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BACKGROUND: Physical activity (PA) provides substantial mental and physical health benefits for individuals of all ages. A limited number of long-term or longitudinal studies have investigated the association between psychosocial factors and PA in healthy older adults aged 65 and above. This study aimed to determine the long-term relationship between psychosocial factors, such as vitality, mental health, anxiety, and depression, and objectively measure PA in older adults. METHODS: Healthy participants from Nakanojo, Japan, aged 65-90, capable of walking, were included in this study and were followed up from 2008 to 2013. Those diagnosed with dementia and depression were excluded. Using a repeated cross-sectional dataset, a multilevel model was developed with psychosocial variables as independent variables and an average daily duration of PA volume of > 3 metabolic equivalents (METs) as the outcome. The Akaike information criterion was used to select the final model. RESULTS: This study included 1108 records from 319 participants. In the multilevel model, age (coefficient = -0.106, 95% confidence interval [CI] = -0.127 to -0.086, p < 0.001) and the Hospital Anxiety and Depression Scale depression scores (coefficient = -0.019, 95% CI = -0.036 to -0.002, p = 0.026) were negatively associated with the duration of PA volume > 3 METs, whereas male sex (coefficient = 0.343, 95% CI = 0.115 to 0.571, p = 0.003) was positively associated with PA volume. CONCLUSION: Depressive symptoms were related to a reduced duration of PA volume of > 3 METs among these adults aged 65 and above.

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The onset and worsening of some diseases are related to the variation and instability of gut microbiota. However, studies examining the personal variation of gut microbiota in detail are limited. Here, we evaluated the yearly variation of individual gut microbiota in 218 Japanese subjects aged 66-91 years, using Jensen-Shannon distance (JSD) metrics. Approximately 9% of the subjects showed a substantial change, as their formerly predominant bacterial families were replaced over the year. These subjects consumed fermented milk products less frequently than their peers. The relationship between the intake frequencies of fermented milk products containing Lactocaseibacillus paracasei strain Shirota (LcS) and JSD values was also investigated. The intra-individual JSD of subjects ingesting LcS products ≥ 3 days/week over the past 10 years was statistically lower than the < 3 days/week group (P = 0.045). Focusing on subjects with substantial gut microbiota changes, only 1.7% of the subjects were included in the LcS intake ≥ 3 days/week group whereas 11.3% were found in the < 3 days/week group (P = 0.029). These results suggest that about one-tenth of the elderly Japanese could experience a substantial change in their gut microbiota during a 1-year period, and that the habitual intake of probiotics may stabilize their gut microbiota.

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BACKGROUND: Japan, like many developed countries, now faces fiscal problems from the escalating health-care expenditures associated with an aging population. Mental health problems such as depression contribute as much to these growing demands as physical disease, and measures to prevent depression are important to controlling costs. There are few longitudinal studies examining the relation between objectively measured physical activity and depressive symptoms. Therefore, the aims of our study were to explore the patterns of change of physical activity in older Japanese adults for 5 years through the use of trajectory analysis and to examine the relation between physical activity trajectories and depressive mood states. MAIN BODY: Ninety-two male and 99 female volunteers aged 65-85 years were asked to equip themselves with an electronic accelerometer with a 60-day storage capacity for at least 5 years. The parameters calculated each July for the 5 years were the average daily step count and the average daily duration of activity > 3 METs (moderate to vigorous physical activity: MVPA). Hospital Anxiety and Depression Scale (HADS) assessed corresponding mood states (HADS-A and HADS-D). Trajectories of the accelerometer data were analyzed and fifth-year HADS-D and HADS-A scores were compared among trajectory groups using an analysis of covariance (ANCOVA) that controlled for baseline scores and for baseline scores and age. Six and five distinct trajectories were identified for daily step count and for daily duration of MVPA, respectively. Using ANCOVA controlling for baseline scores, HADS-D scores differed significantly among trajectory groups classed by daily duration of MVPA (p = 0.04), and Tukey's multiple comparison tests showed significant differences between group 2, whose pattern was stable with the middle duration of MVPA, and group 1, whose pattern was stable with the lowest duration of MVPA (p = 0.02), while the results were not significant controlling for both baseline scores and age. CONCLUSIONS: Older people with less MVPA continued to do less MVPA over the 5 years of study, which may be related to a future more depressive mood. Further clinical studies will be necessary to clarify these findings.

