Health Problem In Japan Research Articles

Underweight in young Japanese women over time: a longitudinal retrospective study of the change in body mass index from ages 6 to 20 years

Background The high prevalence of underweight in young women has become a serious health problem in Japan. When and how young women reach a low body mass index (BMI) has not been clarified. Aim To clarify the characteristics of BMI standard deviation scores (BMI SDS) trajectory of young Japanese women with underweight. Subjects and methods A total of 601 Japanese female university students aged 20 years were classified into underweight and healthy weight groups. Their school health check-up data were available from the ages of 6 to 20 years. We evaluated the estimated mean values of BMI SDS at each age and differences in BMI SDS (ΔBMI SDS) from 6 years to each age using a mixed-effects model and compared between the two groups at each age. Results In the underweight group, the BMI SDS at every age (−1.67 to −0.91) and the ΔBMI SDS after 16 years of age (−0.76 to −0.38) were significantly lower than those in the healthy weight group (−0.41 to −0.13, −0.07 to 0.04), respectively. Conclusion Young Japanese women with underweight have at least two characteristics of BMI SDS trajectory: being constitutionally underweight and shifting their weight status from baseline towards underweight in their late teens.

Service intensity of community mental health outreach among people with untreated mental health problems in Japan: A retrospective cohort study.

This study aimed to clarify the association between treatment status (untreated or treated) at the start of community mental health outreach services and service intensity. This retrospective cohort study was conducted using the Tokorozawa City mental health outreach service users' data. Treatment status at the start of service (exposure variable) and the service intensity (outcome variables) were taken from clinical records. Poisson regression and linear regression analyses were conducted. The frequency of medical or social service use 12 months after service initiation was also calculated. This study was approved by the Research Ethics Committee at the National Center of Neurology and Psychiatry (No. A2020-081). Of 89 people, 37 (42%) were untreated. Family members in the untreated group were more likely to be targets or recipients of services than in the treated group (b = 0.707, p < 0.001, Bonferroni-adjusted p < 0.001). Compared to the treated group, the untreated group received fewer services themselves (b = -0.290, p = 0.005), and also fewer services by telephone (b = -0.252, p = 0.012); by contrast, they received more services at the health center (b = 0.478, p = 0.031) and for family support (b = 0.720, p = 0.024), but these significant differences disappeared after Bonferroni adjustment. At least 11% of people in the untreated group were hospitalized and 35% were outpatients 12 months after service initiation. Family involvement may be a key service component for untreated people. The service intensity with and without treatment may vary by service location.

Job stress and mental health at work

In Japan, a study on mental health in workplace has expanded from tertiary to secondary and primary preventions of mental health disorders among employees. Recent movements suggest a trend of bringing numerous topics outside the industrial health, including those with perspectives from categories generally known as primordial prevention, such as enhancement of working life quality or improvement of work environment.First, according to the aforementioned trends, the present paper made an effort to organize the terms and concepts related to mental health disorders, which included the foundation for research and practice in this area as well as the outcomes of discussions on the tertiary and secondary preventions.Second, the primary models of work-related stress, along its impact on mental health, and the scales for assessing workers' mental health issues were discussed, which have been used in numerous studies since the 1990s. The introduction of those models and scales contributed immensely to the expansion of this field's research areas. However, a number of significant factors, most of which have social or cultural implications, can influence the connection between stress at workplace and health problems. Therefore, conducting large-scale study or systematic reviews targeting domestic cases exclusively is necessary to obtain evidence for establishing highly versatile measures against mental health problems in Japan.Third, in this regard, several noteworthy large-scale research projects in Japan are highlighted as a hope for encouraging such studies in this field. However, the occupational health practitioners' effort to understand the actual workplace situations where they attend to and to put the understanding into practice has been and will remain an indispensable attribute for them in the future.

