SUMMARYSimilar to the healthcare systems in other industrialized countries, the Japanese healthcare system is facing the problem of increasing medical expenditure. In Japan, this situation may be primarily attributed to advanced technological developments, an aging population, and increasing patient demand. Japan also faces the problem of a declining youth population due to a low birth rate. Taken together, these problems present the healthcare system with a very difficult financial situation. Several reforms have been undertaken to contain medical expenditure, such as increasing employee copayment for health insurance from 10% to 20% in 1997 and from 20% to 30% in 2003 in order to curb unnecessary visits to medical institutions. Since the aging of the Japanese population is inevitable, a suitable method to contain medical expenditure may be to screen individuals who are likely to develop lifestyle-related diseases and conduct early intervention programs for them to prevent the development of diseases such as myocardial infarction or stroke that are costly to treat. If this goal is attained, it may contribute to the containment of medical expenditure as well as to improving the quality of life of the elderly. Therefore, the Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008. Here, we discuss (1) the background of the Japanese healthcare system and the problems facing it, (2) the underlying objective and details of the new screening program, and (3) the expected impact of the program. (Int Heart J 2008; 49: 193-203)
Objective: We tested the construct validity and responsiveness of a single-item instrument for measuring absolute presenteeism—the single-item presenteeism question (SPQ). Methods: Two self-report questionnaire surveys were conducted among employees of 24 small- or medium-sized companies (N = 1021) concerning the recognized predictors of presenteeism–absenteeism, subjective health risks, work engagement, and workplace social capital. Responsiveness was measured by determining whether changes in the presence of predictors between the surveys were accompanied by commensurate changes in SPQ presenteeism. Results: SPQ presenteeism exhibited significant associations with the predictors, denoting adequate construct validity. Regarding responsiveness, unfavorable changes in most predictors were associated with increased SPQ presenteeism, as expected. Conclusions: We confirmed the construct validity and responsiveness of the SPQ—an instrument that can be employed to promote workplace health and productivity management.
Background The prevalence of metabolic syndrome (MetS) in Japan, a super-aged society, is increasing and poses a major public health issue. Several studies have reported sex differences in the association between age and MetS prevalence. This study aimed to examine the association between age and the prevalence of MetS based on multiple screening criteria and MetS components by sex. Methods We used 6 years of individual-level longitudinal follow-up data (June 2012 to November 2018; checkup year: 2012–2017) of middle-aged and older adults aged 40–75 years in Japan (N = 161,735). The Joint Interim Statement criteria, International Diabetes Federation criteria, and another set of criteria excluding central obesity were used as the screening criteria for MetS. The prevalence of MetS and MetS components was cross-sectionally analyzed according to sex and age. A longitudinal association analysis of age, MetS, and MetS components by sex was performed using a multilevel logistic model, adjusted for lifestyle- and regional-related factors. Results Sex differences were observed in the prevalence and association of MetS and MetS components. In all age groups, the prevalence of central obesity was higher among women, and the prevalence of high blood pressure and fasting glucose was higher among men (P < 0.001). The prevalence of high triglyceride and low high-density lipoprotein cholesterol was higher among women aged > 60 years (P < 0.05). Based on the criteria of the Joint Interim Statement and International Diabetes Federation, the prevalence of MetS was higher among women than in men aged > 55 years (P < 0.001). Men had a higher prevalence of MetS without central obesity than women in all age groups (P < 0.001). The odds ratio for MetS and MetS components with aging was greater among women than in men. Conclusions Medical management should be based on the prevalence of MetS and its components according to sex and age. In particular, the high prevalence of MetS without central obesity in middle-aged and older Japanese men suggests that the adoption of the Joint Interim Statement criteria, which do not precondition central obesity, should be considered.
carton (30 cans) of chlorogenic acid-enriched coffee and were encouraged to consume one can each day, and record their weight and coffee consumption using a web-based weight-recording system. The chlorogenic acid-enriched coffee showed high consumer acceptability. The mean weight change at Week 12 was −1.06 kg (95% confidence interval: −0.96, −1.16). Weight loss was significantly greater in obese participants compared with those with normal body mass index (<25 kg/m 2 ) in both men and women. Changes in weight at Week 12 showed a significant dose-response relationship (p<0.001, n=1659). The habitual consumption of chlorogenic acid-enriched coffee together with the use of a weight-recording system was effective for achieving weight loss in daily life. The popularity of drinking Abstract Abdominal obesity is considered a fundamental cause of metabolic syndrome. It has been reported that continuous consumption of chlorogenic acid, which is a major component of coffee polyphenols, reduces abdominal fat together with body weight in humans. Chlorogenic acid-enriched ready-todrink coffee has been developed recently. The antiobesity function of chlorogenic acid-enriched coffee has been demonstrated in some clinical trials; however, the efficacy of this coffee in daily life, which is more relevant in terms of consumer health, remains unknown. This paper describes a large single-arm study of the acceptability and effectiveness of chlorogenic acid-enriched coffee in terms of weight loss. Participants received one free 1 3 104 coffee was developed by Kao Corporation under the brand name Healthya™. It contains 270 mg chlorogenic acid per can (185 g) with reduced hydroxyhydroquinone. Regular coffee contains approximately 35-175 mg per cup [19]. Canned beverages, including soft drinks such as fruit juice, carbonated beverages, green tea and brewed coffee, are very popular in Japan [20], and can be easily purchased at many types of retailer and vending machines. Canned coffee has the second largest share of the soft drink market in Japan, after carbonated beverages [21]. A canned coffee product with an anti-obesity function is therefore an ideal product to support a population-based public health strategy [22]. The anti-obesity function of chlorogenic acidenriched coffee has been demonstrated in some clinical trials [17, 18], therefore it has been approved as a food for specified health use (FOSHU) by the Consumer Affairs Agency, Government of Japan, as a part of product development. However, the efficacy of the coffee in daily life, which is more relevant in terms of consumer health, remains unknown. The purpose of this study was to assess the acceptability and effectiveness of chlorogenic acid-enriched coffee in terms of weight loss in daily life through a large single-arm study. Materials and methods Test beverageThe test beverage is a canned coffee already on the Japanese retail market (Healthya coffee) which contains 185 g of brewed coffee without milk and sugar.The coffee is brewed from roasted coffee beans using 2.5 times...
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