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Background: Although the benefits of the recommended level of physical activity on reducing chronic diseases are well-established, most of the Japanese population is not sufficiently active. Thus, examining correlates is an important prerequisite for designing relevant polices and effective programs. The present study investigated psychological, social, and environmental factors associated with meeting physical activity recommendations among Japanese adults.Methods: Data were analyzed for 1,932 men and women (43.6 +/- 13.0 years), who responded to an Internet-based cross-sectional survey. Self-reported measure of physical activity, psychological (self-efficacy, pros, and cons), social ( social support, health professional advice), environmental ( home fitness equipment, access to facilities, neighborhood safety, enjoyable scenery, frequently observing others exercising, residential area), and demographic ( gender, age, marital status, educational level, household income level, employment status) variables were obtained. Based on the current national guidelines for exercise in Japan ( 23 METs.hour per week), respondents were divided into two categories-recommended and not recommended ( insufficient and inactive)-according to their estimated weekly physical activity level. An adjusted logistic regression model was utilized.Results: When adjusting for all other variables, self-efficacy ( men: OR = 2.13; 95% CI: 1.55-2.94, women: OR = 2.72; 95% CI: 1.82-4.08) and possessing home fitness equipment ( men: OR = 1.55; 95% CI: 1.14-2.10, women: OR = 1.41; 95% CI: 1.01-1.99) for both genders, social support ( OR = 1.44; 95% CI: 1.06-1.97) for men, and enjoyable scenery ( OR = 1.60; 95% CI: 1.09-2.36) for women were positively associated with attaining the recommended level of physical activity. In women, cons ( OR = 0.47; 95% CI: 0.33-0.67) and living in rural areas ( OR = 0.50; 95% CI: 0.25-0.97) were negatively associated with meeting the physical activity recommendations.Conclusion: In the psychological, social, and environmental domains, significant correlates of attaining the recommended level of physical activity were observed. Men and women had different patterns of psychological, social, and environmental correlates. These findings suggest that an intervention design that accounts for those correlates may more effectively promote physical activity among Japanese adults.

OBJECTIVE: Leisure-time sedentary behaviors (LTSBs) have been associated adversely with health outcomes. However, limited research has focused on different categories of LTSB. We aimed at identifying categories of LTSBs and examining their separate associations with indices of health among Japanese older adults. METHODS: A postal survey collected data on self-reported health, psychological distress, body mass index, moderate-to-vigorous physical activity (MVPA), LTSBs (five behaviors) and socio-demographic characteristics from 1,580 Japanese older adults (67% response rate; 65-74 years) in 2010. Exploratory factor analysis was used to classify LTSBs. Odds ratios (ORs) were calculated for associations of LTSB categories with self-reported health, psychological distress, overweight, and lower MVPA. Data were analyzed in 2013. RESULTS: Two categories of LTSB: passive sedentary time (consisting of TV time, listening or talking while sitting, and sitting around) and mentally-active sedentary time (consisting of computer-use and reading books or newspapers) were identified. Higher passive sedentary time was associated with a higher odds of being overweight (OR: 1.39, [95% CI: 1.08-1.80]), and lower MVPA (1.26, [1.02-1.54]). Higher mentally-active sedentary time was associated with lower odds of lower MVPA (0.70, [0.57-0.86]). CONCLUSIONS: Two types of sedentary time-passive and mentally-active-may play different roles in older adults' well-being.

