Chiyoe Murata

Validity of self-reported height and weight in a Japanese workplace population.

OBJECTIVE:To assess the validity of self-reported height and weight in a Japanese workplace population, and to examine factors associated with the validity of self-reported weight.DESIGN:Comparison of self-reported height and weight with independent measurement.SUBJECTS:In total, 4253 men and 1148 women aged 35–64 y (mean measured body mass index (BMI): 23.3 kg/m2 in men, 21.9 kg/m2 in women) were included in the study.MEASUREMENTS:Self-reported height and weight were obtained by a self-administered questionnaire. Measured height and weight were based on annual health checkups. Sex, age, measured BMI, and the presence of hypertension, diabetes, and hyperlipidemia were examined as potential factors associated with the accuracy of self-reported weight.RESULTS:Self-reported height and weight were highly correlated with measured height and weight for men and women (Pearson’s r for men and women: 0.979 and 0.988 in height, 0.961 and 0.959 in weight, 0.943 and 0.950 in BMI, respectively). For men, mean differences±2 s.d. of height and weight were 0.078±2.324 cm and −0.034±5.012 kg, respectively, and for women 0.029±1.652 cm and 0.024±4.192 kg, respectively. The prevalence of obesity with BMI ≥25 kg/m2 based on self-reported data (23.6 and 11.5% for men and women, respectively) was slightly smaller than that based on measured data (24.9 and 12.4%, respectively). Specificity and sensitivity, however, were quite high for both men and women (sensitivity was 85.8 and 85.2%, and specificity was 97.0 and 98.9%, respectively). The subjects with higher measured BMI significantly underestimated their weight compared with those with smaller BMI after adjustments for age in men and women. Furthermore, the presence of diabetes in men and age in women affected self-reported weight. Neither the presence of hypertension nor hyperlipidemia was associated with reporting bias.CONCLUSION:The self-reported height and weight were generally reliable in the middle-aged employed Japanese men and women. However, it should be remembered that self-reported weight was biased by actual BMI and affected by age and the presence of diabetes.

The metabolic syndrome is associated with elevated circulating C-reactive protein in healthy reference range, a systemic low-grade inflammatory state.

OBJECTIVE: To elucidate the underlying mechanisms between C-reactive protein (CRP) and cardiovascular disease, we exa-mined the association of circulating CRP in healthy reference range (≤1.0 mg/dl) measured by high-sensitive CRP assay with the metabolic syndrome (MS).DESIGN: Cross-sectional study of circulating CRP in adult men.SUBJECTS: A total of 3692 Japanese men aged 34–69 y.MEASUREMENTS: Serum CRP, total cholesterol, triglycerides, LDL-cholesterol, fasting glucose, fasting insulin, uric acid, systolic blood pressure, diastolic blood pressure, and body mass index (BMI).RESULTS: There was a statistically significant positive correlation between CRP and BMI (r=0.25), total cholesterol (r=0.096), triglycerides (r=0.22), LDL-cholesterol (r=0.12), fasting glucose (r=0.088), fasting insulin (r=0.17), uric acid (r=0.13), systolic blood pressure (r=0.12), and diastolic blood pressure (r=0.11), and a significant negative correlation of CRP with HDL-cholesterol (r=0.24). After adjusting for age, smoking, and all other components of MS, obesity, hypertriglyceridemia, hyper-LDL-cholesterolemia, diabetes, hyperinsulinemia, and hyperuricemia were significantly associated with both mildly (≥0.06 mg/dl) and moderately (≥0.11 mg/dl) elevated CRP. Compared with men who had no such components of the MS, those who had one, two, three, four, and five or more components were, respectively, 1.48, 1.84, 1.92, 3.42, and 4.17 times more likely to have mildly elevated CRP levels (trend P<0.001). As for moderately elevated CRP, the same association was observed.CONCLUSIONS: These results indicate that a variety of components of the MS are associated with elevated CRP levels in a systemic low-grade inflammatory state.

Eating fast leads to obesity: findings based on self-administered questionnaires among middle-aged Japanese men and women.