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Infrequent bowel movements decrease the number of beneficial bacteria in the human intestines, thereby potentially increasing the individual's risk of colorectal cancer. The correction of such bowel problems could therefore make an important contribution to improving population health and quality-adjusted lifespan. We examined independent and interactive effects upon the fecal microbiota of two potentially favorable determinants of intestinal motility: the intake frequency of a fermented milk product containing Lactobacillus casei strain Shirota (LcS) and the quantity/quality of habitual physical activity in 338 community-living Japanese aged 65-92 years. Subjects were arbitrarily grouped on the basis of questionnaire estimates of LcS intake (0-2, 3-5, and 6-7 days/week) and pedometer/accelerometer-determined patterns of physical activity [<7000 and ≥7000 steps/day, or <15 and ≥15 min/day of activity at an intensity >3 metabolic equivalents (METs)]. After adjustment for potential confounders, the respective numbers of various beneficial fecal bacteria tended to be larger in more frequent consumers of LcS-containing products, this trend being statistically significant (mostly P < 0.001) for total Lactobacillus, the Lactobacillus casei subgroup, and the Atopobium cluster; in contrast, there were no statistically significant differences in fecal bacterial counts between the physical activity groups. A multivariate-adjusted logistic regression analysis estimated that the risk of infrequent bowel movements (arbitrarily defined as defecating ≤3 days/week) was significantly lower (P < 0.05) in subjects who ingested LcS-containing products 6-7 rather than 0-2 days/week [odds ratio (95% confidence interval) 0.382 (0.149-0.974)] and was also lower in those who took ≥7000 rather than <7000 steps/day [0.441 (0.201-0.971)] or spent ≥15 rather than <15 min/day of physical activity at an intensity >3 METs [0.412 (0.183-0.929)]. The risk of infrequent bowel movements in subjects who combined 6-7 days/week of LcS with ≥7000 steps/day or ≥15 min/day of activity at >3 METs was only a tenth of that for individuals who combined 0-2 days/week of LcS with <7000 steps/day or <15 min/day at >3 METs. These results suggest that elderly individuals can usefully ingest LcS-containing supplements regularly (≥6 days/week) and also engage in moderate habitual physical activity (≥7000 steps/day and/or ≥15 min/day at >3 METs) in order to enhance their gastrointestinal health.

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BACKGROUND: An age-related decrease in functional capacity is consistently reported, but it is not consistently related to a worsening of health-related quality of life (HRQOL) or psychological adjustment. A poor functional capacity and HRQOL have been associated with anxiety or depression, but the possible causal nature and direction of the relationship remain to be explored using long-term longitudinal data. OBJECTIVE: The purpose of this study was to examine age-related changes in functional capacity, HRQOL, and scores on the Hospital Anxiety and Depression Scale (HADS), and possible causal interrelationships between these variables. METHODS: Study participants were 5,124 Japanese aged ≥65 years. After the baseline study (2003), annual follow-up observations continued for 10 years. Generalized linear mixed models examined age-related changes in Barthel index (BI), Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), HRQOL, and HADS. Cross-lagged effects models tested possible causal interrelationships. RESULTS: With age, functional capacity and HRQOL scores showed similar declines in both sexes. Changes in mental health, anxiety, and depression developed more slowly than decreases in physical health (BI, TMIG-IC, and physical functioning scores). Cross-lagged effects models demonstrated that functional capacity had positive effects on psychological adjustment, and that psychological adjustment had positive effects on functional capacity 5 years later. Interactions between functional capacity and psychological adjustment showed no sex differences. A decline in functional capacity negatively affected psychological adjustment, but reduced psychological adjustment had no significant impact on functional capacity 5 and 10 years later. Moreover, functional capacity and poor psychological adjustment showed no interactions in either sex. CONCLUSION: Functional capacity and mood state are interrelated. Greater function could sustain vitality and mental health, possibly reducing anxiety and depression.

