Publications by authors named "Sachiko Inoue"

53 Publications

Randomized, crossover clinical efficacy trial in humans and mice on tear secretion promotion and lacrimal gland protection by molecular hydrogen.

Sci Rep 2021 Mar 19;11(1):6434. Epub 2021 Mar 19.

Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan.

The incidence of dry eye disease is increasing worldwide because of the aging population and increasing use of information technology. Dry eye disease manifests as tear-layer instability and inflammation caused by osmotic hypersensitization in tear fluids; however, to our knowledge, no agent that treats both pathologies simultaneously is available. Molecular hydrogen (H) is known to be effective against various diseases; therefore, we aimed to elucidate the effects of H on tear dynamics and the treatment of dry eye disease. We revealed that administering a persistent H-generating supplement increased the human exhaled H concentration (p < 0.01) and improved tear stability (p < 0.01) and dry eye symptoms (p < 0.05) significantly. Furthermore, H significantly increased tear secretion in healthy mice (p < 0.05) and significantly suppressed tear reduction in a murine dry eye model (p = 0.007). H significantly and safely improved tear stability and dry eye symptoms in a small exploratory group of 10 human subjects, a subset of whom reported dry eye symptoms prior to treatment. Furthermore, it increased tear secretion rapidly in normal mice. Therefore, H may be a safe and effective new treatment for dry eye disease and thus larger trials are warranted.
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http://dx.doi.org/10.1038/s41598-021-85895-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979688PMC
March 2021

Associations of Social Capital with Mental Disorder Prevalence, Severity, and Comorbidity among U.S. Adolescents.

J Clin Child Adolesc Psychol 2021 Mar 3:1-12. Epub 2021 Mar 3.

Intramural Research Program, National Institute of Mental Health.

: To examine cross-sectional associations between social capital constructs and 1) adolescent lifetime mental disorders, 2) severity of functional impairment, and 3) psychiatric comorbidity.: Data were from the National Comorbidity Survey Adolescent Supplement, a nationally representative mental health survey of 6,483 U.S. adolescents aged 13-18 years. Information from fully-structured diagnostic interviews, including adolescent and caregiver reports, was used to measure seven social capital constructs and lifetime DSM-IV mental disorders (mood, anxiety, behavior, substance use and eating disorder classes). Disorder severity was divided into severe vs. mild/moderate. Comorbidity was measured as the number of different classes of lifetime mental disorders.: Adjusted for socio-demographics and caregivers' mental health, the most consistent associations with adolescent mental disorder were for supportive friendships (any disorder OR = 0.95, 95%CI = 0.91-0.99), family cohesion (OR = 0.81, 95%CI = 0.75-0.86), school bonding (OR = 0.76, 95%CI = 0.71-0.81), and extracurricular participation (OR = 0.90, 95%CI = 0.86-0.95), although results differed by disorder class. Caregiver-reported neighborhood trust and reciprocity and caregiver community involvement were less consistently associated with mental disorder. Medium levels of adolescent-reported affiliation with neighbors was associated with lower odds of mood (OR = 0.81, 95%CI = 0.66-0.98) and anxiety (OR = 0.78, 95%CI = 0.64-0.96) disorder, while high levels were associated with higher odds of behavior disorder (OR = 1.47, 95%CI = 1.16-1.87). Several associations were stronger for severe vs. mild/moderate disorder and with increasing comorbidity.: Although we cannot infer causality, our findings support the notion that improving actual and/or perceived social capital, especially regarding friendships, family, and school, (e.g., through multimodal interventions) could aid in the prevention and treatment of both individual adolescent mental disorders and psychiatric comorbidity.
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http://dx.doi.org/10.1080/15374416.2021.1875326DOI Listing
March 2021

Role of transient receptor potential melastatin 8 activity in menthol-induced cold sensitivity and its qualitative perception in dry eye.

Ocul Surf 2021 01 27;19:307-312. Epub 2020 Oct 27.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Tsubota Laboratory, Inc., Tokyo, Japan.

Purpose: To evaluate the role of transient receptor potential melastatin 8 (TRPM8) activity in menthol-induced cold sensitivity and its qualitative perception in patients with dry eye (DE).

