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COVID-19 has caused a significant global disease burden since it was first identified in December 2019; as of May 2024, [greater than or equal to]750 million cases had been confirmed, [...]

BACKGROUND/OBJECTIVE: Dietary patterns in Western populations have been linked to type 2 diabetes, but the association Of distinctive dietary patterns of Japanese population remains unclear. We prospectively investigated the association between dietary patterns and risk of developing type 2 diabetes among Japanese adults. SUBJECTS/METHODS: Participants were 27 816 men and 36 889 women aged 45-74 years who participated in the second survey of the Japan Public Health Center-based prospective study and had no history of diabetes. Dietary patterns were derived by using principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Odds ratios of self-reported physician-diagnosed type 2 diabetes over 5 year were estimated using logistic regression analysis. RESULTS: A total of 1194 new cases (692 men and 502 women) of type 2 diabetes were self-reported. We identified three dietary patterns: prudent, westernized and traditional Japanese patterns. Any dietary pattern was not significantly associated with type 2 diabetes risk after adjustment for covariates in both men and women. The multivariate-adjusted odds ratios (95% confidence interval) for type 2 diabetes for the highest versus lowest quartile of each dietary pattern score in men and women, respectively, were 0.93 (0.74-1.16) and 0.90 (0.69-1.16) for the prudent pattern, 1.15 (0.90-1.46) and 0.81 (0.61-1.08) for the westernized pattern, and 0.97 (0.74-1.27) and 0.87 (0.66-1.15) for the traditional pattern. CONCLUSIONS: Although a small protective effect of the prudent dietary pattern cannot be excluded, dietary patterns may not be appreciably associated with type 2 diabetes risk in Japanese. European Journal of Clinical Nutrition (2013) 67, 18-24; doi:10.1038/ejcn.2012.171; published online 24 October 2012 Keywords: cohort studies; dietary patterns; Japanese; type 2 diabetes, INTRODUCTION Type 2 diabetes has been increasing worldwide. (1) In Japan, in particular, the prevalence of diabetes has increased from 6.9 to 8.9 million between 1997 and 2007. (2) Although [...]

BACKGROUND/OBJECTIVES: Although high or low (no) meat consumption was associated with elevated or reduced mortality from cardiovascular disease, respectively, few studies have investigated the association between moderate meat consumption and cardiovascular disease. We aimed to evaluate the associations between moderate meat consumption and cardiovascular disease mortality. SUBJECTS/METHODS: We conducted a prospective cohort study of 51 683 Japanese (20466 men and 31 217 women) aged 40-79 years living in all of Japan (The Japan Collaborative Cohort Study; JACC Study). Consumptions of meat (beef, pork, poultry, liver and processed meat) were assessed via a food frequency questionnaire administrated at baseline survey. Hazard ratios (HRs) of mortality from cardiovascular disease were estimated from Cox proportional hazards regression models according to quintiles of meat consumption after adjustment for potential confounding variables. RESULTS: During 820076 person-years of follow-up, we documented 2685 deaths due to total cardiovascular disease including 537 ischemic heart diseases and 1209 strokes. The multivariable HRs (95% confidence interval) for the highest versus lowest quintiles of meat consumption (77.6 versus 10.4 g/day) among men were 0.66 (0.45-0.97) for ischemic heart disease, 1.10 (0.84-1.43) for stroke and 1.00 (0.84-1.20) for total cardiovascular disease. The corresponding HRs (59.9 versus 7.5 g/day) among women were 1.22 (0.81-1.83), 0.91 (0.70-1.19) and 1.07 (0.90-1.28). The associations were similar when the consumptions of red meat, poultry, processed meat and liver were examined separately. CONCLUSION: Moderate meat consumption, up to ~100 g/day, was not associated with increased mortality from ischemic heart disease, stroke or total cardiovascular disease among either gender. European Journal of Clinical Nutrition (2012) 66, 687-693; doi: 10.1038/ejcn.2012.6; published online 15 February 2012 Keywords: meat; cardiovascular diseases; ischemic heart disease; stroke; mortality; prospective study, INTRODUCTION Meat is a major protein source for humans. (1) Unlike fish or beans, however, meat in particular red or processed meat is often considered to be unhealthy because of [...]