Hansen's disease (leprosy) in Japan, 1947-2020: an epidemiologic study during the declining phase to elimination

ObjectivesLeprosy, or Hansen's disease was a major public health problem in Japan in the early 20th century. Today, the number of new cases has decreased significantly. We aimed to investigate the trends of leprosy in Japan over the past 73 years and the challenges faced in recent years. MethodsWe assessed the data on newly registered cases of leprosy from 1947 to 2020. ResultsA total of 10,796 newly registered cases of leprosy were reported during the study period, of which 7573 were registered in mainland Japan, 2962 in Okinawa, and 250 were of foreign origin. Most autochthonous cases were born before 1950 in mainland Japan and before 1975 in Okinawa. The number of nonautochthonous cases surpassed that of autochthonous cases in 1992. Nonautochthonous cases originated from 26 countries, particularly Brazil and the Philippines. Three cases of antimicrobial resistance have been detected among nonautochthonous cases since 2004. ConclusionOur data suggest that ongoing transmission of leprosy likely ceased in the 1940s in mainland Japan and in the 1970s in Okinawa. With the recent rise of nonautochthonous cases with globalization, continuous surveillance and efforts to maintain leprosy services within the country are necessary even after reaching the state of elimination.

An Improved and Simplified Propagation System for Pollen-Free Sugi (Cryptomeria japonica) via Somatic Embryogenesis.

Sugi (Japanese cedar, Cryptomeria japonica) is the most important forestry tree species in Japan, covering 44% of the total artificial forest area. Large amounts of pollen released from these forests each spring cause allergic reactions in approximately 40% of the population, which are a serious social and public health problem in Japan. As a countermeasure, there is an urgent need to reforest using male-sterile plants (MSPs; pollen-free plants); however, the production of MSPs via conventional methods is inefficient, time consuming, and requires considerable resources in terms of labor and space. In the present paper, we described an improved and simplified methodology for the efficient propagation of pollen-free Japanese cedar, combining the use of genetic markers (marker-assisted selection or marker-aided selection) for the early selection of male-sterile genotypes and the use of somatic embryogenesis (SE) for the clonal mass propagation of seedlings. We describe all the stages involved in the production process of somatic seedlings. Our results demonstrated that this methodology easily and efficiently produces MSPs with a discrimination rate of 100% in a short period of time. Production of 243.6 ± 163.6 cotyledonary embryos per plate, somatic embryo germination, and plantlet conversion frequencies of 87.1 ± 11.9% and 84.8 ± 12.6%, respectively, and a 77.6 ± 12.1% survival rate after ex vitro acclimatization was achieved. Moreover, we also describe an easy method for the collection of somatic embryos prior to germination, as well as an efficient and practical method for their storage at 5°C. Finally, a representative schedule for the propagation of pollen-free sugi somatic seedlings is presented as a reference for practical uses. This methodology will definitively help to accelerate the production of C. japonica MSPs across Japan.

Conceptual Analysis of &lt;i&gt;Ohen&lt;/i&gt; as Practiced in the Medical Field for People with Some Health Problems in Japan

Conceptual Analysis of &lt;i&gt;Ohen&lt;/i&gt; as Practiced in the Medical Field for People with Some Health Problems in Japan

Seamless support from screening to anti-HCV treatment and HCC/ decompensated cirrhosis: Subsidy programs for HCV elimination.

Viral hepatitis poses a major public health problem in Japan. Chronic viral hepatitis is a progressive liver disease that eventually develops into liver cirrhosis and liver cancer. Since nucleic acid analog therapy for hepatitis B and interferon-free therapy for hepatitis C have made it possible to control the disease status or eliminate the viruses, it is very important that more people receive hepatitis virus tests to confirm the presence of infection at an early stage, and that patients with hepatitis detected by the tests receive appropriate medical care. Currently, the government of Japan is implementing comprehensive measures for hepatitis control based on five key strategies. Moreover, the goal listed in the Basic Guidelines on Hepatitis Measures is to reduce the frequency of progression of hepatitis to cirrhosis or liver cancer through a scheme consisting of testing people for hepatitis, getting those who test positive to visit a medical institution and receive treatment, and providing appropriate and high-quality hepatitis care through specialized medical institutions and regional core centers for the management of liver disease. To achieve the goal, various subsidy programs including an expense subsidy system for hepatitis treatment have been implemented in Japan. It is important for healthcare professionals to have sufficient knowledge of public support for efficient hepatitis C virus (HCV)-related liver disease detection and care.