Methods: This prospective, cross-sectional, comparative study included 52 eyes of 52 subjects (mean age: 66.8 ± 9.2 years; range: 44-86) with a tear break-up time (TBUT) of ≤5 s. The participants were classified into three groups: 17 patients with DE symptoms and keratoconjunctival (KC) staining scores of ≥3 points (positive KC-DE group), 18 patients with DE symptoms and KC staining scores of <3 points (negative KC-DE group), and 17 individuals with KC staining scores of <3 points and no symptoms (non-DE control group). The menthol-induced cool sensation (M-cool) and TBUT were measured after administration of 2 μl of 1.0 mM menthol eye drops. Furthermore, participants answered a questionnaire regarding their stimulus perception (pleasant, unpleasant, or neither).

Results: M-cool values were similar in the three groups. TBUT significantly increased in the negative KC-DE and control groups (P < 0.05) and remained unchanged in the positive KC-DE group (P > 0.05) after menthol administration. DE patients reported the sensation as pleasant or unpleasant, whereas most control participants were indifferent (P < 0.05).

Conclusions: While M-cold sensitivity was similar in DE and control groups, its qualitative perception differed between these groups. Thus, TRPM8 activation at the peripheral level alone may not be sufficient to account for the manifestation of discomfort symptoms associated with DE.
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http://dx.doi.org/10.1016/j.jtos.2020.10.008DOI Listing
January 2021

Investigation of Meibomian Gland Function and Dry Eye Disease in Patients with Graves' Ophthalmopathy.

J Clin Med 2020 Aug 31;9(9). Epub 2020 Aug 31.

Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

We prospectively evaluated the relationship between meibomian gland dysfunction (MGD) and Graves' ophthalmopathy (GO) in 19 patients (38 eyes) with subjective dry eye symptoms, compared to 14 age-matched normal participants (14 eyes). Extraocular muscle and lacrimal gland enlargement were evaluated by magnetic resonance imaging (MRI). Ocular surface examinations included fluorescein staining for keratoconjunctival epithelial damage, tear breakup time (TBUT) evaluation, and Schirmer's test. Dry eye symptoms were evaluated with the Dry Eye-related Quality-of-Life Score (DEQS) questionnaire. Lid-margin abnormalities, meibum grade, and meiboscores were assessed using meibography. Clinical activity scores and T2 signal intensity ratios were used to define GO activity. All GO patients had obstructive MGD and 79% exhibited levator muscle enlargement. Ocular surface parameters of TBUT ( = 0.000), meibum score ( = 0.000), eyelid vasculitis ( = 0.000), meiboscore of the upper lid ( = 0.002), total meiboscores ( = 0.001), and DEQS ( = 0.000) significantly differed between GO patients and normal subjects. In addition, GO patients had significantly more abnormalities of the central region of the upper eyelid than normal subjects ( = 0.000). Thus, MGD might be related to eye discomfort and deterioration of the ocular surface in GO patients. Inflammation and morphological meibomian gland changes might be characteristic of GO.
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http://dx.doi.org/10.3390/jcm9092814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565905PMC
August 2020

Morphological Changes of Meibomian Glands in Men With Benign Prostate Hyperplasia.

Cornea 2020 Aug 19. Epub 2020 Aug 19.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

Purpose: Meibomian glands are subject to regulation by sex hormones. We have now investigated the possible relation between benign prostate hyperplasia (BPH) and meibomian gland dysfunction (MGD).

Methods: Men diagnosed with BPH and receiving treatment with tamsulosin and age-matched male control subjects who attended Itoh Clinic, Saitama, Japan, were enrolled. An ocular symptom score, lid margin abnormality score, and superficial punctate keratopathy score as well as the meiboscore (0-6), meibum grade, breakup time of the tear film, and Schirmer test values were evaluated. Male pattern baldness was also graded according to the Hamilton-Norwood scale.

Results: Forty-four eyes of 44 men with BPH (mean age ± SD, 76.1 ± 2.2 years) and 46 eyes of 46 control subjects (mean age ± SD, 75.3 ± 6.2 years) were enrolled. The meiboscore in the BPH group (4.5 ± 1.4) was significantly higher than that in the control group (1.8 ± 1.5, P < 0.0001). Breakup time of the tear film was significantly shorter (3.6 ± 1.7 vs. 5.6 ± 2.5 seconds, P < 0.0001), and Schirmer test value was significantly smaller (9.8 ± 4.8 vs. 13.3 ± 8.0 mm, P = 0.048) in the BPH group than that in the control group. Other ocular parameters did not differ significantly between the 2 groups. The proportion of men with androgenic alopecia was also higher in the BPH group than that in the control group.

