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While late chronotype and greater social jetlag have been associated with poor dietary behavior among the general population, these associations have not been investigated among workers, who struggle to align their sleep timings with work schedules. We aimed to explore the cross-sectional association of social jetlag and a late chronotype with adherence to a healthy diet among Japanese workers. Participants were 1,435 non-shift workers (18-78 years) who attended a nutritional survey. Social jetlag was defined as the difference in the midpoint of sleep times between weekdays and weekends, while chronotype was estimated using the mid-sleep time on weekends that was corrected with sleep debt on weekdays. We calculated the adherence score of the Japanese Food Guide Spinning Top (JFGST) - healthy diet guidelines for Japanese. Multivariable linear regression analyses were used to calculate the adjusted means and 95% confidence intervals (CI) for adherence scores of social jetlag and chronotype. We found that greater social jetlag was associated with a lower JFGST score. The multivariable-adjusted mean (95% CI) of JFGST scores were 39.7 (39.1-40.2), 38.7 (37.9-39.6), and 38.1 (36.6-39.7) for1 hour, 1 to2 hours, and ≥2 hours of social jetlag, respectively (

This study aimed to examine the sex-associated differences in the relationship between dyslipidemia and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike immunoglobulin (Ig)G antibodies among BNT162b2 vaccine recipients.Participants were staff members (aged 21-75 years) of a medical and research institution who underwent an anti-SARS-CoV-2 spike IgG antibody test after the second (n=1,872) and third doses (n=1,075) of the BNT162b2 vaccine. Dyslipidemia was defined as triglyceride level ≥150 mg/dL, high-density lipoprotein-cholesterol level40 mg/dL, low-density lipoprotein-cholesterol level ≥140 mg/dL, or lipid-lowering medication use. Multivariable linear regression was used to calculate the ratio of means for SARS-CoV-2 spike IgG titer according to dyslipidemia status.The prevalence of dyslipidemia was 38.0% in men and 19.6% in women. The relationship between dyslipidemia and SARS-CoV-2 spike IgG titers after the second dose differed markedly by sex (P for interaction0.001). In men, dyslipidemia was associated with significantly lower IgG titers: ratio of means [95% confidence interval (CI)] was 0.82 (0.72-0.93). However, this association disappeared after the third dose (0.96 [0.78-1.18]). Of dyslipidemia components, hypertriglyceridemia was inversely associated with SARS-CoV-2 spike IgG antibody titer after both the second and third doses [ratio of means: 0.82 (0.70-0.95) and 0.73 (0.56-0.95), respectively]. In women, IgG titers did not differ according to dyslipidemia or hypertriglyceridemia status after either dose.These results suggest a detrimental role of hypertriglyceridemia in the humoral immune response to the BNT162b2 vaccine for COVID-19 in men but not in women. This article is protected by copyright. All rights reserved.

OBJECTIVE Prediabetes has been suggested to increase risk for death; however, the definitions of prediabetes that can predict death remain elusive. We prospectively investigated the association of multiple definitions of prediabetes with the risk of death from all causes, cardiovascular disease (CVD), and cancer in Japanese workers. RESEARCH DESIGN AND METHODS The study included 62,785 workers who underwent a health checkup in 2010 or 2011 and were followed up for death from 2012 to March 2019. Prediabetes was defined according to fasting plasma glucose (FPG) or glycated hemoglobin (HbA1c) values or a combination of both using the American Diabetes Association (ADA) or World Health Organization (WHO)/International Expert Committee (IEC) criteria. The Cox proportional hazards regression model was used to investigate the associations. RESULTS Over a 7-year follow-up, 229 deaths were documented. Compared with normoglycemia, prediabetes defined according to ADA criteria was associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.53; 95% CI 1.12–2.09) and death due to cancer (HR 2.37; 95% CI 1.45–3.89) but not with death due to CVD. The results were materially unchanged when prediabetes was defined according to ADA FPG, ADA HbA1c, WHO FPG, or combined WHO/IEC criteria. Diabetes was associated with the risk of all-cause, CVD, and cancer deaths. CONCLUSIONS In a cohort of Japanese workers, FPG- and HbA1c-defined prediabetes, according to ADA or WHO/IEC, were associated with a significantly increased risk of death from all causes and cancer but not CVD.

