Mortality-and Health-Related Factors in a Community-Dwelling of Oldest-Older Adults at the Age of 90: A 10-Year Follow-Up Study.

Mortality is obviously intended for epidemiological studies of community-dwelling older adults. There are several health-related factors associated with nutritional status and mortality. The aim of this study was to elucidate the risk factor for mortality in community-dwelling oldest-older adults at the age of 90 and clarify the structure of health-related factors associated with mortality. A 10-year follow-up study was performed for 93 subjects at the age of 90. The mean and median of their survival days were 2373 and 2581 days for women, and 1694 and 1793 days for men. By Cox's proportional hazards model, health-related factors associated with mortality were self-assessed for chewing ability, activities of daily living (ADLs), serum albumin, total cholesterol, serum creatinine, and gripping power for women but not for men. These factors interacted with each other, and the association of these factors was different in women and men. Self-assessed chewing ability was a powerful risk factor for mortality in women at the age of 90. It acted independently from nutritional status. For older adults, addressing healthy food choices together with improved oral functions is useful. However, risk factors for mortality may depend on the life stage of subjects. To investigate the risk factor for the mortality, the life course approach is necessary.

Effects of Breastfeeding on Stress Measured by Saliva Cortisol Level and Perceived Stress.

Purpose: The effects of breastfeeding on postpartum depression symptoms and stress using physiological measures require investigation. Background: Breastfeeding suppresses the secretion of cortisol. Oxytocin levels correlate negatively with symptoms of postpartum depression. Aim: To investigate the effects of breastfeeding on stress and postpartum depression. Methods: We examined 79 breastfeeding women using the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale-10, and the Breastfeeding Self-Efficacy Scale, and measured the salivary cortisol levels before and after breastfeeding. Findings: There was a negative correlation between the duration of suckling and changes in salivary cortisol levels following breastfeeding (r s = -0.333, p < 0.05). Salivary cortisol levels immediately following breastfeeding were significantly lower compared to mothers who used mixed feeding methods (p < 0.001). Breastfeeding mothers had lower perceived stress than mothers using mixed feeding methods (ß = -0.260, p < 0.05). There was no association between breastfeeding and postpartum depression; however, there was an association between postpartum depression and perceived stress (ß = 0.526, p < 0.001). Conclusion: Salivary cortisol levels significantly decreased following breastfeeding, with longer suckling times correlating with lower cortisol levels. Breastfeeding reduced stress and increased breastfeeding self-efficacy.

Post-breastfeeding stress response and breastfeeding self-efficacy as modifiable predictors of exclusive breastfeeding at 3 months postpartum: a prospective cohort study.

BACKGROUND: The rate of exclusive breastfeeding at 3 months postpartum is only 50% in Japan. In order to increase this rate, we aimed to examine modifiable factors related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables at 1 month postpartum. METHODS: This prospective cohort study was conducted at a secondary medical care center in Osaka, Japan from February 2017 to October 2018. Demographic variables, infant feeding modality, breastfeeding-related variables, and psychosocial variables were obtained using questionnaires at 1 month postpartum. Daytime salivary cortisol levels before and after breastfeeding at 1 month postpartum were measured as a biological marker for stress responses associated with breastfeeding. Each infant's feeding modality was re-assessed at 3 months postpartum. Multiple logistic regression analyses were performed to examine factors affecting exclusive breastfeeding at 3 months postpartum. RESULTS: Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors were significantly associated with exclusive breastfeeding at 3 months postpartum: multiparity (adjusted odds ratio, 95% confidence interval: 11.13, 2.08-59.59), having a university degree (5.25, 1.04-26.53), no plan to return to work by 6 months postpartum (0.02, 0.00-0.46), and exclusive breastfeeding (42.84, 6.05-303.52), lower cortisol level after breastfeeding (0.00, 0.00-0.02), and higher breastfeeding self-efficacy scale score (1.07, 1.00-1.14) at 1 month postpartum. In parity-specific analyses, exclusive breastfeeding (25.33, 4.75-134.98) and lower cortisol level after breastfeeding (0.00, 0.00-0.21) at 1 month postpartum in primiparous women, and lower cortisol level after breastfeeding (0.00, 0.00-0.94), higher breastfeeding self-efficacy score (1.18, 1.05-1.32), and absence of breast complications (0.09, 0.01-0.82) at 1 month postpartum in multiparous women were associated with exclusive breastfeeding at 3 months postpartum. CONCLUSIONS: Stress levels after breastfeeding, breastfeeding self-efficacy, and the presence of breast complications could be modifiable factors associated with subsequent exclusive breastfeeding. Further research is needed to examine whether approaches to reducing breastfeeding-related stress, improving breastfeeding self-efficacy, and preventing breast complications during lactation are effective to increase exclusive breastfeeding practices.