Trends in Energy Imbalance Gap and Body Weight Status in the Japanese Adult Population: A System Dynamics Approach.

BackgroundThe double burden of malnutrition is a growing public health problem in Japan. We estimated the dynamics of the energy imbalance gap (EIG) (average daily difference between energy intake and expenditure) to explain trends in the prevalence of underweight, overweight, and obese Japanese adults.MethodsWe used individual-level data on body height and weight from the National Health and Nutrition Surveys from 1975 to 2015. We calibrated a validated system dynamics model to estimate the EIG for Japanese adults aged 20 to 74 years by survey year, sex, and weight status classified by the body mass index (BMI).ResultsThe overall EIG for men increased from 2.3 kcal/day in 1975 to 4.7 kcal/day in 1987 and then decreased to 2.3 kcal/day in 2015. The overall EIG for women consistently decreased from 4.3 kcal/day in 1975 to −0.5 kcal/day in 2015. By BMI class, the EIG for men with a BMI of <30 kg/m2 began to decrease around 1990, indicating a deceleration in the prevalence of overweight and obese men. The EIG consistently decreased for women with a BMI of <25 kg/m2 and reached negative values from the late 2000s to early 2010s, indicating a gradual decrease in the prevalence of overweight and obese women.ConclusionsThe dynamics of the EIG were different across sex and weight groups. Public health interventions should target a further decrease in the EIG for normal-weight, overweight, and obese men and a stop in the decreasing trends of the EIG in underweight and normal-weight women.

Fatty Acid Metabolism during Exercise

Obesity-induced metabolic syndrome is becoming a severe health problem in Japan due to the increasing popularity of the Western-style diet and fast food. Endurance exercise is one of the most effective ways to reduce fat content and thus prevent metabolic syndrome, as endurance exercise leads to larger amounts of fatty acids being used to create energy with higher efficiency in skeletal muscle. There are two major types of skeletal muscle fibers: type I muscle fibers, which contain a large number of mitochondria and burn fatty acids for energy, and type II fibers, which contain fewer mitochondria and depend on glycolysis to acquire energy. Endurance exercise results in the development of type I muscle fibers and enhanced mitochondrial function, with increased expression and activity of mitochondrial enzymes such as carnitine palmitoyltransferase 1, β-hydroxy-acyl-CoA dehydrogenase and citrate synthase. On the other hand, in adipose tissues, higher amounts of fatty acids are released to support their increased usage in muscle fibers by increasing the activity levels of adipocyte triglyceride lipase and hormone-sensitive lipase following endurance exercise. The increased usage of fatty acids is considered an outcome of activated peroxidase proliferator-activated receptors (PPARs), nuclear receptors for fatty acids, and the induced transcription of proteins that play essential roles in fatty acid metabolism upon stimulation of those fatty acids. In three PPAR isoforms, muscle fibers predominantly express PPARγ, a regulator of mitochondrial enzyme transcription and type I muscle fiber development. In adipocytes, PPARγ is abundantly expressed to regulate fatty acid catabolism. Furthermore, skeletal muscles, adipose tissues and other tissues communicate through hormones such as myokines and adipokines, which optimize fatty acid metabolism in the entire body during endurance exercise. Collectively, endurance exercise shifts our energy metabolism to be more lipolytic for a healthier lifestyle.

Somatic Embryogenesis and Plant Regeneration from Sugi (Japanese Cedar, Cryptomeria japonica D. Don, Cupressaceae) Seed Families by Marker Assisted Selection for the Male Sterility Allele ms1.