In 2005, the Regional Committee of WHO's Western Pacific Region set a target of 2012 for eliminating measles from all Member States. In Japan, measles control strategies implemented during the [...]

Dietary guidelines which are found in Volume 22 of the 'Ishinpou', a text in Japanese medical literature, are described. Medieval Asians considered proper diet, physical activity, and a disciplined mind as measures to avoid birth defects and abnormal deliveries. This view still influences Asian health principles though current health practices. Most of the recommendations found in the text are similar to current beliefs among Asian Americans.

BACKGROUND: The expected ratio of male to female births is generally believed to be 1.05, also described as the male proportion of 0.515. OBJECTIVES: We describe trends in sex ratio [...]

Food guides to help consumers make healthy choices have recently been released in three countries: Japan, Canada, and the United States. The visual symbol that introduces key concepts is a spinning top in Japan, a rainbow in Canada, and a pyramid in the United States. The main features of the new guides are given in printed consumer resources, and more detailed information is available at related websites. Although the process of developing the guides varied among the countries, the resulting recommended food patterns are remarkably consistent. Key words: dietary guidance, food guides, food patterns

The impact of structural breaks on the health expenditure growth rates in United States, Japan, and few European countries, is discussed.

Byline: N. Yoshimura (1), H. Kinoshita (2), S. Danjoh (3), T. Takijiri (1), S. Morioka (1), T. Kasamatsu (4), K. Sakata (1), T. Hashimoto (1) Keywords: Key words:Bone loss -- Bone mineral density -- Cohort study -- DXA -- Generation gap Abstract: Bone mineral density (BMD) was measured over a ten year period in a cohort study in Miyama village, Wakayama Prefecture, Japan, to provide information on rate of bone loss in the mature and elderly population. Four hundred subjects were selected by sex and age decade from the full list of residents born in 1910--1949, and aged 40--79 years at the end of 1989, with 50 men and 50 women in each age decade. Baseline BMD of the lumbar spine and the proximal femur was measured using dual energy X-ray absorptiometry (DXA) in 1990 and again in 1993, 1997 and 2000. Annual rate of change in BMD (% per year) in the lumbar spine in men in their forties, fifties, sixties and seventies was 0.17, 0.55, 0.01 and -0.16, respectively, and in women, -0.87, -0.83, -0.48 and -0.48, respectively. Thus in men, BMD at the lumbar spine increased in all age strata but the oldest, when it decreased, whereas in women, it decreased in all age strata. On the other hand, BMD at the proximal femur decreased in both sexes in all age strata. Our results show that bone loss rates differ depending on the site involved, demonstrating that different strategies are needed for the prevention of bone loss in the spine and hip. aFurthermore, we found evidence of differences in BMD for given age strata between birth cohorts. Data in 1990 and in 2000 showed significant improvements for men in their sixties and for women in their fifties, suggesting that future problems of osteoporosis might be less severe than has previously been predicted in Japan. Author Affiliation: (1) Department of Public Health, Wakayama Medical University School of Medicine, JP (2) Department of Orthopaedics, Saiseikai Wakayama Hospital, JP (3) Department of Orthopaedics, Saiseikai Arita Hospital, JP (4) Department of Health Science, Kobe City College of Nursing, Japan, JP Article note: Received: 11 January 2002 / Accepted: 22 April 2002

