Background: Hypertension is one of the most common chronic diseases, and dietary factors play an important role in hypertension. We examined the interaction of dietary sodium-to-potassium (Na/K) ratio and dinner energy ratio on hypertension.

Methods: We conducted this study using data from the cross-sectional National Survey for Nutrition and Adult Chronic Disease in 2015 in Inner Mongolia, China. Dietary data were collected using 24-hour diet records with food weights across 3 consecutive days. Logistic regression was used to determine the interaction of dinner energy ratio and dietary Na/K ratio on hypertension.

Results: A total of 1,861 participants were included in this study, and 914 individuals were hypertensive (49.1%). Dinner energy ratio and high dietary Na/K ratio were independently related to high prevalence of hypertension. A formal test showed that dinner energy ratio interacted significantly with dietary Na/K ratio on hypertension (P < 0.001), with an adjusted odds ratio (OR) of 1.119 (95% confidence interval [CI], 1.040–1.203). Participants whose dinner energy ratio greater than 39.1% and dietary Na/K ratio of 3.625–6.053 had the highest OR of hypertension prevalence, with an adjusted OR of 2.984 (95% CI, 1.758–5.066), compared with participants with dinner energy ratio of 30.2–39.1%, and dietary Na/K ratio less than 2.348.

Conclusion: Our study highlighted the interactive effect of dinner energy ratio and dietary Na/K ratio on hypertension among adults in Inner Mongolia. We advocated a balanced diet (dinner energy ratio not small or large) and a low dietary Na/K ratio for reducing the prevalence of hypertension.

Background: Since 2011, commercial truck drivers have been required to take alcohol breath tests at the beginning and end of their working hours due to their employers’ legal obligations. However, non-commercial truck drivers are not required to do so. We examined whether alcohol-related crashes had decreased after 2011 among commercial truck drivers.

Methods: Using police data, we conducted a joinpoint regression analysis to examine the trend in the proportion of alcohol-related crashes from 1995 through 2020 caused by commercial truck drivers (who were subjected to alcohol breath testing) and non-commercial truck drivers (who were not subjected to testing). The annual percentage change in this trend was also estimated.

Results: During the 26-year study period, truck drivers caused 1,846,321 at-fault crashes, and 0.4% of the crashes involved intoxicated driving. A significant decreasing trend in the proportion of alcohol-related crashes was identified among both commercial and non-commercial truck drivers in the 2000s, during which several legal amendments were made against drunk driving. The annual percentage change was −13.5% from 2001 to 2012 among commercial truck drivers, and −14.9% from 2001 to 2011 among non-commercial truck drivers. No decreasing trend was observed afterwards, despite the introduction of mandatory alcohol breath testing in 2011.

Conclusion: The effect of mandatory alcohol breath testing on reducing alcohol-related crashes among commercial truck drivers was not evident.

Background: Little is known about the impacts of sleep duration and daytime napping on the risk of type 2 diabetes mellitus (T2DM).

Methods: In this study, 20,318 participants (7,597 men, 12,721 women) aged 40–79 years without a history of T2DM, stroke, coronary heart disease, or cancer at baseline (1988–1990), completed the baseline survey and the 5-year follow-up questionnaires, which included average sleep duration, napping habits, and self-reports of physician-diagnosed diabetes. The multivariable odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model.

Results: During the 5-year follow-up, 531 new cases of T2DM (266 men and 265 women) were documented. Sleep duration ≥10 hours was associated with higher risk of T2DM compared to sleep duration of 7 hours (OR 1.99; 95% CI, 1.28–3.08). The excess risk was observed for both sexes and primarily found among the non-overweight; the multivariable ORs of sleeping ≥10 hours compared to 7 hours were 2.05 (95% CI, 1.26–3.35) for the non-overweight (BMI <25 kg/m²) and 1.38 (95% CI, 0.49–3.83) for the overweight (BMI ≥25 kg/m²). The respective ORs of nappers versus non-nappers were 1.30 (95% CI, 1.03–1.63) and 0.92 (95% CI, 0.65–1.29). Among the non-overweight, nappers who slept ≥10 hours had the highest risk of T2DM (OR 2.84; 95% CI, 1.57–5.14), non-nappers who slept ≥10 hours (OR 2.27; 95% CI, 1.27–4.06), and nappers who slept <10 hours (OR 1.30; 95% CI, 1.03–1.64), compared with non-nappers who slept <10 hours.

