Lifestyle-related Diseases Research Articles

Epidemiology and Risk Factors of Eosinophilic Esophagitis in Japan: A Population-Based Study

Background and AimsEosinophilic esophagitis (EoE) has been increasingly diagnosed globally. However, there have been few general population-based studies in Asia. The aim of this study was to investigate EoE epidemiology in the Japanese general population. MethodsWe analyzed an employer-based health insurance claim database from January 2005 to September 2022. EoE cases were identified based on the International Classification of Diseases-tenth Revision code, K20.0. We calculated the incidence and prevalence of EoE using Poisson regression and binomial distribution, respectively. Using 10 matched controls for each EoE case, a nested case-control study was performed to identify potential risk factors for EoE. ResultsOf 15,200,895 individuals, 1,010 EoE cases were identified. The incidence and prevalence of EoE were 2.82 (95% CI 2.44–3.26) per 100,000 person-years and 10.68 (95% CI 10.01–11.37) per 100,000 people in 2022, nearly three and eight times as high as those in 2017, respectively. Smoking was associated with decreased risk of EoE (OR 0.45 (0.36 to 0.56), p<0.001) whereas alcohol consumption (OR 1.51 (1.21 to 1.88), p<0.001) were associated with increased risk of EoE along with several allergic conditions and psychiatric disorders. EoE was not related to either body mass index or lifestyle-related diseases such as hypertension, diabetes mellitus, hyperuricemia, and dyslipidemia. ConclusionThe incidence and prevalence of EoE in Japan have steadily increased over the past two decades. Nevertheless, EoE remains less common in Japan compared to the United States and Western Europe. Factors contributing to the epidemiology of EoE on a global basis may improve our understanding of the contribution of genetic and environmental risk factors.

Characterizing Healthy Dietary Practices in Japan: Insights from a 2024 Nationwide Survey and Cluster Analysis.

The increasing burden of lifestyle-related diseases highlights the need to address unhealthy dietary habits. This study aims to explore the latest dietary patterns in Japan following the COVID-19 pandemic, focusing on trends in health-promoting food choices. A web-based survey was conducted among 27,154 Japanese adults, selected via quota sampling to mirror national demographics. The study evaluated dietary diversity, measured through the Dietary Variety Score (Outcome 1), and the prioritization of nutritional and health considerations in food selection, assessed via a Likert scale (Outcome 2). Uniform Manifold Approximation and Projection (UMAP) and Ordering Points To Identify the Clustering Structure (OPTICS) algorithms were used to delineate patterns in health-centric food selections. OPTICS clustering revealed four distinct clusters for each outcome. Cluster 3, with a diverse diet, comprised older, predominantly female individuals with higher well-being and lower social isolation compared to Cluster 4, which lacked distinct dietary patterns. Cluster 3 also engaged more in snacking, treat foods, home cooking, and frozen meals. Similarly, a divide emerged between those prioritizing dietary considerations (Cluster C) and those indifferent to such aspects (Cluster D). The findings underscore the need for holistic post-COVID-19 public health initiatives addressing socioeconomic and cultural barriers to healthier dietary practices.

Anthocyanins and the Antioxidant Capacities of Wild Berries that Grow in Shizuoka, Japan

ABSTRACT Fruits from five wild edible berries that grow in the eastern region of Shizuoka (Japan) were collected, and their antioxidant activities were evaluated using the ORAC, DPPH, FRAP, and ABTS assays to obtain basic scientific knowledge of these species. Among the Shizuoka wild berries tested, Rubus microphyllus L. fil. exhibited the highest antioxidant activity, which is equivalent to that of commercial raspberry (Rubus idaeus L.). Furthermore, anthocyanins from these wild berries were analyzed using quantitative 1H NMR spectroscopy. Cyanidin-3-glucoside and pelargonidin-3-glucoside were detected in Shizuoka wild berries, with the latter identified as the characteristic anthocyanin. The present study revealed that Shizuoka wild berries are rich in natural antioxidants and pigments and are therefore potentially beneficial for reducing the risks of associated with lifestyle-related diseases in consumers.

Development of an Improved Adenovirus Vector and Its Application to the Treatment of Lifestyle-Related Diseases.