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Relationships between habitual physical activity and sleep-related phenomena were examined in 623 male and 1022 female Japanese participating in the Nakanojo Community Study, using data collected in 2012-2013. Ages ranged from infancy to very old. Daily step count and daily duration of exercise at an intensity >3 metabolic equivalents (METs) were determined by pedometer/accelerometer, 24 h/day for 1 week. Duplicate axillary temperatures were also taken on rising and when retiring. Total bed time was noted, and the efficiency of sleep determined as hours of actual sleep (from a validated pedometer/accelerometer algorithm) divided by bed time. Step counts and especially duration of activity >3 METs peaked in teenagers and decreased as age advanced (p < 0.001). Both axillary temperatures subsequently showed a gradual age-related decline (p < 0.001). The duration and efficiency of sleep also showed a small age-dependent decrease (p < 0.001). Multivariate-adjusted correlation coefficients indicated a better quality of sleep in individuals who took greater habitual physical activity. In individuals aged ≥40 years, these findings were modified by chronic disease conditions including hypertension, diabetes mellitus and hyperlipemia; after controlling statistically for potential confounders, both physical activity and axillary temperature were lower (p < 0.05 or 0.01), and the time spent lying was longer but the efficiency of sleep was poorer (p < 0.01) in those with chronic conditions. These results suggest that habitual physical activity bears an important relationship to sleep-related phenomena at all ages, with a modification of relationships by chronic disease in people aged ≥40 years.

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OBJECTIVES: To examine dose/response relationships between habitual physical activity and bone health in the elderly. DESIGN: Longitudinal. SETTING: Community of Nakanojo. PARTICIPANTS: Community-living Japanese aged 65 to 84 (212 men, 284 women). MEASUREMENTS: Daily 24-h pedometer/accelerometer data were collected continuously for 5 years. A quantitative calcaneal osteosonic index (OSI) was determined annually. RESULTS: Year-end OSI values were higher in those with greater daily step counts and especially a greater duration of activity >3 metabolic equivalents (METs). However, after controlling for baseline OSI, age and body mass, final OSI values were not significantly greater in the fourth than in the third activity quartile, where men and women, respectively, took means of 7,700 and 7,500 steps/day and/or exercised at an intensity >3 METs for means of 19 and 17 min/day. A multivariate-adjusted proportional hazards model predicted that the OSI values of men and women were, respectively, 2.6 (1.4-4.4) and 3.3 (2.1-5.2) and/or 2.8 (1.5-5.6) and 3.9 (2.4-6.7) times more likely to drop below the OSI fracture threshold over 5 years in the two lowest activity quartiles (<7,000 and <6,900 steps/day and/or <18 and <17 min/day at >3 METs) than in the highest quartile (>9,100 and >8,800 steps/day and/or >30 and >25 min/day at >3 METs). CONCLUSION: After adjustment for potential confounders, the calcaneal health of seniors is associated with both the daily step count and the duration of activity at an intensity >3 METs. The bone health is optimal in elderly people who take at least 7,000-8,000 steps/day and/or spend at least 15-20 min/day at an intensity >3 METs.

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BACKGROUND: We examined the relative contributions of habitual physical activity and aerobic fitness to the prevention of arteriosclerosis. METHODS: Elderly individuals (97 men and 109 women, aged > 65 y) each wore a uniaxial activity monitor continuously for 1 year, with activity data summarized as an average daily step count and duration of activity > 3 metabolic equivalents (METs). Aerobic fitness was assessed by a standardized 5-m walking test measure of maximal walking speed. Central arterial stiffness was determined using an automatic waveform analyzer measure of cardio-femoral pulse wave velocity (cfPWV). RESULTS: The cfPWV was negatively associated with daily step count, duration of activity > 3 METs, and maximal walking speed (P < .05). Multiple stepwise regression analysis revealed that the step count, duration of activity > 3 METs, and maximal walking speed were all significant predictors of cfPWV, accounting for 11%, 7%, and 4% of total variance, respectively. CONCLUSIONS: In contrast to findings from studies using potentially fallible questionnaires, our data suggest that a measure of health (arterial stiffness) is more closely related to objective measures of physical activity than to an estimate of aerobic fitness.

