Background and Objectives: Although excess white sugar intake imposes various health burdens, brown sugar is high in minerals, polyphenols, and polycosanol. However, few epidemiological studies have ...assessed brown sugar intake for health benefit. People in the Amami islands region, with a relatively high proportion of individuals with longevity, consume brown sugar as a type of refreshment. This cohort study was conducted in Amami to clarify the association of brown sugar intake with mortality risk and cancer incidence.
Methods and Study Design: Participants were recruited from the general population of Amami as part of the Japan Multi-Institutional Collaborative Cohort Study. The number of eligible participants was 5004 (2057 men and 2947 women). During the median follow-up period of 13.4 years, 274 deaths and 338 cases of cancer were observed. HRs and 95% CIs were estimated using the Cox proportional hazard model, after adjusting for sugar-related and other variables.
Results: After adjusting for their related confounding factors, brown sugar intake was associated with decreased HRs and a decreasing trend for all-site and stomach cancer incidence (p equivalent 0.001 and 0.017, respectively) in women and men, and for breast cancer incidence (p equivalent 0.034) in women. Additionally, a decreasing trend in the HRs for lung cancer incidence was observed among never and ex-smokers (p equivalent 0.039). Decreased HRs for overall death, cancer, and cardiovascular disease were not apparent.
Conclusions: Brown sugar intake was associated with decreased risk of all-site, stomach, and breast cancer incidences in the Amami population.
Introduction: Solid and sensitive infectious disease surveillance systems need to be developed and implemented to prevent and control epidemics. Although statutory national infectious disease ...surveillance systems have been developed in many countries, some challenges remain, such as their limited timeliness, representativeness, and sensitivity, as well as the fact that they cannot capture all local outbreaks that occur in small communities. To overcome these limitations, local community-based infectious disease surveillance systems that meet local needs and can operate with constrained resources need to be developed, especially in remote and rural low-resource areas. This study aimed to develop, implement, and evaluate a voluntary and unique local Rural and Remote Health rrh.org.au James Cook University ISSN 1445-6354 1 2 3 4 1 2, 3, 4 community-based ophthalmology sentinel surveillance system in Isa city (OSSS-Isa), a remote rural area in Japan.
Methods: For the development of OSSS-Isa, one hospital in Isa city assumed a leading role and developed a network with all medical institutions - 20 hospitals and clinics in the local community, including two ophthalmology clinics - as sentinel reporting sites. Surveillance was conducted on a weekly basis from Monday to Sunday. The collection, aggregation, and reporting of the surveillance data were implemented promptly on the same day, Monday, using a paper-based form and fax. For the evaluation of OSSS-Isa, the study followed the updated guidelines for evaluating public health surveillance systems proposed by the Centers for Disease Control and Prevention to select the evaluation criteria and develop a questionnaire. The questionnaires were then distributed to 20 hospitals and clinics, with the responses evaluated on a five-point Likert scale. Results: For the implementation of OSSS-Isa, the system issued alerts twice to the networked hospitals and clinics when signs of an increase in the prevalence of a target infectious eye disease appeared in Isa city. After the alerts, the number of cases decreased in the community. Regarding the evaluation survey, physicians from 18 hospitals and clinics responded to the questionnaire (response rate 90%). In contrast to flexibility, more than 75% of the respondents gave high ratings to simplicity, data quality, acceptability, timeliness, and stability in evaluating OSSS- Isa, with the mean score for these evaluation criteria higher than 3.67.
Conclusion: The present results indicate that OSSS-Isa has high simplicity, data quality, acceptability, timeliness, and stability, which is highly embedded with the local healthcare providers in Isa city. OSSS-Isa contributed to the early and accurate detection of signs of infectious eye disease outbreaks emerging in a small remote rural local community. The success factors seem to include its simple well-designed implementation methods, good external factors, and active human factors suited to the characteristics of the small remote rural community. The OSSS-Isa initiative appears to be a meaningful practical example of successful health advocacy by healthcare providers by developing a system at the local social level while going beyond the boundaries of routine medical practice. If voluntary small-scale surveillance systems can complement statutory large-scale ones and work together locally, nationally, and internationally, it might be possible to detect small, unusual happenings that occur in the community, such as emerging infectious diseases, and thereby help avert global outbreaks.
