Junko Minai

Is Maternal Smoking during Early Pregnancy a Risk Factor for All Low Birth Weight Infants

Background Low birth weight (LBW) infants do not form a homogeneous group; LBW can be caused by prematurity or poor fetal growth manifesting as small for gestational age (SGA) infants or intrauterine growth retardation. We aimed to clarify the relationship of maternal smoking with both SGA and preterm LBW infants. Methods The study population comprised pregnant women who registered at the Koshu City between January 1, 1995, and December 31, 2000, and their children. We performed multivariate analyses using multiple logistic regression models to clarify the relationship of maternal smoking during pregnancy with the SGA outcome and preterm birth in LBW infants. Results In this study period, 1,329 pregnant women responded to questionnaires, and infant data were collected from 1,100 mothers (follow-up rate: 82.8%). The number of LBW infants was 81 (7.4%). In this cohort, maternal smoking during early pregnancy was associated with LBW and the SGA outcome. Maternal smoking during early pregnancy was a risk factor for LBW with SGA outcome and for LBW with full-term birth. However, it was not a risk factor for LBW with appropriate weight for gestational age (AGA) and LBW with preterm birth. Conclusion These results suggested that LBW with AGA and LBW with preterm birth were associated with other risk factors that were not considered in this study, such as periodontal disease. For the prevention of LBW, not only abstinence from smoking during pregnancy but also other methods such as establishing a clinical setting should be adopted.

Specific alcoholic beverage and blood pressure in a middle-aged Japanese population: The High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study

The purpose of this study was to clarify the effects of popular Japanese alcoholic beverages on blood pressure. We performed a cross-sectional study on 4335 Japanese male workers using baseline data from an intervention study. We defined six groups according to the type of alcoholic beverage that provided two-thirds of the subjects total alcohol consumption: beer, sake (rice wine), shochu (traditional Japanese spirits), whiskey, wine and others. The partial regression coefficients of daily alcohol intake (1 drink=11.5 g of ethanol) to systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 0.87(P<0.001, standard error (s.e.)=0.09) and 0.77(P<0.001, s.e.=0.06), respectively. A comparison among the types of alcoholic beverages mainly consumed revealed significant differences in SBP and DBP. Both SBP and DBP were highest in the shochu group. However, an analysis of covariance adjusting for total alcohol consumption resulted in the disappearance of these differences. Although after adjustment for total alcohol consumption, the shochu group exhibited a significant positive association with ‘high-normal blood pressure or greater’ (odds ratio 1.43, 95% confidence interval 1.06–1.95) compared with the beer group, this significant relation disappeared after adjusting for the body mass index (BMI), urinary sodium and potassium excretion. The pressor effect, per se, of popular Japanese alcoholic beverages on blood pressure may not be different among the types of alcoholic beverages after adjusting for other lifestyle factors.

Barriers and catalysts of nutrition literacy among elderly Japanese people.

Improving skills for accessing and utilizing diet/nutrition information is important for preventing non-communicable diseases and frailty among elderly people. With the rapidly increasing number of elderly people in the world, promoting nutrition literacy among them is a pivotal health policy for maintaining and promoting health. This article describes the barriers and catalysts of nutrition literacy among elderly Japanese people (aged ≥75 years). A cross-sectional analysis of the responses to a questionnaire administered to 678 study participants (men = 347, women = 331) was conducted. Logistic regression analysis revealed that more men had limited nutrition literacy than did women. After stratification by gender, the limited nutrition literacy group was associated with cognitive difficulty in men and women, visual impairment in men and hearing impairment in women. Lower education level and economic status were associated with limited nutrition literacy among women. Adjusted odds ratios (ORs) controlling for age, education level and economic status, as well as cognitive, visual and hearing function, indicated that informational support [OR = 5.59, 95% confidence interval (95% CI) = 1.28-24.49] and diet/nutrition information obtained from friends of the participants (OR = 2.16, 95% CI = 1.11-4.20) were both associated with adequate nutrition literacy among men, whereas diet/nutrition information from health professionals (OR = 3.96, 95% CI = 1.97-7.95) had a significant relation with adequate nutrition literacy among women. Moreover, in the adequate nutrition literacy group, men were more likely to be overweight (OR = 2.17, 95% CI = 1.20-3.91). These findings suggested that cognitive and sensory functions should be taken into account when diet information is provided to older adults. Enhancement of social networks is also a key point in improving nutrition literacy. An effective intervention to improve nutrition literacy in elderly people, particular old men, warrants further investigation.

Cognition of Social Capital in Older Japanese Men and Women

Objective: This study explored factors related to cognition of social capital among Japanese older people. Method: Using a cross-sectional survey design, data were gathered from 940 people aged over 65 years. Cognition of social capital was compared by gender, and it was regressed on participation in community activities and health behaviors of middle age and current health status. Results: Men had higher cognitive social capital than women (p = .004). Multiple regression analysis shows that men who rested for health during middle age had high cognition of social capital. Cognition of social capital was also related to self-rated health, depression, and cognitive difficulties for both men and women. Daily activity was included among women. Discussion: Participation in community activities and health behaviors during middle age were associated factors for cognition of social capital among the older people, and encouraging cognition of social capital was important for active aging.

Positive and negative effects of finance-based social capital on incident functional disability and mortality: an 8-year prospective study of elderly Japanese.

Background Rotating savings and credit associations (ROSCAs) involve group financial self-help activities. These voluntary financial cooperative associations—mujin in Japanese—are found in some rural areas of Japan. Cross-sectional evidence suggests that active participation in mujin correlates with rich social capital and better functional capacities among older adults. However, the effect of mujin on subsequent health outcomes is unknown. Methods In 2003, we conducted a baseline interview survey of 583 functionally independent adults randomly selected from Yamanashi Prefecture residents aged 65 years or older. They were followed up until 2011. We used proportional hazards models, and factor analysis of 8 mujin-related questions identified 2 components: the “intensity and attitude” and “financing” aspects of mujin. Results The hazard ratios (HRs) for incident functional disability—identified by using the public long-term care insurance database—per 1-SD increase in factor scores were 0.82 (95% CI: 0.68–0.99) for the intensity and attitude score and 1.21 (1.07–1.38) for financing score. Adjustments for age, sex, marital status, household composition, physical health, education, income, and other factor scores only slightly attenuated these HRs. The results for mortality models were very similar to those for incident functional disability. Conclusions ROSCA-type activities in Japan could have beneficial effects on the health of older adults if used primarily for the purpose of friendship. Mujin for aggressively financial purposes might be somewhat harmful, as such activities might reflect the “dark side” of social capital, ie, overly demanding expectations of group conformity.

Maternal negative attitudes towards pregnancy as an independent risk factor for low birthweight

Aim:  Recently, Japan has witnessed an increase in the number of low‐birthweight (LBW) infants. LBW children face a variety of social and medical risk factors. Thus, besides reducing infant mortality, preventing LBW would have many other important health benefits. Emotional status during pregnancy is stated as one of the important risk factors for LBW. This study aims to clarify the relationship between maternal emotions and low birthweight (LBW) after adjusting the effects of other well‐known factors that influence LBW.