One of the possible countermeasures for pollinosis caused by sugi (Cryptomeria japonica), a serious public health problem in Japan, is the use of male sterile plants (MSPs; pollen-free plants). However, the production efficiencies of MSPs raised by conventional methods are extremely poor, time consuming, and resulting in a high seedling cost. Here, we report the development of a novel technique for efficient production of MSPs, which combines marker-assisted selection (MAS) and somatic embryogenesis (SE). SE from four full sib seed families of sugi, carrying the male sterility gene MS1, was initiated using megagametophyte explants that originated from four seed collections taken at one-week intervals during the month of July 2017. Embryogenic cell lines (ECLs) were achieved in all families, with initiation rates varying from 0.6% to 59%. Somatic embryos were produced from genetic marker-selected male sterile ECLs on medium containing maltose, abscisic acid (ABA), polyethylene glycol (PEG), and activated charcoal (AC). Subsequently, high frequencies of germination and plant conversion (≥76%) were obtained on plant growth regulator-free medium. Regenerated plantlets were acclimatized successfully, and the initial growth of male sterile somatic plants was monitored in the field.

Social Correlates of Recent Suicidal Ideation Among Men Who Have Sex with Men in Greater Tokyo

Suicide is a major public health problem in Japan, where mortality rates are among the highest in the world. Globally, men who have sex with men (MSM) report elevated rates of suicidal ideation and attempts compared to their heterosexual peers. However, there is a paucity of research on suicidal ideation among MSM in Japan, where MSM continue to experience significant stigma and discrimination, and where resources are limited for MSM-specific mental health support. This study examined the prevalence and correlates of recent suicidal ideation among MSM in Greater Tokyo. We recruited 1,657 MSM for an anonymous, online, cross-sectional survey posted on social mobile applications popular with MSM in Japan (e.g., Grindr, 9Monsters) from November 2015 through January 2016. Recent suicidal ideation, measured as suicidal thoughts in the preceding two weeks, was reported by almost one-third (31%) of participants. Participants who reported unemployment or part-time employment (compared to full-time employment) and knowing a heterosexual person who restricted their freedom or excluded them from a group had higher odds of suicidal ideation. Being aged 46 years or older, reporting good health, and having a medium or high level of access to social capital networks with other MSM were associated with reduced odds of suicidal ideation. Our findings indicate that suicide prevention interventions with MSM in Greater Tokyo and similar urban settings in Japan should work to enhance MSM social networks as a protective factor; attend to employment concerns, particularly in younger MSM; and augment current efforts to address stigma and discrimination in the community.

State of the Art: Development of a Sublingual Allergy Immunotherapy Tablet for Allergic Rhinitis in Japan.

Allergic rhinitis (AR) caused by house dust mite (HDM) and Japanese cedar pollen (JCP) represents a significant, expanding health problem in Japan. Allergic symptoms often have a severe impact on the QOL such as sleep disturbance and reduced school and work performance. In addition to the classical symptoms, AR is known to be a risk factor for the development of allergic asthma, a potentially life-threatening condition. Allergy immunotherapy (AIT) is a well-documented, safe, effective treatment option for respiratory allergic disease. It has been demonstrated that AIT can provide relief from clinical symptoms and that AIT has the potential to provide long-term post-treatment effect. Although the mechanism of AIT is not fully understood, it can actively modulate protective allergen-reactive pathways of the immune system and alter the natural course of disease. Unlike pharmacotherapy, AIT addresses the basic immunological mechanisms that are responsible for the development and persistence of allergic conditions. Currently two main routes of AIT administration are commonly available, subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Both SCIT and SLIT are clinically effective, and SLIT is particularly well tolerated, with a lower risk of systemic allergic reactions compared with SCIT. To date, SLIT tablets have been developed for a range of different allergies including HDM and JCP and are the best-documented AIT treatment form. Here we introduce the current status of development of a SLIT tablet in Japan for AR, examine the clinical aspects and mechanism of action of AIT, and discuss the future directions of SLIT.

