths were recorded during the median follow-up period of 5.3 years. We found a negative association between LSM score and overall mortality even after adjusting for confounders [Q1: reference; Q2: hazard ratio (HR) 0.81, 95% CI 0.69-0.95; Q3: HR 0.70, 95% CI 0.59-0.85; Q4: HR 0.68, 95% CI 0.55-0.84, P for trend < .001]. Similar results were observed for the spline model; up to a score of 60 points, LSM showed a strong dose-dependent negative association with mortality, but no significant differences were observed thereafter (L-shaped relationship). CONCLUSIONS AND IMPLICATIONS: Our findings demonstrate an L-shaped relationship between LSM and mortality. This study will be useful in establishing target values for expanding the range of mobility among withdrawn older adults with a constricted life-space.

The gut microbiota is closely related to good health; thus, there have been extensive efforts dedicated to improving health by controlling the gut microbial environment. Probiotics and prebiotics are being developed to support a healthier intestinal environment. However, much work remains to be performed to provide effective solutions to overcome individual differences in the gut microbial community. This study examined the importance of nutrients, other than dietary fiber, on the survival of gut bacteria in high-health-conscious populations. We found that vitamin B1, which is an essential nutrient for humans, had a significant effect on the survival and competition of bacteria in the symbiotic gut microbiota. In particular, sufficient dietary vitamin B1 intake affects the relative abundance of Ruminococcaceae, and these bacteria have proven to require dietary vitamin B1 because they lack the de novo vitamin B1 synthetic pathway. Moreover, we demonstrated that vitamin B1 is involved in the production of butyrate, along with the amount of acetate in the intestinal environment. We established the causality of possible associations and obtained mechanical insight, through in vivo murine experiments and in silico pathway analyses. These findings serve as a reference to support the development of methods to establish optimal intestinal environment conditions for healthy lifestyles.

BACKGROUND: Weight misperception adversely affects health-related quality of life (HRQol); however, few studies have evaluated the relationship between weight misperception and muscle mass. This study aimed to examine the relationship of weight misperception with low muscle mass using skeletal muscle index (SMI) estimated by multifrequency bioelectrical impedance analysis (MF-BIA) among community-dwelling Japanese. METHODS: Participants were 525 Japanese individuals aged 40-91 years old (male 89, female 436). Misperception was calculated by subtracting measured value from self-reported weight, presented as a percentage and categorized into tertiles based on sex (under-reporters, acceptable reporters, and over-reporters). Appendicular lean mass was estimated using MF-BIA, and low muscle mass was defined using SMI values of 7.0 and 5.7 kg/m2 for males and females, respectively, based on the Asian Working Group for Sarcopenia 2019 consensus. We evaluated the association between prevalence of low muscle mass and weight misperception (under-reporters and over-reporters) using multivariate logistic regression including covariate. RESULTS: In total, 9.3% (49/525) of participants had low muscle mass. After adjusting for covariates, prevalence of low muscle mass was higher among over-reporters than acceptable-reporters (odds ratio [OR]; 2.37, 95% confidence interval [CI]; 1.03-5.44). Additionally, sensitivity analysis was performed on females, which confirmed that the prevalence of low muscle mass was higher in over-reporters than in acceptable-reporters (OR, 3.27; 95% CI, 1.18-9.12). CONCLUSION: Weight misperception was significantly correlated with low muscle mass, especially in over-reporters.

BACKGROUND: Barley contains abundant soluble beta-glucan fibers, which have established health benefits. In addition, the health benefits conferred by the gut bacteria have attracted considerable interest. However, few studies have focused on the barley consumption and gut bacteria of the Japanese population. In this study, we aimed to identify the relationship between the barley consumption and gut bacteria composition of the Japanese population. METHODS: In total, 236 participants were recruited in Japan, and 94 participants with no complications of diabetes, hypertension, or dyslipidemia were selected for the study. We analyzed fecal samples from the participants, their medical check-up results, and responses to questionnaires about dietary habits. The participants were grouped according to their median barley consumption. Then, we assessed the relative abundance of 50 genera. Characteristic bacteria were evaluated for their relationship with barley consumption by multiple regression analysis, adjusted for disease and dietary habits, in all participants. We also analyzed the networks and clustering of the 20 selected genera. RESULTS: According to the comparison between barley groups, Bifidobacterium, Butyricicoccus, Collinsella, Ruminococcus 2, and Dialister were characteristic candidate bacterias of the group that consumed large amounts of barley (P < 0.05). The relationship between barley consumption and Bifidobacterium remained after adjusting for disease and dietary habits, and that of Butyricicoccus remained after adjusting for disease. Furthermore, network and cluster analyses revealed that barley consumption was directly correlated with Bifidobacterium and Butyricicoccus. CONCLUSIONS: Barley consumption generates changes in the intestinal bacteria of the Japanese population. We found that Bifidobacterium and Butyricicoccus abundance was positively associated with barley consumption.

PURPOSE: While the association between diet quality and mortality has been previously demonstrated, the association between frailty and diet quality has not been evaluated well. This study aimed to investigate the association between diet quality and prevalence of both physical and comprehensive frailty, using two validated tools, in a community-based cohort of older adults. METHODS: We conducted cross-sectional analyses using baseline data of 7022 participants aged ≥ 65 years in the Kyoto-Kameoka study. Diet quality was assessed by calculating the adherence scores to the Japanese Food Guide Spinning Top using a validated questionnaire; the participants were stratified into quartile groups based on these scores. Physical and comprehensive frailty was assessed using the Fried phenotype model-based Frailty Screening Index and the Kihon Checklist, respectively. Multivariable logistic regression and the restricted cubic spline model were used to calculate odds ratios (ORs) and their 95% confidence intervals (CIs) for associations between adherence scores and frailty prevalence. RESULTS: Higher adherence scores signified a higher intake of vitamin C, vegetables, dairy products, and fruits. Physical and comprehensive frailty prevalence was 14.2 and 35.8%, respectively. In a multivariable adjusted model, compared with the bottom adherence score quartile, the top quartile was associated with lower ORs of physical (OR 0.64; 95% CI 0.52-0.80) and comprehensive frailty (OR 0.60; 95% CI 0.51-0.71). These relationships were similar to results in the spline model. CONCLUSIONS: This study shows an inverse dose-response relationship between diet quality and prevalence of both physical and comprehensive frailty in older adults.

Dietary ω3 fatty acids have important health benefits and exert their potent bioactivity through conversion to lipid mediators. Here, we demonstrate that microbiota play an essential role in the body's use of dietary lipids for the control of inflammatory diseases. We found that amounts of 10-hydroxy-cis-12-cis-15-octadecadienoic acid (αHYA) and 10-oxo-cis-12-cis-15-octadecadienoic acid (αKetoA) increased in the feces and serum of specific-pathogen-free, but not germ-free, mice when they were maintained on a linseed oil diet, which is high in α-linolenic acid. Intake of αKetoA, but not αHYA, exerted anti-inflammatory properties through a peroxisome proliferator-activated receptor (PPAR)γ-dependent pathway and ameliorated hapten-induced contact hypersensitivity by inhibiting the development of inducible skin-associated lymphoid tissue through suppression of chemokine secretion from macrophages and inhibition of NF-κB activation in mice and cynomolgus macaques. Administering αKetoA also improved diabetic glucose intolerance by inhibiting adipose tissue inflammation and fibrosis through decreased macrophage infiltration in adipose tissues and altering macrophage M1/M2 polarization in mice fed a high-fat diet. These results collectively indicate that αKetoA is a novel postbiotic derived from α-linolenic acid, which controls macrophage-associated inflammatory diseases and may have potential for developing therapeutic drugs as well as probiotic food products.

Previous cohort study reported that high physical activity was associated with a low risk of self-reported hearing loss in women. However, no studies have examined the association between physical activity and the development of hearing loss as measured using an objective assessment of hearing loss in men and women. Here we used cohort data to examine the association between leisure-time physical activity and incidence of objectively assessed hearing loss in men and women. Participants included 27,537 Japanese adults aged 20-80 years without hearing loss, who completed a self-administered physical activity questionnaire between April 2001 and March 2002. The participants were followed up for the development of hearing loss as measured by audiometry between April 2002 and March 2008. During follow-up, 3691 participants developed hearing loss. Compared with the none physical activity group, multivariable adjusted hazard ratios for developing hearing loss were 0.93 (95% confidence interval, 0.86-1.01) and 0.87 (0.81-0.95) for the medium (<525 MET-min/week) and high (≥525 MET-min/week) physical activity groups, respectively (P for trend = .001). The magnitude of risk reduction was slightly greater in vigorous-intensity activity than in moderate-intensity activity (P for interaction = .01). Analysis by sound frequency showed that the amount of physical activity was inversely associated with high frequency hearing loss development (P for trend <.001), but not with low frequency hearing loss development (P for trend = .19). Higher level of leisure-time physical activity was associated with lower incidence of hearing loss, particularly for vigorous-intensity activities and high sound frequencies.

Human skeletal muscle fiber is heterogenous due to its diversity of slow- and fast-twitch fibers. In human, slow-twitched fiber gene expression is correlated to MOTS-c, a mitochondria-derived peptide that has been characterized as an exercise mimetic. Within the MOTS-c open reading frame, there is an East Asian-specific m.1382A>C polymorphism (rs111033358) that changes the 14th amino acid of MOTS-c (i.e., K14Q), a variant of MOTS-c that has less biological activity. Here, we examined the influence of the m.1382A>C polymorphism causing MOTS-c K14Q on skeletal muscle fiber composition and physical performance. The myosin heavy chain (MHC) isoforms (MHC-I, MHC-IIa, and MHC-IIx) as an indicator of muscle fiber composition were assessed in 211 Japanese healthy individuals (102 men and 109 women). Muscular strength was measured in 86 physically active young Japanese men by using an isokinetic dynamometer. The allele frequency of the m.1382A>C polymorphism was assessed in 721 Japanese athletes and 873 ethnicity-matched controls. The m.1382A>C polymorphism genotype was analyzed by TaqMan SNP Genotyping Assay. Individuals with the C allele of the m.1382A>C exhibited a higher proportion of MHC-IIx, an index of fast-twitched fiber, than the A allele carriers. Men with the C allele of m.1382A>C exhibited significantly higher peak torques of leg flexion and extension. Furthermore, the C allele frequency was higher in the order of sprint/power athletes (6.5%), controls (5.1%), and endurance athletes (2.9%). Additionally, young male mice were injected with the MOTS-c neutralizing antibody once a week for four weeks to mimic the C allele of the m.1382A>C and assessed for protein expression levels of MHC-fast and MHC-slow. Mice injected with MOTS-c neutralizing antibody showed a higher expression of MHC-fast than the control mice. These results suggest that the C allele of the East Asian-specific m.1382A>C polymorphism leads to the MOTS-c K14Q contributes to the sprint/power performance through regulating skeletal muscle fiber composition.

Previous cross-sectional studies have indicated that low relative appendicular lean mass (ALM) against body weight (divided by body weight, ALM/Wt, or divided by body mass index, ALM/BMI) was negatively associated with metabolic syndrome (MetS). Conversely, previous cross-sectional studies have indicated that the absolute ALM or ALM divided by squared height (ALM/Ht2) were positively associated with MetS. The aim of this longitudinal study was to investigate the association between low absolute or relative skeletal muscle mass, leg muscle power, or percent body fat and the development of MetS in Japanese women in a 7-y prospective study. The study participants included 346 Japanese women aged 26 to 85 years. The participants were divided into low and high groups based on the median values of ALM/Wt, ALM/BMI, ALM/Ht2, absolute ALM, or leg power. The longitudinal relationship between ALM indices or leg power and MetS development was examined using Kaplan-Meier curves and Cox regression models (average follow-up duration 7 years, range 1 to 10 years). During follow-up, 24 participants developed MetS. MetS incidence was higher in the low ALM/Wt group than the high ALM/Wt group even after controlling for age, obesity, waist circumference, family history of diabetes, smoking, and physical activity [adjusted hazard ratio = 5.60 (95% CI; 1.04-30.0)]. In contrast, MetS incidence was lower in the low ALM/Ht2 group than the high ALM/Ht2 group [adjusted hazard ratio = 10.6 (95%CI; 1.27-89.1)]. MetS incidence was not significantly different between the low and high ALM/BMI, absolute ALM, and leg power groups. Both ALM/Ht2 and ALM/Wt were not significant predictive variables for MetS development when fat mass or percent body fat was taken into account in the Cox model. At the very least, the results of this study underscore the importance of body composition measurements in that percent body fat, but not ALM, is associated with MetS development.

Little is known about the optimal daily magnesium (Mg) intake for individuals with high levels of physical activity. The aim of this study was to clarify the optimal dietary Mg intake for people with high levels of physical activity in a scoping review. In this review, we searched MEDLINE and Japan Medical Abstracts Society for studies published up to May 31, 2020. We conducted two searches, one for studies using gold standard measurement methods such as the balance method and factorial calculation (Search 1), and the other for studies using estimation from daily food intake (Search 2). We also performed a meta-analysis of studies that compared the Mg intake among physically active people with the Mg intake among controls. After the primary and secondary screening, 31 studies were included in the final review. All of the included studies examined professional or recreational athletes. We found no studies that examined the optimal intake of Mg using gold standard measurement methods. The Mg intake among physically active individuals was below the recommended dietary allowance in most studies. In five studies that conducted meta-analyses, physically active individuals had significantly higher intakes of Mg than controls, although these levels were still below the recommended dietary allowance. The present review revealed that evidence regarding the optimal daily magnesium intake is currently scarce, and further studies are needed.

In older adults, the quantitative decline of the quadriceps femoris is associated with the augmentation of difficulty in the execution of a stand-up task. However, it is unclear whether the cross-sectional areas (CSAs) of individual thigh muscles differ between older adults who can stand up from a 40-cm-height chair on a single leg and those who cannot. To investigate this, the present study determined the CSAs of individual mid-thigh muscles in 67 Japanese women aged 60-77 years by using a magnetic resonance imaging method. Participants were asked to stand up from a 40-cm-height chair on a single leg, and those who could and could not stand up without leaning back and maintain a standing posture for 3 seconds on a single leg were allocated into the successful group (SG, n = 40) and unsuccessful group (USG, n = 27), respectively. Only the CSA of the adductors (sum of the adductor longus and adductor magnus) was significantly smaller in USG compared to SG. When CSA was expressed relative to the two-third power of body mass, the values for the four heads of the quadriceps femoris and biceps femoris long head, as well as the adductors, were significantly lower in USG than in SG. The current results indicate that in terms of the value relative to body mass, the reduced CSAs of the adductors and biceps femoris long head, as well as the four heads of the quadriceps femoris, are associated with the failure of attempts to stand up from a 40-cm-height chair on a single leg in older women. This may be due to the anatomical function of the two muscle groups, which contributes to hip extension movement involved in transitioning from a sitting position to a standing position during the stand-up task.

Background: Many cross-sectional studies have identified modifiable factors such as dietary intake, physique, and physical activity associated with diet quality but were unable to determine how a specific individual's diet quality changes with these factors. These relationships may vary depending on an individual's dietary intake. We aimed to determine the association between temporal changes in diet quality and concurrent changes in dietary intake, body mass index (BMI), and physical activity according to the diet quality trajectory pattern. Methods: This longitudinal prospective study included 697 Japanese adults aged 26-85 years, at baseline, with available data from at least two dietary intake surveys (4,118 measurements). Dietary intake and physical activity were evaluated using validated dietary questionnaires and a triaxial accelerometer. Diet quality was calculated using the Nutrient-Rich Food Index 9.3 (NRF9.3), while physical activity was calculated based on the duration of activity performed at each level of intensity (sedentary, light, moderate, and vigorous). Body mass index was calculated from the measured height and weight. Statistical analyses involved latent class growth models (LCGM) and random-effect panel data analysis. Results: During a mean follow-up period of 6.8 years, NRF9.3 scores were assessed, on average, 5.4 times in men and 6.1 times in women. Based on the NRF9.3 score, three separate trajectory groups-"low-increasing," "medium-increasing," and "high-stable"-among individuals aged 26-90 years were identified using LCGM. In the multivariate analysis, the NRF9.3 score trajectory was positively associated with intake of energy, protein, dietary fiber, vitamins A and C, magnesium, and food items, such as fruits and vegetables, and was negatively associated with BMI and the intake of added sugar, saturated fats, sodium, and food items, such as meat and sugar and confectioneries, even after adjusting for covariates. These relationships displayed heterogeneity across the identified NRF9.3 score trajectory groups. In the low-increasing group, an inverse relationship was observed between sedentary behavior and NRF9.3 score trajectory. Conclusions: We identified modifiable factors associated with temporal changes in diet quality across a wide age range; however, these factors may vary according to the diet quality trajectories. Our findings may help develop effective strategies for improving diet quality, according to the trajectory of diet quality.

Barley is a grain rich in β-glucan, a soluble dietary fiber, and its consumption can help maintain good health and reduce the risk of metabolic disorders, such as dyslipidemia. However, the effect of barley intake on the risk of dyslipidemia has been found to vary among individuals. Differences in gut bacteria among individuals may be a determining factor since dietary fiber is metabolized by gut bacteria and then converted into short-chain fatty acids with physiological functions that reduce the risk of dyslipidemia. This study examined whether gut bacteria explained individual differences in the effects of barley intake on dyslipidemia using data from a cross-sectional study. In this study, participants with high barley intake and no dyslipidemia were labeled as "responders" to the reduced risk of dyslipidemia based on their barley intake and their gut bacteria. The results of the 16S rRNA gene sequencing showed that the fecal samples of responders (n = 22) were richer in Bifidobacterium, Faecalibacterium, Ruminococcus 1, Subdoligranulum, Ruminococcaceae UCG-013, and Lachnospira than those of non-responders (n = 43), who had high barley intake but symptoms of dyslipidemia. These results indicate the presence of certain gut bacteria that define barley responders. Therefore, we attempted to generate a gut bacteria-based responder classification model through machine learning using random forest. The area under the curve value of the classification model in estimating the effect of barley on the occurrence of dyslipidemia in the host was 0.792 and the Matthews correlation coefficient was 0.56. Our findings connect gut bacteria to individual differences in the effects of barley on lipid metabolism, which could assist in developing personalized dietary strategies.

BACKGROUND: In an effort to increase people's adherence to active lifestyles, contemporary physical activity (PA) guidelines now include low-dose PA. METHODS: PA was evaluated in 583 participants of the Nutritional and Physical Activity Intervention Study (NEXIS) cohort (30-65 years old); 349 inactive participants (MVPA, 2.7 ± 1.0 MET-h/day) were randomly assigned to the intervention or control groups, and 235 active participants participated in follow-up visits. The intervention aimed to increase MVPA and comprised five brief counseling sessions over 1 year. The 1-year target for the participant was increasing their step-count to 10,000 steps/d or +3000 steps/d, relative to the baseline score. The counseling sessions were designed to stimulate progressive changes in physical behaviors by recommendations promoting small and/or light-intensity bouts of PA. PA was measured at baseline, the end of the intervention, and 1 year after the intervention ended. Additionally, several nutrition, health, and fitness parameters were measured. RESULTS: Participants in the intervention group significantly increased their step-count from 8415 ± 1924 at baseline to 9493 ± 2575 at the end of the 1-year period. During the same period, MVPA significantly increased by 0.9 MET-h. The daily time spent in ≥ 3, ≥ 4 and ≥ 5 MET activities increased by 11, 6, and 3 min, respectively. This increase in PA remained observable 1 year after intervention concluded. The active group maintained higher physical activity levels throughout the two years. The intervention group showed smaller energy intakes at the end of the 2-year period. Significant correlations were noted between the 1-year change in MVPA and the change in resting heart rate (r =  - 0.22), and between the 2-year change in MVPA and the change in waist circumference (r =  - 0.08) and peak oxygen consumption capacity (r = 0.23) in the intervention group only. CONCLUSIONS: A prolonged and progressive PA intervention promoting small bouts of light-to-moderate PA may be used in healthy, not-optimally-active people to increase PA beyond the strict period of the intervention. Further studies are necessary to understand whether low-dose PA messages can be effective in initiating a progressive increase toward larger amounts of PA. TRIAL REGISTRATION: Clinical Trials.gov, NCT00926744, retrospectively registered.

BACKGROUND & AIMS: A limited number of studies have developed simple anthropometric equations that can be implemented for predicting muscle mass in the local community. Several studies have suggested calf circumference as a simple and accurate surrogate maker for muscle mass. We aimed to develop and cross-validate a simple anthropometric equation, which incorporates calf circumference, to predict appendicular skeletal muscle mass (ASM) using dual-energy X-ray absorptiometry (DXA). Furthermore, we conducted a comparative validity assessment of our equation with bioelectrical impedance analysis (BIA) and two previously reported equations using similar variables. METHODS: ASM measurements were recorded for 1262 participants (837 men, 425 women) aged 40 years or older. Participants were randomly divided into the development or validation group. Stepwise multiple linear regression was applied to develop the DXA-measured ASM prediction equation. Parameters including age, sex, height, weight, waist circumference, and calf circumference were incorporated as predictor variables. Total error was calculated as the square root of the sum of the square of the difference between DXA-measured and predicted ASMs divided by the total number of individuals. RESULTS: The most optimal ASM prediction equation developed was: ASM (kg) = 2.955 × sex (men = 1, women = 0) + 0.255 × weight (kg) - 0.130 × waist circumference (cm) + 0.308 × calf circumference (cm) + 0.081 × height (cm) - 11.897 (adjusted R2 = 0.94, standard error of the estimate = 1.2 kg). Our equation had smaller total error and higher intraclass correlation coefficient (ICC) values than those for BIA and two previously reported equations, for both men and women (men, total error = 1.2 kg, ICC = 0.91; women, total error = 1.1 kg, ICC = 0.80). The correlation between DXA-measured ASM and predicted ASM by the present equation was not significantly different from the correlation between DXA-measured ASM and BIA-measured ASM. CONCLUSIONS: The equation developed in this study can predict ASM more accurately as compared to equations where calf circumference is used as the sole variable and previously reported equations; it holds potential as a reliable and an effective substitute for estimating ASM.

Evidence on the effects of a community-wide intervention (CWI) on population-level physical activity (PA), especially in the long term, is limited. Therefore, we evaluated the five-year effect of CWI on promoting PA through information dissemination, education, and community support primarily targeting older adults, by incorporating Japanese guidelines, in Fujisawa City, from 2013. To assess the effect of the whole-city intervention, we distributed questionnaires in 2013, 2015, and 2018 to three independent random samples of 3,000 community-dwelling adults (aged ≥ 20 years) using a quasi-experimental study design. Three separate samples responded to the survey (41% at baseline, 46% at the two-year mark, and 48% at the five-year follow-up). The primary outcome was change in PA participation. At the five-year follow-up, PA (median: 120 minutes/day) was significantly higher than at baseline (86 minutes/day) and the two-year follow-up (90 minutes/day). The results of the multivariate analysis indicated that PA among older adults-the primary target population of the CWI-increased significantly at the five-year follow-up, compared to those aged 20-64 (mean difference of change between groups: 14.7 minutes/day, P= 0.029). Among older adults, PA was significantly lower in those with poorer perceived economic status than in their more well-off counterparts at the two-year follow-up (P= 0.003); however, there was no significant difference at the five-year follow-up (P= 1.000). There was a positive interaction between group and period (mean difference of change between groups: 40.9 minutes/day, P= 0.001). In conclusion, the five-year CWI targeting older adults, incorporating national guidelines, improved population-level PA.

BACKGROUND: The Escherichia coli strain that is known to produce the genotoxic secondary metabolite colibactin is linked to colorectal oncogenesis. Therefore, understanding the properties of such colibactin-positive E. coli and the molecular mechanism of oncogenesis by colibactin may provide us with opportunities for early diagnosis or prevention of colorectal oncogenesis. While there have been major advances in the characterization of colibactin-positive E. coli and the toxin it produces, the infection route of the clb + strain remains poorly characterized. RESULTS: We examined infants and their treatments during and post-birth periods to examine potential transmission of colibactin-positive E. coli to infants. Here, analysis of fecal samples of infants over the first month of birth for the presence of a colibactin biosynthetic gene revealed that the bacterium may be transmitted from mother to infant through intimate contacts, such as natural childbirth and breastfeeding, but not through food intake. CONCLUSIONS: Our finding suggests that transmission of colibactin-positive E. coli appears to be occurring at the very early stage of life of the newborn and hints at the possibility of developing early preventive measures against colorectal cancer.

Lifestyle changes during the coronavirus disease (COVID-19) lockdown have been previously examined, but there is limited understanding about changes after such restrictions were lifted. This study examines changes in lifestyle habits and body weight among the Japanese population with regard to the length of at-home hours both during (April to May) and after (September) the nationwide stay-at-home request compared to those before the COVID-19 pandemic (January 2020). An online survey was conducted in September 2020 involving 10,000 Japanese survey monitors, selected according to population distribution. During the stay-at-home request, 34% participants extended their at-home hours. More respondents in the group with extended at-home hours experienced an increase or decrease in total physical activity, snacking, food intake, alcohol drinking, and body weight than those in the group with nonextended at-home hours. Some of these changes had a trend according to age. The prevalence of most of these changes decreased when at-home hours returned to normal after the stay-at-home request period; however, increased alcohol consumption and increased or decreased body weight persisted. Our findings suggest that close monitoring for further health outcomes and age-appropriate measures to encourage favorable health behaviors is needed.

BACKGROUND: Colibactin-producing Escherichia coli containing polyketide synthase (pks+ E. coli) has been shown to be involved in colorectal cancer (CRC) development through gut microbiota analysis in animal models. Stool status has been associated with potentially adverse gut microbiome profiles from fecal analysis in adults. We examined the association between stool patterns and the prevalence of pks+ E. coli isolated from microbiota in fecal samples of 224 healthy Japanese individuals. RESULTS: Stool patterns were determined through factorial analysis using a previously validated questionnaire that included stool frequency, volume, color, shape, and odor. Factor scores were classified into tertiles. The prevalence of pks+ E. coli was determined by using specific primers for pks+ E. coli in fecal samples. Plasma and fecal fatty acids were measured via gas chromatography-mass spectrometry. The prevalence of pks+ E. coli was 26.8%. Three stool patterns identified by factorial analysis accounted for 70.1% of all patterns seen (factor 1: lower frequency, darker color, and harder shape; factor 2: higher volume and softer shape; and factor 3: darker color and stronger odor). Multivariable-adjusted odds ratios (95% confidence intervals) of the prevalence of pks+ E. coli for the highest versus the lowest third of the factor 1 score was 3.16 (1.38 to 7.24; P for trend = 0.006). This stool pattern exhibited a significant positive correlation with fecal isobutyrate, isovalerate, valerate, and hexanoate but showed a significant negative correlation with plasma eicosenoic acid and α-linoleic acid, as well as fecal propionate and succinate. No other stool patterns were significant. CONCLUSIONS: These results suggest that stool patterns may be useful in the evaluation of the presence of tumorigenic bacteria and fecal fatty acids through self-monitoring of stool status without the requirement for specialist technology or skill. Furthermore, it may provide valuable insight about effective strategies for the early discovery of CRC.

BACKGROUND: The Asian Working Group for Sarcopenia (AWGS) 2019 recommended the use of dual-energy X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) to assess appendicular lean mass (ALM). AWGS, European Working Group on Sarcopenia in Older People 2 (EWGSOP2), Foundation for the National Institutes of Health Sarcopenia Project (FNIH), and International Working Group on Sarcopenia (IWGS) reported different cutoff values for sarcopenia. We aimed to validate these cutoff values in a Japanese population using DXA and two different devices of segmental multi-frequency BIA (MF-BIA). METHODS: We examined the data of Japanese individuals aged 18-86 years using the DXA (n = 756) and two 8-electrode MF-BIA devices (InBody and TANITA MC) (n = 1884). To validate these cutoff values, we used a population aged 18-40 years, and calculated the 95% confidence intervals (CIs) of [mean-2SD]. RESULTS: In DXA, the 95%CIs of [mean-2SD] for ALM/Ht2 were 5.2-5.8 and 6.6-7.3 kg/m2 in women and men, respectively. The AWGS (<5.4 in women and <7.0 in men), and IWGS (≤5.67 in women and ≤7.23 in men) cutoffs were acceptable. Regarding TANITA MC, the 95%CIs of [mean-2SD] for ALM/Ht2 were 5.6-6.0 and 6.9-7.4 kg/m2 in women and men, respectively. The AWGS (<5.7 in women and <7.0 in men), EWGSOP2 (<6.0 in women and <7.0 in men), and IWGS cutoffs were acceptable. Regarding InBody, the 95%CIs of [mean-2SD] for ALM/Ht2 were 4.8-5.2 and 6.4-6.8 kg/m2 in young women and men, respectively. All cutoff values were too high compared to those measured by InBody. InBody and TANITA MC were highly correlated (P < 0.001), but the values by InBody were significantly lower than those by TANITA MC or DXA. Using Yamada's equation for InBody raw data, the AWGS, EWGSOP2, or IWGS cutoffs were acceptable. The BMI-adjusted muscle mass cutoff values were <0.60 and <0.82 m2 in women and men, respectively. We also obtained the 20th percentile in older adult population (ALM/Ht2 , <6.2 in women and <7.5 in men for TANITA MC; <5.4 in women and <7.0 in men for InBody). CONCLUSIONS: The AWGS and IWGS cutoffs were valid for DXA, and the AWGS, IWGS, and EWGSOP2 cutoffs were valid for TANITA MC in Japanese population. Because the prevalence of sarcopenia is too low particularly in women when using those criteria, the 20th percentile might be a good alternative criteria. If the ALM original InBody values are used, the cutoffs should be <5.0 kg/m2 in women and <6.6 kg/m2 in men.

BACKGROUND: Inter-individual variations in gut microbiota composition are observed even among healthy populations. The gut microbiota may exhibit a unique composition depending on the country of origin and race of individuals. To comprehensively understand the link between healthy gut microbiota and host state, it is beneficial to conduct large-scale cohort studies. The aim of the present study was to elucidate the integrated and non-redundant factors associated with gut microbiota composition within the Japanese population by 16S rRNA sequencing of fecal samples and questionnaire-based covariate analysis. RESULTS: A total of 1596 healthy Japanese individuals participated in this study via two independent cohorts, NIBIOHN cohort (n = 954) and MORINAGA cohort (n = 642). Gut microbiota composition was described and the interaction of these microorganisms with metadata parameters such as anthropometric measurements, bowel habits, medical history, and lifestyle were obtained. Thirteen genera, including Alistipes, Anaerostipes, Bacteroides, Bifidobacterium, Blautia, Eubacterium halli group, Faecalibacterium, Fusicatenibacter, Lachnoclostridium, Parabacteroides, Prevotella_9, Roseburia, and Subdoligranulum were predominant among the two cohorts. On the basis of univariate analysis for overall microbiome variation, 18 matching variables exhibited significant association in both cohorts. A stepwise redundancy analysis revealed that there were four common covariates, Bristol Stool Scale (BSS) scores, gender, age, and defecation frequency, displaying non-redundant association with gut microbial variance. CONCLUSIONS: We conducted a comprehensive analysis of gut microbiota in healthy Japanese individuals, based on two independent cohorts, and obtained reliable evidence that questionnaire-based covariates such as frequency of bowel movement and specific dietary habit affects the microbial composition of the gut. To our knowledge, this was the first study to investigate integrated and non-redundant factors associated with gut microbiota among Japanese populations.

Objectives The purpose of this study was to examine the prevalence of frailty and its associated factors in community-dwelling middle-aged and elderly adults in Settsu and Hannan cities, which are located in the north and south of Osaka prefecture, respectively.Methods We conducted a mailed, self-administered, questionnaire survey of individuals aged 40 years and older in Settsu city in 2019 and Hannan city in 2020. There are 10 primary school districts in Settsu city and 8 districts in Hannan city, from each of which 1,000 people were selected according to the age and sex structures of the districts. We included 5,134 individuals from Settsu city and 3,939 individuals from Hannan city. We defined frailty using self-reported questionnaires, the Kihon Checklist (KCL), and Simple Frailty Index (SFI). Multivariate logistic regression analysis was performed for each city to examine the association of frailty with age, sex, body mass index (BMI), family structure, subjective health, economic status, subjective physical fitness, sleeping status, smoking history, alcohol use, meal frequency and awareness of the word "frailty."Results The average age (standard deviation) of participants was 62.7 (12.5) years in Settsu city and 63.4 (12.2) years in Hannan city. The prevalence of frailty by KCL was 18.7% and 17.9% for participants in their 40s, 18.2% and 14.6% for those in their 50s, 17.0% and 15.7% for those in their 60s, 25.4% and 20.8% for those in their 70s, 39.7% and 36.1% for those 80 years and older from Settsu and Hannan cities, respectively. Using SFI, the prevalence of frailty was 16.2% and 13.5% for participants in their 40s, 15.0% and 11.9% for those in their 50s, 12.5% and 10.0% for those in their 60s, 14.6% and 12.3% for those in their 70s, and 24.7% and 22.3% for those aged 80 years and older in Settsu and Hannan cities, respectively. Significant common independent variables associated with frailty as defined using the KCL and SFI in Settsu and Hannan cities were age, subjective health, economic status, subjective physical fitness, sleeping status, and awareness of the word "frailty."Conclusion This study found some participants to be frail as early as their 40s or 50s. Thus, efforts must be made to prevent frailty in working-age populations, including those aged 40 years and older. Six factors were associated with frailty. Longitudinal or interventional studies are required to examine their causal relationships and public health significance.

BACKGROUND: It has been pointed out that prolonged television (TV) viewing is one of the sedentary behaviors that is harmful to health; however, the association between socioeconomic status (SES) and prolonged TV viewing time has not been sufficiently investigated in Japan. METHODS: The study population are the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2752 adults. SES was classified according to the employment status, educational attainment, living status, and equivalent household expenditure (EHE). Prolonged TV viewing time was defined as more than or equal to 4 h of TV viewing per day. Multivariable logistic regression analyses were conducted to examine the association of SES with prolonged TV viewing time. RESULTS: The mean TV viewing time was 2.92 h in all participants. Of 2752 participants, 809 (29.4%) prolonged TV viewing, and the mean TV viewing time of them was 5.61 h. The mean TV viewing time in participants without prolonged TV viewing time was 1.81 h. The mean TV viewing time was prolonged as age classes increased and significantly longer in aged ≥60 years. Prolonged TV viewing time was associated with not working for all age classes and sexes. Only among women, education attainment and living status were also associated with prolonged TV viewing time. For education attainment, the lower the received years of education, the higher odds ratios (OR) of prolonged TV viewing time. For living status, in women aged <60 years, living with others had a significantly higher OR compared to living with spouse. On the other hand, in women aged ≥60 years, living alone had a significantly higher OR. EHE did not have any significant associations with prolonged TV viewing time. CONCLUSIONS: In a general Japanese population, it should be noted that the association between SES and prolonged TV viewing time differed by age and sex. Particularly, it must draw attention to the prolonged TV viewing in elderly. The intervention in order to shorten TV viewing time needs to consider these attributes.

BACKGROUND: Previous epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults. METHODS: We conducted face-to-face surveys of 525 adults, who were aged 40-91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40-97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia. RESULTS: Sarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject's calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8-9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants. CONCLUSIONS: Sarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia. TRIAL REGISTRATION: UMIN000036880, registered prospectively May 29, 2019,  https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027.

PURPOSE: The age-associated increase in arterial wall viscosity (AWV) is attenuated by high cardiorespiratory fitness level. However, AWV in endurance-trained athletes have not been determined. We designed a cross sectional study to compare central AWV and compliance between endurance-trained young athletes and age-matched control men. METHODS: Twenty-one endurance-trained men (age 20.7 ± 0.3 years) and 20 age-matched healthy control men (age 21.6 ± 0.4 years) were studied. The common carotid artery was measured noninvasively by tonometry and automatic tracking of B-mode images to obtain instantaneous pressure and diameter hysteresis loops, and we calculated the dynamic carotid arterial compliance, static (effective and isobaric) compliance, and viscosity index. RESULTS: The AWV index in the endurance-trained men was larger than the control peers (2285 ± 181 vs. 1429 ± 124 mmHg·s/mm: P < 0.001). In addition, dynamic and static compliance were not statistically different between both groups. CONCLUSION: The present study indicated that the central AWV in endurance-trained athletes was greater than age-matched healthy control men. We believe that the AWV, as well as arterial compliance, is an important element for assessing vascular adaptation to endurance training.

PURPOSE: This study aimed to examine the association between whole-body or segmental phase angle (PhA) based on bioelectrical impedance analysis (BIA) and aerobic capacity (endurance), complex gait ability, and total fitness age score (FAS). METHODS: A total of 426 community-dwelling older adults (332 women and 94 men) aged 60 to 93 years participated in this study. PhA and appendicular skeletal mass index (ASMI) were obtained by an eight-electrode standing BIA. Aerobic capacity was assessed using the shuttle stamina walk test (SSTw); complex gait ability, using the timed-up-and-go test (TUG). FAS was obtained using the previously validated multi-dimensional equations based on 7-year longitudinal data. SSTw, TUG, and FAS were compared between the low PhA (<4.4° for women and <5.2° for men) and normal PhA groups. Pearson's correlation between PhA and SSTw, TUG, and FAS was determined. Multiple linear regression analysis was conducted using SSTw, TUG, and FAS as dependent variables. Age, sex, height, body mass index (BMI), ASMI, and PhA were entered into the linear model. RESULTS: SSTw and TUG results and FAS were significantly lower in the low PhA group (P < 0.05). PhA was significantly correlated with SSTw, TUG, and FAS (P < 0.001), and leg PhA showed a stronger correlation than whole-body or arm PhA. PhA at 50 kHz had higher correlation coefficients with SSTw, TUG, or FAS compared with PhA at 5 or 250 kHz. Multiple regression analyses indicated that leg PhA at 50 kHz was a significant predictor of SSTw, TUG, and FAS, independent of age, sex, height, BMI, and ASMI. CONCLUSION: Our results indicate that leg PhA is associated with multi-dimensional physical fitness in community-dwelling older adults. PhA is a highly informative biomarker of skeletal muscle and exercise physiology in clinical settings.

目的 ふん便(以下、便)は、我々の食事や栄養状態ならびに腸内細菌叢の特徴を反映し、身体の健康状態や栄養摂取状況を、簡便かつ非侵襲的に評価できるツールであると考えられる。一方で、便を包括的に評価し、簡便かつ客観的に評価する適切なツールに関する検討は十分に行われておらず、日常の排便状況や便性状を的確に把握できる有用な質問票が求められている。習慣的な排便状況(排便回数)や便性状(排便量、色、形状など)を把握するための評価ツールを作成し、排便日誌に基づく排便回数や便性状の記録と比較し内的妥当性を検討した。方法 22から78歳までの成人男女35人(45.2±17.1歳)を解析対象とした。習慣的な便に関する質問票(以下、習慣的便質問票)による最近1ヵ月間における平均的な排便回数、1回あたりの排便量、便の色や形状、便の浮きや腹部膨満感を調査した。この習慣的便質問票の各項目の再現性を検討するため、2回の調査を実施し、再現性を確認した。その後、排便日誌を用いて、毎日の排便時刻や便の性状などを1週間記録した。この排便日誌を基にした排便回数や便性状を内的妥当基準とし、習慣的便質問票により得られた回答を比較した。なお、習慣的便質問票における排便回数は、排便回数がカテゴリー化された回答を選択する選択回答法と数値による自由回答法の2種類で回答した。結果 習慣的便質問票の再現性を検討した結果、全ての項目においてスピアマン順位相関係数の有意な相関(ρ=0.431〜0.911)が認められ、重みづけκ係数においても高い一致度を示した(weighted κ=0.348〜0.841)。また、内的妥当性については、排便日誌による1週間あたりの排便回数と、習慣的便質問票における排便回数の回答を比較すると、自由回答法による1週間あたりの排便回数の方が、選択回答法より高い相関(ρ=0.855)を示した。さらに、便性状については、1週間の排便日誌における便性状の回答の中央値と習慣的便質問票での回答との相関を検討したところ、「便の浮き」を除いて有意な相関が示された(ρ=0.429〜0.800)。結論 本研究で作成した質問票は、習慣的な排便状況や便性状を評価する上で、再現性と内的妥当性が高いことが確認された。(著者抄録)

BACKGROUND: Lower socioeconomic status (SES) may be related to inactivity lifestyle; however, the association between SES and physical inactivity has not been sufficiently investigated in Japan. METHODS: The study population is the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2,609 adults. Physical activity was assessed by physical activity index (PAI) calculated from activity intensity and time. The lowest tertile of PAI for each 10-year age class and sex was defined as physical inactivity. Multivariable logistic regression analyses were conducted to examine the association of SES (employment status, educational attainment, living status, and equivalent household expenditure (EHE)) with physical inactivity. RESULTS: In the distribution of PAI by age classes and sex, the highest median PAI was aged 30-39 years among men (median 38.6), aged 40-49 years among women (38.0), and median PAI was decreased with increasing age. Multivariable-adjusted model shows that not working was significantly associated with physical inactivity after adjustment for age in all age groups and sexes. Not living with spouse for adult women and elderly men was significantly associated with physical inactivity compared to those who living with spouse. However, neither educational attainment nor EHE had any significant associations with physical inactivity. CONCLUSIONS: The result indicated that physical inactivity was associated with SES in a general Japanese population. SES of individuals need to be considered in order to prevent inactivity lifestyle.

