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BackgroundThe worldwide rise in the prevalence of noncommunicable diseases has increased the recognition of the need to identify modifiable risk factors for preventing and managing these diseases. The office worker, as a representative group of physically inactive workers, is exposed to risk factors for metabolic syndrome, which is a primary driver of noncommunicable diseases. The use of virtual reality (VR) exergames may offer a potential solution to the problem of increasing noncommunicable disease prevalence, as it can help individuals increase their physical activity levels while providing a more immersive experience. ObjectiveThis exploratory study aims to examine the interventional efficacy of at-home immersive VR exergames on metabolic syndrome biomarkers among office workers. Additionally, it seeks to investigate the impacts of at-home immersive VR exergames on the active and sedentary behaviors of office workers. MethodsA 3-arm, single-blinded pilot randomized controlled trial will be conducted to examine the therapeutic effects of at-home immersive VR exergames. A total of 120 Chinese office workers, engaging in less than 150 minutes per week of moderate to vigorous intensity physical activity, will be recruited via a convenience sampling method. The participants, who will be tested over a 12-week period, will be randomly assigned to one of three groups: (1) the VR exergame intervention group, (2) the regular physical activity control group, and (3) the nonexercise control group. Throughout the 12-week trial, three categories of variables will be collected across the three groups: clinical risk factors associated with metabolic syndrome, active and sedentary behaviors, and demographics. To analyze variance among the groups, a mixed linear model will be applied to assess the efficacy of each group. Differences in metabolic syndrome clinical risk factors among all groups will be used to evaluate the effects of at-home immersive VR exergames. Changes in active and sedentary behaviors will also be used to determine the impacts of VR exergames on metabolic syndrome. ResultsThe ethics committee of Guangzhou University, China, approved this study on September 25, 2024. Participant recruitment will begin in early 2025 and continue for approximately 3 months. Data will be analyzed after the 12-week trial is completed, with full results expected to be presented in early 2026. ConclusionsThis study explores an emerging topic by applying an at-home immersive VR exergame intervention, potentially contributing to understanding the effects of an exergame program on metabolic syndrome risk among office workers. Trial RegistrationClinicalTrials.gov NCT06556784; https://clinicaltrials.gov/study/NCT06556784 International Registered Report Identifier (IRRID)PRR1-10.2196/64560

Summary: MOTS-c is a mitochondrial microprotein that improves metabolism. Here, we demonstrate CK2 is a direct and functional target of MOTS-c. MOTS-c directly binds to CK2 and activates it in cell-free systems. MOTS-c administration to mice prevented skeletal muscle atrophy and enhanced muscle glucose uptake, which were blunted by suppressing CK2 activity. Interestingly, the effects of MOTS-c are tissue-specific. Systemically administered MOTS-c binds to CK2 in fat and muscle, yet stimulates CK2 activity in muscle while suppressing it in fat by differentially modifying CK2-interacting proteins. Notably, a naturally occurring MOTS-c variant, K14Q MOTS-c, has reduced binding to CK2 and does not activate it or elicit its effects. Male K14Q MOTS-c carriers exhibited a higher risk of sarcopenia and type 2 diabetes (T2D) in an age- and physical-activity-dependent manner, whereas females had an age-specific reduced risk of T2D. Altogether, these findings provide evidence that CK2 is required for MOTS-c effects.

Abstract Identifying the types of exercise that enhance cerebral blood flow is crucial for developing exercise programs that enhance cognitive function. Nevertheless, few studies have explored the amount of light-intensity, short-duration exercises that individuals can easily perform on cerebral blood flow, particularly in children. We examined the effects of these exercises on the hemodynamics of the prefrontal cortex (PFC) using functional near-infrared spectroscopy. Participants comprised 41 children (aged 12.1 ± 1.5 years, 37% female) who engaged in seven light-intensity exercises, with each movement performed in two patterns lasting 10 or 20 s. Changes in oxygenated hemoglobin (oxy-Hb) levels at rest and during exercise were compared using analysis of covariance, with sex and age as covariates. Significant increases in oxy-Hb were observed in multiple regions of the PFC during all forms of exercise (including dynamic and twist stretching [66.6%, 8/12 regions, η2 = 0.07–0.27], hand and finger movements [75.0%, 9/12 regions, η2 = 0.07–0.16], and balance exercises (100.0%, 6/6 regions, η2 = 0.13–0.25]), except for static stretching with monotonic movements. This study implies that short-duration, light-intensity exercises, provided that they entail a certain degree of cognitive and/or physical demands, can activate the PFC and increase blood flow.

Abstract Objectives Poor cardiorespiratory fitness (CRF) and high body mass index (BMI) increased the risk of developing metabolic Syndrome (MetS) mostly in Caucasians. However, the sex-specific combined association of CRF and BMI on MetS considering health-related behaviors has yet to be thoroughly examined in Japanese. This study aims to investigate the sex-specific independent and combined associations of CRF and BMI with MetS in middle-aged Japanese adults. Methods 421 participants were included in this cross-sectional study. CRF was estimated using a submaximal cycle ergometer. CRF and BMI were respectively divided into three categories according to tertile distribution. MetS was diagnosed based on five risk factors: waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose. Multivariable logistic regression models were used to estimate independent and combined association of CRF and BMI with MetS. Results Results showed that 154 (57.5%) and 70 (45.8%) of men and women had MetS, respectively. Compared to men with lower CRF or higher BMI, men with middle and higher CRF or middle and lower BMI were less likely to have MetS. Compared with ‘unfit and higher BMI’ group, ‘unfit and lower BMI’, ‘fit and higher BMI’, and ‘fit and lower BMI’ groups in men showed statistically significant decreased prevalences of MetS. However, no significant associations were found in women. Conclusions This study found significant independent and combined associations of CRF and BMI with MetS only in men, but not in women. However, prospective studies are warranted to confirm sex-specific associations of CRF and BMI with MetS.

Abstract The ‘Bow-Wow Patrol (BWP)’, established to avert local crime by encouraging dog walking, may help build social relationships among individuals through dog walking. However, details of its social influence remain unclear. Thus, this study aimed to elucidate the social roles of BWP in the urban areas of Japan. A total of 18 BWP organisation members from two Tokyo municipalities were recruited using snowball sampling between November 2021 and July 2022. In an interview, participants were asked about their perceptions of changes in their social relationships through the BWP. Qualitative content analysis was conducted after text mining using the KH Coder software. The mean age of the participants was 63.9 years, and 83.3% engaged in BWP 7 days a week. The content analysis revealed six social roles of the BWP: establishment of social networks with schools as the centre, establishment of loose networks inside and outside the BWP organization, enhancement of a sense of trust among neighbours, enhancement of a sense of trust in communities, norms of reciprocity among dog owners, and dog and owner characteristics. This study found that the BWP in urban Japan strengthens social cohesion and expands social networks among dog walkers, encouraging them to continue walking.

