In recent Japan, life-style related diseases such as diabetes (type II diabetes mellitus), hypertension, hyperlipidemia, and arteriosclerosis have been increasing due to changes in the life-style, particularly in eating habits. The trend interferes with people's pleasant and healthy longevity in Japan facing the world's most aged society while raising an issue that increased health care expenditure including medical one is threatening nation's finance. It is important for people to have proper eating habits to prevent both life-style related diseases and metabolic syndrome lying ahead of them. Therefore, it is essential that adults and even young people should be provided with dietary education so that they can adapt to healthy eating habits. This paper describes preventive measures against life-style related diseases including ways of eating to avoid rapid elevation in blood glucose level after a meal, advantages of traditional Japanese diet that is high in dietary fiber and low in fat content, and the prevention of hypertension by reduced salt and high potassium intake. In addition, it introduces examples of communities in Japan that implemented such measures with successful results.
Metabolic Syndrome (MetS) has recently been receiving much attention in Japan. Though some earlier studies discussed the effects of eating behavior or physical activity in developing MetS, it is not clear which of them has the greater effect. The study population was 35,415 males (average age: 45.3 years old) who have had health checkups at a health care center established by one of the largest manufacturers in Japan during the period from 1995 to 2005. They are registered in the study cohort retrospectively using the year when their checkup result was first found in the record files during the period. The exposures are life-style risk factors identified by questionnaires submitted at the checkups and the event is to become diagnosed with MetS based on the estimated abdominal circumference and the diagnostic criteria proposed by 8 Japanese medical academic societies. The impact of each exposure on contributing to the event is examined based on hazard ratios developed by Cox's proportional hazard model. After adjusting for age and family history by multivariate analysis, the hazard ratios of "slow eating: no" to "yes" is 1.228 (p<0.001), "sedentary work" to "standing work, etc" 1.195 (p<0.001), "drinking: 3 times or more per week" to "less than 3 times" 1.094 (p=0.003), "sleeping: less than 6 hours" to "6 hours or more" 1.085 (p=0.013). The effects of eating behavior and physical activity are suggested to be almost the same at approximately 1.2, and those of drinking and sleeping hours appear to be less, at around 1.1.
In order to formulate the prevention program under the Long Term Care Insurance (LTCI) scheme, the authors conducted a cross-sectional study of frailty status among the elderly in a Japanese city. The population studied was inhabitants of one city, Fukuoka prefecture. The 3000 inhabitants more than 65 years old were randomly selected from citizen registration by the city council. From June to September 2002, the trained interviewers visited to chosen inhabitants and gathered information using a structured questionnaire composing of demographic data (sex, age, address, household's type), health status, ADL, and IADL. The present study has clarified that most of the aged live independently, even though they have some level of chronic health problems, such as knee-joint disorder and hypertension. Furthermore, even if they have got some problems for their transfer ability, most of them stay independent for other ADL and IADL, such as eating, toileting, bathing and house affaires. There was an interesting difference between male and female for house affaire autonomy. For female, 90% of persons categorized "mobility level 5" were independent for house affaires. On the contrary, only 40% of same mobility level of male were independent for house affaires. This finding indicates the necessity of another important preventive program especially for male.
We investigated the effects of an occupational mental health program, which was introduced into Company A since April 2002, on the following: 1) sick leave duration, 2) restoration and 3) contract retirement rates. This occupational mental health program included primary prevention by mental health seminars, early detection of mental health problem by an occupational counselor, referral to mental health facilities, and a reinstatement support program recommended by the Ministry of Health, Labor and Welfare. This new program is called Program A. And sick leave duration, restoration and contract retirement rates were compared between before and after the Program A was introduced. As a result, the sick leave duration according to mental health problems for each person was 519.2 ± 267.8 days before, and 307.6 ± 249.8 days after the introduction of Program A, which produced a significant difference (p<0.01, paired t-test). There was also increase in restoration rates from 34% (before Program A) to 38% (after Program A). Furthermore, there was decrease in contract retirement rate from 41% to 28% (after Program A).