Transcutaneous Delivery of Immunomodulating Pollen Extract-Galactomannan Conjugate by Solid-in-Oil Nanodispersions for Pollinosis Immunotherapy.

Japanese cedar pollinosis is a type I allergic disease and has already become a major public health problem in Japan. Conventional subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) cannot meet patients’ needs owing to the side effects caused by both the use of conventional whole antigen molecules in the pollen extract and the administration routes. To address these issues, a surface-modified antigen and transcutaneous administration route are introduced in this research. First, the pollen extract (PE) was conjugated to galactomannan (PE-GM) to mask immunoglobulin E (IgE)-binding epitopes in the PE to avoid side effects. Second, as a safer alternative to SCIT and SLIT, transcutaneous immunotherapy (TCIT) with a solid-in-oil (S/O) nanodispersion system carrying PE-GM was proposed. Hydrophilic PE-GM was efficiently delivered through mouse skin using S/O nanodispersions, reducing the antibody secretion and modifying the type 1 T helper (Th1)/ type 2 T helper (Th2) balance in the mouse model, thereby demonstrating the potential to alleviate Japanese cedar pollinosis.

Assessment of the local clonal spread of Streptococcus pneumoniae serotype 12F caused invasive pneumococcal diseases among children and adults

BackgroundWe conducted active surveillance to elucidate the distribution of Streptococcus pneumoniae serotypes causing invasive pneumococcal disease (IPD) and clarified the genetic relatedness among the isolates in Kobe City, Japan. MethodsForty-five IPD-causing S. pneumoniae strains were analyzed from March 2016 to May 2018 through active surveillance in Kobe City, Hyogo, Japan. Serotypes were determined by multiplex serotyping PCR and the Quellung reaction with pneumococcal antisera. Fourteen Sp12F strains were subjected to whole-genome sequencing (WGS). ResultsAmong 45 isolates, the most frequent serotypes were 12F (n=14, 31%), 24F (n=5, 11%), and 10A (n=4, 9%). Multilocus sequence typing (MLST) analysis of 14 isolates of Sp12F divided them into ST4846 (n=4) and ST6495 (n=10). WGS showed clonality of the 10 isolates of ST6495, with only 13 single nucleotide polymorphisms in the genomes. Meanwhile, ST4846 strains in Kobe differed from only the outbreak strains of Sp12F ST4846 in Tsuruoka, Japan, reported on 2018. ConclusionsSerotype monitoring showed Sp12F to be the predominant serotype in Kobe, and WGS revealed the clonal spread of Sp12F ST6495 in this city. Thus, the spread of Sp12F could become a serious public health problem in Japan, warranting thorough monitoring in future.

Mental health care and the cultural toolboxes of the present-day Japanese population: Examining suggested patterns of care and their correlates

An extensive body of literature has documented the under-utilization of mental health services among Asian populations, regardless of where they live. Japan is one Asian country where the mental health care system has improved substantially in the recent decades. Yet, Japan continues to report greater under-utilization of mental health services than other developed countries. One primary reason for this is hypothesized to be the cultural climate, which includes the stock of social, cultural and medical knowledge surrounding mental illness. Previous studies have not examined the cultural toolkit (Swidler, 2001) of the Japanese public, nor have they linked these to public attributions or assessments surrounding mental health. The Stigma in Global Context - Mental Health Study (SGC-MHS), a multi-stage probability sample of Japanese residents aged 18–64 years (N = 994) in 2006 provides data to describe the unprompted care suggestions from the general population regarding case scenarios meeting psychiatric criteria for schizophrenia and depression. Guided theoretically by the Network Episode Model, we analyze if and how respondents socially organize solutions into patterns of culturally acceptable care for mental health problems in Japan. Six cultural utilization patterns appear to be shaped by beliefs about underlying attributions, perceived severity of conditions, and type of mental health problem. Further, women, older individuals and those with differing education levels suggest different care patterns than their counterparts. In sum, the findings indicate unique patterns of mental health care recommendations among the Japanese public, which are culturally and socially constrained.

