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Yasuzato M, Kikuchi R, Kawahara T, Nakayama Y, Yamazaki A. Psychometric examination of the Japanese translation of the Satter eating competence Inventory-2.0™ for parents of fifth and sixth grade students. Jpn J Nurs Sci 2020; 18:e12393. [PMID: 33174680 DOI: 10.1111/jjns.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/09/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
AIM To verify the reliability and validity of a Japanese translation of the Satter eating competence Inventory-2.0™ (ecSI-2.0™) for parents of fifth and sixth grade elementary school students. METHODS Participants were parents who prepared meals for their children aged 10-12 years. A preliminary study was conducted with 11 parents using semi-structured interviews and questionnaires, followed by a main study of 2,825 parents. Internal consistency and test-retest methods were used to verify reliability. Face and content validity were confirmed in the preliminary study, and feasibility was examined by the valid response rate and response time. Construct validity was verified using factor validity and known population validity. RESULTS Of the 2,825 persons surveyed, 626 returned valid responses, and among the 60 persons who received the re-survey, 48 returned valid responses. The average score of the Japanese translation of the ecSI-2.0™ was 33.1 (SD ± 7.8) points. Cronbach's alpha coefficient for the whole scale was .87 and ranged from .67-.79 for the four subscales. The test-retest method confirmed the scale's stability. Factor analysis confirmed that reproducibility of the four factors was similar to the original version. In the examination of known population validity, the same correlation as the original edition was confirmed. CONCLUSIONS The Japanese translation of the ecSI-2.0™ may be reliable and valid for understanding eating competence related to behavior of parents of school-age children.
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Affiliation(s)
- Maiko Yasuzato
- Graduate School of Medicine, Division of Health Sciences, Area of Nursing Science, Osaka University, Osaka, Japan.,Osaka University Dental Hospital, Osaka, Japan
| | - Ryota Kikuchi
- Graduate School of Medicine, Division of Health Sciences, Area of Nursing Science, Osaka University, Osaka, Japan
| | - Tae Kawahara
- Graduate School of Medicine, Division of Health Sciences, Area of Nursing Science, Osaka University, Osaka, Japan
| | - Yuichi Nakayama
- Graduate School of Medicine, Division of Health Sciences, Area of Nursing Science, Osaka University, Osaka, Japan.,Faculty of Nursing, Setsunan University, Osaka, Japan
| | - Akemi Yamazaki
- Graduate School of Medicine, Division of Health Sciences, Area of Nursing Science, Osaka University, Osaka, Japan
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Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165811. [PMID: 32796692 PMCID: PMC7459630 DOI: 10.3390/ijerph17165811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 11/26/2022]
Abstract
The effect of the sodium-to-potassium ratio (Na/K) on renal function within the clinically normal range of renal function are limited. We investigated the effects of an estimated 24 h urinary Na/K (e24hUNa/K) on a 6-year renal function decline among 927 urban Japanese community dwellers with no history of cardiovascular diseases and medication for hypertension, diabetes, or dyslipidemia. We partitioned the subjects into quartiles according to the e24hUNa/K. The estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD/EPI) formula and renal function decline was defined as an absolute value at or above the third quartile of the eGFR decline rate. A multivariable logistic regression model was used for estimation. Compared with the first quartile of the e24hUNa/K, multivariable-adjusted odds ratios (ORs) for eGFR decline in the second, third, and fourth quartiles were 0.96 (95% confidence interval: 0.61–1.51), 1.06 (0.67–1.66), and 1.65 (1.06–2.57), respectively. These results were similar when the simple spot urine Na/K ratio was used in place of the e24hUNa/K. Apparently healthy urban residents with an almost within normal range mean baseline eGFR and high e24hUNa/K ratios had an increased risk for a future decline in renal function. Reducing the Na/K ratio may be important in the prevention of chronic kidney disease in its early stage.
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Age Differences in Health Behavior and Weight Changes in Japanese Workers: 1-Year Follow-Up Study. J Occup Environ Med 2018; 60:839-846. [PMID: 29787397 DOI: 10.1097/jom.0000000000001354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine 1-year changes in stage of health behavior change and its associations with changes in health behavior and weight in a working population cohort. METHODS Using annual health examination data, 57,431 eligible Japanese workers aged 18 to 64 years were examined for their 1-year changes in stage of change, eating and exercise habits, and weight. RESULTS The stages of change became polarized into the precontemplation and the action/maintenance (ie, post-action) and became stabilized with increasing age. The 1-year change in stage of change was accompanied by changes in eating and exercise habits and weight. CONCLUSIONS The age-dependent tendency towards bipolarization and stabilization of stages of change suggested that workplace health promotion interventions for facilitating health behavior changes should be started at younger ages.
