Mortality from major causes and lifestyles by proportions of public assistance recipients among 47 prefectures in Japan: Ecological panel data analysis from 1999 to 2016.

Objective: Comprehensive investigations of correlations between subnational socioeconomic factors and trends in mortality and lifestyle are important for addressing public health problems. Methods: Forty-seven prefectures in Japan were divided into quartiles based on the proportion of public assistance recipients (PPAR). Age-standardized mortality from all causes, cancer, heart disease, and stroke in each prefecture were averaged for these quartiles in 2000, 2005, 2010, and 2015. Data from the National Health and Nutrition Survey were obtained for the following periods: 1999-2001, 2003-2005, 2007-2009, 2012, and 2016. Body mass index (BMI), intake of total energy, vegetable and salt, step count, and prevalence of current smoking and drinking for individuals aged 40-69 years age range were standardized for each prefecture and averaged by quartile. A two-way analysis of variance was used to assess differences in mortality and lifestyle across different years or periods, and quartiles. Results: Mortality rates decreased, with the first (lowest) quartile showing the lowest rates, across all causes, cancer and heart diseases in both sexes. BMI exhibited an increase in men, whereas, BMI in women and other lifestyle factors in both sexes, excluding smoking and drinking in women, exhibited a decrease. BMI, vegetable and salt intake, total energy intake in men, and smoking in women varied across quartiles. Lower quartiles exhibited lower BMI and smoking prevalence but higher energy, vegetables, and salt intake. Conclusions: PPAR exhibited favorable trends and significant differences in mortality related to all causes, cancer and heart disease across both sexes, along with BMI among women.

Trends in mortality from major causes and lifestyle factors by per capita prefectural income: Ecological panel data analysis from 1995 to 2016 in Japan.

In Japan, trends in mortality and lifestyle have not been fully investigated according to subnational socioeconomic factors. Forty-seven prefectures (subnational units) were divided into quartiles by annual per capita prefectural income. Age-standardized mortality from all causes, cancer, heart disease, and stroke was averaged by quartile in 1995, 2000, 2005, 2010, and 2015. Data from the National Health and Nutrition Survey were obtained for periods 1 (1995-1997), 2 (1999-2001), 3 (2003-2005), 4 (2007-2009), 5 (2012), and 6 (2016). Body mass index (BMI), the intake of vegetables and salt, the number of steps, and the prevalence of current smoking and drinking for the 40-69-year age range were standardized by 10-year age groups in the 2010 Japanese population and were averaged by quartile. Differences in mortality and lifestyle by year and period, and quartile were tested using a two-way analysis of variance. Mortality decreased in both sexes and mortality in men from all causes, cancer, and stroke differed by quartile, with mortality highest in the first (lowest) quartile. BMI in men and smoking prevalence in women increased, whereas remaining lifestyle factors except for the prevalence of drinking decreased in women. BMI and the number of steps in both sexes and current smoking prevalence in women differed by quartile, with lower quartiles showing a higher BMI and fewer step counts. In conclusion, favorable trends and significant differences in mortality from all causes, cancer, and stroke in men and BMI in women were observed by per capita prefectural income level.

[Prevalence of frailty and its related factors in community-dwelling middle-aged and elderly adults in Settsu and Hannan cities in Osaka prefecture].

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.

Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan.

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.

Study of the Relationship between Body Mass Index, Body Image, and Lifestyle Behaviors: A Community Survey in Fiji.

INTRODUCTION: Public health promotion efforts aimed at overweight and obesity prevention often proceed from the premise that the first step should be losing weight. Appropriate perceptions of body image may be important for improving weight loss awareness. Therefore, we aimed to examine the relationship between body mass index and body image perception in Fiji, where increasing obesity is currently the most important health-related issue. METHODS: Using the resident register based on the governmental census, one household member, aged between 18 and 69 years, was randomly selected from each household in two areas. There were 1,014 participants in the study. The questionnaire items were related to body image, dietary behaviors, physical activity, smoking habits, and alcohol consumption habits. Moreover, information regarding height, weight, blood pressure, and hemoglobin A1c were measured, and questions about social status (age, ethnicity, education, marital status, and employment), and subjective living status were asked. A multivariate logistic regression analysis was performed to analyze the relationship between body mass index (BMI) and body image perception. RESULTS: Data from 391 men and 537 women were analyzed. Men within higher BMI quartiles smoked less (p = 0.0004) and drank less alcohol (p = 0.042). Women in higher BMI quartiles engaged in less physical activity (p = 0.022). Among the assessed data, both men and women in the higher BMI quartiles underestimated their body image compared with their actual physique (p < 0.0001). The higher BMI was associated with underestimated body image (men: odds ratio [OR] = 3.22, 95% confidence interval [CI], 1.94-5.35; p < 0.0001; women: OR = 18.11, 95% CI, 10.10-32.47; p < 0.0001). CONCLUSIONS: Higher BMI is strongly associated with underestimated body image among Fiji residents. Health-related counseling should be included within programs that aim to increase recognition of one's actual physical size.

