A genome-wide association study identifies a locus associated with knee extension strength in older Japanese individuals.

Sarcopenia is a common skeletal muscle disease in older people. Lower limb muscle strength is a good predictive value for sarcopenia; however, little is known about its genetic components. Here, we conducted a genome-wide association study (GWAS) for knee extension strength in a total of 3452 Japanese aged 60 years or older from two independent cohorts. We identified a significant locus, rs10749438 which is an intronic variant in TACC2 (transforming acidic coiled-coil-containing 2) (P = 4.2 × 10-8). TACC2, encoding a cytoskeleton-related protein, is highly expressed in skeletal muscle, and is reported as a target of myotonic dystrophy 1-associated splicing alterations. These suggest that changes in TACC2 expression are associated with variations in muscle strength in older people. The association was consistently observed in young and middle-aged subjects. Our findings would shed light on genetic components of lower limb muscle strength and indicate TACC2 as a potential therapeutic target for sarcopenia.

Sarcopenia as a robust predictor of readmission within six months among individuals experiencing acute stroke.

Objective: Sarcopenia negatively affects the short-term prognosis of hospitalized older adults. However, no evidence currently supports a direct relationship between sarcopenia and readmission among individuals who have experienced an acute stroke. Therefore, we investigated whether sarcopenia is associated with readmission after discharge. Methods: This retrospective cohort study included patients who had experienced acute stroke. Sarcopenia was defined as the coexistence of low skeletal muscle mass index (SMI) and grip strength. We applied the log-rank test and Cox proportional hazards regression analysis to analyze whether sarcopenia, low SMI, and low grip strength were associated with readmission within 6 months. Results: Among 228 included patients (mean age, 72.8 years; 146 males), the prevalence of sarcopenia was 24.6% (n=56; male, 17.8%; female, 36.6%). Cox proportional hazards regression analysis using the propensity score as a covariate revealed that sarcopenia (hazard ratio [HR] 7.21 [95% confidence interval (CI) 1.45-35.8]; p=0.016) and low skeletal muscle mass (HR 7.40 [95% CI 1.14-48.1; p=0.036), but not low grip strength (HR 1.42 [95% CI 0.281-7.21]; p=0.670), were significantly associated with readmission for stroke within 6 months. Conclusions: Sarcopenia was negatively associated with readmission within 6 months of stroke onset in patients in Japan who had experienced an acute stroke. These findings suggest that the identification of sarcopenia may facilitate prognostic prediction from the acute stage and intervention(s) to prevent rehospitalization.

Association between different types of physical activity and occupational stress in Japanese workers: a cross-sectional study.

This cross-sectional study investigated the association between different types of physical activity (PA) and occupational psychological and physical stress responses among workers in Japan. Stress responses were assessed using the Brief Job Stress Questionnaire. Work-related PA (time spent sitting, sitting bouts, standing, walking, engaging in heavy labor, and moderate-to-vigorous PA [MVPA]) and exercise-based PA (frequencies [times/wk] of flexibility and muscle-strengthening activity, and walking) were measured using a questionnaire. Multiple linear regression was performed to examine the association between each type of PA and stress responses. Participants who engaged in >108 min/d of work-related MVPA exhibited a statistically significant association with higher psychological stress responses when compared to those who engaged in 0-42 min/d of work-related MVPA. For exercise-based PA, participants who engaged in flexibility activity or walking five or more times/wk, or muscle-strengthening activity one to three times/wk, demonstrated significantly lower psychological stress responses compared to those who did not exercise. Participants who engaged in flexibility activity five or more times/wok demonstrated significantly lower physical stress responses compared to those who did not exercise. This study suggests that work-related MVPA is associated with higher psychological stress responses, while exercise-based PA is associated with lower psychological or physical stress responses.

Detection of episodic nocturnal hypercapnia in patients with neurodegenerative disorders.