Conclusions: BPH was associated with meibomian gland loss and instability of the tear film as well as with the presence of androgenic alopecia.
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http://dx.doi.org/10.1097/ICO.0000000000002454DOI Listing
August 2020

Morphological Changes of Meibomian Glands in Men With Benign Prostate Hyperplasia.

Cornea 2020 Aug 19. Epub 2020 Aug 19.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

Purpose: Meibomian glands are subject to regulation by sex hormones. We have now investigated the possible relation between benign prostate hyperplasia (BPH) and meibomian gland dysfunction (MGD).

Methods: Men diagnosed with BPH and receiving treatment with tamsulosin and age-matched male control subjects who attended Itoh Clinic, Saitama, Japan, were enrolled. An ocular symptom score, lid margin abnormality score, and superficial punctate keratopathy score as well as the meiboscore (0-6), meibum grade, breakup time of the tear film, and Schirmer test values were evaluated. Male pattern baldness was also graded according to the Hamilton-Norwood scale.

Results: Forty-four eyes of 44 men with BPH (mean age ± SD, 76.1 ± 2.2 years) and 46 eyes of 46 control subjects (mean age ± SD, 75.3 ± 6.2 years) were enrolled. The meiboscore in the BPH group (4.5 ± 1.4) was significantly higher than that in the control group (1.8 ± 1.5, P < 0.0001). Breakup time of the tear film was significantly shorter (3.6 ± 1.7 vs. 5.6 ± 2.5 seconds, P < 0.0001), and Schirmer test value was significantly smaller (9.8 ± 4.8 vs. 13.3 ± 8.0 mm, P = 0.048) in the BPH group than that in the control group. Other ocular parameters did not differ significantly between the 2 groups. The proportion of men with androgenic alopecia was also higher in the BPH group than that in the control group.

Conclusions: BPH was associated with meibomian gland loss and instability of the tear film as well as with the presence of androgenic alopecia.
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http://dx.doi.org/10.1097/ICO.0000000000002454DOI Listing
August 2020

Capsaicin-induced pain sensitivity in short tear break-up time dry eye.

Ocul Surf 2020 10 24;18(4):620-626. Epub 2020 Jul 24.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Tsubota Laboratory Inc., Tokyo, Japan.

Purpose: To evaluate transient receptor potential vanilloid 1 (TRPV1)-mediated pain sensitivity in patients with short tear break-up time (TBUT) dry eye (DE) by using the capsaicin stimulus test.

Methods: This prospective cross-sectional comparative study included 22 eyes of 22 patients with short TBUT DE and 11 eyes of 11 non-DE control subjects. Patients were divided into two groups based on response to standard DE treatments: 10 non-responders (intractable DE) and 12 responders (responsive DE). Mechanical touch (M-touch) and mechanical pain (M-pain) were measured using a Cochet-Bonnet esthesiometer. Capsaicin-induced pain (C-pain) and C-pain duration (C-pain DT) were measured using a capsaicin stimulus test. Psychological distress was also assessed.

Results: M-touch sensitivity was similar among all three groups. M-pain sensitivity was higher in the responsive DE group than in the intractable DE and control groups (P < .001). C-pain sensitivity was lower (P < .001) in the intractable DE group than in the responsive DE and control groups, and C-pain DT was shorter (P = .006) in the intractable DE group than in the responsive DE group. Psychological distress was higher in the intractable DE group than in the control group (P < .001).

Conclusions: Patients with intractable short TBUT DE were less sensitive to the effects of capsaicin than patients with responsive short TBUT DE and controls. Altered neural activation may contribute to the development of DE symptoms in the short TBUT DE subjects. The capsaicin stimulus test may be used to better understand pain sensitivity in short TBUT DE patients.
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http://dx.doi.org/10.1016/j.jtos.2020.07.008DOI Listing
October 2020

Capsaicin-induced pain sensitivity in short tear break-up time dry eye.

Ocul Surf 2020 10 24;18(4):620-626. Epub 2020 Jul 24.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Tsubota Laboratory Inc., Tokyo, Japan.

Purpose: To evaluate transient receptor potential vanilloid 1 (TRPV1)-mediated pain sensitivity in patients with short tear break-up time (TBUT) dry eye (DE) by using the capsaicin stimulus test.

