Abstract
Background
Widespread use of smartphones has enabled the continuous monitoring of people’s movements and physical activity. Linking global positioning systems (GPS) data obtained via ...smartphone applications to physical activity data may allow for large-scale and retrospective evaluation of where and how much physical activity has increased or decreased due to environmental, social, or individual changes caused by policy interventions, disasters, and infectious disease outbreaks. However, little attention has been paid to the use of large-scale commercial GPS data for physical activity research due to limitations in data specifications, including limited personal attribute and physical activity information. Using GPS logs with step counts measured by a smartphone application, we developed a simple method for daily walking step estimation based on large-scale GPS data.
Methods
The samples of this study were users whose GPS logs were obtained in Sendai City, Miyagi Prefecture, Japan, during October 2019 (37,460 users, 36,059,000 logs), and some logs included information on daily step counts (731 users, 450,307 logs). The relationship between land use exposure and daily step counts in the activity space was modeled using the small-scale GPS logs with daily step counts. Furthermore, we visualized the geographic distribution of estimated step counts using a large set of GPS logs with no step count information.
Results
The estimated model showed positive relationships between visiting high-rise buildings, parks and public spaces, and railway areas and step counts, and negative relationships between low-rise buildings and factory areas and daily step counts. The estimated daily step counts tended to be higher in urban areas than in suburban areas. Decreased step counts were mitigated in areas close to train stations. In addition, a clear temporal drop in step counts was observed in the suburbs during heavy rainfall.
Conclusions
The relationship between land use exposure and step counts observed in this study was consistent with previous findings, suggesting that the assessment of walking steps based on large-scale GPS logs is feasible. The methodology of this study can contribute to future policy interventions and public health measures by enabling the retrospective and large-scale observation of physical activity by walking.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose We evaluated the association of nocturia with fracture and death in a large, community based sample of Japanese individuals 70 years old or older. Materials and Methods The baseline in this ...population based study was determined in 2003 by an extensive health interview with each participant. In this study we followed 784 individuals with a mean ± SD age of 76.0 ± 4.6 years (range 70 to 97). Information on mortality and fracture during the study period was provided by the National Health Insurance system and details on fractures were collected from medical records. We compared the risk of bone fracture and death with or without nocturia in a multivariate Cox proportional hazard model. Results Nocturia (2 or greater voids per night) was present in 359 of the 784 participants (45.7%). Fracture was observed in 41 cases, including 32 fall related cases. For all fractures and fall related fractures with nocturia the HR was 2.01 (95% CI 1.04–3.87) and 2.20 (95% CI 1.04–4.68, each p = 0.04). Death occurred in 53 cases. The mortality rate in individuals with nocturia was significantly higher than in those without nocturia. For mortality in patients with nocturia the age-gender adjusted HR was 1.91 (95% CI 1.07–3.43, p = 0.03). Even when further adjusted for diabetes, smoking status, history of coronary disease, renal disease and stroke, tranquilizers, hypnotics and diuretics, the positive relationship was unchanged (HR 1.98, 95% CI 1.09–3.59, p = 0.03). Conclusions During a 5-year observation period elderly individuals with nocturia were at greater risk for fracture and death than those without nocturia.
Cardiovascular disease (CVD) is a leading cause of death in Japan. To reduce the threat of CVD, it is important to identify its major risk factors. The population attributable fraction (PAF) is ...calculated from the prevalence and relative risk of risk factors and can be used to estimate the burden of these factors with respect to CVD. We analyzed the findings from several prospective studies to determine the PAFs of CVD.
PAF was calculated as pd × (multiadjusted relative risk - 1)/multiadjusted relative risk, where pd is the proportion of patients exposed to that risk factor category, according to data from the Ohsaki Cohort Study, EPOCH-JAPAN, NIPPON DATA80, Miyagi Cohort Study, CARDIA Study, and ARIC Study.
Nonoptimal blood pressure explained 47% and 26% of CVD mortality in middle-aged and elderly Japanese, respectively. Cigarette smoking explained 34% of all-cause mortality in middle-aged men. The combination of hypertension and cigarette smoking explained 57% and 44% of CVD mortality in younger men and women, respectively. Furthermore, the presence of at least 1 nonoptimal risk factor explained most CVD deaths and all-cause deaths.
Established CVD risk factors, especially high blood pressure and cigarette smoking, explained a large proportion of CVD mortality and all-cause mortality. Prevention, early detection, and treatment of these conventional risk factors are required to reduce mortality risk.