The number of patients with lifestyle-related diseases such as type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), has continued to increase worldwide. Therefore, development of innovative therapeutic methods targeting lifestyle-related diseases is required. Gene therapy has attracted considerable attention as an advanced medical treatment. Safe and high-performance vectors are essential for the practical application of gene therapy. Replication-incompetent adenovirus (Ad) vectors are widely used in clinical gene therapy and basic research. Here, we developed a novel Ad vector, named Ad-E4-122aT, exhibiting higher and longer-term transgene expression and lower hepatotoxicity than conventional Ad vectors. We also elucidated the mechanisms underlying Ad vector-induced hepatotoxicity during the early phase using Ad-E4-122aT. Next, we examined the therapeutic effects of the genes of interest, namely zinc finger AN1-type domain 3 (ZFAND3), lipoprotein lipase (LPL), and lysophospholipid acyltransferase 10 (LPLAT10), on lifestyle-related diseases using Ad-E4-122aT. We showed that the overexpression of ZFAND3 in the liver improved glucose tolerance and insulin resistance. Liver-specific LPL overexpression suppressed hepatic lipid accumulation and improved glucose metabolism. LPLAT10 overexpression in the liver suppressed postprandial hyperglycemia by increasing glucose-stimulated insulin secretion. Furthermore, we also focused on foods to advance research on the pathophysiology and treatment of lifestyle-related diseases. Cranberry and calamondin, which are promising functional foods, attenuated the progression of MASLD/NAFLD. Our findings will aid the development of new therapeutic methods, including gene therapy, for lifestyle-related diseases such as T2DM and MASLD/NAFLD.

Oral Intake of Linseed Oil Inhibits Skin Barrier Dysfunction in Obese Mice.

Obesity is not only a risk factor for lifestyle-related diseases but also causes skin barrier dysfunction, which leads to a reduced quality of life due to dryness, itching, and scratching, and thus requires appropriate treatment. However, there are no studies on this issue. Therefore, this study aimed to examine whether oral intake of linseed oil is effective for skin barrier function in obesity and to confirm how the effect is demonstrated. TSOD mice received either sterile distilled water (Control group) or linseed oil (Omega group), containing a high level of omega-3 fatty acids, including α-linolenic acid, orally for eight weeks. Mice were then irradiated with ultraviolet B (UVB) and three days later, transepidermal water loss (TEWL), which is the primary outcome of skin barrier function, was measured and gross skin appearance was observed. Hematoxylin and eosin (HE) staining and Ki-67 immunostaining were performed on skin samples. mRNA expression levels of the inflammatory markers Tnfα, Cox2, Mcp1, and Hmox1 were measured by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). We also performed fatty acid analysis of skin and erythrocytes by gas chromatography.Statistical analysis was performed using unpaired Student's t-test and Pearson's correlation analysis. Compared with the Control group, the Omega group exhibited lower TEWL values and little skin erythema. Histological analysis revealed thinner epidermis and fewer Ki-67 positive cells. Additionally, in the Omega group, mRNA levels of four inflammation-related genes were lower, α-linolenic acid levels in both skin and erythrocytes were higher, and a lower n-6/n-3 ratio was observed.And α-linolenic acid levels in the skin were negatively correlated with the expression levels of inflammation-related genes. Oral intake of linseed oil was found to inhibit skin barrier dysfunction in obesity. This effect was mediated by α-linolenic acid, a major component of linseed oil with anti-inflammatory properties, which was taken up by erythrocytes and supplied to the skin. Therefore, oral intake of linseed oil is expected to be a useful therapeutic method forskin barrier dysfunction in obesity.

Prevalence of oral Capnocytophaga species and their association with dental plaque accumulation and periodontal inflammation in middle‑aged and older people.

