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Objective: To investigate the effects of lifestyle factors on overweight among Japanese adolescents., Methods: We studied 5753 junior high school students (2842 boys and 2911 girls) aged 12 to 13 years. The students were residents of Toyama prefecture, Japan and completed a questionnaire about their height, weight, and lifestyle factors, in June and July 2002. Subjects with a body-mass index (BMI) higher than age- and sex-specific cut-off points were defined as obese. Parental overweight was defined as a BMI of 25 or higher. Logistic regression analysis was used to examine associations between lifestyle factors and overweight., Results: Skipping breakfast, eating quickly, excessive eating, physical inactivity, and long hours of TV watching were positively and significantly associated with overweight in both sexes. There was a negative association between snacking and overweight in girls (P<0.001); no such association was found in boys (P>0.05). Nighttime snacking was negatively associated with overweight in boys and girls (P<0.05). Extended video game playing (>or=2 hours; OR=2.00, P=0.012) and short sleep duration (<7 hours; OR=1.81, P=0.004) were significantly associated with overweight in girls only. The respective risks of overweight that derived from the subjects' fathers and mothers were 2.0 and 2.5 times, respectively, in boys and 1.9 and 3.0 times in girls., Conclusions: Parental overweight, skipping breakfast, eating quickly, excessive eating, long hours of TV watching, long hours of video game playing, physical inactivity, and short sleep duration were associated with adolescent overweight. Furthermore, there were significant negative associations between adolescent overweight and snacking in girls and nighttime snacking in both sexes.

Background: The validity of sleep quality and quantity indices as reported by schoolchildren has not been established. The purpose of this study is to evaluate the relationship between subjective sleep habits estimation and objective measurement data in schoolchildren., Methods: The study consisted of 42 healthy junior high school children aged 13-14. Sleep log information was gathered over 7 consecutive days, using a sleep-monitoring device (Actiwatch) and a questionnaire which covered the following aspects for sleep quality and quantity: bed time, sleep latency, sleep start, sleep end, wake up and assumed sleep length. The means of the sleep indices for 5 weekdays were used for analysis. Pearson's correlation coefficients and paired t-tests were used to evaluate the correlation and difference between subjective and objective sleep parameters., Results: The correlation coefficient between subjective and objective records was 0.49 (p < 0.001) for sleep latency, 0.99 (p < 0.001) for sleep start time, 0.99 (p < 0.001) for sleep end time, and 0.97 (p < 0.001) for assumed sleep length. The difference between subjective and objective records was 7.67 min (95% confidence interval [CI]: 4.64-10.71) for sleep latency, and 0:02 min (95% CI: -0:01-0:05) for sleep start time, 0:02 min (95% CI: 0:01-0:03) for sleep end time, and 8.19 min (95% CI: 4.93-11.45) for assumed sleep length., Conclusions: Although children tended to overestimate sleeping hours, the correlation between subjective and objective sleep indices except sleep latency was quite high. Thus, children's sleep questionnaire can be applied to surveys for sleep habits screening.

Background: There is little information about validation of young children's self-reported physical activity. This study assessed the validity of a self-reported questionnaire designed to measure children's physical activity., Methods: Subjects were 34 boys from 4th to 6th grade of a public elementary school. Contents of the self-reported physical activity questionnaire included participation in sports club, physical activity intensity, preference for physical activity, and frequency of physical activity. Subjects were equipped with a Lifecorder and an Actiwatch for 7 consecutive days to monitor physical activity. Physical activity index was calculated from the Lifecorder data of total energy expenditure per day (TEE) divided by basal metabolic rate. Unpaired t-test, analysis of variance, and multiple linear regression analysis were performed to clarify the relationship between the objective and subjective data., Results: Subjects who reported participation in a sports club had a higher physical activity index and energy expenditure originating from physical activity than those who did not. Those characterized by a "vigorous" physical activity intensity had a higher physical activity index (1.63 +/- 0.08), when compared with peers in "moderate" (1.59 +/- 0.06) or "light" categories (1.54 +/- 0.07) (p for linear trend p < 0.05). A high frequency of physical activity was significantly associated with an increasing trend in energy expenditure originating from physical activity, steps, and activity counts. Preference for physical activity was significantly related to data from the Lifecorder and the Actiwatch., Conclusions: Schoolchildren's self-reported physical activity is in accordance with the objective data, and could be used as a valid measure to evaluate physical activity level in school settings.

