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Objectives: In this study, we aimed to clarify and measure the interrelationships among decrease in communication, exercise, and physical and mental health under COVID-19 prevention measures, restricting individuals from going out of the house. Methods: Participants included 540 middle-aged and older adults who are regular exercise class members. The survey was conducted between April 15 and May 10, 2020. For the self- administered questionnaire survey, a municipal employee of City A and an exercise instructor visited the home of each participant to collect the survey data. The survey items were sex, age, limitation of going out, feeling of inactivity, interaction with others, health status, and forgetfulness; a covariance structural analysis was performed to clarify the interrelationship between lifestyle and health status. Results: Restrictions on going out due to the COVID-19 prevention measures were associated with the physical and mental health of middle-aged and older adults who regularly attended exercise classes because they enforced inactivity and decreased the frequency of conversation. Conclusions: Several waves of COVID-19 may arrive in Japan in the future. Therefore, it is necessary to implement measures to prevent secondary health damage and not focus only on infection prevention.

Epicardial adipose tissue may affect hemodynamics and cardiorespiratory fitness as it is a metabolically active visceral adipose tissue and a source of inflammatory bioactive substances that can substantially modulate cardiovascular morphology and function. However, the associations between epicardial adipose tissue and hemodynamics and cardiorespiratory fitness remain unclear. This cross-sectional study aimed to examine the association between epicardial adipose tissue volume and hemodynamics, and cardiorespiratory fitness among Japanese individuals of various ages and of both sexes. Epicardial adipose tissue volume was measured in 120 participants (age, 21–85 years) by cardiac magnetic resonance imaging. To evaluate cardiorespiratory fitness, peak oxygen uptake was measured by cardiopulmonary exercise testing. Peak cardiac output and arteriovenous oxygen difference were calculated by impedance cardiography. The epicardial adipose tissue volume was significantly increased in middle-aged and older women. The epicardial adipose tissue volume was significantly and negatively correlated to peak cardiac output and peak oxygen uptake, regardless of age and sex; furthermore, epicardial adipose tissue showed a strong negative correlation with peak heart rate. Epicardial adipose tissue and peak cardiac output were significantly associated (β = -0.359, 95% confidence interval, -0.119 to -0.049, p < 0.001), even after multivariate adjustment (R2 = 0.778). However, in the multiple regression analysis with peak oxygen uptake as a dependent variable, the epicardial adipose tissue volume was not an independent predictor. These data suggest that increased epicardial adipose tissue volume may be correlated with decreased peak oxygen uptake, which might have mediated the abnormal hemodynamics among Japanese people of various ages and of both sexes. Interventions targeting epicardial adipose tissue could potentially improve hemodynamics and cardiorespiratory fitness.

This study aimed to elucidate whether the volume of epicardial adipose tissue (EAT) is associated with left ventricular (LV) structural and functional abnormalities and exercise capacity in patients with type 2 diabetes mellitus (T2DM).EAT thickness and LV structural and functional abnormality components (e.g., global longitudinal strain, E/e', LV mass index, relative wall thickness) were measured using echocardiography in 176 patients with asymptomatic stage A and B heart failure (SAHF and SBHF, respectively) and 62 healthy controls (HC). Peak oxygen uptake (peakVO2) was measured by using cardiopulmonary exercise testing.Even when matching study participants for age, sex, and body mass index, the EAT was thicker (HCs 5.5 ± 1.2 versus SAHF 6.4 ± 1.0 and SBHF 9.3 ± 1.7 mm) and peakVO2 was lower (HC 24.1 ± 3.3 versus SAHF 19.1 ± 2.0 and SBHF 16.9 ± 3.1 ml/kg/min) in the heart failure (HF) group than in the HC group (p 0.001). EAT thickness (β = -0.189, p 0.001) and peakVO2 were significantly associated, even after adjusting for multivariates (RIn T2DM patients with asymptomatic HF, EAT may be associated with LV structural and functional abnormalities and exercise intolerance.

Aim: This study aimed to examine the effects of exercise training on kidney function and nutrition status in obese Chronic Kidney Disease (CKD) patients. Methods: This is a prospective randomized controlled trial. Twelve adult obese CKD patients were randomly assigned to dietary instruction alone group (Group-D) or to both dietary instruction and exercise training group (Group-E). All patients received supervised dietary advice including calorie, protein, and salt intake for a period of 12 weeks. In addition, patients in Group-E underwent a fitness-training program. A change in glomerular filtration rate (GFR) was the main outcome. Secondary outcomes were changes in body mass index, serum creatinine-based estimated-GFR, serum albumin, and albuminuria. Results: Changes in GFR and all secondary outcomes were not statistically significant in either of the two groups. Although exercise training did not appear to significantly affect serum albumin levels in either group, it did present with a large sized effect. Conclusion: Exercise training might not have any effect on kidney function; however, the combination of exercise training along with dietary advice may prove to be more effective in maintaining the nutrition status when compared with dietary instructions alone in obese CKD patients. These results suggest that appropriate exercise training with dietary instructions is recommended for the treatment of obese CKD patients.