Capnocytophaga species are commonly found in human oral microbiome. The aim of the present study was to understand the association of the prevalence of oral Capnocytophaga species with oral hygiene and periodontal inflammation. A total of 136 patients (median age 72 years) who visited the Hiroshima University Hospital (Hiroshima, Japan) between April 2021 and June 2023 were enrolled. Swab samples were obtained from the tongue surface. DNA from Capnocytophaga species (C. ochracea and C. sputigena) was detected by real-time PCR analysis. Dental plaque accumulation was observed to assess the oral hygiene condition of participants. Additionally, clinical periodontal inflammation was assessed with periodontal inflamed surface area (PISA) scores. Clinical confounding factors such as age, sex, lifestyle-related disease, remaining teeth and denture wearing between Capnocytophaga species-positive and -negative groups were adjusted with a propensity score matching method. Mann-Whitney U and χ2 or Fisher's exact test were employed for statistical analysis. The prevalence rate was 67.6% for oral C. ochracea and 83.1% for C. sputigena. C. ochracea-positive participants showed significantly higher plaque control record scores (an indicator of dental plaque accumulation) than C. ochracea-negative participants (P=0.03). Additionally, C. ochracea/C. sputigena dual-positive participants exhibited significantly higher plaque control record and PISA scores than non-dual-positive participants (P=0.01 and P=0.04, respectively). Propensity score matching was conducted in the C. ochracea/C. sputigena dual-positive group and the non-dual-positive group for adjustment of clinical factors, resulting in 51 matched patient pairs. C. ochracea/C. sputigena dual-positive participants had significantly higher plaque control record scores than non-dual-positive participants (P=0.02). The present results suggest that the prevalence of both oral C. ochracea and C. sputigena is associated with poor oral hygiene in middle-aged and older people.

The Evaluation of Physiopathological and Immunological Exercise Effects During Pandemic and Pathogenicity on Coronavirus COVID-19 (with Considerations and Instructions of Doing Related Physical Activity)

Context: The 2019 coronavirus disease (COVID-19), also commonly known as the coronavirus, is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus is associated with several challenges, including an increased sedentary lifestyle, obesity, and elevated inflammatory factors and related diseases. Evidence Acquisition: In conducting this research, we utilized the latest articles from prestigious domestic and foreign journals indexed in databases such as PubMed, Google Scholar, and ScienceDirect. Results: There are various hypotheses regarding the intensity of exercise and its impact on infection rates. Moderate-intensity exercise is believed to enhance immune function and reduce mortality, whereas high-intensity and stressful exercise may have the opposite effect. When exposed to infection, high-intensity exercise can suppress the immune system, whereas moderate-intensity exercise may reduce inflammation. Conclusions: Therefore, given that exercise affects the strength and anti-inflammatory mechanisms of the immune system, it plays a crucial role in reducing complications for patients. Consequently, it can be concluded that exercise strengthens the immune system, reduces inflammation, and creates favorable physiological and immunological conditions to aid athletes in overcoming the virus.

Utilization of the standard questionnaire in specific health checkups

Objectives Interviewing people about their health behaviour in specific health checkups (SHCs) is thought to promote awareness of and help improve such behaviour. The standard questionnaire (SQ) for SHCs consists of 22 items presented in the guidelines of the Ministry of Health, Labour, and Welfare. However, using items other than those necessary for stratification for specific health guidance (SHG) is optional. We believe that clarifying the actual utilization of SQ items could contribute to improving the procedure used for the fourth SHCs and SHG, which will be initiated in 2024. This study seeks to clarify the actual utilization of the SQ for (1) conducting SHCs, (2) planning, implementing, and evaluating SHG and health programs aimed at preventing lifestyle-related diseases, and (3) planning, implementing, and evaluating the data health plan.Methods We enrolled 3,179 people from 1,741 departments in charge of national health insurance, 47 Japan Health Insurance Association branches, and 1,391 health insurance societies across all municipalities in Japan. One participant among the study participants was the main person in charge of SHCs and SHG at each facility. We conducted a self-reported survey on the implementation of SHCs and SHG in February 2022. This study was approved by the ethics review board of the institution to which the first author belongs.Results A total of 1,221 (38.4%) were received. The proportions of valid responses from national health insurance departments, Japan Health Insurance Association branches, and health insurance societies were 816 (46.9%), 47 (100%), and 358 (25.7%), respectively. Over 96% of responders used the group SHCs method, and over 93% of those adopting the individual SHCs method used each of the 22 SQ items. However, 187 (18.2%) responders found it difficult to use the item "If you had the opportunity to receive health guidance for lifestyle improvement, would you take it?" The reason was that the on-request SHG system was misunderstood. Additionally, only approximately 50% of respondents used the SQ to develop, implement, and evaluate their health program.Conclusion We believe there will be no problem in implementing the SQ even if using all its component items is required. However, the aforementioned item needs to be revised. Methods to encourage health insurers and their supporters to use the SQ for health-related data collection and health program planning should be devised.

High Fat Diet-Wheat Gliadin Interaction and its Implication for Obesity and Celiac Disease Onset: In Vivo Studies.