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FFLJ, NUK, ODKLJ, UL, UM, UPUK
It has been pointed out that eye-level greenery streetscape promotes leisure walking which is known to be a health -positive physical activity. Most previous studies have focused on the total amount ...of greenery in the eye-level streetscape to investigate its association with walking behaviour. While it is acknowledged that taller trees contribute to greener environments, providing enhanced physical and psychological comfort compared to lawns and shrubs, the examination of streetscape metrics specifically focused on greenery height remains largely unexplored. Therefore, this study examined the relationship between objective indicators of street greenery categorized by height from a pedestrian viewpoint and leisure walking time. We created streetscape indices of street greenery using Google Street View Images at 50-m intervals in an urban area in Sendai City, Japan. The indices were classified into four ranges according to the latitude of the virtual hemisphere centred on the viewer. We then investigated their relationship to self-reported leisure walking. Positive associations were identified between the street greenery in higher positions and leisure walking time, while there was no significant association between the greenery in lower positions. The findings indicated that streets with rich greenery in high positions may promote residents' leisure walking, indicating that greenery in higher positions contributes to thermally comfortable and aesthetic streetscapes, thus promoting leisure walking. Increasing the amount of greenery in higher positions may encourage residents to increase the time spent leisure walking.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Secondhand smoke (SHS) causes many deaths. Inequalities in SHS have been reported in several countries; however, the evidence in Asian countries is scarce. We aimed to investigate the ...association between socioeconomic status (SES) and SHS at home and the workplace/school among non-smoking Japanese adults. Methods: Cross-sectional data from the Miyagi Prefectural Health Survey 2014 were analyzed. Self-reported questionnaires were randomly distributed to residents ≥20 years of age and 2,443 (92.8%) responded. The data of the 1,738 and 1,003 respondents were included to the analyses for SHS in the past month at home and at the workplace/school, respectively. Ordered logistic regression models considering possible confounders, including knowledge of the adverse health effects of tobacco, were applied. Results: The prevalence of SHS at home and the workplace/school was 19.0% and 39.0%, respectively. Compared with ≥13 years of education, odds ratios (ORs) and 95% confidence intervals (CIs) for SHS at home were 1.94 (95% CI, 1.42–2.64) for 10–12 years and 3.00 (95% CI, 1.95–4.60) for ≤9 years; those for SHS at the workplace/school were 1.80 (95% CI, 1.36–2.39) and 3.82 (95% CI, 2.29–6.36), respectively. Knowledge of the adverse health effects of tobacco was significantly associated with lower SHS at home (OR 0.95; 95% CI, 0.91–0.98) but it was not associated with SHS at the workplace/school (OR 1.02; 95% CI, 0.98–1.06). Conclusions: Social inequalities in SHS existed among Japanese non-smoking adults. Knowledge about tobacco was negatively associated with SHS at home but not at workplace/school.
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FFLJ, NUK, ODKLJ, UL, UM, UPUK
Chronic kidney disease (CKD) is a global health burden. Previous studies have shown a J- or U-shaped association between serum uric acid (SUA) and cardiovascular mortality. We assessed the risk of ...CKD incidence in a refined SUA category in middle-aged adults stratified by sex.
We analyzed data from 138,511 participants <65 years old (29.6% women; mean age 44.1 years) without CKD at baseline acquired from the JMDC database. The Cox model was used to assess the adjusted hazard ratio (HR).
During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The fully adjusted HRs (95% confidence interval CI, p-value) for CKD incidence in men with SUA <4.0, 10.0–10.9 and ≥ 11.0 mg/dL compared to men with SUA 4.0–4.9 mg/dL were 1.13 (1.01–1.26, p = 0.030), 1.98 (1.32–2.97, p = 0.0010), and 3.74 (1.68–8.35, p = 0.0013), respectively. The fully adjusted HRs for CKD incidence in women with SUA <4.0, 8.0–8.9, and ≥9.0 mg/dL compared to women with SUA 4.0–4.9 mg/dL were 1.08 (1.01–1.16, p = 0.032), 2.39 (1.07–5.35, p = 0.034), and 3.20 (0.80–12.8, p = 0.10), respectively.
Both high and low SUA levels were identified as risk factors for CKD incidence in middle-aged men and women. The association of SUA levels with the increase in the risk of CKD incidence differed by sex, and the range of SUA levels associated with an increase in the risk of CKD incidence varied by sex.
