Tetsuya Mizoue

National Center for Global Health and Medicine in Japan, Edo, Tōkyō, Japan

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Publications (261)804.26 Total impact

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    ABSTRACT: Experimental studies have shown that some nutrients are involved in initiating and maintaining sleep, but epidemiological evidence on overall dietary patterns and insomnia is scarce. We investigated the relationship between dietary patterns and sleep symptoms in a Japanese working population.
    Sleep Medicine 12/2014; · 3.10 Impact Factor
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    ABSTRACT: Background/Objectives:Although adipokines and insulin resistance are known to be correlated with body fatness, it is unclear whether they are independently related to weight gain experience. We examined the associations of serum adipokines and marker of insulin resistance with past weight gain during adulthood by taking the degree of attained body mass index (BMI) level into consideration.Subjects/Methods:Subjects were 399 Japanese municipal employees, aged ⩾30 years, who participated in a health survey. Serum adipokines were measured using a Luminex suspension bead-based multiplexed array. Weight change during adulthood was calculated as the difference between measured current weight and recalled weight at the age of 20 years. Multiple regression was performed to calculate mean adipokine levels and homeostasis model assessment of insulin resistance (HOMA-IR) according to weight gain (<5 kg, 5-9.9 kg, or ⩾10 kg) with adjustment for current BMI.Results:Weight gain from the age of 20 years was significantly and positively associated with leptin levels even after adjustment for current BMI (P for trend <0.001), whereas it was significantly and inversely associated with adiponectin levels in a BMI-adjusted model among subjects aged ⩾40 years (P for trend=0.03). Weight gain was associated with HOMA-IR in a BMI-unadjusted model (P for trend <0.001), but this association was largely attenuated after adjustment for BMI. Resistin, plasminogen activator inhibitor-1 and visfatin were not associated with past weight gain.Conclusions:Results suggest that a large weight gain during adulthood is associated with higher leptin and lower adiponectin levels independently of the degree of attained BMI level.European Journal of Clinical Nutrition advance online publication, 3 December 2014; doi:10.1038/ejcn.2014.257.
    European Journal of Clinical Nutrition 12/2014; · 2.95 Impact Factor
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    ABSTRACT: The Great East Japan Earthquake caused a gigantic tsunami which devastated coastal areas of northern Japan on 11 March 2011. Despite the large number of 'resident survivors' who continued to reside in their damaged houses on the second or upper floors, research on the mental health of these individuals has been limited. This study explored the prevalence of depressive reaction and risk factors for depressive reaction among these resident survivors.
    PLoS ONE 10/2014; 9(10):e109240. · 3.53 Impact Factor
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    ABSTRACT: Aims Few studies have examined the prevalence of diabetes using glycated hemoglobin (HbA1c), a newly recommended diagnostic test. We examined the prevalence of diabetes and pre-diabetes using both HbA1c and fasting plasma glucose (FPG) and their associations with risk factors for type 2 diabetes in a large-scale Japanese working population. Methods Participants were 47172 men and 8280 women aged 20-69 years who received periodic health checkup in nine companies which participated in the Japan Epidemiology Collaboration on Occupational Health study. Participants were categorized into diabetes (HbA1c ≥ 6.5% (≥ 48 mmol/mol), FPG ≥ 126 mg/dl (≥ 7.0 mmol/L), or medication for diabetes), pre-diabetes (HbA1c 6.0-6.4% (42-46 mmol/mol) or FPG 110-125 mg/dl (6.1-6.9 mmol/L) among those without diabetes), and normal glucose regulation. Results The prevalence of diabetes was 8.0% and 3.3% in men and women, respectively. Of individuals with diabetes, approximately 80% were defined by HbA1c ≥ 6.5% (≥ 48 mmol/mol) criterion. The prevalence of pre-diabetes was 14.1% in men and 9.2% in women. Prevalence of these glucose abnormalities increased with advancing age, especially during mid-40s and 50s. Higher body mass index and waist circumference, hypertension, dyslipidemia, and current smoking were each associated with higher prevalence of diabetes in both men and women. Conclusions Using HbA1c and FPG criteria or current medication, one in 13 men and one in 30 women had diabetes in the present Japanese working population. Interventions targeted for those in an early stage of impaired glucose metabolism would be required to prevent diabetes.