The intestinal immune system plays a crucial role in obesity and insulin resistance. An altered intestinal immunity is associated with changes to the gut microbiota, barrier function, and tolerance to luminal antigens. Lipid metabolism and its unbalance can also contribute to acute and chronic inflammation in different conditions. In celiac disease (CD), the serum phospholipid profile in infants who developed CD is dramatically different when compared to that of infants at risk of CD not developing the disease. In a mouse model of gluten sensitivity, oral wheat gliadin challenge in connection with inhibition of the metabolism of arachidonic acid, an omega-6 polyunsaturated fatty acid, specifically induces the enteropathy. Recent evidence suggests that gluten may play a role also for development of life-style related diseases in populations on a high fat diet (HFD). However, the mechanisms behind these effects are not yet understood. Exploratory studies in mice feed HFD show that wheat gliadin consumption affects glucose and lipid metabolic homeostasis, alters the gut microbiota, and the immune cell profile in liver.

Comparative Study On ‘Dietary Education’ In Japan And Korea: From The Latest Nutritional Knowledge Perspective

According to the Japan’s National Health and Nutrition Survey, trends in the intake of vegetables and fruits (1999-2018), which are considered effective in preventing lifestyle-related diseases, are far below the target value; In the under-50 age group, less than 30% achieved the target vegetable intake of 350g, and less than 15% achieved the target fruit intake of 200g 53. Against such background, it has become a challenge to nurture children's ‘self-management ability’ that leads to spontaneous and healthy dietary habits 16. Until now, almost all research on ‘Dietary education’ has been conducted in the field of nutrition, focusing on accumulating nutritional knowledge by explaining each nutritional component and its function. However, it is difficult to nurture spontaneous and healthy dietary habits simply through repeated nutrition-based education. It can be said that the pedagogical approach of this paper has made it possible to pursue from a broader perspective that influences food choices. Research on ‘nutrition transition’ points out “worldwide obesity dynamics and their determinants” based on “a shift in the broader patterns of dietary habits (Western-style diet) and corresponding nutrition-related diseases” 42. Nutrition transition research 50, 40 has a broad and holistic perspective on food and health, making it easy to understand nutrition. The purpose of this paper is to pursue how to nurture the ‘self-management ability’ for spontaneous and healthy dietary habits, based on these latest nutritional knowledges. Because nutrition transition is a global phenomenon, the author choses to use broader methods of international comparative research. Comparisons lead to discoveries and value creation. This can be said to have the greatest significance in comparative research.

Heterogeneity of the effect of the COVID-19 pandemic on the incidence of Metabolic Syndrome onset at a Japanese campus.

The coronavirus disease 2019 (COVID-19) outbreak began in China in December 2019, with the World Health Organization declaring a state of emergency in January 2020. Worldwide implementation of lockdown measures to slow the spread of the virus led to reduced physical activity, disrupted eating habits, mental health issues, and sleep disturbances, which increased the risk of lifestyle-related diseases such as metabolic syndrome (MetS). During the COVID-19 pandemic, healthcare workers, especially intensive care workers, experienced longer working hours and burnout, which further increased the risk of lifestyle-related diseases. Accordingly, it is important to identify individuals at a risk of new-onset MetS during a pandemic, which could direct preventive interventions. This study aimed to assess the heterogeneous impact of the COVID-19 pandemic on the incidence of new-onset MetS based on the conditional average treatment effect (CATE) and to identify at-risk populations. This study analyzed health checkup data obtained from Okayama University Shikata Campus workers using paired baseline and follow-up years. Baseline data encompassed 2017 to 2019, with respective follow-up data from 2018 to 2020. Furthermore, as the COVID-19 pandemic in Japan began in January 2020, workers who underwent follow-up health checkups in 2018 to 2019 and 2020 were considered as "unexposed" and "exposed," respectively. As the Shikata campus has several departments, comparisons among departments were made. The primary outcome was new-onset MetS at follow-up. Predictor variables included baseline health checkup results, sex, age, and department (administrative, research, medical, or intensive care department). X-learner was used to calculate the CATE. This study included 3,572 eligible individuals (unexposed, n=2,181; exposed, n=1,391). Among them, 1,544 (70.8%) and 866 (62.3%) participants in the unexposed and exposed groups, respectively, were females. The mean age (±standard deviation) of the unexposed and exposed groups was 48.2 ± 8.2 and 47.8 ± 8.3 years, respectively. The COVID-19 pandemic increased the average probability of new-onset MetS by 4.4% in the overall population. According to the department, the intensive care department showed the highest CATE, with a 15.4% increase. Moreover, there was large heterogeneity according to the department. The high-CATE group was characterized by older age, urinary protein, elevated liver enzymes, higher triglyceride levels, and a history of hyperlipidemia treatment. This study demonstrated that the COVID-19 pandemic increased the incidence of new-onset MetS, with this effect showing heterogeneity at a single Japanese campus. Regarding specific populations, workers in the intensive care department showed an increased risk of new-onset MetS. At-risk populations require specific preventive interventions in case the current COVID-19 pandemic persists or a new pandemic occurs.