The purpose of this study was to explore patterns of lifestyle walking behavior among Japanese adults aged 30-49 and to identify their sociodemographic characteristics.A sample of 5,009 was collected from registrants of a social research company. The study was a cross-sectional survey using the Internet. Measured variables were walking behavior in five domains (commuting, working, shopping, exercising and other movement) and sociodemographic characteristics. Hierarchical cluster analysis was utilized to identify walking patterns.Four walking behavior clusters were identified: cluster 1 (N=1,089) walking while commuting, working and shopping; cluster 2 (N=381) walking while commuting; cluster 3 (N=1,257) walking for exercise; cluster 4 (N=1,161) walking while shopping. Cluster 1 had the highest proportion of walkers who met physical activity recommendations. Also it had a high proportion of women who were unmarried, employed, without children, or finished university or graduate school. Cluster 2 showed a high proportion of men who were married, with children, with high household income, or finished university or graduate school, and women who were married, employed, without children, with high household income, or finished university or graduate school. Cluster 3 had a high proportion of women aged 40-49. Cluster 4 showed a low proportion of men with high household income and a high proportion of women who were married, unemployed, or with children.This study indicated that walking behavior patterns in both genders was different depending on marital status, number of children, educational level and household income. In addition, the employment status of women had apparent effects on these patterns.

Background–Several non-pharmaceutical policies, which include stay-at-home orders, mobility restrictions, and quarantine, have been implemented to reduce the spread of novel coron-avirus disease 2019 (COVID-19). The present study examines work style changes among company workers after COVID-19 and analyses their effects on workers’ domain-specific sedentary and active behaviours. Methods-We analysed data from a nationwide prospective online survey in Japan. The data were obtained in February 2019 (n = 3200) and in July 2020 (n = 1709) from the registered individuals of a Japanese internet research service company. The participants reported work style patterns before and after the outbreak of COVID-19 in the follow-up survey. Domain-specific sedentary behaviours and physical activities were assessed by questionnaires. Paired t-tests were used to compare work styles before and after the outbreak of COVID-19. Multivariable linear regression models were used to assess the associations between changes in work style and changes in sedentary behaviours and physical activities. Results. Workers had more working from home days and fewer office-based working days after the outbreak of COVID-19 (p < 0.001 and p < 0.001, respectively). The increase in the number of working from home days per week was significantly associated with increases in work-related sitting time and total sitting time (b = 0.16, 95% CI 0.08, 0.24, p < 0.001 and b = 0.23, 95% CI 0.11, 0.36, p < 0.001, respectively). However, it was also associated with a decrease in car sitting time (b = −0.04, 95% CI −0.06,-0.01, p < 0.001). In addition, the increase in the number of working from home days was associated with a decrease in work-related moderate physical activity (b =−0.06, 95% CI −0.10, −0.02, p < 0.001). Conclusions. Our study provided preliminary evidence of an increase in working from home days in response to COVID-19 in Japan and of how this increase in the number of working from home days has affected workers’ sedentary behaviours and physical activities. These findings shed light on the effects of COVID-19 on work styles and workers’ sedentary behaviours and physical activity.

BACKGROUND: Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers. METHODS: Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors. RESULTS: A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, "typically seeing work colleagues take sedentary breaks" was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = -7.08 [-13.75 to -0.40]). "I am motivated to take sedentary breaks" had an unfavorable association with less sedentary breaks (B [95% CI] = -1.36 [-2.61 to -0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, "Too stressed to take sedentary breaks" was significantly associated with less sedentary breaks (B [95% CI] = -5.6 [-9.17 to -2.02]). CONCLUSIONS: Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.

