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Aims/Introduction Recently, the prevalence of lifestyle-related disease has increased, and its associated medical costs have become considerable. Although walking is thought to prevent lifestyle-related disease, few studies have evaluated its effect on medical costs in Japanese subjects. We aimed at evaluating the effect of walking on medical costs by simulation mainly focusing on diabetes in the Japanese population. Materials and Methods A Markov model focusing on diabetes was constructed. As complications of diabetes, 'dialysis', 'ischemic heart disease' and 'stroke' were included. The model has four states: 'non-diabetes', 'diabetes', 'dialysis' and 'dead', and 'ischemic heart disease' and 'stroke' were included as events that occurred in each state. The effect of walking was included as changing the rate of transition and incident rates of events. Results After 10 years, the numbers of subjects with diabetes were 4.3 and 7.3% lower for daily increase of 3,000 and 5,000 steps, respectively. The numbers of cases of ischemic heart disease and stroke also decreased. Lower medical costs were also seen according to the daily increase in steps. In 10 years, the total medical costs were 5.2 and 8.4% lower for 3,000 and 5,000 steps increase, respectively. The cost reduction associated with a daily increase of 3,000 steps walked was calculated as ¥0.00146 for each step. Conclusions Walking is one of the most common and accessible forms of exercises. The present results suggested that walking reduced the medical costs associated with lifestyle-related disease, which will have a large impact on health policy. [ABSTRACT FROM AUTHOR]

Background: Socio-economic status has been associated with diabetes in cross-sectional studies. This study aimed to evaluate associations of household income and wealth with both prevalent and incident diabetes among older adults in the UK. It also evaluated the association between obesity and socio-economic status. Methods: A cohort of people aged ≥50 years was selected from the English Longitudinal Study of Ageing. The relation of prevalent and incident self-reported physician diagnosed diabetes to household income and wealth was evaluated in logistic regression models adjusting for education, social class, housing tenure, age, ethnicity, marital status, body mass index (BMI), smoking, alcohol use and physical activity stratified by sex. The relation of prevalent obesity to household income and wealth was also evaluated using logistic regression models. Results: There were 9053 participants (4021 men and 5032 women) including 721 (8.0%) with diabetes at baseline. Among 8332 participants initially free from diabetes, 246 (3.0%) were diagnosed with diabetes during ∼4 years follow-up. The adjusted odds ratio for prevalent diabetes in the lowest quintile of wealth compared with the highest was 1.56 for men and 2.08 for women. Incident diabetes was associated with lower wealth (P for trend 0.05 for men and 0.004 for women) after adjusting for socio-economic and demographic factors, but attenuated after further adjustment for lifestyle and BMI. Prevalent obesity was significantly associated with lower wealth in women but not in men. Conclusion: Lower wealth, but not income, may be associated with prevalent and incident diabetes among older adults in UK. [ABSTRACT FROM AUTHOR]