Impact of the Serum Level of Albumin and Self-Assessed Chewing Ability on Mortality, QOL, and ADLs for Community-Dwelling Older Adults at the Age of 85: A 15 Year Follow up Study.

Quality of life (QOL) and mortality are true endpoints of epidemiological or medical research, especially for community-dwelling older adults. Nutritional status and activities of daily living (ADLs) are associated with QOL and mortality. Good oral health status supports a good nutritional status. The aim of this study was to elucidate the complex structure of these important health-related factors. We surveyed 354 healthy older adults at the age of 85. Nutritional status was evaluated by the serum level of albumin. QOL, ADLs, self-assessed chewing ability, serum albumin level, and mortality during the 15 year follow up period were analyzed. Self-assessed chewing ability was associated with QOL and ADLs. Self-assessed chewing ability for slight-hard foods was associated with mortality in men. However, it was not associated with the serum albumin level. The serum albumin level was associated with mortality in women. These results indicate that maintaining good oral function is not enough. Nutritional instruction in accordance with oral function is indispensable for health promotion in older adults. When planning health promotion strategies for older adults, different strategies are needed for men and women.

Effects of self-assessed chewing ability, tooth loss and serum albumin on mortality in 80-year-old individuals: a 20-year follow-up study.

BACKGROUND: The association between dental status and mortality in community-dwelling older adults has been documented by several studies. The aim of this study was to analyze the contribution of self-assessed chewing ability, number of remaining teeth and serum albumin levels to mortality and the interactions between the three factors. METHODS: A 20-year follow-up study was conducted with 666 subjects aged 80 years (from 1996 to 2017) who resided in the 8 areas served by one health center in Iwate Prefecture. Health check-ups including physical fitness measurements were conducted at a meeting place or gymnasium. Medical interview and blood sampling were conducted by physician. Oral examination was examined by dentist. The number of remaining teeth, serum albumin levels, and self-assessed chewing ability were used as predictors of mortality. RESULTS: Among the 608 subjects (233 men and 375 women) included in this study, only 12 subjects (1.97%) survived after 20 years of follow-up. For men, dental status and serum levels of albumin were significantly associated with mortality. The hazard ratios of self-assessed chewing ability calculated by item response theory analysis and the inability to chew at least one food adjusted for serum albumin and tooth conditions were statistically significant in men. When adjusted by health status evaluated by blood tests, self-assessed chewing ability was statistically significant in men. According to path analysis, self-assessed chewing ability and serum albumin independently affected mortality in men. CONCLUSION: Masticatory dysfunction may be an important risk factor for mortality in men, even though it was self-assessed. Retaining chewing ability might be a useful predictor of longevity in older male adults.

Salt Restriction Affects the Excretions of Minerals (Na, K, Ca, Mg, P and Zn) in the Second Voided Fasting Early Morning Urine.

The plasma concentrations of mineral (sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), phosphorus (P), and zinc (Zn)) are kept within narrow ranges to maintain homeostasis; hence, it is difficult to use them as indicators of nutritional status. We selected the excretion of these minerals in the second voided fasting early morning urine (EMU) as potential indicators of nutritional status. We previously reported that Na restriction caused a negative balance of Ca and Mg. Therefore, Na restriction can cause changes in EMU-minerals. This study aimed to examine the relationship between dietary Na restriction and urinary mineral excretion. The study lasted for 21 d, including 16 d of balance period and 3 d of recovery period. The participants (11 healthy young women) were divided into the Na restriction group (n=5) (NaCl: 6 g/d) and control group (n=6) (NaCl: 12 g/d). The Na restriction group changed to the control diet (NaCl: 12 g/d) during only the recovery period. The EMU-Na, Ca, Mg, P and Zn in the Na restriction group significantly decreased compared with that of the control group. The EMU-Na, K, Ca, Mg, and Zn in the group with NaCl intake of 6 g/d significantly decreased compared with that of the group with NaCl intake of 12 g/d (in the Na restriction group). We conclude that the decrease in excretion of Na, Ca, Mg and Zn in the EMU can lead to Na restriction. This result can serve as basis when considering EMU as an indicator of mineral status.

