Objective: To examine whether physical activity and sedentary behavior were associated with the occurrence of falls among a community-dwelling older population.

Methods: This was a community-based, 1-year prospective cohort study. In 2009, baseline questionnaires were mailed to 3080 randomly selected residents aged 60 to 79 years; 2534 residents (82.3%) responded to the baseline survey, and 1-year follow-up surveys were subsequently mailed to them. The data for 1890 respondents who had no falls in the past year at baseline were analyzed. Physical activity and sedentary behavior were assessed by the Japanese short version of the International Physical Activity Questionnaire. Association between physical activity status (moderate to vigorous physical activity; MVPA and sedentary behavior time; SBT) and the occurrence of falls was analyzed by multivariable-adjusted logistic regression analysis with adjustment for sex, age, education years, self-rated health, depressive symptom, smoking, chronic disease history, chronic knee pain, medication use and consultation with physicians.

Results: A total of 163 (10.5%) participants had at least one fall during 12 months at 1-year follow-up. MVPA level was not significantly associated with falls. Compared with adults reporting lowest MVPA (0 MET-hours/week), odds ratios for falls were 1.72 (95% confidential interval; CI 0.98–3.02) among those with the middle MVPA (8.25–23.0 MET-hours/week) and 1.31 (95% CI 0.75–2.29) among those with the highest MVPA (≥75.4 MET-hours/week). However, the longest SBT (≥420 min/day) was significantly associated with higher risk of falls (adjusted odds ratio=1.96, 95% CI=1.02–3.79), compared with the shortest SBT (0–119 min/day).

Conclusions: Prolonged SBT was associated with greater risk of falls in older adults. Our findings indicate the importance of evaluating the SBT as a predictor of falls in community-dwelling older adults. Future longitudinal studies with objective measurements are needed.

Objective: The purpose of this longitudinal study was to examine whether exercise self-efficacy (SE) mediated the relationship between the change of physical activity (PA) and health related quality of life (HRQOL) in community-dwelling older adults.

Methods: The sample consisted of 49 non-demented community-dwelling older participants. Participants were assessed at baseline (2006) and 7 years later (2013). PA and SE were calculated each change. HRQOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) instrument at follow up, and calculated physical component summary score (PCS) and mental component summary score (MCS). PA was assessed by pedometers, and SE was assessed by the exercise self-efficacy questionnaire. Mediation analysis followed the approach outlined by Baron and Kenny.

Results: In mediation analysis, the mediating effect of SE on the association PCS and PA was observed. However, SE didn’t act as a mediator of the association MCS and PA.

Conclusion: Results of this study suggested that exercise self-efficacy partially mediated the relationship between the change of PA and HRQOL with physical health in community-dwelling older adults.

Purpose: This report was written with two goals: The first goal was to compare the differences between physical activity guidelines of each Asian country. The second goal was to compare the methods and results of the physical activity assessments of each of the Asian countries.

Methods: We performed a comprehensive search of Google Search, Google Scholar, MEDLINE, ELSEVIER, BioMed, and BMC Public Health search for information on the physical activity guidelines, as well as the methods and results of physical activity assessment across all Asian countries (n=51).

Results: We obtained the physical activity guidelines, methods and results of physical activity assessment from six countries (Hong Kong, Malaysia, Singapore, Saudi Arabia, Korea, and Japan). The physical activity guidelines of many countries were similar to those recommended by the WHO such as “at least 150 minutes of moderate level aerobic exercise, or 75 minutes of intense aerobic exercise per week”. Numerous countries have also been using the same definition of physical activity as the WHO such as “do meet at least one of the following criteria; 1) three or more days of vigorous activity of at least 20 minutes per day, 2) five or more days of moderate-intensity activity or walking of at least 30 minutes per day, 3) five or more days of any combination of walking, moderate-intensity or vigorous intensity activities achieving a minimum of at least 600 MET-min/week” for the purposes of physical activity assessment.