Background: It is vital to reduce the proportion of sedentary behavior in children. Understanding the duration and behavioral context is needed. The present study examined school-grade and sex differences in domain-specific sedentary times and concurrence with screen-time guidelines among Japanese elementary school children.Methods: A total of 625 children (330 boys) were surveyed in 2010 and 2014. Using a questionnaire, data regarding participants' grade (first through third grades: lower grades; fourth through six grades: higher grades), sex, weight, and height were collected in addition to the time spent per day engaging in each specific sedentary behavior separately: (1) reading or listening to music, (2) TV or video viewing, (3) TV game use, (4) internet use excluding class, (5) homework, and (6) car travel. Two-way analysis of covariance and logistic regression analyses, adjusted for BMI and moderate to vigorous physical activity, were used to examine school-grade and sex differences in sedentary behaviors and the independent risk of exceeding recommended total daily screen time ( 2 h).Results: On 625 children, mean minutes (SD) of sedentary behavior per week in (1) - (6) were 90.3 (123.4), 535.0 (356.6), 167.3 (222.1), 23.9 (70.9), 264.9 (185.3), and 33.4 (61.2) in weekdays and 42.1 (70.0), 323.9 (232.0), 123.0 (96.4), 15.8 (49.9), 74.4 (96.4), and 71.3 (84.9) in weekends, respectively. There were differences in the minutes of sedentary behavior between participants of 2010 and 2014; e.g., TV game use and homework in weekdays and weekdays and car travel in weekends. Boys spent more time in TV game use, and girls spent more time reading, listening to music, doing homework, and car travel. Higher-grade students spent more time reading or listening to music, using a computer, and doing homework. Higher-grade students were 2.09 times (95% CI: 1.32 - 3.30) in whole week, 2.08 times (95% CI: 1.45 - 3.00) in weekday, and 1.88 times (95% CI: 1.29 - 2.74) in weekend more likely to spend = 2 h per day in domains (2) - (4) (screen-time) than lower-grade students.Conclusions: Time spent engaging in each domain-specific sedentary behavior differed according to sex and school grade. Higher-grade students were less likely to meet screen-time guidelines. These findings highlight the need for domain-focused strategies to decrease sedentary behavior in Japanese school-age children.

Background: Dog ownership is emerging as an important correlate of sufficient physical activity and therefore has the potential to positively affect a portion of the population. A growing body of literature indicates that dog-walking contributes to increased physical activity. However, most of the previous studies have been conducted in Australia or the U.S. and have sampled from the general adult population. Purpose: This study examined the association between dog ownership, dog-walking, and physical activity in older Japanese adults. Methods: Participants were community-dwelling residents aged 65-74 years who responded to a population-based cross-sectional survey (N=1926). Physical activity, dog ownership, dog-walking, and sociodemographic attributes were self-reported (collected in 2010 analyzed in 2011). ANCOVAs and multivariate logistic regressions were used. Results: Overall, 14.0% of older adults were dog owners, with 71% reporting that they walked their dog for an average of 308.5±300.7 minutes/week. Dog walkers reported more minutes/week of moderate-to-vigorous physical activity (M±SE: 241.7±27.0) and total physical activity (M±SE: 698.6±40.6) than both non-dog walkers (M±SE: 110.7±41.8 M±SE: 527.2±62.9) and non-dog owners (M±SE: 164.7±9.1 M±SE: 519.2±13.7), respectively (p<0.05). Dog walkers also walked more minutes per week (M±SE: 508.0±33.4) than non-dog owners (M±SE: 384.5±11.3 p<0.05). Dog walkers were more likely to be sufficiently active than both non-dog walkers and non-dog owners (p<0.001). Conclusions: Use of dog-walking may be a potentially viable means of intervention for increasing walking and overall physical activity in older Japanese adults. © 2012 American Journal of Preventive Medicine.

BackgroundThere are spatial disparities in cardiovascular disease (CVD) mortality related to area‐level socioeconomic status (SES) disadvantage, but little is known about the spatial distribution of CVD mortality according to built environment factors. We examined joint associations of neighborhood walkability attributes and SES with CVD mortality rates through linkage of Japanese national data sets.Methods and ResultsNational data were used from the 1824 municipalities (of the 1880 potentially eligible municipalities) across Japan. The outcome was mortality from CVD for a 5‐year period (2008–2012) for each municipality. A national index of neighborhood deprivation was used as an indicator of municipality‐level SES. A national walkability index (based on population density, road density, and access to commercial areas) was calculated. Compared with higher SES municipalities, relative rates for CVD mortality were significantly higher in medium SES municipalities (relative rate, 1.05; 95% CI, 1.02–1.07) and in lower SES municipalities (relative rate, 1.09; 95% CI, 1.07–1.12). There were walkability‐related gradients in CVD mortality within the high and medium SES areas, in which lower walkability was associated with higher rates of mortality; however, walkability‐related CVD mortality gradients were not apparent in lower SES municipalities.ConclusionsCVD mortality rates varied not only by area‐level SES but also by walkability. Those living in areas of lower walkability were at higher risk of CVD mortality, even if the areas have a higher SES. Our findings provide a novel element of the evidence base needed to inform better allocation of services and resources for CVD prevention.