Objectives Although providing incentives for a better lifestyle has been of increasing concern, there is insufficient evidence about its effect. Therefore, this research aims to discover new insights by verifying the effect of rewards to motivate persistence in a project for health promotion.Methods A total of 7,622 participants of an incentivized project for health promotion (Wellness Point Project) were recruited from 6 municipalities in Japan, namely Tohoku, Chubu, Kanto, Kinki, and Chugoku, of which the 4,291 individuals who had the necessary information for estimation were analyzed. Persistence in the project was judged by whether there was information about daily steps and/or participation in some fitness classes every month for one year at most. In addition, we used the reason participants chose certain rewards in order to categorize the characteristic of rewards, and estimated opt-out hazard ratios from the project using survival time analysis. Furthermore, the estimation in the model included individual features such as age, education, status of physical activity before joining the project, lifestyles such as smoking, drinking, and so on.Results A multivariate analysis reveals that those who had chosen a reward for regional contribution were more likely to opt out than those who had chosen a certain reward because it is close to cash. The opt-out hazard ratio was 1.63 (95% CI: 1.18-2.25) among men and 1.40 (95% CI: 1.08-1.81) among women. In addition, insufficient physical activity, smoking, working for men, and physical condition for women were associated with opt-out.Conclusions This research verified that a reward that participants felt was close to cash, compared to the internal motivation of regional contribution, could enhance the persistence rate of the project. Moreover, it was found that not only giving incentives but also considering participants' conditions is necessary to enhance persistence.

Intermuscular adipose tissue (IMAT) accumulates with age. However, there has been no long-term intervention study examining whether daily walking prevents or decreases the age-related IMAT accumulation. The purpose of this study was to determine effects of a long-term lifestyle-based daily walking program on age-related IMAT accumulation after a 5-year follow-up. Using a pedometer, daily step count was evaluated for 5 years in 24 middle-aged and elderly male and female participants. Using magnetic resonance imaging, thigh muscle, thigh subcutaneous adipose tissue, IMAT, abdominal subcutaneous adipose tissue, and visceral adipose tissue were examined at baseline and after 5 years. After 5 years, there was no significant increase in IMAT in all participants. In addition, IMAT significantly decreased in participants with a daily step count of > 9000 (4.0 ± 2.1 vs. 3.1 ± 1.6 cm2; p

The purpose of the study was to evaluate the effects of Lactobacillus pentosus strain b240 (b240) intake and appropriate physical training on salivary secretory immunoglobulin A secretion in elderly adults with low physical fitness. Elderly adults with low physical fitness (daily step count below 3,500 steps) were divided into 2 groups: a b240 intake + exercise group (b240 group) and a placebo intake + exercise group (placebo group). Each subject continued intake of b240 or placebo and moderate-intensity resistance exercise for 12 weeks. Before and 4, 8, and 12 weeks after the start of intervention, each subject underwent saliva sampling. Before and after intervention, physical fitness tests and step count were measured. Our results showed that secretory immunoglobulin A secretion in 57 subjects during the b240/placebo intake period was significantly greater in the b240 group than in the placebo group (p

Background.This study aimed to investigate whether a lifestyle-based physical activity program could contribute to reduced medical expenditure.Methods.The study participants were 60 adults aged 63.1 (standard deviation, 4.4) years in the intervention group; the case-control group consisted of 300 adults who were randomly selected from Japan’s national health insurance system. This community-based retrospective study incorporated a 3-year follow-up.Results.The total and outpatient medical expenditure in the intervention group were significantly lower than in the control group: total expenditure, $US640.4/year; outpatient expenditure, $369.1/year. The odds ratio for outpatient visiting was 6.47-fold higher in the control than in the intervention group.Conclusion.Our study suggests that a health program to promote physical activity can result in reduced total medical expenditure, outpatient medical expenditure, and possibly also inpatient medical expenditure.

The relation between ACTN3 R577X polymorphism and muscle mass in women has been reported, but its relation to age remains unclear. We investigated the relationship between ACTN3 R577X polymorphism and muscle mass in both middle-aged and elderly women. Two age groups (middle-aged and older) were formed among 162 healthy, nontraining Japanese women (mean ± SE, 58.6 ± 0.8 year). Their midthigh-muscle cross-sectional area (CSA) was assessed using magnetic resonance imaging, revealing no difference in thigh-muscle CSA among ACTN3 R577X genotypes in the middle-aged group (XX, 87.3 ± 2.5 cm(2); RRRX, 86.1 ± 1.7 cm(2), p=0.7). In contrast, the XX genotype in the older group had a smaller thigh-muscle CSA adjusted to body weight than the RRRX genotypes (XX, 67.8 ± 2.0 cm(2); RRRX, 72.5 ± 1.2 cm(2), p0.05). The present study showed an association between ACTN3 R577X polymorphism and smaller thigh-muscle CSA in a group of elderly women but not in a group of middle-aged women.