Methods: This prospective cross-sectional comparative study included 22 eyes of 22 patients with short TBUT DE and 11 eyes of 11 non-DE control subjects. Patients were divided into two groups based on response to standard DE treatments: 10 non-responders (intractable DE) and 12 responders (responsive DE). Mechanical touch (M-touch) and mechanical pain (M-pain) were measured using a Cochet-Bonnet esthesiometer. Capsaicin-induced pain (C-pain) and C-pain duration (C-pain DT) were measured using a capsaicin stimulus test. Psychological distress was also assessed.

Results: M-touch sensitivity was similar among all three groups. M-pain sensitivity was higher in the responsive DE group than in the intractable DE and control groups (P < .001). C-pain sensitivity was lower (P < .001) in the intractable DE group than in the responsive DE and control groups, and C-pain DT was shorter (P = .006) in the intractable DE group than in the responsive DE group. Psychological distress was higher in the intractable DE group than in the control group (P < .001).

Conclusions: Patients with intractable short TBUT DE were less sensitive to the effects of capsaicin than patients with responsive short TBUT DE and controls. Altered neural activation may contribute to the development of DE symptoms in the short TBUT DE subjects. The capsaicin stimulus test may be used to better understand pain sensitivity in short TBUT DE patients.
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http://dx.doi.org/10.1016/j.jtos.2020.07.008DOI Listing
October 2020

The validity of ICD-11 PTSD and Complex PTSD in East Asian cultures: findings with young adults from China, Hong Kong, Japan, and Taiwan.

Eur J Psychotraumatol 2020 30;11(1):1717826. Epub 2020 Jan 30.

School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK.

: The ICD-11 classifies posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as two distinct diagnoses. Few studies have tested the validity of ICD-11 CPTSD in non-Western settings, particularly in Asia. : This study assessed the factorial, concurrent, and discriminant validity of CPTSD symptoms with four samples of young adults from mainland China, Hong Kong, Japan, and Taiwan. : Young adults aged 18-24 years were recruited by convenience sampling and provided their data anonymously online. Study measures included the International Trauma Questionnaire (ITQ) to measure PTSD and CPTSD, and measures of childhood adversity, depression, anxiety, age, and sex. Confirmatory factor analysis (CFA) was performed for each sample to evaluate the validity of two CPTSD measurement models. Structural equation modelling (SEM) was used to determine the multivariate associations between study variables for the full sample. : A total of 1,346 young adults completed the survey. CFA showed both models of CPTSD examined fit the data well across all four samples. SEM findings showed that number of childhood adversities significantly associated with both PTSD and CPTSD factors; depression significantly associated with CPTSD factors but not PTSD, whereas anxiety significantly associated with both. : Study findings provide evidence for PTSD and CPTSD as separate and valid diagnoses in Asia. More cross-cultural comparisons are needed to understand whether risks for either condition differ by geographical or sociocultural norms.
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http://dx.doi.org/10.1080/20008198.2020.1717826DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034426PMC
January 2020

The Relationship of Dry Eye Disease with Depression and Anxiety: A Naturalistic Observational Study.

Transl Vis Sci Technol 2018 Nov 28;7(6):35. Epub 2018 Dec 28.

Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.

Purpose: In recent years, the relationship between dry eye disease (DED) and psychiatric disorders has been gaining attention. The relationship between dry eye symptoms and psychiatric symptoms has been reported in multiple retrospective studies. However, in previous studies there have been limitations to these observations, such as a lack of close examination of either DED or mood symptoms.

Methods: In this study, we evaluated the psychological state and social functionality of DED patients by administering validated psychiatric tests as well as ophthalmologic examinations twice during the course of DED treatment. Forty subjects (61.3 ± 18.1-years old) received the primary psychiatric assessments and 26 received the secondary psychiatric assessments.

Results: In a cross-sectional examination, we found patients with depressive and/or anxiety symptoms had higher Dry Eye Related Quality of Life Score (DEQ) scores, whereas the objective symptoms of DED did not differ between groups. We also found a positive relationship between depression/anxiety scores and DED subjective symptoms. On the other hand, in longitudinal examination, we found psychiatric symptoms had no impact on subjective and objective DED symptoms throughout the course of DED symptoms.

Conclusions: We found depression and anxiety were related to the subjective symptoms of DED but not the objective symptoms.

Translational Relevance: It is important to pay attention to psychiatric symptoms in patients with DED and an investigation into appropriate treatment strategies for patients with DED in combination with psychiatric symptoms is needed in the future.
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http://dx.doi.org/10.1167/tvst.7.6.35DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314109PMC
November 2018

Life Satisfaction, Interpersonal Relationships, and Learning Influence Withdrawal from School: A Study among Junior High School Students in Japan.

