日足P&Fの状況：（11月10日）～（11月14日）

Objective: To examine differences in physiologic and psychosocial outcomes between age groups after an exercise-based supervised-recovery phase 11 cardiac rehabilitation outpatient program.Design: This is a longitudinal observational study. The study assessed 442 consecutive cardiac patients. Patients were divided into the middle-aged group (65 yrs, n = 242) and older-age group (= 65 yrs, n = 200). Peak oxygen uptake, handgrip and knee extensor muscle strength, upper- and lower-body self-efficacy for physical activity, and physical component summary and mental component summary scores as assessed by SF-36 were measured at 1 and 3 mos after the onset of acute myocardial infarction or cardiac surgery and were compared.Results: All physiologic and psychosocial outcomes increased significantly between months 1 and 3 in both groups. However, increases were greater in the middle-aged vs. older-aged group in peak oxygen uptake (+13.1% vs. +8.7%, P 0.01), knee extensor muscle strength (+17.6% vs. +13.3%, P = 0.01), lower-body self-efficacy for physical activity (+17.3% vs. +12.7%, P = 0.02), and physical component summary score (+5.4% vs. +2.7%, P = 0.02).Conclusions: Age-related differences in various physiologic and psychosocial measures indicated greater improvement from an exercise-based supervised recovery-phase II cardiac rehabilitation outpatient program in middle-aged vs. older-aged patients. Older adults may derive equal mental or emotional benefit from such a cardiac rehabilitation program but do not experience as much improvement in physiologic outcomes as middle-aged adults.

Previous studies have not investigated the determinants of resting oxidative stress, including physical fitness, as it relates to redox regulation. The present study therefore was aimed at identifying lifestyle and biological factors that determine resting oxidative stress, including objectively measured physical fitness. In 873 middle-aged and elderly men and women, age and anthropometric parameters, lifestyle-related parameters, medication and supplementation status, physical fitness, biochemical parameters, and nutritional intake status, as well as three plasma oxidative stress markers: protein carbonyl (PC), F2-isoprostane (F2-IsoP), and thiobarbituric acid reactive substances (TBARS), were surveyed and measured. The determinants of PC, F2-IsoP, and TBARS in all participants were investigated using stepwise multiple regression analysis. In PC, age (β = -0.11, P = 0.002), leg extension power (β = -0.12, P = 0.008), BMI (β = 0.12, P = 0.004), and HDL-C (β = 0.08, P = 0.040) were included in the regression model (adjusted R 2 = 0.018). In the F2-IsoP, smoking status (β = 0.07, P = 0.060), BMI (β = 0.07, P = 0.054), and HbA1c (β = -0.06, P = 0.089) were included in the regression model (adjusted R 2 = 0.006). In TBARS, glucose (β = 0.18, P < 0.001), CRF (β = 0.16, P < 0.001), age (β = 0.15, P < 0.001), TG (β = 0.11, P = 0.001), antioxidant supplementation (β = 0.10, P = 0.002), and HbA1c (β = -0.13, P = 0.004) were included in the regression model (adjusted R 2 = 0.071). In conclusion, the present study showed that age, anthropometric index, lifestyle-related parameters, medication and supplementation status, objectively measured physical fitness, biochemical parameters, and nutritional intake status explain less than 10% of oxidative stress at rest.

Objective: To investigate the effect of the self-monitoring of physical activity by hospitalized cardiac patients attending phase I cardiac rehabilitation (CR).Design: Randomized controlled trial.Setting: University hospital CR program.Participants: CR patients (N=126) with a mean age of 59.1 years.Interventions: Patients were randomly assigned to the selfmonitoring group (group A, n=63) or the control group (group B, n=63). Along with CR, group A patients performed selfmonitoring of their physical activity at the beginning of a phase I CR program (acute in-hospital phase for inpatients) and ending just before they began a phase 11 CR program (postdischarge recovery phase for outpatients).Main Outcome Measures: Physical activity (averages of daily number of steps taken and daily energy expenditure for lwk) as measured by accelerometer was assessed in both groups at baseline (t1) and before the beginning of phase II CR (t2).Results: Although there were no significant differences in physical activity values between groups A and B at t1, values of group A at t2 were significantly higher than those of group B (8609.6 vs 5512.9 steps, P.001; 242.6 vs 155.9kcal, P.001).Conclusions: Self-monitoring of patient physical activity from phase II CR might effectively increase the physical activity level in preparation for entering a phase IT CR program. Results of the present study could contribute to the development of new strategies for the promotion of physical activity in cardiac patients.

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.