The purpose of this study was to examine the effects of exercise training on age-related impairment of immune parameters related to T-cell activation in elderly individuals. Twenty-four elderly subjects were assigned to an exercise training group (EXC: 3 men, 9 women; age 61-76 years) or a nonexercise control group (CON: 4 men, 8 women; age 62-79 years). Subjects in EXC participated in exercise sessions 2 d·wk(-1) for 12 weeks. The training session included stretching and endurance exercise (10 minutes), resistance training comprised leg extension, leg press, hip abduction, and hip adduction using exercise machine and each subject's body weight. Subjects in CON maintained their normal physical activity levels during the study period. Blood samples were collected before and after the training period. Samples were measured for the numbers of leukocytes, lymphocytes, and monocytes, and for CD3(+), CD4(+), CD8(+), CD28(+)CD4(+), CD28(+)CD8(+), TRL-4(+)CD14(+), and CD80(+)CD14(+) cells. The number of leukocytes, lymphocytes, monocytes, CD3(+), CD4(+), and CD8(+) cells did not change after 12 weeks in either EXC or CON. The number of CD28(+)CD8(+) cells increased significantly after training in EXC (p ≤ 0.05), although CON showed no significant change. In the EXC group, CD80(+)CD14(+) cell counts were significantly higher after training (p ≤ 0.05), but the TLR-4(+)CD14(+) cell counts were unchanged. In the CON group, no significant alteration existed in TLR-4(+)CD14(+) and CD80(+)CD14(+) cell numbers. In conclusion, exercise training in elderly people is associated with increased CD28-expressing Tc cells and CD80-expressing monocytes. Therefore, exercise training might upregulate monocyte and T-cell-mediated immunity in elderly people.

Background: Resistance training has been increasingly incorporated into the overall exercise programme because of its effect on muscle strength, functional capacity and osteoporosis. High-intensity resistance training increases arterial stiffness. However, the effect of moderate-intensity resistance training on arterial stiffness is unknown. Objective: To determine whether 12 weeks of moderate-intensity resistance training increases arterial stiffness in middle-aged women. Methods: 35 middle-aged women (age range 32 to 59 years) volunteered to participate. The subjects were randomly assigned to one of three groups: resistance training (RT) group, aerobic exercise training (AET) group or control group. The RT and AET groups performed 12 weeks of moderate-intensity resistance training or aerobic exercise training (two days/week). Results: In the RT group, one-repetition maximum strength significantly increased after the intervention. Interestingly, aortic (carotid–femoral) pulse wave velocity (PWV; an index of arterial stiffness), and peripheral (femoral–ankle) PWV did not change with moderate-intensity resistance training. In contrast, in the AET group, carotid–femoral PWV significantly decreased after the intervention. Resistance training and aerobic exercise training did not affect blood pressure. Conclusions: This study found that moderate-intensity resistance training did not increase arterial stiffness in middle-aged women, which may have great importance for health promotion with resistance training.

application/pdf, An increase in arterial stiffness with advancing age is associated with several pathological states, including hypertension and arteriosclerosis. Regular exercise improves the aging-induced increase in arterial stiffness and has a protective effect against these diseases. However, not all individuals respond to exercise to the same extent. Atrial natriuretic peptide (ANP) is involved in the regulation of basal blood pressure, blood flow, and vascular tone. The present study was designed to clarify whether gene polymorphisms in ANP-related genes affect exercise-induced improvements in arterial stiffness. We performed a cross-sectional study of 291 healthy middle-aged and older Japanese subjects (63±1 years), examining the relationship between daily physical activity–induced improvements in arterial stiffness, estimated by brachial-ankle arterial pulse wave velocity (baPWV), and the gene polymorphisms of valine32methionine (V32M: 664G>A) in exon 1 of ANP and asparagine521aspartic acid (N521D: 1780A>G) in exon 8 of the ANP clearance receptor (NPR-C). The baseline baPWV was significantly lower in the active group, but no differences were seen in blood pressure. Active subjects with the ANP-VV genotype had significantly lower baPWV and higher plasma ANP levels compared with inactive subjects, but there were no variations related to the VM+MM genotype. Additionally, baPWV and plasma ANP levels were negatively correlated in ANP-VV genotype subjects, but were not correlated in VM+MM individuals. Our results suggest that ANP polymorphism in older Japanese subjects may affect the cardiovascular response to regular exercise.