Promoting Stair Climbing as an Exercise Routine among Healthy Older Adults Attending a Community-Based Physical Activity Program.

Stair climbing provides a feasible opportunity for increasing physical activity (PA) in daily living. The purpose of this study was to examine the daily walking and stair-climbing steps among healthy older adults (age: 74.0 ± 4.9 years; Body Mass Index (BMI): 22.3 ± 2.5 kg/m²). Participants (34 females and 15 males) attended a weekly 6-month community-based PA program. During the entire program period, daily walking and stair-climbing steps were recorded using a pedometer (Omron, HJA-403C, Kyoto, Japan). Before and after the 6-month program, height, body weight and leg muscle strength were assessed. After the 6-month program, the mean walking and stair-climbing steps in both women and men increased significantly (p ≤ 0.01). Daily stair-climbing steps increased about 36 steps in women and 47 steps in men. At the end of 6 months, only male participants had significant correlation between the number of stair steps and leg muscle strength (r = 0.428, p = 0.037). This study reported that healthy older adults attending the community-based PA program had regular stair-climbing steps during daily living. Promoting stair climbing as an exercise routine was feasible to increase their walking and stair-climbing steps.

Effects of maternity yoga on the autonomic nervous system during pregnancy.

AIM: To elucidate the changes in the daily variation seen in the autonomic nervous system during pregnancy brought about by maternity yoga and to evaluate how maternal yoga affects stress and sleep. METHODS: A prospective, longitudinal study was conducted between January 2013 and December 2014. Pregnant women who were attending maternity yoga classes at Palmore Hospital between 20 and 23 weeks' gestation were enrolled as the yoga group, and a matched control group was also enrolled. Study participants completed questionnaires, including a perceived stress scale and sleep logs, during their second and third trimesters. Heart rate variability and salivary α-amylase levels were evaluated as stress indices at 20-23 weeks' gestation, 28-31 weeks' gestation and 36-40 weeks' gestation. RESULTS: A total of 38 women were in the yoga group, with 53 in the control group. At 28-31 weeks' gestation, heart rate variability during night and late-night periods was significantly higher in the yoga group than in the control group. At 36-40 weeks' gestation, variability between the morning, afternoon and late night was significantly higher in the yoga group. Salivary α-amylase levels decreased significantly immediately after practicing yoga during all evaluation periods in the yoga group. Night-time sleep duration was significantly longer in the yoga group. CONCLUSION: Our results suggest that practicing yoga activates the parasympathetic nervous system during the third trimester of pregnancy, consolidating sleep during the night and decreasing α-amylase levels, which indicates reduced stress.

Dietary Salt (Sodium Chloride) Requirement and Adverse Effects of Salt Restriction in Humans.

Inevitable sodium loss under sodium restriction must not be construed as evidence for the estimated average requirement (EAR) for sodium (Na) in humans. We conducted human mineral balance studies to determine the EAR for some minerals (Na, K, Ca, Mg, P, Zn, Fe, Cu and Mn). Na concentration in arm sweat was low while those of calcium (Ca) and magnesium (Mg) were high, during relatively heavy bicycle-ergometer exercise under relatively low Na intake (100 mmol/d). This suggests that Na was released from the bone, the sole pool of Na, with Ca and Mg. Additionally, the negative balances of Ca and Mg was observed under a relatively low sodium intake (100 mmol/d) even with the sufficient supply and intake of Ca and Mg into human body. Finally, we found no correlation between the Na intake and the Na balance, while the Na-intake was correlated significantly to the balances of K, Ca and Mg. The Na intake necessary to keep the balances of Ca and Mg positive was calculated to be 68 mg/kg body weight/d. To learn the signs and symptoms of low sodium intake, we compared the results of a metabolic study in which subjects consumed diets with 6 g and 12 g salt/d respectively. The blood pressure decreased only with the 6 g/d group. Fecal moisture contents of the 6 g/d group were lower than for the 12 g/d group, suggesting the fecal Na was strongly reabsorbed with water when the dietary Na was insufficienct. Indiscriminate Na restriction may have adverse effects on health.

Daily step count and all-cause mortality in a sample of Japanese elderly people: a cohort study.

