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Step-Defined Physical Activity and Cardiovascular Risk Among Middle-Aged Japanese: The National Health and Nutrition Survey of Japan 2006

Shigeru Inoue, Yumiko Ohya, Catrine Tudor-Locke, Nobuo Yoshiike, and Teruichi Shimomitsu

Background:

Pedometers are becoming widely accepted for physical activity measurement. To use step data effectively, an index which categorizes steps/day by < 5000, ≥ 5000, ≥ 7500, ≥ 10,000, and ≥ 12,500 steps/day has been previously proposed. However, evidence is insufficient to validate this index compared with health outcomes. This study examined the association of steps/day categories with cardiovascular (CVD) risk.

Methods:

Cross-sectional data from the National Health and Nutrition Survey of Japan 2006, including 1166 men and 1453 women aged 40–64 years, were analyzed to calculate odds ratios (OR) for having CVD risk including overweight/obesity, blood pressure, high density lipoprotein cholesterol, hemoglobin A1c, and clustered risk factors by steps/day categories.

Results:

Among men, inverse gradient associations between steps/day categories and CVD risk (overweight/obesity, blood pressure, HbA1c, and clustered risk factors) were observed. Among women, those taking ≥ 5000 steps/day had substantially lower risk of overweight/obesity and high blood pressure compared with those taking < 5000 steps/day. However, additional decreases of OR by taking more steps were modest among women.

Conclusions:

CVD risk was generally lower with higher steps/day categories. Given the limitations of cross-sectional design, further studies, especially using longitudinal designs, are needed to precisely calibrate the association between steps/day and CVD risk.

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Results From Japan’s 2018 Report Card on Physical Activity for Children and Youth

Chiaki Tanaka, Shigeho Tanaka, Shigeru Inoue, Motohiko Miyachi, Koya Suzuki, Takafumi Abe, and John J. Reilly

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Differences in Association of Walking for Recreation and for Transport With Maximum Walking Speed in an Elderly Japanese Community Population

Masamitsu Kamada, Jun Kitayuguchi, Kuninori Shiwaku, Shigeru Inoue, Shimpei Okada, and Yoshiteru Mutoh

Background:

Physical activity contributes to maintaining functional ability later in life. Specific relationships between walking for particular purposes (eg, recreation or transport) and functional ability are not clear. It is useful for planning health promotion strategies to clarify whether walking time for recreation, or walking time for transport has the stronger relationship with maximum walking speed (MWS), a determinant of functional ability later in life in the elderly.

Methods:

A cross-sectional survey was conducted in 2007 using a sample of 372 community-dwelling elderly people aged 60 to 87 years in Mitoya Town, Unnan City, rural Japan. Associations with MWS were examined for self-reported weekly times of walking for recreation and for transport using multiple linear regression analyses.

Results:

Both in men and women, walking time for recreation was significantly associated with MWS after controlling for age, height, weight, hip and knee pain, and a number of chronic diseases (men: β = 0.18, P = .024; women: β = 0.17, P < .01). However, walking time for transport was not significantly associated with MWS (men: β = −0.094, P = .24; women: β = −0.040, P = .50).

Conclusions:

Walking for recreation may contribute to maintaining functional abilities such as MWS in the elderly.

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Strength-Training Behavior and Perceived Environment Among Japanese Older Adults

Kazuhiro Harada, Koichiro Oka, Ai Shibata, Kaori Ishii, Yoshio Nakamura, Shigeru Inoue, and Teruichi Shimomitsu

The authors examined the relationship between strength-training behavior and perceived environment in older Japanese adults. An Internet-based survey was conducted of 293 adults age 68.2 ± 2.8 yr. The dependent variable was regular strength-training behavior. The IPAQ environment module, access to facilities for strength training, and home equipment for strength training were environmental factors. Logistic-regression analysis was employed. After demographic variables (gender, age, educational background, household income, body-mass index, self-rated health status, smoking habit, and residential area) were adjusted for, home equipment for strength training (OR = 2.14, 95% CI = 1.50–3.06), access to facilities for strength training (OR = 2.53, 95% CI = 1.32–4.85), and observing active people (OR = 2.20, 95% CI = 1.06–4.58) were positively correlated with regular strength-training behavior. In conclusion, environmental factors associated with strength-training behavior were access to facilities for strength training, having home equipment for strength training, and observing active people.

Open access

Results From Japan’s 2016 Report Card on Physical Activity for Children and Youth

Chiaki Tanaka, Shigeho Tanaka, Shigeru Inoue, Motohiko Miyachi, Koya Suzuki, and John J. Reilly

Background:

The Report Card on Physical Activity for Children and Youth aims to consolidate existing evidence, encourage greater evidence-informed physical activity, and improve surveillance of physical activity.

Methods:

The Japan report card followed the methodology of the Canadian and Scottish report cards, but was adapted to reflect the Japanese context. Nationally representative data were used to score each of the respective indicators.

