Ryoma Michishita

The Association Between Unhealthy Lifestyle Behaviors and the Prevalence of Chronic Kidney Disease (CKD) in Middle-Aged and Older Men

Background This cross-sectional study evaluated the association between unhealthy lifestyle behaviors and the prevalence of chronic kidney disease (CKD) in middle-aged and older men. Methods The subjects included 445 men without a history of cardiovascular disease, stroke, or dialysis treatment, who were not taking medications. Unhealthy lifestyle behaviors were evaluated using a standardized self-administered questionnaire and were defined as follows: 1) lack of habitual moderate exercise, 2) lack of daily physical activity, 3) slow walking speed, 4) fast eating speed, 5) late-night dinner, 6) bedtime snacking, and 7) skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions based on the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors). Results According to a multivariate analysis, the odds ratio (OR) for CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or proteinuria) was found to be significantly higher in the ≥4 group than in the 0–1 group (OR 4.67; 95% confidence interval [CI], 1.51–14.40). Moreover, subjects’ lack of habitual moderate exercise (OR 3.06; 95% CI, 1.13–8.32) and presence of late-night dinner (OR 2.84; 95% CI, 1.40–5.75) and bedtime snacking behaviors (OR 2.87; 95% CI, 1.27–6.45) were found to be significantly associated with the prevalence of CKD. Conclusions These results suggest that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

The association between changes in lifestyle behaviors and the incidence of chronic kidney disease (CKD) in middle-aged and older men

Background This study was designed to evaluate whether changes in lifestyle behaviors are correlated with the incidence of chronic kidney disease (CKD). Methods The subjects consisted of 316 men without a history of cardiovascular disease, stroke, or renal dysfunction or dialysis treatment. The following lifestyle behaviors were evaluated using a standardized self-administered questionnaire: habitual moderate exercise, daily physical activity, walking speed, eating speed, late-night dinner, bedtime snacking, skipping breakfast, and drinking and smoking habits. The subjects were divided into four categories according to the change in each lifestyle behavior from baseline to the end of follow-up (healthy–healthy, unhealthy–healthy, healthy–unhealthy and unhealthy–unhealthy). Results A multivariate analysis showed that, with respect to habitual moderate exercise and late-night dinner, maintaining an unhealthy lifestyle resulted in a significantly higher odds ratio (OR) for the incidence of CKD than maintaining a lifestyle (OR 8.94; 95% confidence interval [CI], 1.10–15.40 for habitual moderate exercise and OR 4.00; 95% CI, 1.38–11.57 for late-night dinner). In addition, with respect to bedtime snacking, the change from a healthy to an unhealthy lifestyle and maintaining an unhealthy lifestyle resulted in significantly higher OR for incidence of CKD than maintaining a healthy lifestyle (OR 4.44; 95% CI, 1.05–13.93 for healthy–unhealthy group and OR 11.02; 95% CI, 2.83–26.69 for unhealthy–unhealthy group). Conclusions The results of the present study suggest that the lack of habitual moderate exercise, late-night dinner, and bedtime snacking may increase the risk of CKD.

Hypertension and hyperglycemia and the combination thereof enhances the incidence of chronic kidney disease (CKD) in middle-aged and older males

ABSTRACT Aim: Chronic kidney disease (CKD) may be an etiologic cause of aging, hypertension, diabetes mellitus (DM), and metabolic syndrome. However, the influence of these cardiovascular risk factors and their combination on the development of CKD remains controversial. This retrospective study evaluated the influence of cardiovascular risk factors and their combination on the incidence of CKD during a 6-year follow-up period in middle-aged and older males. Methods: The subjects were 303 males without a history of cardiovascular disease, stroke, renal dysfunction, or dialysis treatment. A biochemical analysis, blood pressure (BP) analysis, and anthropometry measurements were performed every year, and the classification of CKD was also assessed based on the estimated glomerular filtration rate (<60 ml/min/1.73 m2) and/or presence of proteinuria. Results: After 6 years, the incidence of CKD was noted in 32 subjects. According to a multivariable analysis, hypertension (hazard ratio [HR]: 3.95, 95% confidence of interval [CI]: 1.64–9.49, p = 0.002) and hyperglycemia (HR: 3.27, 95% CI: 1.42–7.56, p = 0.006) were significantly associated with the incidence of CKD. According to a Cox proportional hazards model, the HR for the incidence of CKD was significantly higher in the combination of high-normal BP/hypertension and impaired fasting glucose/DM group than in the combination of normotensive and normal glucose tolerance group (HR: 7.16, 95% CI: 2.43–17.25, p = 0.001). Conclusions: These results suggest that the hypertension and hyperglycemia and their combination may be associated with the incidence of CKD.