An inpatient educational program for chronic kidney disease.

Chronic kidney disease (CKD) is a significant health problem in Japan, and prevention programs to slow disease progression are necessary. In this study, we evaluated the effectiveness of a 1-week inpatient education program, delivered during the predialysis stage of CKD, in slowing the deterioration in renal function over the subsequent 2 years, and identified factors influencing the program's effectiveness. We retrospectively evaluated the estimated glomerular filtration rate (eGFR) of 105 consecutive patients who completed the program, at the following time points: 6 months prior to program initiation, at program initiation and, at 6, 12, 18, and 24 months after the program. To identify factors predictive of program effectiveness, we classified patients into a Responder and Non-responder group. In comparison with the rate of deterioration in renal function (mL/min/1.73m2/year) before admission, the rate slowed at 6, 12, 18 and 24months after discharge (all p < 0.01). A urinary protein (UP) level <0.5g/gCr and CKD stages 4-5 were predictive of a slowing of CKD progression after the education program. Although the effectiveness of our program declined over time, it did produce an overall slowing in the rate of renal function deterioration over the 2-year period of observation after discharge. This slowing of CKD progression was more pronounced in patients with low UP levels, indicating that education programs should be considered while these levels are still low. Furthermore, the program still offers benefits to patients with CKD stages 4-5.

COPD uncovered: a cross-sectional study to assess the socioeconomic burden of COPD in Japan.

BackgroundCOPD remains a major health problem in Japan. Patients with COPD experience a reduced quality of life (QoL) and have a higher chance of work impairment and productivity loss. However, there is a lack of data on the impact of COPD in terms of QoL and work activity impairment in Japan. This study assessed the socioeconomic burden of COPD in Japan and the impact it may have on the working age population.Patients and methodsThis was a 2-year retrospective chart review in COPD patients aged ≥40 years, with at least one health care visit to clinic or hospital in the previous 12 months. Patients were required to have available medical charts for at least the previous 24 months. Symptoms were assessed using COPD assessment test score; EuroQoL Group 5 Dimension (EQ-5D-5L) and work productivity and activity impairment general health questionnaires were used to evaluate health-related QoL and work productivity, and health care resource utilization data were obtained from clinical charts.ResultsIn total, 71 patients aged <65 years, and 151 patients aged ≥65 years were included; the majority of patients had moderate or severe airflow limitation. Exacerbations (moderate or severe) were reported by ~35% of patients in both age groups; 52.1% and 62.9% of patients in the <65-year and ≥65-year age groups had COPD assessment test scores ≥10. EQ-5D-5L index scores in the <65-year and ≥65-year age groups were 0.79 and 0.77, respectively. Work productivity and activity impairment scores were higher in <65-year age group. Annual costs of health care resource use per patient in the <65-year and ≥65-year age groups were ¥438,975 (US$4,389) and ¥467,871 (US$4,678), respectively. Costs due to productivity loss were estimated to be ¥5,287,024 (US$52,870) in the <65-year age group and ¥3,018,974 (US$30,187) in the ≥65-year age group.ConclusionCOPD represents a significant socioeconomic burden in Japan. Patients with COPD report significant use of health care resources. Higher impact on work impairment and productivity loss was observed frequently in the working age population.