Abstract This study aimed to investigate the rate of sedentary behaviour and differences in physical outcomes and activities of daily living (ADL) based on sedentary behaviour time of hospitalized older cardiovascular disease patients undergoing phase I cardiac rehabilitation. Older cardiovascular disease patients were enrolled from October 2020 to September 2023 and were divided into the high sedentary behaviour group (≥ 480 min/day) and low sedentary behaviour group (

Objective: Place attachment plays an important role in individuals' health and well-being. Understanding the associations between urban design attributes and place attachment can inform strategies to promote place attachment. This study aims to examine the associations between walkable built environment metrics and place attachment. Methods: This study used data collected from October to November 2020, involving 25,340 adults across 21 major cities in Japan. Geographic address information was used to measure objective walkability, while perceived walkability and place attachment were assessed using adapted scales. Ordinary least squares regression models were employed to analyse associations. Results: For individual metrics, three objective measures—availability of destinations, population density, and street integration—were positively associated with place attachment. Several perceived measures, including access to shops, daily life facilities, public green spaces, public transports, the presence of paths, crime safety, and aesthetics, also showed positive associations with place attachment. For composite indices, traditional walkability, space syntax walkability, and perceived walkability were positively correlated with place attachment. Conclusions: These findings demonstrate the associations between walkable built environment metrics and place attachment, showing variations in metric types.

BackgroundDuring the COVID-19 pandemic, much misinformation and disinformation emerged and spread rapidly via the internet, posing a severe public health challenge. While the need for eHealth literacy (eHL) has been emphasized, few studies have compared the difficulties involved in seeking and using COVID-19 information between adult internet users with low or high eHL. ObjectiveThis study examines the association between eHL and web-based health information–seeking behaviors among adult Japanese internet users. Moreover, this study qualitatively shed light on the difficulties encountered in seeking and using this information and examined its relationship with eHL. MethodsThis cross-sectional internet-based survey (October 2021) collected data from 6000 adult internet users who were equally divided into sample groups by gender, age, and income. We used the Japanese version of the eHL Scale (eHEALS). We also used a Digital Health Literacy Instrument (DHLI) adapted to the COVID-19 pandemic to assess eHL after we translated it to Japanese. Web-based health information–seeking behaviors were assessed by using a 10-item list of web sources and evaluating 10 topics participants searched for regarding COVID-19. Sociodemographic and other factors (eg, health-related behavior) were selected as covariates. Furthermore, we qualitatively explored the difficulties in information seeking and using. The descriptive contents of the responses regarding difficulties in seeking and using COVID-19 information were analyzed using an inductive qualitative content analysis approach. ResultsParticipants with high eHEALS and DHLI scores on information searching, adding self-generated information, evaluating reliability, determining relevance, and operational skills were more likely to use all web sources of information about COVID-19 than those with low scores. However, there were negative associations between navigation skills and privacy protection scores when using several information sources, such as YouTube (Google LLC), to search for COVID-19 information. While half of the participants reported no difficulty seeking and using COVID-19 information, participants who reported any difficulties, including information discernment, incomprehensible information, information overload, and disinformation, had lower DHLI score. Participants expressed significant concerns regarding “information quality and credibility,” “abundance and shortage of relevant information,” “public trust and skepticism,” and “credibility of COVID-19–related information.” Additionally, they disclosed more specific concerns, including “privacy and security concerns,” “information retrieval challenges,” “anxieties and panic,” and “movement restriction.” ConclusionsAlthough Japanese internet users with higher eHEALS and total DHLI scores were more actively using various web sources for COVID-19 information, those with high navigation skills and privacy protection used web-based information about COVID-19 cautiously compared with those with lower proficiency. The study also highlighted an increased need for information discernment when using social networking sites in the “Health 2.0” era. The identified categories and themes from the qualitative content analysis, such as “information quality and credibility,” suggest a framework for addressing the myriad challenges anticipated in future infodemics.

Aging is the greatest risk factor for numerous diseases and mortality, and establishing geroprotective interventions targeting aging is required. Previous studies have suggested that healthy dietary patterns, such as the Mediterranean diet, are associated with delayed biological aging; however, these associations depend on nationality and sex. Therefore, this study aimed to investigate the relationship between dietary patterns identified through principal component analysis and biological aging in older men of Japan, one of the countries with the longest life expectancies. Principal component analysis identified two dietary patterns: a healthy Japanese dietary pattern and a Western-style dietary pattern. Eight epigenetic clocks, some of the most accurate aging biomarkers, were identified using DNA methylation data from whole-blood samples. Correlation analyses revealed that healthy Japanese dietary patterns were significantly negatively or positively correlated with multiple epigenetic age accelerations (AgeAccel), including AgeAccelGrim, FitAgeAccel, and age-adjusted DNAm-based telomere length (DNAmTLAdjAge). Conversely, the Western-style dietary pattern was observed not to correlate significantly with any of the examined AgeAccels or age-adjusted values. After adjusting for covariates, the healthy Japanese dietary pattern remained significantly positively correlated with DNAmTLAdjAge. Regression analysis showed that healthy Japanese dietary pattern contributed less to epigenetic age acceleration than smoking status. These findings suggest that a Western-style dietary pattern may not be associated with biological aging, whereas a healthy Japanese dietary pattern is associated with delayed biological aging in older Japanese men. Our findings provide evidence that healthy dietary patterns may have mild beneficial effects on delayed biological aging in older Japanese men.

Sports science focuses on enhancing athletes’ performance, requiring a multifaceted approach. It is evolving from a purely muscle-centred approach to an interdisciplinary one. This paper investigates built environment design science, a dimension less explored in relation to enhancing athlete performance in sports science. The discussion is divided into three categories: athlete-centric training built environment design, enhanced fan and community engagement, and improved integrative accessibility. The study also identifies future research directions, including evidence of the relative impact of the built environment, financial aspects, and performance evaluation methods. Collaboration between sports scientists and scholars in urban design, parks, transportation, landscape architecture and environmental psychology is necessary to advance this topic further.