BACKGROUND: The prevention of metabolic syndrome (MetS) is a major public health concern in Japan. The effects of the relationship between eating behavior and nutritional intake on MetS remained unclear. To evaluate nutrition's role in preventing or exacerbating MetS, we examined the associations among eating behavior, nutritional intake, and MetS for the baseline study in the cohort subjects undergone health checkups. METHODS: Four thousand and four hundred forty-seven Japanese men and women were enrolled at the Saku Central Hospital. They received an anthropometric and clinical examination and were assessed for present illness, lifestyle factors such as physical activity, smoking, drinking, and dietary habits at the enrollment. Eating behavior was analyzed by the Sakata's Eating Behavior Questionnaire. Dietary assessment was made using a brief self-administered diet history questionnaire. Two thousand and six hundred two men and 1844 women aged more than 20 were analyzed. RESULTS: The mean age in men and women were 59.2 and 58.4 years old and the mean body mass index (BMI) were 23.7 and 22.3 kg/m2, respectively. The percentages of MetS were 20.6 in men and 6.1 in women. In some nutrients, significantly higher energy-adjusted intakes in subjects without MetS than with Mets appeared both in men and women after age adjustment. After adjusting by age, energy-adjusted intake beverages in men and cereals in women were significantly higher in subjects with MetS than those without MetS. The scores of all the categories in eating behavior were significantly worse in subjects with MetS than those without MetS. CONCLUSIONS: The differences in dietary intake between subjects with Mets and without Mets were relatively small. The scores of all the categories in eating behavior were worse in subjects with MetS than without MetS. It was suggested that the problem lay in the quality of diet, not in the quantity, caused by bad eating habits. The potential influence of eating behavior and nutritional intake on MetS was presented in men and women.

The Life Science Symposium held by the Nutrition Research Committee of the International Life Sciences Institute (ILSI) Japan in 2018, "Fusion of Nutrition and Exercise Sciences Leading to Extension of Healthy Life Expectancy," covered current topics in the science of nutrition and exercise to address extending healthy life expectancy. Presentation topics included (1) lifestyle and gut microbiota; (2) how to use lipids in sports nutrition; (3) the effect and molecular mechanism of improvement of arteriosclerosis by exercise and nutrition; (4) physical activity and nutrition that support brain function; (5) skeletal muscles and food ingredients that support healthy longevity; (6) measures against sarcopenia by exercise and nutrient intake; (7) physical activity/exercise for disease prevention; (8) nutritional epidemiology research for the Japanese population; (9) new developments in health science in viewed from nutrition and intestinal flora; (10) why do Asians develop nonobese metabolic disease?; and (11) social implementation of the health promotion program by ILSI Japan. The speakers emphasized the promotion of research on exercise and nutrition interactions and encouraged social implementation of the research results in public and private sectors.

CONTEXT: Lean body mass is essential for health, yet consensus regarding the effectiveness of protein interventions in increasing lean body mass is lacking. OBJECTIVE: The aim of this systematic review was to evaluate the dose-response relationship of the effects of protein intake on lean body mass. DATA SOURCES: The PubMed and Ichushi-Web databases were searched electronically, and reference lists of the literature included here and in other meta-analyses were searched manually. STUDY SELECTION: Randomized controlled trials evaluating the effects of protein intake on lean body mass were included. DATA EXTRACTION: Two authors independently screened the abstracts; 5 reviewed the full texts. RESULTS: A total of 5402 study participants from 105 articles were included. In the multivariate spline model, the mean increase in lean body mass associated with an increase in protein intake of 0.1 g/kg of body weight per day was 0.39 kg (95%CI, 0.36-0.41) and 0.12 kg (95%CI, 0.11-0.14) below and above the total protein intake of 1.3 g/kg/d, respectively. CONCLUSIONS: These findings suggest that slightly increasing current protein intake for several months by 0.1 g/kg/d in a dose-dependent manner over a range of doses from 0.5 to 3.5 g/kg/d may increase or maintain lean body mass. SYSTEMATIC REVIEW REGISTRATION: UMIN registration number UMIN000039285.

A high level of physical fitness, especially cardiorespiratory fitness, is associated with lower incidence of hypertension. However, the relationship between flexibility, which is a component of physical fitness, and the incidence of hypertension is unknown. The purpose of this study was to investigate the relationship between flexibility and the incidence of hypertension in a cohort study. A total of 22,972 (14,805 men and 8167 women; median age 49 years) normotensive participants were included in this study. Between April 2001 and March 2002, flexibility (standing forward bending) was measured using a standing trunk flexion meter. The participants were divided into quartiles of flexibility by sex and age group. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, or a self-reported history of previously diagnosed hypertension or current medication for hypertension at a health examination between April 2002 and March 2008. Hazard ratios and 95% confidence intervals (95% CI) for the incidence of hypertension were estimated using Cox proportional hazards models after adjusting for age, sex, body mass index, exercise habits, smoking status, and drinking status. During 102,948 person years of follow-up (median 5.6 years), 4235 participants developed hypertension. Compared with the lowest flexibility (quartile 1), hazard ratios and 95% CI were 0.96 (0.88 - 1.04) for quartile 2, 0.94 (0.86 - 1.03) for quartile 3, and 0.83 (0.76 - 0.91) for quartile 4. A high level of flexibility was associated with lower incidence of hypertension, independent of other confounding factors.

BACKGROUND: To examine the association between muscular and performance fitness (MPF) and the incidence of glaucoma. METHODS: A total of 27,051 glaucoma-free participants aged 20-87 years underwent physical fitness tests between April 2001 and March 2002. The MPF index was calculated using an age- and sex-specific summed z-score from grip strength, vertical jump, single-leg balance, forward bending, and whole-body reaction time. The participants were divided into quartiles according to the MPF index and each physical fitness test. Participants were followed up for the development of glaucoma, which was defined based on physician-diagnosed glaucoma at an annual health examination between April 2002 and March 2008. Hazard ratios for the incidence of glaucoma were estimated using Cox proportional hazards models. RESULTS: During follow-up, 303 participants developed glaucoma. Compared with the lowest MPF index group, hazard ratio (95% confidence interval) of developing glaucoma was 0.64 (0.46-0.89) for the highest MPF index group (P for trend = .001). Vertical jump and whole-body reaction time were associated with incident glaucoma (P for trend = .01 and <.001, respectively). There were no associations between the other physical fitness tests and the incidence of glaucoma. CONCLUSION: Higher MPF is associated with lower incidence of glaucoma.

AIM: To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. METHODS: In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. RESULTS: Calf circumference was positively correlated with BIA-measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2 . The optimal calf circumference cut-offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. CONCLUSIONS: Calf circumference is positively correlated with BIA- and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943-950.

The relative contribution of diet to colorectal cancer (CRC) incidence is higher than that for other cancers. Animal models have revealed that Escherichia coli containing polyketide synthase (pks+ E. coli) in the gut participates in CRC development. The purpose of this cross-sectional study was to examine the relationship between dietary intake and the prevalence of pks+ E. coli isolated from the microbiota in faecal samples of 223 healthy Japanese individuals. Dietary intake was assessed using a previously validated brief-type self-administered diet history questionnaire. The prevalence of pks+ E. coli was evaluated using faecal samples collected from participants and specific primers that detected pks+ E. coli. The prevalence of pks+ E. coli was 26.9%. After adjusting for baseline confounders, the prevalence of pks+ E. coli was negatively associated with the intake of green tea (odds ratio [OR], 0.59 [95% confidence interval (CI) 0.30-0.88] per 100 g/1,000 kcal increment) and manganese (OR, 0.43 [95% CI 0.22-0.85] per 1 mg/1,000 kcal increment) and was positively associated with male sex (OR, 2.27 [95% CI 1.05-4.91]). While futher studies are needed to validate these findings, these results provide insight into potential dietary interventions for the prevention of CRC.

Walking football was born in United Kingdom around 2011, that is forbidden to running. In recent years, walking football has become increasingly popular as a sport that diverse people can enjoy together. However, it is not clarified exercise intensity and how they feel after playing walking football. We aimed to determine the intensity when playing walking football and investigated how mood change. Twenty-six men and women (18 males, 8 females) out of those who participated in walking football event agreed to the present study. Heart rate (HR) was measured using wearable device with photoplethysmography when playing walking football. Metabolic equivalents (METs) was assessed using a triaxial accelerometer worn on the waist. McGill pain questionnaire was used to assess pain sites and number. To assess change in mood, short version of physical activity enjoyment scale (sPACES) was used before and after playing walking football. Borg scale was measured before and after walking football. The HR and METs were respectively as follows; male, 111.9 ± 11.4 bpm and 4.3 ± 0.6METs; female, 118.6 ± 16.2 bpm and 4.8 ± 0.7METs. There was no significant difference between men and women in both HR and METs during walking football. The sPACES was indicated significantly positive changes in mood, and Borg scale was significantly increased after playing walking football, without increasing acute or chronic pain. The walking football is safe and moderate-intensity sports and induce positive changes in mood.

Atrial fibrillation (AF) reduces the quality of life by triggering stroke and heart failure. The association between AF onset and gut metabolites suggests a causal relationship between AF and gut microbiota dysbiosis; however, the relationship remains poorly understood. We prospectively enrolled 34 hospitalized patients with AF and 66 age-, sex-, and comorbidity-matched control subjects without a history of AF. Gut microbial compositions were evaluated by amplicon sequencing targeting the 16S ribosomal RNA gene. We assessed differences in dietary habits by using a brief-type self-administered diet history questionnaire (BDHQ). Gut microbial richness was lower in AF patients, although the diversity of gut microbiota did not differ between the two groups. At the genus level, Enterobacter was depleted, while Parabacteroides, Lachnoclostridium, Streptococcus, and Alistipes were enriched in AF patients compared to control subjects. The BDHQ revealed that the intake of n-3 polyunsaturated fatty acids and eicosadienoic acid was higher in AF patients. Our results suggested that AF patients had altered gut microbial composition in connection with dietary habits.

BACKGROUND: Several cross-sectional studies have linked higher physical fitness with better hearing sensitivity but have not established a causal relation; none have used a prospective design that is less susceptible to bias. We used a prospective cohort study to investigate the association between muscular and performance fitness and the incidence of hearing loss. METHODS: A total of 21,907 participants without hearing loss received physical fitness assessments between April 2001 and March 2002. Muscular and performance fitness index, an age- and sex-specific summed z-score based on grip strength, vertical jump height, single-leg balance, forward bending, and whole-body reaction time was calculated. Participants were classified into quartiles according to the muscular and performance fitness index and each physical fitness test. They were followed up for the development of hearing loss, assessed by pure-tone audiometry at annual health examinations between April 2002 and March 2008. Hazard ratios and 95% confidence intervals for hearing loss incidence were estimated using Cox proportional hazards regression models. RESULTS: During follow-up, 2765 participants developed hearing loss. The hazard ratios (95% confidence intervals) for developing hearing loss across the muscular and performance fitness index quartiles (lowest to highest) were 1.00 (reference), 0.88 (0.79-0.97), 0.83 (0.75-0.93), and 0.79 (0.71-0.88) (Ptrend <.001). Among the various physical fitness components, a clear dose-response association with hearing loss incidence was observed for vertical jump height and single-leg balance (Ptrend <.001 for both). CONCLUSION: Higher muscular and performance fitness is associated with a lower incidence of hearing loss.

BACKGROUND: Grip strength reflects systemic muscle strength and mass and is reportedly associated with various metabolic variables. However, its prognostic association with dyslipidemia is unknown. We examined the association of grip strength and other physical fitness markers with the incidence of dyslipidemia among Japanese adults. METHODS: A total of 16,149 Japanese (6208 women) individuals aged 20-92 years who underwent a physical fitness test between April 2001 and March 2002 were included in this cohort study. Grip strength, vertical jump, single-leg balance with eyes closed, forward bending, and whole-body reaction time were evaluated at baseline. Dyslipidemia was annually determined based on fasting serum lipid profiles and self-reported dyslipidemia from April 2001 to March 2008. RESULTS: During the follow-up period, 4458 (44.9%) men and 2461 (39.6%) women developed dyslipidemia. A higher relative grip strength (grip strength/body mass index) was associated with a lower incidence of dyslipidemia among both men and women (P for trend < 0.001). Compared with those for the first septile, the hazards ratios and 95% confidence intervals for the seventh septile were 0.56 (0.50, 0.63) for men and 0.69 (0.58, 0.81) for women. Moreover, relative vertical jump (vertical jump strength/body mass index) was also inversely associated with the incidence of dyslipidemia among both men and women (P for trend < 0.001). There was no association between other physical fitness and dyslipidemia among both men and women. CONCLUSION: Relative grip strength and vertical jump may be useful risk markers of the incidence of dyslipidemia.

PURPOSE: Iron is an important component of the oxygen-binding proteins and may be critical to optimal athletic performance. Previous studies have suggested that the G allele of C/G rare variant (rs1799945), which causes H63D amino acid replacement, in the HFE is associated with elevated iron indexes and may give some advantage in endurance-oriented sports. The aim of the present study was to investigate the association between the HFE H63D polymorphism and elite endurance athlete status in Japanese and Russian populations, aerobic capacity and to perform a meta-analysis using current findings and three previous studies. METHODS: The study involved 315 international-level endurance athletes (255 Russian and 60 Japanese) and 809 healthy controls (405 Russian and 404 Japanese). Genotyping was performed using micro-array analysis or by PCR. VO2max in 46 male Russian endurance athletes was determined using gas analysis system. RESULTS: The frequency of the iron-increasing CG/GG genotypes was significantly higher in Russian (38.0 vs 24.9%; OR 1.85, P = 0.0003) and Japanese (13.3 vs 5.0%; OR 2.95, P = 0.011) endurance athletes compared to ethnically matched controls. The meta-analysis using five cohorts (two French, Japanese, Spanish, and Russian; 586 athletes and 1416 controls) showed significant prevalence of the CG/GG genotypes in endurance athletes compared to controls (OR 1.96, 95% CI 1.58-2.45; P = 1.7 × 10-9). Furthermore, the HFE G allele was associated with high V̇O2max in male athletes [CC: 61.8 (6.1), CG/GG: 66.3 (7.8) ml/min/kg; P = 0.036]. CONCLUSIONS: We have shown that the HFE H63D polymorphism is strongly associated with elite endurance athlete status, regardless ethnicities and aerobic capacity in Russian athletes.

Objectives: This study examined how healthcare costs might change by reducing long-term care needs among older Japanese people. Methods: A simulation model was constructed comprising two aging chains for independent and dependent people aged ≥65 years by sex. Changes in the base run from 2020 to 2040 were compared with those in two hypothetical scenarios: a 2% annual reduction in death rates (S1), and S1 plus a 2% annual reduction in the proportion of dependent people aged 65 years and in transition rates from the independent to dependent state for people aged ≥65 years (S2). Results: In the base run, the population increased by 13.0% for men and 11.3% for women, and the proportion of dependent people increased by 4.6% for men but decreased by 13.4% for women. The sum of medical and long-term care expenditure increased in the base run, S1, and S2 by 8.2, 27.4, and 16.4%, respectively, for men and women combined. Conclusions: Healthcare costs will increase as death rates fall, but the increase will be attenuated if the proportion of dependent people decreases.

With an ever-increasing interest in understanding the relationships between the microbiota and the host, more tools to map, analyze and interpret these relationships have been developed. Most of these tools, however, focus on taxonomic profiling and comparative analysis among groups, with very few analytical tools designed to correlate microbiota and the host phenotypic data. We have developed a software program for creating a web-based integrative database and analysis platform called MANTA (Microbiota And pheNoType correlation Analysis platform). In addition to storing the data, MANTA is equipped with an intuitive user interface that can be used to correlate the microbial composition with phenotypic parameters. Using a case study, we demonstrated that MANTA was able to quickly identify the significant correlations between microbial abundances and phenotypes that are supported by previous studies. Moreover, MANTA enabled the users to quick access locally stored data that can help interpret microbiota-phenotype relations. MANTA is available at https://mizuguchilab.org/manta/ for download and the source code can be found at https://github.com/chenyian-nibio/manta.

We determined the total energy expenditure (TEE) of healthy overweight or obese people, and those with impaired glucose tolerance and/or impaired fasting glycemia (IGT/IFG), or type 2 diabetes (T2DM) using the doubly-labeled water method. As a second purpose, we compared the measured TEE with the target energy intake recommended in the treatment guidelines for diabetes. The participants were normal glucose tolerance (NGT), and IGT/IFG (n=11) and T2DM (n=9) patients, who were 50-59 y and had a body mass index >25 kg/m2. The median TEE/body mass (BM) values were 32.6, 33.3, and 34.4 kcal/kg BM and the TEE/target BM values (target BM: BM at a BMI of 22 kg/m2) were 43.7, 50.2, and 46.5 kcal/kg target BM for each group, respectively, and did not differ significantly among them. Obese Japanese participants with T2DM in this study had lower TEE/BM than previously studied in non-obese participants with T2DM. In IGT/IFG or T2DM patients, if 30 kcal/kg target BM was used as the energy coefficient, on the basis of the treatment guidelines, the difference between TEE and the target energy intake would be -1,174±552 kcal (-38±11%). When 35 kcal/kg target BM was used as the energy coefficient, the difference between TEE and the target energy intake would be -877±542 kcal (-27±13%). Thus, the energy coefficients used to estimate target energy intake during lifestyle modification in obese/overweight patients with T2DM are considered to be quite low during the first step of diet therapy.

Background: The genetic predisposition to elite athletic performance has been a controversial subject due to the underpowered studies and the small effect size of identified genetic variants. The aims of this study were to investigate the association of common single-nucleotide polymorphisms (SNPs) with endurance athlete status in a large cohort of elite European athletes using GWAS approach, followed by replication studies in Russian and Japanese elite athletes and functional validation using metabolomics analysis. Results: The association of 476,728 SNPs of Illumina DrugCore Gene chip and endurance athlete status was investigated in 796 European international-level athletes (645 males, 151 females) by comparing allelic frequencies between athletes specialized in sports with high (n = 662) and low/moderate (n = 134) aerobic component. Replication of results was performed by comparing the frequencies of the most significant SNPs between 242 and 168 elite Russian high and low/moderate aerobic athletes, respectively, and between 60 elite Japanese endurance athletes and 406 controls. A meta-analysis has identified rs1052373 (GG homozygotes) in Myosin Binding Protein (MYBPC3; implicated in cardiac hypertrophic myopathy) gene to be associated with endurance athlete status (P = 1.43 × 10-8, odd ratio 2.2). Homozygotes carriers of rs1052373 G allele in Russian athletes had significantly greater VO2
max
than carriers of the AA + AG (P = 0.005). Subsequent metabolomics analysis revealed several amino acids and lipids associated with rs1052373 G allele (1.82 × 10-05) including the testosterone precursor androstenediol (3beta,17beta) disulfate. Conclusions: This is the first report of genome-wide significant SNP and related metabolites associated with elite athlete status. Further investigations of the functional relevance of the identified SNPs and metabolites in relation to enhanced athletic performance are warranted.

目的:全国の都道府県を対象として,身体活動促進を目的とした行動計画の策定とその実施状況を明らかにすること。方法:Bullらが開発した「健康増進のための身体活動に関する国の政策を監査するためのツール(Health-Enhancing Physical Activity Policy Audit Tool;HEPA PAT)」を改変し,地方自治体向けの新たな政策監査ツール(Local PAT;L-PAT)を作成した。内容は,「身体活動促進に関する行動計画の策定」,「行動計画の策定における部門・組織間の連携」,「実際に行われた事業や活動」など11項目とした。研究期間は2015年8月から2016年3月であった。対象は全国47都道府県の保健,スポーツ,教育,都市計画,交通,環境の6つの部門で,合計282(47都道府県×6部門)であった。結果:全対象282のうち202から回答が得られ,回答率は71.6%であった。保健部門とスポーツ部門は,行動計画の策定率(それぞれ100%,97.6%)および実施率(それぞれ93.6%,100%)が他の部門よりも高かった。環境整備に携わる都市計画部門と交通部門においても行動計画が策定されていたが(それぞれ55%,30%),実施率は低かった(それぞれ13.6%,22.2%)。保健,スポーツ,教育の部門間には連携が認められたが,その他の部門との連携は不十分だった。結論:都道府県レベルの身体活動促進に関する行動計画の策定・実施は,保健部門とスポーツ部門を中心に行われていた。都市計画部門や交通部門においても関連する計画がみられた。今後は策定や実施の具体的内容および活動の効果など質的な検討が求められる。(著者抄録)

BACKGROUND: Self-monitoring using certain types of pedometers and accelerometers has been reported to be effective for promoting and maintaining physical activity (PA). However, the validity of estimating the level of PA or PA energy expenditure (PAEE) for general consumers using wearable devices has not been sufficiently established. OBJECTIVE: We examined the validity of 12 wearable devices for determining PAEE during 1 standardized day in a metabolic chamber and 15 free-living days using the doubly labeled water (DLW) method. METHODS: A total of 19 healthy adults aged 21 to 50 years (9 men and 10 women) participated in this study. They followed a standardized PA protocol in a metabolic chamber for an entire day while simultaneously wearing 12 wearable devices: 5 devices on the waist, 5 on the wrist, and 2 placed in the pocket. In addition, they spent their daily lives wearing 12 wearable devices under free-living conditions while being subjected to the DLW method for 15 days. The PAEE criterion was calculated by subtracting the basal metabolic rate measured by the metabolic chamber and 0.1×total energy expenditure (TEE) from TEE. The TEE was obtained by the metabolic chamber and DLW methods. The PAEE values of wearable devices were also extracted or calculated from each mobile phone app or website. The Dunnett test and Pearson and Spearman correlation coefficients were used to examine the variables estimated by wearable devices. RESULTS: On the standardized day, the PAEE estimated using the metabolic chamber (PAEEcha) was 528.8±149.4 kcal/day. The PAEEs of all devices except the TANITA AM-160 (513.8±135.0 kcal/day; P>.05), SUZUKEN Lifecorder EX (519.3±89.3 kcal/day; P>.05), and Panasonic Actimarker (545.9±141.7 kcal/day; P>.05) were significantly different from the PAEEcha. None of the devices was correlated with PAEEcha according to both Pearson (r=-.13 to .37) and Spearman (ρ=-.25 to .46) correlation tests. During the 15 free-living days, the PAEE estimated by DLW (PAEEdlw) was 728.0±162.7 kcal/day. PAEE values of all devices except the Omron Active style Pro (716.2±159.0 kcal/day; P>.05) and Omron CaloriScan (707.5±172.7 kcal/day; P>.05) were significantly underestimated. Only 2 devices, the Omron Active style Pro (r=.46; P=.045) and Panasonic Actimarker (r=.48; P=.04), had significant positive correlations with PAEEdlw according to Pearson tests. In addition, 3 devices, the TANITA AM-160 (ρ=.50; P=.03), Omron CaloriScan (ρ=.48; P=.04), and Omron Active style Pro (ρ=.48; P=.04), could be ranked in PAEEdlw. CONCLUSIONS: Most wearable devices do not provide comparable PAEE estimates when using gold standard methods during 1 standardized day or 15 free-living days. Continuous development and evaluations of these wearable devices are needed for better estimations of PAEE.

AIMS/INTRODUCTION: To investigate the relationship between combined aerobic and resistance training, and the incidence of type 2 diabetes mellitus. MATERIALS AND METHODS: The present study included 10,680 Japanese women. Participants enrolled between 2005 and 2010, and were followed up until 2014. The frequency of combined training was counted for the first 3 months, the 6th month and the 9th month. In 2014, women reported whether or not they had diabetes, as well as the year of developing diabetes. Hazard ratios and 95% confidence intervals (CI) for the incidence of type 2 diabetes were obtained using Cox proportional hazard models. RESULTS: The median duration of follow up was 5 years, with 166 women developing type 2 diabetes. Using the lowest frequency of training group (1st quartile) as the reference, the hazard ratios for the second through fourth quartiles was as follows: 0.95 (95% CI 0.64-1.41), 0.73 (95% CI 0.48-1.13) and 0.69 (95% CI 0.44-1.07), respectively (P for trend = 0.116). After adjustment for age, body mass index and thigh circumference, the hazard ratios were: 0.84 (95% CI 0.56-1.26), 0.69 (95% CI 0.45-1.06) and 0.61 (95% CI 0.39-0.95), respectively (P for trend = 0.040). CONCLUSIONS: A higher frequency of combined aerobic and resistance training is associated with a lower risk of developing type 2 diabetes in Japanese women.

BACKGROUND: Simple physical fitness test can be a useful potential predictor of type 2 diabetes (T2DM). We examined the association between performances on simple physical fitness tests and the incidence of T2DM. METHODS: This longitudinal study was conducted in 21,802 nondiabetic Japanese (6,649 women) aged 20 to 92 years, who underwent all physical fitness tests at baseline (April 2001 to March 2002). From April 2001 to March 2008, physical fitness tests, including grip strength, vertical jump, single-leg balance with eyes closed, forward bending, whole-body reaction time, and supine legs-up, were performed every year. Participants had physical fitness tests at least two times during the period. T2DM was also annually determined based on fasting blood glucose, glycated hemoglobin, and self-reported diabetes during the period. Discrete-time logit models were used to examine the influence of the serial level of each physical fitness test on the incidence of T2DM. RESULTS: During the entire study period, 972 participants developed diabetes. Lower relative grip strength (grip strength/body weight) and single-leg balance performance were associated with a higher incidence of T2DM. For relative grip strength, as compared with the fourth quartile group, the odds ratios for other groups ranged from 1.16 to 1.56 (P for trend < 0.001). For single-leg balance, the odds ratios ranged from 1.03 to 1.49 (P for trend < 0.001). CONCLUSION: The performance of a simple single-leg balance test as well as that of a grip strength test were negatively associated with the risk of T2DM among Japanese.

運動に関する感情経験、態度、行動意図を評価する尺度を作成し、その妥当性・信頼性を検証するとともに、感情要因と運動行動との相互関連性について検討した。60歳代であり、かつ配偶者と同居している500名を対象に、質問紙によるインターネット調査を行った。運動の感情経験尺度を探索的因子分析した結果、2因子が抽出され、各因子には因子負荷量の大きい上位3項目が採用された。運動への態度尺度、運動の行動意図尺度の探索的因子分析でも2因子が抽出された。運動行動と肯定的な感情経験尺度、感情的態度尺度、手段的態度尺度および運動の継続意図尺度との効果量は大きく、運動行動と阻害要因への対処意図尺度との関連性の効果量は中程度であった。1年後の追跡調査時にも、初期モデルと同様に感情的態度が運動行動の予測因子であった。感情的態度には、肯定的および否定的な感情経験が直接関連していた。

OBJECTIVES: Although maintaining cardiorespiratory fitness is encouraged to reduce the risk of hypertension, the level at, and length of time for which, individuals need to maintain fitness remains unclear. We examined the association between the frequency of achieving the recommended fitness levels of the 'Physical Activity Reference for Health Promotion 2013' and the risk of hypertension among Japanese men. METHODS: This cohort study was conducted in 6653 men without hypertension enrolled in 1986. Whether the participants' fitness level was equal to or exceeded the reference value (fit) or not (unfit) was determined. The frequency of achieving the recommended fitness level was calculated by counting the number of times the fitness level was achieved in 1980 through 1986. Incident hypertension was defined as the first visit with a SBP/DBP of at least 140/90 mmHg or self-reported antihypertensive medication use and was evaluated during annual health examinations from 1986 until 2009. RESULTS: During the follow-up period, 3630 men developed hypertension. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing men with fit versus unfit at baseline was 0.79 (0.74-0.85). Moreover, the frequency of achieving the recommended fitness level was inversely associated with the incidence of hypertension. The risk of hypertension was lower among those who achieved three or more of the recommended levels (0.72 for three times to 0.62 for seven times). CONCLUSION: Achieving the fitness level recommended in the Japanese guideline three or more times during a 6-year period can be beneficial for the risk reduction of hypertension.

Faecal volume, form, colour, and odour are associated with various diseases, dietary habits, and the gut microbiome. Multifaceted assessment of faecal condition will be needed for future research and practice. Faecal observation has advantages, as it is non-invasive, frequent, and easy. We have developed and validated an illustrative card tool for comprehensively faecal assessment. In 38 healthy adults, observations of volume, form, colour, and odour of faeces using the tool were compared to the objective characteristics of the actual faeces determined using a weighing scale, moisture meter, hardness meter, colourimeter, and odour measuring device. A significant positive correlation (ρ = 0.778) was observed between the number of faecal model (2 cm × 10 cm) units and the actual weight. The Bristol Stool Form Scale showed a significant positive correlation with the moisture content (ρ = 0.717) and negative correlations with faecal hardness (ρ = -0.843) and adhesiveness (ρ = -0.761). The L*a*b* colour space values of the stool differed significantly among observational judgments using the colour card tool. No significant correlation was observed between the observation of odour and the measured odour index. In conclusion, the faecal volume, form, and colour can be estimated by observation using the multifaceted assessment card tool.

© 2019 Japanese Society of Physical Fitness and Sports Medicine. All rights reserved. This study aimed to develop affective experience, attitude, and behavioral intention scales for exercise, and examine their associations with exercise behavior. A web-based questionnaire survey was conducted among 500 individuals aged 60 to 69 years at baseline. The survey measured respondents’ affective experiences, attitude, behavioral intention, exercise behavior, and demographic factors. The same survey was conducted 2 weeks (n = 345) and 1 year later (n = 338). Exploratory and confirmatory factor analyses showed that the factor structures of the affective experience (2 factors: 3 items each for positive experience and negative experience), attitude (2 factors: 3 items each for affective attitudes and instrumental attitudes), and behavioral intention scales (2 factors: 4 items each for intention to maintain behavior and intention to overcome barriers) were acceptable. For these scales, the Cronbach’s alpha coefficients ranged from 0.69 to 0.92, Pearson’s correlation coefficients for baseline and 2-week follow-up ranged from 0.51 to 0.81, and Cohen’s d values for the associations with exercise behavior ranged from 0.46 to 0.98. After adjusting for demographic factors and exercise behavior at baseline, structural equation modeling showed that an affective attitude toward exercise at baseline significantly predicted exercise behavior at 1-year follow-up (standardized coefficient = 0.27), and that the affective attitude was predominantly explained by the positive affective experience of exercise (standardized coefficient = 0.80). The results confirmed the validities and reliabilities of the scales. Positive affective experiences and affective attitudes may be important determinants of exercise behavior.

BACKGROUND AND OBJECTIVES: Limited information is available on how weight loss intervention programs affect skeletal muscle mass especially in trunk. METHODS AND STUDY DESIGN: A total of 235 overweight Japanese men and women aged 40-64 years with a body mass index of 28.0 to 44.8 kg/m2 participated in this randomized controlled intervention study. They were randomly divided into a lifestyle intervention group and control group. Before and after the one-year lifestyle intervention for weight loss an abdominal transverse image was acquired by computed tomography. The cross-sectional areas (CSAs) of visceral fat, subcutaneous fat, and skeletal muscle of rectus abdominis, abdominal oblique, iliopsoas, and erector spinae muscle were calculated. RESULTS: The body weight changed by approximately -5% in the intervention groups. The corresponding values for subcutaneous fat and visceral fat CSAs were -10.8 to -17.5% in both sexes. The reductions observed in skeletal muscle CSAs were significantly less (-6.0% and -7.2% in the men and women intervention groups respectively) than those in fat tissue CSAs. The CSA of each of the four skeletal muscle groups also significantly decreased; however, after adjustments for body weight at each time point, only reductions in the iliopsoas muscle in both sex and abdominal oblique muscles in men remained significant. CONCLUSIONS: The lifestyle weight loss intervention might reduce the relative amount of the abdominal skeletal muscles especially in iliopsoas muscle.

Background: The momentum to promote physical activity (PA) by various government agencies such as the Japan Sports Agency established in 2015, academic organizations, and companies is increasing towards the Tokyo Olympic and Paralympic Games. The goal of the 2018 Japan Report Card on Physical Activity for Children and Youth is to assess and track levels of health behaviors related to PA in Japanese children and youth, facilitators and barriers for PA, and related health outcomes. Methods: Nationally representative data were used to score the indicators. Results: The 2018 Japan Report Card on Physical Activity for Children and Youth consists of health behaviors and outcomes (7 indicators), and influences on health behaviors (4 indicators). The key four health behaviors and outcomes (Organized Sport Participation: B-; Active Transportation: A-; Physical fitness: A, Weight status: A) were favorable. Sedentary Behavior received C- grade, while 2 indicators (Overall Physical Activity, and Active Play) could not be graded. In the Influences domain, Family Influence and Community were graded as C-, while School (B+), Community and Environment (B-), and Government Strategies and Investments (B) were favorable. Conclusions: The 2018 Japan Report Card on Physical Activity for Children and Youth shows that Japanese children and youth have favorable levels of organized sport participation, active transportation to and from school, and physical fitness and weight status. Future nationally representative surveys on overall PA and active play are needed.

AIM: Recent studies have suggested that non-high-density lipoprotein cholesterol (non-HDL-C) may be a good marker of coronary heart disease and cardiovascular disease risk. Therefore, we investigated the relationship between cardiorespiratory fitness (CRF) and non-HDL-C. METHODS: We evaluated CRF and the incidence of high level of non-HDL-C in 4,067 Japanese men without dyslipidemia. The participants were given a submaximal exercise test, a medical examination, and questionnaires on their health habits in 1986. A cycle ergometer was used to measure the CRF and maximal oxygen uptake was estimated. The incidence of a high level of non-HDL -C (≥170 mg/dL) from 1986 to 2006 was ascertained based on the fasting blood levels. A high level of non-HDL-C was found in 1,482 participants during the follow-up. Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of a high level of non-HDL-C. RESULTS: Following age adjustment, and using the lowest CRF group (quartile Ⅰ) as reference, the HRs and 95% CIs for quartiles II through IV were: 1.00 (95% CI: 0.87-1.15), 0.87 (95% CI: 0.76-1.00), and 0.70 (95% CI: 0.60-0.81), respectively (P for trend ＜0.001). After additional adjustment for body mass index, systolic blood pressure, smoking, alcohol intake, and family history of dyslipidemia, the HRs and 95% CIs were: 1.05 (95% CI: 0.92-1.21), 0.94 (95% CI: 0.81-1.08), and 0.79 (95% CI: 0.67-0.92), respectively (P for trend=0.001). CONCLUSIONS: These results suggest that there is an inverse relationship between CRF levels and the incidence of a high level of non-HDL-C in Japanese men.

Family history of hypertension (FH) is a nonmodifiable risk factor for hypertension. However, cardiorespiratory fitness (CRF) is a modifiable risk factor and might be important for preventing hypertension in both people with and without FH. The purpose of this study was to investigate the combined association of CRF and FH on the incidence of hypertension in normotensive male Japanese workers. A total of 6890 workers were included in this study. CRF was determined using a submaximal exercise test. A self-reported questionnaire was used to determine FH. Six groups were established, combining the two groups with and without FH (Yes, No) and the three CRF groups (Low, Moderate, High). The incidence of hypertension, defined as systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg, or self-reported physician-diagnosed hypertension was evaluated. During the observation period of 101,212 man-years (median 17 years, minimum 1 year, maximum 23 years), 2210 workers developed hypertension. There were 3860 participants who had FH (56%). Compared with the Yes-Low CRF group, the HRs (95% CI) for hypertension were 66% lower in the No-High CRF group (0.34 [0.28-0.40]), 47% lower in the No-Low CRF group (0.53 [0.46-0.61]), and 24% lower in the Yes-High CRF group (0.76 [0.67-0.86]). FH and CRF did not show a significant interaction (p for interaction = 0.181). The combination of FH and CRF showed a clear association with the risk of incident hypertension, and moderate to high levels of CRF might be equally beneficial for preventing hypertension for both people with and without FH.

Type 2 diabetes is increasing globally and in Asia. The purpose of this study was to examine the association of a fit-fat index (FFI) with diabetes incidence among, Japanese men. In total 5,014 men aged 18-64 years old, who had an annual health check up with no history of major chronic disease at baseline from 2002 to 2009 were observed. CRF was estimated via cycle ergometry. Overall, 7.6% of the men developed diabetes. The mean follow-up period was 5.3 years. Hazard ratios, 95% confidence intervals and P trend for diabetes incidence were obtained using the Cox proportional hazards model while adjusting for confounding variables. High FFI demonstrated lower risk 0.54 (0.36-0.82) compared to low BMI 0.63 (0.44-0.90), low WHtR 0.64 (0.41-1.02), and High CRF 0.72 (0.51-1.03). FFI showed a marginally stronger dose response relationship across quartiles (P (trend) =0.001) compared to BMI (P (trend) =0.002), WHtR (P (trend) =0.055), and CRF (P (trend) =0.005). Overall, both fitness and fatness play independent roles in determining diabetes incidence in, Japanese men. FFI may be a more advantageous physical fitness measure because it can account for changes in fitness and/or fatness.

© 2018 Human Kinetics, Inc. Caffeine has been described as a sports performance-enhancing substance. However, it is unclear whether it can increase the level of physical activity (PA) in nonathletic individuals. This study investigates the relationship between daily caffeine consumption and (a) daily PA/fitness or (b) intervention-induced changes in PA in women and men. On the basis of responses to a dietary habit questionnaire, which included items on caffeinated beverages, 1,032 Japanese adults, were categorized into lower or higher caffeine consumption groups (relative to the median caffeine consumption). In each group, daily step count; sedentary time; and light, moderate, and vigorous PA outcomes were objectively measured. Physical fitness, including peak oxygen consumption, was also evaluated. The relationship between daily caffeine consumption and the change in the levels of PA was investigated in a subgroup of 202 subjects who participated in a 1-year PA counseling intervention. Women in the higher caffeine consumption group presented higher moderate-to-vigorous PA and step count compared with their counterparts in the lower consumption group (4.0 ± 2.1 vs. 3.3 ± 2.1 MET-hr/day, p &lt; .001; 10,335 ± 3,499 vs. 9,375 ± 3,527 steps/day, p &lt; .001). A significant positive correlation was noted between caffeine consumption and peak oxygen consumption among women (r = .15, p &lt; .001). No caffeine-related effects were noted in men. The lower and higher caffeine consumption groups showed no significant differences in their levels of PA at the end of the 1-year intervention. Therefore, caffeine consumption appears to be associated with higher levels of PA in Japanese women. Further studies are needed to clarify this association.

In Japan, health insurers are obliged to conduct Specific Health Checkup (SHC) for middle-aged and elderly persons. High-risk persons are referred to Specific Health Guidance (SHG) to receive behavioral counseling based on individual action plans including targets for modification of daily energy balance through diet and physical activity. Using individual-level observational data, we examined the effects of diet and physical activity counseling on cardiometabolic biomarkers across the country. Subjects were 363,440 high-risk persons aged 40-64 who participated in intensive support in SHG for ≥3 months between April 2008 and March 2012. We considered participants as receiving counseling on diet alone, physical activity alone, combined, or neither if they had targets for diet only, physical activity only, both, or neither, respectively. Biomarkers included body mass index, waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, and hemoglobin A1c. Under the difference-in-differences approach, we used multivariable linear regression on repeated measures of biomarkers at SHCs before and after SHG and estimated the effects of each counseling type as an interaction with time of SHC. Compared with neither counseling, diet and physical activity counseling, alone or combined, were significantly associated with additional improvements in biomarkers after SHG, for example, body mass index (men: 0.03-0.06 kg/m2, women: 0.10-0.15 kg/m2) and waist circumference (men: 0.16-0.29 cm, women: 0.43-0.47 cm) in both sexes and high-density lipoprotein cholesterol in men (0.13-0.29 mg/dL). Modest improvements in biomarkers were associated with diet and physical activity counseling, although effect sizes were small.

© 2016 Asia Oceania Association for the Study of Obesity Background: Quantitative evaluation of visceral fat mass and skeletal muscle mass is important for health promotion. Recently, some studies suggested the existence of adipocyte–myocyte negative crosstalk. If so, abdominal skeletal muscles may easily and negatively affected not only by the age but also the visceral fat because age-related reduction in abdominal region is greater compared with limbs. Objective: We cross-sectionally examined the existence of quantitative associations between visceral fat area and abdominal skeletal muscle distribution in overweight people. Methods: A total of 230 Japanese males and females who aged 40–64 years and whose body mass index (BMI) was 28.0–44.8 kg/m 2 participated in this study. The cross-sectional area (CSA) of the visceral fat, subcutaneous fat, and abdominal skeletal muscles, namely, the rectus abdominis, abdominal oblique, erector spinae, and iliopsoas muscles were measured by the computed tomography images. Results: Stepwise regression analyses revealed the existence of sex difference in the relation between visceral fat CSA and other morphological variables. In males, BMI was a positive, and the iliopsoas muscle group CSA was a negative contributor of the visceral fat CSA. In females, both age and BMI were selected as positive contributors. Conclusion: These data suggested that the visceral fat CSA may negatively associated with iliopsoas muscle group CSA in males. In females, the visceral fat CSA was not significantly related to the distribution of the abdominal skeletal muscle groups.

We aimed to replicate, in a specific athletic event cohort (only track and field) and in two different ethnicities (Japanese and East European, i.e. Russian and Polish), original findings showing the association of the angiotensin-II receptor type-2 gene (AGTR2) rs11091046 A>C polymorphism with athlete status. We compared genotypic frequencies of the AGTR2 rs11091046 polymorphism among 282 track and field sprint/power athletes (200 men and 82 women), including several national record holders and Olympic medallists (214 Japanese, 68 Russian and Polish), and 2024 control subjects (842 men and 1182 women) (804 Japanese, 1220 Russian and Polish). In men, a meta-analysis from the two combined cohorts showed a significantly higher frequency of the C allele in athletes than in controls (odds ratio: 1.62, P=0.008, heterogeneity index I
2
=0%). With regard to respective cohorts, C allele frequency was higher in Japanese male athletes than in controls (67.7% vs. 55.9%, P=0.022), but not in Russian/Polish male athletes (61.9% vs. 51.0%, P=0.172). In women, no significant results were obtained by meta-analysis for the two cohorts combination (P=0.850). The AC genotype frequency was significantly higher in Russian/Polish women athletes than in controls (69.2% vs. 42.1%, P=0.022), but not in Japanese women athletes (P=0.226). Our results, in contrast to previous findings, suggested by meta-analysis that the C allele of the AGTR2 rs11091046 polymorphism is associated with sprint/power track and field athlete status in men, but not in women.