Background and Objectives: There is emerging scientific evidence of the health benefits of traditional food plants at both molecular and folk remedy levels; however, epidemiological observations are ...limited. The Amami island region of Japan has a variety of unique traditions conserved till today, where a cohort study was conducted in 2005. The objective of this study was to investigate the associations between the intake of common and local vegetables and the risk of mortality and cancer incidence in Amami. Methods and Study Design: Participants were enrolled from the general population of Amami as part of the Japan Multi-institutional Collaborative Cohort (J-MICC) Study. In total, 5,015 participants (2,053 men and 2,962 women) aged 35-69 years were enrolled in this study. They were followed up to obtain information on movement, death, and cancer incidence. The hazard ratios (HRs) and 95% CIs were estimated using the Cox proportional hazard model after adjusting for potential confounding factors. Results: A significant inverse association was observed between cabbage intake and the HRs for overall mortality (p for trend=0.046) and lung cancer incidence (p=0.016). Intake of handama and togan as local vegetables was associated with decreased HRs for overall mortality (p=0.019 and 0.036, respectively). Conclusions: While the molecular and biochemical reasoning and residual confounding factors behind this association remain unclear, the findings of this study suggest that the dietary lifestyle in Amami has a positive impact on the residents, which can significantly decrease mortality risk.
Abstract
Background
A part of nonalcoholic fatty liver disease (NAFLD) develops nonalcoholic steatohepatitis (NASH), liver cirrhosis and hepatocellular carcinoma. Metabolic syndrome is involved in ...their development, and hepatic fibrosis plays an important role in their pathogenesis. Patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene encode proteins on hepatic lipid metabolism regulation, and PNPLA3 gene polymorphism is associated with the development and progression of NAFLD. To investigate the gene and environmental factors, and their interaction for liver fibrosis, we conducted a prospective study among Japanese general population with NAFLD.
Methods
The subjects were 295 general residents who participated as a part of the Japan Multi-Institutional Collaborative Cohort (J-MICC) study in Kagoshima, Japan, and were followed for 5 years. NAFLD was defined as fatty liver using abdominal ultrasonography. PNPLA3 C/G polymorphism (rs738409) was analysed using TaqMan PCR. Hepatic fibrosis was defined using FIB 4 index (≥1.3). Logistic regression model was used to estimate the odds ratios (ORs) after adjusted for confounding factors.
Results
Mean age was 55.1 years and liver fibrosis was observed at 73.2% among NAFLD subjects. No environmental factors were associated with liver fibrosis, and PNPLA3 GG genotype was not associated with liver fibrosis, too. However, the ORs of CC & CG, and GG genotypes for dyslipidemia was respectively 0.45 (0.19-1.04) and 11.9 (1.81-78.4), and their interaction was significant (p = 0.01).
Conclusions
The interaction between PNPLA3 GG gene polymorphism and dyslipidemia for liver fibrosis was observed.
Key messages
Genetic susceptibility with dyslipidemia may be involved in liver fibrosis of NAFLD.
Although benefits of fish consumption for health are well known, a significant percentage of individuals dislike eating fish. Fish consumption may be influenced by genetic factors in addition to ...environmental factors. We conducted a genome-wide association study (GWAS) to find genetic variations that affect fish consumption in a Japanese population.
We performed a two-stage GWAS on fish consumption using 13,739 discovery samples from the Japan Multi-Institutional Collaborative Cohort study, and 2845 replication samples from the other population. We used a semi-quantitative food frequency questionnaire to estimate food intake. Association of the imputed variants with fish consumption was analyzed by separate linear regression models per variant, with adjustments for age, sex, energy intake, principal component analysis components 1-10, and alcohol intake (g/day). We also performed conditional analysis.