Abstract The design and quality of the neighbourhood built environment can encourage health-supportive behaviours and support cardiometabolic health. However, despite the relationships between demographic and behavioural risk factors of metabolic syndrome being investigated by many studies, only some studies have directly estimated the associations between the built environment and metabolic syndrome. Using data from Canada, we examined the associations between the neighbourhood built environment and metabolic syndrome. Data from Alberta’s Tomorrow Project participants, conducted in Alberta, Canada, was used (n = 6718). Metabolic syndrome was defined as the presence of at least three clinical risk factors among lipid levels, blood pressure, and waist circumference. The normalised difference vegetation index was used to quantify the greenness of each participant’s neighbourhood. Built attributes of participants’ neighbourhoods associated with supporting physical activity, including dwelling density, intersection density, and the number of points of interest, were obtained via the Canadian Urban Environmental Health Research Consortium. Increases in the number of points of interest and total active living environment-friendliness of the neighbourhood were associated with having fewer metabolic syndrome risk factors (b = −0.11, 95% CI −0.16, −0.07 and b = −0.03, 95% CI −0.05, −0.01, respectively) and lower odds of metabolic syndrome (OR = 0.89, 95% CI 0.84, 0.094 and OR = 0.97, 95% CI 0.95, 0.99, respectively). Furthermore, higher dwelling density was associated with having fewer metabolic syndrome risk factors (b = −0.05, 95% CI −0.09, −0.01). Our findings highlight the importance of urban design to prevent and potentially manage metabolic syndrome and improve population health.

Abstract Increased sedentary behaviour (SB) is reportedly associated with mortality and morbidity in cardiovascular disease. However, its relation with physical function is not well understood in phase I cardiac rehabilitation (CR). This study aimed to investigate the rate of SB and the relation between SB and physical function among patients participating in phase I CR. This prospective multicentre cohort study enrolled patients participating in CR from October 2020 to July 2022. Patients with probable dementia and difficulty walking alone were excluded. We used sitting SB time as the index of SB and the Short Performance Physical Battery (SPPB) as the index of physical function at discharge. Patients were divided into the low SB group (

Abstract Background The association of breaks in sedentary time with outcomes of physical function can vary according to the time of day. We examined the association of the diurnal pattern of breaks in sedentary time with physical function outcomes in older adults. Methods A cross-sectional analysis was conducted among 115 older adults (≥60 years). The overall and time-specific breaks (morning: 06:00–12:00; afternoon: 12:00–18:00; evening: 18:00–24:00) in sedentary time were assessed using a triaxial accelerometer (Actigraph GT3X+). A break in sedentary time was defined as at least 1 min where the accelerometer registered ≥100 cpm following a sedentary period. Five physical function outcomes were assessed: handgrip strength (dynamometer), balance ability (single leg stance), gait speed (11-m walking), basic functional mobility (time up and go), and lower-limb strength (five times sit-to-stand). Generalized linear models were used to examine the associations of the overall and time-specific breaks in sedentary time with the physical function outcomes. Results Participants showed an average of 69.4 breaks in sedentary time during the day. Less frequent breaks in the evening (19.3) were found than that in the morning (24.3) and the afternoon (25.3) (p

Abstract High-quality sleep is an important factor in sustaining health and improving well-being. Previous evidence has demonstrated the positive associations between increased physical activity and reduced sedentary behaviour (SB) with sleep quality. The substitutional relationships between SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) need to be considered when examining how a particular behaviour may impact sleep quality. No studies, to our knowledge, have explored these substitutional relationships in middle-aged adulthood. Using an isotemporal substitution approach, this study examined the associations of replacing sedentary time with physical activity on sleep quality measures in a sample of middle-aged adults in Japan. Data from 683 adults aged 40–64 living in Japan were used. The average daily time spent in SB, LPA, and MVPA was objectively assessed by accelerometers. Two self-reported sleep quality measures were obtained using questionnaires, including rest by sleep and sleep quality. Multivariable linear regression models were used to assess the associations of SB, LPA, and MVPA with the sleep quality measures stratified by gender. We found that each 60 min unit of SB or LPA replaced with MVPA was favourably associated with rest by sleep among women (β = 0.16, 95% CI 0.07, 0.28, p

Abstract Understanding the correlates of sedentary behavior among children is essential in developing effective interventions to reduce sitting time in this vulnerable population. This study aimed to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time among a sample of children in Japan. Data from 343 children (aged 6–12 years) living in Japan were used. Domain-specific sedentary behaviors were assessed using a questionnaire. Total sedentary time was estimated using hip-worn accelerometers. Twenty-two potential correlates across five categories (parental characteristics, household indoor environment, residential neighborhood environment, school environment, and school neighborhood environment) were included. Multivariable linear regression models were used to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time. Eight correlates were significantly associated with children’s domain-specific sedentary behaviors: mother’s and father’s age, mother’s educational level, having a video/DVD recorder/player, having a video console, having a TV one’s own room, home’s Walk Score®, and pedestrian/cycling safety. No significant associations were found between potential correlates and accelerometer-based total sedentary time. These findings highlight that strategies to reduce children’s sedentary time should consider the context of these behaviors. For example, urban design attributes such as perceived pedestrian and cycling safety can be improved to reduce children’s car sitting time.

Abstract Background Understanding factors contributing to an individual reducing screen time is essential for promoting a healthy weight. Parents’ behavior affects children by influencing their daily decision-making through modeling, rules or restrictions, social support, and co-participation. We examined how the direct and indirect effects of parents’ and children’s behaviors regarding screen time influenced body mass index (BMI) among Japanese elementary school children. Methods We included 283 Japanese children, one child per household, aged 6–12 years, who were randomly selected from resident registries of two cities. The questionnaires were completed by children and their mothers and fathers. Screen time and sociodemographic attributes, including sex, age, employment status, height, and weight, were assessed using a mail-based survey. Path analyses were conducted to determine associations among children’s, fathers’, and mothers’ variables. It was hypothesized that after controlling for household income and children’s sex and age, mothers’ and fathers’ screen time on weekdays and weekends would be related to children’s weekdays and weekend screen time, respectively. In addition, we hypothesized that children’s weekday and weekend screen time was related to children’s BMI. Results Both fathers’ and mothers’ weekday screen times were associated with children’s weekday and weekend screen times. BMI was affected by children’s weekday screen time (0.117). The path coefficients for the indirect effects of mothers’ and fathers’ screen time on children’s BMI through children’s weekday screen time were 0.016 from the fathers’ weekday screen time and 0.024 from the mothers’ weekday screen time (GFI = .980, AGFI = .953, RMSEA = .030, AIC = 93.030). Conclusions Both fathers’ and mothers’ weekday screen times indirectly affected children’s BMI through children’s weekday screen time among Japanese elementary school children. The strongest indirect effects could be seen by examining the paths of a mother’s weekday screen time through children’s screen time to BMI. Mothers who spend much time with their children are role models, and their behavior could affect the child’s behavior. The findings imply that intervention strategies to reduce screen time in children should also focus on modeling the mothers’ behavior.