BACKGROUND Few epidemiologic studies have examined the association between the rate of eating and obesity. In this study, we cross-sectionally examined the association of the self-reported rate of eating with current Body Mass Index (BMI), and BMI-change from 20 years of age to the current age. METHODS Subjects were 3737 male (mean age ± standard deviation and mean BMI ± standard deviation: 48.2 ± 7.1 years and 23.3 ± 2.7 kg/m2) and 1005 female (46.3 ± 7.0 years and 21.8 ± 2.8 kg/m2) Japanese civil servants. We measured self-reported categorical rate of eating, current BMI, BMI at age 20, and BMI-change from age 20. Energy intake was assessed over a 1-month period with a brief-type diet history questionnaire. RESULTS The multiple regression analysis in which the current BMI was regressed by categorical rate of eating, energy intake, age, and lifestyle factors showed that current BMI steadily increased by -0.99, -0.67, 0.81, and 1.47 kg/m2 along with the progress of categorical rate of eating from the ‘medium’ group to ‘very slow’, ‘relatively slow’, ‘relatively fast’, and ‘very fast’ groups, respectively, in men. In women, the corresponding values were -1.06, -0.35, 0.50, and 1.34 kg/m2. When the BMI increment from age 20 to current age was regressed in the same manner, the increment was -0.63, -0.34, 0.57, and 1.05 kg/m2 in men and -0.71, -0.32, 0.34, and 1.14 kg/m2 in women, respectively. Additionally, both BMI at age 20 and current height were positively associated with rate of eating. CONCLUSIONS Our results among middle-aged men and women suggest that eating fast would lead to obesity.

Barriers to health care among the elderly in Japan.

Japan is undergoing a set of health care reforms aimed at cutting rising health care costs and increasing the efficiency of health care delivery. This empirical study used a large-scale community survey on 15,302 elderly people 65 years and older (56.0% women) conducted in seven municipalities in 2006, to reveal clear-cut evidence of barriers to necessary care. The reasons for not getting health care is attributed to health care cost for the elderly with lower income, while higher income counterparts reported being busy or having a condition not serious enough to seek care.

Assessing the association between all-cause mortality and multiple aspects of individual social capital among the older Japanese

BackgroundFew prospective cohort studies have assessed the association between social capital and mortality. The studies were conducted only in Western countries and did not use the same social capital indicators. The present prospective cohort study aimed to examine the relationships between various forms of individual social capital and all-cause mortality in Japan.MethodsSelf-administered questionnaires were mailed to subjects in the Aichi Gerontological Evaluation Study (AGES) Project in 2003. Mortality data from 2003 to 2008 were analyzed for 14,668 respondents. Both cognitive and structural components of individual social capital were collected: 8 for cognitive social capital (trust, 3; social support, 3; reciprocity, 2) and 9 for structural social capital (social network). Cox proportional hazard models stratified by sex with multiple imputation were used. Age, body mass index, self-rated health, current illness, smoking history, alcohol consumption, exercise, equivalent income and education were used as covariates.ResultsDuring 27,571 person-years of follow-up for men and 29,561 person-years of follow-up for women, 790 deaths in men and 424 in women were observed. In the univariate analyses for men, lower social capital was significantly related to higher mortality in one general trust variable, all generalised reciprocity variables and four social network variables. For women, lower social capital was significantly related to higher mortality in all generalised reciprocity and four social network variables. After adjusting for covariates, lower friendship network was significantly associated with higher all-cause mortality among men (meet friends rarely; HR = 1.30, 95%CI = 1.10-1.53) and women (having no friends; HR = 1.81, 95%CI = 1.02-3.23). Among women, lower general trust was significantly related to lower mortality (most people cannot be trusted; HR = 0.65, 95%CI = 0.45-0.96).ConclusionsFriendship network was a good predictor for all-cause mortality among older Japanese. In contrast, mistrust was associated with lower mortality among women. Studies with social capital indices considering different culture backgrounds are needed.

Socio-economic status and self-rated health in East Asia: a comparison of China, Japan, South Korea and Taiwan

BACKGROUND Few cross-national studies have compared the relationship between socio-economic status (SES) and health among East Asian countries. This study elucidates the relationship between SES and self-rated health (SRH) in four societies of East Asia: China, Japan, South Korea and Taiwan. METHODS We used the data from the East Asian Social Survey 2006, which consists of nationally representative samples from each of the four countries. Logistic regression analysis of SRH was performed using four standardized SES indices (income, education, occupation and class identification) as explanatory variables to compare the degree of association of each SES index with SRH. RESULTS A total of 8120 respondents in the age range of 20-69 years were analysed. Overall, social gradients in health were observed in the East Asian societies. In China, South Korea and Taiwan, three of the four SES indices showed a statistically significant association for both male and female groups. In Japan, except class identification, no other SES index showed a significant relationship with SRH. With regard to the differences between the SES indices, class identification exhibited the strongest association with SRH, while occupational class displayed the weakest association. CONCLUSION Our study results indicate that Japan has low levels of health inequality compared to other East Asian countries. Furthermore, an index of occupational classes may be insufficient to explain health inequalities in East Asia.

