1
|
Chen YR, Hanazato M, Saito M, Koga C, Matsuoka Y, Yoshida H, Kondo K. Does the neighborhood built and social environment reduce long-term care costs for Japanese older people? The JAGES2010-2019 cohort study. Health Place 2024; 86:103223. [PMID: 38479102 DOI: 10.1016/j.healthplace.2024.103223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Japan's population has been aging steadily, evidenced by it spending JPY 11 trillion (USD 110 billion) on annual long-term care (LTC) costs in 2021. In this context, understanding the factors influencing LTC costs has become increasingly vital. Although studies have reported positive relationships between neighborhood environment and health outcomes, the connection between LTC costs and neighborhood environment remains unclear. To address this gap in the literature, this cohort study, conducted from 2010 to 2019 across seven Japanese municipalities and involving 34,982 older people, examined the relationship between eight neighborhood environment elements and the mean monthly cumulate costs (MMCC) of LTC. The results showed that older people who reported the presence of fresh food stores nearby and dangerous places for walking alone at night in the neighborhood had lower MMCC, by JPY 1,367.6 and 1,383.3 per month, respectively, than respondents who did not report the presence of these neighborhood elements. Meanwhile, older people whose neighborhoods had easily accessible facilities had higher MMCC of JPY 739.4. This study's key findings reveal significant relationships between neighborhood environment elements and LTC costs and can be used to support developments in urban design to support healthy aging and reduced LTC costs.
Collapse
Affiliation(s)
- Yu-Ru Chen
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Design Research Institute, Chiba University, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Aichi, Japan
| | - Chie Koga
- Research Center for Advanced Science and Technology, Tokyo University, Tokyo, Japan
| | - Yoko Matsuoka
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Hiroaki Yoshida
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
| |
Collapse
|
2
|
Kinugawa A, Kusama T, Takeuchi K, Aida J, Kiuchi S, Katagiri R, Hikichi H, Sasaki S, Kondo K, Osaka K. Association between dietary pattern and insomnia symptoms among independent older adults: A cross-sectional study based on JAGES. Sleep Med 2023; 112:70-76. [PMID: 37816295 PMCID: PMC10842256 DOI: 10.1016/j.sleep.2023.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/10/2023] [Accepted: 09/23/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Poor diet can cause sleep disorders; however, this association has not been established in older populations. This study investigated the association between dietary patterns and insomnia symptoms in independent older adults. METHODS This cross-sectional study targeted independent older Japanese adults aged ≥74 years. We used insomnia symptoms classified into three domains: difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and insomnia. These symptoms were assessed as dependent variables by a self-reported questionnaire. Dietary patterns (DP), identified by principal component analysis of a self-administered diet history questionnaire, were used as independent variables. Poisson regression analysis was used to estimate the prevalence ratios and 95% confidence intervals with adjustment for potential confounders. RESULTS Among 1,311 participants (mean age = 80.1; women, 48.5%), we identified three dietary patterns: DP1 was characterized by a high intake of vegetables, soy products, and fruits and a low intake of rice; DP2 was characterized by a high intake of fish, chicken, processed meat, and noodles and a low intake of soy products; and DP3 was characterized by a lower intake of fruits and confectionaries. Higher DP1 scores were significantly associated with a lower prevalence of DIS (p-for-trend = 0.012). A higher DP2 score was significantly associated with a higher prevalence of insomnia (p-for-trend = 0.032). There was no significant association between DP3 and insomnia symptoms (p-for-trend >0.05). CONCLUSION Our results highlighted that a dietary pattern with a high intake of vegetables, soy products, and fruits may contribute to reducing insomnia symptoms among independent older adults.
Collapse
Affiliation(s)
- Anna Kinugawa
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan; Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan; Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan.
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan; Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Ryoko Katagiri
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Hiroyuki Hikichi
- Division of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| |
Collapse
|
3
|
An assessment of implementation gaps and priority recommendations on food environment policies: the Healthy Food Environment Policy Index in Japan. Public Health Nutr 2022; 25:1720-1732. [PMID: 34924082 PMCID: PMC9991651 DOI: 10.1017/s1368980021004900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study aimed to evaluate policies and actions for food environments by the Japanese Government using the Healthy Food Environment Policy Index (Food-EPI). DESIGN Public health experts rated the extent of implementation of food environment-related Policy and the Infrastructure-support components, compared with international best practices. Subsequently, the experts proposed and prioritised future actions to address implementation gaps in an online workshop. SETTING Japan. PARTICIPANTS A total of sixty-six experts rated policy implementation by the Japanese Government and twenty-three participated in the workshop on future actions. RESULTS The implementations of regulations on unhealthy foods and non-alcoholic beverages were rated low in the domains of Food composition, Food labelling and Food promotion, Food prices and Food retail in the Policy component. The implementations of several domains in the Infrastructure-support component were, overall, rated at a higher level, specifically for monitoring and intelligence systems. Based on the rating, reducing health inequalities by supporting people, both economically and physically, was the highest priority for future actions in both components. CONCLUSIONS The current study found that Japan has a robust system for long-term monitoring of population health but lacks regulations on unhealthy foods and non-alcoholic beverages compared with international best practices. The current study confirmed the importance of continuous accumulation of evidence through national monitoring systems. Developing comprehensive regulations to restrict food marketing, sales and accessibility of unhealthy foods and non-alcoholic beverages is needed to improve the health of food environments in Japan.