Background: There are several studies on the relationship between low back pain and physical activity. However, the results of these studies vary, and the relationship between them remains unclear. Therefore, we conducted a cross-sectional study to evaluate the association between objectively measured physical activity and low back pain in Japanese men. Methods: The study included 4022 Japanese men [average age: 47 (10) y]. Daily amount of moderate to vigorous physical activity and step counts were measured using an accelerometer. Low back pain, drinking and smoking, and lifestyle-related diseases were surveyed using a self-administered questionnaire. A logistic regression model was used to evaluate the relationship between physical activity and step counts with persistent low back pain after adjusting for confounders. Results: Persistent low back pain was reported in 428 participants. The multivariable-adjusted odds ratios of presenting persistent low back pain across quartiles of amount of moderate to vigorous physical activity were 1.00 (reference)
0.93 (95% confidence interval, 0.70-1.22)
0.97 (95% confidence interval, 0.74-1.28)
and 0.67 (95% confidence interval, 0.50-0.90)
P for linearity =.012. Conclusion: We found a significant inverse relationship between objectively measured physical activity and persistent low back pain.

© 2017 Ryoko Kawakami et al. Background: We sought to examine the association between cardiorespiratory fitness (CRF) and incidence of type 2 diabetes considering the follow-up period in a cohort of Japanese men with a maximum follow-up period of 23 years. Methods: This study enrolled 7,804 male workers free of diabetes in 1986. CRF was measured using a cycle ergometer, and maximal oxygen uptake was estimated. During 1986–2009, participants were followed for development of type 2 diabetes, which was diagnosed using fasting blood tests, self-administered questionnaires, or oral glucose tolerance tests after urinary tests from annual health checkups. Hazard ratios for the incidence of type 2 diabetes were estimated using Cox proportional hazards models. Results: During the follow-up period, 1,047 men developed type 2 diabetes. In analyses by follow-up periods (1986–1993, 1994–2001, and 2002–2009), there was an inverse dose-response relationship between CRF and the development of type 2 diabetes for all three follow-up periods (P for trend 0.019, &lt;0.001, and 0.001, respectively), and the association between CRF at baseline and the incidence of type 2 diabetes did not weaken with longer follow-up period. Compared with the lowest CRF group, hazard ratios of developing type 2 diabetes were 0.69 (95% confidence interval [CI], 0.49–0.97) for the highest CRF group in 1986–1993, 0.57 (95% CI, 0.42–0.79) for the highest CRF in 1994–2001, and 0.47 (95% CI, 0.30–0.74) for the highest CRF in 2002–2009. Conclusion: High CRF is associated with a lower risk of the incidence of type 2 diabetes over an extended period of &gt;20 years among men.

© 2017 Haruki Momma et al. Background: The “Physical Activity Reference for Health Promotion 2013” provides “fit” reference values for cardiorespiratory fitness (CRF) for good health. The importance of achieving a fit CRF level for several years on the subsequent prevention of type 2 diabetes mellitus (T2DM) remains to be clarified. Methods: This cohort study was conducted in 2,235 nondiabetic males aged 21 to 59 years, enrolled in April 1986 through March 1987. We calculated the ratio of the area under the curve (AUCratio) for actual measured values and the AUC for the reference values of CRF in each individual during an 8-year measurement period before the baseline. According to whether they met a fit CRF level or not, participants were categorized into groups based on the AUCratio (FitAUC or UnfitAUC) and initial CRF (Fitinitial or Unfitinitial), respectively. T2DM was evaluated on health checkups until March 2010. Results: During the follow-up period, 400 men developed T2DM. After adjustment for confounders, as compared with those in the FitAUC group, the hazard ratio (HR) for those in the UnfitAUC group was 1.33 (95% confidence interval [CI], 1.06–1.65). A combined analysis with the categories of initial value and AUCratio showed that, compared with the Fitinitial and FitAUC group, the HRs of Fitinitial and UnfitAUC, Unfitinitial and FitAUC, and Unfitinitial and UnfitAUC groups were 1.41 (95% CI, 0.99–2.00), 1.18 (95% CI, 0.81–1.70), and 1.40 (95% CI, 1.08–1.83), respectively. Conclusion: Achievement of a fit CRF level established in the Japan physical activity guideline for several years was associated with lower subsequent risk of T2DM.

© The Author 2017. Background: Evidence from a limited number of short-term trials indicates the difficulty in achieving population-level improvements in physical activity (PA) through communitywide interventions (CWIs). We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster randomized design. Methods: We randomized 12 communities in Unnan, Japan, to either intervention (9) or control (3). Additionally, intervention communities were randomly allocated to three subgroups by different PA types promoted. Randomly sampled residents aged 40-79 years responded to the baseline survey (n=4414; 74%) and were followed at 1, 3 and 5 years (78-83% response rate). The intervention was a 5-year CWI using social marketing to promote PA. The primary outcome was a change in recommended levels of PA. Results: Compared with control communities, adults achieving recommended levels of PA increased in intervention communities [adjusted change difference=4.6 percentage points (95% confidence interval: 0.4, 8.8)]. The intervention was effective for promoting all types of recommended PAs, i.e. aerobic (walking, 6.4%), flexibility (6.1%) and muscle-strengthening activities (5.7%). However, a bundled approach, which attempted to promote all forms of PAs above simultaneously, was not effective (1.3-3.4%, P≥0.138). Linear dose-response relationships between the CWI awareness and changes in PA were observed (P≤0.02). Pain intensity decreased in shoulder (intervention and control) and lower back (intervention only) but there was little change difference in all musculoskeletal pain outcomes between the groups. Conclusions: The 5-year CWI using the focused social marketing strategy increased the population-level of PA.

「健康と生活に関するアンケート」に回答した高齢者534名(男性260名、女性274名、68〜78歳)を対象とした。男女の比較で有意差を認めた人口統計学的属性・社会経済的属性は、居住形態(女性の独居割合が高い)、BMI(男性が高い)、身体活動の制限(女性の医師または足腰の痛みによる制限がある割合が高い)、教育歴(男性の大学卒以上の割合が高い)、収入がある仕事(男性の仕事をもつ割合が高い)であった。ソーシャル・キャピタル(SC)では地域の人とのかかわりと他世代との交流において有意な男女差(女性のSCが高い)を認めた。SCが低いと想定される回答を基準とした解析で、男性では、地域の支え合い:支え合うと思う、地域の人とのかかわり:立ち話をする人がいる、相談しあえる人がいる、他世代との交流:まあまあある、とてもあるにおいて有意な正の関連を認めた。トレンド検定では、有意な量反応関係を認めた。女性では、地域の人とのかかわり:相談しあえる人がいる、地域組織活動へ

Background: The relationship between the combination of physical activity (PA) and body mass index (BMI) with low back pain (LBP) is unclear. The present study offers a cross-sectional assessment of how combinations of PA and BMI are related to LBP in Japanese men. Methods: Participants were 4022 Japanese men (mean age = 47) who underwent regular clinical examinations. PA was measured using a uniaxial accelerometer and divided into tertiles (PAhigh, PAmiddle, PAlow). A self-administered questionnaire was used to report on persistent LBP experience, drinking and smoking habits, and any existing lifestyle diseases. After covariance adjustment, a logistic regression model was used to assess how combinations of PA and BMI are related to persistent LBP. Results: 428 of the participants had persistent LBP. A clear negative dose-response relationship was found between PA levels and persistent LBP (P for linearity = 0.012). Regarding BMI, odd ratios were shown to be higher in the overweight/obese category (BMI ≥ 25 kg/m2) than for the normal weight category (BMI &lt
25 kg/m2). When the PAhigh was taken as the reference in the normal weight category, odds ratios for PAlow and PAmiddle in the normal weight category were shown to be high. Moreover, in the overweight/obese category, odd ratios for every fitness level were also high as for the normal weight category. Conclusion: The present study showed that both PA and BMI are related to persistent LBP. Also, the prevalence of persistent LBP became higher when PAlow and high BMI are combined rather than the group of PAhigh and low BMI combination.

The aim of this study was to clarify heritability estimates for endurance-related phenotypes and the underlying factors affecting these estimates. A systematic literature search was conducted for studies reporting heritability estimates of endurance-related phenotypes using the PubMed database (up to 30 September 2016). Studies that estimated the heritability of maximal oxygen uptake (V˙O2max), submaximal endurance phenotypes, and endurance performance were selected. The weighted mean heritability for endurance-related phenotypes was calculated using a random-effects model. A total of 15 studies were selected via a systematic review. Meta-analysis revealed that the weighted means of the heritability of V˙O2max absolute values and those adjusted for body weight and for fat-free mass were 0.68 (95% CI: 0.59-0.77), 0.56 (95% CI: 0.47-0.65), and 0.44 (95% CI: 0.13-0.75), respectively. There was a significant difference in the weighted means of the heritability of V˙O2max across these different adjustment methods (P < .05). Moreover, there was evidence of statistical heterogeneity in the heritability estimates among studies. Meta-regression analysis revealed that sex could partially explain the heterogeneity in the V˙O2max heritability estimates adjusted by body weight. For submaximal endurance phenotypes and endurance performance, the weighted mean heritabilities were 0.49 (95% CI: 0.33-0.65) and 0.53 (95% CI: 0.27-0.78), respectively. There was statistically significant heterogeneity in the heritability estimates reported among the studies, and we could not identify the specific factors explaining the heterogeneity. Although existing studies indicate that genetic factors account for 44%-68% of the variability in endurance-related phenotypes, further studies are necessary to clarify these values.

Very few community intervention studies that promote physical activity (PA) using guidelines and its dissemination and implementation have been conducted. Consequently, we evaluated the effectiveness of a community-wide intervention (CWI) of PA with adults based on the Japanese guidelines for promoting PA. This was a non-randomized controlled trial, with four administrative districts in Fujisawa city assigned to the intervention group and nine to the control group. The CWI, conducted from 2013 to 2015, comprised information dissemination, education, and community support. The primary outcome was change in PA participation. Secondary outcomes were CWI awareness and PA guideline knowledge. Outcomes were assessed using questionnaires distributed to two independent, random samples of 3000 community-based adults (aged ≥20years). Two separate samples-1230 adults at baseline and 1393 at the two-year follow-up-responded to the survey. The median time spent in PA did not differ between intervention and control groups after adjusting for potential confounders (adjusted difference between groups=-0.02min/day [95% confidence interval (CI): -0.11, 0.10]). However, intervention group participants were more aware of the CWI (33.8%) than were control group participants (25.2%) at the two-year follow-up (odds ratio=1.44 [95% CI: 1.06, 1.95]). A significant difference was also observed in participants' PA guideline knowledge (adjusted difference between groups=0.82% [95% CI: 0.33, 1.31]). Although significant differences in awareness and knowledge were observed between groups, this CWI did not change PA levels over two years. Future studies should investigate the long-term effects of CWIs beyond two years. TRIAL REGISTRATION NUMBER: UMIN-CTR UMIN000018389.

© 2018 Hiroyuki Sasai et al. Background: Physical activity questionnaires (PAQs) used in large-scale Japanese cohorts have rarely been simultaneously validated against the gold standard doubly labeled water (DLW) method. This study examined the validity of seven PAQs used in Japan for estimating energy expenditure against the DLW method. Methods: Twenty healthy Japanese adults (9 men; mean age, 32.4 [standard deviation {SD}, 9.4] years, mainly researchers and students) participated in this study. Fifteen-day daily total energy expenditure (TEE) and basal metabolic rate (BMR) were measured using the DLW method and a metabolic chamber, respectively. Activity energy expenditure (AEE) was calculated as TEE − BMR − 0.1 × TEE. Seven PAQs were self-administered to estimate TEE and AEE. Results: The mean measured values of TEE and AEE were 2,294 (SD, 318) kcal=day and 721 (SD, 161) kcal=day, respectively. All of the PAQs indicated moderate-to-strong correlations with the DLW method in TEE (rho = 0.57–0.84). Two PAQs (Japan Public Health Center Study [JPHC]-PAQ Short and JPHC-PAQ Long) showed significant equivalence in TEE and moderate intra-class correlation coefficients (ICC). None of the PAQs showed significantly equivalent AEE estimates, with differences ranging from −547 to 77 kcal=day. Correlations and ICCs in AEE were mostly weak or fair (rho = 0.02–0.54, and ICC = 0.00–0.44). Only JPHC-PAQ Short provided significant and fair agreement with the DLW method. Conclusions: TEE estimated by the PAQs showed moderate or strong correlations with the results of DLW. Two PAQs showed equivalent TEE and moderate agreement. None of the PAQs showed equivalent AEE estimation to the gold standard, with weak-to-fair correlations and agreements. Further studies with larger sample sizes are needed to confirm these findings.

We aimed to evaluate the associations of individual-level social capital (SC) and physical activity (PA) among Japanese elderly men and women. Individuals aged 65 or above were selected via population-based random sampling of 3000 adults, aged 20 years or above and living in Fujisawa city, who were asked to complete self-administered questionnaires. The sample consisted of 260 men [median (25-75% tile) age 73 (68-78) yrs] and 274 women [73 (68-78) yrs]. The daily duration of PA, SC [e.g., norms of reciprocity (mutual support in the community), social networks (relationship with community people, exchange with other generations), social participation (participation in community organization activities)], socio-economic status [educational attainment, work with income, perceived household economic status], and demographic characteristics [sex, age, living arrangements, BMI, physical limitations] were assessed. Multivariate logistic regression analyses were used to calculate odds ratios (OR) for associations of SC with PA, stratified by sex. High level of mutual support in the community, relationship with community people, and exchange with other generations were associated with longer PA time in men after adjusting for potential confounders in the final model (OR = 2.40 (95% CI: 1.24-4.67), 5.28 (1.42-19.66), and 4.24 (1.15-15.67), respectively). In women, relationship with community people and participation in community organization activities were associated with longer PA time (3.10 (1.32-7.26) and 2.50 (1.27-4.91), respectively). The association of individual-level SC and PA differed between men and women. Future studies can investigate whether similar results can be obtained in other areas or attempt to conduct a large-scale survey.

&lt;p&gt;This study describes relationships between awareness of physical activity (PA) promotion and duration of PA and sedentary behavior (SB) in elderly Japanese. Following a community-wide intervention, 874 individuals 65 years or over were selected via population-based random sampling of 3,000 adults aged 20 years or over living in Fujisawa City, and asked to complete self-administered questionnaires; 550 responded and 373 with data on pertinent variables were included. Forty-eight percent (179/373) stated that they recognized elements of the Japanese PA guidelines such as the &quot;Active Guide&quot; and &quot;+10 (plus ten).&quot; The median duration of PA, of intensity at least equal to walking, and SB among all participants were 100 minutes/day and 300 minutes/day, respectively. Duration of PA did not significantly differ by promotion awareness (Odds Ratio (OR) for ≥100 minutes/day among those aware = 1.02, 95% Confidence Interval (CI) = 0.65-1.62); however, duration of SB did (OR for &lt;300 minutes/day = 1.60, 95% CI = 1.01-2.53). Awareness of PA promotion in elderly Japanese is related to decreased SB, but not increased PA of intensity at least equal to walking.&lt;/p&gt;

The purpose of this study was to clarify the heritability estimates of human muscle strength-related phenotypes (H-2-msp). A systematic literature search was conducted using PubMed (through August 22, 2016). Studies reporting the H-2-msp for healthy subjects in a sedentary state were included. Random-effects models were used to calculate the weighted mean heritability estimates. Moreover, subgroup analyses were performed based on phenotypic categories (eg, grip strength, isotonic strength, jumping ability). Sensitivity analyses were also conducted to investigate potential sources of heterogeneity of H-2-msp, which included age and sex. Twenty-four articles including 58 measurements were included in the meta-analysis. The weighted mean H-2-msp for all 58 measurements was 0.52 (95% confidence intervals [CI]: 0.48-0.56), with high heterogeneity (I-2=91.0%, P&lt;.001). Subgroup analysis showed that the heritability of isometric grip strength, other isometric strength, isotonic strength, isokinetic strength, jumping ability, and other power measurements was 0.56 (95% CI: 0.46-0.67), 0.49 (0.47-0.52), 0.49 (0.32-0.67), 0.49 (0.37-0.61), 0.55 (0.45-0.65), and 0.51 (0.31-0.70), respectively. The H-2-msp decreased with age (P&lt;.05). In conclusion, our results indicate that the influence of genetic and environmental factors on muscle strength-related phenotypes is comparable. Moreover, the role of environmental factors increased with age. These findings may contribute toward an understanding of muscle strength-related phenotypes.

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Background-Few data exist on the association between strength training and mortality rates. We sought to examine the association between strength training and all-cause, cardiovascular disease, and cancer mortality.
Methods and Results-Beginning in 2001 to 2005, 28 879 women throughout the United States (average baseline age, 62.2 years) from the Women's Health Study who were free of cardiovascular disease, diabetes mellitus, and cancer reported their physical activities, including strength training. During follow-up (average, 12.0 years) through 2015, investigators documented 3055 deaths (411 from cardiovascular disease and 748 from cancer). After adjusting for covariables, including aerobic activity, time in strength training showed a quadratic association with all-cause mortality (P=0.36 for linear trend; P&lt;0.001 for quadratic trend); hazard ratios across 5 categories of strength training (0, 1-19, 20-59, 60-149, and = 150 min/wk) were 1.0 (referent), 0.73 (95% confidence interval, 0.65-0.82), 0.71(0.62-0.82), 0.81 (0.67-0.97), and 1.10 (0.77-1.56), respectively. A significant quadratic association was also observed for cardiovascular disease death (P=0.007) but not cancer death (P=0.41). Spline models also indicated a J-shaped nonlinear association for all-cause mortality (P=0.020); the point estimates of hazard ratios were &lt;1.00 for 1 to 145 min/wk of strength training, compared with 0 min/wk, whereas hazard ratios were &gt;1.00 for = 146 min/wk of strength training. However, confidence intervals were wide at higher levels of strength training.
Conclusions-Time in strength training showed a J-shaped association with all-cause mortality in older women. A moderate amount of time in strength training seemed beneficial for longevity, independent of aerobic activity; however, any potential risk with more time (approximate to &gt;= 150 min/wk) should be further investigated.

Background: Forkhead box O3A (FOXOA3) and apolipoprotein E (APOE) are arguably the strongest gene candidates to influence human exceptional longevity (EL, i.e., being a centenarian), but inconsistency exists among cohorts. Epistasis, defined as the effect of one locus being dependent on the presence of 'modifier genes', may contribute to explain the missing heritability of complex phenotypes such as EL. We assessed the potential association of epistasis among candidate polymorphisms related to physical capacity, as well as antioxidant defense and cardiometabolic traits, and EL in the Japanese population. A total of 1565 individuals were studied, subdivided into 822 middle-aged controls and 743 centenarians.
Results: We found a FOXOA3 rs2802292 T-allele-dependent association of fibronectin type III domain-containing 5 (FDNC5) rs16835198 with EL: the frequency of carriers of the FOXOA3 rs2802292 T-allele among individuals with the rs16835198 GG genotype was significantly higher in cases than in controls (P &lt; 0.05). On the other hand, among non-carriers of the APOE 'risk' epsilon 4-allele, the frequency of the FDNC5 rs16835198 G-allele was higher in cases than in controls (48.4% vs. 43.6%, P &lt; 0.05). Among carriers of the 'non-risk' APOE epsilon 2-allele, the frequency of the rs16835198 G-allele was higher in cases than in controls (49% vs. 37.3%, P &lt; 0.05).
Conclusions: The association of FDNC5 rs16835198 with EL seems to depend on the presence of the FOXOA3 rs2802292 T-allele and we report a novel association between FNDC5 rs16835198 stratified by the presence of the APOE epsilon 2/epsilon 4-allele and EL. More research on 'gene*gene' and 'gene*environment' effects is needed in the field of EL.

Purpose: Although the benefit of high cardiorespiratory fitness (CRF) for the prevention of type 2 diabetes mellitus (T2DM) is widely accepted, whether consistently high CRF is necessary or transiently high CRF is sufficient is unclear. The present study was conducted to examine the hypothesis that consistently high level of CRF is more beneficial than transiently high CRF for the prevention of T2DM. Methods: This cohort study was conducted in nondiabetic 7158 men age 20 to 60 yr, enrolled from 1986 to 1987. The area under the curve with respect to ground (AUC(G)) for CRF measurements during an 8-yr measurement period (1979-1987) was calculated as an index of integrated CRF level during the period. The differences (Delta AUC(P)) between AUC(G) and peak AUC (peak CRF-measurement period) was also calculated as an index of the presence and the size of a "spike'' in CRF. T2DM was defined by fasting blood glucose and a self-reported diagnosis of diabetes for participants with blood tests. For participants without blood tests, T2DM was defined by the result of oral glucose test after a nonfasting urinary test and a self-reported diagnosis of diabetes. T2DM was determined on health checkups until 2009. Results: During the follow-up period, 1495 men developed T2DM. After adjustment for confounders, as compared with the first quartile of AUC(G) for CRF, the hazard ratio (95% confidence interval) for the second, third, and fourth quartiles were 0.87 (0.76 to 1.00), 0.80 (0.68 to 0.95), and 0.72 (0.58 to 0.89), respectively. For CRF spike, there was no association between Delta AUC(P) in CRF and the incidence of T2DM. Conclusions: Consistently higher level of CRF over time was associated with lower risk of T2DM.

Background: Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect.
Method: A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term "Wii-Fit." Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG).
Findings: A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training.
Conclusion: Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.

Background: This study aimed to develop and cross-validate prediction equations for estimating appendicular skeletal muscle mass (ASM) and to examine the relationship between sarcopenia defined by the prediction equations and risk factors for cardiovascular diseases (CVD) or osteoporosis in Japanese men and women.
Methods: Subjects were healthy men and women aged 20-90 years, who were randomly allocated to the following two groups: the development group (D group; 257 men, 913 women) and the cross-validation group (V group; 119 men, 112 women). To develop prediction equations, stepwise multiple regression analyses were performed on data obtained from the D group, using ASM measured by dual-energy X-ray absorptiometry (DXA) as a dependent variable and five easily obtainable measures (age, height, weight, waist circumference, and handgrip strength) as independent variables.
Results: When the prediction equations for ASM estimation were applied to the V group, a significant correlation was found between DXA-measured ASM and predicted ASM in both men and women (R-2 = 0.81 and R-2 = 0.72). Our prediction equations had higher R-2 values compared to previously developed equations (R-2 = 0.75-0.59 and R-2 = 0.69-0.40) in both men and women. Moreover, sarcopenia defined by predicted ASM was related to risk factors for osteoporosis and CVD, as well as sarcopenia defined by DXA-measured ASM.
Conclusions: In this study, novel prediction equations were developed and cross-validated in Japanese men and women. Our analyses validated the clinical significance of these prediction equations and showed that previously reported equations were not applicable in a Japanese population.

Background: Appendicular skeletal muscle (or lean) mass (ALM) estimated using dual-energy X-ray absorptiometry (DXA) is considered to be a preferred method for sarcopenia studies. However, DXA is expensive, has limited portability, and requires radiation exposure. Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, and portable, thus BIA might be useful in sarcopenia investigations. However, a large variety of models have been commercially supplied by different companies, and for most consumer products, the equations estimating ALM are not disclosed. It is therefore difficult to use these equations for research purposes. In particular, the BIA equation is often age-dependent, which leads to fundamental difficulty in examining age-related ALM loss. The aims of the current study were as follows: (1) to develop and validate an equation to estimate ALM using multi-frequency BIA (MF-BIA) based on theoretical models, and (2) to establish sarcopenia cutoff values using the equation for the Japanese population. Methods: We measured height (Ht), weight, and ALM obtained using DXA and a standing-posture 8-electrode MF-BIA (5, 50, 250 kHz) in 756 Japanese individuals aged 18 to 86-years-old (222 men and 301 women as developing equation group and 97 men and 136 women as a cross validation group). The traditional impedance index (Ht2/Z50) and impedance ratio of high and low frequency (Z250/Z5) of hand to foot values were calculated. Multiple regression analyses were conducted with ALM as dependent variable in men and women separately. Results: We created the following equations: ALM = (0.6947 × (Ht2/Z50)) + (-55.24 × (Z250/Z5)) + (-10,940 × (1/Z50)) + 51.33 for men, and ALM = (0.6144 × (Ht2/Z50)) + (-36.61 × (Z250/Z5)) + (-9332 × (1/Z50)) + 37.91 for women. Additionally, we conducted measurements in 1624 men and 1368 women aged 18 to 40 years to establish sarcopenia cutoff values in the Japanese population. The mean values minus 2 standard deviations of the skeletal muscle mass index (ALM/Ht2) in these participants were 6.8 and 5.7 kg/m2 in men and women, respectively. Conclusions: The current study established and validated a theoretical and age-independent equation using MF-BIA to estimate ALM and provided reasonable sarcopenia cutoff values.

Hand grip strength is a widely used proxy of muscular fitness, a marker of frailty, and predictor of a range of morbidities and all-cause mortality. To investigate the genetic determinants of variation in grip strength, we perform a large-scale genetic discovery analysis in a combined sample of 195,180 individuals and identify 16 loci associated with grip strength (P&lt;5 x 10(-8)) in combined analyses. A number of these loci contain genes implicated in structure and function of skeletal muscle fibres (ACTG1), neuronal maintenance and signal transduction (PEX14, TGFA, SYT1), or monogenic syndromes with involvement of psychomotor impairment (PEX14, LRPPRC and KANSL1). Mendelian randomization analyses are consistent with a causal effect of higher genetically predicted grip strength on lower fracture risk. In conclusion, our findings provide new biological insight into the mechanistic underpinnings of grip strength and the causal role of muscular strength in age-related morbidities and mortality.

Background: Appendicular skeletal muscle (or lean) mass (ALM) estimated using dual-energy X-ray absorptiometry (DXA) is considered to be a preferred method for sarcopenia studies. However, DXA is expensive, has limited portability, and requires radiation exposure. Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, and portable; thus BIA might be useful in sarcopenia investigations. However, a large variety of models have been commercially supplied by different companies, and for most consumer products, the equations estimating ALM are not disclosed. It is therefore difficult to use these equations for research purposes. In particular, the BIA equation is often age-dependent, which leads to fundamental difficulty in examining age-related ALM loss. The aims of the current study were as follows: (1) to develop and validate an equation to estimate ALM using multi-frequency BIA (MF-BIA) based on theoretical models, and (2) to establish sarcopenia cutoff values using the equation for the Japanese population. Methods: We measured height (Ht), weight, and ALM obtained using DXA and a standing-posture 8-electrode MF-BIA (5, 50, 250 kHz) in 756 Japanese individuals aged 18 to 86-years-old (222 men and 301 women as developing equation group and 97 men and 136 women as a cross validation group). The traditional impedance index (Ht(2)/Z(50)) and impedance ratio of high and low frequency (Z(250)/Z(5)) of hand to foot values were calculated. Multiple regression analyses were conducted with ALM as dependent variable in men and women separately. Results: We created the following equations: ALM = (0.6947 x (Ht(2)/Z(50))) + (-55.24 x (Z(250)/Z(5))) + (-10,940 x (1/Z(50))) + 51.33 for men, and ALM = (0.6144 x (Ht(2)/Z(50))) + (-36.61 x (Z(250)/Z(5))) + (-9332 x (1/Z(50))) + 37.91 for women. Additionally, we conducted measurements in 1624 men and 1368 women aged 18 to 40 years to establish sarcopenia cutoff values in the Japanese population. The mean values minus 2 standard deviations of the skeletal muscle mass index (ALM/Ht(2)) in these participants were 6.8 and 5.7 kg/m(2) in men and women, respectively. Conclusions: The current study established and validated a theoretical and age-independent equation using MF-BIA to estimate ALM and provided reasonable sarcopenia cutoff values.

Metagenomic analysis based on the 16S rRNA gene is generally performed to examine the diversity and abundance of commensal bacteria in feces, which is now recognized to be associated with human health and diseases. Guanidine thiocyanate (GuSCN) solution is used as a less onerous way compared with a frozen method to transport and stock fecal samples at room temperature for DNA analysis; however, optimal methods to measure fecal bacterial composition in GuSCN solution remain to be investigated. Here, we examined the influence of various factors such as pretreatment (e.g., removing GuSCN solution and washing feces with phosphate-buffered saline (PBS) before mechanical lysis), fecal concentration in the GuSCN solution, storage time, and position of fecal subsampling on the 16S rRNA-based analysis of fecal bacteria in GuSCN solution. We found that pretreatment and fecal concentration affected the bacterial composition, and a little change was noted with subsampling position. Based on these results, we propose a basic protocol, including fecal sampling, sample storage, and DNA extraction, for the 16S rRNA-based analysis of bacterial composition in feces suspended in GuSCN solution.

Purpose: Having a low level of physical fitness, especially cardiorespiratory fitness, appears to accelerate age-related aortic stiffening. Whereas, some studies have reported that trunk flexibility is a component of physical fitness, it is also negatively associated with arterial stiffening independent of cardiorespiratory fitness in cross-sectional studies. However, no long-term longitudinal study has determined whether poor trunk flexibility accelerates the progression of age-related aortic stiffening. We examined trunk flexibility and aortic stiffness progression in a 5-year longitudinal study.
Methods and Results: A total of 305 apparently healthy men and women participated in this study (49.6 +/- 9.5 years of age). Trunk flexibility was measured using a sit-and-reach test. Aortic stiffness was assessed using carotid-femoral pulse wave velocity (cfPWV) at baseline and after 5 years. Analysis of covariance (ANCOVA) was used to assess the association of the annual rate of cfPWV across flexibility levels (low, middle, high). There were no significant differences in baseline cfPWV among the three groups (835 164, 853 +/- 140, 855 +/- 2.68 cm/s; P = 0.577). Annual AcfPWV was significantly higher in the low-flexibility group than in the high-flexibility group (P = 0.009). ANCOVA revealed an inverse relationship between flexibility level and annual AcfPWV (14.41 +/- 2.73, 9.79 +/- 2.59, 2.62 +/- 2.68 cm/s/year: P for trend = 0.011). Multiple regression analysis revealed that baseline sit and reach (beta = 0.12, -0.70 to -0.01) was independently correlated with AcfPWV following adjustment for baseline peak oxygen uptake, age, sex, body fat, heart rate, and cfPWV. The 5-year change in cfPWV was not significantly correlated with 5-year change in sit-and-reach performance (P = 0.859).
Conclusion: Poor trunk flexibility is associated with greater progression of age-related aortic stiffening in healthy adults. However, we failed to confirm a significant association between 5-year change in aortic stiffness and 5-year change in trunk flexibility. The association between increased age-related increase in aortic stiffness and deterioration in flexibility due to age may require observation for more than 5 years.

alpha-Actinin-3 (ACTN3) R577X polymorphism is associated with muscular strength and power. This study was performed to investigate the association between ACTN3 R577X polymorphisms and flexibility as another component of fitness in 2 cohorts. Cohort 1 consisted of 208 men and 568 women (ages 23-88), while Cohort 2 consisted of 529 men and 728 women (ages 23-87). All participants were recruited from the Tokyo metropolitan area and underwent a battery of tests to assess their grip strength and sit-and-reach flexibility. Genotyping results were analyzed for ACTN3 (rs1815739) polymorphism using the TaqMan approach. In Cohort 1, sit-and-reach in the RR genotype (35.3 +/- 0.7 cm) was significantly lower than those in the RX and XX genotypes (37.2 +/- 0.3 cm) even after adjusting for sex, age, and exercise habit as covariates (P &lt; 0.01). In Cohort 2, sit-and-reach tended to be lower in RR (38.1 +/- 0.6 cm) than in RX and XX (39.1 +/- 0.3 cm), but the differences were not significant (P = 0.114). Analysis in pooled subjects indicated that RR was associated with significantly lower flexibility than RX and XX (P = 0.009). The RR genotype of ACTN3 R577X in the general Japanese population showed lower flexibility compared to the RX and XX genotypes.

Background: This study aimed to compare relationships between height- or weight-adjusted appendicular skeletal muscle mass (ASM/Ht2 or ASM/Wt) and risk factors for cardiometabolic diseases or osteoporosis in Japanese men and women.
Methods: Subjects were healthy Japanese men (n = 583) and women (n = 1218). The study population included a young group (310 men and 357 women; age, 18-40 years) and a middle-aged and elderly group (273 men and 861 women; age, = 41 years). ASM was measured by dual-energy X-ray absorptiometry. The reference values for class 1 and 2 sarcopenia in each sex were defined as values one and two standard deviations below the sex-specific means of the young group, respectively.
Results: The reference values for class 1 and 2 sarcopenia defined by ASM/Ht(2) were 7.77 and 6.89 kg/m(2) in men and 6. 06 and 5.31 kg/m(2) in women, respectively. The reference values for ASM/Wt were 35.0 and 32.0% in men and 29.6 and 26.4% in women, respectively. In both men and women, ASM/Wt was negatively correlated with higher triglycerides (TG) and positively correlated with serum high-density lipoprotein cholesterol (HDL-C), but these associations were not found in height-adjusted ASM. In women, TG, systolic blood pressure, and diastolic blood pressure in sarcopenia defined by ASM/Wt were significantly higher than those in normal subjects, but these associations were not found in sarcopenia defined by ASM/Ht(2). Whole-body and regional bone mineral density in sarcopenia defined by ASM/Ht(2) were significantly lower than those in normal subjects, but these associations were not found in sarcopenia defined by ASM/Wt.
Conclusions: Weight-adjusted definition was able to identify cardiometabolic risk factors such as TG and HDL-C while height-adjusted definition could identify factors for osteoporosis.

© The Author(s). Background: This study aimed to develop and cross-validate prediction equations for estimating appendicular skeletal muscle mass (ASM) and to examine the relationship between sarcopenia defined by the prediction equations and risk factors for cardiovascular diseases (CVD) or osteoporosis in Japanese men and women. Methods: Subjects were healthy men and women aged 20-90 years, who were randomly allocated to the following two groups: the development group (D group; 257 men, 913 women) and the cross-validation group (V group; 119 men, 112 women). To develop prediction equations, stepwise multiple regression analyses were performed on data obtained from the D group, using ASM measured by dual-energy X-ray absorptiometry (DXA) as a dependent variable and five easily obtainable measures (age, height, weight, waist circumference, and handgrip strength) as independent variables. Results: When the prediction equations for ASM estimation were applied to the V group, a significant correlation was found between DXA-measured ASM and predicted ASM in both men and women (R 2 = 0.81 and R 2 = 0.72). Our prediction equations had higher R 2 values compared to previously developed equations (R 2 = 0.75-0.59 and R 2 = 0.69-0.40) in both men and women. Moreover, sarcopenia defined by predicted ASM was related to risk factors for osteoporosis and CVD, as well as sarcopenia defined by DXA-measured ASM. Conclusions: In this study, novel prediction equations were developed and cross-validated in Japanese men and women. Our analyses validated the clinical significance of these prediction equations and showed that previously reported equations were not applicable in a Japanese population.

[Purpose] This study evaluated whether obesity is a risk factor for low back pain, by using body fat percentage (%FAT) and body mass index (BMI) as indices of obesity among Japanese males. [Subjects and Methods] This study included 1,152 males (average age: 28.0 ± 4.6 years). BMI was calculated from subject’s height and weight, and %FAT was estimated by the thickness of two parts of skin. Low back pain, drinking and smoking were surveyed using a self-administered questionnaire, and maximal oxygen uptake was measured by a submaximal exercise test using a cycle ergometer. [Results] A significant positive dose-response relationship was shown between %FAT and persistent low back pain prevalence. Similarly, a significant positive dose-response relationship was confirmed between BMI and persistent low back pain. [Conclusion] This study suggests that both high %FAT and BMI are risk factors for persistent low back pain.

Background and Objectives: The purpose of the present study was to determine whether depression was associated with metabolic syndrome and unhealthy behaviours in community residents. Methods and Study Design: Using the 2009-2010 baseline data of the Saku Cohort Study, 1,225 men and women who participated in a community health screening were included in the cross-sectional analyses. Depression was assessed using the Zung Self-Rating Depression Scale. Consistent with the Japanese Society of Internal Medicine's definition, we defined metabolic syndrome as abdominal obesity plus two or more of the following: high blood pressure, hyperglycaemia, and dyslipidaemia. We defined 'pre- and metabolic syndrome' as the presence of one or more of the three criteria in addition to abdominal obesity. Results: There was no significant association between depression and metabolic syndrome. In women, the prevalence of pre- and metabolic syndrome was significantly higher in the depression group than that in the non-depression group (17.5% vs 9.5%, p=0.046), whereas no such significant association was observed in men. Logistic regression analysis showed that depression was associated with unhealthy behavioural factors differently in men and women. Conclusions: This study revealed that depression was associated with several unhealthy behavioural factors in both men and women, but depression was associated with pre- and metabolic syndrome only in women. These findings suggest that depression may be a warning sign of metabolic syndrome in women with unhealthy behavioural factors. Psychological factors should be considered in addition to the assessment of physical status.

Objectives: This study aimed to examine the association between a total genotype score (TGS) based on previously published genetic polymorphism candidates and differences in sprint/power performance.
Design: Case-control association study.
Methods: We analysed 21 polymorphisms, which have previously been associated with sprint/power performance and related phenotypes, in 211 Japanese sprint/power track and field athletes (77 regional, 72 national, and 62 international athletes) and 649 Japanese controls using the TaqMan SNP genotyping assay. We calculated the TGS (maximum value of 100 for the theoretically optimal polygenic score) for the 21 polymorphisms.
Results: All groups exhibited similar TGSs (control: 55.9 +/- 7.2, regional: 55.1 +/- 7.1, national: 56.1 +/- 7.4, and international: 56.0 +/- 7.8, p=0.827 by one-way analysis of variance). Nine of the 21 polymorphisms had the same direction of effect (odds ratio &gt;1.0) as in previous studies, while 12 had the opposite direction of effect (odds ratio &lt;1.0). Three polymorphisms (rs699 in AGT, rs41274853 in CNTFR, and rs7832552 in TRHR), which had the same direction of effect as in previous studies, were associated with international sprint/power athlete status (p&lt;0.05). However, after multiple testing corrections, the statistical significance of these polymorphisms was not retained.
Conclusions: These results suggest that TGSs based on the 21 previously published sprint/power performance-associated polymorphisms did not influence the sprint/power athlete status of Japanese track and field athletes. However, our results maintain the possibility that three of these polymorphisms might be associated with sprint/power performance. (C) 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The purpose of this study was to investigate the effects of the MCT1 T1470A polymorphism (rs1049434) on power-oriented performance and lactate concentration during or after cycling sprints in Japanese wrestlers. Participants (199 wrestlers and 649 controls) were genotyped for the MCT1 T1470A genotype (rs1049434) using the TaqMan (R) Assay. All wrestlers were international (n = 77) or national (n = 122) level athletes. Among them, 46 wrestlers performed 2 anaerobic performance tests, a 30-s Wingate Anaerobic test (WAnT) and a series of 10 maximal effort 10-s sprints on a cycle ergometer. Blood lactate levels were measured before, during, and after the tests. In the A-allele recessive model (AA vs. TA + TT), the frequency of the AA genotype was significantly higher in all wrestlers than in controls (p = 0.037). Wrestlers with AA genotype had lower blood lactate concentrations than those with TA + TT genotype at 10 min after the WAnT and following the 5th and the final set of repeated cycling sprints (p &lt; 0.05). The AA genotype of the MCT1 T1470A polymorphism is over-represented in wrestlers compared with controls and is associated with lower blood lactate concentrations after 30-s WAnT and during intermittent sprint tests in Japanese wrestlers.

Myostatin (MSTN) and alpha-actinin-3 (ACTN3) genes are potentially associated with preservation of muscle mass and oxidative capacity, respectively. To explore the possible role of these genes in exceptional longevity (EL), the allele/genotype frequency distribution of two polymorphisms in MSTN (rs1805086, K153R) and ACTN3 (rs1815739, R577X) was studied in Japanese centenarians of both sexes (n = 742) and healthy controls (n = 814). The rs1805086 R-allele (theoretically associated with muscle mass preservation at the expense of oxidative capacity) was virtually absent in the two groups, where genotype distributions were virtually identical. Likewise, no differences in allele (p = 0.838 (women); p = 0.193 (men); p = 0.587 (both sexes)) or genotype distribution were found between groups for ACTN3 rs1815739 (p = 0.975 (women), p = 0.136 (men), p = 0.752 (both sexes)). Of note, however, the frequency of the rs1805086 R-allele observed here is the lowest been reported to date whereas that of the 'highly oxidative/efficient' rs1815739 XX genotype in Japanese male centenarians (33.3%) or supercentenarians of both sexes (&gt;= 110 years) are the highest (32.6%), for a non-American population. No definite conclusions can be inferred in relation to EL owing to its lack of association with both rs1815739 and rs1805086. However, it cannot be excluded that these gene variants could eventually be related to a "healthy" metabolic phenotype in the Japanese population. Further research might determine if such metabolic profile is among the factors that can potentially predispose these individuals to live longer than Caucasians and what genetic variants might be actually involved.

