Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
Volume 26 , Issue 6
Showing 1-8 articles out of 8 articles from the selected issue
Meeting Report
  • Heather Wipfli
    2016 Volume 26 Issue 6 Pages 279-283
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: May 14, 2016
    The Framework Convention on Tobacco Control (FCTC) stands as a landmark approach to addressing a global health problem. It represents the first time the World Health Organization (WHO) used its constitutional right to negotiate an international law and the first time the Member States of WHO agreed to a collective response to chronic, non-communicable diseases. This paper draws lessons from the FCTC’s first decade in force and explores what aspects of the FCTC experience can inform future efforts to address other disease epidemics driven by corporate activity, such as alcohol and food.
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Original Article
  • Ayaka Sunami, Kazuto Sasaki, Yoshio Suzuki, Nobuhide Oguma, Junko Ishi ...
    2016 Volume 26 Issue 6 Pages 284-291
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: February 20, 2016
    Background: Food frequency questionnaires (FFQs) have been developed and validated for various populations. To our knowledge, however, no FFQ has been validated for young athletes. Here, we investigated whether an FFQ that was developed and validated to estimate dietary intake in middle-aged persons was also valid for estimating that in young athletes.
    Methods: We applied an FFQ that had been developed for the Japan Public Health Center-based Prospective Cohort Study with modification to the duration of recollection. A total of 156 participants (92 males) completed the FFQ and a 3-day non-consecutive 24-hour dietary recall (24hDR). Validity of the mean estimates was evaluated by calculating the percentage differences between the 24hDR and FFQ. Ranking estimation was validated using Spearman’s correlation coefficient (CC), and the degree of miscategorization was determined by joint classification.
    Results: The FFQ underestimated energy intake by approximately 10% for both males and females. For 35 nutrients, the median (range) deattenuated CC was 0.30 (0.10 to 0.57) for males and 0.32 (−0.08 to 0.62) for females. For 19 food groups, the median (range) deattenuated CC was 0.32 (0.17 to 0.72) for males and 0.34 (−0.11 to 0.58) for females. For both nutrient and food group intakes, cross-classification analysis indicated extreme miscategorization rates of 3% to 5%.
    Conclusions: An FFQ developed and validated for middle-aged persons had comparable validity among young athletes. This FFQ might be useful for assessing habitual dietary intake in collegiate athletes, especially for calcium, vitamin C, vegetables, fruits, and milk and dairy products.
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  • Daisuke Kawakita, Isao Oze, Satoyo Hosono, Hidemi Ito, Miki Watanabe, ...
    2016 Volume 26 Issue 6 Pages 292-299
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: January 23, 2016
    Background: The association between alcohol drinking, aldehyde dehydrogenase 2 (ALDH2) polymorphism, and survival in patients with head and neck squamous cell carcinoma (HNSCC) remains unclear.
    Methods: We performed a retrospective cohort study of 267 HNSCC patients at Aichi Cancer Center. Of these, 65 patients (24%) were non-drinkers, 104 (39%) were light drinkers (ethanol <46 g or <5 days/week), 46 (17%) were moderate drinkers (ethanol intake 46–68 g/day and ≥5 days/week), and 52 (20%) were heavy drinkers (ethanol intake ≥69 g and ≥5 days/week). The prognostic value of pre-treatment drinking status and ALDH2 polymorphism was investigated using multivariate proportional hazard models.
    Results: Drinking status was associated with disease-free survival (DFS) in HNSCC patients, with marginal statistical significance (5-year DFS: 67.9% [95% confidence interval {CI}, 53.8–78.4%] for non-drinkers, 57.6% [95% CI, 47.4–66.6%] for light drinkers, 46.1% [95% CI, 30.8–60.1%] for moderate drinkers, and 43.5% [95% CI, 29.3–56.9%] for heavy drinkers; P = 0.088). However, this association lost significance when multivariate analyses were adjusted for established prognostic factors. ALDH2 genotype was not significantly associated with DFS in HNSCC patients (5-year DFS: 85.7% [95% CI, 53.9–96.2%] for Lys/Lys, 56.2% [95% CI, 47.4–64.1%] for Glu/Lys, and 50.5% [95% CI, 40.3–59.7%] for Glu/Glu; P = 0.154). After stratification by ALDH2 genotype, we observed a significant positive dose-response relationship between drinking status and DFS in HNSCC patients with ALDH2 Glu/Glu (Ptrend = 0.029).
    Conclusions: In this study, we identified a significant positive dose-response relationship between pre-treatment drinking status and DFS in HNSCC patients with ALDH2 Glu/Glu. To confirm this association, further study is warranted.
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  • Megumi Hara, Tomoyuki Hanaoka, Kazuhiro Maeda, Tetsuo Kase, Satoko Ohf ...
    2016 Volume 26 Issue 6 Pages 300-306
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: January 16, 2016
    Background: While the immunogenicity and effectiveness of seasonal influenza vaccines among subjects with severe motor and intellectual disability (SMID) are known to be diminished, the efficacy of the A/H1N1pdm vaccine has not been evaluated.