Although cardiorespiratory fitness (CRF) and muscle mass (MM) are inversely associated with the risk of diabetes mellitus (DM), the effect of the combination of CRF and MM is unclear. We examined the combined association of CRF and MM with DM prevalence. This cross-sectional study included 1,271 middle-aged and older adults. CRF was measured at peak oxygen uptake (VO2peak) using a cycle ergometer. Appendicular skeletal MM (ASM)/height2 was assessed using bioelectrical impedance analysis. Participants were divided into two groups through the median of CRF or MM by age group and gender, respectively. DM was determined using a self-reported questionnaire and fasting blood tests. The multivariable-adjusted odds ratios (ORs) for DM prevalence were estimated using a logistic regression model. In total, 61 participants had DM. A weak positive correlation between VO2peak and ASM/height2 was observed (r = 0.24). Compared to lower CRF or MM group, the OR (95% confidence interval) was 0.52 (0.28–0.96) or 0.47 (0.23–0.97) for the higher CRF or MM group, respectively. After further adjustment of ASM/height2 for the CRF category or VO2peak for the MM category, the association of CRF or MM was found to be slightly attenuated. Compared to lower CRF with lower MM group, ORs were 0.45 (0.19–1.08) for lower CRF with higher MM group, 0.49 (0.22–1.10) for higher CRF with lower MM group, and 0.29 (0.12–0.73) for higher CRF with higher MM group. In conclusion, both higher CRF and MM were associated with lower DM prevalence compared to both lower CRF and MM.

Abstract Background Although the negative relationship between cardiorespiratory fitness (CRF) or muscular fitness and diabetes mellitus were respectively observed in many previous studies, there is still a lack of studies that include CRF and muscular fitness simultaneously. Therefore, this study aimed to investigate the relationship between the combination of CRF and muscular fitness and diabetes through a cross-sectional study. Methods This study was part of WASEDA'S Health Study, a cohort study launched in 2014. We used a part of the baseline data collected for this study. Maximal exercise test using a cycle ergometer and leg extension power (LEP) test were respectively used to evaluate CRF and muscular fitness. Since LEP is affected by body weight, relative LEP (rLEP) which is LEP per body weight, was used as an index of muscular fitness. 796 men (56.5 ± 10.4 years old) who completed a medical examination and fitness tests, were divided into two groups based on CRF and rLEP, respectively. The prevalence of diabetes was collected based on a self-reported questionnaire or blood test. Odds ratios and 95% confidence intervals (CIs) for the prevalence of diabetes were obtained using logistic regression models while adjusting for age, body mass index, exercise habits, family history of diabetes, smoking habits, and drinking habits. Results 55 (7%) participants had diabetes. Compared to participants with lower CRF or rLEP, the odds ratio (95% CIs) of diabetes in those with higher CRF or rLEP was 0.46 (0.21–0.98) or 0.34 (0.16–0.74), respectively. Furthermore, using the lower CRF and lower rLEP group as the reference, the odds ratio (95% CIs) for the lower CRF and higher rLEP group was 0.32 (0.12–0.88), and higher CRF and higher rLEP group was 0.21 (0.07–0.63), after adjusting for potential confounding factors. Conclusions CRF and rLEP have independent and joint inverse associations with diabetes prevalence. In addition, participants with high CRF and high rLEP had a lower prevalence of diabetes compared to those with only high CRF or only high rLEP.

IntroductionA prior study showed an association between diversity in daily activities (type, frequency, evenness) and frailty in older adults. However, the causality of this relationship is unclear. Therefore, this study aimed to clarify the relationship between activity diversity and frailty through a 2-year longitudinal study conducted among community-dwelling older adults.MethodsWe evaluated data from the 2018 and 2020 waves of the Otassha Study. Frailty was assessed using the Cardiovascular Health Study criteria, with pre-frail and frail participants defined as frail and the other participants categorized into the robust group. We enrolled a total of 207 participants who were not frail at baseline. Activity type, frequency, and evenness scores were calculated using an Activity Diversity Questionnaire. The association between each activity diversity score and the incidence of frailty was evaluated using logistic regression modeling (each diversity score was entered the model after Z-transformation).ResultsOf the 207 enrolled participants (median age, 73 years; age range, 65–91 years; 60.4% women), 64 (30.9%) had incident frailty during the follow-up period. A logistic regression analysis adjusting for sociodemographic and psychosomatic factors revealed odds ratios for activity type and evenness scores of 0.64 and 0.61, respectively (P < 0.05). These factors were significantly associated with the incidence of frailty.DiscussionActivity type and evenness (except frequency) within daily activities were predictors of frailty during 2 years of follow-up. Engagement in diverse activities appears to be more effective in preventing frailty than does engagement in a few activities.

There has been a growing interest in the “metaverse,” and discourse about how this platform may contribute to different fields of science is already beginning to emerge. In this paper, we discuss key opportunities and uncertainties about how a metaverse might contribute to advancing knowledge in the interdisciplinary field of the built environment and public health aimed at reducing noncommunicable diseases.

Abstract Workplace settings—both internal and external—can influence how workers are physically active or sedentary. Although research has identified some indoor environmental attributes associated with sitting at work, few studies have examined associations of workplace neighbourhood built-environment attributes with workplace sitting time. We examined the cross-sectional associations of perceived and objective workplace neighbourhood built-environment attributes with sitting time at work and for transport among desk-based workers in Japan. Data were collected from a nationwide online survey. The Abbreviated Neighborhood Environment Walkability Scale (n = 2137) and Walk Score® (for a subsample of participants; n = 1163) were used to assess perceived and objective built-environment attributes of workplace neighbourhoods. Self-reported daily average sitting time at work, in cars and in public transport was measured using a Japanese validated questionnaire. Linear regression models estimated the associations of workplace neighbourhood built-environment attributes with sitting time. All perceived workplace neighbourhood built-environment attributes were positively correlated with Walk Score®. However, statistically significant associations with Walk Score® were found for sitting for transport but not for sitting at work. Workers who perceived their workplace neighbourhoods to be more walkable reported a longer time sitting at work and in public transport but a shorter sitting time in cars. Our findings suggest that walkable workplace neighbourhoods may discourage longer car use but have workplaces where workers spend a long time sitting at work. The latter finding further suggests that there may be missed opportunities for desk-based workers to reduce sitting time. Future workplace interventions to reduce sitting time may be developed, taking advantage of the opportunities to take time away from work in workplace neighbourhoods.