Effects of Lifestyle Modifications on Improvement in the Blood Lipid Profiles in Patients with Dyslipidemia

Aim: This study was designed to clarify the difference in the effects of aerobic exercise training and diet on the improvement in the blood lipid profiles in patients with dyslipidemia. Subjects and Methods: The study enrolled 86 patients with dyslipidemia [34 males and 52 females; age, 55 ± 10 years (33 to 71 years); low-density lipoprotein cholesterol (LDL-C), 150 ± 33 mg/dl (74 to 206 mg/dl); high-density lipoprotein cholesterol (HDL-C), 54 ± 12 mg/dl (35 to 87 mg/dl) and triglycerides, 165 ± 65 mg/dl (68 to 318 mg/dl)]. The subjects were randomly allocated to exercise training (n=42) or diet (n=44) group. These patients in the exercise training group were instructed to exercise for more than 300 min per week at the lactate threshold intensity. In the diet group, the target caloric intake was 25 kcal/kg of ideal body weight [height (m)2 × 22] according to the guideline of the Japan Society for the Study of Obesity. Results: After the 12-week intervention, the LDL-C, triglyceride level and body weight decreased in both the exercise training and diet groups (p<0.05). There was no significant interaction effect for group × time on the LDL-C, fasting triglyceride level or body weight between the groups. The HDL-C increased only in the exercise training group, and a significant interaction effect for group × time was seen between the exercise training and diet groups for the HDL-C levels (p<0.05). Conclusions: Based on our results, an improvement in the HDL-C level was observed in the exercise training group, but not in the diet group, despite the fact that the reductions in the LDL-C, triglycerides and body weight were not significantly different between the two groups. Therefore, these results suggest that lifestyle modification, especially exercise training, is considered to be important to reduce the risk of cardiovascular disease through by increasing the HDL-C.

Influence of Dietary Sodium and Potassium Intake on the Heart Rate Corrected-QT Interval in Elderly Subjects.

It is well known that imbalances in the dietary electrolytes are associated with a significantly higher incidence of cardiovascular disease (CVD). On the other hand, a prolonged heart rate corrected-QT (QTc) interval is associated with an increased risk of cardiac autonomic nervous system dysfunction, the incidence of CVD and sudden cardiac death. This study was designed to clarify the association between the nutritional status and the QTc interval in elderly subjects. The subjects included 119 elderly subjects (46 males and 73 females, age; 72.9±4.8 y) without a history of CVD, who were taking cardioactive drugs. Resting 12-lead electrocardiography was performed, while the QTc interval was calculated according to Bazetts formula. The nutritional status was assessed using a brief self-administered diet history questionnaire. The subjects were divided into three categories, which were defined as equally trisected distributions of the body mass index (BMI). The QTc interval was significantly longer in both the low and high BMI groups than in the moderate BMI group in both genders (p<0.05, respectively). A stepwise multiple regression analysis showed the QTc interval to be independently associated with the potassium intake in the low BMI group and the sodium intake in the high BMI group in both genders (p<0.05, respectively). These results suggest that the body mass, especially lean body mass and overweight, were associated with a prolonged QTc interval and dietary electrolytes in elderly subjects. Based on our results, we consider that it is necessary to perform dietary counseling, especially focusing on sodium and potassium intake, depending on the body mass.

Association between the physical activity and heart rate corrected‐QT interval in older adults

Increased physical activity can reduce the incidence of cardiovascular disease and the mortality rate. In contrast, a prolonged heart rate corrected‐QT (QTc) interval is associated with an increased risk of arrhythmias, sudden cardiac death and coronary artery disease. The present cross‐sectional study was designed to clarify the association between the physical activity level and the QTc interval in older adults.

An exaggerated blood pressure response to exercise is associated with the dietary sodium, potassium, and antioxidant vitamin intake in normotensive subjects

ABSTRACT Aim: This study was designed to examine the associations between an exaggerated systolic blood pressure (SBP) response to exercise and the nutrient intake in normotensive subjects. Methods: The subjects consisted of 302 normotensive subjects (64 males and 238 females; age, 48.4 ± 11.3 years) without a history of cardiovascular disease or stroke who were not taking any medications. Each subject performed a multistage graded submaximal exercise stress test using an electric bicycle ergometer, and their blood pressure was measured at rest and during the last minute of each stage. The nutrient intake was assessed using a self-administered food frequency questionnaire. An exaggerated SBP response to exercise was defined according to the criteria of the Framingham Study (peak SBP ≥210 mmHg in males, or ≥190 mmHg in females). Results: An exaggerated SBP response to exercise was observed in 85 subjects. A multiple logistic regression analysis revealed that the dietary sodium-to-potassium (Na/K) ratio (odds ratio [OR]: 5.75, 95% confidence interval [CI]: 2.37–13.75, p = 0.001) and vitamin E intake (OR: 0.67, 95% CI: 0.51–0.93, p = 0.012) were significantly associated with an exaggerated SBP response to exercise. Furthermore, the percent change in SBP during exercise was found to be significantly associated with an increase in the dietary Na/K ratio (p for trend = 0.0005) and a decrease in the vitamin E intake (p for trend = 0.018). Conclusions: These results suggest that an exaggerated SBP response to exercise was associated with the dietary sodium, potassium, and antioxidant vitamin intake in normotensive subjects.