OBJECTIVE: The aim of the study was to study the relationship between skipping breakfast and obesity among breakfast skippers. Subjects are 396 male breakfast skippers (mean age 42.7 years) who had a checkup. We classified the subjects according to the frequency of breakfast skipping; 1-2 day/week, 3-4 day/week and every day. In addition, we divided these group into BMI ≤ 25 kg/m2 (control group: CG) and BMI 25 kg/m2 (obesity group: OG) .
STATISTICAL ANALYSES: Frequency of breakfast skipping was compared using Kruskal-Wallis test. CG and OG were compared using Man-Whitney test.
RESULT: We compared CG and OG according to every frequency of skipping. OG was significantly higher in energy per one meal and intake of fish; significantly lower in the level of physical activity and vegetable intake. Those who drink alcohol tend to skip breakfast more frequently. But it is decreased significant physical activity and vegetable intake.
CONCLUSIONS: The characteristics of obese subjects who skip breakfast were low physical activity, high food intake per one meal and unbalanced diet. It was suggested that these characteristics were associated with obesity and skipping breakfast.

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The national program of health evaluation and promotion is supposed to start in 2008. The program mentions to detect impaired glucose metabolism, i.e. firstly either fasting blood glucose (FBS) or HbA₁c may be chosen, secondly if both FBS and HbA₁c are measured, value of FBS takes precedence over HbA₁c. Using our data in 2006, we examined the policy.
Among the subjects whose FBS and HbA₁c were checked simultaneously, 410 were referred to medical facilities for further examination or treatment according to a certain criteria, i.e. FBS of 126 mg/dl or higher and/or HbAlc of 6.1% or higher.
The results of further or re-examination were sent back in 235 subjects (57.3%) . Among 108 subjects with FBS of 126 mg/dl or higher, 86 (79.6%) were diagnosed as diabetes mellitus (DM) . On the other hand, 172 (83.1%) were diagnosed as DM among 207 subjects with HbA₁c of 6.1% or higher. Diagnostic efficiency of DM is not significantly different between FBS and HbA₁c.
In 235 subjects, only FBS, or only HbA₁c or both FBS and HbA₁c meat the criteria were 28 (FBS group), 127 (HbA₁c group), and 80 (FBS + HbA₁c group), respectively.
A hundred and eighty three subjects were diagnosed as DM, 11 in FBS group (39.3%), 97 in HbA₁c group (76.4%), and 75 in FBS + HbA₁c group (93.7%) . Diagnostic efficiency of DM in HbA₁c group was better than in FBS group (p < 0.005), and the efficiency in FBS + HbA₁c group was also better than both in FBS group and in HbA₁c group (p < 0.005, respectively) . If FBS only is examined to detect DM, 97 (53.0%) out of 183 subjects with DM must have been missed. The cost-effectiveness analysis also suggests the usefulness to examine HbA₁c.
Our data suggest that HbA₁c is indispensable to detect DM in health examination, and also both FBS and HbA₁c should be measured in the health examination program.

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Recently, application of information techniques in the various fields has been promoted in Japan. In the medical field, we can see most recently several examples of the practical use of informatics such as an electronic medical record.
Multiphasic health testing has close relation to informatics as it utilize a computer and many devices for information processing. However, so far rather use of hardware is main as to the use of informatics in the region of multiphasic health testing. Hereafter, it is expected that many data obtained by the multiphasic health testing are processed by using various methods and techniques of informatics so that new findings, knowledge or information can be extracted for health control and health promotion of examinees.
In the present paper, the trend of the application of informatics for health evaluation and promotion is described and the several examples of our studies such as estimation of the biological age of examinees, an analysis of the relationship between risk factors of diseases and lifestyles of examinees examined continuously, construction of community health control support system by using Internet and so on are introduced.

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In Japan, there are near 600.000 incidences and 300.000 mortalities of cancer. This mortality rate of cancer is most high in Japan.
Lung cancer, pancreatic duct cancer, esophagus cancer are grouped in poor prognosis. Pancreas is located in retroperitoneal space. Therefore, no symptom appears even in case of small size of pancreatic duct cancer. In fact, the data of summarized small pancreatic cancers demonstrated 57% of 5 year survival even in less tumor size than 1 cm. Therefore, it is necessary to detect much smaller pancreatic cancer. In Osaka Medical Center for Cancer and Cardiovascular Diseases, we have succeeded in establishing high risk group of pancreatic cancer, accompanied with pancreatic duct dilatation and/or pancreatic cyst. There was 9 fold detection of pancreatic cancer in established high risk group. Cytologic examination of pancreatic juice shows a higher positive rate in small size of pancreatic cancer (early stage) . In fact, all patients (only positive cytology) have survived longer than 5 years preserving good QOL.
Survival of esophagus cancer patients is also pretty poor in case of invasing into submucosal space. Endoscopic examination should be performed if we wish get a long survival and good QOL. Endoscopic examination distinguish the difference between cancer and dysplasia. Therefore, it is expected to detect the esophagus cancer of extremely early stage and to resect by the method of EMR and ESD.
It is eagerly expected to develop the effective medical examination against cancer and to detect the extremely small cancer in near future.

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Health promotion in later life has now been one of the most important issues of the health policy in our country, where approximately 29% of the Japanese population will be 65 years or older by the year 2025. It is, however, expected to be a preferable scenario, if the onset of disabilities would be also delayed along with longevity. Therefore, health promotion in the elderly must be an important preventive strategy, where the most suitable geriatric assessment has to be performed timely and effectively to the most appropriate elder persons, its effectiveness has to be scientifically proved as medical evidence and its cost/effective ratio has also to be reasonably demonstrated. Although there has no definite evidence showing that the adequate education to improve lifestyle based on the adequate health evaluation leads to the risk reduction or improvement of morbidity or mortality, effectiveness of preventive intervention seems to be promising, if one sees preliminary reports of Medicare's Healthy Aging Initiative in the USA specified with preventive benefits and reduced behavioral risk factors, such as smoking, falls and physical activity. Comprehensive geriatric assessment (CGA) characterized by holistic health evaluation associated with inter-professional team care was initially developed in England and its usefulness has long been emphasized with regard to evaluation of the necessity of assisting patients and decision of necessary care plans. It is, however, the most useful to the frail elderly for prevention of fall, declining memory function, institutionalization, utilization of medical resources, and increase of sense of wellness and life satisfaction. Since studies concerning cost/ effectiveness on CGA have been extremely rare, the further research is remained to be mandatory under the defined minimum specification of CGA including subjects treated, well accepted type of CGA, standardized styles of geriatric intervention and inter-professional team approach, at least.

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