PURPOSE: Episodic nocturnal hypercapnia (eNH) in transcutaneous carbon dioxide pressure (PtcCO2) corresponding to rapid eye movement sleep hypoventilation is a useful biomarker for detecting nocturnal hypoventilation. However, the relationship between eNH and neurodegenerative diseases with sleep-related breathing disorders (SRBDs) is unknown. The aim of this study was to evaluate the relationship between eNH and nocturnal hypoventilation in neurodegenerative diseases. METHODS: Patients with neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), multiple system atrophy (MSA), Parkinson's disease, progressive supranuclear palsy, corticobasal syndrome, and idiopathic normal pressure hydrocephalus, were enrolled and received overnight PtcCO2 monitoring. The patients were divided into groups for eNH and sleep-associated hypoventilation (SH) prevalence analysis: A (ALS), B (MSA), and C (others). RESULTS: Among 110 patients, twenty-three (21%) and 10 (9%) of the patients met eNH and SH criteria, respectively. eNH and SH were significantly more frequent in groups A and B than in C. The prevalence of SH in the patients with eNH was 39% whereas most of patients with SH (90%) presented with eNH. Among patients with daytime carbon dioxide pressure in arterial blood ≤ 45 mmHg, eNH frequency was 13%, whereas none of the patients met SH criteria. The frequency of noninvasive positive pressure ventilation after PtcCO2 monitoring was significantly higher in those with than without eNH. CONCLUSIONS: eNH is common in patients with MSA and ALS who present with SRBD. eNH with overnight PtcCO2 monitoring is a useful biomarker to detect hypoventilation among neurodegenerative diseases with different SRBD mechanisms.

Association of the number of remaining teeth with kidney function in community-dwelling healthy older adults: a cross-sectional study.

Objectives: Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function. Materials and Methods: We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m2 and creatinine levels, mg/dL). Results: The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=-0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function. Conclusion: This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

Hospital-associated sarcopenia and the preventive effect of high energy intake along with intensive rehabilitation in patients with acute stroke.

OBJECTIVES: Hospital-associated sarcopenia is prevalent and associated with poor outcomes in acutely admitted patients. Prevention of developing sarcopenia during hospitalization is an important factor in stroke management. Therefore, this study aimed to investigate whether energy intake and rehabilitation duration contribute to the prevention of hospital-associated sarcopenia in patients with acute stroke. METHODS: Patients with acute stroke were included in this study. Energy intake during the first week of hospitalization was classified as "high" or "low" based on the reported cutoff value. Rehabilitation time during hospitalization was classified as "intense" or "mild" based on the median. The four groups were compared based on the combinations of high or low energy intake and intense or mild rehabilitation. The primary outcome was the development of sarcopenia during hospitalization. The secondary outcome was the Functional Independence Measure motor item gain during hospitalization. Multivariate analysis was performed with the primary or secondary outcome as the dependent variable and the effect of each group on the outcome was examined. RESULTS: A total of 112 participants (mean age = 70.6 y; 63 men) were included in the study. Multivariate analysis found that high × intense (odds ratio = 0.113; P = 0.041) was independently associated with the development of sarcopenia during hospitalization (i.e., hospital-related sarcopenia). High × intense (ß = 0.395; P < 0.001) was independently associated with the gain of Functional Independence Measure motor items. CONCLUSIONS: In patients with acute stroke, the combination of high energy intake and adequate rehabilitation time is associated with prevention of hospital-associated sarcopenia.

Change in phase angle is associated with improvement in activities of daily living and muscle function in patients with acute stroke.

PURPOSE: The phase angle (PhA) is a simple index that reflects nutritional status and muscle quality. This study aimed to investigate the association between PhA changes and activities of daily living (ADL), muscle strength, and muscle mass in patients with acute stroke. METHODS: This retrospective, observational, cross-sectional study included patients hospitalized for acute stroke. The primary outcome was functional independence measure (FIM) of motor gain. The secondary outcomes were changes in handgrip strength and skeletal muscle mass index (SMI) during hospitalization. Multivariate analysis was used to examine whether PhA changes were associated with outcomes, after adjusting for potential confounders. RESULTS: Hundred and sixty one subjects (mean age 74.6 years, 92 men) were included in the study. Multivariate analysis showed that PhA change was significantly and positively correlated with the gain in FIM motor scores, both for men (ß = 0.634, p < 0.001) and women (ß = 0.660, p < 0.001). Furthermore, there were significant associations between PhA change and changes in handgrip strength for men (ß = 0.222, p = 0.030) and women (ß = 0.491, p < 0.001), as well as SMI for men (ß = 0.556, p < 0.001) and women (ß = 0.290, p = 0.025). CONCLUSIONS: An increased phase angle was positively associated with ADL, muscle strength, and muscle mass at discharge in patients with acute stroke.