Socioeconomic and lifestyle factors associated with depressive tendencies in general Japanese men and women: NIPPON DATA2010.

BACKGROUND: The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. METHODS: Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. RESULTS: Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56-6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22-0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31-9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68-5.22) but not in men. CONCLUSIONS: Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex.

Explaining the decline in coronary heart disease mortality rates in Japan: Contributions of changes in risk factors and evidence-based treatments between 1980 and 2012.

BACKGROUND: We aimed to quantify contributions of changes in risks and uptake of evidence-based treatment to coronary heart disease (CHD) mortality trends in Japan between 1980 and 2012. METHODS: We conducted a modelling study for the general population of Japan aged 35 to 84 years using the validated IMPACT model incorporating data sources like Vital Statistics. The main outcome was difference in the number of observed and expected CHD deaths in 2012. RESULTS: From 1980 to 2012, age-adjusted CHD mortality rates in Japan fell by 61%, resulting in 75,700 fewer CHD deaths in 2012 than if the age and sex-specific mortality rates had remained unchanged. Approximately 56% (95% uncertainty interval [UI]: 54-59%) of the CHD mortality decrease, corresponding to 42,300 (40,900-44,700) fewer CHD deaths, was attributable to medical and surgical treatments. Approximately 35% (28-41%) of the mortality fall corresponding to 26,300 (21,200-31,000) fewer CHD deaths, was attributable to risk factor changes in the population, 24% (20-29%) corresponding to 18,400 (15,100-21,900) fewer and 11% (8-14%) corresponding to 8400 (60,500-10,600) fewer from decreased systolic blood pressure (8.87 mm Hg) and smoking prevalence (14.0%). However, increased levels of cholesterol (0.28 mmol/L), body mass index (BMI) (0.68 kg/m2), and diabetes prevalence (1.6%) attenuated the decrease in mortality by 2% (1-3%), 3% (2-3%), and 4% (1-6%), respectively. CONCLUSIONS: Japan should continue their control policies for blood pressure and tobacco, and build a strategy to control BMI, diabetes, and cholesterol levels to prevent further CHD deaths.

Effects of behavioral counseling on cardiometabolic biomarkers: A longitudinal analysis of the Japanese national database.

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.

Relationships among Food Group Intakes, Household Expenditure, and Education Attainment in a General Japanese Population: NIPPON DATA2010.

BACKGROUND: A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population. METHODS: This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance. RESULTS: When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment. CONCLUSIONS: Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits.

Passive Smoking at Home by Socioeconomic Factors in a Japanese Population: NIPPON DATA2010.

BACKGROUND: Long-term passive exposure to cigarette smoke has been reported to affect the health of non-smokers. This study aims to investigate the relationships among socioeconomic factors and passive smoking at home in the non-current smokers of a representative sample from a general Japanese population. METHODS: Data are from NIPPON DATA2010. Among 2,891 participants, 2,288 non-current smokers (1,763 never smokers and 525 past smokers) were analyzed in the present study. Cross-sectional analyses were performed on the relationships among socioeconomic factors and passive smoking at home (several times a week or more) in men and women separately. Socioeconomic factors were employment, length of education, marital status, and equivalent household expenditure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a multivariable logistic regression model. RESULTS: The multivariable-adjusted model showed that employed women had a higher risk of passive smoking than unemployed women (OR 1.44; 95% CI, 1.06-1.96). Women with 9 years or less of education had a higher risk of passive smoking at home than women with 13 years and more of education (OR 2.37; 95% CI, 1.49-3.78). Single women had a lower risk of passive smoking at home (OR 0.53; 95% CI, 0.37-0.77) than married women. No significant associations were observed in men. CONCLUSIONS: An employed status, lower education, and being single were associated with passive smoking at home in the non-current smoking women of a representative Japanese population.

Differences in Lifestyle Improvements With the Intention to Prevent Cardiovascular Diseases by Socioeconomic Status in a Representative Japanese Population: NIPPON DATA2010.