Chronic Obstructive Pulmonary Disease as a Significant Marker of Prevalent Vertebral Fracture in Patients with Spinal Degenerative Disease: Preoperative Risk Factors Involved in Lifestyle-Related Diseases

Objectives: It is important to recognize prevalent vertebral fractures before spinal surgery due to the possible complications related to bone fragility. Recently, it has been noted that lifestyle-related diseases are associated with vertebral fractures. In this study, we analyzed prevalent vertebral fractures among patients with spinal degenerative disease and investigated their association with lifestyle-related diseases. Methods: We included patients aged ≥60 years who underwent surgery for spinal degenerative disease between March 2019 and February 2021 at our hospital. The primary outcome measure was radiographically prevalent vertebral fractures from T10 to L5. Univariate analyses were performed for variables obtained from preoperative data related to lifestyle-related diseases between the vertebral fracture and non-fracture groups. Multiple logistic regression was performed with adjustments for variables including patient age, sex, and surgical site, and variables that were found to have a p-value of &lt;0.2 in univariate analyses. Results: A total of 220 patients were enrolled, of which 121 had prevalent vertebral fractures. Multiple logistic analysis was conducted with patient age, sex, and surgical site, and those variables identified p &lt; 0.2 in univariate analyses: eGFR &lt;60 mL/min/1.73 m2 serum uric acid &gt;7.0 mg/dL, FEV1/FVC &lt;70%, and bone mineral density (BMD) T-score &lt;–1.0. Patients with vertebral fractures were significantly older and had lower BMD, and lower FEV1/FVC. Conclusions: Patients with FEV1/FVC &lt;70% characterizing COPD had a significantly higher risk of vertebral fractures, independent of sex, age, and BMD. The risk of postoperative complications related to bone fragility should be considered in patients with COPD.

Critical Analysis of Health Literacy and its Impact on Health Outcomes

Objectives: Health literacy has to do with the individual’s capacity to understand, access and apply information available to health so as to make better choices and decisions. In recent times, the increased numbers of health illiterate across the globe with many having difficulties in grasping the notion of disease prevention and several struggling with health promotion. Design and settings: In many parts of the developing countries, there is serious rise in lifestyle linked health problems with high rate of infectious diseases. Also, about 70-80% of death is associated with lifestyle related diseases in developed countries. Thus, there is need to improve health literacy for disease prevention across the globe. Methodology: Extensive literature search was conducted to find published articles on the internet that were involved in health literacy and outcomes. An organized search of MEDLINE/PubMed, ProQuest, Embase, Scopus, Google Scholar and Cochrane were conducted based on suitable synonyms and keywords. One researcher independently conducted the literature search and review. Results: No doubt, that health literacy offers many benefits such as improving health outcomes, increases efficiency of health care system, make better decision, take preventive measures, reduced cost, reduce poverty level, eliminates discrimination, racism, and promotes justice and socioeconomic values.

Adult offspring's education and parental mortality: A nationwide cohort study of the mediating role of lifestyle-related diseases.

Aim: The mechanisms behind the association between adult offspring's socioeconomic position and their parents' mortality are not well understood. This study investigates lifestyle-related diseases as a potential mediating pathway between adult offspring's education and parental mortality. Methods: This nationwide register-based cohort study consists of 963,742 older adults aged 65 years between 2000 and 2018. Lifestyle-related diseases were measured between 60 and 65 years and those with prior lifestyle-related diseases were excluded. Natural Effect Models were performed to assess potential mediation through lifestyle-related diseases of the association between offspring's education and parental mortality measured by additive hazard estimates with 95% confidence intervals (CIs). Results: Between 60 and 65 years, 150,501 (15.6%) older adults were diagnosed with lifestyle-related diseases and 149,647 (15.5%) died during follow-up. Compared with having offspring with long education, short education was associated with 631 (95% CI: 555; 707) and 581 (95% CI: 525; 638) additional deaths per 100,000 person-years for women and men, respectively, of which 15.4% (95% CI: 9.0; 21.6) and 16.8% (95% CI: 14.6; 18.9) were mediated by lifestyle-related diseases. The corresponding numbers for medium education were 276 (95% CI: 205; 347) and 299 (95% CI: 255; 343) with 26.2% (95% CI: 12.0; 40.6) and 27.6% (95% CI: 25.1; 31.8) mediated by lifestyle-related diseases. Conclusions: Lifestyle-related diseases accounted for 15-28% of the association between offspring's education and parental mortality for both men and women.