In Japan, as in many countries around the world, cancer patients are often not told the truth about their illness. Despite polls showing a majority of those surveyed wish to be told, surveys of physicians indicate only a small percentage will tell, especially when the cancer is advanced or terminal. We interviewed physicians from various specialties with experience managing advanced or terminal cancer patients to investigate their approaches to cancer disclosure. Our analysis reveals physicians divide into two groups: those who usually do not tell (non-tellers) such patients and those who usually do tell (tellers). Non-tellers reported the shock of disclosure inhibits telling patients, families' wishes for non-disclosure cannot be ignored, and most patients themselves do not wish to be told. Tellers asserted disclosure is unavoidable and patients want to be told, few problems result when they tell, and telling has many advantages such as not having to lie to the patient. Despite the experience of non-tellers, most physicians continue to follow the traditional approach, for advanced or terminal cancers. Physicians, as well as families and patients, display an aversion to taking responsibility for the potential risks of disclosure, and this may perpetuate the status quo. Keywords: Japan; Medical ethics; Cancer disclosure; Informed consent

Body size and functions change with age. A 36-year study of one Japanese man showed his peak body weight appeared in summer when he was younger but winter or autumn as he aged, while blood pressure did not always peak in the winter.

Researchers have identified Borrelia garinii in ticks from migratory birds in Japan. This is one of the species of Borrelia that causes Lyme disease. The birds probably carried the organism to Japan from northeastern China via Korea.

Research indicates that temperature and air pollution, specifically NO(2), are significant risk factors for heat stroke. Studies were based on residents in Tokyo, Japan, and findings are categorized according to age group and gender.

Japan has been slow to accept artificial reproductive technology (ART) because of its gradual approach in approving new procedures and for the penchant of the Japanese in conducting deliberations privately. Treatment guidelines are formulated by professional societies due to the absence of laws regulating ART. This problem is attributed in part to the small number of physicians specializing in ART and the lack of sufficient expertise in formulating concrete policies.

A familial moyamoya disease gene has been mapped to chromosome 3p13.1-p26, the first genetic locus found for the disease. The disease, which is prevalent in patients younger than 10, in most cases is apparently sporadic, but about 10% of cases are familial. A genomewide search was carried out in 16 families. Spontaneous occlusion of the circle of Willis or moyamoya disease is characterized by occlusion of the terminal portion of the internal carotid artery and/or bilateral stenosis.

Yoshitake Yokokura has been driving efforts to renew primary health care in Japan to meet the needs of an ageing population. He talks to Fiona Fleck. Q: How did you [...]

Research on Caucasian and Japanese subjects shows a correlation between large normal CAG allele frequencies and the CAG-repeat expansions coinciding with dominantly inherited spinocerebellar ataxias (SCAs). Dominant SCA types and dentatorubralpallidoluysian atrophy were found primarily in Caucasian and Japanese populations respectively, with prevalences matching comparatively large numbers of normal alleles.

A new locus for a peculiar form of congenital muscular dystrophy with early rigidity of the spine has been identified on chromosome 1p35-36. A genomewide search has been carried out in a large consanguineous family having 11 siblings and three children affected by CMD without merosin deficiency. The affected children are homozygous for several markers on the chromosome. Two other consanguineous families with affected children showed linkage to the same locus and in the three families early rigidity of the spine, reduced vital capacity and scoliosis were found.

For 50 years, the Atomic Bomb Casualty Commission (ABCC) and its successor, the Radiation Effects Research Foundation (RERF), have conducted epidemiological and genetic studies of the survivors of the atomic bombs and of their children. This research program has provided the primary basis for radiation health standards. Both ABCC (1947-1975) and RERF (1975 to date) have been a joint enterprise of the United States (through the National Academy of Sciences) and of Japan. ABCC began in devastated, occupied Japan. Its mission had to be defined and refined. Early research revealed the urgent need for long term study. In 1946, a Directive of President Truman enjoined the National Research Council of the National Academy of Sciences to develop the program. By 1950, ABCC staff exceeded 1,000, and clinical and genetic studies were underway. Budgetary difficulties and other problems almost forced closure in 1953. In 1955, the Francis Report led to a unified epidemiological study. Much progress was made in the next decade, but changing times required founding of a binational nonprofit organization (RERF) with equal participation by Japan and the United States. New programs have been developed and existing ones have been extended in what is the longest continuing health survey ever undertaken.

