横山 芽衣子

BACKGROUND: Older adults who engage in group sports and exercises achieve greater health benefits than those who exercise by themselves. The benefits of group participation may vary depending on the type of sports/exercise they engage in. The present study aimed to identify the association between specific sports and exercise types performed in groups and evaluate the longitudinal changes in multidimensional frailty scores among community-dwelling older adults in Japan. METHODS: We used 3-year follow-up data from the Japan Gerontological Evaluation Study and analyzed 33,746 men and 36,799 women aged ≥ 65 years. To elucidate the relationship between participation in 20 types of group sports/exercises in 2016 (baseline) and the change in frailty score (using the Kihon Checklist, KCL) from 2016 to 2019, we performed linear regression analyses through multivariate adjustments for age group, self-rated health, marital status, living alone, occupational status, years of education, alcohol drinking status, smoking status, equivalent income, and disease status using an inverse probability weighting method. P < 0.05 was considered statistically significant. RESULTS: The mean change in KCL scores over 3 years was + 0.62 and + 0.61 points in men and women, respectively, implying the degree of frailty worsened. The sports/exercise types that significantly prevented increments in KCL scores for both sexes compared to non-participants were hiking (men: B, - 0.36; women: B, - 0.29), walking (men: B, - 0.26; women: B, - 0.24), tennis (men: B, - 0.23; women: B, - 0.24), ground golf (men: B, - 0.21; women: B, - 0.19), and weight exercises (men: B, - 0.19; women: B, - 0.16). CONCLUSION: Participation in specific sports and exercise groups offer significant physical and psychological benefits for frailty prevention among older adults in Japan. The results of this study may offer substantive evidence to encourage older adults to participate in group activities for the prevention of multidimensional frailty. It will also help public health stakeholders to decide which type of sports and exercise groups to promote in a community.

Abstract Background and Objectives Evidence remains inadequate regarding the benefits of participation in community gathering places, which is Japan’s primary strategy for preventing functional disability in older adults, in other domains of health and well-being. This longitudinal study examined the associations of participation in community gathering places with an array of subsequent health and well-being outcomes among older adults. Research Design and Methods We used three-wave data (2013, 2016, and 2019) from Japan Gerontological Evaluation Study (n = 5,879 or 4,232 depending on the outcome). Our exposure was participation in community gathering places in 2016. We assessed 34 health/well-being outcomes in 2019 across six domains. We adjusted for pre-baseline covariates including prior outcome values in 2013. Results Compared with nonparticipation, participation in community gathering places was associated with some outcomes in the following three domains: physical/cognitive health (better higher-level functional capacity), social well-being (more frequent participation in hobby groups, senior citizens clubs, learning or cultural groups, and seeing more friends within a month), and pro-social/altruistic behaviors (more frequent participation in volunteering) (After Bonferroni correction as p &amp;lt; 0.0015, 0.05/34). Discussion and Implications Evidence was mixed and more modest for the outcomes in three other domains, mental health, psychological well-being, and health behaviors. Promoting participation in community gathering places may not only fulfill its original goal (i.e., preventing functional disability) but also enhance other domains of human well-being, potentially by increasing social interactions.

<title>Abstract</title>This study aimed to identify factors associated with engaging in sports and exercise volunteering among older adults. We used cross-sectional data from the Japan Gerontological Evaluation Study (JAGES), a nationwide mail survey of 20,877 older adults from 60 municipalities. Multilevel mixed-effects logistic regression analysis was used to investigate the correlation between engaging in sports and exercise volunteering and 39 variables classified into five factors: (1) demographic and biological, (2) behavioral, (3) psychological, cognitive, and emotional, (4) social and cultural, and (5) environmental factors. Among the analyzed samples, 1580 (7.6%) participants volunteered a few times/year or more often. Factors that showed positive association with the volunteering were older age, a current drinking habit, excellent self-rated health, high proportion of sports group participants in a living area, low municipal population density, and rich social and cultural features (i.e., social cohesion, support, network, and participation). Meanwhile, those that had a negative association were women, low level of education, deteriorated instrumental activities of daily living, having a past or current smoking habit, poor self-rated health, and depressive symptoms. We clarified the characteristics of the population that is more likely to participate in sports and exercise volunteering as well as those of the population that is less likely to participate and requires support.