BACKGROUND: This study aimed to examine the relationship between pedometer-assessed daily step count and all-cause mortality in a sample of elderly Japanese people. METHODS: Participants included 419 (228 males and 191 females) physically independent, community-dwelling 71-year-old Japanese people. The number of steps per day was measured by a waist-mounted pedometer for seven consecutive days at baseline. Participants were divided into quartiles based on their average number of steps/day (first quartile, < 4503 steps/day; second quartile, 4503-6110 steps/day; third quartile, 6111-7971 steps/day; fourth quartile, > 7972 steps/day) and were followed up over a mean period of 9.8 years (1999-2010) for mortality. RESULTS: Seventy-six participants (18.1%) died during the follow-up period. The hazard ratios (adjusted for sex, body mass index, cigarette smoking, alcohol intake, and medication use) for mortality across the quartiles of daily step count (lowest to highest) were 1.00 (reference), 0.81 (95%CI, 0.43-1.54), 1.26 (95%CI, 0.70-2.26), and 0.46 (95%CI, 0.22-0.96) (P for trend = 0.149). Participants in the highest quartile had a significantly lower risk of death compared with participants in the lowest quartile. CONCLUSION: This study suggested that a high daily step count is associated with a lower risk of all-cause mortality in physically independent Japanese elderly people.

Dentition status and frailty in community-dwelling older adults: A 5-year prospective cohort study.

AIM: To examine the longitudinal association between dentition status and incidence of frailty in older adults. METHODS: The present prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Dental examinations, biochemical blood examinations, physical performance and anthropometric measurements, and structured questionnaires were carried out at baseline. The presence of ≥20 teeth with nine or more occluding pairs of teeth was defined as functional dentition. Annual follow-up examinations, including physical performance, anthropometric measurements and structured questionnaires, were carried out over a 5-year period to determine the incidence of frailty, defined as three or more of the following five components derived from the Cardiovascular Health Study: weight loss, weakness, slowness, poor energy and low physical activity level. Adjusted hazard ratios of frailty incidence according to dentition status were calculated from Cox proportional hazards regression analyses. RESULTS: At baseline, 118 participants (36.6%) were defined as having functional dentition. During the follow up, 48 participants (14.9%) developed frailty. The adjusted hazard ratio for frailty in participants with functional dentition was 0.50 (95% confidence interval 0.25-0.98) compared with participants without functional dentition, after adjusting for sex, income, education, smoking status, body mass index, serum biomarkers and comorbidities. CONCLUSIONS: Functional dentition was significantly associated with a lower risk of frailty defined by the Cardiovascular Health Study frailty index in older Japanese adults. These results suggest that maintaining healthy and functional dentition into later life is important for frailty prevention. Geriatr Gerontol Int 2018; 18: 256-262.

Physical Activity: A Viable Way to Reduce the Risks of Mild Cognitive Impairment, Alzheimer's Disease, and Vascular Dementia in Older Adults.

A recent alarming rise of neurodegenerative diseases in the developed world is one of the major medical issues affecting older adults. In this review, we provide information about the associations of physical activity (PA) with major age-related neurodegenerative diseases and syndromes, including Alzheimer's disease, vascular dementia, and mild cognitive impairment. We also provide evidence of PA's role in reducing the risks of these diseases and helping to improve cognitive outcomes in older adults. Finally, we describe some potential mechanisms by which this protective effect occurs, providing guidelines for future research.

CD56(dim)CD16(high) and CD56(bright)CD16(-) cell percentages associated with maximum knee extensor strength and incidence of death in elderly.

Physical fitness is an indicator of systemic well-being in humans. Little is known about the role of physical fitness for maintaining systemic health in the elderly. Here, we study elderly subjects to determine the relationships between physical fitness and CD56 and CD16 surface NK cell markers on peripheral blood lymphocytes, as well as to analyze the relationship between the surface markers and incidence of death. We selected 253 independent elderly subjects (122 female; 131 male) who were 79-80 years old. Subjects having a higher proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, or ration of CD56(dim)CD16(high) and CD56(dim)CD16(-) cells had a significant positive correlation with maximum bilateral knee extensor strength/weight (kg) (r = 0.425; P < 0.0001 or r = 0.323; P < 0.0001). In contrast, an increased proportion of CD56(bright)CD16(-) cells within lymphocyte significantly negatively correlated with the maximum bilateral knee extensor strength/weight (kg) (r = -0.290; P = 0.0004); and these subjects had a significantly lower mortality during the 5 years following measurement of death. Therefore, we found that a synergistic effect of the right and left leg muscle strength was associated with proportion of matured NK and NKT cells and induced a low proportion of CD56(bright)CD16(-) cells within lymphocyte. Moreover, the low proportion of CD56(bright)CD16(-) cells was associated with incidence of death. In conclusion, measurements of physical fitness, the proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, the ratio of CD56(dim)CD56(high) and CD56(dim)CD16(-) cells, and the proportion of CD56(bright)C16(-) cells in lymphocytes are important indicators to check elderly health.