IntroductionCross-sectional studies consistently find that the neighborhood built environment (e.g., walkability) is associated with walking. However, findings from the few existing longitudinal residential relocation studies that have estimated associations between changes in neighborhood built characteristics and walking are equivocal. The study objective was to estimate whether changes in neighborhood walkability resulting from residential relocation were associated with leisure, transportation, and total walking levels among adults.MethodsThis study included longitudinal data from the “Alberta's Tomorrow Project”—a province-wide cohort study (Alberta, Canada). The analysis included data collected at two time points (i.e., baseline and follow-up) from 5,977 urban adults. The International Physical Activity Questionnaire (IPAQ) captured self-reported walking. We estimated neighborhood walkability, an index capturing intersection, destination, and population counts for the 400 m Euclidean buffer around participants' homes. Using household postal codes reported at baseline and follow-up, we categorized participants into three groups reflecting residential relocation (“non-movers:” n = 5,679; “movers to less walkability:” n = 164, and; “movers to more walkability:” n = 134). We used Inverse-Probability-Weighted Regression Adjustment to estimate differences [i.e., average treatment effects in the treated (ATET)] in weekly minutes of leisure, transportation, and total walking at follow-up between residential relocation groups, adjusting for baseline walking, sociodemographic characteristics, and walkability. The median time between baseline and follow-up was 2-years.ResultsThe three residential relocation groups mainly included women (61.6–67.2%) and had a mean age of between 52.2 and 55.7 years. Compared to “non-movers” (reference group), weekly minutes of transportation walking at follow-up was significantly lower among adults who moved to less walkable neighborhoods (ATET: −41.34, 95 CI: −68.30, −14.39; p < 0.01). We found no other statistically significant differences in walking between the groups.DiscussionOur findings suggest that relocating to less walkable neighborhoods could have detrimental effects on transportation walking to the extent of adversely affecting health. Public health strategies that counteract the negative impacts of low walkable neighborhoods and leverage the supportiveness of high walkable neighborhoods might promote more walking.

This study aimed to evaluate the inter-rater reliability of streetscape audits among online observations using the Microscale Audit of Pedestrian Streetscapes-Global version (MAPS-Global) in Japan.MAPS-Global observations were conducted on routes with distances ranging from 400 to 725 m from a residence toward a non-residential destination. Google Street View audits were independently conducted by two trained raters on each route. A tiered scoring system was applied to summarize the items at multiple levels of aggregation. Positive and negative valence scores were created based on the expected association with physical activity. Inter-rater reliability analyses were performed using kappa statistics or intraclass correlation coefficients (ICC).Of the 32 older adults participating in an intervention study in the community-wide physical activity promotion project in Fujisawa City, 19 addresses were used, excluding those with nearby addresses. Results demonstrated “excellent” agreement for most of the summary scores analyzed (kappa or ICC values of 0.75 or higher [80.4 %]), while 6.5 % of items exhibited “good” agreement (ICC = 0.60–0.74). By contrast, only 13.0 % of the scales had ICC values lower than 0.60 (“fair” or “poor” reliability). The results illustrated high reliability for the grand summary scores and composite subscale measures. However, caution should be exercised when interpreting subscale scores for less frequently observed negative attributes and aesthetic/social characteristics. The results presented in this study support the application of online observations using MAPS-Global in urban areas of Japan, which could be implemented to inform decisions related not only to physical activity but also to traffic safety.

BackgroundLittle is known about what timing and intensity of physical activity (PA) are beneficial to preventing children’s late sleeping habits. We investigated the association between timing and intensity of PA and late sleeping habits among Japanese children.MethodsThe amount of PA on a weekday (light (>1.5 to

BackgroundCommunity sports leaders (CSLs) are expected to play an important role in promoting regional sports in Japan. Increased opportunities for CSLs to work in schools and engage with guardians could encourage middle-aged adults to participate in regional sports activities. However, few CSLs work with guardians, and there is no evidence regarding what CSL characteristics encourage collaboration. The present study aimed to ascertain the aspects of coordination for CSLs collaborating with guardians in urban areas.MethodsA self-administered questionnaire survey was mailed to all 1,489 CSLs through 59 municipalities using the CSL out of 62 in Tokyo, Japan, from July to November 2021. The questionnaire covered sociodemographic data, variables related to CSL activities, coordination functions, and experience collaborating with guardians. We conducted a binomial logistic regression analysis using experience collaborating with guardians as the dependent variable, coordination function as the explanatory variable, and gender, age, residence duration, years of CSL experience, and the number of activities as covariates.ResultsThe analyzed sample comprised 478 CSLs. Binomial logistic regression analysis revealed a significant relationship between experience collaborating with guardians and the coordination function of internal/external CSL organizations, such as participation in non-CSL community activities, experience teaching and supporting their own children's sports, activity initiatives, number of times they used the school gymnasium, awareness of the regional sports plan, and cooperation with the chairman of the neighborhood association.ConclusionsCollaboration with guardians was related to CSL's individual experience engaging in regional sports from parenting and community collaboration, such as participation in non-CSL community activities and their relationship with the chairman of the neighborhood association. CSL activities may have the potential to encourage middle-aged adults to participate in regional sports.

Background: Daily step count is the simplest measure of physical activity. However, little is known about how daily step count related to time spent in different intensities of physical activity (PA) and sedentary behavior (SB). Methods: These cross-sectional data were derived from 450 older Japanese adults (56.7% men; mean age, 74.3 years) who were randomly selected from three communities and responded a survey. Daily step count and time spent in moderate-to-vigorous PA (MVPA), light-intensity PA (LPA), and SB were measured using a validated wearable technology (HJA-350IT). Associations of daily step count with time spent in measured behaviors were examined using linear regression models with isometric log-ratio transformations of time-use composition, adjusting for gender, age, and residential area. Results: Participants averaged 5,412 (standard deviation, 2,878) steps/d and accumulated MVPA, LPA, and SB corresponding to 4.0%, 34.8%, and 61.2% of daily waking time, respectively. Daily step count significantly increased with increase in time spent in MVPA relative to other behaviors (ie, LPA and SB) and in the ratio of LPA to SB after allowing for MVPA. After stratification, daily step count was significantly related to the ratio of LPA to SB in those taking

Abstract Evidence for social pathways to health benefits for dog owners appears positive but less well-developed. Our study aimed to estimate the differences in social capital by dog ownership and dog walking status among young-to-middle-aged adults and older adults in Japan. Data from 3606 residents living in Japan were used. Data on social capital, dog ownership, and dog walking were collected by questionnaires. Age-stratified multivariable linear regression models were used to estimate differences in social capital scores by dog ownership and dog walking status. Among young-to-middle-aged adults, the mean of the activities with neighbours score, adjusted for covariates, was significantly higher (p

