[Show abstract][Hide abstract] ABSTRACT: The objective of this retrospective descriptive study was to determine whether the universal influenza vaccination for schoolchildren was effective in controlling influenza outbreaks in a school. A universal vaccination program for schoolchildren was started in Japan in the 1960s, but the government abandoned the program in 1994 because of lack of evidence that the program was effective in preventing influenza in schoolchildren.
Influenza vaccine coverage rates, total numbers of class cancellation days, and absentee rates were reviewed in a single elementary school during the 24-year period during 1984-2007.
The mean number of class cancellation days and the mean absentee rate in the compulsory vaccination period (1984-1987; mean vaccine coverage rate, 96.5%) were 1.3 days and 2.5%, respectively, and they increased to 8.3 days and 3.2% during the quasi-compulsory vaccination period (1988-1994; vaccine coverage, 66.4%). In the no-vaccination period (1995-1999; vaccine coverage, 2.4%), they were 20.5 days and 4.3%, respectively, and in the voluntary vaccination period (2000-2007; vaccine coverage, 38.9-78.6%), they were 7.0-9.3 days and 3.8%-3.9%. When minor epidemics were excluded, there was a significant inverse correlation between the vaccine coverage rates and both the number of class cancellation days and absentee rates.
The universal influenza vaccination for schoolchildren was effective in reducing the number of class cancellation days and absenteeism in the school.
[Show abstract][Hide abstract] ABSTRACT: Family history of lifestyle-related diseases is an important risk factor and is widely used in epidemiologic studies. To justify its use the validity of the family history needs to be assessed. The aim of the present study was therefore to examine reliability, that is, consistency in repeated measurements, of the family history obtained on questionnaire.
A questionnaire survey on the family history of lifestyle-related diseases was conducted for 438 high school students about students' parents, grandparents, uncles and aunts, twice with a 1 year interval. The questionnaire was filled in by their parents. Discordance between the two questionnaires in age, age at death and a positive history of lifestyle-related diseases expressed by age at onset by decade age among the family members was examined. Kappa was used as a measure of agreement.
The kappas for relatives were high, mostly >0.7 for hypertension and >0.5 for myocardial infarction, angina pectoris, stroke, diabetes mellitus and hypercholesterolemia. The discordance tended to be higher among grandparents than parents, uncles and aunts. The discordance with regard to relatives was mostly <4% for angina pectoris, myocardial infarction, stroke and diabetes mellitus; for hypertension and hypercholesterolemia the discordance was <6%.
The questionnaire provides a reliable and valid method of collecting family history on relatives of high school students. Thus, family history obtained through questionnaires can be used justifiably as a risk factor for lifestyle-related diseases among children and youths.
No preview · Article · Sep 2009 · Pediatrics International
[Show abstract][Hide abstract] ABSTRACT: We investigated the influences of mothers' dieting behaviors on their junior high school daughters. We assessed dieting behaviors and eating habits in 221 pairs of mothers and their junior high school daughters using questionnaires. The subjects were classified into an extraordinary-diet (Ex-D) group, who attempted to diet rapidly with unhealthy methods, a structured-diet (St-D) group, who attempted to diet gradually with healthy methods, and a non-diet (N-D) group, using the questionnaire scores. 1) A significant correlation was observed in the distribution of dieting behavior groups between the mothers and their daughters. 2) The scores for dieting behavior of the mothers whose daughters were classified into the Ex-D group were significantly higher in several question items compared with those of the mothers whose daughters were classified into the N-D group. 3) The scores for eating consciousness of the mothers whose daughters were classified into the Ex-D group were significantly lower for the item "Cooking is a fun pastime" compared with those of the mothers whose daughters were classified into the St-D or N-D groups. 4) The number of experiences of conversation with daughters about diet for the mothers whose daughters were in the Ex-D group was significantly higher than that for the mothers whose daughters were classified into the N-D group. The mothers' dieting behavior, eating consciousness, and number of conversations with daughters about diet influenced dieting behaviors in their junior high school daughters. Appropriate education of mothers would be useful to prevent their daughters' inappropriate diet.