PurposeBoth moderate-to-vigorous physical activity (MVPA) and sedentary behavior can be associated with adult adiposity. Much of the relevant evidence is from cross-sectional studies or from prospective studies with relevant exposure measures at a single time point before weight gain or incident obesity. This study examined whether changes in MVPA and television (TV) viewing time are associated with subsequent changes in waist circumference, using data from three separate observation points in a large population-based prospective study of Australian adults.MethodsData were obtained from the Australian Diabetes, Obesity, and Lifestyle study collected in 1999-2000 (baseline), 2004-2005 (wave 2), and 2011-2012 (wave 3). The study sample consisted of adults age 25 to 74 yr at baseline who also attended site measurement at three time points (n = 3261). Multilevel linear regression analysis examined associations of initial 5-yr changes in MVPA and TV viewing time (from baseline to wave 2) with 12-yr change in waist circumference (from baseline to wave 3), adjusting for well-known confounders.ResultsAs categorical predictors, increases in MVPA significantly attenuated increases in waist circumference (P for trend 0.001). TV viewing time change was not significantly associated with changes in waist circumference (P for trend = 0.06). Combined categories of MVPA and TV viewing time changes were predictive of waist circumference increases; compared with those who increased MVPA and reduced TV viewing time, those who reduced MVPA and increased TV viewing time had a 2-cm greater increase in waist circumference (P = 0.001).ConclusionDecreasing MVPA emerged as a significant predictor of increases in waist circumference. Increasing TV viewing time was also influential, but its impact was much weaker than MVPA.

BACKGROUND: Physical inactivity and sedentary behaviour (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavioural change (e.g. replacing sedentary behaviour with physical activity) on renal function are not well understood. We used isotemporal substitution to model potential impacts of behaviours on renal function by replacing time spent in one behaviour to another. METHODS: In 174 older Japanese adults (age, 50-83 years; females, 76%), the time spent in sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using an uniaxial accelerometer. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels. RESULTS: In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behaviour (rs = - 0.229), LPA (rs = 0.265), and MVPA (rs = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behaviour with an equivalent LPA time was not significantly associated with eGFR (β = 2.26, p = 0.112); however, replacement with an equivalent time of MVPA was beneficially associated with eGFR (β = 5.49, p < 0.05). CONCLUSIONS: These cross-sectional findings suggest that sedentary behaviour (detrimentally) and physical activity (beneficially) may affect renal function and that replacing sedentary behaviour with MVPA may benefit renal health in older adults.

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.

Studies have shown the potential effects of sedentary behavior and physical activity on not only physical and mental health but also academic performance in children. Nevertheless, studies have only focused on either sedentary behavior or physical activity. Examining the joint effects of both behaviors on academic performance provides detailed insights into the patterns of these behaviors in relation to children's academic achievement. The present study investigated the joint longitudinal associations of physical activity and screen time with academic performance among Japanese children. The screen time and physical activity of 261 children aged 7-10 years were assessed, and their academic performance was evaluated one year later. Multivariate logistic regression analysis was used to examine the joint associations of screen time and physical activity with academic performance adjusted for demographic characteristics. Children with low screen time and physical activity had 2.04 (95% confidence interval: 1.11-3.78) times greater odds of having high academic performance compared to children with high screen time and low physical activity, while children with low screen time and high physical activity had 2.75 (1.17-6.43) times greater odds (boys; 4.12 (1.19-14.24)). Low screen time was related to high academic performance after one year, regardless of the physical activity level.

Workplace settings-both internal and external-can influence how workers are physically active or sedentary. Although research has identified some indoor environmental attributes associated with sitting at work, few studies have examined associations of workplace neighbourhood built-environment attributes with workplace sitting time. We examined the cross-sectional associations of perceived and objective workplace neighbourhood built-environment attributes with sitting time at work and for transport among desk-based workers in Japan. Data were collected from a nationwide online survey. The Abbreviated Neighborhood Environment Walkability Scale (n = 2137) and Walk Score® (for a subsample of participants; n = 1163) were used to assess perceived and objective built-environment attributes of workplace neighbourhoods. Self-reported daily average sitting time at work, in cars and in public transport was measured using a Japanese validated questionnaire. Linear regression models estimated the associations of workplace neighbourhood built-environment attributes with sitting time. All perceived workplace neighbourhood built-environment attributes were positively correlated with Walk Score®. However, statistically significant associations with Walk Score® were found for sitting for transport but not for sitting at work. Workers who perceived their workplace neighbourhoods to be more walkable reported a longer time sitting at work and in public transport but a shorter sitting time in cars. Our findings suggest that walkable workplace neighbourhoods may discourage longer car use but have workplaces where workers spend a long time sitting at work. The latter finding further suggests that there may be missed opportunities for desk-based workers to reduce sitting time. Future workplace interventions to reduce sitting time may be developed, taking advantage of the opportunities to take time away from work in workplace neighbourhoods.

