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Objectives: To examine the validity and reproducibility of a self-administered food-frequency questionnaire (FFQ) used for two cohort studies in Japan.Design: Cross-sectional study.Setting: Two rural towns in the Miyagi Prefecture, in north-eastern Japan.Subjects: Fifty-five men and 58 women.Results: A 40-item FFQ was administered twice, 1 year apart. In the mean time, four 3-day diet records (DRs) were collected in four seasons within the year. We calculated daily consumption of total energy and 15 nutrients, 40 food items and nine food groups from the FFQs and the DRs. We computed Spearman correlation coefficients between the FFQs and the DRs. With adjustment for age, total energy and deattenuation for measurement error with the DRs, the correlation coefficients for nutrient intakes ranged from 0.25 to 0.58 in men and from 0.30 to 0.69 in women, with median of 0.43 and 0.43, respectively. Median (range) of the correlation coefficients was 0.35 (-0.30 to 0.72) in men and 0.34 (-0.06 to 0.75) in women for food items and 0.60 (-0.10 to 0.76) and 0.51 (0.28-0.70) for food groups, respectively. Median (range) of the correlation coefficients for the two FFQs administered 1 year apart was 0.49 (0.31-0.71) in men and 0.50 (0.40-0.64) in women for nutrients, 0.43 (0.14-0.76) and 0.45 (0.06-0.74) respectively for food items, and 0.50 (0.30-0.70) and 0.57 (0.39-0.66) respectively for food groups. Relatively higher agreement percentages for intakes of nutrients and food groups with high validity were obtained together with lower complete disagreement percentages.Conclusions: The FFQ has a high reproducibility and a reasonably good validity, and is useful in assessing the usual intakes of nutrients, foods and food groups among a rural Japanese population. [ABSTRACT FROM AUTHOR]

Based on prospective observation of elderly people in the community in Japan, we compared the time-course of development and progression of physical disability between women and men. Men experienced disability at a younger age and at a faster rate than did women. The duration of time spent with disability in women was twice as long as in men. Consequently, women consume about two-thirds of the total resources of formal caregiving services in Japan. Women in Japan are increasingly educated, postponing marriage to higher ages, and less likely to care for parents in the home. Given these changes in family structure and social norms, the capacityfor informal family caregiving has decreased dramatically. A recently enacted national long-term care insurance system may further change the picture of caregiving. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the relationship between passive smoking at home and the incidence of various cancers in a population-based prospective study.Methods: The subjects were 9675 Japanese lifelong nonsmoking women aged over 40 years who lived in three municipalities of Miyagi Prefecture, and completed a self-administration questionnaire in 1984. During 9 years of follow-up, 426 cancers were identified by record linkage to the population-based cancer registry. The data were analyzed using the Cox proportional hazards model.Results: The age-adjusted relative risks (RR) and 95% confidence intervals (CI) of smoking-related cancers and lung cancer for women who had smoking husbands, compared with women whose husbands did not smoke, were 1.7 (0.94 2.9, p = 0.079) and 1.9 (0.81-4.4, p = 0.14), respectively. In contrast, a significant inverse association was observed for breast cancer, the RR (95% CI) was 0.58 (0.34-0.99, p = 0.047). After multivariate adjustment for confounding factors, the risks of smoking-related cancers and breast cancer were materially unchanged.Conclusions: These results show that passive smoking may affect the risk of cancers other than lung cancer. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the effects of cilostazol on the metabolic profiles of serum lipids, uric acid and glycaemic control. Patients: This was a comparative study in a total of 112 patients with impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM) associated with hypertriglyceridaemia (fasting serum triglycerides ≥150 mg/dl) untreated with insulin, 81 of whom were evaluated for drug efficacy. Design: Patients enrolled were randomised to receive either cilostazol (group C) 200 mg/day or placebo (group P) [two tablets twice a day after breakfast and dinner] for 12 weeks according to a double-blind method. The study consisted of a 4-week run-in period (week -4 to week 0) followed by a 12-week administration period. Lipid parameters, uric acid and glycaemic control were measured at baseline (weeks -4, 0) and 4, 8 and 12 weeks after treatment. For each primary study variable, final assessment was based on the change observed after 12 weeks of administration relative to the baseline value obtained at week 0. Results: In group C, triglycerides (TG) decreased significantly (p < 0.05) from 238 ± 85 to 193 ± 105 mg/dl, but increased in group P. There was a significant (p < 0.05) difference between the two groups. High density lipoprotein- cholesterol (HDL-C) increased significantly (p < 0.05) from 39 ± 10 to 41 ± 11 mg/dl in group P. HDL-C in group C also increased but not significantly. When the results of one patient, whose HDL-C was over 100 mg/dl, were excluded, HDL-C in group C changed similarly to that in the subgroup (HDL-C level at baseline <50 mg/dl), which increased significantly (p < 0.001) from 38 ± 7 to 44 ± 10 mg/dl and the difference between groups P and C was also significant (p < 0.01). In group C, apolipoprotein B (apo B) decreased significantly (p < 0.01) from 155 ± 24 to 140 ± 28 mg/dl and apolipoprotein E (apo E) decreased significantly (p < 0.01) from 7.8 ± 1.9 to 6.7 ± 2.0 mg/dl. Uric acid also decreased significantly (p < 0.01) from 5.8 ± 1.5 to 5.3 ± 1.4 mg/dl in group C, but did not decrease significantly in group P, indicating a significant (p < 0.05) difference between the two groups. Glycaemic control (fasting plasma glucose level and HbA level) was not affected by either treatment. Abnormal laboratory findings were seen in 25.5% (14/55) of the patients in group P and in 14.3% (8/56) of those in group C, showing no significant difference between the two groups. Drug-related adverse events were observed in 7.3% (4/55) of the patients in group P and in 35.7% (20/56) of those in group C, indicating a significant (p < 0.001) difference between the two groups. Headache was the most frequent complaint (15 patients in group C). No increased bleeding tendencies or frank haemorrhage were noted in any patient. Conclusions: In IGT or type 2 DM patients with hypertriglyceridaemia, cilostazol 200mg effectively lowers TG and uric acid levels, and shows a potentially important effect in increasing HDL-C levels without significantly affecting glycaemic control. These results indicate that the clinical effect of cilostazol on lipid and uric acid metabolism is a beneficial effect that protects against atherosclerotic disease. [ABSTRACT FROM AUTHOR]