Collapse
|
4
|
Yamaguchi M, Praditsorn P, Purnamasari SD, Sranacharoenpong K, Arai Y, Sundermeir SM, Gittelsohn J, Hadi H, Nishi N. Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations. Nutrients 2022; 14:1788. [PMID: 35565756 PMCID: PMC9099956 DOI: 10.3390/nu14091788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.
Collapse
Affiliation(s)
- Miwa Yamaguchi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
| | - Panrawee Praditsorn
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Sintha Dewi Purnamasari
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Kitti Sranacharoenpong
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, 2-10-1 Wakaba, Mihama-ku, Chiba-shi 261-0014, Japan;
| | - Samantha M. Sundermeir
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Hamam Hadi
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
| |
Collapse
|
5
|
Kim YM, Yang N, Kim K. Effects of Perceived Food Store Environment on Malnutrition and Frailty among the Food-Insecure Elderly in a Metropolitan City. Nutrients 2021; 13:nu13072392. [PMID: 34371905 PMCID: PMC8308648 DOI: 10.3390/nu13072392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to identify food environment factors in the local community that could affect the levels of nutritional status and frailty in 372 older adults (at least 65 years old) experiencing food insecurity and enrolled in the integrated Community Health Promotion Program (CHPP) in two districts of Seoul. The local food environment was assessed using perceived food store accessibility questionnaires. In order to quantify nutrient intake, the 24-h recall method was applied. Malnutrition was measured using the Mini Nutritional Assessment tool, while frailty was assessed using the Frailty Measurement Questionnaire developed for the CHPP. Malnourished or frail elderly adults commonly had a lower intake of cereals and potatoes, meats, and vegetables than those who were not, and their resulting intake levels of energy, protein, iron, and vitamin groups were also significantly lower (all p-values < 0.05). Among the local community food store environment factors, the sufficiency of food stores (odds ratio (OR) = 1.988, 95% confidence interval (CI] = 1.211-3.262), freshness of foods (OR = 1.767, 95% CI = 1.075-2.886), and variety in foods (OR = 1.961, 95% CI = 1.197-3.212) were significant factors affecting the risk of malnutrition. For frailty, the freshness of foods (OR = 1.997, 95% CI = 1.053-3.788), variety in foods (OR = 2.440, 95% CI = 1.277-4.661), and small purchase of foods (OR = 2.645, 95% CI = 1.362-5.139) were significant environmental factors. In conclusion, we found that the perceived food store environment in the local community can influence the occurrence of malnutrition and frailty in vulnerable, urban older adults.
Collapse
Affiliation(s)
- Yu-Mi Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea;
- School of Public Health, Hanyang University, Seoul 04763, Korea
| | - Narae Yang
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea;
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea;
- Correspondence: ; Tel.: +82-41-550-3472
| |
Collapse
|
6
|
The association of dimensions of fruit and vegetable access in the retail food environment with consumption; a systematic review. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2021; 29:100528. [PMID: 34164256 PMCID: PMC8202327 DOI: 10.1016/j.gfs.2021.100528] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/29/2021] [Accepted: 03/04/2021] [Indexed: 12/04/2022]
Abstract
The consumption of fruit and vegetables (F&V) is important for human health to protect against non-communicable disease and micronutrient deficiency. Increasing consumption of F&V may also benefit planetary health if these foods are substituted for foods with higher environmental footprints such as red meat or dairy. The retail food environment (RFE) is an influential junction between the food system and individual diets as it drives access to F&V through external (physical access) and personal (availability, affordability, acceptability) domains. We performed a systematic search of six literature databases (January 2021) for studies assessing access to F&V in the RFE and its association with F&V consumption in adults in high- and upper-middle income countries. 36 studies were identified and categorised by dimensions of food access – accessibility, affordability, acceptability, availability and accommodation. More than half of the studies (n = 20) were based in the USA. F&V accessibility was the most commonly reported dimension (n = 29); no study reported on accommodation. 6 studies were rated to be high quality. A positive association of increased availability of F&V options in the RFE with intake was identified in 9 of 15 studies. Associations in both acceptability and accessibility dimensions were inconsistent. No association was observed between F&V affordability and consumption although available data were limited. Many challenges exist to building a robust evidence base within food environment research including conceptual, definitional and methodological heterogeneity and measurement standardisation. Future food policies should consider multi-dimensional interventions to promote access to F&V in the RFE across all domains. First systematic review of dimensions of access in the retail food environment (RFE) and fruit and vegetable (F&V) intake. This review suggests potential importance of having access to available healthy options in the RFE for F&V intake. The absence of an association of F&V affordability with consumption is likely due to limited and mixed data availability. F&V accessibility and acceptability require development as dimensions of access for clearer links to be made. The retail food environment is complex but likely predictor of F&V consumption.