PURPOSE: This study aimed to identify the association between a specific sports type and exercise group participation and longitudinal changes in sociopsychological health among community-dwelling older adults. METHODS: Three years of data from the Japan Gerontological Evaluation Study were used, comprising a total of 33,746 men and 36,799 women aged ≥65 years. To determine the relationship between 20 types of sports and exercise group participation in 2016 (baseline) and changes in depressive symptoms (Geriatric Depression Scale: GDS-15), self-rated health (4-point scale), subjective well-being (11-point scale), and frequency of laughter (day/month) from 2016 to 2019, we performed linear regression analyses with conducting a multivariate adjustment for potential confounders using an inverse probability weighting method. RESULTS: The mean changes over three years were + 0.32 and + 0.28 in GDS-15, -0.06 and - 0.05 in self-rated health, -0.08 and - 0.06 in subjective well-being, and - 1.21 and - 1.19 in frequency of laughter, in men and women, respectively. Men playing golf in a group were more likely to suppress an increase in the GDS-15 (B = -0.11, 95% CI -0.18--0.05) and decreases in self-rated health (0.04, 0.02-0.06), subjective well-being (0.07, 0.02-0.12), and frequency of laughter (0.45, 0.11-0.80). Women participating in walking, weight exercises, and hiking groups were more likely to prevent an increase in the GDS-15 (-0.12, -0.19--0.04; -0.09, -0.18--0.01; and - 0.16, -0.30--0.03, respectively) and decreases in self-rated health (0.03, 0.01-0.05; 0.03, 0.01-0.06; and 0.08, 0.04-0.12, respectively). CONCLUSIONS: Golf in older men and walking, weight exercises, and hiking in older women could be recommended as an effective program for promoting sociopsychological health among older adults in Japan.

目的:高齢者の運動習慣定着に有効な運動プログラムのあり方を検討するために,民間スポーツクラブを利用する高齢者を対象にグループでの運動の実践と運動の継続との関連を明らかにすることを目的とした.方法:2017年6月から2019年3月にかけてリソルの森の健康増進プログラム(ウェルネスエイジクラブ)に6ヵ月以上参加した65歳以上の227人(女性117人,男性110人)を分析対象とした.半年に1回の質問紙調査,体力測定,年1回の健康診断,及び個人の参加プログラムや参加日時のデータを分析に用いた.24週以上に渡る平均週2日以上の運動プログラム参加を「運動プログラム継続」,平均週1回以上のグループプログラムへの参加を「グループプログラム参加」と定義し,グループプログラム参加と運動プログラム継続との関連をポアソン回帰分析により検証した.結果:グループプログラム参加者は,非参加者に比べて運動プログラムを継続する可能性が高かった(Prevalence ratio=3.63[95%CI:1.98〜6.65],p<0.01).性で層化しても,女性(8.08[1.94〜33.56],p<0.01),男性(2.84[1.39〜5.78],p<0.01)ともにグループプログラム参加と運動プログラム継続に有意な正の関連が認められた.結論:本研究は,民間スポーツクラブに通う高齢者において,グループによる運動プログラムは参加者同士の社会的交流やつながりを増やし運動継続を促進する可能性があることを明らかにした.高齢者のグループ運動への参加を促進することで運動継続者が増加する可能性が示唆された.(著者抄録)