We found 27 single nucleotide polymorphisms (SNPs) located in 12q24 and 14q32.12 that were associated with fish consumption. The 19 SNPs were located at 11 genes including six lead SNPs at the BRAP, ACAD10, ALDH2, NAA25, and HECTD4 regions on 12q24.12-13, and CCDC197 region on 14q32.12. In replication samples, all five SNPs located on chromosome 12 were replicated successfully, but the one on chromosome 14 was not. Conditional analyses revealed that the five lead variants in chromosome 12 were in fact the same signal.
We found that new SNPs in the 12q24 locus were related to fish intake in two Japanese populations. The associations between SNPs on chromosome 12 and fish intake were strongly confounded by drinking status.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Background: The present genome-wide association study (GWAS) aimed to reveal the genetic loci associated with folate metabolites, as well as to detect related gene–environment interactions in ...Japanese.Methods: We conducted the GWAS of plasma homocysteine (Hcy), folic acid (FA), and vitamin B12 (VB12) levels in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study participants who joined from 2005 to 2012, and also estimated gene–environment interactions. In the replication phase, we used data from the Yakumo Study conducted in 2009. In the discovery phase, data of 2,263 participants from four independent study sites of the J-MICC Study were analyzed. In the replication phase, data of 573 participants from the Yakumo Study were analyzed.Results: For Hcy, MTHFR locus on chr 1, NOX4 on chr 11, CHMP1A on chr 16, and DPEP1 on chr 16 reached genome-wide significance (P < 5 × 10−8). MTHFR also associated with FA, and FUT2 on chr 19 associated with VB12. We investigated gene-environment interactions in both studies and found significant interactions between MTHFR C677T and ever drinking, current drinking, and physical activity >33% on Hcy (β = 0.039, 0.038 and −0.054, P = 0.018, 0.021 and <0.001, respectively) and the interaction of MTHFR C677T with ever drinking on FA (β = 0.033, P = 0.048).Conclusion: The present GWAS revealed the folate metabolism-associated genetic loci and gene–environment interactions with drinking and physical activity in Japanese, suggesting the possibility of future personalized cardiovascular disease prevention.
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FFLJ, NUK, ODKLJ, UL, UM, UPUK
ABSTRACT Background Burnout, due to extreme mental and physical fatigue, and emotional exhaustion, leads to decreased nursing quality and turnover. However, not all nurses are observed as burnouts in ...the same work environment, and resilience and related factors may have effects on the development of burnouts. Therefore, we conducted a cross-sectional study to examine the effects of resilience and related factors on the burnout in clinical nurses, Kagoshima, Japan. Methods Data for this cross-sectional study involving nurses (n=98) was collected using the following questionnaire surveys: the Bidimensional Resilience Scale, The Workplace Social Support Scale, and the Japanese version of the Pine's Burnout Scale. Using burnout as a dependent variable, analyses were conducted using one-way analysis of variance and multiple regression analysis after adjusted for related factors. Results The prevalence of burnouts was 19.6% on the mainland and 36.1% on remote island. Innate resilience, acquired resilience, workplace social support, and burnout showed no significant difference between nurses on the mainland and remote island. In the mainland participants, innate resilience (β=-0.492, P<0.001) and acquired resilience (β=-0.325, P=0.007) showed a negative association with burnout, and similar associations were observed innate resilience (β=-0.520, P=0.004) and acquired resilience (β=-0.336, P=0.057) in the remote island participants. For all participants, innate resilience (β=-0.443, P=0.001) and workplace social support (β=-0.204, P=0.031) showed a negative association with burnout, and turnover intention was positively associated (β=0.025, P=0.021). Conclusion A negative association between burnout and innate resilience factors was observed in the mainland and remote island. Further evaluation of innate resilience is necessary for burnout prevention in clinical nurses.