No preview · Article · Oct 2005 · Eating and weight disorders: EWD
[Show abstract][Hide abstract] ABSTRACT: Body mass index (BMI) reference values in consideration of height variation have not previously been reported. This study established height-specific BMI reference curves for Japanese children and adolescents aged from 5 to 17 years.
The 2001 nationwide survey data were utilized for the study. First, the range of variation in BMI corresponding to height (mean +/- 2SD) at each age was compared with the range of variation in BMI corresponding to age (from minimum to maximum) at every cm height. Second, various age groups were combined, and percentile values of BMI (3rd, 5th, 15th, 50th, 85th, 95th, and 97th) were calculated for every cm height, regardless of age, and height-specific BMI reference values (males 100-179 cm, females 100-169 cm) were prepared.
Variation in BMI due to variation in height at each age was significantly (P <0.05) greater than variation in BMI due to age at every cm height [males, 12.7 +/- 0.4 vs 9.2 +/- 0.4; females, 11.7 +/- 0.8 vs 8.8 +/- 0.3 (mean +/- SE)].
Although the use of standard values established in consideration of age and height is desirable for BMI-based guidelines for determining childhood overweight and obesity, to simplify the procedure for practical use, it is necessary to establish standard values by height, not by age. Height-specific BMI reference curves are useful for BMI-based evaluation of childhood overweight and obesity in the school health service and follow-up of obese children until adulthood.
No preview · Article · Nov 2004 · Pediatrics International
[Show abstract][Hide abstract] ABSTRACT: Coronary heart disease occurs nearly exponentially with age and differently between men and women. Therefore, difference in sex and age of family members yields errors in assessing the family history as a risk factor. The influence of sex and age on the positivity of family history was assessed numerically.
Through questionnaires filled in by the parents of 2316 high school students, information was obtained on the past history of coronary heart disease among students' parents, grandparents, uncles, and aunts. The sex- and age-specific proportion of a positive history was calculated from the past history among the 24,071 family members. The influence of sex and age on a positive history was estimated as odds ratios by logistic regression analysis of the past history.
The odds ratios obtained for sex and age difference were 1.61 (95% confidence interval: 1.42-1.83) and 1.07 (95% confidence interval: 1.06-1.07), respectively. This indicated that a positive history was 1.61 times higher among male members than among female members of the same age, and that a positive history increased by (1.07)y, where y was age difference by year.
Potential errors resulting from disregarding the sex and age of family members can be substantial, judging from the above numerical figures. Some measures to control for the sex and age of family members are required in assessing family history of coronary heart disease.
No preview · Article · Apr 2004 · Journal of Epidemiology
[Show abstract][Hide abstract] ABSTRACT: Anorexia nervosa (AN) has a complex pathogenesis resulting sometimes during childhood and adolescence in potential severe complications. Abnormal exercise capacity, which may result from long-term malnourishment and restriction of physical activities for many months, has been observed in the majority of such patients, ever after weight regain. It is widely believed that physical activities may improve exercise capacity and the emotional disorder. However, controversy exists about promoting or withholding exercise . Previous studies reported that excessive exercise may play a role as a causal factor of AN and might be associated with a poor evolution [2, 3]. The use of exercise training as a treat
No preview · Article · Jul 2003 · European Journal of Pediatrics
[Show abstract][Hide abstract] ABSTRACT: No studies of cardiorespiratory response to brief, sudden, strenuous exercise in patients after tetralogy of Fallot (TOF) repair have been reported. We investigated the exercise capacity of TOF patients using a ten-second pedaling test designed to study cardiorespiratory responsiveness to brief, sudden, strenuous exercise. We assessed exercise capacity using a ten-second pedaling test (ten seconds maximal of voluntary cranking as fast as possible against an ergometer's inertial resistance), coupled with a conventional ramp-type progressive exercise test at a constant rate to the limit of tolerance, in eight male postoperative TOF patients and eight male control subjects. In the ten-second pedaling test, there were no significant differences in the integrated areas of heart rate (HR) and oxygen uptake () responses between the TOF patients and controls, but there were significantly longer decreasing phase time constants of HR and responses in the TOF patients than in the controls. In the conventional exercise test, the endurance time, peak-HR, and peak- did not differ between the groups. The TOF group, with a normal exercise capacity assessed by a conventional exercise test, had an impaired cardiorespiratory response to brief, sudden, strenuous exercise assessed by a ten-second pedaling test.