OBJECTIVES:According to the interim report "National Health Promotion in the 21st Century (Healthy Japan 21)", the Exercise and Physical Activity Guide for Health Promotion 2006 (EPAGH2006) is an im-portant resource in the field of physical activity in Japan. A previous study (Higo & Nakamura, 2008) showed that although the awareness level of EPAGH2006 was lower than for other health pro-motion policies (e.g., Healthy Japan 21), the proportion of people who walked regularly was higher in the EPAGH2006 awareness group than in the no-awareness group. This result indicates that pro-motion of EPAGH2006 would contribute to increase in the number of physically active people. The purpose of the present study was to identify longitudinal change in awareness of EPAGH2006, and to examine the relationship with levels of physical activity.;METHODS:The subjects were 1,100 Japanese adults (mean [SD], 39.8 [10.1 years) recruited from among the registrants of a Japanese social research company. This longitudinal study was conducted using online questionnaires in surveys in November 2007 (T1) and December 2008 (T2). The awareness level of EPAGH2006 was assessed with 3 choices, i.e., good understanding, awareness and no-awareness. The International Physical Activity Questionnaire short Version (Craig et al., 2003; Murase et al., 2002) was used to estimate the amount of physical activity that the subjects engaged in. The Mann-Whitney test was utilized to assess inter-group differences in changes in the amount of physical activity between the understanding and no-awareness groups.;RESULTS:The proportion of those who fully understood EPAGH2006 was 1.4% at T1 and 2.2%0 at T2 and did not significantly increase. The physical activity level in the understanding group at T2 was significantly decreased compared with the no-awareness groups at both T1 and T2 (p=0.013).;CONCLUSION:The lack of increase in the awareness level between the two time points suggests that dissemination of EPAGH2006 has not been effective. A more strategic approach would appear to be required. However, the results also did not indicate that the awareness level of EPAGH2006 had a positive in-fluence on physical activity. Further studies, conducted when the awareness levels improve, may elucidate the relationship between the levels of EPAGH2006 awareness and physical activity.

To examine differences in objective and subjective outcomes in outpatients undergoing percutaneous coronary intervention (PCI) performed for acute myocardial infarction versus cardiac surgery (CS) following a phase II cardiac rehabilitation (CR). Longitudinal observational study of 437 consecutive cardiac outpatients after 8 weeks of phase II CR. Patients were divided into the PCI group (n = 281) and CS group (n = 156). Handgrip and knee extensor muscle strength, peak oxygen uptake (VO2), upper- and lower-body self-efficacy for physical activity (SEPA), and physical component summary (PCS) and mental component summary (MCS) scores as assessed by Short Form-36 were measured at 1 and 3 months after PCI or CS. All outcomes increased significantly between months 1 and 3 in both groups. However, increases were greater in the CS versus PCI group in handgrip strength (+12.3 % vs. +8.1%, P < 0.01), knee extensor muscle strength (+19.3% vs. +17.5%, P = 0.008), peak VO2 (+20.9% vs. +16.9%, P < 0.01), upper-body SEPA (+27.7% vs. +9.2%, P = 0.001), and PCS score (+6.5% vs. +4.1%, P = 0.001). Although this relatively short-term phase II CR increased all outcomes for both groups, outcomes showed the recovery process was different between the PCI and CS groups, slightly favoring CS patients. Furthermore, patents in the field of CR are presented. © 2011 Bentham Science Publishers.