BACKGROUND: The relationships among socioeconomic status and lifestyle improvements have not yet been examined in a representative Japanese population. METHODS: We analyzed data from 2,647 participants (1,087 men and 1,560 women) who participated in NIPPON DATA2010. This survey inquired about lifestyle improvements and socioeconomic status. Education was categorized as low (≤9 years), middle (10-12 years), and high (≥13 years). Marital status was categorized as married, divorced, widowed, and never married/other. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of lifestyle improvements with the intention of preventing cardiovascular diseases for educational attainment and marital status, with adjustments for age and awareness of cardiovascular disease risk factors. RESULTS: Overall, 1,507 (56.9%) participants practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome, and the OR of lifestyle improvements was significantly higher with a high education than with a low education in men (OR 2.86; 95% CI, 1.96-4.17) and women (OR 2.36; 95% CI, 1.67-3.33). The number of participants who practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome was significantly lower in divorced than in married men (OR 0.46; 95% CI, 0.22-0.95) and women (OR 0.53; 95% CI, 0.33-0.86). CONCLUSIONS: Specific differences caused by educational attainment and marital status may exist in lifestyle improvements.

Factors Related to Participation in Health Examinations for Japanese National Health Insurance: NIPPON DATA2010.

BACKGROUND: This study investigated relationships among socioeconomic factors and participation in health examinations for Japanese National Health Insurance (NHI) using a representative Japanese population. METHODS: We used the linkage database of NIPPON DATA2010 and Comprehensive Survey of Living Conditions 2010. Participants with NHI aged 40-74 years were included in the analysis. Prevalence ratios (PRs) for participation in health examinations in the past year were set as an outcome. Participant characteristics, including sex, age, socioeconomic factors (educational attainment, employment, equivalent household expenditure [EHE], house ownership, and marital status), laboratory measures, and lifestyle were included in an age-stratified modified Poisson regression analysis to examine relationships. RESULTS: The number of study participants was 812, and 564 (69.5%) participated in health examinations in the past year. Among those aged 40-64 years, there was no significant PR for socioeconomic factors. Among those aged 65-74 years, high (≥13 years) educational attainment (adjusted PR, 1.22; 95% confidence interval [CI], 1.05-1.41) and house ownership (PR 1.40; 95% CI, 1.11-1.77) were positively associated with participation, while high (4th quartile) EHE (PR 0.84; 95% CI, 0.73-0.97) was negatively associated. CONCLUSION: These results suggest that high educational attainment, house ownership, and low EHE were positive factors for participation in health examinations among those aged 65-74 years.

Socioeconomic Status and Knowledge of Cardiovascular Risk Factors: NIPPON DATA2010.

BACKGROUND: The relationship between socioeconomic status (SES) and knowledge of cardiovascular risk factors remains unknown in a general Japanese population. METHODS: Of 8,815 participants from 300 randomly selected areas throughout Japan, 2,467 participants who were free of cardiovascular disease and who provided information on SES in the National Health and Nutrition Survey of Japan 2010 were enrolled in this cross-sectional analysis. SES was classified according to the employment status, length of education, marital and living statuses, and equivalent household expenditure (EHE). Outcomes were ignorance of each cardiovascular risk factor (hypertension, diabetes, hypercholesterolemia, low high-density lipoprotein [HDL] cholesterol, arrhythmia, and smoking) and insufficient knowledge (number of correct answers <4 out of 6). RESULTS: A short education and low EHE were significantly associated with a greater ignorance of most cardiovascular risk factors. A short education (<10 years) was also associated with insufficient knowledge of overall cardiovascular risk factors: age- and sex-adjusted odds ratios (OR) were 1.92 (95% confidence interval [CI], 1.51-2.45) relative to participants with ≥13 years of education. Low EHE was also associated with insufficient knowledge (age- and sex-adjusted OR 1.24; 95% CI, 1.01-1.51 for the lowest quintile vs the upper 4 quintiles). These relationships remained significant, even after further adjustments for regular exercise, smoking, weekly alcohol consumption, body mass index, hypertension, diabetes mellitus, hypercholesterolemia, and low HDL cholesterol. CONCLUSION: Participants with a short education and low EHE were more likely to have less knowledge of cardiovascular risk factors.

Socioeconomic Inequalities in Oral Health among Middle-Aged and Elderly Japanese: NIPPON DATA2010.