Red meat and processed meat have been suggested to increase risk of colorectal cancer (CRC), especially colon cancer. However, it remains unclear whether these associations differ according to meat subtypes or colon subsites. The present study addressed this issue by undertaking a pooled analysis of large population‐based cohort studies in Japan: 5 studies comprising 232 403 participants (5694 CRC cases) for analysis based on frequency of meat intake, and 2 studies comprising 123 635 participants (3550 CRC cases) for analysis based on intake quantity. Study‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model and then pooled using the random effect model. Comparing the highest vs lowest quartile, beef intake was associated with an increased risk of colon cancer in women (pooled HR 1.20; 95% CI, 1.01‐1.44) and distal colon cancer (DCC) risk in men (pooled HR 1.30; 95% CI, 1.05‐1.61). Frequent intake of pork was associated with an increased risk of distal colon cancer in women (pooled HR 1.44; 95% CI, 1.10‐1.87) for “3 times/wk or more” vs “less than 1 time/wk”. Frequent intake of processed red meat was associated with an increased risk of colon cancer in women (pooled HR 1.39; 95% CI, 0.97‐2.00; P trend = .04) for “almost every day” vs “less than 1 time/wk”. No association was observed for chicken consumption. The present findings support that intake of beef, pork (women only), and processed red meat (women only) might be associated with a higher risk of colon (distal colon) cancer in Japanese.

Background Metabolic syndrome (MetS) has been associated with various chronic diseases which may lead to long-term sickness absence (LTSA), but there is lacking information on the direct association between MetS and LTSA. The present study aimed to investigate the all-cause and cause-specific associations between MetS and the risk of medically-certified LTSA among Japanese workers. Method We recruited 67,403 workers (57,276 men and 10,127 women), aged 20-59 years, of 13 companies in Japan, during their health check-ups in 2011 (11 companies) and 2014 (2 companies), and followed them up for LTSA events (≥ 30 consecutive days) until March 31, 2020. MetS was defined according to the Joint Interim Statement. A Cox proportional hazards regression model was used to estimate hazard ratio (HR) and its 95% confidence interval (CI) for LTSA associated with MetS and its components. Results During 408,324 person-years of follow-up, 2,915 workers experienced LTSA. The adjusted HR for all-cause LTSA was 1.54 (95% CI, 1.41-1.68) among those with vs without MetS. In cause-specific analysis, HRs associated with MetS significantly increased for LTSA due to overall physical disorders (1.76), cardiovascular diseases (3.16), diseases of the musculoskeletal system and connective tissue (2.01), cancers (1.24), obesity-related cancers (1.35), mental, behavioral and neurodevelopmental disorders (1.28), reaction to severe stress and adjustment disorders (1.46) and external causes (1.46). The number of MetS components were also significantly associated with increased LTSA risk. Conclusion MetS was associated with an increase in the risk of LTSA due to various diseases among Japanese workers.

ABO blood types could be a biological predisposition for depression. The present cross-sectional analysis was conducted amid the second wave of COVID-19 in Japan during July 2020. We wanted to investigate the association between ABO blood types and depressive symptoms among workers (352 men and 864 women, aged 21–73 years) of a medical institution in Tokyo, Japan, which took a leading role in the response to COVID-19 in the country. A Poisson regression model with a robust variance estimator was used to estimate the prevalence ratio (PR) and 95% confidence interval (CI) for depressive symptoms associated with ABO blood types. Overall, the prevalence of depressive symptoms (using two questions employed from a Two-question case-finding instrument) was 22.0%. The adjusted PRs (95% CI) for depressive symptoms, comparing the carriers of blood type O, A, and AB with those of type B, were 0.88 (0.66, 1.18), 0.81 (0.62, 1.07), and 1.07 (0.74, 1.53), respectively. There was no difference in the prevalence of depressive symptoms between non-B and B carriers. The present study did not support the association of ABO blood types with depressive symptoms.

