Association of Smartphone-Recorded Steps Over Years and Change in Cardiovascular Risk Factors Among Working-Age Adults.

Background Few data exist on long-term steps and their relation to changes in cardiovascular disease risk factors. We aimed to examine the associations using long-term smartphone-recorded steps. Methods and Results The present analysis made use of data from 2 national databases and a commercial app database. We evaluated the associations between smartphone-recorded daily steps over 2 years and 2-year changes in the cardiovascular disease risk factors. A total of 15 708 participants with mean (SD) age of 44.1 (9.5) and 23.5% women were included. After adjustment for potential confounders, differences in weight were almost linearly associated with 2-year steps in men (estimate [SE] per 1000 steps/d: -0.33 [0.029] kg), and inversely related only above 5000 steps/d in women (-0.18 [0.054] kg). An inverse linear association with systolic blood pressure was observed in men (-0.34 [0.097] mm Hg) but not in women. Greater steps were associated with change in high-density lipoprotein cholesterol and triglycerides (0.61 [0.068] and -3.4 [0.61] mg/dL in men; 0.64 [0.17] and -2.3 [0.67] mg/dL in women), while changes in low-density lipoprotein cholesterol were evident in men only (-0.59 [0.17] mg/dL). A significant negative association with hemoglobin A1c was observed only in women (-0.012 [0.0043] %). Conclusions In a large cohort of Japanese adults, smartphone-recorded steps over years were associated with beneficial changes in cardiovascular disease risk factors, with some differences between men and women in the associational patterns. The findings support the benefit of long-term physical activity for cardiovascular disease health and suggest a useful role of smartphone-recorded steps for monitoring cardiovascular disease risk over the long term.

Effects of an mHealth App (Kencom) With Integrated Functions for Healthy Lifestyles on Physical Activity Levels and Cardiovascular Risk Biomarkers: Observational Study of 12,602 Users.

BACKGROUND: Mobile health (mHealth) apps are considered to be potentially powerful tools for improving lifestyles and preventing cardiovascular disease (CVD), although only few have undergone large, well-designed epidemiological research. "kencom" is a novel mHealth app with integrated functions for healthy lifestyles such as monitoring daily health/step data, providing tailored health information, or facilitating physical activity through group-based game events. The app is linked to large-scale Japanese insurance claims databases and annual health check-up databases, thus comprising a large longitudinal cohort. OBJECTIVE: We aimed to assess the effects of kencom on physical activity levels and CVD risk factors such as obesity, hypertension, dyslipidemia, and diabetes mellitus in a large population in Japan. METHODS: Daily step count, annual health check-up data, and insurance claim data of the kencom users were integrated within the kencom system. Step analysis was conducted by comparing the 1-year average daily step count before and after kencom registration. In the CVD risk analysis, changes in CVD biomarkers following kencom registration were evaluated among the users grouped into the quintile according to their change in step count. RESULTS: A total of 12,602 kencom users were included for the step analysis and 5473 for the CVD risk analysis. The participants were generally healthy and their mean age was 44.1 (SD 10.2) years. The daily step count significantly increased following kencom registration by a mean of 510 steps/day (P<.001). In particular, participation in "Arukatsu" events held twice a year within the app was associated with a remarkable increase in step counts. In the CVD risk analysis, the users of the highest quintile in daily step change had, compared with those of the lowest quartile, a significant reduction in weight (-0.92 kg, P<.001), low-density lipoprotein cholesterol (-2.78 mg/dL, P=.004), hemoglobin A1c (HbA1c; -0.04%, P=.004), and increase in high-density lipoprotein cholesterol (+1.91 mg/dL, P<.001) after adjustment of confounders. CONCLUSIONS: The framework of kencom successfully integrated the Japanese health data from multiple data sources to generate a large, longitudinal data set. The use of the kencom app was significantly associated with enhanced physical activity, which might lead to weight loss and improvement in lipid profile.

[Utility of the public health approach for the world population strategy].

OBJECTIVE: The populations of developing countries have so dramatically increased over the past two centuries that it has tended to undermine sustained economic growth and development. The population growth rate in the Philippines, in particular, remains at 2.0%, one of the highest in the other southeastern Asian countries. This has exacerbated problems of economic disparity and deterioration in development so that the Philippine Government has declared it a political priority to address the population problem and for this purpose has asked the Japan International Cooperation Agency (JICA) for assistance. METHOD: Based on past experience with the world population issue, the International Conference on Population and Development in Cairo (ICPD) declared that the population strategy should be merged into socio-economic development strategies that aim to achieve basic human needs, such as, education, public health and gender equality. JICA assistance to improve maternal and child health status and promote community health initiatives in the Philippines is based on this new paradigm; the ICPD plan. OUTPUT AND CONCLUSION: JICA has supported a diverse range of public health activities, such as the establishment of a comprehensive maternal and child health care system, advocacy of reproductive health, performance of adolescence health education and assistance for participatory community action. The efforts were generally geared towards sustainable implementation of health activities in the community. The JICA project employed the public health approach that gained a global consensus at Cairo to challenge the problem of a continuously high rate of population growth.