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Background Waist circumference (WC) increases more than body mass index (BMI) over time. This study investigated the change in WC among middle-aged and elderly Japanese people for 10 years, and its relationship with lifestyle and lipid metabolism factor. Methods Health checkup data and lifestyle habits of a retrospective cohort of 745 people aged 40–65 years who underwent health checkups at least three times between 2008 and 2017 were analyzed. Information of Lifestyle habits about smoking history, regular exercise, alcohol intake skipping breakfast was collected using a self-administered questionnaire. Participants who were taking medications for diabetes, hyperlipidemia, or hypertension were excluded from analyses. Longitudinal associations between the change in WC and lifestyle habit factors with adjustments for sex, age, and WC at the start of health checkups were assessed using generalized linear models. Results Regardless of lifestyle, body weight (BW) decreased 0.8 kg (p p = 0.003) for men, WC increased 0.8 cm (p = 0.007) for women, 0.2 cm (p = 0.657) for men. In addition, serum triglycerides and high- and low-density lipoprotein levels estimated 10 years later revealed that increased WC ratios also exacerbated the respective blood sample data. Conclusion Both men and women showed an increase in WC regardless of BW changes, and the increase in WC worsened lipid metabolism. For the middle-aged and elderly, whose WC increases over time, it will be more important to take notice of their WC than BW or BMI for effective health checkups.

In Japan, the prevention of lifestyle-related diseases is the most important issue for the optimization of medical expenditure. This study aimed to analyze the impact of lifestyle and medication status on medical expenditure. Health checkup data and medical expenditure records of a retrospective cohort of 1463 people aged between 40 and 65 years old who underwent specific health checks at least three times between 2008 and 2017 were analyzed. Regression analysis was performed with medical expenditure as the dependent variable and age, gender, waist ratio, medication status, and lifestyle habits as independent variables using a Tobit model. Focusing on the factors that increase medical expenditure, the regression coefficients of age, medication status, weight gain of 10 kg or more since the age of 20, and walking more than 1 h per day were 0.048 (95% CI 0.04 to 0.06), 1.020 (95% CI 0.88 to 1.16), 0.210 (95% CI 0.06 to 0.36), and −0.208 (95% CI −0.35 to −0.07), respectively. The estimate of 5-year cumulative medical expenditure showed that those with walking habits without medication had the lowest medical expenditure. The result of this study suggests that walking more than 1 h a day may lower health expenditure in the general population.

Background: The residents currently taking prescribed medication have been exempted from the special public health guidance conducted in the act in Japan. This study analyzed blood pressure taken during the special health checks from 2008 to 2011 in light of resident lifestyle, focusing on comparisons between medicated and non-medicated residents. Methods: Health checkup data in retrospective cohort of 4,734 residents undergoing special health checks in B-City from 2008 to 2011 were analyzed. The participants were categorized as taking medication (medicated residents, n=1,083) and others (non-medicated residents, n=3,651). The multiple logistic regression analysis provided odds ratios (ORs) and 95% confidence intervals (95% CI). Results: The medicated residents had higher systolic and diastolic blood pressure than the non-medicated in both 2008 and 2011. Factors on which the OR was significantly higher for the hypertension group (normal blood pressure group=1) were alcohol consumption (OR: 1.30 (95% CI: 1.12-1.50)), and weight gain (OR: 1.45 (95% CI: 1.26-1.67)). Factors on which the OR was significantly higher for the diabetes mellitus group (normal blood glucose group=1) were smoking (OR: 3.14 (95% CI:1.69-5.80)). Factors on which the OR was significantly higher for the neutral fat high-flying group (normal neutral fat group=1) were alcohol consumption (OR: 1.30 (95% CI: 1.12-1.50)) and weight gain (OR: 1.45 (95% CI: 1.26-1.67)). Compared to the group with hypertension only, the group with multiple conditions who consumed alcohol in both 2008 and 2011 had an OR of 1.49 (95% CI: 1.29-1.72), and those who had weight gain of 10 kg had an OR of 1.74 (95% CI: 1.50-2.02). Conclusion: No improvement was found in the lifestyle habits of medicated residents. This study suggested that an appropriate health guidance will be needed to improve the lifestyle habits in medicated residents.