Salivary melatonin levels and sleep-wake rhythms in pregnant women with hypertensive and glucose metabolic disorders: A prospective analysis.

In preeclampsia and gestational diabetes, the sympathetic nerves are activated, leading to disrupted sleep. Melatonin, which transmits information to regulate the sleep-wake rhythm and other such biorhythms, has been implicated in insulin resistance, antioxidant behaviors, and metabolic syndrome. In addition, its reduced secretion increases the risk of hypertension and diabetes. The aim of this study was to elucidate the features of melatonin secretion, sleep quality, and sleep-wake rhythms in pregnant women with complications. Fifty-eight pregnant women with pregnancy complications (hypertensive or glucose metabolic disorders) and 40 healthy pregnant women completed questionnaires, including sleep logs and the Pittsburgh Sleep Quality Index (PSQI), during the second to third trimesters. Their salivary melatonin levels were also measured. Pregnant women with complications had significantly lower morning (p < 0.001), daytime (p < 0.01), evening (p < 0.001), night (p < 0.01), daily mean (p < 0.001), peak (p < 0.001), and bottom (p < 0.01) melatonin values than healthy pregnant women. Pregnant women with complications also had significantly smaller melatonin amplitudes than healthy pregnant women (p < 0.001). Among pregnant women with complications, the duration (p < 0.05) and frequency (p < 0.01) of wake after sleep-onset were significantly greater in the poor sleep group than in the favorable sleep group which was divided by PSQI cutoff value. Pregnant women with hypertensive or glucose metabolic disorder complications had smaller circadian variation in salivary melatonin secretion, and their values were lower throughout the day than healthy pregnant women.

Tracking of Pedometer-Determined Physical Activity in Healthy Elderly Japanese People.

BACKGROUND: Tracking refers to the tendency for an individual to maintain their rank within a group over time. This study longitudinally investigated the 8-year tracking of pedometer-determined physical activity among physically independent elderly Japanese people aged 72 to 80 years. METHODS: Steps/day were measured when participants were aged 72 and assessed again after 2, 5, and 8 years. The number of participants with a 2-year follow-up (72 to 74 years) was 177 (101 males, 76 females), with a 5-year follow-up (72 to 77 years) was 183 people (110 males, 73 females), and with an 8-year follow-up (72 to 80 years) was 145 people (91 males, 54 females). Step counts were continuously measured for 1 week in January, April, July, and October during each year of assessment. RESULTS: A high rank correlation coefficient for steps/day exceeding 0.60 was obtained at the 2-, 5- and 8-year follow-up examinations for both males and females. CONCLUSION: This study suggests that the rank within a group of pedometer-determined steps/day remains stable over up to 8 years in healthy Japanese people aged between 72 to 80 years old.

Sleep quality and stress in women with pregnancy-induced hypertension and gestational diabetes mellitus.

BACKGROUND: Pregnant women with complications including pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM) often experience disrupted sleep patterns because of activation of the sympathetic nervous system. These pathologies are aggravated by sympathetic nervous system activation and may be related to stress. The present study aimed to clarify the characteristics of and changes in sleep quality and stress in pregnant women with PIH and GDM during the second and third trimesters. METHODS: We enrolled 56 women in their second or third trimesters who were diagnosed with PIH or GDM. Participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS). Secretory immunoglobulin A (SlgA) concentrations were measured as a biological indicator of stress. RESULTS: PSS scores and subjective stress parameters were significantly higher than those reported from previous studies of healthy pregnant women (15.2 points and 15.1 points for the second and third trimesters, respectively). Mean one-day values for SIgA were 168.3 and 205.7 µg/mL for the second and third trimesters, respectively. During the second and third trimesters, SIgA scores were higher than those reported for healthy pregnant women in previous studies. The PSQI component scores sleep disturbance (C5) and sleep duration (C3) in follow up case were significantly higher in the third trimester than in the second trimester. DISCUSSION: This investigation suggests that pregnant women with PIH and GDM experience higher stress levels than do non-pregnant women and healthy pregnant women. Further, our results indicate that sleep quality worsens during the third trimester compared with the second trimester.