Evidence about the impacts of the physical activity environment on adults' weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score ® -a free online walkability tool-is related to obesity. This study aimed to examine associations between multiple physical activity environment measures and Walk Score ® ratings with Japanese adults' body mass index (BMI). Data from 1073 adults in the Healthy Built Environment in Japan study were used. In 2011, participants reported their height and weight. Environmental attributes, including population density, intersection density, density of physical activity facilities, access to public transportation, and availability of sidewalks, were calculated using Geographic Information Systems. Walk Scores ® ratings were obtained from the website. Multiple linear regression analysis was conducted to examine the association between each environmental attribute and BMI. Adjusting for covariates, all physical activity environmental attributes were negatively associated with BMI. Similarly, an increase of one standard deviation of Walk Score ® was associated with a 0.29 (95% confidence interval (CI) of -0.49--0.09) decrease in BMI. An activity-friendly built environment was associated with lower adults' BMI in Japan. Investing in healthy community design may positively impact weight status in non-Western contexts.

Background: Physical activity levels in childhood have decreased, making the promotion of children's physical activity an important issue. The present study examined gender and grade differences in objectively measured sedentary behavior, physical activity, and physical activity guideline attainment among Japanese children and adolescents.Methods: In total, 329 boys and 362 girls age 3-15 years completed the survey. School grade, gender, height, and weight were collected by questionnaires and physical activity objectively measured using an accelerometer (Lifecorder Suzuken Co.). Physical activity level (in MET) was classified as sedentary (1.5), light (= 1.5 to 3), moderate (= 3 to 6), or vigorous (= 6). Continuous zero accelerometer counts for = 20 min were censored and a valid accelerometry study required at least 3 days (2 weekdays and 1 weekend day) with 600 min/day total wear time. Two-way analysis of covariance and logistic regression analyses, adjusted for weight status and accelerometer wear time, were used to examine gender and grade differences in physical activity variables and the likelihood of physical activity guideline attainment by gender and grade level.Results: Participants were sedentary 441.4 (SD, 140.1) min/day or 53.7 % of the average daily accelerometer wear time of 811.2 (118.7) min, engaged in light physical activity 307.1 (70.0) min or 38.4 % of wear time, moderate physical activity 34.6 (14.8) min (4.3 %), vigorous physical activity 28.3 (19.1) min (3.6 %), and took 12462.6 (4452.5) steps/day. Boys were more physically active and took more steps/day than girls. Students in higher grades were less active than those in lower grades. Boys were significantly more likely to meet physical activity guidelines than girls (OR: 2.07, 95 % CI: 1.45-2.96). Preschoolers (6.66, 4.01-11.06), lower-grade elementary school students (17.11, 8.80-33.27), and higher-grade elementary school students (7.49, 4.71-11.92) were more likely to meet guidelines than junior high school students.Conclusions: Boys and lower-grade students engaged in more physical activity and were more likely to attain guidelines than girls and higher-grade students. These findings highlight the need for effective and sustainable strategies to promote physical activity in Japanese school children.

This study examined whether a walking program encouraged using the e-mail function of participants' cellular phones promotes behavior changes. Study participants were persons who wanted to join a walking program for their health. The experimental group had 1,111 members (male: n=554, female: n=557, 30-49 yrs) and the control group had 1,190 members (male: n=598, female: n=592, 30-49 yrs). The participants in the experimental group were encouraged to execute a walk behavior with e-mails using their cellular phones twice a week for one month . The contents of the e-mails depended on the level of walking as determined before the study for each participant. The main points studied were the time (in minutes) of walking per week and the extent of changes in the walking behavior. The analysis of results after receiving encouraging e-mail messages for one month showed more time spent walking for the experimental group in comparison with the time of the control group [Mean inter-group difference in change: 70.1 min/week, (p<0.05)]. The extent of changes in walking behavior (expressed as a percentage) was higher in the experimental group (38.5%) than in the control group (22.3%) (χ2=61.19, p<0.05). These results indicates that the walking program, encouraged by e-mail messages received on a cellular phone, promotes walking behavior in people.