The aim of this study was to examine a polygenic profile related to endurance performance, based on current knowledge, in the Japanese population. We analyzed 21 genetic polymorphisms that have been reported to be associated with endurance performance and its related phenotypes in 175 endurance runners (60 international-, 94 national-, and 21 regional-level) and 649 controls in the Japanese population. Then, we calculated the total genotype score (TGS) (maximum value of 100 for the theoretically optimum polygenic score) for endurance performance. There was no association between the TGS and endurance athlete status (Control: 49.0 ± 7.6, Regional: 47.3 ± 7.6, National: 49.1 ± 5.7, and International: 48.2 ± 7.0, P = 0.626). These results suggested that TGSs based on the 21 previously published endurance performance-associated polymorphisms do not influence endurance running performance in the Japanese population. Nevertheless, some marginal tendencies have to be noted: the frequencies of the ACTN3 R577X rs1815739 RR+RX genotype and the GNB3 rs5443 CC+CT genotype were higher in international athletes than in controls (85% vs. 73.6%, P = 0.042 and 90% vs. 76%, P = 0.007, respectively), but not significantly different after Bonferroni correction.

Objectives: Previous studies have indicated that the rs2802292 polymorphism in the human forkhead box O3A (FOXO3A) gene might be associated with exceptional longevity (EL, i.e., living 100+ years), although the results are conflicting.
Study design and main outcome measures: Using a case-control design, we investigated the distribution of the rs2802292 polymorphism in two ethnically distinct cohorts of centenarians (cases) and younger adults (controls). The first cohort included Japanese individuals (733 centenarians and 820 controls) and the second was from Northern Italy (79 disease-free centenarians and 316 controls).
Results: No statistically significant association was found between the rs2802292 polymorphism and EL in either cohort (either examined in their entirety or in a sex-based analysis).
Conclusions: In light of our negative findings, further research and resequencing efforts are needed to shed more light on the potential association between EL and FOXO3A polymorphisms. (C) 2016 Published by Elsevier Ireland Ltd.

Aim: Recent meta-analyses of the literature confirmed the association between the RR+RX genotype of the ACTN3 R577X polymorphism and elite sprint/power athletic status in Europeans but not in Asians and Africans, while the association between the R577X genotype and elite endurance athlete status is less convincing. The aim of the present study was to investigate the association between the ACTN3 R577X genotype and elite athlete status in a large Asian (Japanese) cohort of track and field athletes. Methods: One-thousand fifty-seven Japanese track and field athletes (627 sprint/power athletes and 430 endurance athletes) and 810 Japanese controls were genotyped for the ACTN3 R577X polymorphism (rs1815739) by using the TaqMan (R) SNP Genotyping Assay. Results: Elite sprint/power athletes had a higher frequency of the RR+RX genotype than the controls (OR: 1.59, 95% CI: 1.16-2.18; P=.003). A significant linear correlation was found between the RR+RX genotype and athlete status (i.e. regional&lt;national&lt;international) in sprint/power athletes (regional: 71%, national: 81%, international: 84%; P=.001 for trend) and long-distance runners (regional: 65%, national: 72%, international: 82%; P=.030 for trend). Conclusions: The data obtained for this large Asian (Japanese) cohort of track and field athletes served to confirm the association between the RR+RX genotype of the ACTN3 R577X polymorphism and elite sprint/power athlete status and also the association between the ACTN3 RR+RX genotype and long-distance running athletic status.

背景:高齢者における運動教室終了後の運動継続率は依然低い。本稿では、高齢者の長期的な運動継続のための運動教室と郵送支援の有効性を検証するランダム化比較試験の研究デザインを報告する。方法:本研究では、地域在住高齢者230名を、ランダム化された2群(郵送支援の有無)と補足的な非ランダム化(無介入)対照群に割付ける。全27ヵ月間の本研究には、3ヵ月間の運動教室、12ヵ月間の郵送支援、12ヵ月間の追跡が含まれる。運動教室では、3軸加速度計、目標設定とセルフモニタリングのための運動日誌を利用し、速歩、筋力運動、柔軟性運動の実践を学ぶ。教室修了後に、参加者を郵送支援(MP)群または非郵送支援(NMP)群にランダムに割付け、MP群は運動日誌と運動新聞の郵送を受ける。運動新聞は、運動の知識と社会的支援の提供、友人の運動実践による動機づけを狙いとしている。MP群は切手付き封筒を用いて月末に運動日誌を指導者に郵送する。15ヵ月および27ヵ月時の追跡時に、運動実践率に加え、身体機能、社会・心理・生理的評価項目を測定する。考察:郵送支援による長期的な運動継続が実現すれば、習慣的な運動実践による高齢者の持続的な健康増進に繋がると考えられる。臨床試験登録:UMIN Clinical Trials Registry(UMIN000015099)(著者抄録)

目的 健康日本21(第二次)の推進のため、国民全体から無作為抽出した集団を対象に、平成25〜26年にかけて電話調査を実施し、健康日本21(第二次)に関する健康意識・認知度を調査した。方法 乱数番号法を用いて、全国の20歳代から70歳以上の10歳年齢階級別に男女各150人、計1,800人より回答を得た。調査項目は1)用語の認知度(「健康日本21」、「健康寿命」、「メタボリックシンドローム(MetS)」、「慢性閉塞性肺疾患(COPD)」、「ロコモティブシンドローム」、「アクティブガイド」、「WHOのたばこ規制枠組み条約」、「スマートライフプロジェクト」)、2)健康意識(「最近1年間の健診受診歴」、「喫煙状況」、「健康のために望ましいと思う1日の野菜摂取量」)とし、調査回答の単純集計および性別・年齢階級別のクロス集計を行った。上記1)に対して、「意味を含めて知っている」と「聞いたことはあるがよく知らない」の回答者の割合を認知度とした。また、平成25、26年の年次比較、および男女・年齢階級間比較にはχ2検定を用いた。結果 平成25年で認知度が高かった上位5項目は、「MetS」(96.2%)、「COPD」(51.1%)、「健康寿命」(34.2%)、「ロコモティブシンドローム」(30.2%)、「WHOたばこ規制枠組み条約」(28.0%)であった。年次比較では「健康寿命」、「ロコモティブシンドローム」、「アクティブガイド」の認知度が平成25年より平成26年で有意に高かった。また、「1日の望ましい野菜摂取量」を350g程度と正答できた割合は、平成25年の41.6%と比べ、平成26年で50.1%と有意に高かった。平成25年で「健康寿命」、「COPD」、「ロコモティブシンドローム」の認知度や「1日の望ましい野菜摂取量」の正答割合は、男性より女性で有意に高かった。また、同年で「MetS」、「COPD」、「健康寿命」、「ロコモティブシンドローム」の認知度や「1日の望ましい野菜摂取量」の正答割合は年齢階級間に有意差があった。結論 「健康寿命」と「ロコモティブシンドローム」の認知度や健康意識に関わる「1日の望ましい野菜摂取量」の正答割合は、平成25年より平成26年で有意に高かった。また、項目ごとに認知度や健康意識の低かった性や年齢階級をターゲットにした介入が必要であると考えられた。(著者抄録)

While heavier weight is known to increase the incidence of dyslipidemia, limited data are available on the relationship between weight gain and its development.
A total of 2647 males were categorized into the following four groups according to the difference between their self-reported weight at 20 years of age and their measured weight in 1994-95: a loss of a parts per thousand yen5% (decrease), loss of &lt; 5% or gain of &lt; 5% (no change), gain of a parts per thousand yen5 to &lt; 15% (increase) and gain of a parts per thousand yen15% (sizable increase). They were followed up until their 2002-03 health examination. Using the 'no change' group as reference, the multivariable-adjusted odds ratio (adjusted for age, body mass index at 20 years of age, physical activity, smoking and alcohol intake) and 95% confidence interval (95% CI) for the incidence of dyslipidemia were determined using logistic regression models.
A total of 1342 participants developed dyslipidemia during the follow-up period. The 'increase' and 'sizable increase' groups had odds ratios for the incidence of dyslipidemia of 1.97 (95% CI, 1.59-2.45) and 2.68 (2.15-3.34), respectively, demonstrating that there was a significant dose-response association between weight gain since 20 years of age and the incidence of dyslipidemia (P &lt; 0.001 for trend).
These results suggest that dyslipidemia could be prevented by avoiding weight gain in adulthood.

Physical activity has multiple health benefits but may also increase the risk of developing musculoskeletal pain (MSP). However, the relationship between physical activity and MSP has not been well characterized. This study examined the dose-response relationship between sports activity and MSP among adolescents. Two school-based serial surveys were conducted 1 year apart in adolescents aged 12 to 18 years in Unnan, Japan. Self-administered questionnaires were completed by 2403 students. Associations between time spent in organized sports activity and MSP were analyzed cross-sectionally (n=2403) and longitudinally (n=374, students free of pain and in seventh or 10th grade at baseline) with repeated-measures Poisson regression and restricted cubic splines, with adjustment for potential confounders. The prevalence of overall pain, defined as having pain recently at least several times a week in at least one part of the body, was 27.4%. In the cross-sectional analysis, sports activity was significantly associated with pain prevalence. Each additional 1 h/wk of sports activity was associated with a 3% higher probability of having pain (prevalence ratio=1.03, 95% confidence interval=1.02-1.04). Similar trends were found across causes (traumatic and nontraumatic pain) and anatomic locations (upper limbs, lower back, and lower limbs). In longitudinal analysis, the risk ratio for developing pain at 1-year follow-up per 1 h/wk increase in baseline sports activity was 1.03 (95% confidence interval = 1.02-1.05). Spline models indicated a linear association (P&lt;0.001) but not a nonlinear association (P &gt;= 0.45). The more the adolescents played sports, the more likely they were to have and develop pain.

The aim of this study was to investigate whether rs41274853 in the 3'-untranslated region of the ciliary neurotrophic factor receptor gene (CNTFR) is associated with elite sprint/power athletic status and assess its functional significance. A total of 211 Japanese sprint/power track and field athletes (62 international, 72 national, and 77 regional athletes) and 814 Japanese controls were genotyped at rs41274853. Luciferase reporter assay was conducted to investigate whether this C-to-T polymorphism affects binding of microRNA miR-675-5p to this region. The TT genotype was significantly more frequent among international sprint/power athletes (19.4 %) than in the controls after Bonferroni correction (7.9 %, P = 0.036, OR = 2.81 [95 % CI: 1.43-5.55]). Furthermore, in non-athletic young/middle-aged men (n = 132), TT genotype carriers exhibited significantly greater leg extension power (26.6 +/- 5.4 vs. 24.0 +/- 5.4 W/kg BW, P = 0.019) and vertical jump performance (50.1 +/- 6.9 vs. 47.9 +/- 7.5 cm, P = 0.047) than the CC + CT genotype carriers. Reporter assays revealed that the miR-675-5p binds to this polymorphic region within the CNTFR mRNA, irrespective of the rs41274853 allele present. Although the functional significance of the rs41274853 polymorphism remains unclear, the CNTFR is one of the candidate genes contributing to sprint/power performance.

目的 本研究は、地方都市在住の成人および高齢者を対象に郵便番号によって評価された客観的な自宅近隣施設環境と加速度センサー付活動量計によって客観的に評価された身体活動量との関係を横断的に検討することを目的とした。方法 本研究は、佐久健康長寿プロジェクトの中間解析であり、佐久市に居住しデータの欠損がない30〜84歳の男女1,274人(男性721人、女性553人)を対象とした。身体活動量に関連する自宅近隣施設環境については、駅、スーパーマーケット・コンビニエンスストア、郵便局・銀行、病院・診療所、役所・公民館、文化施設・児童館、公園、公共・民間スポーツ施設について、佐久市役所の公式ホームページおよびNTTが発行しているタウンページのインターネット版iタウンページから、住所と郵便番号を抽出し、郵便番号別に整理した。対象者の身体活動量は、3次元加速度センサー付活動量計を用いて測定し、1日の平均歩数と1週間の中強度以上(3メッツ以上)の活動量について算出した。そして、施設環境を対象者の自宅住所の郵便番号と関連づけ、身体活動量との関係を検討した。分析は、65歳未満と65歳以上の年齢グループ別に、健康日本21(第二次)で設定されている目標歩数と中強度以上の活動量23メッツ・時/週の2つの身体活動量の目標値をそれぞれ従属変数、自宅近隣施設環境を独立変数、満年齢、性別、Body Mass Indexを調整変数とした多重ロジスティック回帰分析を実施した。結果 身体活動量と自宅近隣施設環境の関連は、65歳未満で、週に23メッツ・時の中強度以上の活動量を満たしていることとスーパーマーケット・コンビニエンスストアの数が多いことが統計学的に有意な関連を示した。65歳以上では、健康日本21(第二次)の目標歩数を満たしていることと郵便局・銀行の数が、中強度以上の活動量の目標値(23メッツ・時/週)を満たしていることとスーパーマーケット・コンビニエンスストアの数が統計学的に有意な正の関連を示した。結論 本研究の結果から、買い物や生活に必要な自宅近隣の施設の充実は、身体活動量の多いことと関連することが示唆された。(著者抄録)

生活習慣病に対する身体活動・運動の有効性は多くのエビデンスによって明らかにされている。高齢者が身体活動・運動を行う際には、事前にメディカルチェックを受け、これまでの運動歴や現在の運動習慣によって、個人の体力に応じた運動・身体活動を選択させることが重要である。ヨガやストレッチングなど低強度の運動による血圧・動脈硬化・糖代謝改善効果や、掃除や家事など高齢者でも続けやすい身体活動から生活習慣病予防・改善を考えることも注目されている。(著者抄録)

Cardiorespiratory fitness is negatively associated with arterial stiffness, although it is unclear whether it is associated with prospective arterial stiffness changes. The authors examined cardiorespiratory fitness and arterial stiffness progression in a 2-year follow-up study of 470 healthy men and women aged 26 to 69 years. Peak oxygen uptake (VO2peak) was measured at baseline using a graded cycle exercise test. Arterial stiffness was assessed using brachialankle pulse wave velocity (baPWV) at baseline and after 2 years. Two-year changes in baPWV were significantly higher in patients in the lowest VO2peak tertile (28.8 +/- 7.6 cm/ s) compared with those in the highest VO2peak tertile (-1.4 +/- 7.5 cm/ s) (P=.024) and were inversely correlated with VO2peak (r=-.112, P=.015). Stepwise multiple regression analysis revealed that age, glucose, baPWV, VO2peak, and sex were independent correlates of 2-year changes in baPWV, suggesting that higher cardiorespiratory fitness is associated with age-related arterial stiffening suppression. J Clin Hypertens (Greenwich). 2016; 18: 292-298. (C) 2015 Wiley Periodicals, Inc.

Physical fitness is an indicator of systemic well-being in humans. Little is known about the role of physical fitness for maintaining systemic health in the elderly. Here, we study elderly subjects to determine the relationships between physical fitness and CD56 and CD16 surface NK cell markers on peripheral blood lymphocytes, as well as to analyze the relationship between the surface markers and incidence of death. We selected 253 independent elderly subjects (122 female; 131 male) who were 79-80 years old. Subjects having a higher proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, or ration of CD56(dim)CD16(high) and CD56(dim)CD16(-) cells had a significant positive correlation with maximum bilateral knee extensor strength/weight (kg) (r = 0.425; P &lt; 0.0001 or r = 0.323; P &lt; 0.0001). In contrast, an increased proportion of CD56(bright)CD16(-) cells within lymphocyte significantly negatively correlated with the maximum bilateral knee extensor strength/weight (kg) (r = -0.290; P = 0.0004); and these subjects had a significantly lower mortality during the 5 years following measurement of death. Therefore, we found that a synergistic effect of the right and left leg muscle strength was associated with proportion of matured NK and NKT cells and induced a low proportion of CD56(bright)CD16(-) cells within lymphocyte. Moreover, the low proportion of CD56(bright)CD16(-) cells was associated with incidence of death. In conclusion, measurements of physical fitness, the proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, the ratio of CD56(dim)CD56(high) and CD56(dim)CD16(-) cells, and the proportion of CD56(bright)C16(-) cells in lymphocytes are important indicators to check elderly health.

Objectives The aim of this study was to examine the association between the number of neighborhood facilities that were assessed according to postal code and objectively measured physical activity by using an accelerometer in community-dwelling Japanese people.Methods The participants included 1,274 Japanese people aged 30-84 years from the Saku cohort study. As neighborhood facilities related to physical activity, we extracted information regarding train stations, supermarkets/convenience stores, postal offices/banks, hospitals/clinics, public offices/community centers, cultural facilities/public children's houses, parks, and sports facilities by using each participant's postal code from the online version of the iTownPages directory published by Nippon Telegraph and Telephone Corporation (NTT) and the official homepage of the Saku City Government Office. We measured each participant's physical activity level using an accelerometer, and calculated the average daily step count and the average weekly period of moderate-to-vigorous intensity (≥3 metabolic equivalents of tasks [METs]) physical activity. The association between two selected physical activity-related variables and the numbers of eight types of neighborhood facilities were analyzed by multivariate logistic regression analysis for people aged 30-64 years and for those aged over 65 years.Results On multivariate logistic regression analysis, meeting the 23 METs h/week of moderate-to-vigorous intensity physical activity was significantly and positively associated with the number of supermarkets/convenience stores in the neighborhood in both age groups. In addition, meeting the desired daily step count outlined in the Japanese National Health Promotion guidelines was positively related to the number of postal offices/banks for people aged over 65 years.Conclusion The results of this study suggest that a sufficient number of neighborhood facilities (i.e., stores, banks, and postal offices) is closely associated with the promotion of physical activity.

Objectives To examine the prevalence of health consciousness regarding "Health Japan 21" (2nd edition) among the Japanese population, we conducted a telephone survey of a sample extracted randomly from the whole nation in 2013 and 2014.Methods We extracted 1800 men and women with 150 persons for each gender and 10-year age group (6 age groups ranging from 20 years to 70 years and older) using Random Digital Dialing sampling. Each participant was asked about 1) recognition of the following items: "Health Japan 21," "healthy life expectancy," "metabolic syndrome (MetS)," "chronic obstructive pulmonary disease (COPD)," "locomotive syndrome," "Active Guide," "WHO Framework Convention on Tobacco Control," and "Smart Life Project" and 2) health consciousness toward the following: "health examination taken within the past one year," "smoking status," and "the amount of vegetables considered desirable to consume per day for health." We performed simple tabulation of the collected answers and cross-tabulation by sex and age groups, respectively. For each question about recognition, we categorized "I know the name and meaning" and "I know the name but not the meaning" as "awareness." We compared data between 2013 and 2014, sexes, and age groups, using chi-squared test.Results In 2013, the top 5 items with high awareness were "MetS" (96.2%), "COPD" (51.1%), "healthy life expectancy" (34.2%), "locomotive syndrome" (30.2%), and "WHO Framework Convention on Tobacco Control" (28.0%). Moreover, awareness of "healthy life expectancy," "locomotive syndrome," and "Active Guide" were significantly higher in 2014 than in 2013. Meanwhile, the proportion of participants who correctly chose "350 grams" as "the desirable amount of vegetables to consume per day" was 41.6% in 2013 and became significantly higher at 50.1% in 2014. In 2013, awareness of "healthy life expectancy," "COPD," and "locomotive syndrome" and the proportion of correct answers for "the desirable amount of vegetables to consume per day" were significantly higher among women than among men. In 2013, there were significant differences among age groups in awareness of "MetS," "COPD," "healthy life expectancy," and "locomotive syndrome" and the proportion of correct answers for "the desirable amount of vegetables to consume per day."Conclusion Awareness of "healthy life expectancy," "locomotive syndrome," and health consciousness of "the desirable amount of vegetables to consume per day" were significantly higher in 2014 than in 2013. There were discrepancies on respective items among both sexes and age groups. Therefore, interventions for groups with lower awareness or health consciousness may be required.

BACKGROUND: In Japan, the incidence of kidney stones has increased markedly in recent decades. Major causes of kidney stones remain unclear, and limited data are available on the relationship between overweight/obesity and the incidence of kidney stones. We therefore evaluated body mass index (BMI) and the incidence of kidney stones in Japanese men. METHODS: Of the workers at a gas company, 5984 males aged 20-40 years underwent a medical examination in 1985 (baseline). This study includes 4074 of the men, who were free of kidney stones at baseline and underwent a second medical examination performed between April 2004 and March 2005. BMI was calculated from measured height and weight in 1985, and men were categorized into tertiles. The development of kidney stones during follow-up was based on self-reports from questionnaires at the second medical examination. RESULTS: The average duration of follow-up was 19 years, with 258 participants developing kidney stones during this period. Using the lowest BMI (1st tertile) group as a reference, the hazard ratios (95% confidence intervals [CIs]) for the 2nd and 3rd BMI tertiles were: 1.26 (95% CI, 0.92-1.73) and 1.44 (95% CI, 1.06-1.96), respectively (P for trend = 0.019). After additionally adjusting for potential confounders, such as age, systolic blood pressure, cardiorespiratory fitness, cigarette smoking, and alcohol consumption, the hazard ratios were 1.28 (95% CI, 0.93-1.76) and 1.41 (95% CI, 1.02-1.97), respectively (P for trend = 0.041). CONCLUSIONS: These results suggest that increased BMI is a risk factor for kidney stones in Japanese men.

There are strong genetic components to cardiorespiratory fitness and its response to exercise training. It would be useful to understand the differences in the genomic profile of highly trained endurance athletes of world class caliber and sedentary controls. An international consortium (GAMES) was established in order to compare elite endurance athletes and ethnicity-matched controls in a case-control study design. Genome-wide association studies were undertaken on two cohorts of elite endurance athletes and controls (GENATHLETE and Japanese endurance runners), from which a panel of 45 promising markers was identified. These markers were tested for replication in seven additional cohorts of endurance athletes and controls: from Australia, Ethiopia, Japan, Kenya, Poland, Russia and Spain. The study is based on a total of 1520 endurance athletes (835 who took part in endurance events in World Championships and/or Olympic Games) and 2760 controls. We hypothesized that world-class athletes are likely to be characterized by an even higher concentration of endurance performance alleles and we performed separate analyses on this subsample. The meta-analysis of all available studies revealed one statistically significant marker (rs558129 at GALNTL6 locus, p = 0.0002), even after correcting for multiple testing. As shown by the low heterogeneity index (I-2 = 0), all eight cohorts showed the same direction of association with rs558129, even though p-values varied across the individual studies. In summary, this study did not identify a panel of genomic variants common to these elite endurance athlete groups. Since GAMES was underpowered to identify alleles with small effect sizes, some of the suggestive leads identified should be explored in expanded comparisons of world-class endurance athletes and sedentary controls and in tightly controlled exercise training studies. Such studies have the potential to illuminate the biology not only of world class endurance performance but also of compromised cardiac functions and cardiometabolic diseases.

Background: Physical inactivity is a health issue that often occurs after serious disaster. Social factors, which can be disrupted by disaster, are important determinants of physical activity levels in everyday living. This study was designed to confirm the association between social factors and physical activity among elderly survivors of the Great East Japan Earthquake.
Methods: From September 2011 to February 2012, 4316 males and females aged 65 or older participated in a health survey of Great East Japan Earthquake survivors. Multiple logistic regression analyses were performed with the dichotomous dependent variable of physical activity (high versus low) and working status, social network, and place of residence (one's own home versus elsewhere) as independent variables.
Results: Participants who had been displaced from their homes were more likely to have low physical activity (odds ratio [OR], 95 % confidence interval [CI] for men: 1.37, 1.12 to 1.68; for women: 1.30, 1.09 to 1.55). Non-working status was significantly associated with low physical activity (men: 2.03, 1.65 to 2.49; women: 1.94, 1.60 to 2.34). Detriments to the social network were significantly associated with low physical activity (men: 1.71, 1.41 to 2.08; women: 1.79, 1.51 to 2.13).
Conclusion: Place of residence and social factors were associated with physical activity levels in elderly survivors of the Great East Japan Earthquake. The findings suggest a need for improvement of social factors to encourage increases in physical activity for elderly persons after disaster.

目的:本レポートは2つの目的をもって作成された。1つはアジア各国における身体活動ガイドラインの比較である。そしてもう1つはアジアにおける各国の身体活動調査の方法およびその結果の比較である。方法:アジアにおける身体活動ガイドラインおよび身体活動調査の方法および結果について,Google Search,Google Scholar,MEDLINE,ELSEVIER,BioMed,BMC Public Health searchを利用してアジア全体(n=51)を対象に検索した。結果:インターネットを用いた調査の結果,英語で記載した身体活動ガイドラインおよび身体活動調査の方法や結果を入手できた国は6か国であった(香港,マレーシア,シンガポール,サウジアラビア,韓国,日本)。身体活動ガイドラインについては,多くの国がWHOの推奨する身体活動ガイドライン,すなわち,「中強度の有酸素性身体活動を週150分もしくは高強度の有酸素性身体活動を週75分実施することを推奨」と類似していた。身体活動調査における身体活動の定義についても多くの国がWHOの定義,すなわち,「以下の基準に1つでも適合すること,(1)週に3日以上,1日当たり少なくとも20分の高強度の身体活動を実施,(2)週に5日以上,1日当たり少なくとも30分以上の中強度の身体活動もしくは歩行を実施,(3)週に5日以上,歩行や中高度の身体活動を1週間当たり600 MET-min以上になるように実施」と類似した定義を採用していた。結論:各国の情報を共有し,より良い身体活動ガイドラインを作成していくためにも,多くの国において身体活動ガイドラインの英語版が公表されることが望まれる。更に,最低限の項目については国際的に比較可能な調査が実施されることが望ましいと考えられる。(著者抄録)

Aim: The present study investigated whether a slow movement protocol can be applied to resistance training using bodyweight. In addition, the intervention program combined plyometric exercise with resistance exercise to improve physical function overall.
Methods: A total of 39 active elderly adults participated in a 16-week intervention. The program consisted of five resistance exercises and four plyometric exercises using their own bodyweight with a single set for each exercise. Participants were assigned to one of two experimental groups. One group carried out resistance exercise with slow movement and tonic force generation (3-s concentric, 3-s eccentric and 1-s isometric actions with no rest between each repetition). The other group as a movement comparison followed the same regimen, but at normal speed (1-s eccentric and 1-s concentric actions with 1-s rest between each repetition). Muscle size, strength and physical function were measured before and after the intervention period.
Results: After the intervention, strengths of upper and lower limbs, and maximum leg extensor power were significantly improved in both groups. Muscle size did not change in either group. There were no significant differences in any of the parameters between groups.
Conclusions: The intervention program using only own bodyweight that comprised resistance exercise with slow movement and plyometric exercise can improve physical function in the elderly, even with single sets for each exercise. However, there was no enhanced muscle hypertrophic effect. Further attempts, such as increasing performing multiple sets, would be required to induce muscle hypertrophy.

Prospective cohort studies have shown that people with a larger amount of physical activity (PA) and exercise have lower risks of non-communicable diseases (NCDs). In Japan, the Ministry of Health, Labour and Welfare published in March 2013 the “Active-Guide,” i.e. the Japanese official PA guidelines for health promotion. In this document, the most important message is “+10,” standing for “add 10 min of MVPA per day.” The establishment of the “+10” recommendation is supported by strong scientific evidence. Firstly, a meta-analysis including 26 cohort studies indicated that an increment of 10 min of moderate-to-vigorous PA per day can result in a 3.2% reduction of the average relative risk of NCDs, dementia, joint-musculoskeletal impairment, and mortality. Secondly, the National Health and Nutrition Survey (Japan, 2010) reported that 60.8% of the Japanese population is inclined to add the equivalent of 10 min of PA in their daily life. In line with these results, the “+10” recommendation is viewed as feasible and efficient for the Japanese population. To our knowledge, this implementation of an additional low-dose PA recommendation in a governmental health promotion policy is a world first. We hope that the Japanese PA policy will inspire other national and international public health agencies.

Werner syndrome is a rare autosomal recessive disorder caused by mutations in the human WRN gene and characterized by the early onset of normal aging symptoms. Given that patients with this disease exhibit osteoporosis, the present study aimed to determine whether the WRN gene contributes to the etiology of osteoporosis. A genetic association study of eight non-synonymous polymorphisms in the WRN gene and the incidence of femoral fracture was undertaken in 1,632 consecutive Japanese autopsies in which 140 patients had experienced the fracture during their lifetime. The results were validated in 251 unrelated postmenopausal Japanese women with osteoporosis and 269 non-institutionalized, community-dwelling Japanese adults. A statistically significant association was observed between rs2230009 (c.340G &gt; A)-which results in a Val to Ile substitution-and fracture risk; the incidence of femoral fracture increased dose-dependently with the number of A alleles (p = 0.0120). Femoral neck bone and whole bone densities were lower among postmenopausal women with osteoporosis and community-dwelling adults, respectively, if they were of the AG instead of the GG genotype. The results suggest that Japanese subjects bearing at least one A allele of rs2230009 of the WRN gene are at a significantly higher risk of femoral fracture, possibly due to decreased bone density.

目的:保健指導に関する技術について書面調査を行い、生活習慣改善支援をするために必要なことを抽出することを目的とした。方法:平成26年度人間ドック健診情報管理指導士ブラッシュアップ研修会受講者982人のうち、有効回答を得た842人(医師351人、保健師305人、管理栄養士186人)を対象とした。保健指導者の習得度に関する調査票を用い、研修会開始時に書面により習得度を4段階で自己評価した。習得度を項目ごとに全体と職種別に分析、保健師の一部については保健指導経験年数別に分析した。結果:習得度は、全体として個別支援に関する項目で高いのに対し、集団的支援は低かった。AUDITを用いた適正飲酒支援、ABC/ABR方式に基づく禁煙支援等の節酒や禁煙に関する具体的な支援に関する項目が低かった。運動リスクマネジメントの習得度は医師で高いのに対し、保健師・管理栄養士では低かった。特定保健指導の制度に関する項目は保健師・管理栄養士で高かった。食事に関する項目は管理栄養士で高く、医師・保健師では低かった。経験年数が長い群で、特定保健指導のしくみや評価、身体活動に関する項目、酒・たばこと生活習慣病の関連等で有意に習得度が高かった。結論:保健指導効果を高めるためには、習得度が低い項目に重点をおいた研修会内容にすること、多職種が連携し補完しあうことが望ましいと考えられた。(著者抄録)

AimTo examine the relationship between calf circumference and muscle mass, and to evaluate the suitability of calf circumference as a surrogate marker of muscle mass for the diagnosis of sarcopenia among middle-aged and older Japanese men and women.
MethodsA total of 526 adults aged 40-89 years participated in the present cross-sectional study. The maximum calf circumference was measured in a standing position. Appendicular skeletal muscle mass was measured using dual-energy X-ray absorptiometry, and the skeletal muscle index was calculated as appendicular skeletal muscle mass divided by the square of the height (kg/m(2)). The cut-off values for sarcopenia were defined as a skeletal muscle index of less than -2 standard deviations of the mean value for Japanese young adults, as defined previously.
ResultsCalf circumference was positively correlated with appendicular skeletal muscle (r=0.81 in men, r=0.73 in women) and skeletal muscle index (r=0.80 in men, r=0.69 in women). In receiver operating characteristic analysis, the optimal calf circumference cut-off values for predicting sarcopenia were 34cm (sensitivity 88%, specificity 91%) in men and 33cm (sensitivity 76%, specificity 73%) in women.
ConclusionsCalf circumference was positively correlated with appendicular skeletal muscle mass and skeletal muscle index, and could be used as a surrogate marker of muscle mass for diagnosing sarcopenia. The suggested cut-off values of calf circumference for predicting low muscle mass are &lt;34cm in men and &lt;33cm in women. Geriatr Gerontol Int 2015; 15: 969-976.

Although palmitoleic acid (C16:1) is associated with arrhythmias, and increases in an age-dependent matter, the effects of L-carnitine, which is essential for the transport of long-chain fatty acids into the mitochondria, are unclear. It has been postulated that L-carnitine may attenuate palmitate (C16:0)induced mitochondrial dysfunction and the apoptosis of cardiomyocytes. The aim of this study was to elucidate the activity of L-carnitine in the prevention of the palmitoleic acid-induced mitochondrial membrane permeability transition and cytochrome c release using isolated cardiac mitochondria from rats. Palmitoleoyl-CoA-induced mitochondrial respiration was not accelerated by L-carnitine treatment, and this respiration was slightly inhibited by oligomycin, which is an inhibitor of ATP synthase. Despite pretreatment with L-carnitine, the mitochondrial membrane potential decreased and mitochondrial swelling was induced by palmitoleoyl-CoA. In the presence of a combination of L-carnitine and tiron, a free radical scavenger, there was attenuated mitochondrial swelling and cytochrome c release following palmitoleoyl-CoA treatment. We concluded that palmitoleic acid, but not palmitate, induces the cardiac mitochondrial membrane permeability transition despite the presence of L-carnitine. (C) 2015 Elsevier Inc. All rights reserved.

BackgroundThe United States and Japan have similar standards of living, healthcare systems, and industrializations but exhibit markedly divergent life expectancies both at birth and at later ages (50 or 65years old). Arterial stiffness has been widely regarded as a barometer of biological or physiological aging and could provide insight into the inter-country differences.
ObjectivesTo determine whether the increases in arterial stiffness across the adult age range are greater in U.S. than Japanese adults.
DesignCross-sectional analyses.
SettingLaboratory-based study.
ParticipantsHealthy, nonsmoking Japanese (n=400) and U.S. (n=400) adults without cardiovascular and other chronic diseases.
MeasurementsIndices of arterial stiffness, including carotid-femoral (cfPWV) and brachial-ankle pulse wave velocity (baPWV) were measured, along with a variety of ancillary measures. The recruitment method, measurement technique, and protocol were standardized and identical between U.S. and Japanese facilities.
ResultscfPWV and baPWV increased progressively with advancing age in all subgroups (stratified according to sex and country). The rates of age-related increases in arterial stiffness were not different between U.S. and Japanese men, but age-associated increases in cfPWV were significantly greater in U.S. than Japanese women, widening the intercountry differences at older age ranges.
ConclusionJapanese women had smaller increases in central arterial stiffness with advancing age than U.S. women.

Background: Promotion of physical activity (PA) is a key strategy to prevent non-communicable diseases. However, evidence on the effectiveness of community-wide interventions (CWIs) for promoting PA is limited.
Purpose: To evaluate the effectiveness of a 3-year CWI for promoting PA in middle-aged and older adults compared with usual public health services. This study is an extension to an original 1-year investigation study.
Design: Cluster randomized controlled trial with community as unit of randomization and individual as unit of analysis.
Setting/participants: 12 communities in Unnan, Japan were randomly allocated to the intervention (9) or the control (3). Additionally intervention communities were randomly allocated to aerobic activity promotion (Group A), flexibility and muscle-strengthening activities promotion (Group FM), or aerobic, flexibility, and muscle-strengthening activities promotion (Group AFM), each consisting of three communities. Randomly-sampled 4414 residents aged 40 to 79 years responded to the baseline survey (74 %), and were analyzed in 2013-2014.
Intervention: A 3-year CWI based on social marketing, to promote PA from 2009 to 2012.
Main outcome measures: The primary outcome was a change in regular aerobic, flexibility, and/or musclestrengthening activities, defined by (1) engaging in 150 mins/week or more of walking, (2) engaging in daily flexibility activity, or (3) engaging 2 or more days/week in muscle-strengthening activities, evaluated at the individual level. Secondary outcomes were changes in specific types of PA and musculoskeletal pain. Outcomes were measured at baseline and at 1 and 3 years (2009, 2010, and 2012).
Results: The CWI did not significantly increase the proportion of adults who reached recommended levels of aerobic, flexibility, and/or muscle-strengthening activities (adjusted change difference = 1.6 % [95 % CI: -3.5, 6.6]). In the subgroup analysis, compared to the controls, adults doing flexibility activity daily significantly increased in Group FM (6.3 % [95 % CI: 1.9, 10.7]). In Group A and AFM for PA outcomes and in all groups for pain outcomes, there was no significant change compared to controls.
Conclusions: The CWI did not achieve significant increase in the proportion of adults who reached recommended PA levels. However, it might be effective in promoting flexibility activity in middle-aged and older Japanese.

サルコペニアや認知症、2型糖尿病や高血圧のような老年疾患の予防・改善に、身体活動や運動が有効であることはよく知られている。最近では、これら疾患に対する高齢者を対象としたランダム化比較試験や食事・栄養との併用効果に関する研究が報告され、身体活動・運動は高齢者の健康寿命の延伸を考えるうえで欠かすことができないものとなっている。今後、高齢化により老年疾患の罹患者数は増加することが予想され、身体活動・運動の役割はさらに大きくなると考えられる。これまでは有酸素運動やレジスタンス運動といった、いわゆる"運動"により疾病予防・改善をめざすことが推奨されていたが、最近では日々身体を動かす場面を増やすこと、つまり日常生活での"身体活動"を増加させることの重要性が明らかとなってきた。高齢者にとって、どのような身体活動・運動が取り組みやすく、かつ効果的であるのかを今後も考えていく必要がある。(著者抄録)

There are several gene variants that are candidates to influence functional capacity in long-lived individuals. As such, their potential association with exceptional longevity (EL, i.e., reaching 100+ years) deserves analysis. Among them are rs7832552 in the thyrotropin-releasing hormone receptor (TRHR) gene, rs1800795 in the interleukin-6 (IL6) gene and rs6552828 in the coenzyme A synthetase long-chain 1 (ACSL1) gene. To gain insight into their functionality (which is yet unknown), here we determined for the first time luciferase gene reporter activity at the muscle tissue level in rs7832552 and rs6552828. We then compared allele/genotype frequencies of the 3 abovementioned variants among centenarians [n = 138, age range 100-111 years (114 women)] and healthy controls [n = 334, 20-50 years (141 women)] of the same ethnic and geographic origin (Spain). We also studied healthy centenarians [n = 79, 100-104 years (40 women)] and controls [n = 316, 27-81 years (156 women)] from Italy, and centenarians [n = 742, 100-116 years (623 women)] and healthy controls [n = 499, 23-59 years (356 women)] from Japan. The THRH rs7832552 T-allele and ACSL1 rs6552828 A-allele up-regulated luciferase activity compared to the C and G-allele, respectively (P = 0.001). Yet we found no significant association of EL with rs7832552, rs1800795 or rs6552828 in any of the 3 cohorts. Further research is needed with larger cohorts of centenarians of different origin as well as with younger old people.

This study aimed to compare the accuracy for predicting body composition using single-frequent segmental bioelectrical impedance analysis (BIA) between pre- and postmenopausal women. A total f 559 Japanese women aged 30-88 yr were divided into 4 groups by questionnaire: natural menopause, pathological menopause, regular menstruation, or irregular menstruation. The measurement values by dual-energy X-ray absorptiometry were used as a reference of the body composition. In terms of the results, regardless of the menopausal status, BIA slightly but significantly overestimated the percentage of body fat (standard error of estimate: 5.3%-6.7%) and the leg lean soft tissue mass (LSTM; 5.1%-6.1%), and underestimated the LSTM in the whole body (6.2%-7.6%) and arm (2.8%-3.7%). The absolute values of the predictive error for leg LSTM were significantly higher in postmenopausal groups than in the premenopausal ones. The corresponding values for the whole body and arm LSTM, and the percentage of body fat were higher in premenopausal groups than in postmenopausal ones. In conclusion, the predictive accuracy of BIA for postmenopausal women is not inferior to that for premenopausal ones, unless we target the leg LSTM.

Background: Extended sitting time at work is viewed as a crucial public health issue. Encouraging workers to stand during their office hours via the installation of standing desks maybe one effective option to combat this. Here, we investigate whether the installation of high desks in the workplace can induce positive changes in the amount of physical activity (PA) and thereby lead to subsequent improvements in anthropometric parameters.
Methods: Thirty-two white-collar workers (22 men and 10 women, mean age 44.2) were randomly divided into two groups. A randomised crossover trial was performed for 13 weeks. During the experimental period, subjects completed their office work in a standing position using stationary high desks (standing work, SW) for 10 hours per week or more (SW period). The subjects were asked to maintain their normal sitting working habits during the control period (CONT period). The primary outcome was PA, which was assessed objectively using a triaxial accelerometer during weekdays and weekends. The secondary outcomes were anthropometric measurements. For each group and each parameter, the mean values during each period were recorded and were compared by paired t test.
Results: The daily total PA (10.2 +/- 2.4 vs. 9.7 +/- 2.3 METs . h/day, P = 0.043), MVPA (4.2 +/- 2.2 vs. 3.7 +/- 1.8 METs . h/day, P = 0.025), time spent in moderate PA (58.2 +/- 20.7 vs. 53.4 +/- 17.0 min/day, P = 0.019) and time spent in MVPA (62.8 +/- 25.1 vs. 57.0 +/- 20.3 min/day, P = 0.019) were significantly higher during the SW period compared to the CONT period. A weekdays verses weekends subanalysis revealed that these parameters were significantly higher during the SW period compared to the CONT period during weekdays only. No significant differences were noted before and after SW periods for most of the anthropometric measures, except waist circumference (83.7 +/- 7.9 vs. 83.0 +/- 7.9 cm, respectively, P = 0.007).
Conclusions: Standing work, via the installation of high desks, significantly increases moderate to vigorous physical activity, especially on weekdays.