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OBJECTIVES: To relate 5-year lean tissue loss to habitual physical activity of elderly adults. DESIGN: Longitudinal. SETTING: Community of Nakanojo. PARTICIPANTS: Community-living Japanese aged 65 to 84 (200 men, 268 women). MEASUREMENTS: Daily 24-hour pedometer/accelerometer data, collected continuously for 5 years, were categorized into activity quartiles. Bioelectrical impedance measurements of lean body mass were taken annually. A sarcopenia threshold was defined arbitrarily as an appendicular lean mass/height(2) of more than 1 standard deviation below the mean for healthy young Japanese. RESULTS: Subjects with greater habitual physical activity retained a greater lean mass over the 5 years of observation. Controlling for baseline lean mass and age, final lean mass was greater for the third activity quartile (men and women with respective mean counts of 7,800 and 7,700 steps per day or mean duration of exercise at >3 metabolic equivalents (METs) of 20 and 17 minutes per day) than for the first and second quartiles. A multivariate-adjusted proportional hazards model predicted that, over the 5 years, men and women in the two lowest activity quartiles (<6,700 and <6,800 steps per day) were 2.3 (95% confidence interval (CI) = 1.4-4.5) and 3.0 (95% CI = 1.9-3.4) times as likely, respectively, to be sarcopenic as those in the highest activity quartile (>9,000 and >8,400 steps per day). Likewise, men and women with less than 16 and less than 14 minutes per day, respectively, of activity of more than 3 METs were 3.0 (95% CI = 2.0-6.0) and 3.5 (95% CI = 2.1-6.3) times as likely to develop sarcopenia as those with more than 28 and more than 22 minutes per day. CONCLUSION: After adjustment for potential confounders, the risk of developing sarcopenia was substantially lower in elderly people taking at least 7,000 to 8,000 steps per day or exercising for at least 15 to 20 minutes per day at an intensity greater than 3 METs. Clinicians should encourage seniors to get at least this volume of regular daily exercise.

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BACKGROUND: Although genome-wide association studies (GWASs) have implicated several genes in the predisposition to chronic kidney disease (CKD) in Caucasian or African American populations, the genes that confer susceptibility to CKD in Asian populations remain to be identified definitively. We performed a GWAS to identify genetic variants that confer susceptibility to CKD in Japanese individuals. METHODS: 3851 Japanese individuals from three independent subject panels were examined. Subject panels A, B, and C comprised 252, 910, and 190 individuals with CKD and 249, 838, and 1412 controls, respectively. A GWAS for CKD was performed in subject panel A. RESULTS: Five single nucleotide polymorphisms (SNPs) at chromosome 3q28, ALPK1, FAM78B, and UMODL1 were significantly (false discovery rate<0.05) associated with CKD by the GWAS. The relation of these five SNPs and of an additional 22 SNPs at these loci to CKD was examined in subject panel B, revealing that rs9846911 at 3q28 was significantly associated with CKD in all individuals and that rs2074381 and rs2074380 in ALPK1 were associated with CKD in individuals with diabetes mellitus. These three SNPs were further examined in subject panel C, revealing that rs2074381 and rs2074380 were significantly associated with CKD. For subject panels B and C combined, rs9846911 was significantly associated with CKD in all individuals and rs2074381 and rs2074380 were associated with CKD in diabetic individuals. CONCLUSIONS: Chromosome 3q28 may be a susceptibility locus for CKD in Japanese individuals, and ALPK1 may be a susceptibility gene for CKD in such individuals with diabetes mellitus.

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We review sex differences in the relationship between habitual physical activity and health in the elderly, with particular reference to pedometer/accelerometer data from the Nakanojo Study. Maximal aerobic power, walking speed and habitual physical activity are 10-30% greater in men than in women. This reflects not only biological but also socio-cultural and environmental factors, with the latter becoming dominant as age advances. It implies a need for sex-specific thresholds of moderate activity. Overall health is associated with both the year-averaged daily step count (the best indicator in women) and the year-averaged daily duration of physical activity >3 metabolic equivalents (METs) (the best indicator in men). In both sexes, the threshold ranges of step count and/or duration of activity >3 METs associated with a reduced prevalence of health problems are: 4000-5000 steps/day and/or 5-7.5 min/day for impaired mental and psychosocial health, such as a depressed mood state and a poor health-related quality of life; 7000-8000 steps/day and/or 15-20 min/day for markers of aortic arteriosclerosis, osteoporosis, sarcopenia and poor physical fitness; and 8000-10,000 steps/day and/or 20-30 min/day for components of the metabolic syndrome, especially hypertension and hyperglycemia. Irrespective of sex, both the intensity and the total volume of physical activity are influenced by stressful life events, such as a partner's death, and immediate meteorological factors, particularly precipitation and mean ambient temperature, underlining the need for long-term measurement of activity patterns. These findings have practical implications for those who engage in epidemiological studies and/or design health promotional programs for the elderly.