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•The association of serum uric acid (SUA) levels with the increase in the risk of chronic kidney disease (CKD) incidence differed by sex.•The range of SUA levels associated with an increase in the risk of CKD incidence varied by sex.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK, ZRSKP
Aims: Although physiological effects of hydrophilic- (H-) and lipophilic- (L-) antioxidant capacities (AOCs) are suggested to differ, the association of an antioxidant-rich diet and chronic kidney ...disease (CKD) incidence has not been examined. We therefore explored the association between the H- or L-AOC of a whole Japanese diet and CKD risk in a general population.Methods: A total of 922 individuals without CKD (69.2% women; mean age, 59.5 years old) from Ohasama Town, Japan, were examined. CKD incidence was defined as the presence of proteinuria and/or an estimated glomerular filtration rate (eGFR) of ＜60 ml/min/1.73 m2. Consumption of H-/L-AOC was determined based on the oxygen radical absorbance capacity in a specially developed Japanese food AOC database. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for new-onset CKD using a Cox proportional hazards model.Results: During the median follow-up of 9.7 years, 137 CKD incidents were recorded. After adjusting for potential confounding variables, the highest quartile of L-AOC was significantly associated with a 51% reduced CKD risk among only women. An increased L-AOC intake was more effective in preventing eGFR reduction than in preventing proteinuria in women. These associations were not seen for H-AOC intake in both sexes and L-AOC intake in men.Conclusions: A high intake of lipophilic antioxidants may be associated with a reduced CKD risk. The balance between dietary antioxidant intake and pro-oxidants induced by unhealthy lifestyles may be crucial for preventing future kidney deterioration.
After disasters, people are often forced to reconstruct or move to new residences. This study aimed to reveal the association between the types of reconstructed residences and psychosocial or ...psychiatric conditions among the population. A total of 1071 adult residents in a coastal town, whose houses were destroyed by the tsunami caused by the Great East Japan Earthquake, enrolled in the study five years after the disaster. The type of reconstructed post-disaster residences (reconstructed on the same site/disaster-recovery public condominium/mass-translocation to higher ground/privately moving to remote areas) and the current psychosocial indicators were investigated. The results revealed that individuals living in public condominiums showed significantly worse scores on the Lubben Social Network Scale-6 (p < 0.0001) and the Center for Epidemiologic Studies Depression Scale (p < 0.0001), and slightly worse scores on the Kessler Psychological Distress Scale (p = 0.035) and the Impact of Event Scale-Revised (p = 0.028). Lower psychosocial indicator scores in the public condominium group were more remarkable in younger adults aged < 65 years. Insomnia evaluated using the Athens Insomnia Scale was not different among the four residential types. In summary, residents moving into disaster-recovery public condominiums are likely to have less social interaction, be more depressed, and may need additional interventions.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Early detection and accurate monitoring of patients with chronic kidney disease (CKD) is likely to improve care and decrease the risk of cardiovascular and cerebrovascular diseases. As a new ...diagnostic tool, we examined the retention of uremic solutes as a simpler, more accurate method to assess renal function. To achieve this, we comprehensively evaluated these solutes in CKD patients. By capillary electrophoresis with mass spectrometry, we found 22 cations and 30 anions that accumulated significantly as the estimated glomerular filtration rate (eGFR) decreased. These compounds included 9 cations and 27 anions that were newly identified in this study. In contrast, we also found 7 cations (2 new) and 5 anions (all new) that decrease significantly as eGFR declines. We evaluated each substance for its suitability to detect early CKD stage. Compounds that are highly correlated with eGFR and whose plasma concentration changed in a manner approximated by the first-degree equation are excellent candidates for detecting CKD and identifying uremic toxins that might aggravate kidney function in the early stage of CKD. These results identify a number of uremic compounds, many of which are novel and which predict worsening renal function. These compounds provide diagnostic information and may be targets for therapies designed to treat the complications of CKD patients.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Aims: Few studies have investigated the subclinical atherosclerotic changes in the brain and carotid artery, and in East Asian populations. We sought to investigate whether gravidity, delivery, the ...age at menarche and menopause and estrogen exposure period are associated with subclinical atherosclerosis of the brain and carotid arteriopathy.Methods: This cross-sectional study formed part of a cohort study of Ohasama residents initiated in 1986. Brain atherosclerosis and carotid arteriopathy were diagnosed as white matter hyperintensity (WMH) and lacunae evident on brain magnetic resonance imaging (MRI) and carotid intimal media thickness (IMT) or plaque revealed by ultrasound, respectively. The effect of the reproductive events on brain atherosclerosis and carotid arteriopathy was investigated using logistic regression and general linear regression models after adjusting for covariates.Results: Among 966 women aged ≥ 55 years in 1998, we identified 622 and 711 women (mean age: 69.2 and 69.7 years, respectively) who underwent either MRI or carotid ultrasound between 1992–2008 or 1993–2018, respectively. The highest quartile of gravidity (≥ 5 vs. 3) and delivery (≥ 4 vs. 2), and the highest and second highest (3 vs. 2) quartiles of delivery were associated with an increased risk of WMH and carotid artery plaque, respectively. Neither of age at menarche, menopause, and estrogen exposure period estimated by subtracting age at menarche from age at menopause was associated with atherosclerotic changes of brain and carotid arteries.Conclusions: Higher gravidity and delivery are associated with subclinical atherosclerosis of the brain and carotid plaque.
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