Background To evaluate the association between thigh intermuscular adipose tissue accumulation and number of metabolic syndrome risk factors in middle-aged and older Japanese adults. Methods Thigh muscle cross-sectional area, subcutaneous adipose tissue, thigh intermuscular adipose tissue, abdominal subcutaneous adipose tissue, and visceral adipose tissue were measured in 166 middle-aged and older (mean age, 69 years) Japanese adults using magnetic resonance imaging. Daily physical activity was calculated using pedometers, and energy intake per day was evaluated using 3-day dietary records. Multiple linear regression analysis was used to assess the association between intermuscular adipose tissue and the number of metabolic syndrome risk factors. Results Multiple regression analysis indicated that intermuscular adipose tissue was significantly associated with the number of metabolic syndrome risk factors, after adjusting for age, sex, body mass index, daily physical activity, energy intake, thigh muscle cross-sectional area, and visceral adipose tissue (p Conclusions Thigh intermuscular adipose tissue accumulation was significantly associated with the number of metabolic syndrome risk factors in middle-aged and older Japanese adults, independent of age, sex, body mass index, daily physical activity, energy intake, thigh muscle cross-sectional area, and visceral adipose tissue.

The mechanisms underlying the oxygen uptake (V̇o2) slow component during supra-lactate threshold (supra-LT) exercise are poorly understood. Evidence suggests that the V̇o2slow component may be caused by progressive muscle recruitment during exercise. We therefore examined whether leg muscle activation patterns [from the transverse relaxation time (T2) of magnetic resonance images] were associated with supra-LT V̇o2kinetic parameters. Eleven subjects performed 6-min cycle ergometry at moderate (80% LT), heavy (70% between LT and critical power; CP), and very heavy (7% above CP) intensities with breath-by-breath pulmonary V̇o2measurement. T2 in 10 leg muscles was evaluated at rest and after 3 and 6 min of exercise. During moderate exercise, nine muscles achieved a steady-state T2 by 3 min; only in the vastus medialis did T2 increase further after 6 min. During heavy exercise, T2 in the entire vastus group increased between minutes 3 and 6, and additional increases in T2 were seen in adductor magnus and gracilis during this period of very heavy exercise. The V̇o2slow component increased with increasing exercise intensity (being functionally zero during moderate exercise). The distribution of T2 was more diverse as supra-LT exercise progressed: T2 variance (ms) increased from 3.6 ± 0.2 to 6.5 ± 1.7 between 3 and 6 min of heavy exercise and from 5.5 ± 0.8 to 12.3 ± 5.4 in very heavy exercise (rest = 3.1 ± 0.6). The T2 distribution was significantly correlated with the magnitude of the V̇o2slow component ( P < 0.05). These data are consistent with the notion that the V̇o2slow component is an expression of progressive muscle recruitment during supra-LT exercise.

Increased arterial stiffness is an independent risk factor for cardiovascular disease. The estrogen system (estrogen and estrogen receptor-alpha [ER-alpha]) has potent vasodilator and antiatherosclerotic activity in vascular tissue and therefore was implicated in the regulation of arterial stiffness. We hypothesized that the relationship between arterial stiffness and gene polymorphisms in ER-alpha has a sex-specific component in older humans.Two hundred healthy older subjects, comprised of 85 men and 115 postmenopausal women (men, 66 +/- 5 years old; women, 64 +/- 7 years old; mean +/- SD) participated in a cross-sectional study. We determined the genotypes of single-nucleotide polymorphisms (SNPs) at -401T/C of intron 1 and at 30T/C of exon 1 of ER-alpha, using a TaqMan-polymerase chain reaction method. Arterial stiffness was estimated by brachial-ankle pulse-wave velocity (baPWV).Polymorphisms of both -401T/C and 30T/C in ER-alpha affected baPWV values in postmenopausal women but did not affect men. The baPWV in women was significantly lower in the CC genotype at both -401T/C and 30T/C than in the TT genotype (both P.05), and the CC genotype of two SNPs in women was significantly lower than in men.The present study suggests that the relationship between arterial stiffness and -401T/C or 30T/C polymorphisms in ER-alpha is different between sexes in older humans. These polymorphisms may be important in the health and clinical care of cardiovascular function and disease in older women.

Purpose: The aim of this work was to assess the relationship in elderly subjects between free-living daily physical activity and mucosal immunity, especially salivary secretory immunoglobulin A (SIgA). Methods: Elderly volunteers (114 men and 170 women) aged 71.3 ± 0.3 yr (range: 65-86 yr) participated in this study. Resting saliva samples were collected in the morning. Saliva samples stimulated by chewing a sterile cotton ball at a frequency of 60/60 s were collected. The SIgA concentration was measured using enzyme-linked immunosorbent assay (ELISA), and the SIgA secretion rate was calculated. Free-living step count (steps per day), energy expenditure (kJ·kg-1·d-1), and activity durations (min·d-1) at specific intensity levels (inactive, light, moderate, and vigorous) were evaluated using an electric pedometer. The data obtained were stratified by pedometer-determined steps per day using quartiles (Q1-Q4) for distribution. Results: Elderly in quartiles showed step counts of 2962 ± 94, 5118 ± 62, 6832 ± 59, and 9951 ± 264 steps per day. Significant differences were found in the mean step count (P < 0.0001), energy expenditure (P < 0.0001), and activity duration (P < 0.0001) with increasing pedometer-determined activity quartiles. Both SIgA concentration and SIgA-secretion rate were significantly higher for Q3 than for Q1 (P < 0.05). Meanwhile, saliva flow rates showed no significant differences across quartiles. Conclusion: These results suggest that a free-living daily physical activity level of approximately 7000 steps per day might be regarded as a moderate daily physical activity target for elderly people to improve mucosal immune function.