Associations between dairy consumption and the physical function in Japanese community-dwelling older adults: The Shimane CoHRE study.

OBJECTIVES: We investigated sex differences in the associations between dairy consumption and the physical function among community-dwelling older adults. METHODS: Six hundred and fifty-six older adults (75.6 ± 6.4 years old) participated in this study. Dairy consumption (5-item Likert score) and the physical function (gait speed, handgrip strength, and skeletal muscle mass) were measured. The linear and quadratic associations between dairy consumption and the physical function measures were examined by a multiple linear regression analysis adjusted for covariates. RESULTS: Among women, an increased dairy consumption was significantly linearly associated with greater hand-grip strength and faster gait speed (both p<0.05) after adjusting for covariates. Among men, dairy consumption was not associated with the physical function measures. Dairy consumption was not associated with the muscle mass in either sex. CONCLUSIONS: Increased dairy consumption was associated with a superior physical function in older women.

Association between flexibility activity and blood-pressure change among older adults in Japan: A 5-year longitudinal study.

This longitudinal study examined the relationship between flexibility-activity and blood-pressure (BP) change among older adults in Japan. Our study included 452 older adults who took part in our survey in both 2012/2013 and 2017/2018. The seated systolic blood pressure (SBP) and diastolic BP (DBP) were measured both at baseline and at the 5 years follow-up. The frequencies of the different physical activities at baseline were assessed using a questionnaire. A generalized linear mixed model was used to estimate the non-standardized coefficient (B) of BP change associated with flexibility activity, after adjustments for sex, age, body mass index, smoking status, alcohol consumption, antihypertensive medication use, history of heart disease, walking time, and muscle-strengthening activity as a fixed-effect, and area of residence as a random-effect. Higher flexibility-activity frequency was significantly associated with reduced SBP (B = -0.77 [95% confidence intervals = -1.36, -0.18], p for linear trend = 0.01, p for quadratic trend = 0.85) and DBP (-0.33 [-0.71, 0.05], p for linear trend = 0.09, p for quadratic trend = 0.04). Engaging in flexibility activity for 3 days per week was significantly associated with a reduction in DBP (B = -4.16, 95% CI [-7.53, -0.79], p = 0.02) compared with that in the reference group (0 days per week). Interaction tests were not significant between basic variables (sex, age, BMI, and antihypertensive medication) and flexibility. In conclusion, higher flexibility activity frequency was associated with a reduction in BP in older adults. Future longitudinal and interventional studies should examine the effects of flexibility activity on cardiovascular disease prevention.

Cut-off values for severe low muscle strength and skeletal muscle mass in post-acute patients with sarcopenia.

AIM: This study aimed to calculate the cut-off values for severe decline in muscle strength and skeletal muscle mass in post-acute patients with sarcopenia and to determine their effect on activities of daily living. METHODS: This retrospective cohort study included patients with sarcopenia consecutively admitted to a Japanese rehabilitation hospital between 2014 and 2016. Sarcopenia was diagnosed based on handgrip strength and skeletal muscle mass index. The outcome was the functional independence measure of motor function at discharge. Cut-off values for predicting severe decline in handgrip strength and skeletal muscle mass index were calculated separately by sex. Values below the cut-off were used to define severely low handgrip strength and severely low skeletal muscle mass index. RESULTS: Overall, 451 patients (median age, 83 years; 61.4% women) were evaluated. The median functional independence measure of motor function score at discharge was 57. The optimal cut-off values for severely low handgrip strength were 9.0 kg for women and 14.6 kg for men, and those for severely low skeletal muscle mass index were 4.6 kg/m2 for women and 5.6 kg/m2 for men. Severely low handgrip strength and skeletal muscle mass index were independently associated with the functional independence measure of motor function score at discharge (ß = -0.178, P = 0.005). CONCLUSIONS: In post-acute patients with sarcopenia, a severe decline in muscle strength and skeletal muscle mass is further negatively associated with an improvement in activities of daily living. The cut-off values herein can serve as indicators to assess sarcopenia severity. Geriatr Gerontol Int 2023; 23: 493-499.