Psycho-oncology: History, Current Status, and Future Directions in Japan

One of the most relevant risk factors for cancer is aging; thus, the number of patients who develop cancer and die is increasing in Japan. Cancer has been a leading cause of death since 1981, and more than one-fourth of Japanese people die of cancer. More than 1,000,000 and 37,000 Japanese people develop cancer and die every year, respectively, making it a major health problem in Japan.Psycho-oncology is a relatively new medical field that was established in the 1970s in Western countries and introduced in Japan in the 1980s. Psycho-oncology was developed for investigating two issues neglected in previous medical research: the impact of behavioral and psychosocial factors on cancer morbidity and mortality and the psychological influence of cancer on patients, their families, and medical staff.Because of progress made in cancer treatment, cancer diagnosis is not necessarily equivalent to a death sentence. However, approximately half of patients with cancer die, and many patients with cancer and their families need appropriate care for psychological distress. The most common psychiatric problems patients with cancer experience are adjustment disorders, major depression, and/or delirium. In addition, the suicide rate in Japan for individuals within 1 year of a cancer diagnosis is more than 20 times higher than that for individuals without cancer. Physical symptoms, such as pain and nausea/vomiting, can be closely associated with psychological function. Mental health professionals, particularly psycho-oncologists, are expected to work with other cancer professionals to manage patients' distress.The present review focuses on patients with cancer' psychological distress and physical symptoms that are closely associated with psychological function and provides an overview of the current status of psycho-oncology in Japan. The future perspective of psycho-oncology is also discussed.

Prevalence of central fatness in 1992-1994: 40% of Japanese boys 6-17 years.

Obesity in children is a serious public health problem in Japan. However, the prevalence of central fatness has not been well determined in Japanese youth. We studied the relationship between body mass index (BMI) and waist circumference (WC) using line of equality analysis in 5,787 boys and 4,639 girls aged 6 to 17 years who participated in the 1992-1994 national survey on body sizes. WC was measured at the level of maximum waist narrowing in girls (WC1) and at the level of the top of iliac crest in boys (WC2). Using the 1978-1981 national survey data as baseline reference, excess fatness was defined as measurements exceeding the 90th centile in WC or in BMI. Among boys, 2,466 (42.6%) had WC2 >90th centile and 1,029 (17.8%) BMI >90th centile; whereas among girls, 895 (19.3%) had WC1 >90th centile and 673 (14.5%) BMI >90th centile. WC2-standard deviation scores (SDS) exceeded BMI-SDS in 5,060 (87.4%) boys and WC1-SDS exceeded BMI-SDS in 3,168 (68.3%) girls, respectively. Our results suggested a much higher prevalence of central fatness than generally recognized for Japanese children and adolescents, in particular, in Japanese boys.

The Use of All-You-Can-Drink System, Nomihodai, Is Associated with the Increased Alcohol Consumption among College Students: A Cross-Sectional Study in Japan.

Excessive drinking by college students is a major public health problem in Japan. However, data on heavy episodic drinking (HED) and nomihodai, a several-hour all-you-can-drink system, are scarce. We surveyed the drinking behavior of undergraduate and graduate students at 35 colleges, and examined the association between HED and use of nomihodai. The study used a cross-sectional design conducted by a self-administered questionnaire. From December 2016 to March 2017, we sampled undergraduate and graduate students aged 20 or older at 35 colleges in the Kanto area, including Tokyo. The following items were measured: 1) frequency of drinking; 2) frequency of binge drinking in the past year; 3) nomihodai use; 4) the number of drinks consumed when using or not using nomihodai; and 5) sex and age for demographic data. Paired t-test was used to compare means between use and non-use state of nomihodai. The Fisher's exact test was used to evaluate the significance of the distribution difference between the two types of states. A total of 511 subjects completed the questionnaire, including 274 men and 237 women. The amount of drinking was increased 1.8-fold (85.9 ± 49.7 g vs. 48.2 ± 29.5 g) among men and 1.7-fold (63.7 ± 39.3 g vs. 36.5 ± 26.7 g) among women during nomihodai use, comapred with non-use states. Among them, 109 (39.8%) men and 71 (30.3%) women reported HED only at nomihodai states. These data suggest that the use of nomihodai system may lead to excessive drinking among college students.