Objective Moderate to high intensity exercise training is known to ameliorate the coronary risk factors in relation to an improvement in body composition. However, the benefit of low-intensity and low-volume training for these risk factors remains unclear in elderly people. Therefore, we investigated the effects of low-intensity and low-volume exercise training on blood lipid values and insulin resistance in the elderly. Methods A total of 56 healthy elderly individuals (42 females and 14 males) aged 64±6 years participated in a 12-week exercise program, comprising aerobic training and resistance training. Results After the program, there were no significant changes in high-density lipoprotein cholesterol, triglyceride serum levels, or in peak oxygen uptake on average. However, the homeostasis of minimal assessment of insulin resistance (HOMA-IR) value was significantly reduced by 21%. The participants were categorized into tertiles based on initial Body Mass Index (BMI). The Middle-BMI group (non-obese subjects) showed reduced HOMA-IR (2.0→1.3, P

Increase in arterial stiffness is associated with aging, which is improved by regular exercise. Endothelin (ET) system has crucial roles in regulating vascular tone and in the progression of atherosclerosis. We hypothesized that molecular variations (ie, gene polymorphisms) in ET-related gene might affect exercise-induced improvement in arterial stiffness with age in human subjects. The present study provides a cross-sectional investigation of 191 healthy middle-aged and older (65±1 years) human subjects to clarify the relationship between the regular exercise-induced improvement of arterial stiffness and the gene polymorphisms of ET converting enzyme (ECE)-1, ECE-2, ET-A receptor (ET-A), and ET-B receptor (ET-B). The study subjects were divided into active and inactive groups based on the median value (186 kcal/d) of energy expenditure. Brachial-ankle arterial pulse wave velocity (baPWV) was used to evaluate arterial stiffness. All individuals were genotyped for 4 different polymorphisms of the ET system: 2013(+289)A/G in intron 17 of ECE-1, 669(+17)T/C in intron 5 of ECE-2, 958A/G in exon 6 of ET-A, and 831A/G in exon 4 of ET-B. The baseline baPWV was significantly lower in the active group without any change in blood pressure. Polymorphisms in ECE-1 influenced basal blood pressure. Polymorphisms in ECE-1 and ECE-2 had no effect on baPWV between active and inactive groups. However, polymorphisms in both ET-A and ET-B affected baPWV in the 2 groups. The present results suggest that differences in ET-A and ET-B polymorphisms may influence the response of the vascular wall to exercise whereas ECE-1 polymorphisms may affect basal blood pressure.

Growth trends in the cross-sectional area of the quadriceps femoris (CSA(QF)) and its dynamic strength in 12 teenage tennis players (six boys and six girls), aged from 10.7 to 13.2 years at the onset of the study, were investigated through a 2-year follow-up survey. CSA(QF) values at the three levels (proximal, mid, and distal to the knee joint) and dynamic torques during knee extensions at three pre-set velocities (1.05, 3.14, and 5.24 rad/s) were determined year by year, i.e., three times (T1, T2, and T3), using magnetic resonance imaging and an isokinetic dynamometer, respectively. In both genders, the CSA(QF) values at the three levels tended to increase across the measurement times, with greater gains in the boys than in the girls at the levels mid and distal to the knee joint. Among these changes, only the CSA(QF) at the level proximal to the knee joint significantly increased regardless of changes in both skeletal age and body height. The ratios of torque to the sum of CSA(QF) at the three levels (T/CSA) at 3.14 and 5.24 rad/s for the boys and at 5.24 rad/s for the girls were significantly higher in T2 and T3 than T1. Further, the relative increases in torque and T/CSA values at 3.14 and 5.24 rad/s were greater in the boys than the girls. The findings presented here indicate that young tennis players who are in the earlier stage of adolescence increase the CSA of the QF muscle beyond normally expected growth change at the level proximal to the knee joint and show a predominant development in torque generation capability during high-velocity knee extensions, with a greater gain in boys compared with girls.