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We previously showed that the -1131T→C polymorphism (rs662799) of the apolipoprotein A-V gene (APOA5) and the C→T polymorphism (rs6929846) of the butyrophilin, subfamily 2, member A1 gene (BTN2A1) were significantly associated with an increased serum concentration of triglycerides, a decreased serum concentration of high density lipoprotein (HDL)-cholesterol, and the prevalence of metabolic syndrome (MetS) in Japanese individuals. The purpose of the present study was to examine whether these polymorphisms synergistically affect the prevalence of dyslipidemia and MetS in East Asian populations. The study populations comprised 7471 Japanese and 3529 Korean individuals in the dyslipidemia study, and 3474 Japanese and 1671 Korean individuals in the MetS study. Multivariable logistic regression analysis of combined genotypes with adjustment for age, gender and diabetes mellitus revealed that rs662799 and rs6929846 significantly and synergistically affected dyslipidemia. Japanese or Korean individuals with the C allele of APOA5 and the T allele of BTN2A1 had a 2.05- or 1.92-fold increased risk for hypertriglyceridemia and a 1.82- or 1.56-fold increased risk for hypo-HDL-cholesterolemia, respectively, compared to those with the TT genotype of APOA5 and the CC genotype of BTN2A1. Similar analysis with adjustment for age and gender revealed that Japanese individuals, but not Korean individuals, with the C allele of APOA5 and the T allele of BTN2A1 had a 2.87-fold increased risk for MetS compared to those with the TT genotype of APOA5 and the CC genotype of BTN2A1. Genetic variants of APOA5 and BTN2A1 may synergistically affect the prevalence of dyslipidemia in East Asian populations and of MetS in Japanese individuals.

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Over the years, techniques for the study of human movement have ranged in complexity and precision from direct observation of the subject through activity diaries, questionnaires, and recordings of body movement, to the measurement of physiological responses, studies of metabolism and indirect and direct calorimetry. This article reviews developments in each of these domains. Particular reference is made to their impact upon the continuing search for valid field estimates of activity patterns and energy expenditures, as required by the applied physiologist, ergonomist, sports scientist, nutritionist and epidemiologist. Early observers sought to improve productivity in demanding employment. Direct observation and filming of workers were supplemented by monitoring of heart rates, ventilation and oxygen consumption. Such methods still find application in ergonomics and sport, but many investigators are now interested in relationships between habitual physical activity and chronic disease. Even sophisticated questionnaires still do not provide valid information on the absolute energy expenditures associated with good health. Emphasis has thus shifted to use of sophisticated pedometer/accelerometers, sometimes combining their output with GPS and other data. Some modern pedometer/accelerometers perform well in the laboratory, but show substantial systematic errors relative to laboratory reference criteria such as the metabolism of doubly labeled water when assessing the varied activities of daily life. The challenge remains to develop activity monitors that are sufficiently inexpensive for field use, yet meet required accuracy standards. Possibly, measurements of oxygen consumption by portable respirometers may soon satisfy part of this need, although a need for valid longer term monitoring will remain.

