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Objectives: A positive association between levels of blood 25-hydroxyvitamin D (25[OH]D), an index of vitamin D status, and physical balance has been reported from cross-sectional studies, but longitudinal studies are rare. The present study aimed to test the hypothesis that low serum 25(OH)D levels are longitudinally associated with impaired postural sway over a 6-year follow-up period in older women. Methods: The present cohort consisted of 392 community-dwelling Japanese women aged ≥69 years. Baseline examinations included serum 25(OH)D and physical performance tests, including postural sway velocity. Standing postural sway was evaluated by measuring gravity-center sway velocity. Follow-up physical performance tests were conducted 6 years later. Results: Mean subject age and serum 25(OH)D levels were 73.3 years (SD 3.7) and 61.0 nmol/L (SD 16.9), respectively. No significant association was found between 25(OH)D levels and changes in postural sway velocity (adjusted P for trend=0.72). Women with 25(OH)D

Additional file 1: Table 1. Odds ratios for recurrent falls according to four levels of each physical activity stratified by sex. Table 2. Odds ratios for recurrent falls according to four levels of each physical activity stratified by age group. Table 3. Odds ratios for recurrent falls according to levels of leisure-time PA by non-leisure-time PA subgroup. Table 4. Odds ratios for recurrent falls according to intensity-based levels of leisure-time physical activity.

Background: In order to provide effective dietary guidance, it is necessary to consider dietary intake, which can change over time. This study analyzed changes in the diet of Japanese patients with type 2 diabetes over a 20-year period. Methods: We compared the results of two dietary surveys that used the food frequency questionnaire format. The first was conducted in 1996 by the Japan Diabetes Complications Study (JDCS) (n = 1509, males 53.3%), and the second in 2014–2018 by the Japan Diabetes Clinical Data Management Study (JDDM) (n = 1145, males 65.6%). Both are nationwide representative registries of outpatients with type 2 diabetes in Japan. Results: Over a 20-year period, both men and women with type 2 diabetes had a significant increase in body mass index (BMI). Nonetheless, there was only a small change in energy intake. Conversely, there was a significant increase in fat intake and thus in the fat-to-energy ratio. With regard to food groups, there was a significant increase in meat intake and a decrease in the intake of fish, soybeans/soy products, vegetables, and fruits, with a particularly significant decrease in vegetables. Conclusions: Even in Japan, an industrialized country with a stable socioeconomic environment, there were many significant changes in the dietary intake of patients with type 2 diabetes over the 20-year period.

application/pdf, 論文(Article), Several reports have attempted to explain the difference in life expectancy among the 47 prefectures in Japan. Various factors, such as employment type, medical human resources, contents of nutrition intake, obesity and life style habits have been focused on as causes of the difference in life expectancy. Most of the reported factors were statistically correlated with life expectancy in females, and they are comprehensible and reasonable from the viewpoint of epidemiology. To our knowledge, however, there are very few factors that are consistently and reasonably related to life expectancy in Japanese males. In the case of males in Okinawa, which was ranked first among 47 prefectures suddenly dropped to the 26th place（referred to as 26-shock）in 2000, it was reported that an increase in deaths from cerebral infarction and myocardial infarction was responsible for the drop. This atomistic experience in Okinawa does not seem to be applicable for other prefectures. To our knowledge, there is no scientific agreement in regard to the determinant factor or factors determining life expectancy in males. An attempt was made to disclose the positive factors correlated with the longevity of life in males in particular, as well as in females, by applying multiple regression analysis（stepwise method）to people's life indicators（PLI）in 1996 and life expectancies in 2000 in the 47 prefectures. PLI was defined by the National Life Council in Economic Planning Agency in 1992 in order help quantify the improvement of quality of life. In PLI, 8 activities of life, such as home, consumption, work, raising children, health, play, study, and communication, were classified according to ４ values, including security, fairness, freedom and comfort. In males, communication among the 8 life activities and freedom and comfort among the 4 life values were positively correlated with the longevity of life, and in females, health, home and study, among the life activities, and fairness among the life values were positively correlated with longevity. It is inferred that the prefectures where men can live socially free and comfortable may bring longer life expectancy. On the other hand, the prefectures with good medical facilities and living environment may be related to women’s longer life., 都道府県の平均寿命格差を説明する要因について多くの報告があるが、男性では関連する要因が報告者によって異なり、さらに寿命延長にどのように関わっているか説明が困難である。一方女性では都道府県別の病院数、病床数、看護師等の医療スタッフ数、栄養摂取等が関わっており、これら要因については常識的に理解可能である。そこで男性平均寿命の地域格差を規定する要因を探ることと、女性平均寿命に関連する要因を再確認することを目的として本研究を実施した。研究手法は地域相関研究で、説明変数として平成10年版の新国民生活指標（男女区別なし）、目的変数に平成12年の男性及び女性の平均寿命を用いた。統計的分析は単相関分析と重回帰分析（変数増加法）を用いた。男性の単相関分析では、生活活動領域で「費やす」、「働く」、「学ぶ」、「交わる」、生活評価軸で「自由」、「快適」が有意であった。女性ではそれぞれ「住む」、「癒す」、「公正」であった。男性の重回帰分析では、生活活動領域の「交わる」のみであった。生活評価軸では標準回帰係数の絶対値の大きい順に、「公正」（ただし負の相関）、「快適」、「自由」であった。女性の生活活動領域では「癒す」、「育てる」（ただし負の相関）、「住む」、「学ぶ」であった。生活評価軸では「公正」のみ有意であった。男性平均寿命はヒトとの「交わり」の機会が多く、そして「快適、「自由」なライフスタイルを送れる地域に長いと推測された。女性の場合は、快適住居に定住し、地域の医療・保健・福祉施設や公共の文化施設等の恩恵を受けることが出来る地域の平均寿命が長いことが示唆された。