<title>Abstract</title>The current study investigated the relationship between the frequency of watching sports and depressive symptoms among older adults. This study used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide mail survey of 21,317 older adults. Depressive symptoms were defined as a Geriatric Depression Scale score of ≥ 5. Participants were queried regarding the average frequency at which they watched sports on-site and via TV/Internet over the past year. Among the 21,317 participants, 4559 (21.4%) had depressive symptoms, while 4808 (22.6%) and 16,576 (77.8%) watched sports on-site and via TV/Internet at least once a year, respectively. Older adults who watched sports on-site a few times/year (prevalence ratio, 0.70; 95% confidence interval, 0.65–0.74) or 1–3 times/month (0.66, 0.53–0.82) were less likely to have depressive symptoms compared to non-spectators after adjusting for frequency of playing sports, exercise activities, and other potential confounders. Meanwhile, a dose–response relationship was confirmed for watching via TV/Internet (prevalence ratio of 0.86, 0.79, and 0.71 for a few times/year, 1–3 times/month, and ≥ 1 time/week, respectively). This study suggested that watching sports on-site or via TV/Internet, regardless of whether they regularly engage in sports, may reduce the risk of depressive symptoms among older adults.

サロン、スポーツ、趣味、ボランティアグループ参加は、どの社会経済階層に多いのか明らかにすることを目的とした。2016年度の日本老年学的評価研究(JAGES)のデータを用い、38市町の65歳以上の高齢者20,972人を対象とした。目的変数は各グループへの参加有無とした。説明変数は、教育歴、等価所得、最長職、調整変数は、人口統計学的要因など計11要因とした。変数の欠損値は多重代入法で補完し、男女別にポアソン回帰分析を実施した。サロンはどの社会経済階層とも有意な関連を示さなかった。スポーツは、男性で低所得層の参加が少なく(出現割合比0.90)、趣味は、男女とも低学歴層の参加が少なかった(男0.92、女0.81)。最長職は、スポーツ・趣味で、管理職以外の社会経済階層が低い人たちの参加が少なかったが、ボランティアで参加が多かった。介護予防事業の評価では、社会経済階層に着目した評価も重要と考えられる。(著者抄録)

生活習慣に着目した21世紀における国民健康づくり運動[健康日本21(第一次)]は期待したほど成果が上がらなかった。そこで、21世紀における第二次国民健康づくり運動[健康日本21(第二次)]では基本的方向として"健康格差の縮小"が掲げられ"社会環境の整備"が推し進められることとなった。社会環境の整備がどのように人々の健康によい波及効果をもたらしているのか、それが無関心層にまで及ぶことが徐々に明らかにされつつある。健康日本21(第二次)の中間評価において国や地方自治体、企業などが実施する社会環境の整備が推進していることが示されたが、今後はそれらの政策や事業を評価し、次期政策の立案・実施・評価と好循環のマネジメントサイクルが期待される。しかし、評価に必要な個人および環境両要因のデータ収集には課題が残されている。課題克服のためには健康格差縮小に向け、国、地方公共団体、地域、会社組織などが連携した取り組みを進め、介入方法と評価方法の両面でより効果的で効率的な方法の開発が期待される。(著者抄録)

肝臓がん細胞由来のHepG2細胞を用い、アミノレブリン酸(ALA)がアポトーシスに及ぼす影響を考察することで、ALAのがん細胞増殖抑制効果およびそのメカニズムについて検討した。ALA-と比較してALA+では細胞数が明らかに少なかったが、細胞の構造に大きな差異は観察しなかった。4日間HepG2細胞を培養し、ALA添加の有無による死細胞密度の違いは観察しなかったが、ALA添加により生細胞密度の増加が抑制された。これらの結果より、ALA添加によりHepG2細胞の生存率が低下した。シトクロムCオキシダーゼ活性値では、ミトコンドリア全体における活性は、ALA-と比較してALA+で有意に低い値を示した。ミトコンドリア膜外の活性値はALA+で増加し、ミトコンドリア膜の透過性亢進が示唆された。