Conclusion: Long sleep duration was associated with the risk of T2DM in both sexes, which was confined to the non-overweight.

Background: Pseudohypoparathyroidism (PHP) and nonsurgical hypoparathyroidism (NS-HypoPT) are rare diseases with hypocalcemia, hyperphosphatemia, and high and low parathyroid hormone levels, respectively. In Japan, over 20 years have passed since the last survey on these diseases. We carried out a nationwide cross-sectional survey to estimate the prevalence of these diseases in 2018.

Methods: We conducted a nationwide mail-based survey targeting hospitals in 2018. From a total of 13,156 departments throughout Japan, including internal medicine, pediatrics, neurology, and psychiatry, 3,501 (27%) departments were selected using a stratified random sampling method. We asked each included department to report the number of patients with PHP and NS-HypoPT in 2017.

Results: The overall survey response rate was 52.0% (1,807 departments). The estimated number of patients with PHP and NS-HypoPT was 1,484 (95% confidence interval [CI], 1,143–1,825) and 2,304 (95% CI, 1,189–3,419), respectively; the prevalence per 100,000 population was 1.2 and 1.8, respectively.

Conclusion: In this study, we generated estimates of the national prevalence of PHP and NS-HypoPT in Japan during 2017, which were found to be higher than those previously reported.

Background: The impact of meeting leisure-time physical activity (LTPA) recommendations and household physical activity (HPA) on all-cause mortality in the Taiwanese population is unclear. We aimed to investigate the relationship between sufficient LTPA and all-cause mortality in middle-aged and older Taiwanese adults and the role of HPA in those with insufficient LTPA.

Methods: This nationwide prospective cohort study included 4,960 participants aged ≥50 years from the Taiwan Longitudinal Study in Aging (TLSA) survey. Physical activity patterns were assessed in 2003 and then followed up until 2015 for mortality through the National Death Registration Record. Cox proportional hazards regression was conducted to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality.

Results: Of the 4,960 participants, 1,712 died of all-cause mortality. Compared to those who had insufficient LTPA, participants who engaged in sufficient LTPA showed a significantly lower risk of all-cause mortality (HR = 0.84, 95% CI, 0.73–0.97). For those with insufficient LTPA, HPA also had a significantly reduced risk of all-cause mortality (HR = 0.85, 95% CI, 0.75–0.96) among general population. Similar associations were observed in subsequent sensitivity analyses. The subgroup analysis showed that the relationship between HPA and reduced mortality risk was only found in the women with insufficient LTPA group.

Conclusion: This study confirmed that sufficient LTPA is associated with a lower risk of all-cause mortality. If sufficient LTPA cannot be performed, additional HPA is related to lower mortality.

Background: Although cigarette smoking is an established risk factor for bladder cancer, assessment of smoking impact on bladder cancer in Asian populations has been hindered by few cohort studies conducted in Asian populations. Therefore, we investigated the risk of bladder cancer associated with smoking status, cumulative smoking intensity, and smoking cessation in Japan.

Methods: We analyzed data for 157,295 men and 183,202 women in 10 population-based cohort studies in Japan. The risk associated with smoking behaviors was estimated using Cox regression models within each study, and pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) for the incidence of bladder cancer were calculated.

Results: During 4,729,073 person-years of follow-up, 936 men and 325 women developed bladder cancer. In men, former smokers (HR 1.47; 95% CI, 1.18–1.82) and current smokers (HR 1.96; 95% CI, 1.62–2.38) had higher risk than never smokers. In women, current smokers had higher risk than never smokers (HR 2.35; 95% CI, 1.67–3.32). HRs in men linearly increased with increasing pack-years. Risk decreased with increasing years of smoking cessation in men, with a significant dose-response trend. Former smokers with a duration of more than 10 years after smoking cessation had no significantly increased risk compared with never smokers (HR 1.26; 95% CI, 0.97–1.63).

Conclusion: Data from a pooled analysis of 10 population-based cohort studies in Japan clearly show an association between cigarette smoking and bladder cancer risk. The risk of smokers may approximate that of never smokers following cessation for many years.