Results:

The 2016 Japan Report Card on Physical Activity for Children and Youth consists of Health Behaviors and Outcomes (7 indicators), and Influences on Health Behaviors (4 indicators). Three Health Behaviors and Outcomes received C grades (Participation in Sport; Sedentary Behavior; Recreational Screen Time; Physical Fitness), while 2 indicators could not be graded (Overall Physical Activity, and Active Play). The indicators Active Transportation (B) and Weight Status were favorable (A). In the Influences domain, Family Influence and Community and the Built Environment were graded as D, while School and Government Strategies and Investments were favorable (B).

Conclusions:

The Japan report card illustrated some favorable health behaviors, health outcomes, and influences. There is a need for more evidence especially on overall physical activity levels, active play, and community and the built environment.

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Clustering of Domain-Specific Sedentary Behaviors and Their Association With Physical Function Among Community-Dwelling Older Adults

Seigo Mitsutake, Ai Shibata, Kaori Ishii, Shiho Amagasa, Hiroyuki Kikuchi, Noritoshi Fukushima, Shigeru Inoue, and Koichiro Oka

Background: The present study examined the cluster of domain-specific sedentary behaviors (SBs) and their associations with physical function among community-dwelling older adults to identify the target groups that require intervention for SBs. Methods: A total of 314 older adults who participated in a population-based cross-sectional survey and an on-site functional assessment in Matsudo City in Chiba participated in this study. Participants were asked to report the daily average of 6 domain-specific SBs. To identify the cluster of domain-specific SBs, hierarchical cluster analysis was performed using the Ward method. Analysis of covariance adjusted for sociodemographic factors, exercise habit, chronic disease, and total SB time was performed to examine the associations between each cluster and physical functional status. Results: The average age of the participants was 74.5 (5.2) years. The 4 clusters identified were leisure cluster, low cluster, work and personal computer use cluster, and television viewing cluster. The analysis of covariance adjusted for covariates showed that grip strength (P = .01), maximum walking speed (P = .03), and 1-leg standing time (P = .03) were significantly poorer in the television viewing cluster than other clusters. Conclusions: It has been concluded that the television viewing group identified as a high-risk group of physical functional decline; therefore, interventions targeting this group are needed to prevent physical functional decline.

Open access

Differences in Accelerometer-Measured Physical Activity and Sedentary Behavior Between Middle-Aged Men and Women in Japan: A Compositional Data Analysis

Shiho Amagasa, Shigeru Inoue, Ai Shibata, Kaori Ishii, Sayaka Kurosawa, Neville Owen, and Koichiro Oka

Background: Differences in accelerometer-measured sedentary behavior and different physical activity (PA) intensities between men and women have been poorly described. The authors examined gender differences in time-use activity composition and total volume of PA. Methods: A cross-sectional mail survey was conducted from 2013 to 2015 with a randomized sample of 6000 middle-aged (40–64 y) community-dwelling Japanese adults living in urban and regional cities. Participants wore Active style Pro HJA-350IT on their waist for 7 consecutive days. Gender differences in activity time use was examined using compositional data analysis to control for time spent in all activity measures. Results: In total, 757 participants (303 men, 52.3 [7.1] y) with valid data were included in the analysis. Women spent on average 12.6% less time in sedentary behavior and 23.4% more time in light-intensity PA than men, whereas no significant difference was found for moderate to vigorous PA. Women accumulated a significantly greater volume of PA than men (17.8 vs 15.0 metabolic equivalent of task h/d). Conclusions: Japanese middle-aged women showed higher levels of PA than men because they spent more time in light-intensity PA. Given the health benefits of light-intensity PA, evaluating only moderate to vigorous PA may lead to an underestimation of women’s participation in PA.

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Associations of Perceived and Objectively Measured Neighborhood Environmental Attributes With Leisure-Time Sitting for Transport

Yung Liao, Takemi Sugiyama, Ai Shibata, Kaori Ishii, Shigeru Inoue, Mohammad Javad Koohsari, Neville Owen, and Koichiro Oka

Background:

This study examined associations of perceived and objectively measured neighborhood environmental attributes with leisure-time sitting for transport among middle-to-older aged Japanese adults.

Method:

Data were collected using a postal survey of 998 adults aged 40 to 69 years. Generalized linear modeling with a gamma distribution and a log link was used to examine associations of perceived (International Physical Activity Questionnaire-Environmental module) and Geographic Information Systems (GIS)-derived built environment attributes with self-reported leisure-time sitting for transport.

Results:

Mean leisure-time sitting time for transport was 20.4 min/day. After adjusting for potential confounders, perceived higher residential density, GIS-measured higher population density, better access to destinations, better access to public transport, longer sidewalk length, and higher street connectivity, were associated significantly with lower sitting time for transport.