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Urinary Mineral Concentrations in European Pre-Adolescent Children and Their Association with Calcaneal Bone Quantitative Ultrasound Measurements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050471. [PMID: 27164120 PMCID: PMC4881096 DOI: 10.3390/ijerph13050471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 11/26/2022]
Abstract
This study investigates differences and associations between urinary mineral concentrations and calcaneal bone measures assessed by quantitative ultrasonography (QUS) in 4322 children (3.1–11.9 years, 50.6% boys) from seven European countries. Urinary mineral concentrations and calcaneal QUS parameters differed significantly across countries. Clustering revealed a lower stiffness index (SI) in children with low and medium urinary mineral concentrations, and a higher SI in children with high urinary mineral concentrations. Urinary sodium (uNa) was positively correlated with urinary calcium (uCa), and was positively associated with broadband ultrasound attenuation and SI after adjustment for age, sex and fat-free mass. Urinary potassium (uK) was negatively correlated with uCa but positively associated with speed of sound after adjustment. No association was found between uCa and QUS parameters after adjustment, but when additionally adjusting for uNa, uCa was negatively associated with SI. Our findings suggest that urinary mineral concentrations are associated with calcaneal QUS parameters and may therefore implicate bone properties. These findings should be confirmed in longitudinal studies that include the food intake and repeated measurement of urinary mineral concentrations to better estimate usual intake and minimize bias.
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Johnson JS, Nobmann ED, Asay E. Factors related to fruit, vegetable and traditional food consumption which may affect health among Alaska Native People in Western Alaska. Int J Circumpolar Health 2012; 71:17345. [PMID: 22456043 PMCID: PMC3417710 DOI: 10.3402/ijch.v71i0.17345] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives Determine intake of fruits, vegetables and traditional foods (TF), availability of foods, and attitudes towards increasing their consumption. Study design Establish community baseline through a cross-sectional sample of residents who were weighed, measured and interviewed. Village stores were surveyed for food availability, price and quality. Methods Eighty-eight respondents self-identified as the household member primarily responsible for food shopping and cooking were surveyed in 3 Western Alaska Native villages using a food frequency questionnaire, and village stores were evaluated using food environment surveys. Results Overweight (BMI[kg/m2] >25) was present in 68% of participants. Fruit and vegetable intake (3.3 median servings/day) was low in comparison to recommended intakes of 5–9 servings/d. Seventy-two per cent were eating less than 5 servings/d of fruits and vegetables combined. Thirty-four per cent of respondents were trying to eat more vegetables; 41% were trying to eat more fruits. The median number of servings of TF was 3.2/d (mean 4.3/d). Seventy-seven per cent of respondents reported that they ate enough TF. Conclusion Recommendations to continue use of TF and increase intake of fruits and vegetables are consistent with local attitudes. Our findings indicate that increasing the availability of fruits and vegetables would be well received. Information from this study provides a basis for nutrition education and food supplement programs that is responsive to the needs and perceptions of the residents. Continued TF intake and increased fruit and vegetable intake have the potential to benefit the health of rural residents.
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Yamori M, Njelekela M, Mtabaji J, Yamori Y, Bessho K. Hypertension, periodontal disease, and potassium intake in nonsmoking, nondrinker african women on no medication. Int J Hypertens 2011; 2011:695719. [PMID: 21826260 PMCID: PMC3150144 DOI: 10.4061/2011/695719] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 05/05/2011] [Accepted: 06/15/2011] [Indexed: 11/20/2022] Open
Abstract
The purpose of this cross-sectional study was to investigate the association of periodontitis and/or tooth loss with hypertension by excluding the common confounders. Eighty-one Tanzanian women who were aged 46-58 years, nonsmokers, nonalcoholic drinkers, and on no medication underwent clinical examination. Multiple-regression analysis showed that the severity of periodontitis was significantly correlated with increased systolic blood pressure and diastolic blood pressure. Simple-regression analysis indicated that the severity of periodontitis was inversely correlated with 24-hour urinary excretion of potassium (r = -0.579, P = 0.0004) and also inversely with the frequency of intakes of green vegetables (r = -0.232, P = 0.031) and fruits (r = -0.217, P = 0.0043). Low-potassium intake in the diet mostly accompanied by low dietary fiber intake increases BP as well as periodontal inflammation. Potassium intake may be an important factor linking periodontitis and hypertension in middle-aged nonsmoking and nonalcoholic women on no medication, although chronic inflammation such as periodontitis may cause hypertension through a more direct mechanism.