    Diabetes Research and Clinical Practice 10/2014; · 2.54 Impact Factor
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    ABSTRACT: Limited and inconsistent associations between cholesterol and egg consumption and type 2 diabetes risk have been observed in Western countries. In the present study, the association of dietary cholesterol and egg intakes with type 2 diabetes risk was examined prospectively. The study subjects comprised 27 248 men and 36 218 women aged 45-75 years who participated in the second survey of the Japan Public Health Center-based Prospective Study and had no histories of type 2 diabetes or other serious diseases. Dietary cholesterol and egg intakes were estimated using a validated 147-item FFQ. The OR of self-reported, physician-diagnosed type 2 diabetes over 5 years were estimated using multiple logistic regression. A total of 1165 newly diagnosed cases of type 2 diabetes were self-reported. Although dietary cholesterol intake was not associated with type 2 diabetes risk in men, it was found to be associated with a 23 % lower odds of type 2 diabetes risk in women in the highest quartile of intake, albeit not statistically significant, compared with those in the lowest quartile (P trend= 0·08). Such risk reduction was somewhat greater among postmenopausal women; the multivariable-adjusted OR for the highest quartile of cholesterol intake compared with the lowest quartile was 0·68 (95 % CI 0·49, 0·94; P trend= 0·04). No association between egg intake and type 2 diabetes risk was found in either men or women. In conclusion, higher intake of cholesterol or eggs may not be associated with an increased risk of type 2 diabetes in Japanese populations. The observed association between decreased type 2 diabetes risk and higher dietary cholesterol intake in postmenopausal women warrants further investigation.
    British Journal Of Nutrition 09/2014; · 3.34 Impact Factor
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    ABSTRACT: Long working hours have been associated with an increased risk of cardiovascular disease, but its relationship with hypertension remains unclear. The objective of this study is to examine the relationship between overtime and presence of hypertension using data from a large-scale multi-company study in Japan. Participants were 52 365 workers of four companies that provided both health-checkup data and self-reported data on overtime worked. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, and/or the use of antihypertensive drug. Logistic regression analysis was performed to determine the odds ratio for hypertension for each category of overtime work (<45, 45-79, 80-99 or ≥100 h/month) with adjustments for age, sex, company, smoking status and body mass index. The prevalence of hypertension tended to decrease with increasing overtime work: 17.5, 12.0, 11.1 and 9.1% for the shortest (<45 h/month) through the longest overtime category (≥100 h/month). The age-, sex- and company-adjusted odds ratios (95% confidence interval) were 1.00 (reference), 0.81 (0.75-0.86), 0.73 (0.62-0.86), 0.58 (0.44-0.76), respectively (p for linear trend <0.001). In a sub-cohort, the inverse association remained statistically significant after an additional adjustment for other potential confounders. Results of the present large-scale study among Japanese workers suggest an inverse association between overtime work and presence of hypertension.
    Chronobiology International 09/2014; · 2.88 Impact Factor
  • Isamu Kabe, Yasuo Koga, Takeshi Kochi, Tetsuya Mizoue
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    ABSTRACT: Objective: The aim of this study was to examine the usefulness of a portable Internet-enabled ECG recording system (iECG) in monitoring the heart health of Japanese individuals working abroad. Methods: This study included 24 male Japanese individuals working abroad, who had been found to have risks of cardiovascular diseases (CVDs) at periodic health checkups. The subjects were instructed to send ECG recordings obtained by the iECG via a personal computer from their countries of residence. Interpretations of the ECG results were shared with the participant and the participant's occupational physician via e-mail. Further, a questionnaire survey was conducted among the subjects to determine the usefulness of the iECG. Results: Only 21 subjects (53.7 ± 5.2 years) could send their ECG recordings from their countries of residence. During the monitoring period (average, 0.7 ± 0.3 years), 504 ECG recordings were obtained using the iECG. No new CVD events were observed. The iECG monitoring recorded ST-T abnormality in 4 subjects (19%), ST-T abnormality plus left bundle branch block in 1 subject (5%), bradycardia in 1 subject (5%), atrial fibrillation in 1 subject (5%), short PR interval in 1 subject (5%) and normal findings in 13 subjects (61%). The questionnaire results showed a 68% rating for satisfaction, 58% rating for comfort, 68% rating for device utility and 37% rating for lifestyle improvements brought about by device use. Conclusion: The iECG could serve as a useful support tool for monitoring heart health in Japanese workers residing abroad with risk factors of CVDs.