Abstract Few longitudinal residential relocation studies have explored associations between urban form and physical activity, and none has used the Space Syntax theory. Using a Canadian longitudinal dataset (n = 5944), we estimated: (1) differences in physical activity between non-movers, and those relocating to neighbourhoods with less or more integrated street layouts, and; (2) associations between changes in street layout integration exposure and differences in physical activity. Adjusting for covariates, we found relative to non-movers, those who moved to more integrated neighbourhoods undertook significantly (p

Background: Few studies have examined the associations between urban design attributes and older adults’ physical function. Especially, it is not well known how built-environment attributes may influence physical function in Asian cities. The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults. Methods: Cross-sectional data collected in 2013 from 314 older residents (aged 65–84 years) living in Japan were used. Physical function was estimated from objectively measured upper- and lower-body function, mobility, and balance by a trained research team member. A comprehensive list of built-environment attributes, including population density, availability of destinations, intersection density, and distance to the nearest public transport station, were objectively calculated. Walk Score as a composite measure of neighborhood walkability was also obtained. Results: Among men, higher population density, availability of destinations, and intersection density were significantly associated with better physical function performance (1-legged stance with eyes open). Higher Walk Score was also marginally associated with better physical function performance (1-legged stance with eyes open). None of the environmental attributes were associated with physical function in elderly women. Conclusion: Our findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia. Walking-friendly neighborhoods can not only promote older adults’ active behaviors but can also support their physical function.

Lack of sufficient physical activity in youth is a worldwide concern. School-based extracurricular sports activities (SBECSA) are considered a central opportunity to increase youth physical activity. However, the factors that influence students’ participation in SBECSA are not well established. Therefore, the purpose of the present study was to clarify the factors perceived to influence the motivation of Japanese students to participate in SBECSA. Semi-structured interviews were conducted with 23 junior high and high school students who participated in SBECSA. The KJ method was used to qualitatively analyse the transcribed interview data. Internal/intrapersonal factors included: attraction of sports; sense of responsibility and continuity; spirit of challenge; sense of advancement and physical condition. External factors included: team climate; encouragement and support; attributes of peers; policy and content of coaching; content of practice; events in school life and weather.

Abstract Background Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies. Methods Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019. Results A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving). Conclusions The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships. Protocol registration The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341 ).

Abstract Background Physical inactivity and sedentary behaviour (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavioural change (e.g. replacing sedentary behaviour with physical activity) on renal function are not well understood. We used isotemporal substitution to model potential impacts of behaviours on renal function by replacing time spent in one behaviour to another. Methods In 174 older Japanese adults (age, 50–83 years; females, 76%), the time spent in sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using an uniaxial accelerometer. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels. Results In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behaviour (r s = − 0.229), LPA (r s = 0.265), and MVPA (r s = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behaviour with an equivalent LPA time was not significantly associated with eGFR (β = 2.26, p = 0.112); however, replacement with an equivalent time of MVPA was beneficially associated with eGFR (β = 5.49, p

There has been growing interest in the role of pet ownership, particularly dog ownership, in managing noncommunicable diseases. The built environment can act as a facilitator or barrier to owning a dog or dog walking. Nevertheless, limited studies conducted in different geographical contexts have examined how the built environment can influence dog ownership and dog walking. In this interdisciplinary article, using Japan as a case study, we identify key design challenges to owning and walking dogs in dense urban areas as a means of promoting health and wellbeing.

Although many studies have reported that a posteriori dietary pattern is associated with metabolic health, there is little evidence of an association between dietary patterns and different metabolic phenotypes. The present study aimed to examine the association between major dietary patterns and different metabolic phenotypes (metabolically healthy non-obese [MHNO], metabolically unhealthy non-obese [MUNO], metabolically healthy obese [MHO], and metabolically unhealthy obese [MUO]) in middle-aged and elderly Japanese adults. This cross-sectional study enrolled 2,170 Japanese adults aged ≥40 years. The four different metabolic phenotypes were determined based on the presence of obesity, abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. The major dietary patterns were determined using principal component analysis based on energy-adjusted food intake. Two dietary patterns were identified: the healthy dietary pattern, which was characterized by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweeds, and fish; and the alcohol dietary pattern, which was characterized by a high intake of alcoholic beverages, liver, chicken, and fish. The healthy dietary pattern was associated with the MHNO and MHO phenotypes (MUNO and MUO as reference groups, respectively), and the multivariate-adjusted odds ratios (ORs) (95% confidence intervals [CIs]) in the highest quartile of healthy dietary pattern score with the lowest quartile as the reference category were 2.10 (1.40–3.15) and 1.86 (1.06–3.25), respectively. Conversely, the alcohol dietary pattern was inversely associated with the MHNO and MHO phenotypes, while the multivariate-adjusted ORs (95% CIs) in the highest quartile of the alcohol dietary pattern score with the lowest quartile as the reference category were 0.63 (0.42–0.94) and 0.45 (0.26–0.76), respectively. There were no significant interactions between sex and healthy/alcohol dietary patterns in the prevalence of the MHNO and MHO phenotypes. In conclusion, the present study's findings suggest that major dietary patterns are associated with different metabolic phenotypes in middle-aged and elderly Japanese adults. These findings provide useful evidence for maintaining metabolic health through diet regardless of obesity status.

Evidence suggests that neighbourhood street connectivity is positively associated with physical activity, yet few studies have estimated its associations with sedentary behaviour. We estimated the associations between space syntax derived street integration, a novel measure of street connectivity, and sedentary behaviours among Canadian adults. Data were sourced from a population-based study-Alberta's Tomorrow Project (n = 14,758). Items from the International Physical Activity Questionnaire captured sedentary behaviour, including sitting and motor vehicle travel time and walking. Street integration was measured within a 1600m radius of participants' homes. Covariate-adjusted linear regression models estimated the associations between street integration and sedentary behaviour. Street integration was significantly positively associated with daily minutes of sitting on week (b 6.44; 95CI 3.60, 9.29) and weekend (b 4.39; 95CI 1.81, 6.96) days, and for week and weekend days combined (b 5.86; 95CI 3.30, 8.41) and negatively associated with daily minutes of motor vehicle travel (b -3.72; 95CI -3.86, -1.55). These associations remained significant after further adjustment for daily walking participation and duration. More research is needed to understand the pathways by which street integration positively and or negatively affects sedentary behaviour.