Long-term body weight variability is associated with elevated C-reactive protein independent of current body mass index among Japanese men

OBJECTIVE: To elucidate the effect of long-term weight variability on C-reactive protein (CRP) levels.DESIGN: Cross-sectional study of the circulating CRP.SUBJECTS: A total of 637 Japanese men aged 40–49 y in1997.MEASUREMENTS: Serum CRP levels, body mass index in 1997 (current BMI), the slope of weight on age (weight-slope) representing an individuals weight trend of direction and magnitude, and the root mean square error around the slope of weight on age (weight-RMSE) representing the weight fluctuation magnitude, as calculated by a simple linear regression model in which each value of the subjects five actual weights (aged 20, 25, 30 y, five years ago, and current) was a dependent variable and the subjects ages independent variables.RESULTS: After adjustment for age and confounders, including smoking and health status, the odds ratios of elevated CRP (≥0.06 mg/dl) were 1.83 (95% CI: 1.25–2.69), 2.63 (1.69–4.11), and 10.31 (2.17–48.98) for upper normal-weight (BMI: 22–<25 kg/m2), overweight (25–<30), and obese (≥30) persons, respectively, compared with lower normal-weight persons (18.5–<22). Adjusting for age, confounders, and current BMI, weight-slope was positively associated with CRP level especially among subjects with BMI≥25 kg/m2 (trend P<0.01), and weight-RMSE was positively associated with CRP level particularly among subjects with BMI <25 kg/m2 (trend P<0.05).CONCLUSION: Our results suggest a state of low-grade systemic inflammation not only in overweight and obese persons, but also in normal-weight persons with large weight fluctuation, possibly explaining in part the positive association between weight fluctuation and CVD.

Physical Activity and All-cause Mortality in Japan: The Jichi Medical School (JMS) Cohort Study

Background In April 2008, a new health check-up and health guidance system was introduced by the Japanese Government to promote increased physical activity. However, few studies have documented the health benefits of physical activity in Asian populations. We examined the association between all-cause mortality and level of physical activity in a Japanese multicommunity population-based study. Methods The Jichi Medical School Cohort Study is a multicommunity, population-based study based in 12 districts in Japan. Baseline data from 4222 men and 6609 women (mean age, 54.8 and 55.0 years, respectively) were collected between April 1992 and July 1995. The participants were followed for a mean duration of 11.9 years. To determine the association between all-cause mortality and level of physical activity, crude mortality rates per 1000 person-years and hazard ratios (HRs) with 95% confidence intervals (CI) were determined using the Cox proportional hazards model. Physical activity was categorized by using physical activity index (PAI) quartiles. The lowest (first) PAI quartile was defined as the HR reference. Results In men, the lowest mortality rate was observed in the third quartile, with 95 deaths and a crude mortality rate of 7.6; the age- and area-adjusted HR was 0.59 (95% CI, 0.45–0.76), and the mortality curve had a reverse J shape. In women, the lowest mortality rate was observed in the highest PAI quartile, with 69 deaths and a crude mortality rate of 3.5; the HR was 0.81 (95% CI, 0.58–1.12). Conclusion Our results suggest that increased physical activity lowers the risk for all-cause death in Japanese.

Association between serum leptin concentration and white blood cell count in middle-aged Japanese men and women

Leptins hematopoietic or proinflammatory role has been experimentally reported. We investigated whether serum leptin concentrations are associated with white blood cell (WBC) counts in humans.

Calcium Intake Pattern among Japanese Women across Five Stages of Health Behavior Change

BACKGROUND The transtheoretical model (TTM) of health behavior change is one of the most promising approaches for health professionals to help individuals change their behaviors. Few studies have assessed calcium intake using the model on Asian women. This study aims at clarifying characteristics of each behavioral stage among Japanese women and providing clues to increase calcium intake to prevent osteoporosis. METHODS A cross-sectional survey was conducted from September through November, 2005 using self-administered questionnaires. A total of 226 participants in an osteoporosis screening program were invited to take part in the study, and 150 women were enrolled. RESULTS Adjusted means of total dietary calcium were positively significantly associated with successive stages (p<0.001). The proportion of calcium intake from plants and fish was higher in the precontemplation, contemplation, and preparation stages compared with the action and maintenance stages (p=0.038). Concomitantly, the plants and fish food group contributed 46.7% of total dietary calcium, while 32.4% was derived from milk and dairy food, and 20.9% from other foods. The correlation coefficient (95% confidence interval) between the proportion of calcium obtained from plants and fish and the proportion of fat energy was -0.22 (-0.37, -0.06). CONCLUSIONS The proportion of calcium intake from plants and fish was higher among women in the lower stages compared with higher stages. Given the higher prevalence of lactose intolerance, it would seem plausible to recommend lower-stage women be educated and encouraged to derive more calcium from plants and fish diets as a means to prevent osteoporosis.