A decrease in systemic arterial compliance (SAC) increases left ventricular load along with the demand for excessive myocardial oxygen consumption when the age-related reduction of SAC reaches a marked level, and consequently may depress left ventricular pump function. Reduced left ventricular pump function decreases aerobic capacity, and some study groups have shown that SAC and/or central arterial distensibility is correlated with maximal aerobic capacity in humans. We thus hypothesize that, once the age-related reduction of SAC reaches a marked level, the participation of SAC in aerobic capacity will be significant even during sub-maximal exercise. Thirty young humans and 46 elderly humans participated in this study. SAC, oxygen uptake at the ventilatory threshold (VO2VT), and the ratio of increase in oxygen uptake, in cardiac output, and in effective arterial elastance to increase in work rate (deltaVO2/deltaWR, deltaCO/deltaWR and deltaEa/deltaWR) were measured. SAC was significantly higher in young subjects compared with elderly subjects, and was significantly related to VO2VT in elderly subjects. SAC also significantly correlated with deltaVO2/deltaWR, deltaCO/deltaWR and deltaEa/deltaWR in elderly subjects. When total subjects were divided by the value of SAC into 6 groups, the VO2VT values in the 3 groups with lower SAC were significantly lower than those in the 3 groups with higher SAC, and gradually decreased with the reduction of SAC. There were no changes in VO2VT among the 3 groups with higher SAC. These results suggest that the participation of SAC in aerobic capacity is significant even during sub-maximal exercise in individuals who show a pronounced age-related reduction of SAC.

In order to maintain and promote health among elderly people through the effective use of exercise, an “e-Health Promotion System” is proposed as a network-based health promotion system, to manage health conditions and provide evidence-based exercise prescriptions via the Internet. The personal information such as health conditions and exercise prescriptions need to be securely managed as security threats exist in the Internet medium. The aim of this research is to develop a secure data management server for an e-Health Promotion System. The data management server requires a secure system, a fault tolerance database system and an easy-to-use user interface. In order to establish the server which meets the above-mentioned system requirements, We selected a host computer with a Unix type operating system, which contains a robust security features in its core. Since the database system we adopted here has the features such as a fault-tolerance and high-speed access to the stored data, it can maintain much user information both securely and speedily. Moreover, the web-based user interface allows users to provide secure and easy access to the data server by an access control of authentication. The server can therefore manage the user information with both high security and high reliability, and provide easy user interface for the elderly. As a result of applying this system to field experiments, we confirmed the security and the reliability of the proposed system.

Reduction of systemic arterial compliance (SAC) with aging increases left ventricular afterload. The present study was designed to examine whether age-related reduction of SAC is related to excessive myocardial oxygen consumption during sub-maximal aerobic exercise. We studied elderly (60-69 years; n = 25) and senior (70-82 years; n = 25) subjects. We measured SAC immediately before the start of the ramp-fashion exercise (i.e., at the end of the 20 W warm-up exercise) and the double product (DP: systolic blood pressure x heart rate) during the ramp-fashion exercise (20-50 W). SAC was significantly lower in senior subjects (0.76 +/- 0.25 ml mmHg(-1) m(-2)) compared with elderly subjects (0.95 +/- 0.22 ml mmHg(-1) m(-2)). DP was higher in senior subjects (20 W: 14.3 +/- 3.1; 30 W: 15.9 +/- 4.2; 40 W: 17.7 +/- 4.9; 50 W: 20.6 +/- 5.6 [x 10(3) mmHg bpm]) than in elderly subjects (12.8 +/- 3.0, 14.0 +/- 3.5, 15.1 +/- 4.0, 17.1 +/- 4.3 [x 10(3) mmHg bpm]). In total subjects, SAC correlated significantly with DP (r = -0.64, r = -0.64, r = -0.64, r = -0.64). In senior subjects, SAC was related significantly to DP (r = -0.83, r = -0.78, r = -0.76, r = -0.74). In elderly subjects, SAC tended to correlate with DP although its relationships were not statistically significant (r = -0.34, r = -0.36, r = -0.33, r = -0.31). Correlation coefficients at each respective exercise intensity were significantly higher in senior subjects compared with elderly subjects. These results suggest that the age-related reduction of SAC is related to excessive myocardial oxygen consumption during sub-maximal aerobic exercise in older humans, but this relation does not become significant until the SAC reduction becomes pronounced.

The purpose of this study was to examine the sensitivity of the Japan Fitness Test for elderly people to assess the effects of aging. The participants were 250 male and 377 female, (627 in total) elderly people in residential care. The Japan Fitness Test consists of 6 test items (Gripstrength, Sit-ups, Sit-and-reach, Single-leg balance with eyes open, 10 m hurdle walk, and 6-min walk). Two-way multivariate analysis of variance (MANOVA), and analysis of variance (ANOVA) were used to determine effects of gender and aging on test performance. To estimate the sensitivity of each test for assessing aging, effect sizes (ES) of between young-old (aged 65-74 years) and old-old (aged over 75 years) were calculated. The criterion of the sensitivity of each test was more than ES=0.50. MANOVA and ANOVA results revealed significant effects for age groups on all test items, and there were no significant interaction for all test items except Sit-ups. ES of Grip strength, Single-leg balance with eyes open, 10 m hurdle walk, 6-min walk were indicated more than ES=0.50. For Sit-ups, while ES was 0.71 in male, it was low value (ES=0.25) in female. From these results, it is concluded that the Japan Fitness Test items are sensitive to assess aging effects with the exception of Sit-up routines performed by elderly women in female.