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The rising healthcare costs associated with an aging population have become an urgent fiscal problem. However, evidence of the efficacy of preventive programmes is limited, since almost all studies have involved only small numbers of highly selected participants. This article examines potential physical activity-induced decreases in healthcare expenses, applying a theoretical model to the Nakanojo Study of habitual physical activity and health in an entire elderly community. The Nakanojo Study has shown substantial associations of health with both step count and the duration of moderate effort (intensity >3 metabolic equivalents [METs]). Participants are classed as 'dependent' (n = 800) or 'independent' (n = 4400); the latter category is divided arbitrarily into quartiles, based on physical activity patterns (Q1-Q4; n = 1100 for each quartile). The five groups show a graded prevalence of various morbidities, including dependency, depression, osteoporosis, fractures, hypertension, diabetes mellitus, hyperlipidaemia, ischaemic heart diseases, cerebrovascular diseases, cancer and dementia. Consequently, annual healthcare expenditures (based on 2009 published Japanese costs associated with each of these conditions) differ by about yen (¥)197 900 ($US1979) per person between dependent individuals and those in group Q1, ¥20 700 ($US207) between Q1 and Q2, ¥14 600 ($US146) between Q2 and Q3, and ¥5300 ($US53) between Q3 and Q4. Accepting a causal relationship between physical activity and health, and assuming that an increase in physical activity induces a benefit that is uniform across conditions and diseases, respective morbidity prevalences and associated healthcare costs seem likely to decrease as physical activity increases. Thus, if the physical activity of only 5% of each group could be increased by a single ranking (pedometer/accelerometer scores of 2000 steps/day and 5-10 min/day at >3 METs and/or an adjusted questionnaire score of 10 MET hours/week), one might predict average savings across this population of about ¥12 600 ($US126) per person, or 3.7%, of total medical expenses, including ¥9800 ($US98) of public nursing care insurance costs and an additional ¥2800 ($US28) of national health insurance expenditures. The impact of various changes in the prevalence of physical activity can be simulated using our model. In principle, savings should increase if more people increase their physical activity, and/or the magnitude of individual increases in physical activity is greater. Nevertheless, our analysis suggests that if even a small fraction of individuals in the three least active groups were to make a single-rank increase in their habitual physical activity as a result of focused health support and the promotion of physical activity, a significant reduction in medical expenses might be anticipated, justifying investment in preventive programmes. We now propose to test the validity of the present simulations on a national basis, obtaining accurate and objective evidence of change in individual physical activity patterns using an advanced design of pedometer/accelerometer.

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BACKGROUND: The authors previously showed that the C→T polymorphism (rs6929846) of butyrophilin, subfamily 2, member A1 gene (BTN2A1) was significantly associated with myocardial infarction in Japanese individuals. Given that metabolic syndrome (MetS) is an important risk factor for myocardial infarction, the association of the rs6929846 of BTN2A1 with myocardial infarction might be attributable, at least in part, to its effect on susceptibility to MetS. AIM: The aim of the present study was to examine the relation of the rs6929846 of BTN2A1 to MetS in East Asian populations. METHODS: The study population comprised 5210 Japanese or Korean individuals (3982 individuals with MetS, 1228 controls) from three independent subject panels. Japanese subject panels A and B comprised 1322 individuals with MetS and 654 controls, and 1909 individuals with MetS and 170 controls, respectively, whereas the Korean population samples comprised 751 individuals with MetS and 404 controls. RESULTS: Comparison of genotype distributions using the χ(2) test revealed that the genotype distributions and allele frequencies of rs6929846 were significantly (p<0.05) associated with MetS in Japanese subject panels A (T allele frequency: MetS, 0.091; controls, 0.054; p=6.1×10(-5)) and B (T allele frequency: MetS, 0.091; controls, 0.039; p=0013) but not in the Korean population samples (T allele frequency: MetS, 0.102; controls, 0.125; p=0.0997). Multivariable logistic regression analysis with adjustment for covariates revealed that the rs6929846 of BTN2A1 was significantly (p<0.017) associated with MetS in Japanese subject panel A (p=0.0055, OR 1.97) and in all individuals (p=0.0038, OR 1.38), with the T allele representing a risk factor for this condition. CONCLUSION: BTN2A1 may be a susceptible gene for MetS in Japanese individuals.

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Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and including these background activities, the evidence suggests that 30 minutes of daily MVPA accumulated in addition to habitual daily activities in healthy older adults is equivalent to taking approximately 7,000-10,000 steps/day. Those living with disability and/or chronic illness (that limits mobility and or/physical endurance) display lower levels of background daily activity, and this will affect whole-day estimates of recommended physical activity.

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AIM: Although recent genetic studies suggested that several genetic variants increase the risk for chronic kidney disease (CKD), the genes that underlie genetic susceptibility to this condition remain to be identified definitively. We showed that the C→T polymorphism (rs6929846) of BTN2A1 and A→G polymorphism (rs2569512) of ILF3 were significantly associated with myocardial infarction in Japanese individuals by a genome-wide association study. The purpose of the present study was to examine a possible association of these polymorphisms (rs6929846, rs2569512) with CKD in Japanese individuals. METHODS: A total of 7542 Japanese individuals from two independent populations were examined: Subject panel A comprised 971 individuals with CKD (estimated glomerular filtration rate (eGFR) <60 mL/min 1.73 m(-2)) ) and 2269 controls (eGFR ≥60 mL/min 1.73 m(-2) ); and subject panel B comprised 1318 individuals with CKD and 2984 controls. RESULTS: The χ(2) test revealed that rs6929846 of BTN2A1, but not rs2569512 of ILF3, was significantly related to the prevalence of CKD both in subject panels A (P = 0.0383) and B (P = 0.0477). Multivariable logistic regression analysis with adjustment for covariates revealed that the C→T polymorphism (rs6929846) of BTN2A1 was significantly associated with the prevalence of CKD in subject panels A (P = 0.0422; recessive model; odds ratio, 2.36) and B (P = 0.0386; dominant model; odds ratio, 1.21) with the T allele representing a risk for this condition. CONCLUSION: Our results suggest that BTN2A1 may be a susceptibility gene for CKD in Japanese individuals.