子どもの身体活動を促進するうえで,現存するエビデンスをまとめ,国際比較を実施し,エビデンスに基づいた身体活動や健康面の施策を促すための情報を研究者だけでなく教員,指導者,政策立案者および一般大衆が共有することは,極めて重要なことと考えられる。"Active Healthy Kids ReportCard"は,各国の子どもの身体活動の現状および,身体活動に影響する要因を示すものとして,主に9つの指標によって構造化されている。2005年に,初版の"Active Healthy Kids Canada Report Card"が発表されて以来,Active Healthy Kids Global Alliance(www.activehealthykids.org)を形成するさまざまな国民所得水準の15か国において,"Active Healthy Kids Report Card"が報告されている。きたる2016年の第6回The International Congress on Physical Activity and Public Healthバンコク大会に向け,更に地理的および経済的に異なる国を加えた40か国を超える国が参加する予定である。"Active Healthy Kids JAPAN Report Card"についても,現在ワーキンググループで検討中である。本稿はこれまで報告されている15か国の"Active Healthy Kids Report Card"および国際比較の結果について概説した。(著者抄録)

Background: The independent and combined associations of muscle strength and obesity on the prevalence of type 2 diabetes in Japanese men remain unclear.
Methods: Hand grip strength was cross-sectionally evaluated between 2011 and 2013 to assess muscle strength in 5039 male workers aged 40 to 64 years. Weight and height were measured, and overweight/obesity was defined as a body mass index &gt;= 25 kg/m(2). The prevalence of type 2 diabetes, defined as fasting plasma glucose &gt;= 126 mg/dL and/or hemoglobin A1c &gt;= 6.5% and/or self-reported physician-diagnosed diabetes, was evaluated. Odds ratios (OR) and 95% confidence intervals (95% CI) for the prevalence of type 2 diabetes were obtained using a logistic regression model.
Results: In total, 611 participants had type 2 diabetes, and 1763 participants were overweight/obese. After adjustment for covariates, we found an inverse association between muscle strength and the prevalence of type 2 diabetes (P for trend &lt;0.01). In addition, when the analyses were stratified by obesity status, the multivariable-adjusted OR per 2-standard-deviation increase in muscle strength was 0.64 (95% CI, 0.49-0.83) in the overweight/obese group, compared to a weaker relationship in the normal-weight group (OR 0.79 per 2-standard-deviation increase; 95% CI, 0.60-1.06).
Conclusions: Dynapenia, an age-related decrease in muscle strength, is associated with increased prevalence of type 2 diabetes, and this relationship is stronger in overweight/obese middle-aged Japanese men than in normal-weight men.

There has been a considerable increase in the number of studies reporting associations between DNA sequence variation in specific genes and metabolic syndrome (MetS). A low level of cardiorespiratory fitness is also a strong determining factor in the development of MetS. This cross-sectional study was performed to investigate the influence of the interaction between obesity genes and cardiorespiratory fitness on the risk of MetS. Healthy Japanese men (n = 287) participated in this study. All subjects were divided into four groups, fitness level (high and low fitness groups), and age (younger, age &lt
40 years and middle-aged/older, age ≥ 40 years). The peroxisome proliferator-activated receptor gamma 2 (PPARγ2), the uncoupling protein-2 (UCP2), and the fatty acid binding protein 2 (FABP2) genotypes were analyzed by using real-time polymerase chain reaction (PCR) with Taq-Man probes. Two-way analysis of covariance (ANCOVA) with adjustment for age as a covariate indicated that fitness, the CC genotype of C1431T in the PPARγ2, and the ValVal genotype of Ala55Val in the UCP2 genes interacted to produce a significant effect on MetS risk in Japanese adult men. We concluded that the CC genotype of C1431T in the PPARγ2 and the ValVal genotype of Ala55Val in the UCP2 genes together with low cardiorespiratory fitness may increase the risk of MetS in younger men (age &lt
40 years), even with adjustment for age.

Irisin might play an important role in reducing the risk of obesity, insulin resistance, or several related diseases, and high irisin levels may contribute to successful aging. Thus, the irisin precursor (FNDC5) gene is a candidate to influence exceptional longevity (EL), i.e., being a centenarian. It has been recently shown that two single-nucleotide polymorphisms (SNPs) in the FNDC5 gene, rs16835198 and rs726344, are associated with in vivo insulin sensitivity in adults. We determined luciferase gene reporter activity in the two above-mentioned SNPs and studied genotype distributions among centenarians (n=175, 144 women) and healthy controls (n= 347, 142 women) from Spain. We also studied an Italian [79 healthy centenarians (40 women) and 316 healthy controls (156 women)] and a Japanese cohort [742 centenarians (623 women) and 499 healthy controls (356 women)]. The rs726344 SNP had functional significance, as shown by differences in luciferase activity between the constructs of this SNP (all P &lt;= 0.05), with the variant A-allele having higher luciferase activity compared with the G-allele (P=0.04). For the rs16835198 SNP, the variant T-allele tended to show higher luciferase activity compared with the G-allele (P=0.07). However, we found no differences between genotype/allele frequencies of the two SNPs in centenarians versus controls in any cohort, and no significant association (using logistic regression adjusted by sex) between the two SNPs and EL. Further research is needed with different cohorts as well as with additional variants in the FNDC5 gene or in other genes involved in irisin signaling.

Background: Both little and excessive physical activity (PA) may relate to chronic musculoskeletal pain. The primary objective of this study was to characterize the relationship of PA levels with chronic low back pain (CLBP) and chronic knee pain (CKP).
Methods: We evaluated 4559 adults aged 40-79 years in a community-based cross-sectional survey conducted in 2009 in Shimane, Japan. We used self-administered questionnaires to assess sociodemographics and health status: PA was assessed by the International Physical Activity Questionnaire, and CLBP and CKP were assessed by a modified version of the Knee Pain Screening Tool. We examined relationships of PA with prevalence of CLBP and CKP using Poisson regression, controlling for potential confounders.
Results: CLBP and CKP were both prevalent (14.1% and 10.7%, respectively) and associated with history of injury, medication use, and consultation with physicians. PA was not significantly related to CLBP or CKP (P &gt; 0.05) before or after adjustment for potential confounders. For example, compared with adults reporting moderate PA (8.25-23.0 MET-hours/week), prevalence ratios for CKP adjusted for sex, age, education years, self-rated health, depressive symptom, smoking, chronic disease history, and body-mass index were 1.12 (95% confidential interval [CI] 0.84-1.50) among those with the lowest PA and 1.26 (95% CI 0.93-1.70) among those with the highest PA (P quadratic = 0.08). The prevalence ratios were further attenuated toward the null after additional adjustment for history of injury, medication use, and consultation (P quadratic = 0.17).
Conclusions: This cross-sectional study showed that there were no significant linear or quadratic relationships of self-reported PA with CLBP and CKP. Future longitudinal study with objective measurements is needed.

目的 国民健康・栄養調査における歩数の平均値は、健康日本21における身体活動・運動分野の評価に用いられるとともに、国民の身体活動や運動に関する代表的なデータとして利用されている。本研究は、国民健康・栄養調査における歩数のデータの特性を明らかにすることを目的とした。方法 2008年から2010年の計3年分の国民健康・栄養調査のデータのうち、1日の歩数および歩数計装着状況のデータがある21,914人を対象として分析を行った。栄養摂取状況調査票の身体状況調査項目における歩数計の装着状況として終日歩数計を装着したと回答した群を「終日装着群」とし、「非終日装着群」との平均値、中央値、外れ値、度数分布の比較を行った。結果 2008年、2009年、2010年における「非終日装着群」の割合は、すべての測定年において全体の約8%であった。各年の平均歩数は、「終日装着群」が「非終日装着群」より1,076から1,472歩高い値を示していた。また、両群ともに外れ値が存在し、度数分布については両群とも歩数の多い方に裾を引いていることが確認された。それに伴い、平均値は中央値よりも約600歩多い値を示していた。結論 国民健康・栄養調査の歩数のデータには歩数計を終日装着していない約8%の者が含まれ、データが正規分布を示さないことから、国民の身体活動や運動に関する代表値として利用する際にはデータの特性を考慮する必要があると考えられる。(著者抄録)

Focal adhesion is critical for cell survival. The focal adhesion kinase (FAK, or PTK2) is an important component of the human interactome and thus is a potential longevity-related protein. Here we studied the association between two PTK2 gene single-nucleotide polymorphisms (SNPs) (rs7843014, rs7460) and exceptional longevity (EL). In addition to gaining insight into their functionality by determining luciferase gene reporter activity, we studied the genotype/allele frequency of these two SNPs among three different cohorts: (1) Spanish centenarians (n=175, 100-111 years, 144 women) and healthy controls (n=355, 20-50 years, 284 women); (2) Italian centenarians (n=79, 100-104 years, 40 women) and controls (n=316, 29-50 years, 156 women); and (3) Japanese centenarians (n=742, 100-116 years, 623 women) and healthy controls (n=499, 23-59 years, 356 women). Both SNPs had functional significance, with the A allele up-regulating luciferase activity compared to the other allele (rs7460 T allele and rs7843014 C allele, respectively). The A allele of both SNPs was negatively associated with EL in the Spanish cohort (rs7460, odds ratio [OR] adjusted by sex=0.40, 95% confidence intervals [CI] 0.3, 0.6, p&lt;0.001); rs7843014, OR=0.37, 95% CI 0.3, 0.5, p&lt;0.001). The OR of being a centenarian if having the rs7460-TT genotype was 6.68 (95% CI 4.1, 10.8, p&lt;0.001). The rs7843014 CC genotype was also positively associated with EL (OR=7.58, 95% CI 4.6, 12.3, p&lt;0.001]. No association was, however, found for the Italian or Japanese cohorts. Thus, two genotypes of the FAK gene, rs7460 TT and rs7843014 CC, are possibly associated with lower gene expression and might favor the likelihood of reaching EL in the Spanish population. Further research is needed to unveil the mechanisms by which FAK expression could perhaps influence the rate of aging.

The largest percentage of mortality from tobacco smoking is cardiovascular-related. It is not known whether regular participation in exercise mitigates the adverse influence of smoking on vasculature. Accordingly, the authors determined whether regular aerobic exercise is associated with reduced arterial stiffness in men who smoke cigarettes. Using a cross-sectional study design, 78 young men were studied, including sedentary nonsmokers (n=20), sedentary smokers (n=12), physically active nonsmokers (n=21), and physically active smokers (n=25). Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). There were no group differences in height, body fat, and systolic and diastolic blood pressure. As expected, both physically active groups demonstrated greater maximal oxygen consumption and lower heart rate at rest than their sedentary peers. The sedentary smokers demonstrated greater baPWV than the sedentary nonsmokers (11.8 +/- 1 m/s vs 10.6 +/- 1 m/s, P=.036). baPWV values were not different between the physically active nonsmokers and the physically active smokers (10.8 +/- 1 m/s vs 10.7 +/- 1 m/s). Chronic smoking is associated with arterial stiffening in sedentary men but a significant smoking-induced increase in arterial stiffness was not observed in physically active adults. These results are consistent with the idea that regular participation in physical activity may mitigate the adverse effects of smoking on the vasculature. (C) 2014 Wiley Periodicals, Inc.

Purpose: To investigate the link between peak oxygen uptake and regional body composition by dual energy X-ray absorptiometry (DEXA) in Japanese subjects.
Methods: A total of 93 men (42.2 +/- 12.3 years old) and 106 women (43.5 +/- 12.3 years old) were enrolled in this cross-sectional investigation study. Peak oxygen uptake was measured by the breath-by-breath method. Regional body composition i.e., body fat mass, lean body mass, and body fat percentage was evaluated using DEXA. In addition, metabolic risk parameters were also evaluated.
Results: Peak oxygen uptake was 37.6 +/- 8.7 mL/kg/min in men and 31.1 +/- 6.4 mL/kg/min in women, and decreased with age in both genders. Peak oxygen uptake was significantly correlated with total body fat percentage (men: r = -0.684, p &lt; 0.0001; women: r = -0.681, p &lt; 0.0001). These associations remained even after adjusting for age and total lean body mass. However, peak work rate was positively and significantly correlated with leg lean body mass.
Conclusion: Peak oxygen uptake was closely correlated with total body fat percentage in both genders. Aerobic exercise as well as leg resistance training might be useful for improving peak oxygen uptake in Japanese subjects. Copyright (C) 2014, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved.

The aim of this study was to evaluate the link between circulating leptin levels and physical activity and/or physical fitness in apparently healthy Japanese.
A total of 85 men and 111 women who were not taking any medication were enrolled in this cross-sectional study. Circulating leptin levels, physical activity measured by tri-axial accelerometers and peak oxygen uptake were evaluated. We also assessed anthropometric data, blood pressure, blood examinations and energy intake.
Circulating leptin levels were 3.2 +/- A 2.3 ng/mL in men and 5.9 +/- A 3.8 ng/mL in women. Circulating leptin levels were significantly and positively correlated with body weight, body mass index, abdominal circumference, insulin and the homeostasis model assessment index, and significantly and negatively correlated with peak oxygen uptake in both sexes. Stepwise multiple regression showed that peak oxygen uptake in men and physical activity evaluated by in women were determinant factors for circulating leptin levels after adjusting for confounding factors.

BACKGROUND: The Wii Fit series (Nintendo Inc., Japan) provides active video games (AVGs) to help adults to maintain a sufficient level of daily physical activity (PA). The second generation of home AVG consoles is now emerging with new game modalities (including a portable mini screen in the case of the new Wii U). The present study was performed to investigate the intensity and enjoyment of Wii Fit U games among adults. FINDINGS: Metabolic equivalent (METs, i.e., intensity) of the Wii Fit U activities were evaluated using metabolic chambers in 16 sedentary adults (8 women and 8 men). A short version of the physical activity enjoyment scale was completed for each activity. Wii Fit U activities were distributed over a range from 2.2  ±  0.4 METs (Hula dance) to 4.7  ±  1.2 (Hip-hop dance). Seven activities were classified as light-intensity PA (<3 METs) and 11 activities as moderate-intensity PA (3 - 6 METs). The new portable mini screen game modality does not induce higher METs. Men exercised at higher intensities than women. There was no correlation between enjoyment and MET values in women or men. CONCLUSIONS: More and more moderate-intensity activities are available through video gaming, but the average intensity (3.2  ±  0.6) is still low. Users should be aware that AVGs alone cannot fulfill the recommendations for PA, and the video games industry still must innovate further to enhance gaming intensity and make the tool more attractive to health and fitness professionals.

The aim of this study was to investigate the link between circulating adiponectin levels and peak oxygen uptake and/or physical activity in Japanese.
A total of 528 subjects (188 men and 340 women) were enrolled in this cross-sectional study. Circulating adiponectin levels, physical activity measured by tri-axial accelerometers, peak oxygen uptake and metabolic risk parameters were evaluated. We also assessed anthropometric factors, blood pressure, blood examinations and energy intake.
Circulating adiponectin levels were 6.7 +/- A 3.0 mu g/mL in men and 11.0 +/- A 4.9 mu g/mL in women. Circulating adiponectin levels were positively correlated with physical fitness after adjusting for age, physical activity evaluated by I pound [metabolic equivalents x h per week (METs h/w)], cigarette smoking habit and energy intake in both sexes. However, these associations were attenuated further after adjusting for body mass index including other confounding factors, especially in men. However, circulating adiponectin levels were not associated with physical activity in either sex.
Circulating adiponectin levels were associated with peak oxygen uptake rather than physical activity.

beta 3-Adrenergic receptor (ADRB3) Trp64Arg polymorphism is associated with atherogenic risk factors that include weight gain, insulin resistance, and diabetes. Habitual exercise brings higher cardiorespiratory fitness and results in the amelioration of atherosclerotic risk factors. However, the effects of cardiorespiratory fitness level and ADRB3 Trp64Arg polymorphism on the risk of cardiovascular disease remain unclear. A cross-sectional investigation of 877 Japanese men and women (18-75 years old) was performed to clarify the effects of cardiorespiratory fitness on the relationship between ADRB3 Trp64Arg polymorphism and risk of cardiovascular disease.
Common carotid intima-media thickness (ccIMT) and blood lipid profiles were assessed as surrogate markers of atherosclerosis. We measured peak oxygen uptake (O-2peak) during incremental cycle ergometer exercise testing. Subjects were divided into groups with high (High-Fit) and low (Low-Fit) levels of cardiorespiratory fitness based on the median value of O-2peak for sex and decade.
Levels of body fat, triglycerides, and plasma glucose were lower and high-density lipoprotein cholesterol levels and O-2peak were higher in High-Fit subjects than Low-Fit subjects. ADRB3 Trp64Arg polymorphism did not significantly affect ccIMT or blood lipid profiles. In Low-Fit subjects, ccIMT was higher in individuals with the Arg/Arg genotype compared to the Trp/Trp and Trp/Arg genotypes (each P &lt; 0.0001); however, ADRB3 polymorphism had no effect in High-Fit subjects.
Higher levels of cardiorespiratory fitness may attenuate the risk of atherosclerosis associated with ADRB3 Trp64Arg polymorphism.

To investigate the link between serum vaspin levels and physical activity and/or physical fitness in Japanese.
A total of 156 subjects (81 men and 75 women) was enrolled in this cross-sectional study. Serum vaspin levels, physical activity by uniaxial accelerometers, peak oxygen uptake, and metabolic risk parameters were evaluated. We also assessed anthropometric and body composition parameters.
Serum vaspin levels were over the level of 10 ng/mL in 15 subjects (9.6 %: Vaspin High group). In Vaspin Low group (&lt; 5 ng/mL: 74 men and 67 women), serum vaspin levels were 0.12 +/- A 0.18 ng/mL in men and 0.39 +/- A 0.70 ng/mL in women. Peak oxygen uptake was significantly and positively correlated with serum vaspin levels even after adjusting for age, physical activity evaluated by I [metabolic pound equivalents x h per week (METsa &lt;...h/w)], BMI, and other confounding factors in men. In turn, physical activity was significantly and positively correlated with serum vaspin levels even after adjusting for confounding factors in women.
Serum vaspin levels were closely associated with physical fitness in men and physical activity in women independent of body composition in this Japanese cohort.

The ApoE gene is associated with the risk of Alzheimer or cardiovascular disease but its influence on exceptional longevity (EL) is uncertain. Our primary purpose was to determine, using a case-control design, if the ApoE gene is associated with EL. We compared ApoE allele/genotype frequencies among the following cohorts: cases (centenarians, most with 1+ major disease condition; n=163, 100-111 years) and healthy controls (n=1039, 20-85 years) from Spain; disease-free cases (centenarians; n=79, 100-104 years) and healthy controls (n=597, age 27-81 years) from Italy; and cases (centenarians and semi-supercentenarians, most with 1+ major disease condition; n=729, 100-116 years) and healthy controls (n=498, 23-59 years) from Japan. Ourmain findings were twofold. First, the epsilon 4-allele was negatively associated with EL in the three cohorts, with the following odds ratio (OR) values (adjusted by sex) having been found: 0.55 (95% confidence interval (CI): 0.33, 0.94), P = 0.030 (Spain); 0.41 (95% CI: 0.18, 0.99), P = 0.05 (Italy); and 0.35 (95% CI: 0.26, 0.57), P &lt; 0.001 (Japan). Second, although no association was found in the Spanish cohort (OR = 1.42 (95% CI: 0.89, 2.26), P = 0.145), the epsilon 2-allele was positively associated with EL in the Italian (OR = 2.14 (95% CI: 1.18, 3.45), P = 0.01) and Japanese subjects (OR = 1.81 (95% CI: 1.25, 2.63), P = 0.002). Notwithstanding the limitations of case-control designs, our data suggest that the ApoE might be a candidate to influence EL. The epsilon 4-allele appears to decrease the likelihood of reaching EL among individuals of different ethnic/geographic origins. An additional, novel finding of our study was that the epsilon 2-allele might favor EL, at least in the Italian and Japanese cohorts. (C) 2014 Elsevier Inc. All rights reserved.

The rs1333049 (G/C) polymorphism located on chromosome 9p21.3 is a candidate to influence extreme longevity owing to its association with age-related diseases, notably coronary artery disease (CAD). We compared allele/genotype distributions of rs1333049 in cases (centenarians) and controls (younger adults, without (healthy) or with CAD) in two independent cohorts: Spanish (centenarians: n = 152, 128 women, 100-111 years; healthy controls: n = 343, 212 women, age &lt; 50 years; CAD controls: n = 98, 32 women, age a parts per thousand currency sign65 years) and Japanese (centenarians: n = 742, 623 women, 100-115 years; healthy controls: n = 920, 511 women, &lt; 60 years; CAD controls: n = 395, 45 women, age a parts per thousand currency sign65 years). The frequency of the "risk" C-allele tended to be lower in Spanish centenarians (47.0 %) than in their healthy (52.9 %, P = 0.088) or CAD controls (55.1 %, P = 0.078), and significant differences were found in genotype distributions (P = 0.034 and P = 0.045), with a higher frequency of the GG genotype in cases than in both healthy and CAD controls as well as a lower proportion of the CG genotype compared with healthy controls. In the Japanese cohort, the main finding was that the frequency of the C-allele did not differ between centenarians (46.4 %) and healthy controls (47.3 %, P = 0.602), but it was significantly lower in the former than in CAD controls (57.2 %, P &lt; 0.001). Although more research is needed, the present and recent pioneer findings (Rejuvenation Res 13:23-26, 2010) suggest that the rs1333049 polymorphism could be among the genetic contributors to exceptional longevity in Southern European populations, albeit this association does not exist in the healthy (CAD-free) Japanese population.

Physical activity (PA) is associated with reductions in the risk of all-cause mortality and in the prevalence of cardiovascular disease and stroke. Nevertheless, a large proportion of the general population may not be sufficiently active. PA level has been reported to be influenced by genetic factors, and we investigated whether Q223R polymorphism in the leptin receptor (LEPR) gene was associated with PA level. A total of 556 Japanese adults aged 24-65 years old participated in this cross-sectional study. The duration and intensity of PA were objectively evaluated by triaxial accelerometry. Q223R polymorphism was determined by the TaqMan method. The distribution of Q223R polymorphism was: QQ 0.7%, QR 22.6%, and RR 76.6%. The relation between the LEPR genotype and PA level was analyzed by ANCOVA with age and sex as covariates in the Q dominant genetic model. There were significant differences between LEPR genotypes and the time spent in light PA or inactive time. The subjects with RR genotype showed significantly shorter time spent in light PA (RR genotype: 559.4 +/- 102.9 min/day, QQ/QR genotype: 579.9 +/- 103.1 min/day) and longer inactive time (RR genotype: 815.5 +/- 107.5 min/day, QQ/QR genotype: 792.3 +/- 107.7 min/day) than the subjects with QQ/QR genotype (P &lt; 0.05). There were no such differences in the time spent in moderate or vigorous PA. These results suggest that the variety of PA level, especially spontaneous PA in humans, is partly caused by diversity in the LEPR gene. (C) 2014 The Authors. Published by Elsevier Inc.

Menaquinone-4 (MK-4) administered at a pharmacological dosage of 45 mg/day has been used for the treatment of osteoporosis in Japan. However, it is not known whether a lower dose of MK-4 supplementation is beneficial for bone health in healthy postmenopausal women. The aim of this study was to examine the long-term effects of 1.5-mg daily supplementation of MK-4 on the various markers of bone turnover and bone mineral density (BMD). The study was performed as a randomized, double-blind, placebo-controlled trial. The participants (aged 50-65 years) were randomly assigned to one of two groups according to the MK-4 dose received: the placebo-control group (n = 24) and the 1.5-mg MK-4 group (n = 24). The baseline concentrations of undercarboxylated osteocalcin (ucOC) were high in both groups (&gt; 5.1 ng/ml). After 6 and 12 months, the serum ucOC concentrations were significantly lower in the MK-4 group than in the control group. In the control group, there was no significant change in serum pentosidine concentrations. However, in the MK-4 group, the concentration of pentosidine at 6 and 12 months was significantly lower than that at baseline. The forearm BMD was significantly lower after 12 months than at 6 months in the control group. However, there was no significant decrease in BMD in the MK-4 group during the study period. These results suggest that low-dose MK-4 supplementation for 6-12 months improved bone quality in the postmenopausal Japanese women by decreasing the serum ucOC and pentosidine concentrations, without any substantial adverse effects.

Purpose Weight retention during the postpartum period is critical for the later development of obesity in women. Traditional physical activity is frequently discontinued because of incompatibility with mothers' agenda (i.e., baby care). In the present study, active video games (AVG) are proposed for postpartum women to improve their body composition. Methods Thirty-four postpartum women (body mass index = 24.5 +/- 3.4 kg center dot m(-2)) were randomized to an AVG group or a control group. Subjects assigned to the AVG group were given a Wii Nintendo console with the game Wii Fit Plus for 40 d. The two groups were tested for weight, body mass index, body fat mass, waist and hip circumferences, and other anthropometric parameters. Physical fitness, energy expenditure, energy intake, and adverse events were also investigated. Results The AVG group lost more weight than the control group (-2.2 +/- 0.9 vs. -0.5 +/- 0.7 kg, P &lt; 0.001). They also exhibited more important reductions of BMI, waist and hip circumferences, and body fat (P &lt; 0.05). During the 40-d period, subjects expended an estimated 4682 +/- 2874 kcal just by playing AVG. Daily energy intake was reduced by 206 +/- 559 kcal. There were significant positive correlations between playing frequency, total playing time, total energy expenditure during the 40-d period, and decrease in daily energy intake respectively, and weight loss (P &lt; 0.05). Playing time data suggested no conflict with baby care activities. Conclusions AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention.

Although intense exercise may induce temporary immune depression, it is unclear whether exercise stimulates tumor necrosis factor-alpha (TNF-alpha) production in response to flagella protein flagellin (FG), which binds to toll-like receptor 5 (TLR5) and induces the production of pro-inflammatory cytokines. Male C3H/HeN mice were administered FG (1 mg/kg, i.v.) after exhaustive exercise (EX), and the plasma TNF-alpha concentrations were examined. The production of TNF-alpha and the TLR5 expression in both RAW264 and Caco2 cells were measured under FG conditions in vitro. Although the plasma TNF-alpha concentrations were observed to significantly increase in both the EX and non-EX (N-EX) mice (p &lt; 0.01, respectively) following PG injection, the TNF-alpha levels in the EX mice were significantly higher than those observed in the N-EX mice (p &lt; 0.01). Epinephrine (Ep) treatment accelerated the PG-induced TNF-alpha production and TLR5 expression on the Caco2, but not RAW264 cells. Interestingly, a high Ep-induced TLR5 expression was observed on the Caco2 cell surface, which was inhibited by an inhibitor of phosphoinositide-3-kinase (PI3K), Ly294002, as well as a beta-adrenergic blocker, propranolol. In addition, the EX-induced TNF-alpha production observed in response to PG was also attenuated by pretreatment with propranolol. Our findings suggest that exhaustive exercise upregulates the production of TNF-alpha in response to FG via a high expression of TLR5 on the intestinal cell surface following the stimulation of beta-adrenergic receptors with exercise. (C) 2014 Elsevier B.V. All rights reserved.

Purpose: Weight retention during the postpartum period is critical for the later development of obesity in women. Traditional physical activity is frequently discontinued because of incompatibility with mothers' agenda (i.e., baby care). In the present study, active video games (AVG) are proposed for postpartum women to improve their body composition. Methods: Thirty-four postpartum women (body mass index = 24.5 ± 3.4 kg·m) were randomized to an AVG group or a control group. Subjects assigned to the AVG group were given a Wii Nintendo console with the game Wii Fit Plus for 40 d. The two groups were tested for weight, body mass index, body fat mass, waist and hip circumferences, and other anthropometric parameters. Physical fitness, energy expenditure, energy intake, and adverse events were also investigated. Results: The AVG group lost more weight than the control group (-2.2 ± 0.9 vs. -0.5 ± 0.7 kg, P &lt
0.001). They also exhibited more important reductions of BMI, waist and hip circumferences, and body fat (P &lt
0.05). During the 40-d period, subjects expended an estimated 4682 ± 2874 kcal just by playing AVG. Daily energy intake was reduced by 206 ± 559 kcal. There were significant positive correlations between playing frequency, total playing time, total energy expenditure during the 40-d period, and decrease in daily energy intake respectively, and weight loss (P &lt
0.05). Playing time data suggested no conflict with baby care activities. Conclusions: AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention. © 2014 by the American College of Sports Medicine.

本研究は、仮設住宅に居住している東日本大震災被災者の食物摂取状況を把握することを目的とした。対象者は、18歳以上の岩手県釜石市H地区の仮設住宅居住者72名(男性22名、女性50名)であった。調査は2011年10月に実施した。1日の食物摂取状況は24時間思い出し法(24HR)を用いて評価した。また、対象者には、東日本大震災被災者健康調査の食事に関する9項目の質問票(FFQ-H)への回答を依頼した。FFQ-Hの質問項目は、数日間を振り返った1日あたりの食事回数と、8つの食品群(主食、肉、魚介類、卵、豆類、野菜、果物、乳製品)の1日あたりの摂取回数(0、1、2、3、4回以上)とした。24HRによって評価した1日あたり栄養素および食物摂取状況の中央値[25-75パーセンタイル]は、エネルギー量1903kcal[1493-2238]、総たんぱく質70.7g[47.4-84.7]、ビタミンB1 0.8mg[0.6-1.4]、ビタミンB21.3mg[0.9-1.9]、ビタミンC 86mg[50-144]、食塩相当量12.1g[8.2-14.3]、野菜類220g[158-329]、果物122g[0-161]であった。エネルギー、栄養素、群別食品の摂取状況を2009年国民健康・栄養調査の性・年齢階級別摂取量の結果と比較すると、72名中、ビタミンC48名、野菜53名、果物42名で低値であった。24HRとFFQ-Hによる食物摂取回数間の相関係数は0.03〜0.43の範囲であった。本研究の対象者である岩手県釜石市H地区の仮設住宅居住者は、2009年国民健康・栄養調査の結果と比較して、ビタミンC、野菜、果物の摂取量が少ないことが示唆された。(著者抄録)

Objective: To evaluate the association between adiponectin complexes (high-molecular-weight [HMW], middle-molecular-weight [MMW], and low-molecular-weight [LMW] adiponectin) and diabetes.
Design and Methods: We conducted a case-control study, based on a cohort in Saku, Japan. Among 2565 participants, 300 participants with diabetes and 300 matched controls (430 men and 170 women) were analyzed.
Results: After adjusting for age, physical activity, hypertension, family history, alcohol use, smoking, and menopausal status, total, HMW, and LMW, but not MMW adiponectin levels were inversely associated with diabetes: total adiponectin, odds ratio comparing the highest with the lowest quartiles, 0.46 (95% confidence interval, 0.25-0.82; P for trend = 0.046); HMW, 0.40 (95%CI, 0.22-0.72; P = 0.046); MMW, 1.04 (95%CI, 0.60-1.77; P = 0.81); and LMW, 0.51 (95%CI, 0.29-0.89; P = 0.01). The associations between total and HMW adiponectin and diabetes attenuated after adjustment for BMI (P = 0.15 and 0.13, respectively), but LMW remained (P = 0.04). When stratified by sex, LMW adiponectin levels were associated with diabetes in men only. None of the associations were significant after adjustment for HOMA-IR.
Conclusions: Decreased LMW, total, and HMW adiponectin levels are associated with diabetes. These associations may be secondary to adiposity or insulin resistance.

The ACTN3 R577X genotype has been found to associate with sprint/power phenotypes in all elite athlete cohorts investigated. This association has not been extensively studied in elite Asian athletes. The present study was undertaken to investigate the association between the ACTN3 R577X genotype and elite Japanese track and field athlete status. 299 elite Japanese track and field athletes (134 sprint/power athletes; 165 endurance/middle-power athletes) and 649 Japanese controls were genotyped for the ACTN3 R577X polymorphism. All athletes were of national or international level. Sprint/power athletes showed a higher frequency of RR+RX genotype than controls (111/134 [82.8%] vs. 478/649 [73.7%], P=0.025 under the R-dominant model), while there was no significant difference between endurance/middle-power athletes and controls (126/165 [76.4%] vs. 478/649 [73.7%], P=0.48 under the R-dominant model). Sprinters with the RR+RX genotype had significantly faster personal best times for the 100m than those with XX genotype (10.42 +/- 0.05s vs. 10.64 +/- 0.09s, P=0.042); no such association was found in the 400m sprinters (47.02 +/- 0.36s vs. 47.56 +/- 0.99s, P=0.62). ACTN3 R577X genotype is associated with sprint/power performance in elite Japanese track and field athletes, especially short sprint performance.

OBJECTIVES: This study aimed to examine the association between meeting the reference value for physical activity (PA) defined in the &quot;Physical activity reference for health promotion 2013&quot; recommendations or incremental increases in PA (add 10-minute per day) and the prevalence of metabolic syndrome (MS).METHODS: A total of 906 adults aged 23-64 years participated in this cross-sectional study. The amount of moderate to vigorous PA was measured with a tri-axial accelerometer. The participants were classified into 2 groups-those with a PA level greater than or equal to the reference value of 23 metabolic equivalents (METs)-hours/week versus those with a PA level less than the reference value. Pre-MS and MS were determined based on the diagnostic criteria used in Japan. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of pre-MS and MS by adherence with the PA reference value were analyzed using a multivariable logistic regression model. Furthermore, adjusted ORs were calculated for each 3.5 METs-hours/week increase in PA, which is comparable to 10-minute increments of PA such as walking.RESULTS: The prevalence rates of pre-MS and MS were 10.3% (n=93) and 4.4% (n=40), respectively. The adjusted OR (95% CI) for the prevalence of pre-MS/MS among the participants meeting the PA reference compared with those not meeting the reference was 0.49 (0.33-0.74). Each 3.5 METs-hours/week increase in PA was associated with a lower adjusted OR for the prevalence of pre-MS/MS (OR 0.92, 95% CI 0.87-0.98).CONCLUSION: Our results suggest that meeting the reference value for PA (as defined in the &quot;Physical activity reference for health promotion 2013&quot; recommendations) and an increase in PA (add 10-minute) are both associated with a lower prevalence of pre-MS/MS.

OBJECTIVES: The mean number of steps measured in the National Health and Nutrition Survey is employed for the assessment of physical activity/exercise in &quot;Health Japan 21,&quot; and is used to represent the amount of physical activity/exercise that citizens engage in. In this study, we clarified the characteristics of the data on the number of steps, drawn from the National Health and Nutrition Survey.METHODS: Among the data from the National Health and Nutrition Surveys conducted from 2008 to 2010, data from 21,914 participants on daily number of steps and pedometer attachment were analyzed. On a nutritional intake questionnaire, subjects who responded on the physical status item that they had attached the pedometer all day long were assigned to the &quot;Whole-day-attached&quot; group. Their means, medians, outliers, and frequency distribution were then compared with those in a &quot;Non- whole-day-attached&quot; group.RESULTS: Subjects assigned to the &quot;Non- whole-day-attached&quot; group accounted for about 8% of cases in 2008, 2009, and 2010. In all three years, the mean number of steps in the &quot;Whole-day-attached&quot; group was 1,076 to 1,472 higher than that in the &quot;Non-whole-day-attached&quot; group. In both groups, outliers were present, and the frequency distribution showed a broad range on the side indicating a higher number of steps. Accordingly, the mean value was higher than the median value by approximately 600 steps.CONCLUSION: As data on the number of steps measured in the National Health and Nutrition Survey includes individuals not attaching the pedometer all day (approximately 8% of cases), the data are not normally distributed. Therefore, when utilizing these data as representative of citizens&#039; physical activity/exercise, their characteristics should be taken into consideration.

BACKGROUND: Several active video game (AVG) intervention studies failed in showing an increase in physical activity by using accelerometry measurements.
OBJECTIVE: To test the validity of accelerometry for monitoring AVG playing intensity.
METHOD: Twenty-two adults performed 80 activities included in the Wii Sports and Wii Fit Plus series. The energy expenditure (EE) and subsequent MET values were measured by indirect calorimetry using metabolic chambers. Subjects wore an accelerometer-based monitor displaying MET values. For each activity, METs values obtained from indirect calorimetry and accelerometry were compared. Each activity was classified as light or moderate to vigorous physical activity (LPA: &lt; 3METs or MVPA: &gt;= 3METs) for the two methods.
RESULTS: AVG intensities have been slightly but significantly underestimated by the acceleromater-based monitor compared to the indirect calorimetry (2.5 +/- 1.0 instead of 2.7 +/- 0.9 METs). Fourty percent of activities have been significantly misestimated, and 20% have been misclassified.
CONCLUSION: Those results point out the potential bias of accelerometry measurements for evaluating AVG intensities. Because average AVG intensity lays at the boundary between LPA and MVPA classes, misclassifications can frequently occur. Accelerometry data should be interpreted with caution in intervention studies using AVG.

This study investigated the longitudinal changes in the physical activity of the Great East Japan Earthquake victims living in temporary housing. Thirty-nine residents (10 men and 29 women) living in temporary housing in Kamaishi City, Iwate Prefecture, participated in a health survey in 2012. Among these residents, 31 who also participated in a health survey in 2011 were included in a longitudinal study of physical activity. The physical activity for two weeks after the health survey was measured using a tri-accelerometer. During the one-year period from 2011 to 2012, the median daily step counts changed from 4,959 (interquartile range: 2,910-6,029) steps/day to 4,618 (interquartile range: 3,007-7,123) steps/day. The step counts increased for 18 people (56%). The amount of moderate to vigorous physical activity changed from 13.3 (interquartile range: 7.7-22.4) METs h/week to 16.1 (interquartile range: 6.3-25.2) METs h/week. An increase in daily step counts occurred for 14 out of 21 subjects who were &lt;65 years old (67%) and only 3 out of 10 subjects who were ≥65 years old (30%). It was suggested that physical activity levels increased because the interquartile range of step counts moved in the direction of an increase and the median amount of moderate to vigorous physical activity increased. However, increasing support for physical activity in the future is required because the physical activity levels of the Great East Japan Earthquake victims who were living in temporary housing were still low compared to the national and regional averages.

Background: It is unclear whether light physical activity is beneficially associated with insulin resistance, similar to moderate and/or vigorous physical activity. This cross-sectional study was performed to determine the relationship between the amount of light physical activity, as determined with a triaxial accelerometer, and insulin resistance. Methods: A total of 807 healthy men and women participated in this study. Physical activity was measured using a triaxial accelerometer worn for 28 days and summarized as light intensity (1.1-2.9 METs) or moderate to vigorous intensity (≥ 3.0 METs). Insulin resistance was evaluated by HOMA-R (FPG [mg/dL] × IRI [μU/mL]/405). Results: The daily time spent in light physical activity was inversely associated with HOMA-R (r = -0.173, P &lt
0.05). After adjustment for confounders, the association between light physical activity and HOMA-R remained statistically significant (β = -0.119, P &lt
.05). Light physical activity remained significantly associated with HOMA-R following further adjustment for moderate to vigorous intensity activity (β = -0.125, P &lt
.05). Similar results were observed when light physical activity was modeled as quartiles, especially in elderly women. Conclusions: These cross-sectional data suggest that light-intensity physical activity is beneficially associated with insulin resistance in elderly Japanese women. © 2014 Human Kinetics, Inc..

Background: In "Physical Activity Reference for Health Promotion 2013" the Japan Ministry of Health, Labour and Welfare publication gives reference values for cardiorespiratory fitness (CRF) required for good health. We examined the associations between the CRF reference values and incidence of type 2 diabetes.
Methods: This prospective cohort study enrolled 4633 nondiabetic Japanese men aged 20 to 39 years at baseline. CRF was measured using the cycle ergometer test, and maximal oxygen uptake was estimated. On the basis of the CRF reference value, participants were classified into 2 groups: those with values less than the reference value (under-RV) and those with values equal to or greater than reference value (over-RV). Hazard ratios (HRs) and 95% CIs for incident type 2 diabetes were estimated using a Cox proportional hazards model.
Results: A total of 266 participants developed type 2 diabetes during the 14 years of follow-up. As compared with the under-RV group, the over-RV group had a significantly lower multivariable-adjusted HR for type 2 diabetes (HR 0.67; 95% CI, 0.51-0.89). In receiver operating characteristic analysis, the optimal CRF cut-off value for predicting incident type 2 diabetes was 10.8 metabolic equivalents (sensitivity, 0.64; specificity, 0.64), which was close to the CRF reference value of 11.0 metabolic equivalents.
Conclusions: The reference CRF value appears to be reasonably valid for prevention of type 2 diabetes, especially among Japanese men younger than 40 years. Development of type 2 diabetes can be prevented by maintaining a CRF level above the reference value.

The objective of the present study was to investigate whether a previously reported apparent negative relationship between fat mass and daily physical activity in Japanese adult women would also be observed in Japanese adult men. The subjects were grouped into quartiles of BMI and body fat percentage (%BF). The number of steps walked each day and the duration of light- to vigorous-intensity physical activity were assessed by an accelerometer over the same period of time as for the doubly labelled water experiment. The results showed that BMI negatively correlated with the number of steps and time spent in moderate-intensity physical activity, whereas %BF showed a negative relationship with physical activity-related energy expenditure (PAEE)/body weight (BW) and physical activity level. The analysis of data using %BF quartiles revealed that PAEE/BW decreased from the second quartile in which the BMI was &lt;25kg/m(2). These observations are similar to those reported in our previous study in Japanese adult women. These cross-sectional studies cannot prove causality, and that obesity causes physical inactivity may be the case. However, the results of the present study provide information regarding which physical activity variables should be used in longitudinal studies.