We assessed the accuracy of a 141-item food frequency questionnaire as a screening test to detect high or low consumption of nutrients associated with cancer. Fifty-five men and 58 women participating in two population-based cohort studies in Miyagi, Japan, provided four three-day diet records over a one-year period and subsequently completed the questionnaire twice with a one-year interval. Pearson correlation coefficients between 17 nutrients measured by the diet records and the first questionnaire ranged from 0.24 to 0.85 (median 0.43), and those between the two questionnaires ranged from 0.47 to 0.91 (median 0.68). The sensitivity and specificity of the questionnaire for detecting high-alcohol, high-fat, low-calcium, and low-ascorbic acid consumers were 86.7% and 96.7%, 50.0% and 85.7%, 48.8% and 76.4%, and 61.9% and 70.0%, respectively. Receiver operating characteristic curves indicated comparable performance of the questionnaire and a three-day diet record, regarded as another screening test. The questionnaire performed poorly for other nutrients. The results indicate that our questionnaire is reasonably reproducible, comparable with the diet records, and useful as a screening test to detect high or low consumers of several nutrients associated with cancer for subsequent enrollment in dietary intervention trials or dietary counseling. [ABSTRACT FROM AUTHOR]

Background: This study examined the secular trends of life expectancy without dementia among elderly American members of a health maintenance organization, and observed if an increased life expectancy is accompanied by an increase in the duration of life with dementia.Methods: The data derived from two chronological 9-year prospective cohort studies of members of the Kaiser Permanente Medical Care Program of Northern California. The first and second cohorts included 2,702 and 2,926 people aged > or =65 years free from dementia at baseline. Life expectancy without dementia or dementia-free life expectancy (DemFLE) is defined as the average number of years a person is expected to live without dementia. Total life expectancy is equal to the sum of DemFLE and life expectancy with dementia. Estimations of DemFLE were based on mortality data and incidence of dementia, using double-decrement life tables.Results: Between the first and second cohorts, all-cause mortality rates declined, while the incidence of dementia remained constant in both men and women. Among the males, total life expectancy increased at a higher rate than DemFLE. Consequently, the duration of life with dementia was extended in the second cohort. Conversely, among the females DemFLE increased at a higher rate than total life expectancy, thus the duration of life with dementia decreased in the second cohort. The median age of dementia onset was postponed by 2-3 years in the second cohort for females, and did not show any specific difference between the two cohorts in males.Conclusion: The trends of health expectancies suggest an extension of the duration of life with dementia for males and a compression of dementia for females. A decreased incidence of risk factors for dementia among females in the second cohort such as stroke may explain these trends. [ABSTRACT FROM AUTHOR]

Background: Previous studies indicated that serum beta-carotene levels were low among smokers and drinkers. However these findings may result from the strong relationship between smoking and drinking.Methods: Data were collected from 1902 males randomly selected from participants of a cohort study. The effects of smoking on serum beta-carotene levels were assessed according to drinking status (non-drinker, ex-drinker and current drinker), and those of drinking were assessed according to smoking status (ex-smoker and current smoker) using general linear model including other factors (age, intake of green-yellow vegetables, intake of carrot or pumpkin, body mass index serum cholesterol levels.)Results: An inverse dose-response relationship between daily consumption of alcohol and beta-carotene levels was observed regardless of smoking status, and also between number of cigarettes smoked per day and beta-carotene levels regardless of drinking status.Conclusion: These results suggest that cigarette smoking and alcohol drinking reduce beta-carotene levels independently. [ABSTRACT FROM AUTHOR]

The aim of our study was to determine whether the previously reported findings also apply to a general population in Japan and whether, among current smokers, such personality characteristics can be correlated with the age they started to smoke and their present daily consumption of cigarettes. Cross-sectional survey. Miyagi prefecture, in northern Japan. 20,538 residents in Miyagi, aged 40-64 years. A self-administered questionnaire involving smoking status (current, ex- and non-smokers) and patterns and the Japanese version of the short-form Eysenck Personality Questionnaire-Revised (EPQ-R). (1) Current and ex-smokers were higher on Extraversion and Psychoticism than non-smokers for both genders. (2) Heavy smokers were higher on Psychoticism than light smokers and those who started to smoke prior to the legally permitted age were higher on Psychoticism than those who did not. (1) Our study confirmed that the findings which had been previously reported in selected samples in western countries also apply to a general population in Japan; (2) current smokers were found to be heterogeneous in terms of Psychoticism when the age they started to smoke and their present daily consumption of cigarettes were taken into account. [ABSTRACT FROM AUTHOR]