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Affiliation(s)
- Masashi Yamori
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Huybrechts I, Börnhorst C, Pala V, Moreno LA, Barba G, Lissner L, Fraterman A, Veidebaum T, Hebestreit A, Sieri S, Ottevaere C, Tornaritis M, Molnár D, Ahrens W, De Henauw S. Evaluation of the Children's Eating Habits Questionnaire used in the IDEFICS study by relating urinary calcium and potassium to milk consumption frequencies among European children. Int J Obes (Lond) 2011; 35 Suppl 1:S69-78. [PMID: 21483425 DOI: 10.1038/ijo.2011.37] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Measuring dietary intake in children is notoriously difficult. Therefore, it is crucial to evaluate the performance of dietary intake assessment methods in children. Given the important contribution of milk consumption to calcium (Ca) and potassium (K) intakes, urinary calcium (UCa) and potassium (UK) excretions in spot urine samples could be used for estimating correlations with milk consumption frequencies. OBJECTIVE The aim of this study was to evaluate the assessment of milk consumption frequencies derived from the Food Frequency Questionnaire section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) used in the IDEFICS (Identification and prevention of dietary- and lifestyle induced health effects in children and infants) study by comparing with UCa and UK excretions in spot urine samples. DESIGN This study was conducted as a setting-based community-oriented intervention study and results from the first cross-sectional survey have been included in the analysis. SUBJECTS A total of 10,309 children aged 2-10 years from eight European countries are included in this analysis. METHODS UCa and UK excretions were measured in morning spot urine samples. Calcium and potassium urine concentrations were standardised for urinary creatinine (Cr) excretion. Ratios of UCa/Cr and UK/Cr were used for multivariate regression analyses after logarithmic transformation to obtain normal distributions of data. Milk consumption frequencies were obtained from the CEHQ-FFQ. Multivariate regression analyses were used to investigate the effect of milk consumption frequencies on UCa and UK concentrations, adjusting for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. RESULTS A significant positive correlation was found between milk consumption frequencies and ratios of UK/Cr and a weaker but still significant positive correlation with ratios of UCa/Cr, when using crude or partial Spearman's correlations. Multivariate regression analyses showed that milk consumption frequencies were predictive of UCa/Cr and UK/Cr ratios, when adjusted for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. Mean ratios of UK/Cr for increasing milk consumption frequency tertiles showed a progressive increase in UK/Cr. Children consuming at least two milk servings per day had significantly higher mean UCa/Cr and UK/Cr ratios than children who did not. Large differences in correlations between milk consumption frequencies and ratios of UCa/Cr and UK/Cr were found between the different study centres. CONCLUSION Higher milk consumption frequencies resulted in a progressive increase in UK/Cr and UCa/Cr ratios, reflecting the higher Ca and K intakes that coincide with increasing milk consumption, which constitutes a major K and Ca source in children's diet.
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Affiliation(s)
- I Huybrechts
- Department of Public Health, Ghent University, Belgium.