OBJECTIVES While several experimental studies in animals and humans have suggested the protective effect of nightly fasting duration (NFD) against cardiometabolic risk factors, few population-based studies have been conducted. This study aimed to investigate the association between NFD and metabolic syndrome (MetS) among Japanese non-shift workers. METHODS A subset of 1054 non-shift workers from the Furukawa Nutrition and Health Study were included in this analysis. Participants completed dietary and lifestyle surveys during a periodic checkup. NFD was defined as the time between dinner and breakfast and was categorized into four groups (ie, ≥12 hours, 11 hours, 10 hours, and ≤9 hours). MetS was defined as ≥3 of the following components: high waist circumference (≥90 cm [men] and ≥80 cm [women]), high triglycerides (≥150 mg/dL), low high-density lipoprotein cholesterol (

Smoking has been consistently associated with the risk of colorectal cancer (CRC) in Western populations; however, evidence is limited and inconsistent in Asian people. To assess the association of smoking status, smoking intensity and smoking cessation with colorectal risk in the Japanese population, we performed a pooled analysis of 10 population-based cohort studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox's proportional hazards model and then pooled using a random-effects model. Among 363 409 participants followed up for 2 666 004 person-years, 9232 incident CRCs were identified. In men, compared with never smokers, ever smokers showed higher risk of CRC. The HRs (95% CI) were 1.19 (1.10-1.29) for CRC, 1.19 (1.09-1.30) for colon cancer, 1.28 (1.13-1.46) for distal colon cancer and 1.21 (1.07-1.36) for rectal cancer. Smoking was associated with risk of CRC in a dose-response manner. In women, compared with never smokers, ever smokers showed increased risk of distal colon cancer (1.47 [1.19-1.82]). There was no evidence of a significant gender difference in the association of smoking and CRC risk. Our results confirm that smoking is associated with an increased risk of CRC, both overall and subsites, in Japanese men and distal colon cancer in Japanese women.

Study Objectives Social jetlag, a mismatch between biological and social timing, has been reported to be associated with depressive symptoms among general population. However, evidence on this association is lacking among non-shift workers, who are under pressure to adapt themselves to a work schedule. We investigated the cross-sectional association of social jetlag with depressive symptoms among Japanese non-shift workers. Methods This study included 1,404 employees, aged 18–78 years, who completed a study questionnaire at a periodic health checkup. Social jetlag was calculated as the absolute value of the difference in the midpoint of sleep times between weekdays and weekends. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Multivariable logistic regression was used to estimate the odds ratio (OR) with adjustments for potential confounders including diet and chronotype. Results Of the study participants, 63.5%, 28.4%, and 8.1% had less than 1 hour, 1 to less than 2 hours, and at least 2 hours of social jetlag, respectively. Greater social jetlag was significantly associated with an increased likelihood of having depressive symptoms. The multivariable-adjusted OR (95% confidence interval) were 1.30 (0.95 to 1.78) and 2.14 (1.26–3.62) for 1 to less than 2 hour and at least 2 hours compared to less than 1 hour of social jetlag. The association between social jetlag and depressive symptoms appeared to be linear, according to restricted cubic spline regression. Conclusion Results suggest that greater social jetlag is associated with an increased likelihood of having depressive symptoms among non-shift workers.

