Increasing prevalence of lifestyle-related diseases such as type II diabetes, arteriosclerosis and hypertension has a large economic and fiscal impact on the nation's healthcare system in Japan and many other developed and newly industrializing countries. There are several causes of the increase in these diseases, and one of the major causes is obesity, which is associated with people's diet. Diet and eating habits depend largely upon the culture and environment of the country where people are brought up. Eating habits, which are mainly established in childhood, often decide the person's lifetime eating habits and preference for food. Given that many lifestyle-related diseases are associated with diet, it is obvious that the nation's providing children with dietary education is indispensable for prevention of lifestyle-related diseases. In Japan, obesity rates among school children have been rising currently. The proved fact that obesity in childhood tracks into that in adulthood suggests that dietary education to prevent childhood obesity is important. It is effective to reduce energy intake from fat in meals and to increase proportion of unsaturated fatty acids in fat intake in preventing arteriosclerosis and hypertension. Thus, it is apparent that traditional Japanese meals are ideal. It is important to reduce salt intake for prevention of hypertension. Meanwhile, it requires some efforts to improve taste of law salt food in cooking. Nationwide strategy of establishing healthful eating habits in childhood is indispensable for prevention of lifestyle-related diseases of all generations. Children spend long periods of time in such a comparatively small and mutually influential community as schools and local communities. It is told that custom, behavior, and even obesity and certain diseases spread among people in such interconnected social networks. Given this, it is emphasized that dietary education provided at education sites such as elementary and junior high schools is very important as a strategy to prevent future prevalence of lifestyle-relate diseases in the country.
In order to formulate practical indications for the future Japanese health reform programs, we have conducted a structural analysis of the factors associated with increase in health expenditures for the aged based on the claim data of National Health Insurance (NHS) scheme of one local government, Kyushu, Japan. Total Health Care Expenditures (THCE) of this city increased 5.00% between 2000 and 2001, of which 5.64 % was due to the increase of aged insured, and on the contrary per capita Health Care Expenditures (pHCE) showed negative contribution; -0.64%. For changes in the three factors of pHCE, utilization rate and day per case decreased -1.00% and -2.73% respectively, and on the contrary expenditures per day increased 2.96%. The present analysis has indicated that the rapid ageing of the Japanese society is the most important factor for increase of THCE. In order to realize a healthy aged society and to make our system sustainable, one of the possible solutions is to strengthen the health promotion program. It is expected that the newly introduced national health promotion program from 2008 will contribute to the development of healthy aged society.
In order to investigate the obesity prevalence and its impact on lifestyle related diseases among the working population, we have investigated the chronological data of annual health check up of an occupational setting in Japan. We have compared the prevalence of hypertension, hyperlipidemia, and hyperglycemia in 1999 between the workers in 1995 who become obese in 1999 and who did not, both of whom were categorized as "healthy" in 1995, based on the data of 9,196 "healthy" male workers between 40 to 59 years old. For hypertension statistically positive correlations were observed for the two age groups; 40 to 49, and 50 to 59. For hyperlipidemia statistically positive correlations were observed for the three age groups; 30 to 39, 40 to 49, and 50 to 59. Finally, in the case of hyperglycemia, the two age groups; 40 to 49, and 50 to 59, showed positive correlations. This result has strongly suggested that it is very important to organize an effective anti-obesity program for middle aged men in order to reduce the disease burden of diabetes and other lifestyle related diseases.
In order to test the usefulness of non-machine based physical fitness program, so called "Active centenarian physical fitness program", the authors have applied this program in an isolated island of Kagoshima. The participants were the 18 slightly frail elderly more than 65 years old (4 males and 14 females). The average age was 78.17 ± 4.18 years old (min: 71, max: 85 years old). The main exercises continues about 30 minutes composing of: (1) Raises arms to back (2) Raises arms to sideways (3) Bending and extending knees (4) Standing up from chair (5) Extending knees (6) Raising legs to back (7) Raising legs to horizontal. After the 12 weeks intervention, improvement was observed for most of the physical fitness tests. So far as lifestyle, mental status and IADL were concerned, there were improvement observed in social role, intellectual activeness, outdoor activity, and hobby activity. Compared with the machine-based physical fitness program, the Active centenarian physical fitness program has more merits for application in the community setting, i.e. cheaper cost, easiness to master, safer physical activity.