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Kushida O, Murayama N, Iriyama Y, Horikoshi K, Takemi Y, Yoshiike N. An Algorithm for Assessing Changes in Vegetable Intake Behavior in Adult Male in Japan. ACTA ACUST UNITED AC 2011. [DOI: 10.5264/eiyogakuzashi.69.294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kamon Y, Okamura T, Tanaka T, Hozawa A, Yamagata Z, Takebayashi T, Kusaka Y, Urano S, Nakagawa H, Kadowaki T, Miyoshi Y, Yamato H, Okayama A, Ueshima H. Marital Status and Cardiovascular Risk Factors among Middle‐aged Japanese Male Workers: The High‐risk and Population Strategy for Occupational Health Promotion (HIPOP‐OHP) Study. J Occup Health 2008; 50:348-56. [DOI: 10.1539/joh.l7158] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yuko Kamon
- Department of Health ScienceShiga University of Medical ScienceJapan
| | - Tomonori Okamura
- Department of Preventive Cardiology, National Cardiovascular CenterJapan
| | - Taichiro Tanaka
- Department of Health Sciences, Faculty of MedicineUniversity of YamanashiJapan
| | - Atsushi Hozawa
- Department of Health ScienceShiga University of Medical ScienceJapan
| | - Zentaro Yamagata
- Department of Health Sciences, Faculty of MedicineUniversity of YamanashiJapan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public HealthSchool of Medicine, Keio UniversityJapan
| | - Yukinori Kusaka
- Department of Environmental Health, Faculty of Medical SciencesUniversity of FukuiJapan
| | | | - Hideaki Nakagawa
- Department of Epidemiology and Public HealthKanazawa Medical UniversityJapan
| | - Takashi Kadowaki
- Department of Health ScienceShiga University of Medical ScienceJapan
| | - Yuji Miyoshi
- Tokyo Central Clinic, Health Insurance Society of Meiji Yasuda Life Insurance CompanyJapan
| | - Hiroshi Yamato
- Institute of Industrial Ecological Science, University of Occupational and Environmental HealthJapan
| | - Akira Okayama
- The First Institute of Health Service, Japan Anti‐Tuberculosis AssociationJapan
| | - Hirotsugu Ueshima
- Department of Health ScienceShiga University of Medical ScienceJapan
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Naito M, Nakayama T, Okamura T, Miura K, Yanagita M, Fujieda Y, Kinoshita F, Naito Y, Nakagawa H, Tanaka T, Ueshima H. Effect of a 4-year workplace-based physical activity intervention program on the blood lipid profiles of participating employees: The high-risk and population strategy for occupational health promotion (HIPOP-OHP) study. Atherosclerosis 2008; 197:784-90. [PMID: 17868680 DOI: 10.1016/j.atherosclerosis.2007.07.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2007] [Revised: 07/09/2007] [Accepted: 07/25/2007] [Indexed: 10/22/2022]
Abstract
Individuals who are physically fit or engage in regular physical activity have a lower incidence of cardiovascular disease and risk of mortality. We conducted a large-scale controlled trial of interventions to decrease cardiovascular risk factors, during which we assessed the effect of a workplace-based intervention program, which was part of a population strategy for promoting long-term increases in physical activity, on the blood lipid profiles of participating employees. Data were collected from 2929 participants and this report presents the results of a survey conducted in five factories for the intervention group and five factories for the control group at baseline and year 5. The absolute/proportional changes in HDL-cholesterol were 2.7 mg/dL (4.8%) in the intervention group and -0.6 mg/dL (-1.0%) in the control group. The differences between the two groups in the change in serum levels of HDL-cholesterol were highly significant (p<0.001) in each analysis of covariance, in which the number of cigarettes smoked was included or excluded. In the intervention group, the daily walking time increased significantly (p<0.001) when compared between baseline and year 5, whereas no significant difference was observed in daily walking time in the control group over the identical period. Our results show that an intervention program promoting physical activity raises serum HDL-cholesterol levels of middle-aged employees. Increased awareness of the benefits of physical activity, using environmental rearrangement and health promotion campaigns, which especially target walking, may have contributed to a beneficial change in serum HDL-cholesterol levels in the participants.
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Affiliation(s)
- Mariko Naito
- Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
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Health care providers' knowledge, attitudes, and self-efficacy for working with patients with spinal cord injury who have diverse sexual orientations. Phys Ther 2008; 88:191-8. [PMID: 18029393 DOI: 10.2522/ptj.20060188] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE This study, using an evaluative, cross-sectional design, explored the self-efficacy, knowledge, and attitudes of health care providers who treat people with spinal cord injury (SCI) who may be gay, lesbian, bisexual, or transgender (GLBT). The study also designed and implemented a diversity training program and measured its effect on participants' perceptions of their ability to change their knowledge levels, attitudes, and self-efficacy with regard to sexual orientation diversity. SUBJECTS AND METHODS Health care professionals (N=402) participated in a diversity training program that included a pre-briefing questionnaire, a videotape, a post-briefing questionnaire, and discussion. Descriptive and chi-square analyses were performed on all variables of interest. RESULTS The majority of the participants reported low levels of knowledge, attitudes of tolerance versus respect, and 0% to 20% confidence levels for providing culturally sensitive services for patients with diverse sexual orientations. Three hundred seventeen participants strongly agreed that watching the videotape increased their confidence levels in providing services for people who may be GLBT. DISCUSSION AND CONCLUSION Health care providers who treat people with SCI self-report low levels of knowledge, tolerance versus respect, and low levels of self-efficacy with regard to sexual orientation diversity. If a health care provider has a low level of knowledge, tolerance versus respect, and a low level of diversity self-efficacy toward others, there may be direct physical and mental health consequences for the patient. A limitation of the study was that social desirability bias may have increased the number of participants who reported increased levels of self-efficacy following the videotape. Further research is recommended (1) to determine whether current diversity training for health care professionals includes diversity of sexual orientation and (2) to examine the knowledge levels, attitudes, and self-efficacy of health care professionals with regard to sexual orientation diversity while attempting to control for social desirability bias in participants' responses.