Changes in masticatory performance and the new onset of diabetes mellitus in older adults: a 5-year longitudinal study.

Objective: Although masticatory performance is affected by age-related reduction in number of teeth (or treatment), the relationship between longitudinal changes in masticatory performance and diabetes mellitus is unknown. This longitudinal study investigated the association between changes in masticatory performance and new-onset diabetes mellitus among community-dwelling Japanese older adults. Methods: The data of 214 older adults living in Ohnan Town, Shimane, Japan, who participated in two surveys conducted between 2012 and 2017 were analyzed. Diabetes mellitus was defined as a hemoglobin A1c level ≥ 6.5% or self-reported diabetes mellitus. The masticatory performance (measured by number of gummy jelly pieces collected after chewing) was evaluated by dental hygienists. Masticatory performance was categorized into two groups (high or low) based on the median in each survey; further, four groups (Group A: remained consistently high, Group B: changed from low to high, Group C: remained consistently low, Group D: changed from high to low) were used to determine longitudinal changes in masticatory performance. Logistic regression was used to analyze the association between changes in masticatory performance and new-onset diabetes mellitus. Results: Overall, 10.3% of participants had diabetes mellitus at the follow-up survey. Multivariate analysis showed that Group D (odds ratio 8.69, 95% confidence interval 1.98-38.22) was positively associated with the development of diabetes mellitus compared with Group A after adjusting for sex, age, body mass index, alcohol consumption, physical activity, and eating speed. Conclusions: Deteriorating masticatory performance for 5 years may cause diabetes mellitus among older adults.

Fast Eating Speed Could Be Associated with HbA1c and Salt Intake Even after Adjusting for Oral Health Status: A Cross-Sectional Study.

This study aimed to examine the relationship between eating speed and hemoglobin A1c (HbA1c), considering the number of teeth, using cross-sectional health examination data from community-dwelling older individuals in Japan. We used data from the Center for Community-Based Healthcare Research and Education Study in 2019. We collected data on gender, age, body mass index, blood test results, Salt intake, bone mineral density, body fat percentage, muscle mass, basal metabolic rate, number of teeth, and lifestyle information. Eating speed was evaluated subjectively as fast, normal, or slow. Overall, 702 participants were enrolled in the study and 481 participants were analyzed. Multivariate logistic regression analysis revealed a significant association between fast eating speed and being a male (odds ratio [95% confidence interval]: 2.15 [1.02-4.53]), HbA1c (1.60 [1.17-2.19]), salt intake (1.11 [1.01-1.22]), muscle mass (1.05 [1.00-1.09]), and enough sleep (1.60 [1.03-2.50]). Fast eating may be associated with overall health and lifestyle. The characteristics of fast eaters, after taking oral information into consideration, tended to increase the risk of type 2 diabetes, renal dysfunction, and hypertension. Dental professionals should provide dietary and lifestyle guidance to fast eaters.

Neither Trimethylamine-N-Oxide nor Trimethyllysine Is Associated with Atherosclerosis: A Cross-Sectional Study in Older Japanese Adults.

Recent evidence suggests that trimethylamine-N-oxide (TMAO), a metabolite of L-carnitine and choline, is linked to atherosclerosis and cardiovascular diseases. As TMAO content is very high in fish, we raised the following question: why do Japanese people, who consume lots of fish, show a low risk of atherosclerosis? To address this question, we investigated the effects of TMAO and other L-carnitine-related metabolites on carotid intima-media thickness (IMT). Participants were recruited from a small island and a mountainous region. Plasma L-carnitine, γ-butyrobetaine (γBB), TMAO, trimethyllysine (TML), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) levels were measured using liquid or gas chromatography-mass spectrometry. Plasma L-carnitine concentration was higher in men than in women. TMAO and TML were significantly higher in the residents of the island than in the mountainous people. In multiple linear regression analyses in all participants, TML showed a significant inverse association with max-IMT and plaque score (PS), whereas TMAO did not show any associations. In women, L-carnitine was positively associated with max-IMT and PS. TMAO was correlated with both EPA and DHA levels, implying that fish is a major dietary source of TMAO in Japanese people. Our study found that plasma TMAO was not an apparent risk factor for atherosclerosis in elderly Japanese people, whereas a low level of TML might be a potential risk. L-carnitine may be a marker for atherosclerosis in women.