Iron deficiency anemia (IDA) is one of the most serious forms of malnutrition. A promotion function of mineral absorption has been reported for neutral oligosaccharides, but not acidic xylooligosaccharide (U-XOS), which is a novel oligosaccharide. We hypothesized that U-XOS could promote recovery from IDA by enhancing the serum iron level. Therefore, the aim of this study was to investigate whether or not U-XOS was useful for recovery from IDA in the rat. Twenty-four female Sprague-Dawley rats were randomly divided into a control group fed a control diet (4.0 mg Fe /100 g) and an IDA model group created by employing a low-iron diet (0.4 mg Fe /100 g). The IDA group was further divided into three subgroups on day 21: U-XOS-supplemented diet (LI-X, 4.0 mg Fe /100 g), low-iron diet (LI), and control diet (LI-C) groups. No significant differences in the serum iron transferrin saturation levels were demonstrated between the control and LI-X groups on days 26 and 35. The divalent metal transporter 1 and ferroportin mRNA expression levels shown in the first segment of the small intestines showed a significant decrease in the LI-X group, compared with the LI group. A significant decrease in the hepatic hepcidin mRNA expression level and iron content was also demonstrated in the LI-X group, compared with the control group, but not compared with the LI group. These results suggested that U-XOS could promote recovery from IDA by enhancing serum iron at an early stage of the recovery process.

慢性腎不全の進行を抑制する治療法として、低たんぱく質食事療法は有効な治療のひとつである。本研究では、CKDステージ3である慢性腎不全患者14名を対象に、摂取食品を食品成分表や栄養表示をもとに摂取たんぱく質量を積算して栄養管理する「積算法」と、食品中のたんぱく質3gを1単位とし食品同士を交換して栄養管理する「食品交換法」の2つの栄養指導法について、摂取たんぱく質量や慢性腎不全への影響を後ろ向きに6ヵ月間を比較検討した。推定摂取塩分量の変化率では、積算法は食品交換法に比べ有意に低値を示したことから、積算法は減塩が成功しやすい栄養指導法であると考えられた。蓄尿による推定摂取たんぱく質量の結果から、積算法では指示たんぱく質量が遵守されていたが、食品交換法では増加傾向であり、積算法は指示量との剥離が生じにくい有用な栄養指導法である可能性が示唆された。(著者抄録)

インスリンは脂肪蓄積作用を有することが知られている。インスリンをラットに投与した研究は数多く行われてきたが、インスリン投与による内臓脂肪型肥満誘発の報告はない。本研究の目的は、長期インスリン投与による新たな内臓脂肪型肥満モデル動物を作成することである。雌性ラット(6週齢)に8(8I群)、16(16I群)、32(32I群)IU/kg BW/日のインスリンを12週間皮下投与した。対照群には生理食塩水を投与した(0I群)。実験終了時の32I群の生存率(29%)は0I群、8I群および16I群に比べ有意に低下した。体重および摂食量はインスリン投与量に依存して増加した。8I群の体タンパク質比率は0I群および16I群に比べ有意に増加した。16I群の総内臓脂肪重量と体脂肪比率は0I群および8I群に比べ有意に増加した。以上の結果から、16IU/kg BW/日のインスリンを12週間皮下投与することで内臓脂肪型肥満モデル動物が作成できると結論づけた。(著者抄録)

The objective of this study was to investigate the effects of dietary medium-chain triglycerides (MCT) on hepatic lipid accumulation in growing rats with protein malnutrition. Weaning rats were fed either a low-protein diet (3%, LP) or control protein diet (20%, CP), in combination with or without MCT. The four groups were as follows: CP-MCT, CP+MCT, LP-MCT, and LP+MCT. Rats in the CP-MCT, CP+MCT and LP+MCT groups were pair-fed their respective diets based on the amount of diet consumed by the LP-MCT group. Rats were fed each experimental diet for 30 d. Four weeks later, the respiratory quotient was higher in the LP-MCT group than those in the other groups during the fasting period. Hepatic triglyceride content increased in the LP groups compared with the CP groups. Hepatic triglyceride content in the LP+MCT group, however, was significantly decreased compared with that in the LP-MCT group. Levels of carnitine palmitoyltransferase (CPT) 1a mRNA and CPT2 mRNA were significantly decreased in the livers of the LP-MCT group, as compared with corresponding mRNA levels of the other groups. These results suggest that ingestion of a low-protein diet caused fatty liver in growing rats. However, when rats were fed the low-protein diet with MCT, hepatic triglyceride deposition was attenuated, and mRNA levels encoding CPT1a and CPT2 were preserved at the levels of rats fed control protein diets.