Collapse
|
7
|
Distance to supermarkets and dietary variety among Japanese older adults: examining the moderating role of grocery delivery services. Public Health Nutr 2020; 24:2077-2084. [PMID: 32723418 DOI: 10.1017/s1368980020002219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine whether using grocery delivery services moderates the relationship between distance to supermarket and dietary variety among Japanese older adults. DESIGN We conducted a 1-year prospective cohort study. Distance to supermarket was measured using geographic information systems. We collected information on dietary variety score (range 0-10), regular use of grocery delivery services and socio-demographic factors using a questionnaire delivered via post. SETTING The current study was performed in Nada Ward, Kobe City, Japan, from 2017 to 2018. PARTICIPANTS Older adults living in Nada Ward (n 778). RESULTS The linear mixed model showed that a longer distance to supermarket (per 100 m: B = -0·07, 95 % CI -0·14, -0·01, P = 0·048) significantly predicted lower dietary variety after adjusting for socio-demographic factors. Using grocery delivery services (B = 0·28, 95 % CI -0·08, 0·64, P = 0·127) did not significantly predict dietary variety, and neither did its interaction with distance to supermarket (B = -0·04, 95 % CI -0·17, 0·10, P = 0·604). CONCLUSIONS The current study found that longer distance to supermarket was associated with lower dietary variety among Japanese older adults and that the use of grocery delivery services did not moderate this association. The findings imply that the use of grocery delivery services is insufficient to reduce the negative influence of inconvenient food access on dietary variety among older adults.
Collapse
|
8
|
Iizaka S, Koitabashi E, Negishi T, Kawamura A, Iizuka Y. Distance from the nearest grocery stores and frequency of store-specific shopping are associated with dietary intake frequency among the community-dwelling independent elderly population. Nutr Health 2020; 26:197-207. [PMID: 32400265 DOI: 10.1177/0260106020923806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Low accessibility to grocery stores may change dietary habits and increase health problems for elderly people living in communities. AIM This study investigated whether the distance from the nearest grocery stores, including supermarkets, convenience stores, and drugstores, and the frequency of store-specific shopping were associated with dietary intake frequency among elderly people. METHODS A cross-sectional study was conducted in two towns of suburban cities. A total of 177 people aged ≥65 years were recruited (M age=76.7 years). The frequency of intake of 10 food groups and dietary variety scores (DVS) were evaluated. Distances from the districts to the nearest grocery stores and the frequency of shopping during a week at each store were evaluated using a geographic information system. RESULTS For supermarkets, people living <300 metres from the nearest supermarket showed a higher intake frequency of fruit (p=0.024) and oil/fat (p=0.045), and those shopping three or more times a week showed a higher intake frequency of meat (p=0.025). In the case of drugstores, people shopping one or more times a week showed a higher intake frequency of eggs (p=0.006) and oil/fat (p=0.048). People living <300 m from the nearest supermarkets (p=0.048) and drugstores (p=0.047) showed higher DVS than those living ≥500 m from the nearest supermarkets and drugstores. CONCLUSIONS Our findings suggest that shopping at supermarkets and drugstores is associated with dietary intake frequency and dietary quality for elderly people living in suburban cities.
Collapse
Affiliation(s)
- Shinji Iizaka
- School of Nutrition, College of Nursing and Nutrition, Shukutoku University, Japan
| | - Emiko Koitabashi
- Department of Nursing, Faculty of Health Science, Toho University, Japan
| | - Takako Negishi
- Department of Nursing, Faculty of Health Sciences, Tokyo Kasei University, Japan
| | - Aki Kawamura
- Department of Nursing, Faculty of Nursing, Wayo Women's University, Japan
| | - Yuzuru Iizuka
- School of Nutrition, College of Nursing and Nutrition, Shukutoku University, Japan
| |
Collapse
|