Background Mobilising non-professional health workers has been successful in improving community health, but the effectiveness of an education program targeting youths in a community-based approach remains unclear. The objective of this study was to investigate the effect of an intervention with youth on cardiovascular disease risk factors of community adults. Methods A 12-month cluster randomised trial was conducted in a semi-urban area of Colombo in Sri Lanka. Facilitators trained youth club members aged 15–29 years to assess cardiovascular disease risk factors and take actions in the community to address relevant issues. The control group received no intervention. Body weight and blood pressure as primary outcomes and lifestyle of adults as secondary outcomes were measured pre- and post-intervention. Multilevel linear and logistic regressions were used to assess the effects of the intervention on changes in continuous and binary outcomes, respectively, from baseline to endpoint. Results Of 512 participants at baseline, 483 completed the final assessment after the intervention. Regarding primary outcomes, the intervention group showed a significantly greater decrease in body weight after intervention than the control group. The mean (95% confidence interval) difference of body weight change for intervention versus control group was − 2.83 kg (− 3.31, − 2.35). There was no statistically significant difference in blood pressure between the two groups. Turning to the secondary outcomes, in diet, the intervention group had a higher probability of consuming at least one serving/day of fruits (p = 0.02) and a lower probability of consuming snacks twice/day or more (p

Table S1. Examples of health behaviours of adults implemented in the intervention group. (DOCX 17 kb)

Table S2. Effect of intervention on body weight for people with overweight and on blood pressure for people with hypertension. (DOCX 19 kb)

Social jetlag, ie, the mismatch between biological and social timing, has been suggested to induce obesity and cardiometabolic abnormalities. Yet, no study has currently linked social jetlag to metabolic syndrome (MetS) among Asians. The aim of this study was to investigate the cross-sectional association of social jetlag with MetS in a Japanese working population.Participants were 1164 employees, aged 18-78 years, who completed a health survey at a periodic checkup. Social jetlag was calculated as the difference in hours of midpoint of sleep times between weekdays and weekends. MetS was defined according to the Joint Interim Statement criteria. Multivariable logistic regression was used to examine the association between social jetlag and MetS with adjustment for potential confounding variables.Greater social jetlag was significantly associated with an increased likelihood of having MetS. The multivariable adjusted odds ratio (95% confidence intervals) for ≥2 h of social jetlag was 1.92 (1.01-3.67) compared to those with1 h of social jetlag. Of the components of MetS, greater social jetlag was significantly associated with an increased likelihood of having high waist circumference; the multivariable adjusted odds ratio (95% confidence intervals) for ≥2 h of social jetlag was 2.26 (1.33-3.84) compared to those with1 h of social jetlag.Social jetlag may be associated with an increased likelihood of having MetS among non-shift workers.

Basic characteristics of households, Bangladesh, 2011. Table S2. Incidence of catastrophic expenditure, impoverishment and distress financing by care-seeking behavior and household characteristics, Bangladesh, 2011. (DOC 62Â kb)

Background Financial risk protection and equity are major components of universal health coverage (UHC), which is defined as ensuring access to health services for all citizens without any undue financial burden. We investigated progress towards UHC financial risk indicators and assessed variability of inequalities in financial risk protection indicators by wealth quintile. We further examined the determinants of different financial hardship indicators related to healthcare costs. Methods A cross-sectional, three-stage probability survey was conducted in Bangladesh, which collected information from 1600 households from August to November 2011. Catastrophic health payments, impoverishment, and distress financing (borrowing or selling assets) were treated as financial hardship indicators in UHC. Poisson regression models were used to identify the determinants of catastrophic payment, impoverishment and distress financing separately. Slope, relative and concentration indices of inequalities were used to assess wealth-based inequalities in financial hardship indicators. Results The study found that around 9% of households incurred catastrophic payments, 7% faced distress financing, and 6% experienced impoverishing health payments in Bangladesh. Slope index of inequality indicated that the incidence of catastrophic health payment and distress financing among the richest households were 12 and 9 percentage points lower than the poorest households respectively. Multivariable Poisson regression models revealed that all UHC financial hardship indicators were significantly higher among household that had members who received inpatient care or were in the poorest quintile. The presence of a member with chronic illness in a household increased the risk of impoverishment by nearly double. Conclusion This study identified a greater inequality in UHC financial hardship indicators. Rich households in Bangladesh were facing disproportionately less financial hardship than the poor ones. Households can be protected from financial hardship associated with healthcare costs by implementing risk pooling mechanism, increasing GDP spending on health, and properly monitoring subsidized programs in public health facilities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0556-4) contains supplementary material, which is available to authorized users.