Development and Validation of the Meiji Nutritional Profiling System (Meiji NPS) to Address Dietary Needs of Adults and Older Adults in Japan.

This study introduces the Meiji Nutritional Profiling System (Meiji NPS), which was specifically designed to respond to age-related shifts in nutrient requirements among Japanese adults (<65 years old) and older adults (≥65 years old). Japan has one of the most aged societies in the world. The health issues of interest are malnutrition and lifestyle-related diseases among adults and frailty among older adults. Two versions of the NPS were developed based on nutrients to encourage (protein, dietary fibers, calcium, iron, and vitamin D), food groups to encourage (fruits, vegetables, nuts, legumes, and dairy), and nutrients to limit (energy, saturated fatty acids, sugars, and salt equivalents). The Meiji NPS for older adults did not include iron or saturated fatty acids. The algorithms were based on the Nutrient-Rich Foods Index (NRF). The convergent validity between the Meiji NPS and the existing NPSs for the same foods was confirmed using Spearman's correlation coefficients (NRF: r = 0.67 for adults and r = 0.60 for older adults; Health Star Rating: r = 0.64 for adults and r = 0.61 for older adults). The Meiji NPS may be useful for nutritional evaluation and reformulation of food products, tailored to adults and older adults to ameliorate health issues in Japan.

Health benefits of interval walking training.

Interval walking training (IWT) is a free-living training intervention involving alternating fast and slow walking cycles. IWT is efficacious in improving physical fitness and muscle strength, and reducing factors associated with lifestyle-related diseases. In individuals with type 2 diabetes, IWT improves glycemic control directly through enhanced glucose effectiveness, challenging conventional views on mechanisms behind training-induced improvements in glycemic control. Whereas adherence to IWT in short-term studies is high, ensuring long-term adherence remains a challenge, particularly in populations with chronic diseases and/or overweight/obesity. Long-term studies in real-world settings are imperative to ascertain the widespread effectiveness of IWT and elucidate its impact on hard endpoints.

The impact of retirement on health: Empirical evidence from the change in public pensionable age in Japan

The balance between maintaining and enhancing the health, quality of life, and healthy life expectancy of the elderly and their corresponding social costs, including medical and long-term care expenses, is an important policy issue in the context of Japan’s super-aging society. In this paper, we employ individual panel data from the four waves of the Japanese Study of Aging and Retirement to examine how retirement from the labor market affects the health of elderly males. Numerous empirical studies have shown mixed results concerning the causal effect of retirement on health through diverse and complex mechanisms. However, we present several new insights by focusing on the policy change in 2000 of raising the pensionable age for the earnings-related public pension system which completely eliminates pension income after the statutory retirement age for particular cohorts. Our fixed-effects instrumental variable estimation shows that retirement significantly improves oral function and mental health, but it also makes male retirees more susceptible to lifestyle-related diseases. Supplemental results further suggest that a significant increase in dental care utilization would help improve post-retirement oral function.

Abstract P230: Association Between Gratitude and Lifestyle Related Diseases: The JAGES Cross-Sectional Study