    Journal of Occupational Health 09/2014; · 1.10 Impact Factor
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    ABSTRACT: Although long-lasting insecticide-treated bednets (LLINs) have been widely used for malaria control, little is known about how the condition of LLINs affects the risk of malaria infection. The objective of this cross-sectional study was to examine the association between the use of LLINs with holes and caregiver-reported malaria diagnosed in children under five years of age (U5). Data were collected in Boboye health district, Niger, in 2010. Surveyors conducted interviews and bednet inspections in 1,034 households. If a household had a U5 child, the surveyor asked the caregiver whether the child had experienced a fever episode in the past two weeks that entailed standard treatment for uncomplicated malaria at a healthcare facility. The authors analyzed the association between the use of LLINs with holes and caregiver-reported malaria episodes in U5 children using logistic regression, adjusted for possible confounders. Of the 1,165 children included in the analysis, approximately half (53.3%) used an intact LLIN while far fewer (10.6%) used a LLIN with holes. Compared to children using an intact LLIN, children using a LLIN with holes were significantly more likely to have a caregiver-reported malaria episode (8.7% vs. 17.1%; odds ratio: 2.23; 95% confidence interval: 1.24-4.01). In this study site, LLINs with holes were less protective than intact LLINs.
    Tropical Medicine and Health 09/2014; 42(3):99-105.
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    ABSTRACT: This study was aimed to examine the cross-sectional association of protein, carbohydrate, and fat intake with depressive symptoms among 1794 Japanese male workers aged 18-69 years who participated in a health survey. Dietary intake was assessed with a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Odds ratio of depressive symptoms (CES-D scale of ≥16) was estimated by using multiple logistic regression with adjustment for covariates including folate, vitamin B6, vitamin B12, polyunsaturated fatty acid, magnesium, and iron intake. Multivariable-adjusted odds ratio of depressive symptoms for the highest quartile of protein intake was 26%, albeit not statistically significant, lower compared with the lowest. The inverse association was more evident when a cutoff value of CES-D score ≥19 was used. The multivariable-adjusted odds ratios (95% confidence intervals) for the highest through lowest quartile of protein intake were 1.00 (reference), 0.69 (0.47-1.01), 0.69 (0.44-1.09), and 0.58 (0.31-1.06) (P for trend=0.096). Neither carbohydrate nor fat intake was associated with depressive symptoms. Our findings suggest that low protein intake may be associated with higher prevalence of depressive symptoms in Japanese male workers.
    Psychiatry Research 08/2014; · 2.68 Impact Factor
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    ABSTRACT: Background:Adiponectin has anti-inflammatory and insulin-sensitizing properties. Prospective studies have consistently shown a lower risk of type 2 diabetes among those with higher circulating adiponectin levels.Objective:We examined prospectively the association between serum adiponectin levels and type 2 diabetes risk among Japanese workers, taking visceral fat mass into account.Subjects and methods:Subjects were 4591 Japanese employees who attended a comprehensive health screening in 2008; had biochemical data including serum adiponectin; were free of diabetes at baseline; and received health screening in 2011. Multiple logistic regression analysis was used to examine the association between adiponectin and incidence of diabetes among overall subjects, as well as subgroups. Stratified analyses were carried out according to variables including visceral fat area (VFA).Results:During 3 years of follow-up, 217 diabetic cases were newly identified. Of these, 87% had a prediabetes at baseline. Serum adiponectin level was significantly, inversely associated with incidence of diabetes, with odds ratios (95% confidence interval) adjusted for age, sex, family history, smoking, alcohol drinking, physical activity and body mass index (BMI) for the lowest through highest quartile of adiponectin of 1 (reference), 0.79 (0.55-1.12), 0.60 (0.41-0.88) and 0.40 (0.25-0.64), respectively (P-value for trend <0.01). This association was materially unchanged with adjustment for VFA instead of BMI. After further adjustment for both homeostasis model assessment of insulin resistance and hemoglobin A1c, however, the association became statistically nonsignificant (P-value for trend=0.18). Risk reduction associated with higher adiponectin levels was observed in both participants with and without obesity or insulin resistance at baseline.Conclusions:Results suggest that higher levels of circulating adiponectin are associated with a lower risk of type 2 diabetes, independently of overall and intra-abdominal fat deposition, and that adiponectin may confer a benefit in both persons with and without insulin resistance.