Validity of sarcopenia diagnosis defined by calf circumference for muscle mass to predict functional outcome in patients with acute stroke.

OBJECTIVE: This study examined the association between sarcopenia diagnosed by defining muscle mass with calf circumference and physical function at hospital discharge in patients with acute stroke and to perform a comparison with sarcopenia diagnosis according to the Asian Working Group for Sarcopenia. RESEARCH METHODS & PROCEDURES: This retrospective cohort study included patients with acute stroke. We calculated the calf circumference cut-off value defining low skeletal muscle index for the Asian Working Group for Sarcopenia diagnostic criteria and used a combination of low calf circumference and low grip strength to define sarcopenia-calf circumference. A combination of low skeletal muscle index and low grip strength defined sarcopenia-Asian Working Group for Sarcopenia. Associations between sarcopenia-calf circumference, sarcopenia-Asian Working Group for Sarcopenia, and Functional Independence Measure motor score were evaluated using multiple regression analysis. RESULTS: The study included 308 patients (198 men; mean age, 73.2 years). Sarcopenia-calf circumference prevalence was 24.7% in men and 46.4% in women. In men, sarcopenia-calf circumference (ß=-0.178; 95% CI: -0.284, -0.073; p=0.001) and sarcopenia-Asian Working Group for Sarcopenia (ß=-0.228; 95% CI: -0.330, -0.127; p<0.001) were significantly associated with Functional Independence Measure motor score at discharge. CONCLUSIONS: Sarcopenia diagnosed by defining muscle mass with calf circumference was negatively associated with physical function at discharge in male patients with acute stroke. Sarcopenia diagnosed using Asian Working Group for Sarcopenia criteria was superior to sarcopenia-calf circumference for predicting physical function at discharge. Our findings suggest that the use of CC enables assessment of sarcopenia even at facilities where muscle mass measurements may be difficult.

Applicability of the Diagnostic Criteria for Sarcopenic Obesity Defined by ESPEN/EASO Criteria in Acutely Admitted Patients with Stroke: Prevalence and Association with Outcomes.

Few reports have described sarcopenic obesity in patients with stroke. This study aimed to investigate the prevalence of sarcopenic obesity, as defined by the European Society for Clinical Nutrition and Metabolism (ESPEN) and European Association for the Study of Obesity (EASO) consensus statement, in patients with acute stroke and to determine whether it was associated with improved physical function at discharge. This retrospective cohort study was conducted from May 2020 to November 2021 in patients with acute stroke. Sarcopenic obesity was determined using the ESPEN and EASO consensus statement. The main outcome was physical function based on the Functional Independence Measure motor score at discharge. Multiple regression analysis was conducted to evaluate the association between sarcopenic obesity and the Functional Independence Measure motor score. This study included 276 patients (182 men; mean age, 72.4 y). Sarcopenic obesity screened for obesity with body mass index >27.5 was found in 11 (4%) patients. Multiple regression analysis revealed that sarcopenic obesity screened for obesity with body mass index >27.5 was not significantly associated with the Functional Independence Measure motor score at discharge (ß=0.038; 95% confidence interval: -0.046, 0.123; p=0.369). This study revealed a prevalence rate of 4% for sarcopenic obesity diagnosed by the ESPEN and EASO criteria and showed that sarcopenic obesity was not statistically associated with activities of daily living at acute discharge in patients with stroke.

Combination of High Energy Intake and Intensive Rehabilitation Is Associated with the Most Favorable Functional Recovery in Acute Stroke Patients with Sarcopenia.