No preview · Article · Sep 2002 · Pediatric Cardiology
[Show abstract][Hide abstract] ABSTRACT: Short sleeping hours could cause obesity through increased sympathetic activity, elevated cortisol secretion and decreased glucose tolerance. The aim of this study was to clarify parental and lifestyle factors, particularly sleeping habits, associated with obesity in Japanese children.
Between June and July 1996, 8274 children (4194 males and 4080 females) aged 6-7 years living in Toyama prefecture, Japan, were investigated by questionnaire survey and the collection of anthropometric data. Subjects with a body mass index (BMI; weight in kg divided by square of height in m) greater than the age- and sex-specific cut-off points linked to adulthood overweight (BMI of 25 kg/m2 or more) were defined as obese subjects. Parental obesity was defined as a BMI of 25 kg/m2 or more. Logistic regression analysis was performed to evaluate the strength of the relationships between parental obesity or lifestyle factors and childhood obesity, adjusted for possible confounding factors.
Parental obesity, long hours of TV watching and physical inactivity were significantly associated with childhood obesity. Although wake-up time was not related to obesity, there was a significant dose-response relationship between late bedtime or short sleeping hours and childhood obesity. Compared with children with 10 or more hours of sleep, the adjusted odds ratio was 1.49 (95% confidence interval 1.08-2.14) for those with 9-10 h sleep, 1.89 (1.34-2.73) for those with 8-9 h sleep and 2.87 (1.61-5.05) for those with <8 h sleep, after adjustment for age, sex, parental obesity and other lifestyle factors.
A strong inverse association was observed in the relationship between sleeping hours and childhood obesity. Longitudinal research will be required to confirm this causality.
Preview · Article · Mar 2002 · Child Care Health and Development
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to clarify the impact of parental obesity and lifestyle factors on obesity in preschool children. The subjects consisted of 8941 children aged 3 years, born in 1989. Anthropometric measurements and questionnaire surveys were conducted between 1992 and 1994. Subjects of body mass index (BMI; (weight (kg))/(height (m))2) more than the age- and sex-specific centiles linked to adult overweight were defined as obese subjects. Parental obesity was defined as BMI of 25 kg/m2 or more. Logistic regression analysis was performed to clarify the strengths of parental and lifestyle factors on childhood obesity, adjusted for possible confounding factors. Odds ratios (ORs) of paternal and maternal obesity for childhood obesity were 1.70(1.43-2.02) and 2.56(2.07-3.17), respectively. There was a dose-response relationship between short sleeping hours and obesity. Compared to subjects taking 11 hours sleep or more, the adjusted OR was 1.20(0.97-1.49) for those taking 10 to 11 hours sleep, 1.34(1.05-1.72) for those taking 9 to 10 hours sleep, and 1.57(0.90-2.75) for those taking less than 9 hours sleep. Eating and exercising habits were not significantly associated with obesity. These results indicate that parental obesity and short sleeping hours are possible risk factors for obesity in preschool children.
No preview · Article · Feb 2002 · Journal of Epidemiology
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to identify characteristic lifestyles in children with obese parents.
8,030 children (4,072 males and 3,958 females) aged 6 to 7 years were investigated. A questionnaire relating to the lifestyles of children was distributed through elementary schools for completion by parents. The heights and weights of parents were self-reported. A parent with a body mass index (weight in kilograms divided by the square of height in meters) greater than the 90th percentile for gender (26.7 kg/m(2) for fathers and 24.3 kg/m(2) for mothers) was defined as an obese parent. A chi-square test for each trend was applied to evaluate an increasing trend in the frequency or level of each lifestyle in children with obese parents.
Children with obese parents were significantly associated with increasing trends in the proportions categorized by irregular intake of breakfast, faster eating, longer TV watching, and shorter sleeping hours.
These lifestyles are considered to be possible risk factors for the development of obesity. These characteristic lifestyles observed in children with obese parents could strengthen the relationship between child and parental body compositions, in addition to the genetic predisposition to obesity in children with obese parents. These findings indicate that education with lifestyle modification for obese parents will be required to prevent further weight gain in children with obese parents.