    Nutrition & Diabetes 08/2014; 4:e130. · 1.52 Impact Factor
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    ABSTRACT: The potential associations of diabetes mellitus with malignant neoplasms including liver cancer have become a great concern from both clinical and preventive perspectives. Although sufficient evidence for a positive association between diabetes and liver cancer already exists, it would be informative to summarize up-to-date epidemiologic data in Japan.
    Japanese Journal of Clinical Oncology 08/2014; · 1.75 Impact Factor
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    ABSTRACT: Leptin and ghrelin have been implicated in the pathogenesis of major depression. However, evidence is lacking among apparently healthy people. This study examined the relationship of these appetite hormones to depressive symptoms in a Japanese working population.
    BMC Psychiatry 07/2014; 14(1):203. · 2.24 Impact Factor
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    ABSTRACT: Habitual coffee drinking has been linked to a lower risk for some forms of cancer, but the mechanism remains elusive. Coffee may decrease oxidative DNA damage, an important pathway to carcinogenesis. We examined the association between coffee consumption and urinary 8-hydroxydeoxyguanosine (8-OHdG) concentrations, a biomarker of systemic oxidative DNA damage and repair, in 507 healthy subjects (298 men and 209 women aged 21-67 yr) while adjusting for age, sex, smoking status, body mass index, job type, and fasting blood glucose in multivariable regression models. The association with green tea consumption was also assessed. Urinary 8-OHdG concentrations tended to decrease with coffee consumption in women (trend P = 0.046), with women drinking 2-3 cups of coffee per day showing the lowest mean of urinary 8-OHdG concentrations. This association was largely attenuated after further adjustment for serum ferritin concentrations, a marker of body iron storage (trend P = 0.96). Green tea consumption was not associated with urinary 8-OHdG concentrations. Coffee drinking may be associated with decreased systemic oxidative DNA damage through decreasing body iron storage in women.
    Nutrition and Cancer 07/2014; · 2.47 Impact Factor
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    ABSTRACT: Background: The present study examined the prevalence of diabetes in Japan during the late 1990s and early 2000s using the Japan Public Health Center-based Prospective Diabetes cohort. We also investigated the distributions of HbA1c values in noncompliant diabetic participants in the cohort.Methods: A total of 28 183 registered inhabitants aged 46-75 years from 10 public health center areas were included in the initial survey. The 5-year follow-up survey included 20 129 participants. The prevalence of diabetes was estimated using both a self-reported questionnaire and laboratory measurements. Among the participants who reported the presence of diabetes on the questionnaire (self-reported diabetes), the distributions of HbA1c values were described according to their treatment status.Results: The age-standardized prevalence of diabetes in 55- to 74-year-old adults was 8.2% at the initial survey and 10.6% at the 5-year follow-up. At the initial survey, among participants with self-reported diabetes, the mean HbA1c values in the participants who had never and who had previously received diabetes treatment were 7.01% (standard deviation [SD] 1.56%) and 6.56% (SD 1.46%), respectively. Approximately 15% of the participants who had self-reported diabetes but had never received diabetes treatment had an HbA1c ≥ 8.4%.Conclusions: The prevalence of diabetes increased in the JPHC cohort between the late 1990s and early 2000s. A certain proportion of participants who were aware of their diabetes but were not currently receiving treatment had poor diabetic control. Efforts to promote continuous medical attendance for diabetes care may be necessary.
