Background The objective of this study was to identify factors influencing brain natriuretic peptide (BNP).
 Methods and Results The subjects were 2,670 examinees undergoing a health checkup. Multiple regression analysis concerning log-transformed BNP was performed, and the following findings were clarified: (1) age, systolic blood pressure, and the hemoglobin level were important explanatory factors, (2) there was marked variation in the standard regression coefficient (β) of the percent body fat and body mass index (BMI), (3) there was a high frequency of an opposite sign of β for the BMI and percent body fat, and (4) there were larger absolute values of β for cholinesterase and albumin. Findings (2) and (3) indicate that the combination of the BMI and percent body fat measured by bioelectrical impedance analysis is an important explanatory factors and we proposed that the difference between the BMI and percent body fat serves as a factor representing the body fluid volume or dehydration. Finding (4) suggest that undernutrition elevates the BNP level.
 Conclusion Age, systolic blood pressure, and the hemoglobin level are important factors influencing BNP. The BMI alone is not a so important predictor, but the combination of the BMI and percent body fat measured by bioelectrical impedance analysis is an important predictor. In addition, under-nutrition elevates the BNP level.

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 In this report, I want to clarify the meaning of Gross National Happiness (GNH) comparing with concept of Gross Domestic Product (GDP), which was number 1 in Japan in 1993, but it got down to 18^th.
 The former king of Bhutan made an international news headline in 1972, proposing that the kingdom of Bhutan should aim increased Gross National Happiness instead of GNP (Gross National Product)
 In 2005 Prof. Y. Tsutsui in Japan proposed “Behavioral economics”. He suggested taking a departure from the traditional version of economics that we have become familiar: He proposed that we consider economic more in the framework of human behavior, which cannot be analyzed and summarized with rationalism. He mentioned that it would be in incorrect to assume that we seek monetary gain only. We are also controlled by emotions. Therefore, it is secondary to take into account the individuals philosophy to life, reason and purpose of living as well as of human existence.
 He mentions ultimate goal of study of economics aims at “the ideal state of happiness in life”. From this point of view, Prof. Tsutsui's research, on the subjective view of happiness in degree, can be considered an important landmark. Dr. Tsutsui made a survey in Japan in 2005, asking “How happy are you?”
 In 2006 the same kind of study was done by Dr. A. White, University of Leicester, and “World map of Happiness” was shown. The Denmark people were ranked as first, USA was ranked the 23^rd, and Japan was the 90^th.
 I analyzed the meaning of spirituality in Christian countries and compared it with spirituality in Buddhism (Zen). I introduced Prof. Brook's book, “Gross National Happiness”, which suggests how American people is able to achieve higher degree of G.N.H.
 At the 2011 biannual conference of International Health Evaluation and Promotion Association (IHEPA) held in Hawaii, I proposed to include test of Alzheimer Disease should be as a new screening item and study of fragility should also be added.
 So I introduced the results of 3 years' cohort study done by the volunteers over the age of 75 years old (Health Research Volunteer (HRV)), who are senior members of the Association of the New Elderly. Its results of 3 years' follow up will be reported soon.
 Finally I read my poems titled as “Hope and real happiness”. It tells Happiness is present in our mind of our hope, but not in the behavioral desire of us.

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 Introduction One diagnostic criterion for metabolic syndrome (MS) as a conventional method is the measurement of abdominal circumference size. The aim of this study is to investigate the prevalence of MS precisely based on direct measurement of the visceral fat area (VFA) using computed tomography (CT).
 Methods The VFAs were assessed by CT in 470 individuals, including 262 men (aged 47.6±10.2: mean±SD) and 208 women (aged 43.9±8.5) during a 3-year period. Blood pressure, fasting blood glucose, and lipid profiles were also measured. For those who had VFA>or=100cm², MS was defined as the presence of at least two of the following criteria: a triacylglycerol level>or=150mg/dl, high-density lipoprotein cholesterol level<40mg/dl, blood pressure>or=130/85mmHg, and fasting glucose level>or=110mg/dl.
 Results The mean VFA size was 91.6±43.2 in men and 35.5±29.4 in women respectively. 99 (37.8%) of men and 9 (4.3%) of women demonstrated the VFA of>or=100cm². As a result, 11.1% (29/262) of men and 1.9% (4/208) of women were diagnosed to have MS, which is lower than previously reported in Japan.
 Conclusion Our results suggest that prevalence of MS assessed based on the direct measurement of VFA might therefore be lower than previously reported, especially in case of women.

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 Purpose Currently, general health check-ups are carried out as a part of secondary prevention in Japan. Our Tokai University Tokyo Hospital launched anti-aging health check-ups in June 2006. The aim of this check-up system was to point out signs of aging-related disorders at an early stage and to give guidance according to individual results in combating them. These include examination items backed by published evidence in connection with aging related to various disadvantageous conditions. In this study, we tried to classify these items according to aging, then evaluate their relative importance when introducing new biomarkers to general health checks and holistic health screening.
 Method Five hundred and thirty-six recipients who underwent anti-aging health check-ups at Tokai University Tokyo Hospital between June 2006 and April 2010 were included in the study. These consisted of 299 males and 254 females, and their age range was 30 y/o to 89 y/o with a mean age of 62.6±7.6 years. PWV, IMT, LDL-C, HDL-C, FFA, hs-CRP, TG, 8-OHdG, IPs, vitamin A, B12, folic acid, IGF- 1, DHEA-s, free testosterone in males, estrogen in females, free-T4, adiponectin, blood pressure, HbA1c and cystatin C were measured, and the gender and ten-years age specific averages and standard deviations were expressed. The correlation between age and the results of individual items were statistically analyzed using Pearson product-moment correlation coefficient analysis. Items that showed a significant change with aging (p<0.01) were identified as “aging markers” and those that showed a tendency to change (p<0.05) as “aging associated markers”.
 Results The results showed that baPWV, IMT, FFA, Estradiol, DHEA-s, systolic blood pressure and cystatin-C were included as “aging markers”, which strongly reflect aging related change. On the other hand, IGF-1, free testosterone and adiponectin (males) were thought to be “aging associated markers”, which showed a tendency towards aging-related change. Others have evidence of links to these markers, and can be called aging modulating factors.
 Conclusions A trial study was conducted to propose new examination items for general health check-ups using our anti-aging health check-up data. In combination with our previous publication, many aging and aging-related items can be changed directly or indirectly through modulating factors. Our study indicated that incorporating aging-related items in general health check-ups should be beneficial when considering the benefits focusing on the future super-aging society in Japan.

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 Japan Society of Health Evaluation and Promotion has engaged in several activities for quality improvement of multiphasic health checkups. The activities consist of four major topics. First one concerns total quality control about checkup examinations. Second one relates human resource development including certification of medical specialist. Third one relates to the information quality including health data exchange. Concept of health cloud is mentioned for data management system dedicating health promotion. Last one refers to the development of educational material based on health literacy. Our society is responsible for quality improvement activities and building appropriate evidence concerning multiphasic health checkups.

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