Physical performance and 10-year mortality in a 70-year-old community-dwelling population.

BACKGROUND AND AIMS: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. METHODS: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. RESULTS: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. CONCLUSIONS: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age.

Estimated equilibrated dietary intakes for nine minerals (Na, K, Ca, Mg, P, Fe, Zn, Cu, and Mn) adjusted by mineral balance medians in young Japanese females.

The present study sought to determine estimated equilibrated dietary intakes (EEDIs) for nine essential minerals: sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), phosphorus (P), iron (Fe), zinc (Zn), copper (Cu), and manganese (Mn), using data from 17 human mineral balance studies conducted from 1986 to 2007 (subjects=178). Among these studies, two used male subjects, two subjected some or all subjects to sodium restriction, and one study utilized a low protein diet; these subjects were not included in the present analysis. Consequently, data from 13 studies of young female subjects (n=131) consuming a standard diet were selected. Balance distribution medians for six of the minerals (Na, K, Mg, Fe, Zn and Cu) were positive, so the data were adjusted to set the medians of the balances to zero. Medians for the other minerals (Ca, P and Mn) were close to zero and were not adjusted. Intake and balance for each mineral were divided by body weight (BW), lean body mass (LBM), and standard body weight (SBW), which was calculated using height and standard body mass index (BMI=22), and EEDIs were calculated as the intercept of a simple regression equation. When relationships between intake and balance of a mineral were not significant in the regression equation, a significant regression equation comparing intake and balance of another mineral was used to calculate the intercept. Significant simple regression equations were not obtained from any of the three parameters of Na or Zn, or for two of the parameters of P; thus, K, Fe and Ca balances were used to determine the intercepts for Na, Zn and P, respectively. EEDIs for the minerals were: Na (67.9, 89.0, 62.5), K (39.5, 53.5, 37.4), Ca (11.0, 14.4, 10.1), Mg (4.18, 5.51, 3.86), P (18.7, 24.6, 17.3) (mg/kg BW/d, mg/kg LBM/d, mg/kg SBW/d), Fe (180, 237, 165), Zn (181, 241, 166), [corrected] Cu (32.3, 42.6, 29.7), [corrected] Mn (55.1, 72.1, 50.7) (µg/kg BW/d, µg/kg LBM/d, µg/kg SBW/d), respectively. These values are nearly identical to the mean dietary intakes.

Development of a scale for pregnancy-related discomforts.

AIM: The purpose of this study was to develop a new scale of pregnancy-related discomforts for evaluating expectant women's psychosomatic states during each trimester. METHODS: The study population comprised 786 expectant women (response rate: 38.2%) who underwent antenatal examinations in 13 hospitals located in eight regions of Japan. Respondents answered questions about the incidence of 95 well-known symptoms related to pregnancy. Responses were divided into three groups based on the gestational period. Three scales were then prepared based on item and factor analyses, and reliability and validity were confirmed. RESULTS: The resultant global scales for the first, second, and third trimester consisted of 15, 13, and 13 items, respectively. The three global scales could be divided into three, three, and two subscales, respectively. The reliability coefficients of the global and subscales were 0.7 or more. Validity was confirmed by the conventional group method. CONCLUSIONS: This is the first study to develop scales for pregnancy-related discomforts in Japanese women in order to evaluate psychosomatic states during each trimester of pregnancy. Because the number of scale items had decreased by more than half as compared to previous scales, this new, more feasible scale may be useful in clinical settings.

Influence of dental occlusion on physical fitness decline in a healthy Japanese elderly population.

The aim of this study was to clarify the relationship between dental occlusion and physical fitness by a longitudinal survey. A sample of 348 subjects (171 men and 177 women) aged 71 was investigated by Eichner index (EI) as an occlusal condition (Class A: no loss; Class B: partial loss; Class C: complete loss) and five types of physical fitness tests and were re-examined 8 years later. The upper 50% were sampled to analyze the correlation between each physical fitness decline and the EI at the baseline by logistic regression models. Logistic regression analyses revealed that leg extensor power (Class B vs. Class A; odds ratio=OR=4.61, p=0.010) and one-leg standing time with eyes open (Class C vs. Class A; OR=4.27, p=0.031) showed significant correlations with the EI at the baseline. In this study, partial or complete loss of occlusion was associated with a decline in leg extensor power or a decrease in one-leg standing time with eyes open. These findings suggest that maintenance of dental occlusion may prevent a decrease in activities of daily living in the elderly.