This study examined the validity of nursery teachers' report on the physical activity of young children. Subjects were twenty-one children aged 3 to 4 years (12 boys and 9 girls) at a nursery in Toyama Prefecture, Japan. Children were equipped with the Actiwatch (Mini-mitter Company Inc.) activity monitor and the Caloriecounter Select II (Kenz, Co, Ltd) for three consecutive weekdays to assess their daily physical activity levels. Nursery teachers completed a questionnaire containing questions on children's activity level during the measurement periods at the nursery. The results showed that subjects with a high frequency of physical activity were significantly associated with an increasing trend in total energy expenditure and activity counts per day. Children whose physical activity was rated as "very often" had a significantly higher activity level per day from the Actiwatch instrument, compared with peers whose physical activity was rated as "not often" (570.5 +/- 192.8 counts vs. 334.9 +/- 123.4 counts, p < 0.05). Regarding energy expenditure originating from physical activity and steps per day from the Caloriecounter, a significant difference was found between "very active" children and "inactive" children as rated by the nursery teachers (140.7 +/- 17.5 kcal vs. 78.2 +/- 17.4 kcal, p < 0.05; 16103 +/- 1896 steps vs. 10038 +/- 32 steps, p < 0.05). This study indicates that children's physical activity level as reported by their teachers in nursery surroundings is in accordance with the objective data from the Actiwatch and the Caloriecounter. The results suggest that nursery teachers' respondent for children in physical activity may be used as a valid measure to evaluate young children's physical activity levels, especially in nursery setting.

Epidemiologic and clinical studies have related acute and, less frequently, chronic life stress to cardiovascular diseases. In addition, animal models suggest that chronic psychological stress could cause atherosclerosis, probably by increasing sympathetic activation. In this cross-sectional study we evaluated the association between job strain, as one of the markers of workplace stress, and the urinary excretion of Vanilmandelic acid (VMA) upon awakening as a sympathoadrenal activity marker in the morning. Subjects were 936 male and 823 female civil servants working in departments related to the municipality of a city in Toyama Prefecture, Japan, in the spring of 2001. VMA was measured by high-performance liquid chromatography. We found that there was an age dependent increase in the level of VMA and females had higher VMA levels than males. Males who were current smokers had significantly lower VMA levels than nonsmokers after adjusting for age. Job strain level did not relate to VMA concentration in urine after adjusting for age and smoking status both in men and women. In addition, working and sleeping hours as predictor variables were also not associated with urinary VMA levels upon awakening in the morning. In conclusion, it seems that job strain does not independently relate to the sympathoadrenal activity, but the interaction between job strain and other variables such as personal characteristics and environmental factors and their relation with sympathoadrenal activity should further be explored.

The aim of this study was to evaluate the validity of sleeping hours of young children as reported by their parents. The subjects were 21 healthy children aged 3 to 4 years. They were asked to attach a small instrument for calculating sleeping hours objectively, over 3 consecutive nights. Parents reported the sleeping hours of their children during the study periods. The mean values were used in the analysis. Pearson's correlation coefficients and paired t-tests were used to evaluate the correlations and differences between the reported and objectively measured sleeping hours. The correlation coefficient and difference between the reported and assumed (objective sleeping hours representing the difference between times for falling asleep and waking) sleeping hours were 0.90 (p<0.001) and 0.79 hours (95% confidence interval: 0.59-0.99), respectively. The correlation coefficient and difference between the reported and actual (the assumed sleeping hours minus the sum of epochs being scored as awake during the assumed sleep) sleeping hours were 0.90 (p<0.001) and 0.92 hours (0.73-1.10), respectively. Although parents tended to overestimate the sleeping hours of their children, the correlation between the reported and objective sleeping hours is high, which indicates that reported sleeping hours could be used in a survey that requires data on relative differences in sleeping hours amongst a given population.

The aim of this study was to clarify the impact of parental obesity and lifestyle factors on obesity in preschool children. The subjects consisted of 8941 children aged 3 years, born in 1989. Anthropometric measurements and questionnaire surveys were conducted between 1992 and 1994. Subjects of body mass index (BMI; (weight (kg))/(height (m))2) more than the age- and sex-specific centiles linked to adult overweight were defined as obese subjects. Parental obesity was defined as BMI of 25 kg/m2 or more. Logistic regression analysis was performed to clarify the strengths of parental and lifestyle factors on childhood obesity, adjusted for possible confounding factors. Odds ratios (ORs) of paternal and maternal obesity for childhood obesity were 1.70(1.43-2.02) and 2.56(2.07-3.17), respectively. There was a dose-response relationship between short sleeping hours and obesity. Compared to subjects taking 11 hours sleep or more, the adjusted OR was 1.20(0.97-1.49) for those taking 10 to 11 hours sleep, 1.34(1.05-1.72) for those taking 9 to 10 hours sleep, and 1.57(0.90-2.75) for those taking less than 9 hours sleep. Eating and exercising habits were not significantly associated with obesity. These results indicate that parental obesity and short sleeping hours are possible risk factors for obesity in preschool children.