Iron deficiency anemia (IDA) is one of the most serious forms of malnutrition. This experiment was conducted to investigate whether acidic xylooligosaccharide (U-XOS), expected to have a high iron bioavailability, was useful in the prevention of iron deficiency. Experiment 1: Nineteen female Sprague-Dawley rats (20 wk old) were fed three different diets for 28 d; a U-XOS-supplemented low-iron diet (LI-X, n=7), a low-iron diet (LI, n=6), and a control diet (C, n=6). On day 28, the LI-X and LI groups showed iron deficiency without anemia. A significant difference in the total and unsaturated iron binding capacity, and serum transferrin saturation level was shown in the LI-X and LI groups, compared with the C group. However, the decrease of hepatic iron content of the LI-X group was suppressed compared with the LI group. Experiment 2: Eleven male Sprague-Dawley rats (7 wk old) were fed a U-XOS-supplemented diet (X, n=5) or a control diet (C, n=6) for 7 d. No significant difference in body weight gain or food intake was demonstrated between the two groups; the apparent iron absorption rate of the X group increased clearly compared with that of the C group. These results suggested that a U-XOS diet could preserve storage of hepatic iron in adult female rats fed a low-iron diet and could prevent IDA by promotion of dietary iron absorption, inhibition of iron excretion, and/or improvement of iron bioavailability.

Diabetic nephropathy is associated with lipid deposits in the kidney. We hypothesized that a diet containing polyunsaturated fatty acids (PUFAs) could ameliorate pathogenesis of diabetic kidney diseases associated with lipid depositions in the kidneys. We examined if the pathogenesis and progression of diabetic nephropathy are affected by the type of dietary fat using streptozotocin (45 mg/kg body weight, intravenous)-induced diabetic rats (5-week-old male Sprague-Dawley rats). Streptozotocin-induced diabetic rats were fed a lard diet containing saturated fatty acids or a rapeseed oil diet containing PUFAs (DML and DMR, respectively) for 11 days. Similarly, streptozotocin-nontreated rats were fed a lard diet or a rapeseed oil diet (NL and NR, respectively) for 11 days. Hyperglycemia was induced in DML and DMR, compared with NL and NR groups. The levels of plasma ketone, total cholesterol, and triglyceride (TG) were significantly increased in the DML group. Moreover, albuminuria and renal TG content were enhanced in the DML group. The renal TG content correlated positively with urinary albumin excretion (P < .001). Oil-Red O staining of kidney sections indicated a marked accumulation of neutral lipids in both glomerular and tubular cells in the DML group. In addition, a renal sterol regulatory element-binding protein-1 mature protein increment was induced in the DML group. Conversely, sterol regulatory element-binding protein-1 expression in the kidney was maintained at normal levels in the DMR group. These results suggest that dietary PUFAs may slow the progression of diabetic nephropathy associated with lipid depositions in the kidney.

The introduction of the tumorigenic v-Ha-ras oncogene-transformed rat liver epithelial cells (WBras), which is deficient in gap junctional intercellular communication (GJIC), into F344 rats, induces significant formation of hepatocellular tumors. GJIC plays a major role in maintaining tissue homeostasis. Using this in vivo tumor model system, we used 2-dimensional electrophoresis with isoelectric focusing in the first dimension and SDS-PAGE in the second dimension to globally identify proteins that are uniquely expressed in the livers of WBras-treated rats as compared to the sham control. Immunoblotting was used to identify Ras and Connexin43, which were the positive and negative marker proteins, respectively, of the introduced WBras cells. As predicted, immunoblotting indicated that the whole liver of tumor-bearing animals exhibited a decreased level of Connexin43 and an increased level of Ras. Connexin43 and GJIC were expressed and functional in normal liver, but not in the tumor. In addition to these 2 markers, an additional 4 proteins exhibited decreased levels and 2 proteins exhibited increased levels in the livers of tumor-bearing animals. N-Terminal sequencing analysis was used to identify these proteins, which were glucose-regulated protein 78, 2 isoforms of heat shock protein 60, and the beta-chain of ATP synthase for the down regulated proteins, and beta-Actin with a 46 amino acid deletion from its N-terminus and Vimentin with a 71 amino acid deletion from its N-terminus for the up regulated proteins. These data offer potentially new markers of liver tumorigenicity, particularly, Vimentin. (