application/pdf, 論文(Article), Japan has been a leading country in terms of life expectancy at birth both in males and females since the beginning of 1980s. Inside Japan, however, there is a big discrepancy in life expectancy by prefectures. Various factors, such as climate, socio-economic conditions, medical expenditures, medical resources, major causes of deaths, nutrition and the like have been examined as determinants of discrepancy. Among these factors, we paid special attention to the medical resources, including human resources. Data on life expectancies at birth and age 65 by gender for 47 prefectures in 2005 were obtained from the Ministry of Health, Labor and Welfare. We also consulted a database on the levels of medical resources, listed according to the numbers of hospitals, clinics, dental clinics, pharmacies, beds in hospitals, beds in clinics, medical doctors, dentists, pharmacists, nurses, public health nurses, midwives, dieticians and physical therapists per 100,000 population, and a medical doctors' index. Ecological correlation analysis between life expectancies and these variables in 47 prefectures of Japan was made by using either Pearson's or Spearman's correlation coefficients. The significance level was set at 5% (p

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application/pdf, 論文(Article), Evidence-based nutrition (EBN)は,医学・医療分野におけるevidence-based medicine (EBN)と同様,最近広がったキーワードであるが,現場の栄養士に十分理解され実践されるには至っていない。EBNの手順はEBNと共通で,1)疑問点の抽出,2)エビデンスの収集,3)エビデンスの質の評価,4)エビデンスの適用性判断,という4つの過程からなる。これを実践するためには臨床疫学と生物統計学の知識,そして英語能力が必要である。また手間と時間もかかり,実行に多くの困難が伴う。本論文は,EBNの概略を伝え実践の場での問題点を指摘する意図で書かれた。専門的解説が目的ではないので,EBN理解に最低限必要な事項を中心に概説した。また,EBNの実地演習として「骨粗鬆症とカルシウム(Ca)摂取の関係」について考察した。, Evidence-based nutrition (EBN) is a new keyword in the field of human nutrition. Its concept and procedures are similar to those of evidence-based medicine (EBN). EBM was first described in the English literature in 1991 and is becoming a popular guideline for clinicians in the medical practice. While, the importance of EBN has just begun to be appreciated by dieticians. The process of EBN, same as EBN, comprises of four steps : (1) set the question, (2) find the evidence, (3) appraise the evidence, and (4) make a judgment. When trying to practice EBN in the current situation, the majority of Japanese dietitians will find it very difficult. Although recent development of information technology has made the step of finding evidence easier than before, useful literatures are mostly written in English. We need basic knowledge of statistics and epidemiology in the step of appraising the evidence. Above all, practicing dietitians have little time to read the compiled literatures. To point out these technical problems, we exercised EBN on the topic of calcium intake and osteoporosis. The process and the results presented here will help the readers learn EBN in a practical way.

Background The involvement of β2-adrenergic receptor (ADRB2) and β3-adrenergic receptor (ADRB3) in both adipocyte lipolysis and thermogenic activity suggests that polymorphisms in the encoding genes might be linked with interindividual variation in obesity, an important risk factor for postmenopausal breast cancer. In order to examine the hypothesis that genetic variations in ADRB2 and ADRB3 represent interindividual susceptibility factors for obesity and breast cancer, we conducted a hospital-based, case-control study in the Aichi Cancer Center, Japan. Methods A self-administered questionnaire was given to 200 breast cancer patients and 182 control individuals, and pertinent information on lifestyle, family history and reproduction was collected. ADRB2 and ADRB3 genotypes were determined by polymerase chain reaction (PCR) restriction fragment length polymorphism assessment. Results Twenty-five (12.4%) breast cancer patients and 32 (17.6%) control individuals were found to bear a glutamic acid (Glu) allele for the ADRB2 gene (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.38-1.18), and 60 (30.0%) breast cancer patients and 61 (33.5%) control individuals were found to bear an Arg allele for the ADRB3 gene (OR 0.85, 95% CI 0.55-1.31). A significantly lower risk was observed in those who carried the Glu ADRB2 allele and who reported first childbirth when they were younger than 25 years (OR 0.35; 95% CI 0.13-0.99). Conclusion A potential association may exist between risk of breast cancer and polymorphisms in the ADRB2 and ADRB3 genes; further studies in larger samples and/or in different ethnic groups are warranted to investigate this potential association.

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