Purpose: Positive psychological factors have been reported to be effective in preventing lifestyle-related diseases. People with high frequency of gratitude are considered to have positive psychological factors and to be in a state of social participation. Serum levels of IL-6, an inflammatory marker, have also been reported to decrease in grateful individuals. However, the association between frequency of gratitude and lifestyle-related diseases has not been reported. Methods: Participants of the study was 25,036 (11,656 men and 13,346 women) who responded to the question about gratitude among those who answered the JAGES2019 questionnaire. To the question, "In your daily life, how often do you say "thank you" to those around you?", possible answers were "1. several times a day or more," "2. about once a day," "3. several times a week," "4. several times a month," or "5. almost never. Multivariate odds ratios and 95% confidence interval of hypertension, diabetes, hyperlipidemia, depression, stroke, heart disease, cancer, and dementia were calculated using logistic regression analysis for those who were less grateful compared to those who were grateful "several times a day or more" and the same analyses were conducted for men and women. Covariates were smoking habits, drinking habits, whether they lived alone, exercise time, and body mass index. Results: The prevalence of hypertension, diabetes, depression, and dementia was higher among those who were less frequently grateful compared to those who were more frequently grateful. Multivariate odds ratios (95% confidence interval) were 1.08 (1.00-1.16) for hypertension, 1.12 (1.02-1.24) for diabetes, 1.82 (1.25-2.64) for depression, and 1.81 (1.16-2.8) for dementia, respectively. In men, the association was more pronounced for dementia for 2.37 (1.16-4.87), and similar trends for hypertension, diabetes, and depression. For women, the association was more pronounced for depression for 1.86 (1.17-2.95) and similar trends for hypertension, diabetes, and depression. The prevalence of cancer was lower with lower frequency of gratitude. Discussion: The prevalence of hypertension, diabetes, depression, and dementia was higher among those who were less frequently grateful, and the associations were particularly pronounced for hypertension, diabetes, and depression, especially among women, and for dementia, especially among men. The frequency of gratitude was thought to be influenced by the frequency of social participation, and there is a possibility of a causal reversal in depression, dementia, and cancer. We will examine the association more in detail longitudinally.

Major considerations of enteral nutritional therapy in patients with congestive heart failure: a systematic review

Introduction: Nutrition in the cardiovascular area has focused on improving lifestylerelated diseases such as hypertension, diabetes, dyslipidemia, obesity, and metabolic syndrome from the point of view of primary and secondary prevention, that is, “nutrition for weight loss ” and nutritional guidance has been required. Congestive heart failure (CHF) is a serious and growing public health problem worldwide. Approximately 25 million people are carriers of this disease and two million new cases are diagnosed each year, and enteral nutrition has been highlighted. Objective: It was to develop a systematic review of the main clinical outcomes that highlight the importance of enteral nutritional therapy in patients with congestive heart failure. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from October to November 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 143 articles were found. A total of 45 articles were evaluated and 34 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 17 studies that did not meet GRADE and AMSTAR-2. It was concluded enteral nutrition is highly recommended in an attempt to mitigate weight loss in these patients. Enteral diet therapy can be infused continuously or intermittently. Studies have shown that more debilitated and less active patients better accept the diet via continuous tube, slowly and for a long period, even in those with heart disease.

Effects of lifestyle-related risk factors on life expectancy: A comprehensive model for use in early prevention of premature mortality from noncommunicable diseases.

Morbidity and premature mortality from noncommunicable diseases can be largely prevented by adopting a healthy lifestyle at the earliest possible age. However, tools designed for the early identification of those at risk among young adults are lacking. We developed and validated a multivariable model for the prediction of life expectancy, allowing the early identification of apparently healthy adults at risk of lifestyle-related diseases. We used a cross-sectional approach to calculate life expectancy using data from 38,481 participants of the National Health and Nutrition Examination Survey (1999-2014), aged ≥20 years. A multivariable logistic model was used to quantify the impact of risk factors on mortality. The model included the following lifestyle-related mortality risk factors as predictors: smoking, diet, physical activity, and body mass index. The presence of the following chronic diseases was considered: diabetes, arrhythmia, coronary artery disease, myocardial infarction, stroke, and malignant neoplasms. The model showed a good predictive ability; the area under the receiver operating characteristic curve measure was 0.846 (95% uncertainty interval 0.838-0.859). Life expectancy was determined using the life table method and the period life tables for the US population as the baseline. The results of this model underscore the importance of lifestyle-related risk factors in life expectancy. The difference between life expectancy for 30-year-old individuals with lifestyle characteristics ranked in 90% and 10% of their gender and age groups was 23 years for males and 18 years for females, whereas in 75% and 25%, it was 14 years for males and 10 years for females. In addition to early risk identification, the model estimates the deferred effect of lifestyle and the impact of lifestyle changes on life expectancy. Thus, it can be used in early prevention to demonstrate the potential risks and benefits of complex lifestyle modifications for educational purposes or to motivate behavioral changes.