To investigate the effect of dams' dietary fat type during pregnancy and lactation on fat choice of pups, three groups of dams were fed one of three diets: a low fat diet (LFD), a control diet (CTD) or a high fat diet (HFD). After weaning their pups were offered a self-selection regimen of both a fat protein diet (FPD) and a carbohydrate protein diet (CPD) for 3 wk. Although the ratio of FPD intake [FPD intake (g)/total intake (g)] by pups nursed by dams fed LFD during the self-selection period was higher than that by pups nursed by dams fed CTD and HFD, no significant difference in the ratio was observed between pups nursed by dams fed CTD and HFD. It was considered that pups nursed by dams fed CTD and HFD self-selected FPD and CPD in an adequate fat energy ratio (F ratio) compared to that of AIN-93G and AIN-93M. The ratio of FPD intake by pups of these three groups was 16-21% within the first week after weaning. Although pups nursed by dams fed CTD continued to consume the same ratio of FPD during the self-selection period, the ratio of pups nursed by dams fed LFD increased and that of pups nursed by dams fed HFD decreased. These findings indicate that: [1] pups nursed by dams fed CTD and HFD have the ability to consume FPD and CPD in an adequate F ratio, and [2] preferential fat intake of pups nursed by dams fed LFD is stronger than that of pups nursed by dams fed CTD and HFD.

若年者の魚嫌いが増加している原因を明らかにするため、成長期に摂取した油脂の差異が成熟後の脂質摂取嗜好に及ぼす影響を、低脂肪食飼料(LFD)と等カロリーになるよう調整したラードおよび魚油を添加した高脂肪食飼料(HFD)を用いて調べた。4週齢のFischer 344系雄ラットを、LFD(LFD群)、lard HFD(lard HFD群)、fish oil HFD(fish oil HFD群)で8週間飼育後、LFD群は3群に、HFD群は2群ずつに分け、各群1群ずつを解剖し血漿と肝臓の脂質濃度を測定した。残りのLFD群の1群とlard HFD群にはLFDとlard HFDを、他のLFD群とfish oil HFD群にはLFDとfish oil HFDを同時に与えて3週間選択摂取させた。全実験期間を通して、すべての群の摂取エネルギー量および体重に有意な差はみられなかった。HFD摂取割合は、LFD群、HFD群の両群とも、fish oil HFDがlard HFDに比べて有意に低かった。したがって、LFDとHFDを選択摂取させた場合、fish oil HFDの嗜好性はlard HFDに比べて低いことが明らかになった。(著者抄録)

自施設における栄養食事指導件数の推移,糖尿病の患者会の経緯と特徴,栄養指導のシステムと内容を報告した.入院中の栄養食事指導業務は,標準クリニカルパスにより実施し,特別治療食全患者を対象に行う.入院中は最低2回,1週間に1回程度の割合で病棟訪問を行い,回診の随行,ケアカンファランスでのディスカッションに基づいてケースバイケースで指導を行う.又,月4回開催される糖尿病教室や料理教室の説明,患者会活動について説明する.外来では月2回個別指導を行い,平成13年度の糖尿病の平均栄養指導回数は6.6回であった.患者会の治療内訳をみると,入会前は薬物療法が多かったが,入会後は減少し,食事療法が増えた.入会患者のHbA1cの推移は低下と上昇を繰り返す傾向にあった