    Journal of Epidemiology 07/2014; · 2.86 Impact Factor
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    ABSTRACT: Objective Acid-base status has been suggested to influence blood pressure, but there is a paucity of epidemiologic evidence linking dietary acid load to hypertension. We examined cross-sectionally the association between dietary acid load and hypertension in a Japanese working population. Methods Data were derived from health surveys among 2028 employees, aged 18-70 years, in two workplaces in Japan. Diet was assessed by using a validated brief diet history questionnaire. Two measures were used to characterize dietary acid load: 1) potential renal acid load (PRAL) and 2) estimated net endogenous acid production (NEAP), which were derived from nutrient intakes. Multilevel logistic regression was used to examine the association between dietary acid load and hypertension with adjustment of potential confounding variables. Results High dietary acid load was suggestively associated with increased prevalence of hypertension. The multivariable adjusted odds ratios (95% confidence interval) of hypertension for the lowest through highest tertiles of NEAP were 1.00 (reference), 1.07 (0.80-1.42), and 1.33 (0.998-1.78) respectively (Ptrend=0.053). This positive association was statistically significant among normal-weight (BMI<23 kg/m2) (Ptrend =0.03) and non-shift workers (Ptrend =0.04). Similar positive associations were observed between PRAL and hypertension. Conclusions The present findings suggest that high dietary acid load may be associated with increased prevalence of hypertension among those who were normal weight and non-shift workers.
    Nutrition 07/2014; · 3.05 Impact Factor
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    Diabetes Care 07/2014; 37(7):e164. · 8.57 Impact Factor
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    ABSTRACT: Existing evidence is limited on what extent fitness can counterbalance type 2 diabetes mellitus (T2DM) risk associated with obesity. We investigated the joint association of weight status and estimated VO2max, a marker of fitness, with the risk of developing T2DM among Japanese men using haemoglobin A1c and fasting glucose criterion.
    PLoS ONE 06/2014; 9(6):e98508. · 3.53 Impact Factor
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    ABSTRACT: Objective. Insulin resistance (IR) is regarded as one of the earliest features of many metabolic diseases, and major efforts are aimed at improving insulin function to confront this issue. The aim of this study was to investigate the relationship of body mass index (BMI), cigarette smoking, alcohol intake, physical activity, green tea and coffee consumption to IR. Methods. We performed a cross-sectional study of 1542 male self defense officials. IR was defined as the highest quartile of the fasting plasma insulin (≥ 50 pmol/L) or the homeostasis model assessment-estimated IR (HOMA-IR ≥ 1.81). An unconditional logistic model was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association between IR and influential factors. Stratified analysis by obesity status (BMI < 25 kg/m(2), non-obese; ≥ 25 kg/m(2), obese) was performed. Results. IR was significantly positively related to BMI and glucose tolerance, negatively related to alcohol use. Independent of obesity status, significant trends were observed between IR and alcohol use. Drinking 30 mL or more of ethanol per day reduced IR by less than 40%. Strong physical activity was associated with decreased risk of IR based on fasting plasma insulin only in the obese. Coffee consumption was inversely associated with the risk of IR based on HOMA-IR in the non-obese group. Conclusion. Higher coffee consumption may be protective against IR among only the non-obese. Further studies are warranted to examine the effect modification of the obesity status on the coffee-IR association.
    Scandinavian journal of clinical and laboratory investigation 05/2014; · 1.38 Impact Factor
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    ABSTRACT: Epidemiologic evidence on long working hour and diabetes has been conflicting. We examined the association between overtime work and prevalence of diabetes among Japanese workers. The subjects were 40,861 employees (35,170 men and 5,691 women), aged 16 to 83 years, of 4 companies in Japan. Hours of overtime were assessed using self-reported questionnaires. Diabetes was defined as a fasting plasma glucose ≥126 mg/dl (7.0 mmol/l), hemoglobin A1c ≥6.5% (48 mmol/mol), or current use of anti-diabetic drug. Multiple logistic regression analysis was used to calculate odds ratio of diabetes for each category of overtime. After adjustment for age, sex, company, smoking, and BMI, there was a suggestion of U-shaped relationship between overtime work and prevalence of diabetes (P for quadratic trend = 0.07). Compared with those who worked <45 hours of overtime per month, the adjusted odds ratios (95% confidence interval) of diabetes were 0.86 (0.77-0.94), 0.69 (0.53-0.89), and 1.03 (0.72-1.46) for those who worked 45-79, 80-99, and ≥100 hours of overtime per month, respectively. In one company (n = 33,807), where other potential confounders including shift work, job position, type of department, alcohol consumption, sleep duration, leisure time physical activity, and family history of diabetes was additionally adjusted for, similar result was obtained (P for quadratic trend = 0.05). Long hours of overtime work may not be associated with increased prevalence of diabetes among Japanese workers.