Although Japanese physicians historically have not disclosed cancer diagnoses to patients, pressures upon physicians to disclose have increased in recent years. We questioned physicians practicing at a private medical hospital in rural Japan about their current approach to cancer disclosure. We compared their responses with responses of physicians in a 1991 study conducted in Japan, and two studies conducted in the United States, in 1961 and in 1977. Seventy-seven clinically active physicians with experience treating cancer patients responded (73% response rate). Forty percent of respondents reported usually telling patients of a cancer diagnosis, over three times more than the 13% who reported such a policy in Japan in 1991. Physicians were significantly more likely (P [less than] 0.001) to make exceptions than physicians in the previous Japanese study, and physicians in the previous U.S. studies. Respondents reported considering more factors in deciding whether to tell than participants in the 1977 U.S. study. Factors predicting an increased probability of disclosure included age (in a hyperbolic relationship), improved prognosis, breast or cervical cancer, and social status and religion (by a minority of respondents). Increase in a substitute decision maker's age was predictive for physicians not to involve the person in decision-making. Most respondents reported their disclosure policy is based on clinical experience. More respondents indicated a likelihood of changing in the future than respondents in the previous U.S. studies. These data suggest Japanese physicians are moving away from a rigid policy of nondisclosure to a policy of selective disclosure, but they have not adopted universal cancer disclosure as practiced in many Western countries. Since young age and advanced age predicted self-reports of not disclosing cancer diagnoses, these data raise the question of whether nondisclosure by age groups represents age discrimination or compassionate medical care tailored to individual patient needs. Key words - Japan, cancer disclosure, informed consent

The context of the Japanese health care setting shaped Japanese women's roles as the major and solo caretakers of their ill children, which caused them to be removed from the family unit during the children's illnesses. The mothers became sentinels and tried to protect their children from unnecessary physical and psychological distress and agony in the hospital context. Some of them comforted their children in the home-care context once their children reached the point where no other treatment could help. At the same time, they tried to establish effective relationships with health professionals, especially physicians. One third of the mothers gave the initiative to the physician, but almost half of the mothers shared the initiative to some degree with physicians on an equal or dominant-subordinate basis. Whether the mothers trusted the physicians did not relate to whether they shared the initiative or not, but was a primary factor in deciding whether to change hospitals. The mothers became monitors and advocates of their children during treatment, at first choosing to adapt to their subordinate position in the hospital, but becoming more assertive when they felt their children may be seriously harmed. Key words - mothers, health care system, doctor - patient relationship, crisis management, terminal illness

Escherichia coli O157:H7 was responsible for the outbreak of diarrhea, accompanied by intestinal bleeding among children at the Shirasagi Kindergarten in Urawa, Saitama Prefecture in Oct. 1990. The formerly harmless bacteria has evolved into a virulent strain that produces a toxin which can be fatal for humans. In addition to causing dehydration, O157 also affects the brain and kidneys. Antibiotic treatment aggravates the symptoms by causing the dead bacteria to release verotoxin. A germ free environment hygienic food preparation and eating habits can assure protection from O157.

The Japanese government's lapses and lack of concern are responsible for inadequate treatment and safety systems for infectious diseases caused by the pathogenic 0157 Escherichia coli. Delayed recognition of the infectious nature of the diseases, negligence of secondary infections and lack of timely medical care are some blocks to treatment. The dietary habits and food import system can cause wide-spread contamination. Hygienic school food, regular testing of food workers and an emergency hospital ship are some protective measures for combating the bacteria.

We all labor against our own cure; for death is the cure of all diseases. --Sir Thomas Browne, 1605-1682 'Urn Burial' The boundaries which divide Life and Death are at [...]

I. Introduction '[I]n today's affluent Japan, with the Universal Health Insurance system's modest copayment for medical services, income and copayment play a relatively minor role for the population at large [...]