【目的】先行研究（Izawa et al.,2004,2005）において我々は, 最高酸素摂取量(PVO2)や骨格筋機能などの身体機能指標, 健康関連QOL(HRQOL)およびそれらの媒介変数である身体活動セルフ・エフィカシー(SEPA)に対して, 運動療法を主体とした回復期プログラムがそれらの向上に影響を与えることを報告した. しかし疾患別でのそれら各指標の実態および関連性についての報告は少ない. 本研究の目的は、疾患別の身体機能指標, SEPA,およびHRQOLを比較検討し, HRQOLの関連要因について明らかにすることである.
【方法】 対象は, 当院ハートセンターに急性心筋梗塞(AMI)あるいは心臓外科手術目的で入院後, 急性期プログラムを終了し外来での心肺運動負荷試験（CPX）の依頼があった1924件中, 発症あるいは手術後1か月時点でのCPX, 身体機能指標, SEPAおよびHRQOLの測定を施行した連続600例である. 属性 (年齢, 性別, BMI)に関する情報は診療記録より調査した. 身体機能指標は, 握力, 膝伸展筋力, PVO2を用いた. SEPAはSEPA尺度(2002, 岡)を用い, 上下肢活動に関するSEPAの2項目に分け,その平均値を算出した. HRQOLはSF-36の身体的健康度（PCS）と精神的健康度（MCS）のサマリースコアを用いた. これら各指標について心筋梗塞366例（AMI群）と心臓外科術234例（CS群）の2群間で比較検討し, HRQOLの関連要因を抽出した. 統計学的手法はカイ二乗,t検定および重回帰分析を用いた。統計学的判定の基準は5%未満とした. なお本研究は, 当大学生命倫理委員会の承認を得て施行された.
【結果】結果はAMI群 vs. CS群の順に, 年齢 (61.5 vs. 62.1歳, p=0.55), 性別 (男性の割合, 85 vs. 80% p=0.54), BMI (23.3 vs. 22.1 kg/(m)2, p=0.01), 握力(35.8 vs. 30.6 kg, p=0.01), 膝伸展筋力(1.7 vs. 1.5 Nm/kg, p=0.01), PVO2(24.3 vs. 21.1 ml/kg/min, p=0.01), SEPA (上肢, 64.5 vs. 45.0, 下肢, 69.5 vs. 61.2, p=0.01), PCS (46.7 vs. 43.8, p=0.01), MCS (49.5 vs. 49.1, p=0.52)であった. 重回帰分析の結果, PCSの関連要因としてAMI群は下肢活動のSEPA（R2=0.11, p=0.01）, CS群は上肢活動のSEPA（R2=0.14, p=0.01）が抽出された. 一方, MCSは, AMI群は下肢活動のSEPA（R2=0.12, p=0.01）, CS群は握力と上肢活動のSEPA（R2=0.15, p=0.01）が抽出された.
【考察】CS群はAMI群に比し身体機能, SEPA, PCSは低値を示すことから, 特にCS患者に対するそれらの向上のための配慮が必要であると考えられた. またCS群, AMI群ともにHRQOLの関連要因の一つとして, 媒介変数であるSEPAが少なからず関与することからHRQOLに対するSEPA向上の重要性が示された.

AimSocial participation provides health benefits for older adults. However, there is the need to identify whether higher social participation is associated with older adults being more physically active and less sedentary (sitting time). We examined the associations of social participation with physical activity, and sedentary time, in a population-based sample of older Japanese adults.MethodsA population-based, cross-sectional mail survey carried out in 2010 was used to collect data on social participation, physical activity, sedentary time and sociodemographic characteristics. Data were examined from 1146 community-dwelling, unemployed older adults (mean age 70.1 years, 43% men). Multivariate logistic regression analyses were used to calculate odds ratios (OR) for associations of social participation with physical activity and total sedentary time; and, for associations with passive and mentally-active sedentary (sitting) time.ResultsFor both men and women, those with higher social participation were more physically active (OR 2.10, 95% CI 1.44-3.06 among men; OR 1.93, 95% CI 1.39-2.68 among women). Total sedentary time had significant associations among men (OR 0.62, 95% CI 0.42-0.90), but not among women (OR 0.80, 95% CI 0.58-1.11). Social participation was associated with less passive sedentary time (OR 0.55, 95% CI 0.38-0.81 for men; OR 0.72, 95% CI 0.51-0.99 for women).ConclusionsPromoting social participation among older adults could contribute to increasing physical activity and reducing sedentary time, with potential benefits for chronic disease. Further research is required to elucidate the deleterious and beneficial roles of passive and mentally-active sedentary time for older adults. Geriatr Gerontol Int 2017; 17: 1921-1927.

Purpose Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance. Methods Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments. Results Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working. Conclusions Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.