BACKGROUND: Most studies on socioeconomic inequalities in oral health have not considered the effects of behavioral and biological factors and age differences. Furthermore, the nationwide status of inequalities remains unclear in Japan. METHODS: We analyzed data from 2,089 residents aged ≥40 years throughout Japan. The lowest quartile of the number of remaining teeth for each 10-year age category was defined as poor oral health. Behavioral and biological factors included smoking status, obesity, diabetes mellitus, high-sensitivity C-reactive protein, and the use of dental devices. Multiple logistic regression analyses were conducted to examine the associations of educational attainment and equivalent household expenditure (EHE) with oral health, and stratified analyses by age category were also conducted (40-64 years and ≥65 years). RESULTS: Lower education and lower EHE were significantly associated with an increased risk of poor oral health after adjusting for age, sex, employment status, marital and living statuses, and EHE/education; the odds ratio for junior high school education compared with ≥college education was 1.84 (95% confidence interval [CI], 1.36-2.49), and the odds ratio of the lowest compared with the highest EHE quartile was 1.91 (95% CI, 1.43-2.56). Further adjustments for behavioral and biological factors attenuated but did not eliminate these associations. EHE was significantly associated with oral health among elderly adults only, with a significant interaction by age category. CONCLUSIONS: Those with a lower education and those with lower EHE had a significantly higher risk of poor oral health, even after adjustments for behavioral and biological factors.

Combined associations of physical activity and dietary intake with health status among survivors of the Great East Japan Earthquake.

BACKGROUND AND OBJECTIVES: Each of the effects of physical activity and dietary intake on health is well known, but combined associations of physical activity and dietary intake on health has not been reported yet. Physical activity and dietary intake are key factors for maintaining health of survivors of the Great East Japan Earthquake in 2011. This study aimed to examine combined associations of physical activity and dietary intake with survivors' health status. METHODS AND STUDY DESIGN: We used data from 6668 participants of a cross-sectional survey taken 3 years (2013) after the disaster. To evaluate combined associations of physical activity and dietary intake, answers to questions regarding these two variables were categorized into four groups: poor physical activity and poor dietary intake (Group 1), poor physical activity and good dietary intake (Group 2), good physical activity and poor dietary intake (Group 3), and good physical activity and good dietary intake (Group 4). Multiple logistic regression analyses were performed by sex, with good self-rated health and good mental health as dependent variables, and age, place of residence, living conditions and physical activity/dietary intake group (with Group 1 as the reference category) as independent variables. RESULTS: Good self-rated health was associated with age in both sexes, and Groups 3 (male: odds ratios (ORs) 1.84 (95% confidence intervals (95% CIs) 1.32-2.57), female: OR 1.82 (95% CI 1.32-2.51)) and 4 (male: OR 1.96 (95% CI 1.39-2.76), female: OR 1.94 (95% CI 1.42-2.64)). Good mental health was associated with Groups 3 (OR 1.48 (95% CI 1.10-1.97)) and 4 (OR 1.86 (95% CI 1.37-1.97)) for male respondents; and living place (other than temporary housing) (OR 1.45 (95% CI 1.26-1.68)) was associated with Group 4 (OR 1.42 (95% CI 1.09-1.85)) for female respondents. CONCLUSIONS: Good physical activity alone or combined with good dietary intake was associated with good self-rated health and good mental health. Further interventions regarding physical activity and dietary intake are needed to improve the health status of survivors.

Different Psychosocial Factors Are Associated With Different Intention and Self-Efficacy Toward Eating Breakfast Among Japanese Breakfast Skippers.

A cross-sectional study was conducted among 7593 adults to clarify lifestyle and psychosocial characteristics of breakfast skippers with different intention and self-efficacy toward eating breakfast. Data were obtained from Japan's national survey in 2009. Multinomial logistic regression analyses were performed to examine the characteristics of each breakfast skipper (having intention and self-efficacy toward eating breakfast [IS], having intention but not self-efficacy [INS], and not having intention to eat breakfast [NI]) compared with breakfast eaters. IS men were less likely to demonstrate understanding of healthy eating. INS and NI men were more likely to eat alone. INS and NI women were less likely to demonstrate understanding of healthy eating. NI men and women were less likely to report weight management behavior. Current smoking and being sleep-deprived were commonly associated with breakfast skipping in both sexes. Our results suggested the need for approaches considering type of breakfast skippers (eg, different intention and self-efficacy).

Effects of rapid aging and lower participation rate among younger adults on the short-term trend of physical activity in the National Health and Nutrition Survey, Japan.