Preview · Article · Jul 2001 · Environmental Health and Preventive Medicine
[Show abstract][Hide abstract] ABSTRACT: Incidence of stroke differs between men and women and it increases nearly exponentially with age. Therefore, assessment of family history of stroke disregarding sex and age of family members results in bias or misclassification. In this study the effects of sex and age on the positivity of the past history were analyzed numerically. Sex- and age-specific proportion of a positive history of stroke among 24,007 family members was obtained from a questionnaire survey of 2,316 high school students. By analyzing the sex- and age-specific proportion with the logistic regression model odds ratios resulting from sex and age difference were estimated. The odds ratio for sex difference was 2.458 (95% confidence interval: 2.067-2.924) and odds ratio for age difference was 1.064 (95% confidence interval: 1.058-1.070). This indicated that a positive history of stroke was 2.458 times higher in male members than in female members of the same age and that a positive history increased by (1.064)y, where y was age difference in years. Potential bias or misclassification resulting from disregarding sex and age can be substantial. Some measures to control for sex and age of family members are required in assessing the family history.
No preview · Article · Oct 2000 · Journal of Epidemiology
[Show abstract][Hide abstract] ABSTRACT: Patterns of eating habits were analyzed to elucidate its relationship to the temporal change of body build from childhood through school age in subjects of the Toyama study. Survey questionnaires at the time of entrance to elementary school were used. Subjects were 6,452 (males 3,293, and females 3,159). Subjects were classified into 6 clusters among the males, 8 clusters among females based on the results of cluster analysis of eating habits. The cluster in males that preferred egg, milk, dairy products, fats, fish and shellfish, soybeans, fruits, green yellow vegetables indicated more frequent subjects whose BMI were less that 14. The cluster in girls that preferred fats indicated more frequent subjects whose BMI were more or equal to 18. The ANOVA showed significant relation of parental body build on their children. Even after grouping by parental body build, the cluster based on patterns of eating habits showed different frequencies of obese children. Preference for intake of milk indicated less frequent obese children among the similar parental body build for boys, while preference for intake of fats indicated more frequent obese children among a similar parental body build for girls. In conclusion, the obesity of a school child has a close relationship to parent's body build. However, the temporal changes of obesity were seen among eating habits clusters even if body builds of their parents are the same. It was shown that patterns of eating habit are important in school children's obesity development.
No preview · Article · Oct 1999 · [Nippon kōshū eisei zasshi] Japanese journal of public health
[Show abstract][Hide abstract] ABSTRACT: To demonstrate the temporal course of obesity development in Japanese school children by conducting a school-site cohort study over 12 years.
From 1981 to 1984, height and weight of 479 subjects (343 boys and 136 girls) were measured every year from entrance into primary school until graduation from high school in Tokyo. Obese children were defined as those with a body mass index (BMI) at or above the age-sex-specific standard value, derived from Japanese nationwide data.
Approximately 50% of the children who were obese in the primary school period were obese at age 17. Likewise, 40% who were obese in the junior high school period and 70% who were obese in the high school period were obese at age 17. Among 44 children who were obese at age 17, 14 showed tracking of obesity from the preschool period, 14 showed tracking from ages 7 to 11 years, 10 showed tracking from the junior high school period, and 6 showed tracking from the high school period.
Among children who were obese at age 17, most tracked from the primary school age or earlier. The earlier the tracking commenced, the greater the BMI at age 17. This indicates the importance of conducting health education for school children at an early age.