Objectives This study investigated the longitudinal changes in the physical activity of the Great East Japan Earthquake victims living in temporary housing.<br/>Methods Thirty-nine residents (10 men and 29 women) living in temporary housing in Kamaishi City, Iwate Prefecture, participated in a health survey in 2012. Among these residents, 31 who also participated in a health survey in 2011 were included in a longitudinal study of physical activity. The physical activity for two weeks after the health survey was measured using a tri-accelerometer.<br/>Results During the one-year period from 2011 to 2012, the median daily step counts changed from 4,959 (interquartile range: 2,910–6,029) steps/day to 4,618 (interquartile range: 3,007–7,123) steps/day. The step counts increased for 18 people (56%). The amount of moderate to vigorous physical activity changed from 13.3 (interquartile range: 7.7–22.4) METs h/week to 16.1 (interquartile range: 6.3–25.2) METs h/week. An increase in daily step counts occurred for 14 out of 21 subjects who were <65 years old (67%) and only 3 out of 10 subjects who were ≥65 years old (30%).<br/>Conclusion It was suggested that physical activity levels increased because the interquartile range of step counts moved in the direction of an increase and the median amount of moderate to vigorous physical activity increased. However, increasing support for physical activity in the future is required because the physical activity levels of the Great East Japan Earthquake victims who were living in temporary housing were still low compared to the national and regional averages.

BACKGROUND:It is unclear whether light physical activity is beneficially associated with insulin resistance, similar to moderate and/or vigorous physical activity. This cross-sectional study was performed to determine the relationship between the amount of light physical activity, as determined with a triaxial accelerometer, and insulin resistance.;METHODS:A total of 807 healthy men and women participated in this study. Physical activity was measured using a triaxial accelerometer worn for 28 days and summarized as light intensity (1.1-2.9 METs) or moderate to vigorous intensity (≥ 3.0 METs). Insulin resistance was evaluated by HOMA_R (FPG [mg/dL] × IRI [μU/mL]/405).;RESULTS:The daily time spent in light physical activity was inversely associated with HOMA_R (r = -0.173, P &lt; 0.05). After adjustment for confounders, the association between light physical activity and HOMA_R remained statistically significant (β = -0.119, P &lt; .05). Light physical activity remained significantly associated with HOMA_R following further adjustment for moderate to vigorous intensity activity (β = -0.125, P &lt; .05). Similar results were observed when light physical activity was modeled as quartiles,

Background: In "Physical Activity Reference for Health Promotion 2013" the Japan Ministry of Health, Labour and Welfare publication gives reference values for cardiorespiratory fitness (CRF) required for good health. We examined the associations between the CRF reference values and incidence of type 2 diabetes.
Methods: This prospective cohort study enrolled 4633 nondiabetic Japanese men aged 20 to 39 years at baseline. CRF was measured using the cycle ergometer test, and maximal oxygen uptake was estimated. On the basis of the CRF reference value, participants were classified into 2 groups: those with values less than the reference value (under-RV) and those with values equal to or greater than reference value (over-RV). Hazard ratios (HRs) and 95% CIs for incident type 2 diabetes were estimated using a Cox proportional hazards model.
Results: A total of 266 participants developed type 2 diabetes during the 14 years of follow-up. As compared with the under-RV group, the over-RV group had a significantly lower multivariable-adjusted HR for type 2 diabetes (HR 0.67; 95% CI, 0.51-0.89). In receiver operating characteristic analysis, the optimal CRF cut-off value for predicting incident type 2 diabetes was 10.8 metabolic equivalents (sensitivity, 0.64; specificity, 0.64), which was close to the CRF reference value of 11.0 metabolic equivalents.
Conclusions: The reference CRF value appears to be reasonably valid for prevention of type 2 diabetes, especially among Japanese men younger than 40 years. Development of type 2 diabetes can be prevented by maintaining a CRF level above the reference value.

The purpose of the present study was to identify mitochondrial DNA (mtDNA) polymorphisms and rare variants that associate with elite Japanese athletic status. Subjects comprised 185 elite Japanese athletes who had represented Japan at international competitions (that is, 100 endurance/middle-power athletes: EMA; 85 sprint/power athletes: SPA) and 672 Japanese controls (CON). The entire mtDNA sequences (16 569 bp) were analyzed by direct sequencing. Nucleotide variants were detected at 1488 sites in the 857 entire mtDNA sequences. A total of 311 variants were polymorphisms (minor allele frequency &gt;= 1% in CON), and the frequencies of these polymorphisms were compared among the three groups. The EMA displayed excess of seven polymorphisms, including subhaplogroup D4e2- and D4g-specific polymorphisms, compared with CON (P &lt; 0.05), whereas SPA displayed excess of three polymorphisms and dearth of nine polymorphisms, including haplogroup G-and subhaplogroup G2a-specific polymorphisms, compared with CON (P &lt; 0.05). The frequencies of 10 polymorphisms, including haplogroup G-and subhaplogroup G2a-specific polymorphisms, were different between EMA and SPA (P &lt; 0.05): although none of these polymorphisms differed significantly between groups after correcting for multiple comparison (false discovery rate q-value &gt;= 0.05). The number of rare variants in the 12S ribosomal RNA and NADH dehydrogenase subunit I genes were also higher in SPA than in CON (P &lt; 0.05). Analysis of the entire mtDNA of elite Japanese athletes revealed several haplogroupand subhaplogroup-specific polymorphisms to be potentially associated with elite Japanese athletic status.

Objectives: Age-related arterial stiffening and reduction of arterial elasticity are attenuated in individuals with high levels of cardiorespiratory fitness. Viscosity is another mechanical characteristic of the arterial wall; however, the effects of age and cardiorespiratory fitness have not been determined. We examined the associations among age, cardiorespiratory fitness and carotid arterial wall viscosity.
Methods: A total of 111 healthy men, aged 25-39 years (young) and 40-64 years (middle-aged), were divided into either cardiorespiratory fit or unfit groups on the basis of peak oxygen uptake. The common carotid artery was measured noninvasively by tonometry and automatic tracking of B-mode images to obtain instantaneous pressure and diameter hysteresis loops, and we calculated the effective compliance, isobaric compliance and viscosity index.
Results: In the middle-aged men, the viscosity index was larger in the unfit group than in the fit group (2533 vs. 2018 mmHg.s/mm, respectively: P&lt;0.05), but this was not the case in the young men. In addition, effective and isobaric compliance were increased, and viscosity index was increased with advancing age, but these parameters were unaffected by cardiorespiratory fitness level.
Conclusion: These results suggest that the wall viscosity in the central artery is increased with advancing age and that the age-associated increase in wall viscosity may be attenuated in cardiorespiratory fit men.

Objective: To investigate the link between serum interleukin-18 (IL-18) levels and physical activity in Japanese men.
Methods: A total of 81 men (45.7617.6 years old) was enrolled in this cross-sectional investigation study. We assessed anthropometric and body composition parameters. Serum IL-18 levels, physical activity by uniaxial accelerometers, peak oxygen uptake and metabolic risk parameters were also evaluated.
Results: Serum IL-18 levels were 179.4 +/- 84.7 pg/mL. Physical activity evaluated by Sigma[metabolic equivalents x h per week (METs.h/w)] was significantly and negatively correlated with serum IL-18 levels (r = -0.252, p = 0.0235). These associations remained even after adjusting for age, peak oxygen uptake and other confounding factors.
Conclusion: Serum IL-18 levels were closely associated with physical activity independent of peak oxygen uptake in Japanese men.

Objective: Lower birth weight is associated with higher insulin resistance in later life. The aim of this study was to determine whether cardiorespiratory fitness modifies the association of birth weight with insulin resistance in adults.
Methods: The subjects were 379 Japanese individuals (137 males, 242 females) aged 20-64 years born after 1943. Insulin resistance was assessed using a homeostasis model assessment of insulin resistance (HOMA-IR), which is calculated from fasting blood glucose and insulin levels. Cardiorespiratory fitness (maximal oxygen uptake, VO(2)max) was assessed by a maximal graded exercise test on a cycle ergometer. Birth weight was reported according to the Maternal and Child Health Handbook records or the subject's or his/her mother's memory.
Results: The multiple linear regression analysis revealed that birth weight was inversely associated with HOMA-IR (beta = -0.141, p = 0.003), even after adjustment for gender, age, current body mass index, mean blood pressure, triglycerides, HDL cholesterol, and smoking status. Further adjustments for VO(2)max made little difference in the relationship between birth weight and HOMA-IR (beta = -0.148, p = 0.001), although VO(2)max (beta = -0.376, p&lt;0.001) was a stronger predictor of HOMA-IR than birth weight.
Conclusions: The results showed that the association of lower birth weight with higher insulin resistance was little modified by cardiorespiratory fitness in adult life. However, cardiorespiratory fitness was found to be a stronger predictor of insulin resistance than was birth weight, suggesting that increasing cardiorespiratory fitness may have a much more important role in preventing insulin resistance than an individual's low birth weight.

Background: During the year after the Great East Japan Earthquake on March 11, 2011, the health conditions and lifestyles of survivors were extensively surveyed. We examined the relationship between living conditions and dietary pattern among survivors.
Methods: A total of 10 466 survivors aged 18 years or older (25% of the population of that age in the area) participated in a survey of Iwate Prefecture. The average frequency of daily consumption of 8 food groups was determined by questionnaire. After excluding staple foods, which were consumed 3 times a day by 5% of participants, factor analysis was performed on 7 food groups among 9789 people (3795 men, 5994 women).
Results: Factor analysis identified 2 dietary patterns-prudent and meat. The prudent dietary pattern is characterized by high intakes of fish and shellfish, soybean products, vegetables, fruit, and dairy products and was more evident among older participants and women. The meat dietary pattern is characterized by high intakes of meat and eggs and was more evident among younger participants and men. Age-adjusted multiple logistic regression analyses showed that male and female current smokers and men and women living in difficult conditions were likely to have a lower prudent dietary pattern score; male current smokers and male daily alcohol drinkers were likely to have a higher meat dietary pattern score.
Conclusions: During the year after the earthquake, the prudent dietary pattern was associated with better living conditions among survivors, whereas the meat dietary pattern was not.

Background: Diabetes is an important risk factor for cardiovascular disease, certain types of cancer, and death, and self-reports are one of the most convenient methods for ascertaining diabetes status. We evaluated the validity of diabetes self-reports among Japanese who participated in a health checkup.
Methods: Self-reported diabetes was cross-sectionally compared with confirmed diabetes among 2535 participants aged 28 to 85 years in the Saku cohort study. Confirmed diabetes was defined as the presence of at least 1 of the following: fasting plasma glucose (FPG) level of 126 mg/dL or higher, 2-hour post-load glucose (2-hPG) level of 200 mg/dL or higher after a 75-gram oral glucose tolerance test, glycated hemoglobin (HbA1c) level of 6.5% or higher, or treatment with hypoglycemic medication(s).
Results: Of the 251 participants with self-reported diabetes, 121 were taking hypoglycemic medication(s) and an additional 69 were classified as having diabetes. Of the 2284 participants who did not self-report diabetes, 80 were classified as having diabetes. These data yielded a sensitivity of 70.4%, a specificity of 97.3%, a positive predictive value of 75.7%, and a negative predictive value of 96.5%. The frequency of participants with undiagnosed diabetes was 3.0%. Of these, 64.2% had FPG within the normal range and were diagnosed by 2-hPG and/or HbA1c.
Conclusions: Our findings provide additional support for the use of self-reported diabetes as a measure of diabetes in epidemiologic studies performed in similar settings in Japan if biomarker-based diagnosis is difficult.

We investigated the effect of macrophage differentiation on the chemotactic activity to invade local damaged myoblasts using in vitro models of muscle injury. We found that: 1) the chemotactic activity of macrophages toward areas of damaged myoblasts might be induced more by live myoblasts than dead ones, 2) the chemotactic activity of macrophages is not due to velocity, but depends on the directionality toward damaged myoblast cells, and 3) macrophage differentiation strongly influence the chemotactic activity toward damaged myoblast cells through the expression of CCR2 and/or F-actin. (c) 2013 Elsevier B.V. All rights reserved.

PURPOSE: Polymorphic variation in the angiotensin-converting enzyme (ACE) and α-actinin-3 (ACTN3) genes has been reported to be associated with endurance and/or power-related human performance. Our aim was to investigate whether polymorphisms in ACE and ACTN3 are associated with elite swimmer status in Caucasian and East Asian populations. METHODS: ACE I/D and ACTN3 R577X genotyping was carried out for 200 elite Caucasian swimmers from European, Commonwealth, Russian, and American cohorts (short and middle distance, ≤400 m, n = 130; long distance, >400 m, n = 70) and 326 elite Japanese and Taiwanese swimmers (short distance, ≤100 m, n = 166; middle distance, 200-400 m, n = 160). Genetic associations were evaluated by logistic regression and other tests accommodating multiple testing adjustment. RESULTS: ACE I/D was associated with swimmer status in Caucasians, with the D allele being overrepresented in short-and-middle-distance swimmers under both additive and I-allele-dominant models (permutation test P = 0.003 and P = 0.0005, respectively). ACE I/D was also associated with swimmer status in East Asians. In this group, however, the I allele was overrepresented in the short-distance swimmer group (permutation test P = 0.041 and P = 0.0098 under the additive and the D-allele-dominant models, respectively). ACTN3 R577X was not significantly associated with swimmer status in either Caucasians or East Asians. CONCLUSIONS: ACE I/D associations were observed in these elite swimmer cohorts, with different risk alleles responsible for the associations in swimmers of different ethnicities. The functional ACTN3 R577X polymorphism did not show any significant association with elite swimmer status, despite numerous previous reports of associations with "power/sprint" performance in other sports.

Background Regular aerobic exercise prevents and reverses arterial stiffening, but the association between resistance training and arterial stiffness is unclear.
Aim This study was performed to conduct a systematic review and meta-analysis of randomised controlled clinical trials (RCTs) assessing the associations between resistance training and changes in arterial stiffness.
Methods MEDLINE and SPORTDiscus databases were searched from January 1980 through to April 2011. RCTs evaluating the ability of resistance training to increase arterial stiffness in comparison with a control group were included in the meta-analysis. Two independent reviewers extracted data and assessed the quality of the included studies. Data from 185 reports of eight RCTs (193 participants) were included. Pooled mean differences in arterial stiffness indices (carotid arterial beta stiffness and pulse wave velocity (PWV)) between intervention and control groups were calculated using a random-effects model.
Results The overall association of resistance training versus control with relative changes in carotid beta index or PWV (eight studies; 193 participants) was 10.7% (95% CI 3.4% to 18.0%; I-2, 89%; heterogeneity, p&lt;0.001). Five studies indicated that resistance training in young subjects (n=115) was significantly associated with an increase in stiffness index of 14.3% (95% CI 8.5% to 20.1%; I-2, 71%; heterogeneity, p&lt;0.001) compared with controls. However, three studies showed that resistance training in middle-aged subjects (n=78) was not associated with changes in arterial stiffness. In addition, although high-intensity resistance training (n=87) was significantly associated with an increase in stiffness of 11.6%, moderate-intensity resistance training (n=106) showed no such association.
Conclusion High-intensity resistance training is associated with increased arterial stiffness in young subjects with low baseline levels of arterial stiffness.

Preproghrelin gene single-nucleotide polymorphisms are possible predisposing factors to obesity and other metabolic syndromes. To study the correlation between genotypes and obesity, we recruited 117 obese Japanese women (BMI, 25.0-41.1; average, 31.1). Minor homozygotes for five preproghrelin gene polymorphisms, namely, -1500C &gt; G (rs3755777), -1062G &gt; C (rs26311), -994C &gt; T (rs26312) (promoter region), Leu72Met (rs696217) (exon 2), and +3056T &gt; C (rs2075356) (intron 2), had high values of total and visceral fat areas, waist circumference, and BMI, indicating significant correlation of the polymorphisms with obesity and fat metabolism. Here, we studied the relationship between the genotypes and dietary tendency. Self-administered Diet History Questionnaire showed that total food intake, sugar, and dairy product intake were low in +3056C/C women. Their energy, protein, fat, and meat intake was also low. Energy balance calculation showed considerably reduced fat and protein consumption. Dietary habits were surveyed using Sakata's Questionnaire on Eating Behavior. Of the genotypes, -1062C/C women showed low scores for "motivation for eating" and "eating because of stress or something else." Thus, surprisingly, it was revealed that minor homozygotes for preproghrelin gene polymorphisms were light eaters, did not prefer fat or protein, and apparently had a poor appetite, although they were predisposed to obesity. (C) 2012 Elsevier Ltd. All rights reserved.

Background: A reduction in adiposity may be associated with an improvement in insulin sensitivity and beta-cell function as well as cardiovascular disease (CVD) risk factors; however, few studies have investigated these associations in a longitudinal setting.
Methods: To investigate these associations over a 1-year period, we conducted an observational analysis of 196 Japanese subjects with obesity in the Saku Control Obesity Program. We investigated the relations between changes in adiposity (body mass index [BMI], waist circumference, subcutaneous fat area [SFAT], and visceral fat area [VFAT]) and changes in HbA1c, fasting plasma glucose (FPG), insulin sensitivity index (ISI), the homeostasis model assessment beta cell function (HOMA-beta), lipids, and blood pressure.
Results: All adiposity changes were positively associated with HbA1c and FPG changes. Reductions in BMI and VFAT were associated with HOMA-beta reduction. Reductions in all adiposity measures were associated with an improvement in the ISI. Changes in most adiposity measures were positively associated with changes in blood pressure and lipid levels, except for LDL.
Conclusion: The present findings provide additional supportive evidence indicating that a reduction in adiposity may lead to an improvement in insulin sensitivity and the reduction of CVD risk factors in obese individuals.

Fujie S, Iemitsu M, Murakami H, Sanada K, Kawano H, Gando Y, Kawakami R, Miyachi M. Higher cardiorespiratory fitness attenuates arterial stiffening associated with the Ala54Thr polymorphism in FABP2. Physiol Genomics 45: 237-242, 2013. First published January 29, 2013; doi:10.1152/physiolgenomics.00089.2012.-Fatty acid binding protein 2 (FABP2) Ala54Thr polymorphism is a candidate gene associated with the risk of cardiovascular disease. Habitual exercise brings higher cardiorespiratory fitness and results in the improvement of cardiovascular disease risk. However, the effect of cardiorespiratory fitness level and FABP2 Ala54Thr polymorphism on the risk of cardiovascular diseases remains unclear. In the present study, a cross-sectional investigation of 837 Japanese men and women was performed to clarify the effects of cardiorespiratory fitness on the relationship between risk of cardiovascular disease and FABP2 Ala54Thr gene polymorphism. The study subjects were divided into high-cardiorespiratory fitness (High-Fit) and low-cardiorespiratory fitness (Low-Fit) groups based on the median value of peak oxygen uptake in each sex and decade. The FABP2 Ala54Thr polymorphism did not significantly affect carotid beta-stiffness or blood pressure. In the Low-Fit group, carotid beta-stiffness, systolic blood pressure, and diastolic blood pressure were higher for individuals with the Ala/Ala genotype compared with those with the Ala/Thr or Thr/Thr genotype, whereas no differences were observed in the High-Fit group. Additionally, serum triglyceride and plasma glucose levels were lower and serum high-density lipoprotein cholesterol levels were higher in the High-Fit group compared with the Low-Fit group; the FABP2 Ala54Thr polymorphism did not significantly affect these parameters. These results suggest that the higher cardiorespiratory fitness may attenuate the changes in central arterial stiffness and blood pressure that are associated with the FABP2 genotype.

This study was performed to assess the validity and reproducibility of a questionnaire on physical activity status used for health surveying among victims of the Great East Japan Earthquake. Seventy-four residents (21 men and 53 women) living in temporary housing in Kamaishi City, Iwate Prefecture, participated in this study. The physical activity status questionnaire was composed of 4 questions regarding the frequency of performing domestic and occupational physical activities, the frequency of leaving their residence, walking duration per day, and sedentary time. The physical activity level for 2 weeks was measured using a tri-accelerometer to validate the responses to the questionnaire. Test-retest reproducibility was examined at 2-week intervals. The physical activity levels were 4,521 +/- 2,266 steps/day for men and 4,533 +/- 2,070 steps/day for women. There was a significant difference in step count between those responding differently to the 3 options in the questionnaire regarding average walking duration per day: those who reported walking for &gt; or = 60 min, 30-60 min, or &lt; or = 30 min had step counts of 5,343 +/- 1,757, 4,760 +/- 1,752, and 3,063 +/- 1,772 steps/day, respectively (P &lt; 0.05). When the response options for 3 questions (excluding those for sedentary time) were given scores (a higher score for a higher physical activity level), there were significant correlations between question score and step count (r = 0.486, P &lt; 0.05) and the amount of moderate to vigorous physical activity (r = 0.342, P &lt; 0.05). The test-retest trial showed a moderate degree of reproducibility, with weighted K coefficients of 0.41-0.65. Three questions on physical activity levels may allow assessment of an individual&#039;s physical activity level, with a moderate degree of reproducibility.

The authors investigated the effects of low-intensity resistance training on muscle size and strength in older men and women. Thirty-five participants (age 59-76 yr) were randomly assigned to 2 groups and performed low-intensity (50% of 1-repetition maximum) knee-extension and -flexion exercises with either slow movement and tonic force generation (LST; 3-s eccentric, 3-s concentric, and 1-s isometric actions with no rest between repetitions) or normal speed (LN; 1-s concentric and 1-s eccentric actions with 1-s rests between repetitions) twice a week for 12 wk (2-wk preparation and 10-wk intervention). The LST significantly increased thigh-muscle thickness, as well as isometric knee-extension and -flexion strength. The LN significantly improved strength, but its hypertrophic effect was limited. These results indicate that even for older individuals, the LST can be an effective method for gaining muscle mass and strength.

Several studies have shown that low cardiorespiratory fitness (CRF) or heavy alcohol consumption is risks of total or certain types of cancer death. However, the combined influence of CRF and drinking habits on total cancer mortality is not clear. The purpose of this study was to investigate the joint effect of CRF and drinking habits on total cancer mortality among Japanese men. We evaluated the CRF and drinking habits on risk of total cancer mortality in 8,760 Japanese men (age: 19-59 yr) who were given a submaximal exercise test, a medical examination test, and questionnaires on their health habits. CRF was measured using a cycle ergometer test, and the men were classified into two categories by CRF levels based on the reference value of CRF (R-CRF) in "Physical Activity Reference for Health Promotion 2013" (Under R-CRF and Over R-CRF). Also, the men were assigned to Non Drinking, Moderate Drinking, and Heavy Drinking categories. There were 178 cancer deaths during the 20-yr follow-up period. Relative risk and 95% confidence intervals for total cancer mortality were obtained using the Cox proportional hazards model while adjusting for age, body mass index, systolic blood pressure, and smoking habits. Using the Under R-CRF &amp
Heavy Drinking group as reference, the relative risk and 95% confidence intervals were 0.37 (0.16-0.85) for the Over R-CRF &amp
Non Drinking group. This result suggests that Japanese male with a high CRF and a low drinking habit have a lower risk of total cancer mortality.

Objectives This study was performed to assess the validity and reproducibility of a questionnaire on physical activity status used for health surveying among victims of the Great East Japan Earthquake.<br/>Methods Seventy-four residents (21 men and 53 women) living in temporary housing in Kamaishi City, Iwate Prefecture, participated in this study. The physical activity status questionnaire was composed of 4 questions regarding the frequency of performing domestic and occupational physical activities, the frequency of leaving their residence, walking duration per day, and sedentary time. The physical activity level for 2 weeks was measured using a tri-accelerometer to validate the responses to the questionnaire. Test-retest reproducibility was examined at 2-week intervals.<br/>Results The physical activity levels were 4,521±2,266 steps/day for men and 4,533±2,070 steps/day for women. There was a significant difference in step count between those responding differently to the 3 options in the questionnaire regarding average walking duration per day: those who reported walking for ≥60 min, 30-60 min, or ≤30 min had step counts of 5,343±1,757, 4,760±1,752, and 3,063±1,772 steps/day, respectively (P<0.05). When the response options for 3 questions (excluding those for sedentary time) were given scores (a higher score for a higher physical activity level), there were significant correlations between question score and step count (r=0.486, P<0.05) and the amount of moderate to vigorous physical activity (r=0.342, P<0.05). The test-retest trial showed a moderate degree of reproducibility, with weighted κ coefficients of 0.41-0.65.<br/>Conclusion Three questions on physical activity levels may allow assessment of an individual's physical activity level, with a moderate degree of reproducibility.

Conclusion: Haplogroup D4b, especially subhaplogroup D4b2, may be one of the modifiers associated with the phenotypic expression of hereditary hearing loss (HL). Objectives: The present study investigated the association between suspected hereditary HL and 12 major mtDNA haplogroups in a Japanese population. Besides the mutations of mitochondrial DNA, many modifiers including environmental factors and genetic polymorphisms are involved in HL. Methods: The subjects comprised 373 unrelated Japanese patients with suspected hereditary HL and 480 controls. Twenty of the 373 patients were excluded from the study because the m. 1555A&gt;G or the m. 3243A&gt;G mutation had been detected in them. The mitochondrial haplotypes were classified into 12 major Japanese haplogroups (i.e. F, B, A, N9a, N9b, M7a, M7b, G1, G2, D4a, D4b, and D5). The frequency of each haplogroup in patients with HL was compared with that of the controls using the chi-squared test. Results: The frequency of the HL patients carrying the mitochondrial haplogroup D4b was significantly higher than that of the controls (37/353 [10.5%] vs 31/480 [6.5%]; OR 1.70 [95% CI 1.03-2.79, p = 0.036]) and evidence for enhancement was found in subhaplogroup D4b2 (32/353 [9.1%] vs 24/480 [5%], OR 1.89 [95% CI 1.09-3.28, p = 0.021]).

In this article, we determine the reference values for sarcopenia, and test the hypothesis that sarcopenia is associated with risk factors for cardiovascular disease. Moreover, we develop prediction models of sarcopenia in Japanese men and women. A total of 1,488 Japanese men and women, aged 18-85 years, participated in this study. Appendicular muscle mass (AMM) was measured by dual-energy X-ray absorptiometry. Reference values for classes 1 and 2 sarcopenia (skeletal muscle index; AMM/height², kg･m^-2) in each sex were defined as values one and two standard deviations below the sex-specific means of reference values obtained in this study from young adults aged 18-40 years. The reference values for classes 1 and 2 sarcopenia were 7.77 kg･m^-2 and 6.87 kg･m^-2 in men, and 6.12 kg･m^-2 and 5.46 kg･m^-2 in women, respectively. In subjects with both class 1 and class 2 sarcopenia, body mass index and % body fat were significantly lower than in normal subjects. Despite this, whole blood glycohaemoglobin A1c in men with class 1 sarcopenia was significantly higher than in normal subjects, and brachial-ankle pulse wave velocity in women, with both class 1 and class 2 sarcopenia, was significantly higher than in normal subjects. Stepwise regression analysis indicated that the body mass index (BMI), waist circumference, and age were independently associated with skeletal mass index (SMI) in men; and BMI, handgrip strength, and waist circumference were independently associated with SMI in women. The SMI prediction equations were applied to the validation group, and strong correlations were also observed between DXA (dual-energy x-ray absorptiometry) -measured and predicted SMI in men and women. We concluded that sarcopenia is associated with more glycation of serum proteins in men and with greater arterial stiffness in women. Moreover, the prediction models of SMI using anthropometric measurement are valid for alternative DXA-measured SMI in Japanese adults.

BACKGROUND/OBJECTIVES: Little information is available regarding the interactions of sarcopenia and metabolic syndrome (MetS) in the risks of these age-associated diseases in women. The present cross-sectional study was performed to investigate whether the coexistence of sarcopenia and MetS further increases the risks of lifestyle-related diseases in Japanese women.
SUBJECTS/METHODS: Healthy Japanese women (n = 533) aged 30-84 participated in this study. MetS was defined as higher body mass index, fasting plasma glucose, systolic or diastolic blood pressure and blood lipid abnormalities. Appendicular muscle mass and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry. The criterion of low muscle mass and strength defined median skeletal muscle index (appendicular muscle mass/height(2), kg/m(2)) and handgrip strength.
RESULTS: Two-way ANCOVA with adjustment for age, body fat percentage and whole-body lean tissue mass indicated that sarcopenia and MetS interacted to produce a significant effect on HbA1c, systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity in Japanese women. The systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity were significantly higher in women with coexisting sarcopenia and MetS than in healthy controls or in those with sarcopenia or MetS alone. The HbA1c in the coexisting sarcopenia and MetS group was higher than in healthy controls and sarcopenia subjects.
CONCLUSIONS: The coexistence of sarcopenia and MetS further increases the risks of cardiovascular diseases, such as type 2 diabetes mellitus, hypertension, arterial stiffness and hyperlipidemia even adjustment of age and body composition in adult Japanese women.

Background: Sex hormone-binding globulin (SHBG) levels and sex hormones have been implicated in the pathogenesis of type 2 diabetes and cardiovascular diseases. As fatty liver has been suggested to be a major determinant of SHBG levels, we examined whether the associations of SHBG and testosterone with diabetes were independent of fatty liver.
Methods: We conducted a case-control study that included 300 diabetes cases (215 men and 85 women) and 300 matched controls from the Saku cohort study. Diabetes was defined by either fasting plasma glucose levels &gt;= 126 mg/dL, 2-h post-load glucose levels &gt;= 200 mg/dL after a 75 g oral glucose tolerance test, or diabetes diagnosed by physicians. We fitted conditional logistic regression models to examine the associations between SHBG and total testosterone levels with diabetes by sex. To evaluate the impact of fatty liver, we used the fatty liver index (FLI), a validated measure derived from serum triglyceride levels, body mass index (BMI), waist circumference, and gamma-glutamyltransferase levels.
Results: After adjusting for age, family history of diabetes, smoking, physical activity, BMI, and FLI, SHBG levels were inversely associated with diabetes among women (odds ratio [OR] comparing the highest with the lowest quartiles, 0.13 [95% confidence interval {CI}, 0.02-0.96]), but not among men. Similar patterns were observed in a subgroup analysis restricted to postmenopausal women"(OR, 0.12 [95% CI, 0.01-1.17]). In contrast, testosterone levels were inversely associated with diabetes among men (OR, 0.45 [95% CI, 0.23-0.89]), but not among women.
Conclusions: Our findings suggest that SHBG in women and testosterone in men may be inversely associated with diabetes.

We determine reference values for sarcopenia and test the hypothesis that sarcopenia is associated with risk factors for cardiovascular disease. Moreover we develop prediction models of sarcopenia in Japanese men and women. A total of 1,488 Japanese men and women aged 18-85 years participated in this study. Appendicular muscle mass (AMM) was measured by dual-energy X-ray absorptiometry. Reference values for classes 1 and 2 sarcopenia (skeletal muscle index; AMM/height2, kg・m^<-2>) in each sex were defined as values one and two standard deviations below the sex-specific means of reference values obtained in this study from young adults aged 18-40 years. The reference values for class 1 and class 2 sarcopenia were 7.77 kg・m^<-2> and 6.87 kg・m^<-2> in men and 6.12 kg・m^<-2> and 5.46 kg・m^<-2> in women. In subjects both with class 1 and class 2 sarcopenia, body mass index and % body fat were significantly lower than in normal subjects. Despite whole-blood glycohaemoglobin A1c in men with class 1 sarcopenia was significantly higher than in normal subjects, and brachial-ankle pulse wave velocity in women both with class 1 and class 2 sarcopenia were significantly higher than in normal subjects. Stepwise regression analysis indicated that the body mass index (BMI), waist circumference and age were independently associated with SMI in men; and BMI, handgrip strength and waist circumference were independently associated with SMI in women. The SMI prediction equations were applied to the validation group, and strong correlations were also observed between the DXA-measured and predicted SMI in men and women. We concluded that sarcopenia is associated with more glycation of serum proteins in men and with greater arterial stiffness in women. Moreover the prediction models of SMI using anthropometric measurement are valid for alternative DXA-measured SMI in Japanese adults.

Background: Dietary glycemic index or load is thought to play an important role in glucose metabolism. However, few studies have investigated the relation between glycemic index (GI) or load (GL) and glycemia in Asian populations. In this cross-sectional analysis of a randomized controlled trial, the Saku Control Obesity Program, we examined the relation between the baseline GI or GL and glycemia (HbA1c and fasting plasma glucose [FPG] levels), insulin resistance (HOMA-IR), beta-cell function (HOMA-beta), and other metabolic risk factors (lipid levels, diastolic and systolic blood pressure, and adiposity measures).
Methods: The participants were 227 obese Japanese women and men. We used multiple linear regression models and logistic regression models to adjust for potential confounding factors such as age, sex, visceral fat area, total energy intake, and physical activity levels.
Results: After adjustments for potential confounding factors, GI was not associated with HbA1c, but GL was positively associated with HbA1c. For increasing quartiles of GI, the adjusted mean HbA1c were 6.3%, 6.7%, 6.4%, and 6.4% (P for trend = 0.991). For increasing quartiles of GL, the adjusted mean HbA1c were 6.2%, 6.2%, 6.6%, and 6.5% (P for trend = 0.044). In addition, among participants with HbA1c &gt;= 7.0%, 20 out of 28 (71%) had a high GL (&gt;= median); the adjusted odds ratio for HbA1c &gt;= 7.0% among participants with higher GL was 3.1 (95% confidence interval [CI] = 1.2 to 8.1) compared to the participants with a lower GL (&lt;median). Further, among 16 participants with FPG &gt;= 150 mg/dL, 13 participants (81.3%) had a higher GL; the adjusted odds ratio for FPG &gt;= 150 mg/dL among participants with a higher GL was 8.5 (95% confidence interval = 1.7 to 43.4) compared to those with a lower GL. In contrast, GI and GL were not associated with metabolic risk factors other than glycemia.
Conclusions: Our findings suggest that participants with poor glycemic control tend to have a higher GL in an obese Japanese population.

The present study was undertaken to examine the effect of mitochondrial haplogroups on aerobic and anaerobic performance phenotypes such as maximum oxygen consumption, muscle power, and muscle mass. We recruited 474 healthy Japanese individuals and measured their physical performance phenotypes such as peak oxygen uptake, muscle power, and muscle mass. The genotypes for 186 polymorphisms in the mitochondrial DNA were determined, and the haplotypes were classified into 2 macrohaplogroups (i.e., N and M) and 12 haplogroups (i.e., F, B, A, N9a, N9b, M7a, M7b, G1, G2, D4a, D4b, and D5). When we compared the 2 major Japanese macrohaplogroups, leg extension power (P = 0.0395), leg extension power based on body weight (P = 0.0343), and vertical jump performance (P = 0.0485) were significantly higher in subjects with mitochondrial macrohaplogroup N than in those with macrohaplogroup M. However, peak oxygen uptake was similar between the 2 groups. When we analyzed the 12 haplogroups, all of the measured parameters were similar among them. In conclusion, mitochondrial macrohaplogroup N may be one of the determinant factors of anaerobic physical performance phenotype such as muscle power.

Aim: Sarcopenia is the significant degenerative loss of skeletal muscle mass and strength associated with aging, and it is one of the components of frailty. We previously reported an association between the 29C&gt;T polymorphism in the transforming growth factor-beta 1 gene (rs1800470) and the prevalence of vertebral fractures in subjects with postmenopausal osteoporosis. The association was not attributable to bone mineral density, which suggests that polymorphism influences some aspects of bone quality that affects strength and/or frailty rather than bone strength itself. Thus, we examined the relationship between genetic polymorphism and lean body mass in a Japanese population.
Methods: A total of 479 adults comprising 143 men and 336 women, age 23 to 85 years, participated in the present study. Fat-free mass was measured by dual energy X-ray absorptiometry, and the relative skeletal muscle index was calculated as the ratio of appendicular (sum of arms and legs) fat-free mass to the square of height.
Results: Total, leg, and appendicular fat-free mass as well as the relative skeletal muscle index were significantly lower in male subjects with CT/ TT genotypes compared to those with CC genotype. Female subjects did not show any genotype-dependent differences when analyzed as a group, but when those without menstruation (postmenopausal women) were analyzed, arm fat-free mass was significantly lower in the CT/ TT genotypes than in the CC genotype.
Conclusions: T allele of the 29C&gt; T polymorphism in the transforming growth factor-b1 gene might be a risk factor of sarcopenia in a Japanese population. Geriatr Gerontol Int 2012; 12: 292-297.

A physical activity reference value for health promotion, 23 METs-h/week was es-tablished 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.

Objectives We evaluated anthropometric parameters and physical fitness in elderly Japanese. Methods A total of 2,106 elderly Japanese (749 men and 1,357 women), aged 60-79 years, were enrolled in a crosssectional investigation study. Anthropometric parameters and physical fitness, i.e., muscle strength and flexibility, were measured. Of the 2,106 subjects, 569 subjects (302 men and 267 women) were further evaluated for aerobic exercise level, using the ventilatory threshold (VT). Results Muscle strength in subjects in their 70s was significantly lower than that in subjects in their 60s in both sexes. Two hundred and twenty-nine men (30.6%) and 540 women (39.8%) were taking no medications. In men, anthropometric parameters were significantly lower and muscle strength, flexibility, and work rate at VT were significantly higher in subjects without medications than these values in subjects with medications. In women, body weight, body mass index (BMI), and abdominal circumference were significantly lower, and muscle strength was significantly higher in subjects without medications than these values in subjects with medications. Conclusion This mean value may provide a useful database for evaluating anthropometric parameters and physical fitness in elderly Japanese subjects. © The Japanese Society for Hygiene 2011.

The present study elucidated the effects of habitual rowing exercise on arterial stiffness and plasma levels of the vasoconstrictor endothelin-1 and the vasodilator nitric oxide (NO) in older men. Eleven rowers (68.0 +/- 1.6 years) and 11 sedentary control older men (64.9 +/- 1.1 years) were studied. Peak oxygen uptake (36.0 +/- 1.7 vs. 27.7 +/- 1.9 ml . kg(-1) . min(-1)), leg press power (1346 +/- 99 vs. 1077 +/- 68 W), and HDL-cholesterol (75 +/- 5 vs. 58 +/- 3 mg . ml(-1)) were higher and triglyceride (78 +/- 9 vs. 120 +/- 14 mg . ml(-1)) was lower in rowers than in control participants (all P &lt; 0.05). Arterial stiffness indices (carotid beta-stiffness and cardio-ankle vascular index) and plasma endothelin-1 and NOx (nitrite+nitrate) levels did not differ between the two groups. These results suggest that habitual rowing exercise in older men is associated with high muscle power and aerobic capacity, and favourable blood lipid profile without affecting arterial stiffness or plasma levels of endotheline-1 and NO.

This study evaluated effects of a behavioral approach which placed emphasis on tailored behavior counseling, diet, weight loss and weight maintenance. A one-year randomized controlled trial was conducted among 235 overweight/obese adults in Japan. The intervention group (n=119) received individual-based counseling using a behavioral approach and the changes made in the diet and physical activity were dependent on each participant as much as possible. One year later, the intervention group lost significantly more weight than the control group (-5.0 kg vs. 0.1 kg for men and -3.9 kg vs. -0.2 kg for women). Compared to the control group, the male intervention group reduced overall energy, cereals and dairy products consumption significantly, while increasing green and yellow vegetable intake, and the female intervention group significantly reduced intake of dairy products. Regarding behaviors, both male and female intervention groups increased the number of walking steps and women improved their irregular eating habits compared to those in the control groups. Behavior changes were related to weight loss; participants who maintained the action/maintenance stage or moved to later stages lost significantly more weight than participants who remained in the pre-contemplation/contemplation/preparation stages or regressed to earlier stages. After one-year follow-up, the intervention group maintained significantly lower weights, lower energy intakes and improvements in irregular eating habits. Our behavioral approach led to diet and behavior modification, weight loss and maintenance. Because modified variables differed between men and women, gender-specific approaches may be necessary.

Purpose. To examine behavioral factors related to successful weight maintenance. Methods. Subjects were 90 middle-aged participants who attended a weight loss program and were followed for one year. The subjects were classified into either successful weight maintainers (maintained a weight loss of 5 or more from their initial weight for one year) (SWM) or unsuccessful weight maintainers (USWM), and weight control practice, stress, obstacles, support, and self-efficacy during the program and follow-up period were compared. Results. SWM had mean loss of 12 from their initial weight during the program. They showed a greater improvement in their regularity of eating, walked more, and felt less stress regarding their increased physical activity than the USWM. During the follow-up period, significantly more SWM participants had self-efficacy (for measuring weight, practicing dietary objective, and assessing the practice and keeping records), actually kept records and measured weight more than the USWM participants. In contrast, more USWM participants felt stress about measuring weight. Conclusion. In addition to a substantial initial weight loss due to an increased amount of physical activity, having a higher self-efficacy and consistently keeping records of one's activities, as well as regularly weighing themselves, may be important for successful weight maintenance. © 2012 Makiko Nakade et al.

Elevated fasting plasma homocysteine (Hcy) level is a vascular disease risk factor. Plasma Hcy is affected by 5,10-methylenetetrahydofolate reductase (MTHFR) genotype and dietary folate intake. This cross-sectional study in 434 Japanese adults examined the associations among objectively measured physical activity (PA), plasma Hcy adjusting for dietary folate intake, and MTHFR C677T genotype. Daily PA was measured by triaxial accelerometry and all subjects completed a questionnaire about their dietary habits. Plasma Hcy and MTHFR C677T genotype were determined. Plasma Hcy in subjects with the TT genotype was significantly higher than in those with CC or CT genotype (p &lt; 0.001). Plasma Hcy was significantly different between a parts per thousand yen200 (7.6 +/- A 0.2 nmol/mL) and &lt; 200 A mu g/day (8.3 +/- A 0.3 nmol/mL) folate intake groups (p = 0.003). There were no differences in plasma Hcy adjusting for age, sex, and folate intake between groups according to PA category in all subjects. However, there were significant interactions between time spent in light PA (p = 0.003), vigorous PA (p = 0.001), or inactivity (p = 0.004), and MTHFR genotype. In only the TT genotype, shorter time spent in light PA was associated with higher plasma Hcy than a longer time spent in light PA (11.5 +/- A 3.3 nmol/mL vs. 8.5 +/- A 3.3 nmol/mL, p &lt; 0.001), and longer time spent in vigorous PA and inactivity were associated with higher plasma Hcy (11.8 +/- A 3.3 nmol/mL vs. 8.4 +/- A 3.2 nmol/mL, 11.6 +/- A 3.3 nmol/mL vs. 8.4 +/- A 3.3 nmol/mL, respectively, p &lt; 0.001). In conclusion, light and vigorous PA were associated with plasma Hcy only in the TT genotype, but there were no such associations in all genotypes.