Background and aims: Physical activity (PA) levels are related to mortality and morbidity in patients with chronic heart failure (CHF). Health utility (HU), a very important cost-effectiveness analysis for health care and health status, is measured by several preference-based utility measures. This study aimed to evaluate the relation between PA and HU and the effect of disease severity on PA and HU in patients with CHF. Methods: We enrolled 226 consecutive outpatients with CHF (mean age, 57.5 years; males, 79.6%) in this retrospective cross-sectional study. Patients were divided into three groups by NYHA class for classification of disease severity. Patient characteristics, average step count in steps/day, PA energy expenditure (PAEE) in kcal/day for 7 days as assessed by accelerometer, and HU assessed by Short Form-6D were compared between the groups. Results: Average step count (r = 0.37, P

Sedentary behaviour is associated with risks of detrimental health outcomes. It is crucial to understand how much time people spend in sedentary behaviour and what factors affect too much sedentary time for effective intervention. However, few studies examined the prevalence and the correlates of sedentary behaviour in Japan. Therefore, we assessed total sedentary time and its sociodemographic correlates using a nationally representative sample of adults in Japan. Cross-sectional data from Sports-Life Survey in 2016 and 2018 conducted by Sasagawa Sports Foundation was used. Participants’ sociodemographic factors and total sedentary time were collected by questionnaires. We classified those with

Walk Score® is a free web-based tool that provides a walkability score for any given location. A limited number of North American studies have found associations between Walk Score® and perceived built environment attributes, yet it remains unknown whether similar associations exist in Asian countries. The study’s objective is to examine the covariate-adjusted correlations between the Walk Score® metric and measures of the perceived built environment in ultrahigh density areas of Japan. Cross-sectional data were obtained from a randomly selected sample of adult residents living in two Japanese urban localities. There was a large correlation between Walk Score® and access to shops (0.58; p

Abstract Background Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers. Methods Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors. Results A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, “typically seeing work colleagues take sedentary breaks” was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = −7.08 [−13.75 to −0.40]). “I am motivated to take sedentary breaks” had an unfavorable association with less sedentary breaks (B [95% CI] = −1.36 [−2.61 to −0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, “Too stressed to take sedentary breaks” was significantly associated with less sedentary breaks (B [95% CI] = −5.6 [−9.17 to −2.02]). Conclusions Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.

Background: Cross-sectional studies provide useful insight about the associations between the built environment and physical activity (PA), particularly when reasons for neighborhood choice are considered. Our study analyzed the relationship between levels of weekly transportation and leisure PA among 3 neighborhood designs, statistically adjusting for sociodemographic characteristics and reasons for neighborhood choice. Methods: A stratified random sample of adults (age ≥20 years) living in Calgary (Canada) neighborhoods with different neighborhood designs (grid, warped-grid, and curvilinear) and socioeconomic status completed a self-administered questionnaire capturing PA, sociodemographic characteristics, and reasons for neighborhood choice (response rate = 10.1%; n = 1023). Generalized linear models estimated associations between neighborhood design and transportation and leisure PA outcomes (participation (any vs. none) and volume (metabolic equivalent: h/week)), adjusting for neighborhood socioeconomic status, sociodemographic characteristics (gender, age, ethnicity, education, household income, marital status, children, vehicle access, dog ownership, and injury), and reasons for neighborhood choice (e.g., proximity and quality of recreational and utilitarian destinations, proximity to work, highway access, aesthetics, and sense of community). Results: Overall, 854 participants had resided in their neighborhood for at least 12 months and provided complete data. Compared with those living in curvilinear neighborhoods, grid neighborhood participants had greater odds (p < 0.05) of participating in any transportation walking (odds ratio (OR) = 2.17), transportation and leisure cycling (OR = 2.39 and OR = 1.70), active transportation (OR = 2.16), and high-intensity leisure PA (≥6 metabolic equivalent; OR = 1.74), respectively. There were no neighborhood differences in the volume of any transportation or leisure PA undertaken. Adjustment for neighborhood selection had minimal impact on the statistical or practical importance of model estimates. Conclusion: Neighborhood design is associated with PA patterns in adults, independent of reasons for neighborhood choice and sociodemographic factors. Keywords: Active transportation, Built environment, Self-selection, Urban design, Walkability

Background: Prolonged periods of sitting time can be adversely associated with older adults’ well-being and functional capacities. Understanding patterns and contexts of sedentary behaviors (SB) can inform approaches to prevention. This study examined Japanese older adults’ objectively-assessed patterns and reported domains of SB and their interrelationships. Methods: Participants (n = 297; aged 65–84 years) of this cross-sectional study wore an accelerometer for 7 days and completed a survey. Five measures related to SB patterns were identified from the accelerometer data. SB from six domains, socio-demographics, and chronic conditions were identified from the survey data. Relative contributions of six domains to objectively-measured prolonged sedentary time (≥30 minutes) and the number of breaks were examined in a series of multivariate linear regressions. Covariates were socio-demographics, chronic conditions, and accelerometer wear time. Results: On average, participants spent 8.8 hours a day sedentary (58% of accelerometer wear time), with 7.6 breaks per sedentary hour, and 3.7 hours a day through prolonged sedentary bouts (4.4 time/day). The proportions of time in the SB domains were 9.4% for car, 4.0% for public transport, 6.1% for work, 45.5% for television (TV) viewing, 9.8% for computer use, and 25.1% for other leisure. Domains of SB that contributed significantly to longer sedentary time through prolonged bouts were TV viewing and computer use. TV viewing was also associated with a lesser number of breaks. Conclusions: For Japanese older adults, initiatives to address SB could focus on breaking-up prolonged periods of SB by encouraging more frequent breaks, especially during TV viewing.

The purpose of this study was to identify typologies of diurnal sedentary behavior patterns and sociodemographic characteristics of desk-based workers. The sedentary time of 229 desk-based workers was measured using accelerometer devices. The within individual diurnal variations in sedentary time was calculated for both workdays and non-workdays. Diurnal variations in sedentary time during each time period (morning, afternoon, and evening) was calculated as the percentage of sedentary time during each time period divided by the percentage of the total sedentary time. A hierarchical cluster analysis (Ward's method) was used to identify the optimal number of clusters. To refine the initial clusters, a non-hierarchical cluster analysis (k-means method) was performed. Four clusters were identified: stable sedentary cluster (46.7%), off-morning break cluster (26.6%), off-afternoon break cluster (8.3%), and evening sedentary cluster (18.3%). The stable sedentary cluster had the lowest variations in sedentary time throughout the day and the highest amount of total sedentary time. Participants in the off-morning and off-afternoon break clusters had nearly the same sedentary patterns but took short-term breaks during non-workday mornings or afternoons. The evening sedentary cluster had a completely different pattern, with a longer sedentary time during the evening both on workdays and non-workdays. Sociodemographic attributes such as sex, household income, educational attainment, employment status, sleep duration, and residential area, differed significantly between groups. Initiatives to address desk-based workers' sedentary behavior need to focus not only on the workplace but also on the appropriate timing for reducing excessive sedentary time in non-work contexts depending on the characteristics and diurnal patterns of target subgroups.