Conclusion:

Residents living in neighborhoods with attributes previously found to be associated with more walking tended to spend less time sitting for transport during leisure-time. The health benefits of walkability-related attributes may accrue not only through increased physical activity, but also through less sedentary time.

Open access

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys

Andrea Ramírez Varela, Pedro C. Hallal, Juliana Mejía Grueso, Željko Pedišić, Deborah Salvo, Anita Nguyen, Bojana Klepac, Adrian Bauman, Katja Siefken, Erica Hinckson, Adewale L. Oyeyemi, Justin Richards, Elena Daniela Salih Khidir, Shigeru Inoue, Shiho Amagasa, Alejandra Jauregui, Marcelo Cozzensa da Silva, I-Min Lee, Melody Ding, Harold W. Kohl III, Ulf Ekelund, Gregory W. Heath, Kenneth E. Powell, Charlie Foster, Aamir Raoof Memon, Abdoulaye Doumbia, Abdul Roof Rather, Abdur Razzaque, Adama Diouf, Adriano Akira Hino, Albertino Damasceno, Alem Deksisa Abebe, Alex Antonio Florindo, Alice Mannocci, Altyn Aringazina, Andrea Backović Juričan, Andrea Poffet, Andrew Decelis, Angela Carlin, Angelica Enescu, Angélica María Ochoa Avilés, Anna Kontsevaya, Annamaria Somhegyi, Anne Vuillemin, Asmaa El Hamdouchi, Asse Amangoua Théodore, Bojan Masanovic, Brigid M. Lynch, Catalina Medina, Cecilia del Campo, Chalchisa Abdeta, Changa Moreways, Chathuranga Ranasinghe, Christina Howitt, Christine Cameron, Danijel Jurakić, David Martinez-Gomez, Dawn Tladi, Debrework Tesfaye Diro, Deepti Adlakha, Dušan Mitić, Duško Bjelica, Elżbieta Biernat, Enock M. Chisati, Estelle Victoria Lambert, Ester Cerin, Eun-Young Lee, Eva-Maria Riso, Felicia Cañete Villalba, Felix Assah, Franjo Lovrić, Gerardo A. Araya-Vargas, Giuseppe La Torre, Gloria Isabel Niño Cruz, Gul Baltaci, Haleama Al Sabbah, Hanna Nalecz, Hilde Liisa Nashandi, Hyuntae Park, Inés Revuelta-Sánchez, Jackline Jema Nusurupia, Jaime Leppe Zamora, Jaroslava Kopcakova, Javier Brazo-Sayavera, Jean-Michel Oppert, Jinlei Nie, John C. Spence, John Stewart Bradley, Jorge Mota, Josef Mitáš, Junshi Chen, Kamilah S Hylton, Karel Fromel, Karen Milton, Katja Borodulin, Keita Amadou Moustapha, Kevin Martinez-Folgar, Lara Nasreddine, Lars Breum Christiansen, Laurent Malisoux, Leapetswe Malete, Lorelie C. Grepo-Jalao, Luciana Zaranza Monteiro, Lyutha K. Al Subhi, Maja Dakskobler, Majed Alnaji, Margarita Claramunt Garro, Maria Hagströmer, Marie H. Murphy, Matthew  Mclaughlin, Mercedes Rivera-Morales, Mickey Scheinowitz, Mimoza Shkodra, Monika Piątkowska, Moushumi Chaudhury, Naif Ziyad Alrashdi, Nanette Mutrie, Niamh Murphy, Norhayati Haji Ahmad, Nour A. Obeidat, Nubia Yaneth Ruiz Gómez, Nucharapon Liangruenrom, Oscar Díaz Arnesto, Oscar Flores-Flores, Oscar Incarbone, Oyun Chimeddamba, Pascal Bovet, Pedro Magalhães, Pekka Jousilahti, Piyawat Katewongsa, Rafael Alexander Leandro Gómez, Rawan Awni Shihab, Reginald Ocansey, Réka Veress, Richard Marine, Rolando Carrizales-Ramos, Saad Younis Saeed, Said El-Ashker, Samuel Green, Sandra Kasoma, Santiago Beretervide, Se-Sergio Baldew, Selby Nichols, Selina Khoo, Seyed Ali Hosseini, Shifalika Goenka, Shima Gholamalishahi, Soewarta Kosen, Sofie Compernolle, Stefan Paul Enescu, Stevo Popovic, Susan Paudel, Susana Andrade, Sylvia Titze, Tamu Davidson, Theogene Dusingizimana, Thomas E. Dorner, Tracy L. Kolbe-Alexander, Tran Thanh Huong, Vanphanom Sychareun, Vera Jarevska-Simovska, Viliami Kulikefu Puloka, Vincent Onywera, Wanda Wendel-Vos, Yannis Dionyssiotis, and Michael Pratt

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.