Methods: 1109 Japanese men were categorized by their exercise habits. Clinical data, number of MetS risk factors, and differences in lifestyle-related behaviors of the non-training group (n = 233) and the detraining group (n = 483) were compared with those of the training group (n = 87). Results: Waist circumference and body mass index were significantly higher in the non-training group and the detraining group than in the training group, and also higher in the detraining group than in the non-training group. High-density lipoprotein cholesterol (HDL-C) was lower and low-density lipoprotein cholesterol (LDL-C) was higher in the non-training group and the detraining group than in the training group. Both the non-training group and the detraining group had more MetS risk factors than the training group. The odds ratio for smoking was higher in the detraining group than in the training group. Conclusions: Detraining results in similar degrees of obesity, low HDL-C, high LDL-C, and high MetS risk as non-training. To prevent lifestyle-related diseases, it is particularly important not only to encourage adults to become physically active, but also discourage active young people from discontinuing physical exercise.

The objective of the present study was to investigate the relationship between the indices of body size such as BMI, fat-free mass index (FFMI, FFM/height(2)), fat mass index (FMI, FM/height(2)), and body fat percentage (%BF), and physical activities assessed by the doubly-labelled water (DLW) method and an accelerometer in free-living Japanese adult women. We conducted a cross-sectional study in 100 female subjects ranging in age from 31 to 69 years. Subjects were classified in quartiles of BMI, FFMI, FMI and %BF. Daily walking steps and the duration of light to vigorous physical activity were simultaneously assessed by an accelerometer for the same period as the DLW experiment. Only physical activity-related energy expenditure (PAEE)/FFM and PAEE/body weight (BW) decreased in the highest quartile of BMI. Physical activity level, PAEE/FFM and PAEE/BW decreased in the highest quartile of FMI and %BF, whereas they were not different among quartiles of FFMI. Daily walking steps and the duration of moderate-and vigorous-intensity physical activities decreased or tended to decrease in the highest quartile of FMI and %BF, but did not differ among quartiles of FFMI and BMI. These results clearly showed that Japanese adult women with higher fat deposition obviously had a low level of physical activities assessed by both the DLW method and accelerometry, but those with larger BMI had lower PAEE/FFM and PAEE/BW only. Our data suggest that the relationship between obesity and daily physical activities should be discussed using not only BMI but also FMI or %BF.

A high level of arterial stiffness (baPWV) is an independent risk factor of cardiovascular diseases. We examined the effect of a health fitness programmer prepared 12 week exercise program on baPWV. 102 middle-aged people participated in this study. A health fitness programmer administered the program, which was rated 11 to 13 on the Borg scale in terms of intensity. Subjects exercised once a week for three month, and were divided into three groups, based on their participation rate. The group that had a 100% participation rate was designated H-group, 80-99% participation rate was designated M-group, and less than 80% was designated L-group. baPWV and blood pressure decreased significantly in H and M groups after completion of the exercise program. However, there were no significant changes in L group. Our results suggest that a health fitness programmer prepared and administered exercise program decreased baPWV.

The link between cigarette smoking and ventilatory threshold (VT) was investigated. We used data for 407 men and 418 women not taking medication. Habits of cigarette smoking were obtained through interviews by well-trained staff. The influence of cigarette smoking on oxygen uptake, work rate, and heart rate at VT was evaluated. Oxygen uptake at VT in women and work rate at VT in men with cigarette smoking were significantly lower than in subjects without cigarette smoking after adjusting for age. The differences of parameters at VT did not reach significant levels after adjusting for age and exercise habits in both sexes. However, in women without exercise habits, there was significant difference of oxygen uptake at VT between women with and without cigarette smoking after adjusting for age [cigarette smoking (+): 11.5 ± 1.8 ml/ kg/min, cigarette smoking (-): 12.4 ± 2.1 ml/kg/min, p = 0.0006]. The number of cigarettes smoked per day and the Brinkman Index were not clearly correlated with oxygen uptake at VT. A combination of promoting exercise habits and prohibiting cigarette smoking might be recommended for improving the aerobic exercise level, especially in women. © 2010 The Japanese Society for Hygiene.

Sanada K, Iemitsu M, Murakami H, Tabata I, Yamamoto K, Gando Y, Suzuki K, Higuchi M, Miyachi M. PPAR gamma 2 C1431T genotype increases metabolic syndrome risk in young men with low cardiorespiratory fitness. Physiol Genomics 43: 103-109, 2011. First published December 14, 2010; doi:10.1152/physiolgenomics.00129.2010.-The peroxisome proliferator-activated receptor gamma 2 (PPAR gamma 2) genotypes are related to obesity and the metabolic syndrome (MetS). A low level of cardiorespiratory fitness is also a strong determining factor in the development of MetS. This cross-sectional study was performed to investigate the influence of the interaction between the PPAR gamma 2 genotype and cardiorespiratory fitness on the risk of MetS. Healthy Japanese men (n = 211) and women (n = 505) participated in this study. All subjects were divided into 8 groups according to sex, fitness level (high and low fitness groups), and age (younger, age &lt; 40 yr; middle-aged/older, age &gt;= 40 yr). The PPAR gamma 2 genotypes (Pro12Ala and C1431T) were analyzed by real-time PCR with Taq-Man probes. Two-way ANCOVA with adjustment for age as a covariate indicated that fitness and the CC genotype of C1431T in the PPAR gamma 2 gene interacted to produce a significant effect on MetS risk in younger men and that the risk of MetS in the CC genotype group with low cardiorespiratory fitness was significantly higher than that in the corresponding CT + TT genotypes or in the high fitness groups. There was no significant interaction between fitness and genotype in determining MetS risk in middle-aged/older men or in women in any group. With regard to the Pro12Ala genotype of the PPAR gamma 2 gene, there were no significant differences in fitness or genotype effects nor were there any interactions between measurement variables. We concluded that the CC genotype of C1431T in the PPAR gamma 2 gene together with low cardiorespiratory fitness may increase the risk of MetS in younger men (age &lt; 40 yr), even with adjustment for age.

Aim: Cardiorespiratory fitness (CRF) is independently associated with a reduced risk of cardiovascular disease. Carotid arterial remodeling, which is derived from the interplay between carotid luminal dilation and wall thickening, is also an independent predictor of cardiovascular events. We hypothesized that high CRF may be associated with reduced age-related carotid arterial remodeling. This cross-sectional study was performed to determine the relationships between CRF and age-related luminal dilation and wall thickening.
Methods: A total of 771 adults (180 men and 591 women), under age 40 (young), 40-59 (middle-aged), and over age 60 (older) participated in this study. Subjects in each age category were divided into either high (fit) or low (unfit) CRF groups based on (V) over dotO(2peak). Carotid artery intima-media thickness (IMT) and lumen diameter were measured on ultrasound images. Carotid wall mass was calculated as rho L(pi Re-2-Ri(2)).
Results: Two-way ANOVA indicated a significant interaction (p&lt;0.01) between age and CRF in determining IMT, lumen diameter, and wall mass. In older subjects, IMT, lumen diameter, and wall mass were significantly lower (p&lt;0.05) in the fit than in the unfit group (IMT, 0.69 +/- 0.01 vs. 0.74 +/- 0.01 mm; lumen diameter, 5.99 +/- 0.06 vs. 6.28 +/- 0.06 mm; wall mass, 7.41 +/- 0.25 vs. 8.71 +/- 0.25 mm(3)). Multiple regression analysis indicated that the value of (V) over dotO(2peak) was independently correlated with carotid IMT, lumen diameter and wall mass.
Conclusion: The present study indicated that a high level of CRF is associated with reduced age-related wall thickening and luminal dilation in the carotid artery.

High-intensity resistance training increases muscle size, but reduces arterial compliance. Muscular blood flow reduction (BFR) during low-intensity training has been shown to elicit muscle hypertrophy. However, the effect on arterial compliance is unknown. We examined the effects of walk training with BFR on carotid arterial compliance and muscle size in the elderly adults. Both BFR-walk training (BFR-W, n = 13, 66 +/- 1 year) and control-walk training (CON-W, n = 10, 68 +/- 1 year) groups performed 20 minutes treadmill walking at an exercise intensity of 45% of heart rate reserve, 4 days/week for 10 weeks. The BFR-W group wore pressure cuffs on both legs during training. Maximum knee joint strength (similar to 15%) and MRI-measured thigh muscle cross-sectional area (3%) increased in the BFR-W, but not in the CON-W. Carotid arterial compliance improved in both BFR-W (50%) and CON-W (59%) groups. Walk training with blood flow reduction can improve thigh muscle size/strength as well as carotid arterial compliance, unlike high-intensity training, in the elderly.

Objective: To evaluate exercise intervention efficacy for the prevention and treatment of sarcopenia in the elderly. Methods: We conducted a systematic literature search of randomized controlled trials in the Physical Activity Guidelines Advisory Committee Report (before 2007), Pubmed, the Cochrane database, and Igaku Chuo Zasshi (January 2006 to August 2009) Data Extraction: Two authors independently extracted relevant data. A total of 951 articles were found by search engines, and 9 studies were finally selected after a review by 2 experts. The content of these studies, especially duration, sets, periods, frequency, and intensity of exercise intervention were extracted and summarized in a results table. Five of 6 articles concluded that high-intensity resistance training significantly increased soft lean tissue and muscle mass. The remaining 3 articles indicated that moderate-intensity resistance training did not affect soft lean tissue or muscle mass. Conclusion: This systematic review suggested that high-intensity resistance training with sufficient periods, frequency, repetitions, and sets is effective to counteract the loss of muscle mass associated with advancing age.

サルコペニアの代替指標である骨格筋量に対する運動介入研究を検索し、サルコペニアの予防・改善のための適切な運動方法について検討した。一次検索により951本の論文が抽出され、うち選定された9論文を対象とした。5本は高強度筋力トレーニングが高齢者の骨格筋量を増加させるとしたものであった。3本は低・中強度筋力トレーニングは骨格筋に影響しないというものであった。骨格筋量を増加させるためには、最大挙上重量(1RM)の80%以上の強度で、1セット当たりの挙上回数が8〜12回の運動を2〜3セット、週3回、3ヵ月以上行う高強度筋力トレーニングを行う必要があることが示唆された

Objective: The aim of this study was to evaluate aerobic exercise levels, expressed in terms of ventilatory threshold (VT), in a Japanese population and explore the relationship between VT and exercise habits in this population. Methods: This was a cross-sectional study in which data collected from 547 men and 524 women aged 20-69 years and not on medications, were used to assess exercise habits and parameters at VT, namely, oxygen uptake, work rate, and heart rate. Results: Age-related changes in parameters at VT were noted. Of the participants, 205 men (37.5%) and 142 women (27.1%) had exercise habits. Oxygen uptake and work rate at VT in subjects with exercise habits were significantly higher than those without exercise habits after age had been adjusted for in both sexes. Anthropometric parameters were significantly correlated with oxygen uptake at VT, and the highest correlation coefficient rate was found between oxygen uptake at VT and body fat percentage (men r = -0.589, women r = -0.631). Conclusion: The mean values determined here may provide a useful database for evaluating VT in Japanese adult subjects. © 2010 The Japanese Society for Hygiene.

Greater venous compliance is associated with attenuation of the tolerance response to orthostatic stress and reduced incidence of venous diseases. Resistance training induces tolerance to orthostatic challenge and the growth of capillaries, which may lead to negative and positive effects on venous compliance, respectively. It has not been confirmed, however, whether habitual resistance training positively or negatively affects venous compliance. We compared the forearm venous compliance in resistance-trained men with age-matched controls. Eleven resistance-trained middle-aged men (37.7 +/- A 1.5 years) and 12 age-matched sedentary controls (36.7 +/- A 1.6 years) were studied. Forearm venous compliance was measured in subjects in the supine position by inflating a venous collecting cuff placed around the upper arm to 60 mmHg for 8 min and then decreasing cuff pressure to 0 mmHg at a rate of 1 mmHg/s. Forearm venous compliance was determined using the first derivative of the pressure-volume relation during cuff pressure reduction (compliance = beta(1) + 2 beta(2) x cuff pressure). Forearm venous compliance at 20 mmHg cuff pressure was 16% greater in the resistance-trained group than in the age-matched sedentary controls (0.097 +/- A 0.005 vs. 0.083 +/- A 0.004 ml/dl/mmHg, P &lt; 0.05). Forearm venous compliance was positively related to forearm venous volume (r = 0.643, P = 0.0009), but not forearm muscle mass (r = 0.391, P = 0.0648). In conclusion, the present study suggests that (1) the resistance-trained men have greater forearm venous compliance than age-matched controls, and (2) the higher forearm venous compliance in the resistance-trained men may be explained by greater forearm venous capacitance.

Purpose This study aimed to determine the validity of a standard questionnaire to assess amount of physical activity (PA) and cardiorespiratory fitness (VO_2peak).<br/>Methods A total of 483 men and women, aged 20 to 69 years, participated. The standard questionnaire included 3 items about exercise, PA, and walking speed. All questions were designed to require an answer of Yes or No. Subjects were classified into one of four groups regarding the number of Yes answers to thee three questions, giving activity levels of 0 to 3. The amount of PA was measured objectively with a tri-axial accelerometer which could also calculate daily step counts, and the amounts of PA under 3 metabolic equivalents (METs) and at 3 METs or more. VO_2peak was measured by incremental cycle exercise tests with indirect calorimetry.<br/>Results The daily step counts, the amount of PA at 3 METs or more, and the VO_2peak were significantly higher in subjects who answered Yes to each question than in those who answered No. Sensitivity and specificity of each question were 62~73% and 45~71% for the amount of PA established with the "Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006)". The sum of sensitivity and specificity was the highest when the cutoff value was activity level 2 (sensitivity 73%, specificity 68%). Sensitivity and specificity for VO_2max established by EPAR2006 were lower than those for the amount of PA.<br/>Conclusion These results suggest that only answering simple questions with a standard questionnaire is sufficient for estimation of PA levels for specific medical checkups and health guidance, even though the accuracy is somewhat limited.

In this study of Japanese men and women, we determine reference values for sarcopenia and test the hypothesis that sarcopenia is associated with risk factors for cardiovascular disease, independent of waist circumference. A total of 1,488 Japanese men and women aged 18-85 years participated in this study. Appendicular muscle mass (AMM) was measured by dual-energy X-ray absorptiometry. Reference values for classes 1 and 2 sarcopenia (skeletal muscle index: AMM/height(2), kg m(-2)) in each sex were defined as values one and two standard deviations below the sex-specific means of reference values obtained in this study from young adults aged 18-40 years. The reference values for class 1 and class 2 sarcopenia were 7.77 and 6.87 kg m(-2) in men and 6.12 and 5.46 kg m(-2) in women. In subjects both with class 1 and class 2 sarcopenia, body mass index and % body fat were significantly lower than in normal subjects. Despite whole-blood glycohaemoglobin A1c in men with class 1 sarcopenia was significantly higher than in normal subjects, and brachial-ankle pulse wave velocity in women both with class 1 and class 2 sarcopenia were significantly higher than in normal subjects, using one-way ANCOVA with adjustment for the covariate of waist circumference. Although sarcopenia is associated with thin body mass, it is associated with more glycation of serum proteins in men and with greater arterial stiffness in women, independent of waist circumference.

Habitual moderate-to-vigorous-intensity physical activity attenuates arterial stiffening. However, it is unclear whether light physical activity also attenuates arterial stiffening. It is also unclear whether light physical activity has the same effects in fit and unfit individuals. This cross-sectional study was performed to determine the relationships between amount of light physical activity determined with a triaxial accelerometer and arterial stiffness. A total of 538 healthy men and women participated in this study. Subjects in each age category were divided into either high-light or low-light physical activity groups based on daily time spent in light physical activity. Arterial stiffness was measured by carotid-femoral pulse wave velocity. Two-way ANOVA indicated a significant interaction between age and time spent in light physical activity in determining carotid-femoral pulse wave velocity (P&lt;0.05). In the older group, carotid femoral pulse wave velocity was higher in the low-light physical activity level group than in the high-light physical activity level group (945 +/- 19 versus 882 +/- 16 cm/s; P&lt;0.01). The difference remained significant after normalizing carotid-femoral pulse wave velocity for amounts of moderate and vigorous physical activity. The carotid-femoral pulse wave velocity (r=-0.47; P&lt;0.01) was correlated with daily time spent in light physical activity in older unfit subjects. No relationship was observed in older fit subjects. These results suggested that longer time spent in light physical activity is associated with attenuation of arterial stiffening, especially in unfit older people. (Hypertension. 2010;56:540-546.)

Iemitsu M, Murakami H, Sanada K, Yamamoto K, Kawano H, Gando Y, Miyachi M. Lack of carotid stiffening associated with MTHFR 677TT genotype in cardiorespiratory fit adults. Physiol Genomics 42: 259-265, 2010. First published April 20, 2010; doi: 10.1152/physiolgenomics.00039.2010.-The TT genotype of C677T polymorphism in 5,10-methylenetetrahydrofolate reductase (MTHFR) induces elevation of homocysteine level and leads to atherosclerosis and arterial stiffening. Furthermore, cardiorespiratory fitness level is also associated with arterial stiffness. In the present study, a cross-sectional investigation of 763 Japanese men and women (18-70 yr old) was performed to clarify the effects of cardiorespiratory fitness on the relationship between arterial stiffness and MTHFR C677T gene polymorphism. Arterial stiffness was assessed by carotid beta-stiffness with ultrasonography and tonometry. The study subjects were divided into high-cardiorespiratory fitness (High-Fit) and low-cardiorespiratory fitness (Low-Fit) groups based on the median value of peak oxygen uptake in each sex and decade. The plasma homocysteine level was higher in the TT genotype of MTHFR C677T polymorphism compared with CC and CT genotype individuals. MTHFR C677T polymorphism showed no effect on carotid beta-stiffness, but there was a significant interaction effect between fitness and MTHFR C677T polymorphism on carotid beta-stiffness (P = 0.0017). In the Low-Fit subjects, carotid beta-stiffness was significantly higher in individuals with the TT genotype than the CC and CT genotypes. However, there were no such differences in High-Fit subjects. In addition, beta-stiffness and plasma homocysteine levels were positively correlated in Low-Fit subjects with the TT genotype (r = 0.71, P &lt; 0.0001), but no such correlations were observed in High-Fit subjects. In CC and CT genotype individuals, there were also no such correlations in either fitness level. These results suggest that the higher cardiorespiratory fitness may attenuate central artery stiffening associated with MTHFR C677T polymorphism.

MIYACHI, M., K. YAMAMOTO, K. OHKAWARA, and S. TANAKA. METs in Adults While Playing Active Video Games: A Metabolic Chamber Study. Med. Sci. Sports Exerc., Vol. 42, No. 6, pp. 1149-1153, 2010. Purpose: Active video game systems controlled through arm gestures and motions (Nintendo Wii Sports) and video games controlled through force plate (Wii Fit Plus) are becoming increasingly popular. This study was performed to determine the energy expenditure (EE) during Wii Fit Plus and Wii Sports game activities. Methods: Twelve adult men and women performed all the activities of Wii Sports (five activities: golf, bowling, tennis, baseball, and boxing) and Wii Fit Plus (63 activities classified as yoga, resistance, balance, and aerobic exercises). Each activity was continued for at least 8 min to obtain a steady-state EE. Because EE was assessed in an open-circuit indirect metabolic chamber consisting of an airtight room (20,000 or 15,000 L), subjects were freed of apparatus to collect expired gas while playing the games. MET value was calculated from resting EE and steady-state EE during activity. Results: The mean MET values of all 68 activities were distributed over a wide range from 1.3 METs (Lotus Focus) to 5.6 METs (single-arm stand). The mean MET values in yoga, balance, resistance, and aerobic exercise of Wii Fit Plus and Wii Sports were 2.1, 2.0, 3.2, 3.4, and 3.0 METs, respectively. Forty-six activities (67%) were classified as light intensity (&lt;3 METs), and 22 activities (33%) were classified as moderate intensity (3.0-6.0 METs). There were no vigorous-intensity activities (&gt;6.0 METs). Conclusions: Time spent playing one-third of the activities supplied by motion-and gesture-controlled video games can count toward the daily amount of exercise required according to the guidelines provided by the American College of Sports Medicine and the American Heart Association, which focus on 30 min of moderate-intensity daily physical activity 5 d.wk(-1).

The present study investigated the use of the accelerometer-determined physical activity (PA) variables as the objective PA variables for estimating (V) over dotO(2max) in Japanese adult men. One hundred and twenty-seven Japanese adult men aged from 20 to 69 years were recruited as subjects of the present study. Maximal oxygen uptake ((V) over dotO(2max)) was measured with a maximal incremental test on a bicycle ergometer. Daily step counts (SC) and the amount spent in moderate to vigorous PA (MVPA) and vigorous PA (VPA) were measured using accelerometer-based activity monitors worn at the waist for seven consecutive days. The non-exercise models were derived using hierarchical linear regression analysis, and cross-validated using two separate cross-validation procedures. SC, MVPA, and VPA were significantly related to (V) over dotO(2max) (partial correlation coefficient r = 0.58, r = 0.42, and r = 0.51, respectively) after adjusting for age. Two models were developed by multiple regression to estimate (V) over dotO(2max) using data of age, SC, VPA, and either BMI (the coefficient of determination (R-2) = 0.71, standard error of estimate (SEE) = 4.2 ml kg(-1) min(-1)), or waist circumference (R-2 = 0.74, SEE = 3.9 ml kg(-1) min(-1)). All regression models demonstrated a high level of cross-validity supported by the minor shrinkage of R-2 and increment of SEE in the PRESS procedure, and by small constant errors for subgroups of age, SC, and (V) over dotO(2max): This study demonstrated that combining SC with VPA, but not with MVPA, was useful in predicting (V) over dotO(2max) variance and improved the ability of the regression models to accurately predict (V) over dotO(2max).

Arterial stiffening, hypertension and left ventricular (LV) remodelling are associated with increased risk of cardiovascular disease. Cardiorespiratory fitness is associated with cardiovascular function and reduced risk of cardiovascular disease. This cross-sectional study was carried out to determine the relationships between cardiorespiratory fitness, arterial stiffness, blood pressure (BP) and LV remodelling in women. On the basis of peak oxygen uptake, a total of 159 premenopausal (young) and postmenopausal (older) women were categorized into either low (unfit) or high (fit) cardiorespiratory fitness groups. The arterial stiffness and LV remodelling were measured by brachial-ankle pulse wave velocity (baPWV) and carotid augmentation index (AI) and LV relative wall thickness (RWT). Two-way analysis of variance indicated a significant interaction between age and cardiorespiratory fitness in baPWV, carotid AI, BP and RWT. In the older group, arterial stiffness (baPWV; 1401 +/- 231 vs 1250 +/- 125cms(-1), P&lt;0.01, AI; 32.9 +/- 9.9 vs 24.8 +/- 10.1%, P&lt;0.01), systolic blood pressure (SBP) (130 +/- 22 vs 117 +/- 15mmHg, P&lt;0.01) and RWT (0.47 +/- 0.08 vs 0.42 +/- 0.04, P&lt;0.05) in fit women were lower than in unfit women. In older women, RWT was significantly related to baPWV (r = 0.46, P&lt;0.01), carotid AI (r = 0.29, P&lt;0.05), SBP (r = 0.57, P&lt;0.01). (V) over dot(2peak) (r = -0.32, P&lt;0.05). In young women, they were not significant correlations, except for a weak correlation between RWT and SBP (r = 0.21, P&lt;0.05). These results suggest that higher cardiorespiratory fitness is associated with lower arterial stiffness, BP and RWT in older women. Journal of Human Hypertension (2010) 24, 197-206; doi:10.1038/jhh.2009.57; published online 16 July 2009

This study aimed to determine the validity of a standard questionnaire to assess amount of physical activity (PA) and cardiorespiratory fitness (VO2peak). A total of 483 men and women, aged 20 to 69 years, participated. The standard questionnaire included 3 items about exercise, PA, and walking speed. All questions were designed to require an answer of Yes or No. Subjects were classified into one of four groups regarding the number of Yes answers to the three questions, giving activity levels of 0 to 3. The amount of PA was measured objectively with a tn-axial accelerometer which could also calculate daily step counts, and the amounts of PA under 3 metabolic equivalents (METs) and at 3 METs or more. VO2peak. was measured by incremental cycle exercise tests with indirect calorimetry. The daily step counts, the amount of PA at 3 METs or more, and the VO2peak. were significantly higher in subjects who answered Yes to each question than in those who answered No. Sensitivity and specificity of each question were 62-73% and 45-71% for the amount of PA established with the &quot;Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006)&quot;. The sum of sensitivity and specificity was the highest when the cutoff value was activity level 2 (sensitivity 73%, specificity 68%). Sensitivity and specificity for VO2max established by EPAR2006 were lower than those for the amount of PA. These results suggest that only answering simple questions with a standard questionnaire is sufficient for estimation of PA levels for specific medical checkups and health guidance, even though the accuracy is somewhat limited.

The purpose of this study was to develop prediction models of sarcopenia in 1,894 Japanese men and women aged 18-85 years. Reference values for sarcopenia (skeletal muscle index, SMI; appendicular muscle mass/height , kg/m2) in each sex were defined as values two standard deviations (2SD) below the gender-specific means of this study reference data for young adults aged 18-40 years. Reference values for predisposition to sarcopenia (PSa) in each gender were also defined as values one standard deviations (1SD) below. The subjects aged 41 years or older were randomly separated into 2 groups, a model development group and a validation group. Appendicular muscle mass was measured by DXA. The reference values of sarcopenia were 6.87 kg/m2 and 5.46 kg/nf, and those of PSa were 7.77 kg/m2 and 6.12 kg/m8. The subjects with sarcopenia and PSa aged 41 years or older were 1.7% and 28.8% in men and 2.7% and 20.7% in women. The whole body bone mineral density of PSa was significantly lower than in normal subjects. The handgrip strength of PSa was significantly lower than in normal subjects. Stepwise regression analysis indicated that the body mass index (BMI), waist circumference and age were independently associated with SMI in men; and BMI, handgrip strength and waist circumference were independently associated with SMI in women. The SMI prediction equations were applied to the validation group, and strong correlations were also observed between the DXA-measured and predicted SMI in men and women. This study proposed the reference values of sarcopenia in Japanese men and women. The prediction models of SMI using anthropometric measurement are valid for alternative DXA-measured SMI in Japanese adults.

CAO Z., N. MIYATAKE. M. HIGUCHI, M. MIYACHI, K. ISHIKAWA-TAKATA, and I. TABATA. Predicting (V)over dotO(2max) with an Objectively Measured Physical Activity in Japanese women. Med. Sci. Sports Exerc., Vol. 42. No. 1 pp. 179-186, 2010. Purpose: To investigate the use of the accelerometer-determined physical activity (PA) intensity variables as the objective PA variables for estimating (V)over dotO(2max) in Japanese adult women. Methods: The subjects Of this Study were 148 Japanese women aged 20 to 69 yr. Maximal oxygen Uptake was measured with a maximal incremental test oil a bicycle ergometer. Daily step Counts (SC) and file amount Spent ill moderate to vigorous PA (MVPA) and Vigorous PA (VPA) were measured using accelerometer-based activity monitors for 7 consecutive days. Using data of age. SC, MVPA, or VPA, and either body mass index (BMI) or waist circumference (WC), the nonexercise (V)over dotO(2max) prediction models Were derived as BMI model(MVPA), WC models(MVPA), BMI models(VPA), and WC models(VPA), and cross-validated by using two separate cross-validation procedures. Results: SC, MVPA, and VPA were significantly related to (V)over dotO(2max) (r = 0.43, r = 0.52, and r = 0.58, respectively), The Multiple correlation coefficients for the BMI and WC models(MVPA) were 0.83and 0.85, respectively and for the BMI and WC models(MVPA), they were 0.85 and 0.86. respectively. The SEE Was 3.3 and 3.1 mL.kg(-1).min(-1) for the BMI and WC models(MVPA), respectively, and it Was 3.1 and 3.0 mL.kg(-1).min(-1) for the BMI and WC models(VPA), respectively, All regression models demonstrated a high level of cross-validity Supported by the minor shrinkage of the coefficient of determination and the increment of SEE in file predicted residual sum of squares procedure, and by small constant errors for the Subgroups of age, SC, and (V)over dotO(2max) between 25 and 35 mL.kg(-1).min(-1). Conclusions: This study demonstrated that multiple regression models using data of MVPA or VPA were useful in predicting for Japanese adult women.

Objective Changes in metabolic syndrome and its components with lifestyle modification were evaluated in Japanese men.
Methods We used data for 160 Japanese men (45.6 +/- 8.8 years) with a 1-year follow up. Anthropometric, blood examination and blood pressure measurements were evaluated. Metabolic syndrome was defined by using a criterion in Japan. All subjects were given instructions by well-trained medical staff on how to change their lifestyle.
Results With a 1-year follow-up, anthropometric parameters, blood pressure (BP), triglyceride and HDL cholesterol were significantly improved and the prevalence of metabolic syndrome was significantly reduced. The number of subjects with abdominal obesity at baseline and at follow-up was higher (81 men) than that of subjects with other components at baseline and at follow-up. Parameters at baseline were significantly correlated with changes in parameters for one year. With lifestyle modification, the level of 163 mmHg in systolic BP (SBP), 115 mmHg in diastolic BP (DBP), 226 mg/dL in triglyceride and 33 mg/dL in HDL cholesterol at baseline was estimated to improve to the level without medications with a 1-year follow up.
Conclusion Lifestyle modification is useful for improving metabolic syndrome and its components. However, items of metabolic syndrome were improved, even when the abdominal circumference was greater than the normal value for Japanese men.

保健指導における運動中止者の阻害要因について、全国の保健指導プログラムの企画・実施者の成果報告分析および運動指導を含む保健指導プログラム参加者を対象とした調査結果から検討した。その結果、運動効果が実感できない、運動に対する自己効力感(セルフエフィカシー)をもてない、家族・職場上司・地域などの理解や支援がないの3要因をプログラムから排除することが重要であった。以上より、保健指導における脱落を抑制し継続を促すためには、脱落せず最後までプログラムに参加できれば効果が実感でき、自信も湧いてきて、周囲の理解も高まっていくとの考えから脱落を予防するためのチェックシートおよび運動継続を促す循環モデルを呈示した。

Reduced response to reactive hyperemia (RH) in the extremities reflects impaired endothelium-dependent vasodilation of the microvasculature. The aims of the present study were to determine whether resistance training and a combination of aerobic and resistance training increase the endothelial vasodilation of the forearm assessed by RH. A total of 39 young men were assigned to either high-intensity resistance training (HIR; six types of exercises, 80% 1RM x 10 repetitions x 3 sets, n = 14) or moderate-intensity resistance training (MIR; six types of exercises, 50% 1RM x 16 repetitions x 3 sets, n = 14) or a combination of high-intensity resistance training and moderate-intensity endurance training (COMBO; HIR and 60% maximal heart rate x 30 min, n = 11) groups. We measured forearm blood flow response to RH before and after 4 months of exercise intervention. All training groups increased maximal strength in all muscle groups tested (all P &lt; 0.05). After 4 months of training, the forearm blood flow during RH increased significantly in the MIR and COMBO groups, from 57 +/- 4 to 66 +/- 7 ml/min per 100 ml tissue and from 59 +/- 6 to 74 +/- 8 ml/min per 100 ml tissue, respectively (both P &lt; 0.05). There was no change in the response to RH in the HIR groups. In conclusion, the findings in this study demonstrate that combined resistance and aerobic training may affect the vasoreactivity response to RH in the forearm, but not resistance training alone.

Tanimoto M, Arakawa H, Sanada K, Miyachi M, and Ishii N. Changes in muscle activation and force generation patterns during cycling movements because of low-intensity squat training with slow movement and tonic force generation. J Strength Cond Res 23( 8): 2367-2376, 2009-Our previous studies showed that relatively low-load (similar to 50-60% 1 repetition maximum [1RM]) resistance training with slow movement and tonic force generation (LST) significantly increased muscle size and strength. However, LST is a very specific movement that differs from natural movements associated with sport activities and activities of daily life, and therefore, it might have some unfavorable effects on dynamic sport movement. We investigated the effects of LST on muscle activity and force generation patterns during cycling movement as a representative dynamic sports movement. Twenty-four healthy young men who were not in the habit of bicycle riding and did not have a history of regular resistance training were randomly assigned to the LST (similar to 60% 1RM load, 3-second lifting, and 3-second lowering movement without a relaxing phase: n = 8), a high-intensity exercise at normal speed (HM) group (85% 1RM load, 1-second lifting, 1-second lowering, and 1-second relaxed movement: n = 8), or sedentary control (CON, n = 8) group. Subjects in the training groups performed vertical squats by the assigned method. Exercise sessions consisted of 3 sets and were performed twice a week for 13 weeks. Pre- and posttraining muscle activation and force generation patterns during the cycling movements were evaluated by the coefficient of variation (CV) of the rectified electromyographic (EMG) wave from the vastus lateralis and CV of pedaling force. Both the CV of the rectified EMG and of pedaling force decreased significantly in the LST group (221 and 218%, p &lt; 0.05, respectively), whereas there were no significant changes in either the HN or the CON group. This decrease in CV in the LST group could mean that muscle activity and force generation during cycling movement have become more tonic. This result following LST may have an unfavorable effect on cycling movement and other dynamic sports movements.

Yamamoto K, Kawano H, Gando Y, Iemitsu M, Murakami H, Sanada K, Tanimoto M, Ohmori Y, Higuchi M, Tabata I, Miyachi M. Poor trunk flexibility is associated with arterial stiffening. Am J Physiol Heart Circ Physiol 297: H1314-H1318, 2009. First published August 7, 2009; doi: 10.1152/ajpheart.00061.2009.-Flexibility is one of the components of physical fitness as well as cardiorespiratory fitness and muscular strength and endurance. Flexibility has long been considered a major component in the preventive treatment of musculotendinous strains. The present study investigated a new aspect of flexibility. Using a cross-sectional study design, we tested the hypothesis that a less flexible body would have arterial stiffening. A total of 526 adults, 20 to 39 yr of age (young), 40 to 59 yr of age (middle-aged), and 60 to 83 yr of age ( older), participated in this study. Subjects in each age category were divided into either poor- or high-flexibility groups on the basis of a sit-and-reach test. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Two-way ANOVA indicated a significant interaction between age and flexibility in determining baPWV (P &lt; 0.01). In middle-aged and older subjects, baPWV was higher in poor- flexibility than in high-flexibility groups (middle-aged, 1,260 +/- 141 vs. 1,200 +/- 124 cm/s, P &lt; 0.01; and older, 1,485 +/- 224 vs. 1,384 +/- 199 cm/s, P &lt; 0.01). In young subjects, there was no significant difference between the two flexibility groups. A stepwise multiple-regression analysis (n = 316) revealed that among the components of fitness (cardiorespiratory fitness, muscular strength, and flexibility) and age, all components and age were independent correlates of baPWV. These findings suggest that flexibility may be a predictor of arterial stiffening, independent of other components of fitness.

The aim of this study was to explore muscle strength and its relation to exercise habits in Japanese. We used data from 3,018 men and 6,881 women aged 20-69 years and not using medications in a cross-sectional study. Exercise habits and muscle strength, i.e. grip strength and leg strength, were measured. Age-related changes in muscle strength were noted. Exercise habits were found in 984 men (32.6%) and 1,664 women (24.2%). For subjects of both sexes over 50 years, grip strength was significantly decreased with age. However, the ratio of leg strength to body weight significantly decreased with age as early as 30 years in men and 40 years in women. Grip strength, leg strength and the ratio of leg strength to body weight in subjects with exercise habits were significantly higher than those without exercise habits after adjusting for age in both sexes. This standard mean value may provide a useful database for evaluating muscle strength in Japanese adult subjects. Copyright © 2009 by Okayama University Medical School.

Metabolic syndrome is associated with reductions in basal limb blood flow. Resistance training increasing muscle mass and strength increases basal limb blood flow. Low-intensity resistance exercise with slow movement and tonic force generation (LST) has been proposed as one of the effective methods of resistance training increasing muscle mass and strength. The hypothesis that LST training increases basal femoral blood flow as well as traditional high-intensity resistance training at normal speed (HN) was examined. Thirty-six healthy young men without a history of regular resistance training were randomly assigned to the LST [similar to 55-60% one repetition maximum (1RM) load, 3 s lifting and 3 s lowering with no relaxation phase, n = 12], HN (similar to 85-90% 1RM, 1 s lifting and 1 s lowering with 1 s relaxation, n = 12) or sedentary control (CON, n = 12) groups. Participants in the training groups underwent two whole-body training sessions per week for 13 weeks. Basal femoral blood flow increased significantly by +18% in LST and +35% in HN (both P &lt; 0.05), while there was no such change in CON. There were no significant differences between these increases induced by LST and HN, although the increase in LST corresponded to about half that in HN. In conclusion, not only resistance training in HN but in LST as well, were effective for increasing basal limb blood flow, and that this effect was evident even in healthy young men.

Objective: To evaluate the possibility that measurement of the magnitude and distribution of fundamental somatic heat-producing units using dual-energy X-ray absorptiometry (DXA) can be used to estimate resting energy expenditure (REE) in both young and elderly women with different aerobic fitness levels.
Subjects and methods: Peak oxygen uptake (VO(2) peak) and REE(m) were directly measured in 116 young (age: 22.3 +/- 2.1 years) and 72 elderly (63.3 +/- 6.4 years) women. The subjects were divided into four groups according to categories of age and VO(2) peak; young: high fitness (YH, n = 58); low fitness (YL, n = 58); elderly: high fitness (EH, n = 37) and low fitness (EL, n = 35). Using DXA, systemic and regional body compositions were measured, and REE(e) was estimated from the sum of tissue organ weights multiplied by corresponding metabolic rate.
Results: Although there were remarkable differences in systemic and regional body compositions, no significant differences were observed between REE(m) and REE(e) in the four groups. REE(e) significantly correlated with REE(m) in elderly as well as young women; the slopes and intercepts of the two regression lines were statistically not different between the elderly and young groups (elderly: y = 0.60x+472, r = 0.667; young: y = 0.78x+250, r = 0.798; P &lt; 0.001, respectively). A Bland-Altman analysis did not indicate bias in calculation of REE for all the subjects.
Conclusion: These results suggest that REE can be estimated from tissue organ components in women regardless of age and aerobic fitness.

Objective: To investigate the relationships between regional skeletal muscle mass (SM mass) and bone mineral indices and to examine whether bone mineral content (BMC) normalized to SM mass shows a similar decrease with age in young through old age.
Subjects/Methods: One hundred and thirty-eight young and postmenopausal women aged 20-76 years participated in this study and were divided into three groups: 61 young women, 49 middle-aged postmenopausal women and 28 older postmenopausal women. Muscle thickness (MTH) was determined by ultrasound, and regional SM mass (arm, trunk and leg) was estimated based on nine sites of MTH. Whole-body and regional lean soft tissue mass (LSTM), bone mineral density (BMD) and BMC (whole body, arms, legs and lumbar spine) were measured using dual-energy X-ray absorptiometry.
Results: Ultrasound spectroscopy indicated that SM mass is significantly correlated with site-matched regional bone mineral indices and these relationships correspond to LSTM. The BMC and BMD in older women were significantly lower than those in middle-aged women. When BMC was normalized to site-matched regional SM mass, BMC normalized to SM mass in arm and trunk region were significantly different with age; however, whole-body and leg BMC normalized to SM mass showed no significant difference between middle-aged and older postmenopausal women.
Conclusions: The age-related differences in BMC were found to be independent of the ageing of SM mass in the arm and trunk region. However, differences in BMC measures of the leg and whole body were found to correspond to age-related decline of SM mass in postmenopausal women.

Objectives: The link between changes in leg strength per body weight and metabolic syndrome was evaluated in Japanese men with a 1-year follow up.<br>Subjects and Methods: We used data for 136 Japanese men (45.5 ± 8.5 years) with a 1-year follow up. All subjects were given instructions by well-trained medical staff on how to change their lifestyle. Metabolic syndrome has been defined by a new criterion in Japan. The association between changes in leg strength per body weight and metabolic syndrome was evaluated.<br>Results: With a 1-year follow up, body weight, abdominal circumference, systolic blood pressure, diastolic blood pressure and triglyceride were significantly reduced. Leg strength and leg strength per body weight and HDL cholesterol were significantly increased. The prevalence of metabolic syndrome was significantly reduced. There was significant relationship between changes in metabolic syndrome and changes in leg strength per body weight. The prevalence of metabolic syndrome was significantly reduced in subjects with an increase in leg strength per body weight (Group I) compared to subjects without such an increase (Group D). In addition, there were remarkable differences in delta abdominal circumference (delta represents positive changes in parameters) between Group I and Group D.<br>Conclusion: An increase in leg strength per body weight may be associated with improving metabolic syndrome and abdominal circumference in Japanese men.