    Methods: We prospectively evaluated 103 subjects with SMID (mean age, 41.7 years) who received trivalent inactivated influenza vaccine during the 2010/11 influenza season. The hemagglutination inhibition (HI) antibody titer was measured in serum samples collected pre-vaccination (S0), post-vaccination (S1), and end-of-season (S2) to evaluate subjects’ immunogenicity capacity. Vaccine efficacy was assessed based on antibody efficacy and achievement proportion.
    Results: The proportions of seroprotection and seroconversion, and the geometric mean titer (GMT) ratio (GMT at S1/GMT at S0) for A/H1N1pdm were 46.0%, 16.0%, and 1.8, respectively—values which did not meet the European Medicines Evaluation Agency criteria. The achievement proportion was 26%. During follow-up, 11 of 43 subjects with acute respiratory illness were diagnosed with type A influenza according to a rapid influenza diagnostic test (RIDT), and A/H1N1pdm strains were isolated from the throat swabs of 5 of those 11 subjects. When either or both RIDT-diagnosed influenza or serologically diagnosed influenza (HI titer at S2/HI titer at S1 ≥2) were defined as probable influenza, subjects with A/H1N1pdm seroprotection were found to have a lower incidence of probable influenza (odds ratio, 0.31; antibody efficacy, 69%; vaccine efficacy, 18%).
    Conclusions: In the present seasonal assessment, antibody efficacy was moderate against A/H1N1pdm among SMID subjects, but vaccine efficacy was low due to the reduced immunogenicity of SMID subjects.
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  • Ryota Sakurai, Hisashi Kawai, Hideyo Yoshida, Taro Fukaya, Hiroyuki Su ...
    2016 Volume 26 Issue 6 Pages 307-314
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: February 20, 2016
    Background: The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function.
    Methods: On the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests.
    Results: Regular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists.
    Conclusions: The ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults.
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  • Takashi Kimura, Hiroyasu Iso, Kaori Honjo, Satoyo Ikehara, Norie Sawad ...
    2016 Volume 26 Issue 6 Pages 315-321
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: April 09, 2016
    Background: Suicide rates have been related to educational level and other socioeconomic statuses. However, no prospective study has examined the association between educational level and the risk of suicide in Japan.
    Methods: We examined the association of education level and suicide risk in a population-based cohort of Japanese men and women aged 40–59 years in the Japan Public Health Center-based Prospective Study Cohort I. In the baseline survey initiated in 1990, a total of 46 156 subjects (21 829 men and 24 327 women) completed a self-administered questionnaire, which included a query of educational level, and were followed up until the end of December 2011. Educational levels were categorized into four groups (junior high school, high school, junior or career college, and university or higher education). During a median follow-up of 21.6 years, the hazard ratios (HRs) and 95% confidence intervals (CIs) of suicide according to educational level were estimated using the Cox proportional hazards regression model adjusted for age; study area; previous history of stroke, ischemic heart disease, or cancer; self-reported stress; alcohol consumption; smoking; living with spouse; and employment status. A total of 299 deaths attributed to suicide occurred.
    Results: The HR for university graduates or those with higher education versus junior high school graduates was 0.47 (95% CI, 0.24–0.94) in men, and that for high school graduates versus junior high school graduates was 0.44 (95% CI, 0.24–0.79) in women.
    Conclusions: High educational levels were associated with a reduced risk of suicide for both Japanese men and women.
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  • Mieko Nakamura, Toshiyuki Ojima, Miyo Nakade, Rika Ohtsuka, Tatsuo Yam ...
    2016 Volume 26 Issue 6 Pages 322-329
    Published: June 05, 2016
    Released: June 05, 2016
    [Advance publication] Released: January 30, 2016
    Background: Involuntary weight loss and underweight increase the risks of mortality and disability in older people. However, the association and interaction of poor oral health and dietary intake with body mass index (BMI) have not been elucidated.
    Methods: Data were analyzed for 96 794 respondents aged >65 years who were randomly selected from 31 Japanese municipalities in the Japan Gerontological Evaluation Study. Weight loss was defined as ≥2–3 kg of loss over the preceding 6 months. BMI was evaluated in respondents without weight loss. Multiple logistic regression analysis was performed with weight loss, underweight, and obesity as dependent variables and having fewer teeth (<20) and infrequent food intake as independent variables, with adjustment for potential confounders.
    Results: Weight loss was associated with having fewer teeth (men: odds ratio [OR] 1.3; 95% confidence interval [CI], 1.2–1.3; women: OR 1.2; 95% CI, 1.1–1.3) and infrequent fruit/vegetable intake (men: OR 1.1; 95% CI, 1.1–1.2; women: OR 1.4; 95% CI, 1.3–1.5) and fish/meat intake (OR 1.2; 95% CI, 1.1–1.3 for both sexes). No interaction was observed between having fewer teeth and food intake. Obesity was associated with the same factors: having fewer teeth (ORs 1.2 and 1.3 for men and women, respectively) and infrequent intake of fruit/vegetables (ORs 1.1 and 1.2 for men and women, respectively) and fish/meat (OR 1.1 for both sexes). Infrequent fruit/vegetable intake showed a higher OR for underweight in women with fewer teeth than for others.
    Conclusions: Having fewer teeth and infrequent food intake were associated with both weight loss and obesity. A significant interaction was observed in the associations of having fewer teeth and infrequent food intake with underweight in women.
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