Energy intake and rehabilitation time individually contribute to the improvement of activities of daily living (ADL). This study aimed to investigate the additive effect of energy intake and rehabilitation time on ADL improvement in acute stroke patients with sarcopenia. The study included 140 patients (mean age 82.6 years, 67 men) with stroke. Energy intake during the first week of hospitalization was classified as "Sufficiency" or "Shortage" based on the reported cutoff value and rehabilitation time was classified as "Long" or "Short" based on the median. The study participants were categorized into four groups based on the combination of energy intake and rehabilitation time. The primary outcome was the gain of functional independence measure (FIM) motor during hospitalization. The secondary outcomes were length of stay and home discharge rates. Multivariate analysis was performed with primary/secondary outcomes as the dependent variable, and the effect of each group on the outcome was examined. Multivariate analysis showed that "long rehabilitation time and sufficient energy intake" (ß = 0.391, p < 0.001) was independently associated with the gain of FIM motor items. The combination of high energy intake and sufficient rehabilitation time was associated with ADL improvement in acute stroke patients with sarcopenia.

Neighborhood-level socioeconomic factors moderate the association between physical activity and relative age effect: a cross-sectional survey study with Japanese adolescents.

BACKGROUND: Relative age effect is defined as a phenomenon where children born early generally perform better than children born later in the same cohort. Physical activity is an important factor that might be influenced by the relative age effect. Socioeconomic factors (e.g., parent's income, education level) are also associated with the adolescent's physical activity. However, no existing study has examined whether socioeconomic factors moderate the relative age effect on the adolescent's physical activity. This study aims to clarify whether and how birth month and socioeconomic factors relate to organized sports and physical activity among adolescents in Japan. METHODS: We conducted a questionnaire survey targeting 21,491 adolescents who live in a widespread neighborhood. We included 8102 adolescents (4087 males and 4015 females: mean age 13.1 ± 1.4) in the analysis. Based on the participants' birth months, we divided them into four groups (April to June, July to September, October to December, January to March). We asked participants to report their organized sports participation. Using the International Physical Activity Questionnaire for Japanese Early Adolescents, we identified their moderate to vigorous physical activity (MVPA). Neighborhood-level socioeconomic factors (areal deprivation, average annual income, education level) were analyzed based on national surveys, such as the population census. We performed multilevel logistic and linear regression analysis for organized sports participation and MVPA, respectively. Moreover, a simple slope analysis was implemented if the interaction between birth month and socioeconomic factor was significant in the multilevel linear regression analysis. RESULTS: Among males, relatively younger adolescents (adolescents who were born later in the same grade) were less likely to participate in organized sports activites (OR=0.90, 95% CI 0.82-0.97, p<0.05), while both males and females engaged in less MVPA (b=-0.54, b=-0.25, p< 0.01, respectively). We observed an interaction between birth month and socioeconomic factors. Among males in low-income neighborhoods, and females in more deprived neighborhoods, relatively younger adolescents engaged in less MVPA. CONCLUSIONS: Socioeconomic factors moderate the relative age effect on adolescents' physical activity. The relative age effect on adolescents' physical activity might be more likely to appear among adolescents from socioeconomically disadvantaged neighborhoods.

Changes in the Urinary Sodium-to-Potassium Ratio Are Associated with Blood Pressure Change in Older Japanese Adults: A 7-Year Longitudinal Study.

Studies on the association between sodium-to-potassium (Na/K) ratio changes and blood pressure (BP) changes among older adults are limited. This 7-year longitudinal study examined the association between Na/K ratio changes (evaluated using spot urine tests) and BP changes among older Japanese adults. Data were collected from 432 participants (mean age: 70.3±4.4; range: 65−84 years) in 2012 and 2019. Changes in BP and the Na/K ratio over 7 years were calculated by subtracting baseline values from values noted during a follow-up survey. The median systolic and diastolic BP (SBP) and (DBP) changes after 7 years were 4 (IQR, −7, 14) and −1 (IQR, −9, 5) mmHg, respectively. The median Na/K ratio was changed during the follow-up period by −0.2 (IQR, −1.3, 0.7). A generalized linear model indicated that Na/K ratio changes were positively associated with SBP (B = 2.03, p < 0.001) and DBP (B = 0.62, p = 0.021) changes. In the non-antihypertensive medication-using group, urinary Na/K ratio changes were associated with SBP and DBP changes (B = 2.39, p = 0.001; B = 0.99, p = 0.033). In the antihypertensive medication user group, urinary Na/K ratio changes were associated with SBP changes (B = 1.62, p = 0.015). We confirmed the association between changes in the Na/K ratio and changes in BP.

Results from the Japan 2022 report card on physical activity for children and youth.

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.