Conclusions: The publication of English versions of each country’s physical activity guidelines and sharing of information would, therefore, lead to further improvement of each country’s physical activity guidelines. Moreover, it is ideal to use survey methods that assure comparability on minimally required items at an international level.

The Japanese Association of Exercise Epidemiology has approved a research project “to promote the creation, communication, and utilization of evidence from intervention studies in Japan”. In response, we aimed to provide evidence of an effective group-based weight-loss program called the SMART Diet for overweight and obese adults. We conducted a randomized controlled trial to demonstrate the effectiveness of the SMART Diet, which was developed based on one-arm and non-randomized controlled trials. In terms of generalizability through the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, the participants in the previous studies were relatively small and biased (“reach”). The SMART Diet is composed of a motivational single lecture, educational materials, and group-based support. The “effectiveness” of each component was verified in a randomized controlled trial. Although “adoption” and “implementation” have not been verified, training seminars for instructors of the SMART Diet have been held to promote the adoption and implementation of the program. “Maintenance” of the program was examined, and the result was acceptable. However, further intervention for weight-loss maintenance is needed. Although challenges remain to be addressed, the SMART Diet was verified as an effective weight-loss program over a relatively short period and is expected to be utilized for health promotion practice.

We conducted a randomized controlled trial to demonstrate the effectiveness of a home-based exercise program, called the RAKUHIZA Taiso, which is sent by mail for the alleviation of knee pain. This article responds to a research project approved by the Japanese Association of Exercise Epidemiology to promote the creation, communication, and utilization of evidence from intervention studies in Japan. We aimed to provide evidence for the effectiveness of an exercise program, which is sent by mail, in alleviating knee pain, and to discuss its generalizability through the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Participants in this program were 0.1% of the elderly in the target area who were presumed to have knee pain; 4.0% received the information for this program (“reach”). Further work is needed to improve the dissemination of information and recruitment to take advantage of this program. On the other hand, the completion rate was 84.1%; the exercise implementation rate was as high as 84.5%; and the effect size of this program was equivalent to that of group exercise (“effectiveness”). In this program, the participants exercised by following a manual. In addition to the improvement of the exercise manual, “implementation” appears to require the development of an operating manual as well as the involvement of experts to provide participants with expert advice to promote this program safely. Future study is required to verify the “adoption” and “maintenance” of this program. Although generalization of the intervention remains an issue, this is a valid and practicable program for alleviation of knee pain, which is expected to be actively utilized as part of health promotion practice.

Background: Differences in the characteristics of respondents and nonrespondents to a survey can be a cause of selection bias. The aim of this study was to determine the sociodemographic and lifestyle characteristics of respondents to a field-based accelerometry survey.

Methods: A cross-sectional mail survey was sent to 4000 adults (50% male; age 20 to 69 years) who were randomly selected from the registries of residential addresses of 4 cities in Japan. There were 1508 respondents (responding subsample) to the initial questionnaire. A total of 786 participants from the responding subsample also agreed to wear an accelerometer for 7 days (accelerometer subsample). Age, sex, and city of residence were compared between the accelerometer subsample and all 3214 nonrespondents, including those who did not respond to the initial questionnaire. In addition, multiple logistic regression analyses were used to compare the sociodemographic and lifestyle characteristics of the accelerometer subsample and the 722 respondents who participated in the questionnaire survey but not the accelerometry (questionnaire-only subsample).

Results: As compared with all nonrespondents, the accelerometer subsample included significantly more women, middle-aged and older adults, and residents of specific cities. Multiple logistic regression analyses comparing the accelerometer and questionnaire-only subsamples revealed that participation in the accelerometry survey was greater among nonsmokers (odds ratio, 1.35; 95% confidence interval, 1.02–1.79) and persons who reported a habit of leisure walking (1.56, 1.21–2.01).

Conclusions: Sex, age, city of residence, smoking status, and leisure walking were associated with participation in accelerometry. This response pattern reveals potential selection bias in mail-based accelerometry studies.