Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
28 巻 , 6 号
Original Article
  • Jeevitha Mariapun, Chiu-Wan Ng, Noran N. Hairi
    2018 年 28 巻 6 号 p. 279-286
    発行日: 2018/06/05
    公開日: 2018/06/05
    [早期公開] 公開日: 2018/04/14
    ジャーナル オープンアクセス

    Background: Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth.

    Methods: We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index.

    Results: Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor.

    Conclusion: As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

  • Kiyohide Tomooka, Isao Saito, Shinya Furukawa, Koutatsu Maruyama, Eri ...
    2018 年 28 巻 6 号 p. 287-291
    発行日: 2018/06/05
    公開日: 2018/06/05
    [早期公開] 公開日: 2017/12/28
    ジャーナル オープンアクセス

    Background: Yellow tongue coating is one of the clinical signs for diabetes mellitus according to traditional East Asian medicine. Few reports have been available on the association between yellow tongue coating and the prevalence of type 2 diabetes in the general population. We examined that association among population samples of non-smoking men and women.

    Methods: The study subjects were Japanese non-smoking men (n = 315) and women (n = 654) aged 30–79 years who resided in Toon city and participated in the Toon Health Study from July 2011 through November 2014. Tongue coating was assessed by a nationally licensed acupuncturist and classified into three categories of white (normal), light yellow, and yellow. We performed an oral glucose tolerance test to confirm the presence of diabetes mellitus and prediabetes. The associations between yellow tongue coating and the prevalence of diabetes mellitus and prediabetes were examined using multivariable logistic regression analyses, adjusting for age, sex, body mass index, drinking status, and physical activity.

    Results: The multivariable odds ratios of diabetes mellitus were 1.39 (95% confidence interval [CI], 0.72–2.67) for light yellow tongue coating and 2.23 (95% CI, 1.16–4.30) for yellow tongue coating compared with white tongue coating. The respective multivariable odds ratios of prediabetes were 1.13 (95% CI, 0.80–1.61) and 1.43 (95% CI, 0.96–2.12).

    Conclusions: Yellow tongue coating was associated with higher prevalence of diabetes mellitus and tended to be associated with that of prediabetes among Japanese non-smoking men and women.

  • Jinkyung Cho, Youngyun Jin, Hyunsik Kang
    2018 年 28 巻 6 号 p. 292-299
    発行日: 2018/06/05
    公開日: 2018/06/05
    [早期公開] 公開日: 2018/01/20
    ジャーナル オープンアクセス

    Background: This study aimed to explore the associations between weight status, physical activity, and depression in Korean older adults.

    Methods: We used the baseline data drawn from the 2008 baseline survey utilized in the Living Profiles of Older People Survey, comprised of 15,146 community-dwelling older people (42.6% men and 57.4% women) aged 60 years and older residing in the Republic of Korea. After excluding respondents with missing data on height, weight, and physical activity (PA), data on 10,197 samples (43.3% men and 56.7% women) were analyzed in this study.

    Results: Underweight and completely inactive individuals had poorer sociodemographic and health behavioral characteristics and increased risks of late-life depression compared with normal weight and sufficiently active individuals, respectively. In terms of the aerobic PA guidelines, completely inactive individuals had a significantly higher risk of late-life depression (odds ratio 1.730; 95% confidence interval, 1.412–2.120) compared with sufficiently active individuals, even after adjustments for age, education, household income, night sleeping, living status, marital status, smoking, number of comorbidities, nutritional status, self-reported health status, and cognitive performance as covariates. In addition, those who did not meet the PA guidelines and were underweight or overweight/obese were more likely to have late-life depression compared to those who were active and normal weight.

    Conclusions: The current findings of the study suggest that modifiable, lifestyle risk factors, such as physical inactivity, underweight, and overweight/obesity, are positively associated with late-life depression in Korean older adults.

  • Ryusuke Ae, Yosikazu Nakamura, Hiroshi Tada, Yumi Kono, Eiko Matsui, K ...
    2018 年 28 巻 6 号 p. 300-306
    発行日: 2018/06/05
    公開日: 2018/06/05
    [早期公開] 公開日: 2018/01/20
    ジャーナル オープンアクセス

    Background: Globally, few published studies have tracked the temporal trend of dioxin levels in the human body since 2000. This study describes the annual trend of dioxin levels in human breast milk in Japanese mothers from 1998 through 2015.

    Methods: An observational study was conducted from 1998 through 2015. Participants were 1,194 healthy mothers following their first delivery who were recruited annually in Japan. Breast milk samples obtained from participants were analyzed using gas chromatography and mass spectrometry for dioxins, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (PCBs).

    Results: Mean age was 29.5 years, and 53% of participants were 20–25 years old. A declining trend in total dioxin levels was found, from a peak of 20.8 pg toxic equivalence (TEQ)/g fat in 1998 to 7.2 pg TEQ/g fat in 2014. Data from the last 5 years of the study indicated a plateau at minimal levels. In contrast, an increasing trend was found in the mean age of participants during the last 5 years. Although significantly higher dioxin levels were observed in samples from older participants, an upward trend in dioxin levels was not observed, indicating that dietary and environmental exposure to dioxins had greatly diminished in recent years.

    Conclusions: Dioxin levels in human breast milk may be approaching a minimum in recent years in Japan. The findings may contribute to global reference levels for environmental pollution of dioxins, which remains a problem for many developing countries.

  • Yui Yamaoka, Naho Morisaki, Haruko Noguchi, Hideto Takahashi, Nanako T ...
    2018 年 28 巻 6 号 p. 307-314
    発行日: 2018/06/05
    公開日: 2018/06/05
    [早期公開] 公開日: 2018/02/10
    ジャーナル オープンアクセス

    Background: Public attention is given to infants with socially high risks of child abuse and neglect, while clinical attention is provided to infants with a biologically high risk of diseases. However, few studies have systematically evaluated how biological or social factors cross over and affect cause-specific infant mortality.

    Methods: We linked birth data with death data from the Japanese national vital statistics database for all infants born from 2003–2010. Using multivariate logistic regression, we examined the association between biological and social factors and infant mortality due to medical causes (internal causes), abuse (intentional external causes), and accidents (unintentional external causes).

    Results: Of 8,941,501 births, 23,400 (0.26%) infants died by 1 year of age, with 21,884 (93.5%) due to internal causes, 175 (0.75%) due to intentional external causes, and 1,194 (5.1%) due to unintentional external causes. Infants with high social risk (teenage mothers, non-Japanese mothers, single mothers, unemployed household, four or more children in the household, or birth outside of health care facility) had higher risk of death by intentional, unintentional, and internal causes. Infant born with small for gestational age and preterm had higher risks of deaths by internal and unintentional causes, but not by intentional causes.

    Conclusions: Both biological as well as social factors were associated with infant deaths due to internal and external causes. Interdisciplinary support from both public health and clinical-care professionals is needed for infants with high social or biological risk to prevent disease and injury.