The aim of the present study was to evaluate the validity of the estimated prevalence of childhood obesity from height and weight reported by parents. The subjects were 170 first-grade children (83 males and 87 females) and 206 fourth-grade children (99 males and 107 females). A questionnaire including questions on height and weight was distributed to children and completed by parents. Anthropometric measurements were conducted in the standard way. Age- and sex-specific cut-off points linked to adult overweight were employed to determine childhood obesity. The correlation and difference between reported and measured values were calculated separately for grade and gender. Correlation coefficients ranged from 0.90 to 0.96 for height, 0.95 to 0.99 for weight, and 0.86 to 0.97 for body mass index (BMI). Sensitivity and specificity, the indices predicting the presence or absence of actual obesity from reported height and weight, ranged from 83.3 to 93.3% and 96.3 to 98.9%, respectively. The estimated prevalence of obesity (as calculated by reported data) minus actual prevalence (as calculated by measured data) ranged from -1.2 to 1.0%. These results indicate that height and weight reported by parents provides a reliable assessment of childhood obesity.

The case subjects were 67 stroke patients (27 males and 40 females, mean age 65.7+/-7.1), who suffered from stroke attack and had participated in annual medical check-up between 1987 and 1988 at Oyabe Public Health Center. The controls, which were adjusted for sex, age and blood pressure level with the case subjects, were selected from participants attending their annual medical check-up in 1987-1988. The serum thiocyanate level of case subjects were significantly higher than that of controls (p<0.05). The usefulness of measurement of serum thiocyanate level as an indicator of smoking status was assessed by using multiple logistic regression analysis adjusting for body mass index, mean blood pressure, and serum cholesterol was found. An odds ratio of 3.00 (95% confidence interval: 1.06-8.48, p<0.05) in cerebral infarction. It is considered that serum thiocyanate may be useful as an indicator of smoking status to assess the relationship with stroke onset, especially for cerebral infarction.

The purpose of this study is to observe the disease-disability association through a cross-sectional study. Between 1994 and 1995, we conducted a questionnaire survey in 5 towns in Japan. Among the items included in the questionnaire, 5 related to ADL (bathing, feeding, dressing/undressing, toileting, and going out socially) were treated as purpose variables; and 5 related to the history of medical treatment received over the past year (diabetes, heart disease, cerebrovascular disease, neuralgia, and bone fractures) were used as explanatory variables. Multiple logistic models were applied to observe the relationship. The history of medical treatment for cerebrovascular disease greatly and unavoidably affects disability related to ADL. Bone fractures, diabetes, and heart diseases contributed to specific ADL disabilities.

The major earthquake increases cardiovascular disease during the period from night-time to morning, especially in the elderly patients living around the epicenter. Earthquake-induced stress increased BP and blood viscosity determinants, and enhanced fibrin turnover with endothelial cell stimulation in a group of hypertensive elderly subjects. Earthquake might trigger the cardiovascular events through the potentiation of these acute risk factors. Reduction of stress and related acute risk factors in this period may suppress cardiovascular deaths following a major earthquake. Further investigation of the mechanisms triggering cardiovascular events after the a major event such as a major earthquake is a necessary part of the strategy for the prevention of cardiovascular disease.

Family history serves as the most important risk factor in prevention of coronary heart disease from youth. Prevalent methods of assessing family history, however, have serious drawbacks: a sudden rise of risk when a family member develops the disease; insufficient control for age among family members. We propose a simple quantitative method overcoming such drawbacks. Data on family history were obtained by questionnaires sent to 2,393 male high school students and their cholesterol levels were measured. Family risk from each family member was calculated by (30/Risk age)4, where the risk age was age at onset expressed by decade; if absent, it was replaced by present age or age at death. A mean score in a family served as the family risk. A total of 1,584 students and 17,127 family members were analyzed. The proposed method yielded a statistically significant association (Odds ratio = 1.60; 95% confidence interval: 1.15-2.25) between the family risk (above or below the median) and the student's atherogenic index (above or below the 90th percentile) calculated from cholesterols. This association was stronger than those by conventional methods. The proposed method may be useful in prevention activities and its efficiency needs to be confirmed in other studies.

A community-based survey to examine the actual number of ischaemic heart disease (IHD) deaths was undertaken in the western area of Toyama, a rural area with a population of 209,000. IHD deaths (International Classification of Diseases [ICD], ninth revision, codes 410-414) and heart failure (HF) deaths (ICD code 428) according to the death certificate aged 15 to 74 in 1987 to 1990 were reevaluated from medical records using the criteria of the multinational monitoring of trends and determinants in cardiovascular disease (MONICA). Of 97 subjects with IHD and of 170 subjects with HF according to the death certificate, 85 cases (87.6%) and 143 cases (84.1%) could be examined, respectively. Using the MONICA criteria, of 85 subjects with IHD, 18 (21.2%) were reevaluated as "definite acute myocardial infarction (AMI)" and 30 (35.3%) as "possible AMI". On the other hand, of 143 subjects with HF, 1 (0.7%) were reevaluated as "definite AMI" and 12 (8.4%) as "possible AMI". From these results, the number of deaths as reevaluated IHD was estimated 104.5 in the study period, and it was 7.7% increase at least compared with the number of deaths judged from the death certificate.