Background There are spatial disparities in cardiovascular disease (CVD) mortality related to area‐level socioeconomic status (SES) disadvantage, but little is known about the spatial distribution of CVD mortality according to built environment factors. We examined joint associations of neighborhood walkability attributes and SES with CVD mortality rates through linkage of Japanese national data sets. Methods and Results National data were used from the 1824 municipalities (of the 1880 potentially eligible municipalities) across Japan. The outcome was mortality from CVD for a 5‐year period (2008–2012) for each municipality. A national index of neighborhood deprivation was used as an indicator of municipality‐level SES. A national walkability index (based on population density, road density, and access to commercial areas) was calculated. Compared with higher SES municipalities, relative rates for CVD mortality were significantly higher in medium SES municipalities (relative rate, 1.05; 95% CI, 1.02–1.07) and in lower SES municipalities (relative rate, 1.09; 95% CI, 1.07–1.12). There were walkability‐related gradients in CVD mortality within the high and medium SES areas, in which lower walkability was associated with higher rates of mortality; however, walkability‐related CVD mortality gradients were not apparent in lower SES municipalities. Conclusions CVD mortality rates varied not only by area‐level SES but also by walkability. Those living in areas of lower walkability were at higher risk of CVD mortality, even if the areas have a higher SES. Our findings provide a novel element of the evidence base needed to inform better allocation of services and resources for CVD prevention.

Abstract Background The isotemporal substitution (IS) approach can be used to assess the effect of replacing one activity with the equal duration of another activity on relevant outcomes. This study examined the associations of objectively assessed sedentary behavior (SB) and physical activity (PA) with health-related quality of life (HRQOL) in older Japanese adults, using the IS approach. Methods Participants were 287 older Japanese adults (aged 65–84 years) who wore accelerometers for at least 7 days. We calculated the average daily time spent in SB (≤1.5 METs); light-intensity PA (LPA: > 1.5 to

Although greater sedentary time has been found to be associated with negative health impacts, little is known whether the specific pattern of sedentary behavior (i.e. sedentary bouts, breaks and durations) are associated with physical function among older adults. The present study examined the associations between objectively measured sedentary behavior and physical function among older Japanese adults. A total of 174 male and 107 female community-dwelling older Japanese adults aged 65–84 years (mean age: 74.5 ± 5.2 years) were recruited. Sedentary behavior and physical activity were assessed using a triaxial accelerometer. Physical function was measured through hand grip strength, eye-open one leg standing, 5-m walking, and timed up and go tests. Forced-entry multiple linear regression models adjusted for potential confounders were performed. After adjustment, total daily sedentary time and duration of prolonged sedentary bouts (both ≥ 30 min) were positively associated with time spent on the 5-m walking stage and timed up and go tests in older women; however, no significant associations were observed in older men or the whole sample. This paper highlights the importance of developing sedentary behavior change strategies for interventions aiming to improve mobility in in older women. Further evidence from a prospective study is required to establish directions of causality between sedentary behavior and mobility. Keywords: Accelerometer, Physical fitness, Seniors, Sitting, Mobility

Abstract Background Inconsistent associations of neighbourhood walkability with adults’ body weight have been reported. Most studies examining the relationships of walkability and adiposity are cross-sectional in design. We examined the longitudinal relationships of two walkability indices – conventional walkability and space syntax walkability, and their individual components, with weight change among adults over four years. Methods Data were from the Physical Activity in Localities and Community study in Adelaide, Australia. In 2003–2004, 2650 adults living in 154 Census Collection Districts (CCDs) returned baseline questionnaires; in 2007–2008, the follow-up survey was completed by 1098. Participants reported their weight at baseline and at follow-up. Neighbourhood walkability indices were calculated using geographic information systems and space syntax software. Linear marginal models using generalized estimating equations with robust standard errors were fitted to examine associations of the two walkability indices and their individual components with the weight at follow-up, adjusting for baseline weight, socio-demographic variables, and spatial clustering at the level of CCD. Results The overall mean weight gain over four years was 1.5 kg. The two walkability indices were closely correlated (r = 0.76, p

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan.Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017).Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density (r = 0.82) and with the number of local destinations (r = 0.77).Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data. Keywords: Urban design, Walking, Tool, Built environment, Active design, Geographic information systems

Background: Good quality measures of Japanese adults’ sedentary behaviors are needed to accurately assess correlates of specific sedentary behaviors. The present study assessed criterion validity of total sedentary behavior and test-retest reliability of six domain-specific sedentary behaviors. Methods: We administered a questionnaire, based on previous studies, that measured domain-specific sedentary behaviors. To examine validity, agreement between self-reported time spent in sedentary behaviors from the questionnaire and objectively-measured sedentary time using accelerometers was compared among 392 adults (aged 40–64 years) in two Japanese cities. For reliability, a 2-week interval test-retest was administered to a convenience sample of 34 participants. Results: The correlation between total self-reported and objectively measured sedentary time was significant (all P < 0.001) and fair-to-good for workdays (ρ = 0.57) and whole week (ρ = 0.49), but was low for non-workdays (ρ = 0.23). The difference between the two measures was significant for whole week (z = −2.25, P = 0.03) and non-workdays (z = −5.50, P < 0.001), but was not significant for workdays (z = −0.60, P = 0.55). There was a significant positive association between the difference in the two measures and the average of these two measures (workdays: r = 0.53; non-workdays: r = 0.45; and whole week: r = 0.54, all P < 0.001). There was fair-to-good test-retest reliability of total sedentary time for each domain (workdays: interclass correlation coefficient [ICC] = 0.77, non-workdays: ICC = 0.53, and whole week: ICC = 0.7; all P < 0.01). Conclusions: The scale of domain-specific sedentary behaviors is reliable for estimating where and for what purpose Japanese adults spend their sedentary time, and total sedentary time is valid for workdays and the whole week.

Abstract Backgrounds The purpose of this study was to examine, in a sample of Japanese older adults, the associations of objectively-assessed sedentary behavior (SB) and physical activity (PA) with performance-based physical function. The isotemporal substitution (IS) approach was used to model simultaneously the effects of the specific activity being performed and the activity being displaced, in an equal time-exchange manner. Methods Among 287 older adults (65–84 years), we used accelerometers to identify the daily average time spent on SB (≤1.5 METs); light-intensity PA (LIPA) (>1.5 to