    PLoS ONE 05/2014; 9(5):e95732. · 3.53 Impact Factor
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    ABSTRACT: Coffee and green tea consumption may be associated with circulating adipokines, but data are inconsistent, scarce or lacking. We examined the association of coffee and green tea consumption with serum adiponectin, leptin, visfatin, resistin and plasminogen activator inhibitor-1 (PAI-1) among a Japanese working population. The authors analyzed data (n = 509) from a cross-sectional survey among Japanese workers aged 20-68 years. Serum adipokines were measured using a Luminex suspension bead-based multiplexed array. Coffee and green tea consumption was assessed using a validated diet history questionnaire, and caffeine consumption from these beverages was estimated. Multiple regression analysis was performed with adjustment for potential confounding variables. Coffee consumption was significantly, inversely associated with leptin and PAI-1 (P for trend = 0.007 and 0.02, respectively); compared with subjects consuming <1 cup per day, those consuming ≥4 cups per day had 13 and 10 % lower means of leptin and PAI-1, respectively. Similar associations were observed for caffeine consumption (P for trend = 0.02 for both leptin and PAI-1). Additionally, we noted a significant positive association between coffee consumption and adiponectin in men (P for trend = 0.046), but not in women (P for trend = 0.43, P for interaction = 0.11). Moreover, there was a positive association between coffee consumption and resistin in current male smokers (P for trend = 0.01), but not in male non-smokers (P for trend = 0.35, P for interaction = 0.11). Green tea consumption was not associated with any adipokine. Higher consumption of coffee and caffeine but not green tea was associated with lower serum levels of leptin and PAI-1 in Japanese adults.
    European Journal of Nutrition 04/2014; · 3.84 Impact Factor

Publication Stats

3k Citations
804.26 Total Impact Points


  • 2011–2014
    • National Center for Global Health and Medicine in Japan
      • • Department of Cardiovascular Surgery
      • • Department of Clinical Research
      Edo, Tōkyō, Japan
    • Clinical Research Hospital, Tokyo
      Edo, Tōkyō, Japan
    • University of the Ryukyus
      • Graduate School of Medicine
      Okinawa, Okinawa-ken, Japan
    • Waseda University
      • Waseda Institute for Advanced Study (WIAS)
      Tokyo, Tokyo-to, Japan
  • 2005–2013
    • National Cancer Center, Japan
      • Research Center for Cancer Prevention and Screening
      Edo, Tōkyō, Japan
    • Saitama Medical University
      • Department of Public Health
      Saitama, Saitama-ken, Japan
    • Aichi Medical University
      • Department of Public Health
  • 2012
    • Osaka University
      • Graduate School of Medicine
      Suika, Ōsaka, Japan
    • National Institute of Public Health
      Saitama, Saitama, Japan
  • 2011–2012
    • Fukuyama University
      Hukuyama, Hiroshima, Japan
  • 2006–2012
    • Saga University
      • Faculty of Medicine
      Сага Япония, Saga, Japan
  • 2006–2011
    • Gifu University
      • Department of Epidemiology and Preventive Medicine
      Gihu, Gifu, Japan
    • Aichi Cancer Center
      Ōsaka, Ōsaka, Japan
  • 2002–2011
    • Nagoya University
      • • Department of Preventive Medicine
      • • Division of Social Life Science
      Nagoya-shi, Aichi-ken, Japan
  • 1991–2010
    • University of Occupational and Environmental Health
      • • Department of Preventive Medicine and Community Health
      • • Institute of Industrial Ecological Sciences
      • • Department of Clinical Epidemiology
      • • Department of Mental Health
      • • School of Medicine
      Kitakyūshū, Fukuoka, Japan
  • 2009
    • Hitachi, Ltd.
      Edo, Tōkyō, Japan
  • 2003–2009
    • Kyushu University
      • • Graduate School of Medical Sciences
      • • Faculty of Medical Sciences
      Fukuoka-shi, Fukuoka-ken, Japan
    • Yamaguchi Prefectural University
      Yamaguti, Yamaguchi, Japan
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
  • 2005–2007
    • University of Tsukuba
      • Institute of Community Medicine
      Tsukuba, Ibaraki-ken, Japan
  • 2002–2004
    • Showa University
      • Department of Public Health
      Shinagawa, Tōkyō, Japan