We researched the medical expenditure of the elderly who participated in exercise group (aerobic exercise and muscle exercise), comparing control subjects who matched sex and birth year with exercise groups in 2 cities and 2 towns. We calculated the cumulative medical expenditures from the previous years. In result, yearly cumulative medical costs of control subjects increased more than exercise groups in all test areas. Similar tendencies were shown in medical costs of each year's May in 2 cities. In another town we compared medical expenditures of elderly people between 3 different types of exercise groups: muscle exercise using their own body weight, quoits, and Swiss ball exercise. Medical costs of muscle exercise group increased less although not significantly. In conclusion, cumulative medical costs are useful for evaluating effects of exercise on medical economy, and the exercise, especially muscle exercise using their own body weight, might reduce the medical costs among the elderly.

The purpose of this study was to examine the relationships between nutrition intake status, nutritional condition and physical fitness in elderly women. One hundred-seventy seven community-dwelling healthy elderly people (age=68.7±5.0 years) were measured for physical activity, diet, physical fitness, biochemical parameters, and body composition. There were no significant differences between the 60-69 year-old group and the 70+ year-old group in nutrition intake and nutritional condition, which were higher than the national average in each age. Both nutrition intake and blood data satisfied an age standard level, and all subjects were in good nutritional condition. There was a significant positive correlation between protein intake and energy consumption (p

This study aimed to investigate the effects of age and gender on the power generation capabilities of lower limb muscles in the elderly aged from 65 to 79 yrs. In addition to isometric knee extension torque (KT) and leg extension power (LP), mechanical power during movements specific to maximal walking (WP) and running (RP) without arm movements were determined using a non-motorized treadmill in 140 men (71.3±4.0 yrs, mean±SD) and 172 women (70.2±3.7 yrs). The measured variables were expressed as relative to body mass and then their percentages to mean values for the subjects aged 65 to 69 yrs of men and women, respectively, were calculated. The percentages of all measured variables except for KT in the women were negatively correlated to age in both men (r=-0.207 to -0.375, p

Regular exercise training brings about desirable physical effects, including an increase in both endurance capacity and muscle strength/volume and an improvement in arterial stiffness that regulate blood pressure. However, these effects vary greatly between individuals. In addition to environmental factors, the genetic backgrounds causing those individual variations are inferred. Research exploring genes which regulate physical capabilities and training-induced effects is widely being implemented. These studies will encourage an individually tailored prescription of lifestyle/exercise for health. This review focused on individual variations of exercise training-induced effects on physical endurance capacity, muscle strength/volume and arterial stiffness. The relation between these effects and the gene and genetic factors, and future perspectives were discussed. Concerning endurance capacity, many studies have been carried out on ACE genotype, and also the relation to polymorphisms of mtDNA, UCP gene or HIF1A gene. In our studies, the polymorphisms of mitochondria-related genes were explored, revealing a suggestion that polymorphism is related to the endurance capacity and the phenotypes in skeletal muscles. Regarding muscle strength and volume, polymorphisms in myostatin, AMPD and CNTFR have been investigated. Our study observed genes that indicated expression dynamics related to exercise training effects on muscle strength and volume. As a result of investigation of genes concerned with arterial stiffness improvements by exercise training, changes in many gene expressions were found. Moreover, using the genes regulated by the training as candidates, training-induced effects on arterial stiffness and polymorphisms of these candidate genes were studied. The results suggest the possibility of genetic factors influencing training-induced effects on arterial stiffness. Genetic factors are clearly involved in exercise training-induced effects on endurance capacity, muscle strength/volume and arterial stiffness. Considering the effects of exercise training, the time is approaching when genetic factors will be taken into consideration.

Low back pain (LBP) and knee pain are among the most common orthopedic complaints. The factors associated with these pains are various, and their interactions are complicated; therefore, no consensus regarding causes and aggravation factors has emerged. Because LBP and knee pain deteriorate the QOL and ADL for elderly people, we examined the relationships between the experiences of LBP and knee pain and the muscle volumes of the trunk and extremities of 156 people aged 60 years and older participating in an exercise program. We used logistic regression analyses adjusted for age and gender. The decrease of latissimus dorsi muscle thickness was significantly associated with LBP (P=0.048), and the decrease of anterior femoral muscle volume was significantly associated with knee pain (P=0.025). The complication rate between LBP and knee pain was significant (P=0.003). Because our study is a cross-sectional study, there are no certainties about cause-and-effect relationships. However, our results suggest that back muscle exercises for people with LBP and training for strengthening the quadriceps femoris muscle for people with knee pain may be effective in reducing the frequency and intensity of the pain.