Objective: The link between leg strength per body weight and oxygen uptake at ventilatory threshold (VT) was evaluated in Japanese women with a 1-year follow up.<br>Subjects and Methods: We used data for 60 Japanese women (46.1 ± 10.6 years) with a 1-year follow up. Changes in leg strength per body weight on oxygen uptake at VT were also evaluated.<br>Results: Oxygen uptake at VT (per body weight) was significantly correlated with body weight, body mass index (BMI), abdominal circumference, hip circumference, body fat percentage, leg strength and leg strength per body weight (r=0.520, p‹0.001). Body weight, BMI, abdominal circumference and body fat percentage were significantly reduced; work rate and right grip strength were significantly increased with a 1-year follow up. In addition, changes in oxygen uptake at VT (per body weight) were also significantly correlated with leg strength and leg strength per body weight (r=0.317, p=0.0137).<br>Conclusion: An increase in leg strength per body weight may be associated with increasing oxygen uptake at VT in Japanese women.

Objective: Both aerobic exercise level and body composition are associated with aging. In addition, lower aerobic exercise level and excess of body fat are risk for atherosclerosis. Therefore, the link between maximal oxygen uptake and anthropometric, body composition parameters was investigated.<br>Subjects and Methods: We used data for 300 Japanese (150 men: 44.2±14.1 years, 150 women: 44.4±14.1 years) in a cross sectional analysis. Maximal oxygen uptake was measured by breath-by-breath method and body composition was evaluated by dual energy X-ray absorptiometry (DEXA).<br>Results: Maximal oxygen uptake was significantly decreased with age over the age of 40. Body fat percentage measured by DEXA was significantly correlated with maximal oxygen uptake (men: r=−0.622, women: r=−0.604). In addition, the significant relationships between body fat percentage and clinical parameters i.e. triglyceride, high density lipoprotein (HDL) cholesterol, blood sugar, insulin and homeostasis model assessment (the HOMA index) were also noted.<br>Conclusion: Lower maximal oxygen uptake may be characteristic in subjects with higher body fat percentage and aerobic exercise should be recommended for preventing lifestyle-related disease.

Background/Objective: The most significant complication and leading cause of death for people with spinal cord injury (SCI) is coronary artery disease (CAD). It has been confirmed that aortic pulse wave velocity (PVW) is an emerging CAD predictor among able-bodied individuals. No prior study has described PWV values among people with SCI. The objective of this study was to compare aortic (the common carotid to femoral artery) PVW, arm (the brachial to radial artery) PWV, and leg (the femoral to posterior tibial artery) PVW in people with SCI (SCI group) to able-bodied controls (non-SCI group). Methods: Participants included 12 men with SCI and 9 non-SCI controls matched for age, sex, height, and weight. Participants with a history of CAD or current metabolic syndrome were excluded. Aortic, arm, and leg PWV was measured using the echo Doppler method. Results: Aortic PVW (mean ± SID) in the SCI group (1,274 ± 369 cm/s) was significantly higher (P &lt
0.05) than in the non-SCI group (948 ± 110 cm/s). There were no significant between-group differences in mean arm PWV (SCI: 1,152 ± 193 cm/s, non-SCI: 1,237 ± 193 cm/s) or mean leg PWV (SCI: 1,096 ± 173 cm/s, non-SCI: 994 ± 178 cm/s) values. Conclusions: Aortic PWV was higher among the SCI group compared with the non-SCI group. The higher mean aortic PWV values among the SCI group compared with the non-SCI group indicated a higher risk of CAD among people with SCI in the absence of metabolic syndrome. © 2009 by the American Paraplegia Society.

The purpose of the study was to develop a new non-exercise VO(2max) prediction model using a physical activity (PA) variable determined by pedometer-determined step counts (SC, steps day(-1)) in Japanese women aged 20-69 years old. Eighty-seven and 102 subjects were used to develop the prediction model, and to validate the new model, respectively. VO(2max) was measured using a maximal incremental test on a bicycle ergometer. SC was significantly related to VO(2max) (partial correlation coefficient r = 0.40, P &lt; 0.001) after adjusting for BMI (kg m(-2)) and age (years). When the new prediction equation developed by multiple regression to estimate VO(2max) from age, BMI, and SC (R = 0.71, SEE = 5.3 ml kg(-1) min(-1), P &lt; 0.001) was applied to the Validation group, predicted VO(2max) correlated well with measured VO(2max) (r = 0.81, P &lt; 0.001), suggesting that SC is a useful PA variable for non-exercise prediction of VO(2max) in Japanese women.

It has been reported that treatment with a pharmacological dose (45 mg/ d) of menaquinone-4 (MK-4) prevents bone loss in postmenopausal women. However, it is not known whether supplementation with low dose MK-4 has beneficial effects on bone metabolism in healthy women. The aim of this study is to examine the effects of the supplementation of 1.5 mg/d MK-4 for 4 wk on bone and lipid metabolism in healthy postmenopausal Japanese women. The study was performed as a randomized double blind placebo-controlled trial. The participants aged 53-65 y were randomly assigned to 2 groups and supplemented with 1.5 mg/d of MK-4 or a placebo for 4 wk (n=20 for each group). The most marked effects of MK-4 intake were observed on serum osteocalcin (OC) concentrations. Serum undercarboxylated OC (ucOC) concentration decreased, and the γ-carboxylated OC (GlaOC) and GlaOC/GlaOC+ucOC ratio that indicates the degree of OC γ-carboxylation increased significantly at 2 and 4 wk compared with that at baseline in the MK-4 group. The serum ucOC and GlaOC concentrations in the MK-4 group were significantly different from those in the placebo group at 2 wk. These results suggest that supplementation with 1.5 mg/d MK-4 accelerated the degree of OC γ-carboxylation. The concentrations of serum lipids and other indices were not different between the groups at either intervention period. Thus, the additional intake of MK-4 might be beneficial in the maintenance of bone health in post-menopausal Japanese women.

The aim of this cross-sectional study was to compare body composition and risk factors of lifestyle-related diseases between young and older male rowers and sedentary controls. Healthy males aged 19-73 years participated in the study, and were divided into four groups: 26 young rowers, 24 senior rowers, 23 young sedentary controls, and 22 senior sedentary controls. Total and regional lean soft tissue, fat mass, and bone mineral density were measured using dual-energy X-ray absorptiometry. The HDL-cholesterol of senior rowers (67.4 +/- 13.4 mg . dl(-1)) was significantly (P &lt; 0.05) higher than that of senior sedentary controls (59.2 +/- 11.9 mg . dl(-1)), while HDL-cholesterol was similar in senior rowers and young rowers (66.1 +/- 10.8 mg . dl(-1)). Arm, leg, and trunk lean soft tissue mass were significantly higher in senior rowers (5.6 +/- 0.6 kg, 18.2 +/- 1.8 kg, and 27.3 +/- 3.2 kg respectively) than in senior sedentary controls (5.1 +/- 0.4 kg, 16.3 +/- 1.4 kg, and 24.6 +/- 1.7 kg respectively; P &lt; 0.05). Bone mineral density was also significantly higher in senior rowers than in senior sedentary controls (ribs, lumbar spine, and pelvic segments; P &lt; 0.05). We conclude that age-related increases in the risk of lifestyle-related diseases, such as osteoporosis and sarcopenia, are attenuated in male rowers. These results suggest that regular rowing exercise may have a positive influence in the prevention of lifestyle-related diseases in older Japanese people.

Tanimoto, M, Sanada, K, Yamamoto, K, Kawano, H, Gando, Y, Tabata, I, Ishii, N, and Miyachi, M. Effects of whole-body low-intensity resistance training with slow movement and tonic force generation on muscular size and strength in young men. J Strength Cond Res 22(6): 1926-1938, 2008-Our previous study showed that relatively low-intensity (similar to 50% one-repetition maximum [1RM]) resistance training (knee extension) with slow movement and tonic force generation (LST) caused as significant an increase in muscular size and strength as high-intensity (similar to 80% 1RM) resistance training with normal speed (HN). However, that study examined only local effects of one type of exercise (knee extension) on knee extensor muscles. The present study was performed to examine whether a whole-body LST resistance training regimen is as effective on muscular hypertrophy and strength gain as HN resistance training. Thirty-six healthy young men without experience of regular resistance training were assigned into three groups (each n = 12) and performed whole-body resistance training regimens comprising five types of exercise (vertical squat, chest press, latissimus dorsi pull-down, abdominal bend, and back extension: three sets each) with LST (similar to 55-60% 1RM, 3 seconds for eccentric and concentric actions, and no relaxing phase); HN (similar to 80-90% 1RM, 1 second for concentric and eccentric actions, 1 second for relaxing); and a sedentary control group (CON). The mean repetition maximum was eight-repetition maximum in LST and HN. The training session was performed twice a week for 13 weeks. The LST training caused significant (p &lt; 0.05) increases in whole-body muscle thickness (6.8 +/- 3.4% in a sum of six sites) and 1RM strength (33.0 +/- 8.8% in a sum of five exercises) comparable with those induced by HN training (9.1 +/- 4.2%, 41.2 +/- 7.6% in each measurement item). There were no such changes in the CON group. The results suggest that a whole-body LST resistance training regimen is as effective for muscular hypertrophy and strength gain as HN resistance training.

Background: Since it is essential to maintain a high level of cardiorespiratory fitness to prevent life-style related disease, the Ministry of Health, Labour and Welfare of Japan in 2006 proposed to determine the maximal oxygen uptake (Vo(2)max: mL . kg(-1) . min(-1)) reference values to prevent lifestyle related diseases (LSRD). Since muscle mass is one of the determinant factors of Vo(2)max, it could be used as the reference parameter for preventing LSRD. The aim of this study was to determine and quantify the muscle mass required to maintain the Vo2max reference values in Japanese women.
Methods: A total of 403 Japanese women aged 20-69 years were randomly allocated to either a validation or a cross-validation group. In the validation group, a multiple regression equation, which used a set of age and the percentage of muscle mass (%MM, percentage of appendicular lean soft tissue mass to body weight), as independent variables, was derived to estimate the Vo(2)max. After the equation was cross-validated, data from the two groups were pooled together to establish the final equation. The required %MM for each subject was recalculated by substituting the Vo(2)max reference values and her age in the final equation.
Results: The mean value of required %MM was identified as (28.5 +/- 0.35%). Thus, the present study proposed the required muscle mass (28.5% per body weight) in Japanese women to maintain the Vo(2)max reference values determined by the Japanese Ministry of Health Labour and Welfare.
Conclusion: The estimated required %MM (28.5% per body weight) can be used as one of the reference parameters of fitness level in Japanese women.

The present study was performed to test the hypothesis that the blood pressure (BP) response to resistance exercise in middle-aged men with stiffening arteries is greater than that in young men with compliant arteries. The BP responses to acute dynamic resistance exercise (leg press) at individual relative (low, moderate and high) and absolute intensities were investigated in both young and middle-aged men. A total of 21 sedentary healthy normotensive men, 21-25 years of age (young) and 41-59 years of age (middle-aged), were included in the study. At rest, the arterial compliance (simultaneous ultrasound and applanation tonometry) and muscle strength (leg press) were lower, and indices of arterial stiffness and BP were higher in the middle-aged men than in the young men (p &lt; 0.05). There were no significant differences in height, body mass, or heart rate between the two groups. During exercise, the systolic BP of the middle-aged men at 80% one-repetition maximum (1RM) was significantly lower than that of the young men for the last half of the exercise period (p &lt; 0.05). The amounts of change in systolic and diastolic BP from baseline to the end of resistance exercise were lower in the middle-aged men than in the young men at individual relative intensities (p &lt; 0.05) and at individual absolute intensity. In contrast to our hypothesis, these findings indicated that the BP response during dynamic resistance exercise using large muscle groups may be attenuated in middle-aged men relative to young men.

Resistance training is a popular mode of exercise, but may result in stiffening of the central arteries. Changes in carotid artery diameter were determined using the cold pressor test (CPT), which results in production of nitric oxide via sympathetic activation and is one of the novel methods available for assessing endothelial function in the carotid artery. To investigate the effect of resistance training on endothelial function, we designed a cross-sectional study of carotid arterial vasoreactivity to CPT in men participating in regular resistance training with increased carotid arterial stiffness compared with age-matched control subjects. Twelve resistance-trained middle-aged men (age 38.7 +/- 1.7 years) and 17 age-matched control subjects (age 36.8 +/- 1.2 years) were studied. The direction and magnitude of changes in carotid artery diameter were measured by B-mode ultrasonography during sympathetic stress induced by submersion of the foot in ice slush for 90 s. Carotid arterial beta-stiffness index, and systolic and mean arterial blood pressure were higher (7.7 +/- 0.7 versus 6.0 +/- 0.4 arbitrary units, 116 +/- 2 versus 131 +/- 4 mmHg and 86 +/- 2 versus 95 +/- 2 mmHg, respectively, all P &lt; 0.05) in the resistance training group compared with control subjects. There were, however, no significant differences in the amount or percentage change in carotid artery diameter in CPT between the two groups (resistance training group, 0.33 +/- 0.07 mm and 5.2 +/- 1.1%; control group, 0.37 +/- 0.06 mm and 5.8 +/- 0.9%, respectively). These findings suggest that while carotid arterial stiffening and higher blood pressure are observed in regular resistance-trained men, these are not associated with abnormalities in carotid arterial vasoreactivity to sympathetic stimulus, which implies intact endothelial function.

BACKGROUND: Japan has entered the epidemic of obesity. To clarify the contributing factors to the development of metabolic syndrome triggered by visceral fat obesity and to investigate the effectiveness of a weight-loss program, we launched a new intervention program for obese people. <br>METHODS: Japanese subjects with high body mass index (BMI > 28.3 kg/m⊃2;) were selected for a weight-loss program from those who had undergone a medical checkup at the Saku Central Hospital. The baseline anthropometric and clinical findings of the participants were analyzed.<br>RESULTS: At baseline, 235 subjects (116 men and 119 women) participated in this program. The mean weight, waist circumference, and visceral fat area were 86.4 ± 11.8 kg, 101.5 ± 8.7 cm, and 159.0 ± 54.1 cm⊃2; in men and 75.2 ± 9.5 kg, 103.7 ± 8.3 cm, and 129.8 ± 47.0 cm⊃2; in women, respectively. Using the Japanese diagnostic criteria, the prevalence of metabolic syndrome was 62.9% in men and 51.3% in women. Leptin, c-peptide, and insulin levels tended to increase with increasing numbers of metabolic risk factors in men. In women, c-peptide and free fatty acid levels tended to increase with increasing numbers of these factors, but adiponectin decreased dose-dependently with increasing numbers of factors. <br>CONCLUSIONS: More than half the subjects were founded to meet the criteria for metabolic syndrome. Immediate intervention to lose weight and to improve other risk factors of metabolic syndrome is necessary in such seriously obese people.

BACKGROUND: Long-term weight loss is difficult to maintain, but recently cognitive behavioral therapy has been shown to be effective for long-term weight loss and maintenance.<br>METHODS: The 119 participants, who had been assigned to program to lose weight, were interviewed by dieticians regarding their motivation for weight loss and psychological status and self-corrected problems with their eating activities and exercises, following recognition of problems, discussing solutions, and devising personal dietary plans and exercise plan to loose weight at 1.0-2.0 kg per month.<br>RESULTS: In women, the prevalence of motivation to resolve the situation (n = 44, 84.6%) was significantly higher than that of men (n = 33, 67.3%; p < 0.05). In men, awareness of the need to keep healthy by oneself was significantly associated with the motivation to resolve the situation (p = 0.002) and the availability of support from others (p = 0.004). Thirty problems and 29 dietary goals were set by participants. The percentages of intake of alcohol (p < 0.05) and intake of sweets (p < 0.01) as the problems and decrease of intake in specified foods (p < 0.01) and snacks (p = 0.05) as dietary goals were significantly different between men and women. Women with BMI over 31 kg/m&sup2; set fewer additional steps as exercise goals than those with BMI under 29 kg/m&sup2; (p < 0.05).<br>CONCLUSIONS: The characters of subjects such as psychological status and the problems and the target recognized by participants were different between gender and the degree of obesity.

Specific medical checkups and health guidance procedures to prevent and alleviate metabolic syndrome in middle-aged or older subjects (aged 40&ndash;75 years old) were initiated in workplaces and autonomous communities throughout Japan in April 2008, according to the guidance of the Ministry of Health, Labor and Welfare of Japan. As it is important to provide instruction regarding exercise, physical activities and diet, a safe and efficient evidence-based instruction program is required. The requirements for such a program are as follows: (1) knowledge of necessary exercise and physical activity levels for prevention and alleviation of metabolic syndrome; (2) ability to appropriately evaluate the physical activity level of subjects; (3) motivation of subjects to positively modify their behavior; (4) sufficient consideration of exercise and diet combination; (5) conducting sufficient risk management to prevent accident and injury; and (6) acquiring necessary licenses for instruction. The subject should then actively engage in exercise and physical activity based on the instruction given.<br>

身体活動に伴うエネルギー消費は、肥満やその関連疾患と負の関係があり、運動はこれらの疾患の予防改善に重要な役割を果たす。本研究は、230名の肥満者を対象に日常の歩数と身体活動関連エネルギー消費量を測定し、身体活動量と腹部脂肪との関係を検討した。結果として、加速度計で評価した身体活動量は全身性肥満だけでなく、腹部肥満とも部分的に関係した。

We measured the basal metabolic rate (BMR), fat-free mass (FFM) and physical activity level (PAL) of well-trained bodybuilders as typical athletes with muscular development by resistance training in order to examine the standard BMR and PAL ranges for athletes. The subjects were 14 bodybuilders (mean±SD age: 36.8±9.1y.; height: 171.6±6.2cm; weight: 77.1±7.6kg; FFM: 67.6±6.8kg) who each trained for an average of 7.5h per week. BMR was measured by using a Douglas bag, the oxygen and carbon dioxide concentrations were analyzed by mass spectrometry, and FFM was measured by dual X-ray energy absorptiometry. PAL was measured by the doubly labeled water method for 7 subjects selected from the 14 bodybuilders. BMR/FFM was 25.4±2.1kcal/kg of FFM/day. Total energy expenditure (TEE) was 3, 432±634kcal, and PAL calculated as TEE divided by BMR was 2.00±0.21. The FFM value needs to be considered when evaluating a standard BMR range, and both training and daily physical activity levels should be considered when evaluating a standard PAL range.

Objective: It has been suggested that exercise has preferential effects on visceral fat reduction. However, the dose-response effect remains unclear because of limited evidence from individual studies. The purpose of this study was to systematically review the current literature to establish whether reduction of visceral fat by aerobic exercise has a dose-response relationship.
Methods: A database search was performed (PubMed, 1966-2006) with appropriate keywords to identify studies exploring the effects of aerobic exercise as a weight loss intervention on visceral fat reduction. Visceral fat reduction was expressed as the percentage of visceral fat change per week (% Delta VF/w). The energy expenditure by aerobic exercise was expressed as Sigma(metabolic equivalents x h per week (METs center dot h/w)).
Results: Nine randomized control trials and seven non-randomized control trials were selected. In most of the studies, the subjects performed aerobic exercise generating 10 METs center dot h/w or more. Among all the selected groups (582 subjects), visceral fat decreased significantly (P &lt; 0.05) in 17 groups during the intervention, but not in the other 4 groups. There was no significant relationship between METs center dot h/w from aerobic exercise and %Delta VF/w in all the selected groups. However, when subjects with metabolic-related disorders were not included (425 subjects), METs center dot h/w from aerobic exercise had a significant relationship with %Delta VF/w (r= -0.75). Moreover, visceral fat reduction was significantly related to weight reduction during aerobic exercise intervention, although a significant visceral fat reduction may occur without significant weight loss.
Conclusion: These results suggest that at least 10 METs center dot h/w in aerobic exercise, such as brisk walking, light jogging or stationary ergometer usage, is required for visceral fat reduction, and that there is a dose-response relationship between aerobic exercise and visceral fat reduction in obese subjects without metabolic-related disorders.

It has been demonstrated in a previous study that resting energy expenditure (REE) is associated with adiponectin levels in the blood. However, body composition was not taken into consideration in that study. The purpose of the present study was to again investigate the relationship between blood adipocytokines and REE, adjusted by body composition, in both young and elderly women. REE and blood adipocytokines were measured in 115 young (age: 22.3 +/- 2.1 y, BMI: 21.3 +/- 1.9 kg/ml) and 71 elderly (63.4 +/- 6.5 y, 22.9 +/- 2.3 kg/m(2)) women. Dual energy X-ray absorptiometry was used to measure percent body fat. Fat mass and fat free mass (FFM) were calculated. REE (kcal/d and kcal/kg BW/d) was lower in elderly women than in young women, but no significant difference was observed in REE, expressed as kcal/kg FFM/d, between the two groups. Although elderly women had a higher percent body fat and higher serum leptin concentrations than young women, plasma adiponectin concentrations did not differ between young and elderly women. In elderly women, REE (kcal/d) was significantly and inversely correlated with plasma adiponectin concentration (r = -0.386, p&lt;0.001), but REE expressed per kilogram of BW or FFM was not significantly correlated. Furthermore, no significant correlation was observed between REE (kcal/d) and concentrations of plasma adiponectin or serum leptin, after adjusting for potential confounders such as body composition and hormones, in either age group. These results suggest that adipocytokines do not influence REE in adult women.

We evaluated the linkage between oxygen uptake at the ventilatory threshold (VT) and muscle strength in subjects with and without metabolic syndrome. We used data of 226 Japanese men with metabolic syndrome and 265 Japanese men without the syndrome. Metabolic syndrome has recently been defined by a new criterion in Japan. Oxygen uptake at VT and muscle strength, i.e. grip strength and leg strength were measured. Oxygen uptake at VT and muscle strength/body weight were found to be significantly lower in subjects with metabolic syndrome than in those without the syndrome. However, the differences did not reach significant levels after adjusting for leg strength/body weight or oxygen uptake at VT. A combination of aerobic exercise and resistance training might be considered for preventing and improving metabolic syndrome.

Objective: We compared the levels of ventilatory threshold (VT) and exercise habits in subjects with metabolic syndrome with those in age, sex-matched subjects without metabolic syndrome.
Methods: We used data of 155 Japanese men (47.1 +/- 9.2 years) with metabolic syndrome; the diagnosis was given by the definition and the diagnostic standard for metabolic syndrome in Japan. The influence of metabolic syndrome on oxygen uptake, work rate and heart rate at VT, and exercise habits were evaluated.
Results: Oxygen uptake and work rate at VT in subjects with metabolic syndrome were significantly lower than those in subjects without metabolic syndrome even after adjusting for body mass index (BMI). The number of subjects with exercise habits was significantly lower in metabolic syndrome. The subjects with exercise habits were significantly older than that in subjects without exercise habits. Furthermore, oxygen uptake and work rate at VT were significantly higher in subjects with exercise habits than those in subjects without exercise habits.
Conclusion: Lower level of VT was characteristic in subjects with metabolic syndrome. Promotion of exercise habits is necessary for preventing and improving metabolic syndrome in Japanese men. (C) 2006 Elsevier Ireland Ltd. All rights reserved.

We compared muscle strength between Japanese men with and without metabolic syndrome. We used data for 323 Japanese men with metabolic syndrome and 893 Japanese men without the syndrome. Metabolic syndrome was defined by a new criterion in Japan, and the parameters for muscle strength, i.e. grip strength, leg strength were measured. Leg strength was found to be significantly higher in subjects with metabolic syndrome than in those without, while muscle strength per body weight was significantly lower in subjects with the syndrome. Lower muscle strength per body weight may be one of the characteristic features in subjects with metabolic syndrome.

Ventilatory threshold (VT) is an important predictor of cardiorespiratory fitness, such as peak oxygen uptake (&lt;(V)over dot &gt;(O2peak)) and is a valuable index of aerobic exercise intensity. However, little is known about the role of skeletal muscle ( SM) mass in the ageassociated decline of VT. Therefore, the present study was performed to investigate the effects of age on cardiopulmonary fitness normalised for regional SM mass in 1,463 Japanese men and women, and to determine the relevance of VT normalised to SM mass based on age and gender. Total, trunk and thigh SM mass were measured using an ultrasound method, while &lt;(V)over dot &gt;(O2pea)k and VT were determined during treadmill walking. &lt;(V)over dot &gt;(O2peak) was estimated using the predicted maximum heart rate ( HR) and the HR-&lt;(V)over dot &gt;(O2) relationship for sub- maximal treadmill walking. There were significant negative correlations between VT normalised for body mass and age in men and women ( P &lt; 0.001). Age- associated declines were also observed in VT normalised for body mass in both men and women; however, VT normalised for SM mass was not significantly different with age. Significant correlations were also observed between thigh SM mass and VT in both men and women. These results suggest that thigh SM mass is closely associated with &lt;(V)over dot &gt;(O2peak) and/ or VT in both men and women, and the decrease in VT with age is predominantly due to an age- related decline of SM mass. Moreover, this study provides normative cardiorespiratory fitness data regarding VT normalised SM mass in healthy men and women aged 20 - 80 years.

It has frequently been demonstrated that prior high-intensity exercise facilitates pulmonary oxygen uptake (VO2) response at the onset of subsequent identical exercise. To clarify the roles of central O-2 delivery and/or peripheral O2 extraction in determining this phenomenon, we investigated the relative contributions of cardiac output (CO) and arteriovenous O-2 content difference (a-(v) over bar DO2) to the VO2 transient during repeated bouts of high-intensity knee extension (KE) exercise. Nine healthy subjects volunteered to participate in this study. The protocol consisted of two consecutive 6-min KE exercise bouts in a supine position (work rate 70-75% of peak power) separated by 6 min of rest. Throughout the protocol, continuous-wave Doppler ultrasound was used to measure beat-by-beat CO (i.e., via simultaneous measurement of stroke volume and the diameter of the arterial aorta). The phase II VO2 response was significantly faster and the slow component (phase III) was significantly attenuated during the second KE bout compared to the first. This was a result of increased CO during the first 30 s of exercise: CO contributing to 100 and 56% of the VO2 speeding at 10 and 30 s, respectively. After this, the contribution of (a-(v) over bar DO2) became increasingly more predominant: being responsible to an estimated 64% of the VO2 speeding at 90 s, which rose to 100% by 180 s. This suggests that, while both CO and a-(v) over bar DO2 clearly interact to determine the VO2 response, the speeding of VO2 kinetics by prior high-intensity KE exercise is predominantly attributable to increases in a-(v) over bar DO2.

BACKGROUND: Obesity is one of the most common risks for lifestyle-related diseases, but the personality of individuals in relation to obesity has not been well studied. We investigated the association of personality traits with physical activity levels and eating behaviors in obese subjects. METHOD: The subjects were 116 males and 119 females in the Saku Control Obesity Program SCOP study. The influence of personality on obesity was analyzed using a questionnaire from the NEO-FFI. We analyzed the association of physical activity level (measured with an accelerometer) and eating behavior (assessed by a questionnaire) among the three classes (low, average, high) of scores within five personality domains. RESULTS: Scores in the Neuroticism and Agreeableness domains of females were significantly higher than those of males. There were significant differences among the three classes of Neuroticism and Agreeableness with regard to physical activity levels. Eating behavior was associated with the Neuroticism and Openness domains. The scales of bad eating behavior related to obesity were positively correlated with scores in the Neuroticism domain in both males and females. In males the scale of all categories of eating behavior increased as scores in the Openness domain rose; in females the scale of "perception of constitution and weight" decreased as Openness scores rose. CONCLUSION: Personality determined by NEO-FFI was related to physical activity level and eating behavior. In particular, the Neuroticism domain had great effects on these parameters.

BACKGROUND: The increasing number of patients with metabolic syndrome and resultant diabetes mellitus, hypertension, hyperlipidemia, and other lifestyle-related diseases are an urgent focus of the Ministry of Health, Labor and Welfare. Because obesity is a common basis of these diseases, the control of obesity is an important aim. METHODS: A cognitive-behavioral treatment is being employed in a randomized intervention trial at the Saku Health Dock Center. 976 people whose BMI in upper quintile were identified from the health checkup database, and 235 people participated in the Saku Control Obesity Program (SCOP). Various biomarkers (including lipokines and single nucleotide polymorphism SNPs), physical activity, personality type (measured by the NEO-FFI), and dietary habits and dietary intake behavior (measured by the SQ-DHQ) will be measured to clarify the multiple factors influencing obesity. Each participant will use a diary to record body weight, body fat, number of steps, physical activity energy expenditure (PAEE), and success in achieving the established plan; a dietary record and appropriate equipment are also provided. At 1, 3, 6, 9, and 12 months, each participant will be interviewed by a doctor and dietician and receive individual education regarding physical activity. Follow-up will occur 1 and 2 years after baseline measurements. RESULTS: A total of 116 men (52.9 ± 6.6 years) and 119 women (54.4 ± 6.5 years) are participating in the study. Average body weight (± SD) was 86.4 ± 11.8 kg in males and 75.2 ± 9.5 in females. BMI was 30.4 ± 3.5 in males and 31.1 ± 3.1 in females. Waist and visceral fat area were 101.5 ± 8.7 cm and 159 ± 54 cm² in males and 103.7 ± 8.3 cm and 130 ± 47 cm² in females, respectively. PAEE was 271 ± 127 kcal in males and 246 ± 102 kcal in females. Basal metabolic rate, measured in one-tenth of the participants, was 1659 ± 226 kcal in males and 1477 ± 210 kcal in females. CONCLUSION: The purpose of this study is to evaluate the effectiveness of a cognitive-behavioral treatment designed to help obese patients lose weight and to maintain their weight losses over time. SCOP has been started with a good participation rate.

We investigated the relation between metabolic syndrome and whole body reaction time. We used data for 169 men with metabolic syndrome and 398 men without. Metabolic syndrome was defined by a new criteria developed in Japan. Whole body reaction time was also measured by THP-15 (Sakai, Tokyo, Japan). Whole body reaction time in men with metabolic syndrome was significantly longer than without the syndrome. In addition, the clinical impact of dyslipidemia and body mass index (BMI) was also noted. Longer whole body reaction time was noted in Japanese men with metabolic syndrome.

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.

The purpose of the present study was to examine the effect of unilateral lower limb suspension (ULLS) deconditioning on oxygen uptake kinetics. Eight healthy males underwent ULLS for 20 days and performed a series of 6-min square-wave transitions from rest to 60-W single-leg cycling exercises just before and after ULLS. To characterize the kinetics of the oxygen uptake response, a single exponential model was applied to the data until the end of the fast component omitted the first 15 s of the on-transit using a nonlinear least-squares fitting procedure. The following results were found: (i) the time constant of oxygen uptake was unchanged before and after ULLS; (ii) although there was no significant difference in the baseline and the asymptotic amplitude of the fast component, the asymptote, i.e., the absolute asymptotic amplitude of the fast component (the sum of the baseline and the asymptotic amplitude), and the end exercise oxygen uptake were decreased after ULLS; (iii) the contribution of the slow component to the total response of oxygen uptake was unchanged at pre- and post-ULLS. In conclusion, the asymptote in the fast component and the end exercise oxygen uptake were decreased after 20-d ULLS, though the response speed and the amplitude of the slow component of oxygen uptake were not changed. It is suggested that deconditioning as a result of limb disuse affects oxygen uptake response.

Objectives This study aimed to determine the effects of moderate resistance training as well as the combined resistance and aerobic training intervention on carotid arterial compliance.
Background Resistance training has become a popular mode of exercise, but intense weight training is shown to stiffen carotid arteries.
Methods Thirty-nine young healthy men were assigned either to the moderate-intensity resistance training (MODE), the combined resistance training and endurance training (COMBO) or the sedentary control (CONTROL) groups. Participants in the training groups underwent three training sessions per week for 4 months followed by four additional months of detraining.
Results All training groups increased maximal strength in all the muscle groups tested (P &lt; 0.05). Carotid arterial compliance (via simultaneous carotid ultrasound and applanation tonometry) decreased approximately 20% after MODE training (from 0.20 +/- 0.01 to 0.16 +/- 0.01 mm(2)/mmHg, P &lt; 0.01). No significant changes in carotid arterial compliance were observed in the COMBO (0.20 +/- 0.01 to 0.23 +/- 0.01 mm(2)/mmHg) and CONTROL (0.20 +/- 0.01 to 0.20 +/- 0.01 mm(2)/mmHg) groups. Following the detraining period, carotid arterial compliance returned to the baseline level. Peripheral (femoral) artery compliance did not change in any groups.
Conclusions We concluded that simultaneously performed aerobic exercise training could prevent the stiffening of carotid arteries caused by resistance training in young healthy men.

健常者12名(男6名・女6名,平均44.2歳)を対象に,仰臥位安静時の膝下丈弾性ストッキング着用による下腿静脈容量をストレンゲージプレチスモグラフにより測定し,駆血用カフ圧-下腿静脈容量曲線より下腿静脈コンプライアンス(VC)を算出した.弾性ストッキングは低圧迫非段階的(LS),中圧迫段階的(MS),高圧迫段階的(HS)のものを使用した.VCは段階的弾性ストッキングの着圧増加に従って上昇傾向を示し,VCの傾きはHS,MSが裸足と比較して有意に上昇した.静脈容量および最大静脈還流量も着圧が増加するに従って増大し,HS,MSは裸足と有意差を認めた.VCと静脈容量および最大静脈還流量は正の相関を示した.段階的弾性ストッキング着用による下腿圧増加は,VCを上昇させ,静脈還流を亢進させることが示唆された

The effect of menstrual cycle phase on arterial elasticity is controversial. In 10 healthy women (20.6 +/- 1.5 years old, mean +/- S.D.), we investigated the variations in central and peripheral arterial elasticity, blood pressure (carotid and brachial), carotid intima-media thickness (IMT), and serum oestradiol and progesterone concentrations at five points in the menstrual cycle (menstrual, M; follicular, F; ovulatory, O; early luteal, EL; and late luteal, LL). Carotid arterial compliance (simultaneous ultrasound and applanation tonometry) varied cyclically, with significant increases from the values seen in M (0.164 +/- 0.036 mm(2) mmHg(-1)) and F (0.171 +/- 0.029 mm(2) mmHg(-1)) to that seen in the O phase (0.184 +/- 0.029 mm(2) mmHg(-1)). Sharp declines were observed in the EL (0.150 +/- 0.033 mm(2) mmHg(-1)) and LL phases (0.147 +/- 0.026 mm(2) mmHg(-1); F=8.51, P &lt; 0.05). Pulse wave velocity in the leg (i.e. peripheral arterial stiffness) did not exhibit any significant changes. Fluctuations in carotid arterial elasticity correlated with the balance between oestradiol and progesterone concentrations. No significant changes were found in carotid and brachial blood pressures, carotid artery lumen diameter, or IMT throughout the menstrual cycle. These data provide evidence that the elastic properties of central, but not peripheral, arteries fluctuate significantly with the phases of the menstrual cycle.

Aim: Fluctuations in autonomic nervous functions throughout the menstrual cycle and the underlying mechanism concerning them are not well known. This study was designed to test the hypothesis that fluctuations in cardiovagal baroreflex sensitivity (BRS) throughout the menstrual cycles of young women are due to fluctuations in carotid arterial distensibility.
Methods: In eight eumenorrhoeic healthy young women (18-24 years), we determined the variations in the carotid arterial distensibility coefficient (DC; via simultaneous ultrasonography and applanation tonometry), cardiovagal BRS (phase IV of the Valsalva manoeuvre and the sequence method; up- or down-sequence spontaneous BRS), and serum oestradiol and progesterone concentrations at five points in the menstrual cycle (menstrual = M, follicular = F, ovulatory = O, early luteal = EL, and late luteal = LL).
Results: Serum oestradiol and progesterone levels were consistent with the predicted cycle phases. Carotid arterial DC fluctuated cyclically, increasing significantly from the M (52.4 +/- 4.9 x 10(-3) kPa(-1), mean +/- SE) and F (52.7 +/- 4.4) phases to the O (57.6 +/- 4.4) phase and declining sharply in the EL (46.0 +/- 4.0) and LL (45.1 +/- 3.0) phases (F = 6.37, P &lt; 0.05). Contrary to our prediction, however, cardiovagal BRS by the Valsalva manoeuvre (P = 0.73) or sequence method (up-sequence spontaneous BRS; P = 0.84: down-sequence spontaneous BRS; P = 0.67) did not change significantly during the menstrual cycle.
Conclusion: The results suggest that, although carotid arterial distensibility fluctuates with the changes in ovarian hormone levels that occur during the menstrual cycle, the fluctuations in carotid arterial distensibility do not influence cardiovagal BRS.

The purpose of the present study was to clarify effect of increase in calf pressure on calf venous compliance. The calf pressures were increased by wearing elastic compression stockings with different pressures (Calf pressure 0, 12, 17, 21 mmHg). Healthy twelve people (six men and six women, 43.3 ± 15.3 years) volunteered to participate in this study. Changes in calf venous volume during spine rest were measured by mercury plethysmography. We analyzed the calf venous compliance by inflating the venous collecting cuff to 60 mmHg for 7 min, then decreasing cuff pressure at 1 mmHg/sec (over 1 min) to 0 mmHg, using cuff pressure as an estimate of venous pressure. This method produced pressure-volume curves fitting the quadratic regression (Δlimb volume) = β 0 + β 1 · (cuff pressure) + β 2 ·(cuff pressure) 2 , where Δ is change. The higher calf venous compliance and volume were observed in with the higher pressure stocking. These results suggest that higher calf pressure induced by wearing elastic compression stocking increases calf venous compliance and maximum venous outflow.

Reductions in basal leg blood flow have been implicated in the pathogenesis of metabolic syndrome and functional impairment in humans. We tested the hypothesis that reductions in basal whole leg blood flow with age are either absent or attenuated in those who perform regular strength training. A total of 104 normotensive men aged 20-34 yr (young) and 35-65 yr (middle aged), who were either sedentary or resistance trained, were studied. Mean and diastolic blood pressures were higher (P &lt; 0.05-0.001) in the middle-aged compared with the young men, but there were no significant differences between the sedentary and resistance-trained groups. In the sedentary group, basal whole leg blood flow (duplex Doppler ultrasound) and vascular conductance were lower (similar to 30 and similar to 38%, respectively; P &lt; 0.01) in the middle-aged compared with the young men. There were no such age-related differences in the resistance-trained group. In the young men, basal whole leg blood flow and vascular conductance were not different between the two activity groups, but, in the middle-aged men, they were higher (similar to 35 and similar to 36%, respectively; P &lt; 0.01) in the resistance-trained men than in the sedentary men. When blood flow and vascular conductance were expressed relative to the leg muscle mass, the results were essentially the same. We concluded that the age-related reduction in basal whole leg blood flow is absent in resistance-trained men. These results suggest that resistance training may favorably influence leg perfusion in aging humans, independent of its impact on leg muscle mass.

To examine the possible age-related blood pressure (BP) deregulation in response to central hypervolemia, we measured spontaneous baroreflex sensitivity (SBRS), carotid arterial compliance (CC), and R-R interval coefficient of variation (RRICV) during basal and thermoneutral resting head-out-of-water immersion (HOWI) in 7 young (YG = 24.0 ± 0.8 years) and 6 middle-aged/older (OL = 59.3 ± 1.3 years) healthy men. Compared with basal conditions (YG = 19.6 ± 4.0 vs OL = 6.1 ± 1.5 ms/mmHg, P &lt
0.05), SBRS remained higher in YG than OL during rest HOWI (YG = 23.6 ± 6.6 vs OL = 9.3 ± 2.1 ms /mmHg, P &lt
0.05). The RRICV was significantly different between groups (YG = 6.5 ± 1.4 vs OL = 2.8 ± 0.4%, P &lt
0.05) under HOWI. The OL group had no increase in CC, but a significant increase in systolic BP (basal = 115.3 ± 4.4 vs water = 129.3 ± 5.3 mmHg, P &lt
0.05) under HOWI. In contrast, the YG group had a significant increase in CC (basal = 0.16 ± 0.01 vs water = 0.17 ± 0.02 mm2/mmHg, P &lt
0.05) with no changes in systolic BP. SBRS was positively related to CC (r = 0.58, P &lt
0.05 for basal vs r = 0.62, P &lt
0.05 for water). Our data suggest that age-related vagal dysfunction and reduced CC may be associated with SBRS differences between YG and OL groups, and with BP elevation during HOWI in healthy older men.

Background - Reductions in the compliance of central arteries exert a number of adverse effects on cardiovascular function and disease risk. Endurance training is efficacious in increasing arterial compliance in healthy adults. We determined the effects of resistance training on carotid arterial compliance using the intervention study design.
Methods and Results - Twenty-eight healthy men 20 to 38 years old were randomly assigned to the intervention group ( n = 14) and the control group ( n = 14). Control subjects were instructed not to alter their normal activity levels throughout the study period. Intervention subjects underwent 3 supervised resistance training sessions per week for 4 months and detraining for a subsequent 4 months. The resistance training increased maximal strength in all muscle groups tested ( P &lt; 0.001). There were no significant differences in baseline arterial compliance and &beta;-stiffness index between the intervention and control groups. In the intervention group, carotid arterial compliance decreased 19% ( P &lt; 0.05), and beta-stiffness index increased 21% ( P &lt; 0.01) after resistance training. These values returned completely to the baseline levels during the detraining period. Arterial compliance did not change in the control group. In both groups, there were no significant changes in brachial and carotid blood pressure, carotid intima-media thickness, lumen diameter, and femoral arterial compliance. Changes in carotid artery compliance were significantly and negatively related to corresponding changes in left ventricular mass index ( r = - 0.56, P &lt; 0.001) and left ventricular hypertrophy index ( r = - 0.68, P &lt; 0.001).
Conclusions - In marked contrast to the beneficial effect of regular aerobic exercise, several months of resistance training "reduces" central arterial compliance in healthy men.