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BACKGROUND: We previously showed that the C→T polymorphism (rs6929846) in butyrophilin, subfamily 2, member A1 gene (BTN2A1) was associated with myocardial infarction in Japanese individuals. Given that hypertension is a major risk factor for myocardial infarction, the association of rs6929846 of BTN2A1 with myocardial infarction might be attributable, at least in part, to its effect on susceptibility to hypertension. We have thus examined the relation of rs6929846 of BTN2A1 to hypertension in Japanese individuals. METHODS: A total of 8,567 Japanese individuals from two independent subject panels were examined: Subject panels A and B comprised 2,317 hypertensive individuals and 1,933 controls, and 2,911 hypertensive individuals and 1,406 controls, respectively. The genotype of rs6929846 was determined by a method that combines the PCR and sequence-specific oligonucleotide probes with suspension array technology. RESULTS: Multivariable logistic regression analysis with adjustment for covariates revealed that rs6929846 of BTN2A1 was significantly associated with hypertension in subject panel A (P = 2.6 × 10(-6); odds ratio, 1.69) and in subject panel B (P = 0.0284; odds ratio, 1.24), with the T allele representing a risk factor for hypertension. The rs6929846 was associated with systolic blood pressure (BP) in subject panels A (P = 0.0063) and B (P = 0.0115) and with diastolic BP in subject panel B (P = 0.0323), with the T allele being related to high BP. CONCLUSIONS: BTN2A1 may be a susceptibility gene for hypertension in Japanese individuals. Determination of genotype for this polymorphism may prove informative for assessment of the genetic risk for hypertension.

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Dyslipidemia is an important risk factor for myocardial infarction (MI). We previously showed that gene polymorphisms associated with MI differed among individuals with different lipid profiles. We also showed that rs6929846 of BTN2A1 and rs2569512 of ILF3 were significantly associated with MI in Japanese individuals. In the present study, we examined the relationship between rs6929846 of BTN2A1 or rs2569512 of ILF3 and MI in individuals with low or high serum concentrations of triglycerides, high density lipoprotein (HDL) cholesterol, or low density lipoprotein (LDL) cholesterol, respectively. The study population comprised 5513 unrelated Japanese individuals, including 1537 subjects with MI and 3976 controls. Multivariable logistic regression analyses with adjustment for covariates revealed that rs6929846 of BTN2A1 was significantly associated with MI in individuals with low (P=3.1 x 10-5; odds ratio, OR=1.66) or high (P = 1.1 x 10⁻6; OR = 2.09) triglycerides; in individuals with low (P = 0.0082; OR = 1.75) or high (P = 2.0 x 10⁻9; OR = 1.85) HDL cholesterol; and in individuals with low (P = 3.2 x 10⁻7; OR = 1.75) or high (P = 2.8 x 10⁻5; OR =2.18) LDL cholesterol. Similar analyses revealed that rs2569512 of ILF3 was significantly associated with MI in individuals with low (P = 0.0066; OR = 1.47) or high (P = 0.0013; OR = 1.88) triglycerides; in individuals with low (P = 0.0059; OR = 1.96) or high (P = 0.0020; OR = 1.51) HDL cholesterol; and in individuals with low (P = 0.0004, OR = 1.62) LDL cholesterol, but not in those with high LDL cholesterol. The results suggest that the relationship between rs6929846 of BTN2A1 or rs2569512 of ILF3 and MI is influenced by the serum concentrations of HDL and LDL cholesterol, respectively. Stratification of subjects according to lipid profiles may thus be useful for the personalized prevention of MI based on genetic information.

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