Oxidation produces reactive oxygen species (ROS), which cause peroxidation, enzyme inhibition and genetic damage in muscle cells. Genetic damage to cells and tissues caused by ROS facilitates aging. Therefore, the functional capacity of the antioxidant system against ROS is important to protect cells and tissues. The health benefits of regular exercise are well documented in a large number of reports. Moderate exercise can result in greater health benefits than vigorous exercise, because intense activity may be more susceptible to producing oxidative damage. Evidence would appear, as an indirect sign of muscle cell damage, such as an increase in lipid peroxidation, glutathione oxidation, and oxidative protein damage. During exercise, increased aerobic metabolism is a potential source of ROS in mitochondria. In muscle cells, mitochondria are one important source of reactive intermediates that include superoxides, hydrogen peroxide, and possibly hydroxyl radicals. Furthermore, a recent report suggested the occurrence of inter-mitochondrial complementation through exchange of genetic contents. This complementation could be a mitochondria-specific mechanism for avoiding expression of deletion-mutant mitochondria DNA from oxidative stress. Unfortunately, because research focusing on oxidative stress and antioxidants following exercise has up to now been narrow in scope, the mechanism linking oxidative stress and antioxidants in muscle tissue during exercise is not fully understood. Knowledge of the mechanism of ROS formation during exercise will be useful for health promotion for elderly as well as young exercise enthusiasts and may lead to the prevention of oxidative stress and damage associated with physical activity. This review paper provides a brief account of how exercise leads to oxidative stress and the link with antioxidants, and implys appropriate exercise regmen as prevention of oxidative stress for elderly individuals.

This study examines the validity for estimating physical fitness age (PFA) using the Japan Fitness Test through the application of single and multiple regression analyses and principal component analysis. The participants were 484 community-dwelling Japanese elderly men and women. A Physical fitness test consisting of 6 performance tests, namely grip strength, sitting trunk flexion, foot balance with opened eye, 10-m hurdle walk, sit-ups, and 6-min walk were used. Participants were divided into two groups for modeling PFA equations (n=322) and for cross-validation of them (n=162). The equation models for estimating the PFA were a single regression model with a physical fitness test score, a multiple regression model with the 6 performance tests, and the first principal component model obtained from the 6 performance tests. The validity of three PFA models was compared by concurrent validity with chronological age (CHA), cross-validity using shrinkage, and degree of agreement between aging effect for physical fitness and the correlation coefficients of PFA and CHA. Results of statistical analyses reveal that the three PFA models satisfy concurrent validity and cross-validity, but the single regression PFA model detected a greater degree of agreement for aging than the other models.

Until the idea of the “health promotion” was advocated by the Ottawa charter in 1986, the purpose of health care was only seen as the improvement of an individual's health. Up to that time, social environmental factors and the processes involved in carrying out health projects and physical fitness promotion — its practice, evaluation, public participation and so on — had not been appreciated. In keeping with the basic concept of health promotion, and with the effort of individuals, it is essential to establish public policy for the support of health care. This implies that specialist groups, including administration, must respond to the demands of health care and physical fitness promotion. Furthermore, we can say that health care and physical fitness promotion must be carried out with regard for social policy. However, the ideals of health promotion have not been achieved so far. We examined the actual status of Health Japan 21 health promotion in two surveys, a basic survey in October 2003 and the main examination in October 2004. All local governments were examined in order to propose a community system for promoting life function and social participation for the elderly. We analyzed and assessed the questionnaire including 1) the planning and practice of Health Japan 21 strategies (a concrete assessment of the status of each of the nine items and of the details of each sub-item of plans in administrative divisions, government-designated major cities, special districts, and cities, towns, and villages); 2) the level of recognition of public participation in and opinion of projects, during execution and evaluation, and the level of cooperation with civilian organizations; 3) ways of spreading awareness of projects; 4) project evaluations (intermediate evaluation); and 5) the importance of and prospects for the future of health care Health Japan 21 projects. It is thought that research into these factors will become a reference point for an intermediate evaluation of Health Japan 21, and will help solve various problems facing health improvement in our country.

The aim of this study was to assess the usefulness of the break-point in the heart rate/work rate relationship (HRBP). Ninety-seven middle-aged and elderly people performed a ramp-fashion incremental exercise test on a cycle ergometer. Breath-by breath O2 consumption and CO2 production data and beat-to-beat systolic blood pressure and heart rate data were obtained during the test, and work rate and heart rate corresponding to ventilatory threshold (VT), double product break point (DPBP), and HRBP were obtained by a linear regression analysis. Work rate and heart rate at HRBP correlated significantly with the corresponding values at VT (r=0.773, r=0.858, both P