Full-text · Article · Jul 1999 · Journal of Pediatrics
[Show abstract][Hide abstract] ABSTRACT: It has been observed that obese children receive genetic and environmental effects that are associated with them being overweight. With regard to the latter, lifestyles such as eating habits and physical activity have been focused on. In the present study, the social characteristics which would dominate their lifestyles were investigated as background variables. For this purpose, 9668 Japanese children aged three years who were all born in Toyama prefecture, Japan, in 1998, served as birth cohort subjects. For the comparison between obese (Kaup Index; mass in kg/(height in m)2 > or = 18) and nonobese (Kaup index < 18) children, irregular snack intake, physical inactivity and reduced sleeping hours were chosen as statistically significant obesity-related lifestyle indicators for the children. For social characteristics, family construction (expanded family with grandparents/nonexpanded family), main caregiver (mother/other), attending a nursery school (yes/no) and mother's employment (full-time worker/other) were chosen. These were significantly associated with the obesity-related lifestyles mentioned above using multiple logistic regression analysis adjusted for other variables of social characteristics as well as for gender and birth month (July-December/January-June). The two greatest population-attributable risk percentages were observed for mother as main caregiver (-36.5%) and attending a nursery school (-28.9%) for irregular snack intake. Therefore, these two social characteristics substantially reduced the number of children with irregular snack intake. On the other hand, the two social characteristics were reversed in children with reduced sleeping hours (population-attributable risk percentage of mother as main caregiver: 15.4%; attending a nursery school: 17%). In contrast with favourable effects on snack intake these social characteristics showed an adverse influence on the sleeping habits of children.
No preview · Article · Jun 1999 · Child Care Health and Development
[Show abstract][Hide abstract] ABSTRACT: Diabetes mellitus occurs nearly exponentially with aging and its occurrence differs between men and women in adulthood. Therefore, the sex and age of family members should be considered in assessing the family history. In this report the effects of sex and age on the positivity of family history were estimated numerically.
Sex- and age-specific proportion of a positive history of diabetes mellitus among 24,273 family members was obtained from a questionnaire survey of 2,316 high school students in Japan. By analyzing the sex- and age-specific proportion with the logistic regression model, odds ratios were estimated which indicated potential bias or misclassification resulting from sex and age differences.
The odds ratios were 1.97 (95% confidence interval, 1.74-2.23) for the sex difference and 1.05 (95% confidence interval, 1.04-1.05) for an age difference of 1 year. This indicated that a male family member had a 1.97 times higher chance of having a positive history than a female member and that a positive history increased by (1.05)y, where y was age difference in years.
A control for sex and age of family members will be required in assessing the family history of diabetes mellitus as a risk factor.
No preview · Article · Feb 1999 · Preventive Medicine
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to call attention to a potential bias or misclassification resulting from disregarding sex and age of family members in assessing family history of hypertension. Family history of hypertension was obtained among 23,803 family members through a questionnaire survey of 2,316 high school students. From the obtained data sex- and age-specific proportion of a positive history of hypertension was calculated. The effects of sex and age on a positive history was assessed by the logistic regression analysis of the family history. Below age 70 the odds ratios for sex difference were at least 1.24 (p < 0.05) and odds ratios for age difference were at least 1.05 (p < 0.05). This indicated that below age 70 male members had a positive history at least 1.24 times more frequently than females of the same age, and that a positive history increased by at least (1.05)y, where y was age difference by year. Above age 70 the odds ratios for sex and age differences were small. A potential bias or misclassification resulting from sex and age difference can be substantial below age 70. Some measures to control for sex and age of family members are required in assessing the family history.
No preview · Article · Jun 1998 · Journal of Epidemiology
[Show abstract][Hide abstract] ABSTRACT: Family history serves as the most important risk factor in prevention of coronary heart disease from youth. Prevalent methods of assessing family history, however, have serious drawbacks: a sudden rise of risk when a family member develops the disease; insufficient control for age among family members. We propose a simple quantitative method overcoming such drawbacks. Data on family history were obtained by questionnaires sent to 2,393 male high school students and their cholesterol levels were measured. Family risk from each family member was calculated by (30/Risk age)4, where the risk age was age at onset expressed by decade; if absent, it was replaced by present age or age at death. A mean score in a family served as the family risk. A total of 1,584 students and 17,127 family members were analyzed. The proposed method yielded a statistically significant association (Odds ratio = 1.60; 95% confidence interval: 1.15-2.25) between the family risk (above or below the median) and the student's atherogenic index (above or below the 90th percentile) calculated from cholesterols. This association was stronger than those by conventional methods. The proposed method may be useful in prevention activities and its efficiency needs to be confirmed in other studies.
No preview · Article · Jul 1997 · Journal of Epidemiology