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Tuekpe MKN, Todoriki H, Sasaki S, Zheng KC, Ariizumi M. Potassium excretion in healthy Japanese women was increased by a dietary intervention utilizing home-parcel delivery of Okinawan vegetables. Hypertens Res 2006; 29:389-96. [PMID: 16940700 DOI: 10.1291/hypres.29.389] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Potassium, which is abundant in vegetables, is inversely related to blood pressure. Although the situation has changed somewhat in recent years, the Okinawan diet has generally included a large amount of vegetables, and until recently Okinawans had the lowest rates of mortality due to stroke and coronary heart disease in Japan. Based on the hypothesis that these low mortality rates are partly attributable to increased potassium intake resulting from the high vegetable consumption, this study examined whether increasing the consumption of typical yellow-green Okinawan vegetables increases potassium intake. The purpose of this investigation was to determine whether increased consumption of these vegetables should be one of the dietary modifications recommended in public health promotion programs for Okinawans. The study employed 56 healthy, normotensive, free-living Japanese women aged 18-38 years living in Okinawa. They were randomized to a dietary intervention group (n=27) or a control group (n=29). Members of the dietary intervention group received an average weight of 371.4 g/day of a combination of the following vegetables twice weekly through an express home parcel deliver service for a period of 14 days: Goya (Momordica charantia), green papaya (Carica papaya), Handama (Gynura bicolor), Karashina (Brassica juncea), Njana (Crepidiastrum lanceolatium), Fuchiba (Artemisia vulgaris) and Fudanso (Beta vulgaris); and they consumed an average of 144.9 g/day, resulting in a 20.5% increase in their urinary potassium excretion over the baseline (p=0.045). The members of the control group were asked to avoid these vegetables, and the change in potassium excretion in this group was not significant (p=0.595). Urinary sodium and magnesium excretions, systolic and diastolic blood pressures, folic acid, triglycerides and serum high density lipoprotein cholesterol, low density lipoprotein cholesterol and total cholesterols changed non-significantly in both groups. Also, post-intervention urinary potassium excretion correlated positively with vegetable consumption in both the dietary intervention (p<0.0001) and control (p=0.008) groups and with Okinawan vegetable intake in the dietary intervention group (p=0.0004).
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Affiliation(s)
- Mallet K-N Tuekpe
- Department of Environmental and Preventive Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara-cho, Okinawa, Japan
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Nakamura K, Okamura T, Kanda H, Hayakawa T, Kadowaki T, Okayama A, Ueshima H. Impact of hypertension on medical economics: A 10-year follow-up study of national health insurance in Shiga, Japan. Hypertens Res 2006; 28:859-64. [PMID: 16555573 DOI: 10.1291/hypres.28.859] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hypertension and related cardiovascular diseases may lead to an increase in medical costs for patients. We attempted to clarify the relationship between hypertension and long-term medical costs by a cohort study utilizing existing data as well as baseline blood pressures and medical costs over a 10-year period. The participants included 4191 Japanese National Health Insurance beneficiaries aged 40-69 years, living in one area, who were not taking anti-hypertensive medication and did not have a history of major cardiovascular disease. They were classified into four categories according to their blood pressure. We evaluated the mean medical costs per month, cumulative hospitalization, and all-cause mortality for each blood pressure category. Hypertension-related medical costs attributable to hypertensive individuals, as compared to normotensive individuals, were estimated. There was a positively graded correlation between blood pressure and personal total medical costs, especially for men. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensive men were also higher than those in normotensive men. However, the hypertension-related medical costs for mild to moderate hypertensives were higher than those for severe hypertensives. The hypertension-related medical costs for all hypertensives accounted for 23.7% of the total medical costs for the Japanese population. In conclusion, high blood pressure was a useful predictor for excess medical costs; moreover, concomitant hypertension, regardless of the grade, increased the medical costs of Japanese National Health Insurance beneficiaries.
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Affiliation(s)
- Koshi Nakamura
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
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