The association between a dietary pattern characterised by high alcohol intake and dyslipidaemia has not been fully investigated. Therefore, the present study aimed to investigate the association between alcohol dietary patterns and the prevalence of dyslipidaemia and its components. This cross-sectional study enrolled 2,171 men and women aged ≥40 years who were alumni of a Japanese university. To identify dietary patterns, a principal component analysis was performed based on the energy-adjusted food intake estimated by a brief-type self-administered diet history questionnaire. Three dietary patterns were identified, the second of which was named the alcohol dietary pattern and was characterised by a high intake of alcoholic beverages, liver, chicken, and fish. This alcohol dietary pattern was associated with reduced low-density lipoprotein cholesterol (LDL-C) levels. The fully adjusted odds ratios (95% confidence intervals) of high LDL-C for the lowest through highest quartile of alcohol dietary pattern score were 1.00 (reference), 0.83 (0.64-1.08), 0.84 (0.64-1.10), and 0.68 (0.49- 0.94), respectively. Subgroup analysis showed that the alcohol dietary pattern was inversely associated with the prevalence of dyslipidaemia in women, whereas it was positively associated with high triglyceride levels in men. In conclusion, the alcohol dietary pattern, characterised by a high intake of alcoholic beverages, liver, chicken, and fish, was associated with the prevalence of dyslipidaemia and its components. This finding provides useful information for the prevention and treatment of dyslipidaemia by modifying the diet.

Background: Inconsistent associations of neighbourhood walkability with adults' body weight have been reported. Most studies examining the relationships of walkability and adiposity are cross-sectional in design. We examined the longitudinal relationships of two walkability indices - conventional walkability and space syntax walkability, and their individual components, with weight change among adults over four years. Methods: Data were from the Physical Activity in Localities and Community study in Adelaide, Australia. In 2003-2004, 2650 adults living in 154 Census Collection Districts (CCDs) returned baseline questionnaires in 2007-2008, the follow-up survey was completed by 1098. Participants reported their weight at baseline and at follow-up. Neighbourhood walkability indices were calculated using geographic information systems and space syntax software. Linear marginal models using generalized estimating equations with robust standard errors were fitted to examine associations of the two walkability indices and their individual components with the weight at follow-up, adjusting for baseline weight, socio-demographic variables, and spatial clustering at the level of CCD. Results: The overall mean weight gain over four years was 1.5 kg. The two walkability indices were closely correlated (r = 0.76, p < 0.01). No significant associations were found between the overall neighbourhood walkability indices and weight change. Among walkability components, there was a marginally significant negative association between space syntax measure of street integration and weight change: one standard deviation increment in street integration was associated with 0.31 kg less weight gain (p = 0.09). Conclusions: Using a prospective study design and a novel space-syntax based measure of walkability, we were not able to identify relationships between neighbourhood walkability with weight gain. This is consistent with other inconclusive findings on the built environment and obesity. Research on the built environment and adults' weight gain may need to consider not just local environments but also a larger scale environment within a city or workplace environment in order to capture multiple behaviours relevant to weight gain.

Background: In addition to insufficient moderate-to-vigorous physical activity (MVPA), prolonged sitting time is also a health risk for older adults. An understanding of population subgroups who have prolonged television viewing (TV) time, a predominant sedentary behavior, can aid in the development of relevant health promotion initiatives; however, few such studies have focused on older adults, the most sedentary segment of the population as a whole. The aim of this study is to examine the socio-demographic attributes associated with TV time among community-dwelling Japanese older men and women.Methods: A population-based, cross-sectional mail survey was used to collect data on TV time, MVPA, and socio-demographic characteristics. The survey was conducted from February through March 2010. Participants were 2700 community-dwelling older adults (aged 65-74 years, 50% men) who were randomly selected from the registry of residential addresses of three cities in Japan. Data from 1665 participants (mean age: 69.5 years, 52% men) who completed all variables for the present study were analyzed. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of prolonged TV time (2 hours/day) for each socio-demographic attribute, stratified by gender.Results: Of the 1665 participants, 810 (48.6%) watched TV for more than 2 hours/day. The median television viewing time (25th, 75th percentile) was 2.00 (1.07, 3.50) hours/day. Prolonged TV time was associated with not in full-time employment, lower educational attainment, weight status, living in regional areas and low MVPA for the whole sample. For men, prolonged TV time was associated with lower educational attainment; (OR = 1.53, 95% CI: 1.12 2.07), underweight (OR = 1.63, 95% CI: 1.02-2.60), overweight (OR = 1.57, 95% CI: 1.11-2.21), and low MVPA (OR = 1.43, 95% CI: 1.02-2.02). For women, living in regional areas (OR = 2.02, 95% CI: 1.33-3.08), living alone (OR = 1.61, 95% CI: 1.03-2.49), not driving (OR = 1.79, 95% CI 1.21-2.65), overweight (OR = 1.50, 95% CI: 1.00-2.24), and low MVPA (OR = 1.51. 95% CI: 1.05-2.17) were associated with prolonged TV time.Conclusions: These findings identify particular socio-demographic and behavioral characteristics related to TV time among Japanese older adults. It should be noted that correlates of prolonged TV time differed by gender. Women in living situations with limited transportation options tended to spend prolonged time watching TV. Health promotion initiatives for older adults, particularly for older women, may be more effective if they take these attributes into account.