Aim: Accumulating evidence reveals that sedentary behavior is associated with mortality and cardiometabolic disease; however, there are potential age and sex differences in sedentary behavior and ...health outcomes that have not been adequately addressed. This study aimed to determine the association of sedentary behavior with cardiometabolic diseases such as hypertension, dyslipidemia, diabetes mellitus, and its risk factors in a large Japanese population according to age and sex. Methods: Using data from the Japan Multi-Institutional Collaborative Cohort Study obtained from baseline surveys, data of 62,754 participants (27,930 males, 34,824 females) were analyzed. This study uses a cross-sectional design and self-administered questionnaires to evaluate sedentary time and anamnesis. For the logistic regression analysis, sedentary time <5 h/day was used as the reference and then adjusted for age, research areas, leisure-time metabolic equivalents, and alcohol and smoking status. From the analysis of anthropometric and blood examinations, 35,973 participants (17,109 males, 18,864 females) were analyzed. Results: For hypertension and diabetes, sedentary time was associated with a significantly higher proportion of male participants. Both sexes were associated with a significantly higher proportion of participants with dyslipidemia. Participants who had longer sedentary time tended to have increased levels of blood pressure, triglycerides, and non-high-density lipoprotein cholesterol (HDL-C), and decreased levels of HDL-C, especially in the 60–69 years group. Conclusions: Independent of leisure-time physical activity, sedentary time was associated with cardiometabolic diseases in a large Japanese population classified by age and sex. Our findings indicate that regularly interrupting and replacing sedentary time may contribute to better physical health-related quality of life.
PURPOSEAlthough several genetic factors may play a role in leisure-time exercise behavior, there is currently no evidence of a significant genomewide association, and candidate gene replication ...studies have produced inconsistent results.
METHODSWe conducted a two-stage genomewide association study and candidate single-nucleotide polymorphisms (SNP) association study on leisure-time exercise behavior using 13,980 discovery samples from the Japan Multi-Institutional Collaborative Cohort (J-MICC) study, and 2036 replication samples from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center-2 study. Leisure-time physical activity was measured using a self-administered questionnaire that inquired about the type, frequency and duration of exercise. Participants with ≥4 MET·h·wk of leisure-time physical activity were defined as exhibiting leisure-time exercise behavior. Association testing using mixed linear regression models was performed on the discovery and replication samples, after which the results were combined in a meta-analysis. In addition, we tested six candidate genetic variants derived from previous genomewide association study.
RESULTSWe found that one novel SNP (rs10252228) located in the intergenic region between NPSR1 and DPY19L1 was significantly associated with leisure-time exercise behavior in discovery samples. This association was also significant in replication samples (combined P value by meta-analysis = 2.2 × 10). Several SNP linked with rs10252228 were significantly associated with gene expression of DPY19L1 and DP19L2P1 in skeletal muscle, heart, whole blood, and the nervous system. Among the candidate SNP, rs12612420 in DNAPTP6 demonstrated nominal significance in discovery samples but not in replication samples.
CONCLUSIONSWe identified a novel genetic variant associated with regular leisure-time exercise behavior. Further functional studies are required to validate the role of these variants in exercise behavior.
ABSTRACT Background Although it is known that resilience is negatively associated with burnout, and that certain interventions can effectively increase resilience, little is known about online ...resilience-enhancing interventions during the COVID-19 crisis. The aim of this study was to identify the association between an online resilience-enhancing intervention and workplace social support, and burnout among nurses working in the mainland and remote islands of Japan during the COVID-19 crisis. Methods Pretest-posttest was conducted between April 2020 and February 2021, and the questionnaire survey included the bidimensional resilience scale, the Japanese version of Pine's Burnout Measure, and the workplace social support scale. Changes in burnout, resilience, and social support and the associations with nursing discussions as intervention were analyzed. Participants were 98 Nurses with 1 to 10 years of experience from Japan's mainland and remote island hospitals of Kagoshima Prefecture participated in a baseline survey in April 2020. Of these, 76 participated in a secondary survey in September 2020, and 69 participated in the intervention program and a third survey in February 2021. The online intervention over Zoom consisted of small-group nursing discussions based on the broaden-and-build theory. Results Changes in burnout showed a significant negative association with change in workplace social support (Coef. = -0.019, 95% CI -0.035- -0.003), as did the interaction between change in acquired resilience and intervention (Coef. = -0.088, 95% CI -0.164- -0.011). Conclusion Change in workplace social support was significantly negatively associated with changes in burnout, as was the interaction of intervention and acquired resilience. Promotion of this intervention and making workplace social support more accessible may contribute to reduce burnout in nurses.