AIM: The National Health and Nutrition Survey, Japan, has annually monitored two indicators of physical activity in adults. They are contrasting in the association with age; the prevalence of exercise habit is lower and step counts are higher among younger participants. The present study aimed to examine the effects of rapid aging of the Japanese population and the lower participation rate among younger adults on the short-term trend of two indicators of physical activity using tabulated data. METHODS: The prevalence of exercise habit and step counts by age groups (≥20 years) from 2003 to 2010 were estimated using tabulated data from the National Health and Nutrition Survey by calculating sex-specific means weighted by age-specific Japanese population data for each year (population-weighted estimates) and for a fixed year (2005; age-standardized estimates). Linear regression analyses were used to test the statistical significance of their trends. RESULTS: Statistically significant increasing trends in the prevalence of exercise habit were observed for the crude means (P = 0.029), the population-weighted estimates (P = 0.007) and the age-standardized estimates (P = 0.016) only in men. Statistically significant decreasing trends in the step counts were observed for the crude means (P = 0.006 in men and P = 0.033 in women) and the population-weighted estimates (P = 0.008 in men and P = 0.049 in women) both in men and women, but for the age-standardized estimates (P = 0.039) only in men. CONCLUSIONS: The effects of rapid aging of the Japanese population and the lower participation rate among younger adults on the short-term trend are not small, and age-standardization is necessary to observe even the short-term trend of physical activity data. Geriatr Gerontol Int 2017; 17: 1677-1682.

Associations of socioeconomic status with prevalence, awareness, treatment, and control of hypertension in a general Japanese population: NIPPON DATA2010.

OBJECTIVE: To investigate associations between socioeconomic status (SES) and prevalence, awareness, treatment, and control of hypertension in Japan's general population. METHODS: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. The cohort included 2623 adults from 300 randomly selected areas across Japan. Using baseline data, four cross-sectional analyses were performed: association of SES with prevalent hypertension in 2623 participants; association of SES with unawareness of hypertension and with no treatment in 1282 hypertensive patients; and association of SES with uncontrolled hypertension in 720 treated hypertensive patients. SES was classified according to employment status, length of education, marital and living status, and household expenditure. RESULTS: The overall prevalence of hypertension was 48.9%. Among hypertensive participants, the proportions of unawareness and no treatment were 33.1 and 43.8%, respectively. Target blood pressure levels were not achieved among 61.2% of treated hypertensive patients. Hypertension was more prevalent in the unmarried and living alone group than in the married group (odds ratio 1.76; 95% confidence interval 1.26-2.44), after adjustment for age, sex, BMI, smoking, alcohol consumption, habitual exercise, history of cardiovascular diseases, diabetes mellitus, hypercholesterolemia, dietary sodium, and potassium intake. SES was not clearly associated with unawareness, no treatment, nor poor control of hypertension. CONCLUSION: Being unmarried and living alone was associated with increased prevalence of hypertension. There was no clear association of SES with unaware, untreated, and uncontrolled hypertension.

Personal behaviors including food consumption and mineral supplement use among Japanese adults: a secondary analysis from the National Health and Nutrition Survey, 2003-2010.

BACKGROUND AND OBJECTIVES: A daily mineral supplement is useful for those who are at risk of a deficiency. Some Western reports suggest that mineral supplement users have healthy behaviors and are not mineral-deficient. It is unknown whether the same phenomenon is observed in Japan where there is a different dietary culture. The aim of this study was to examine the characteristics of personal behaviors including food consumption nationwide among mineral supplement users from the National Health and Nutrition Survey in Japan 2003-2010. METHODS AND STUDY DESIGN: Data were obtained from 16,275 adults aged 20-59 years who completed sociodemographic, health status, and 1-day household dietary assessments. Supplement users were compared with non-users. Logistic regression models were utilized to identify the characteristics of food consumption and calcium and iron supplement use, using the medium intake group as a reference. RESULTS: Overall, 2.1% and 1.4% of adults reported using calcium supplements and iron supplements, respectively. Calcium supplement users were more likely to be physically active, non-smokers, and eat less fat compared with non-users. Furthermore, they were more likely than non-users to consume a higher intake of calcium from foods such as tea, vegetables, seaweeds, and fruits. Iron supplement users were more likely than non-users to be non-smokers. These individuals tended to have a high intake of seaweeds and fruits. CONCLUSIONS: Japanese adults who had healthier behaviors were more likely to use mineral supplements, especially calcium. Mineral supplement users tended to choose healthy foods such as seaweeds and fruits, without considering their overall mineral consumption.