AbstractDNA methylation-based age estimators (DNAm aging clocks) are currently one of the most promising biomarkers for predicting biological age. However, the relationships between objectively measured physical fitness, including cardiorespiratory fitness, and DNAm aging clocks are largely unknown. We investigated the relationships between physical fitness and the age-adjusted value from the residuals of the regression of DNAm aging clock to chronological age (DNAmAgeAcceleration: DNAmAgeAccel) and attempted to determine the relative contribution of physical fitness variables to DNAmAgeAccel in the presence of other lifestyle factors. DNA samples from 144 Japanese men aged 65–72 years were used to calculate first- (i.e., DNAmHorvath and DNAmHannum) and second- (i.e., DNAmPhenoAge, DNAmGrimAge and DNAmFitAge) generation DNAm aging clocks. Various surveys and measurements were conducted, including physical fitness, body composition, blood biochemical parameters, nutrients intake, smoking, alcohol consumption, disease status, sleep status, and chronotype. The peak oxygen uptake (VO2peak) per kg body weight had a significant negative correlation with GrimAgeAccel (r= -0.222,p= 0.008). A comparison of the tertile groups showed that the GrimAgeAccel of the highest VO2peakgroup was decelerated by 1.6 years compared to the lowest group (p= 0.035). Multiple regression analysis suggested that rather than physical fitness, serum triglycerides, carbohydrate intake, and smoking status, were significantly associated with DNAmAgeAccel. In conclusion, the contribution of cardiorespiratory fitness to DNAmAgeAccel was relatively low compared to lifestyle factors such as smoking. However, this study reveals a negative relationship between cardiorespiratory fitness and DNAmAgeAccel in older men.

The present study investigated the relative contributions of psychological, social, and environmental factors to meeting physical activity recommendation by walking among Japanese adults. Self-reported measures of total weekly physical activity, vigorous and moderately intense activity, walking, self-efficacy, pros, cons, social support, health-professional advice, home exercise equipment, access to facilities, neighbourhood safety, enjoyable scenery, frequently observing others exercising, and residential area were obtained from 1932 Japanese male and female adults using an Internet-based cross-sectional survey on February, 2008. Based on the recommendation criteria of the Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006), respondents were divided into 3 groups: recommended, insufficient, and inactive. A force entry multivariate logistic regression model was utilized. Overall, 69.0% of responders walked in daily life, for transportation or for exercise. However, only 12.1% walked according to the recommended criterion of the EPAR2006. When adjusting for all other variables, there was no association between psychological, social, and environmental factors and recommended group in males. However, self-efficacy, pros, enjoyable scenery were positively whereas social support and living in both suburban and rural areas were negatively associated with only insufficient group in males. For females, selfefficacy, home exercise equipment, and enjoyable scenery were positively associated, whereas living in rural area was negatively associated with both recommended and sufficient groups. Living in suburban area was negatively associated with only insufficient group. Different psychological, social, and environmental correlates were found in walking behaviours with the recommended and insufficient level as well as for males and females. This suggests that a design of intervention that accounts for the specific correlates with each walking activity level and gender found in the current study may more effectively promote walking due to well-matching the needs and characteristics of the target population among Japanese adults.