Int J Environ Res Public Health 2018 10 20;15(10). Epub 2018 Oct 20.

Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, 1-1-1Tsushimanaka, Kita-ku, Okayama 700-8350, Japan.

School absenteeism, particularly among junior high school students, has increased annually in Japan. This study demonstrates the relationship between subjective adjustment to school life and students' absenteeism. Data were collected from 17,378 junior high school students in Japan. A longitudinal design was used for the study. Teachers were asked to distribute the Adaptation Scale for School Environments on Six Spheres (ASSESS) questionnaire to junior high school students and ask the students to fill out the questionnaire at the beginning of the 2014 academic year in April 2014, and the relationship between their subjective adjustment and absenteeism as measured by the total number of absent days during the 2014 academic year was evaluated by logistic regression and a survival analysis model. Low life satisfaction was associated with absences. The corresponding odds ratio (OR) was higher for seventh graders (OR 3.29, confidence interval (CI): 2.41⁻4.48, hazard ratio (HR) 5.57, CI: 3.51⁻8.84) than for students in other grades. Interpersonal relationships were significantly related to absenteeism for seventh and eighth graders in the group with scores less than 39 points. Lower adjustment to learning seemed to be related to absenteeism for seventh and eighth graders. For effective interventions, a well-designed study that uses detailed information regarding life-related covariates is necessary.
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http://dx.doi.org/10.3390/ijerph15102309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210206PMC
October 2018

Assessment of physical inactivity and locomotor dysfunction in adults with visual impairment.

Sci Rep 2018 08 13;8(1):12032. Epub 2018 Aug 13.

National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

To evaluate the association between vision-related quality of life (QoL), physical inactivity, and locomotor dysfunction in subjects with visual impairment.This cross-sectional study included 215 visually impaired subjects recruited from six ophthalmology departments in Japan. The physical inactivity and locomotor dysfunction associated with their visual impairment was investigated. The physical activity level was assessed using the short form of the International Physical Activity Questionnaire and classified as high, moderate, or low. Locomotor function was evaluated with the Geriatric Locomotive Function Scale. Vision-related QoL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire. Background data, including for age, sex, best-corrected visual acuity for each eye, causative eye diseases, systemic comorbidities, and body mass index, were also collected.The average patient age was 69.6 (range, 20-93 years; standard deviation, 14.5 years) and 118 patients (54.9%) were men. Multivariate analysis showed that vision-related QoL and best-corrected visual acuity in the worse eye were significantly associated with physical inactivity and that vision-related QoL, female sex, age, and presence of systemic comorbidity were significantly associated with locomotor dysfunction. Vision-related quality of life is associated with physical inactivity and locomotor dysfunction.
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http://dx.doi.org/10.1038/s41598-018-30599-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089939PMC
August 2018

Physical Health Care for People with Severe Mental Illness: the Attitudes, Practices, and Training Needs of Nurses in Three Asian Countries.

Int J Environ Res Public Health 2018 02 15;15(2). Epub 2018 Feb 15.

Department of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, 3086, Australia.

People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses' attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses' attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI.
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http://dx.doi.org/10.3390/ijerph15020343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858412PMC
February 2018

National data showed that delayed sleep in six-year-old children was associated with excessive use of electronic devices at 12 years.

Acta Paediatr 2018 08 22;107(8):1439-1448. Epub 2018 Feb 22.

Department of Nursing Science, Okayama Prefectural University Graduate School of Health and Welfare Science, Okayama, Japan.

Aim: Cross-sectional studies have shown associations between adolescent sleep problems and the use of electronic devices, such as mobile phones, but longitudinal studies remain scarce. We explored any association between delayed bedtimes at six years old and the excessive use of electronic devices at 12 years of age. Texting was a prime focus.

Methods: We analysed 9607 adolescents who owned mobile phones in 2013 using the Japanese Longitudinal Survey of Newborns in the 21st Century, which started in 2001. The outcomes were daily excessive use of a mobile phone, television (TV) and video games.

Results: Delayed bedtime at the age of six years was associated with excessive texting at weekends. The adjusted odds ratios and 95% confidence intervals obtained from logistic regression analyses were 1.88 (1.14-3.10) for the 10-11 pm group and 1.98 (1.08-3.63) for the after 11 pm group, compared with the before 9 pm group. Later bedtimes were also associated with increased risks of excessive TV viewing and video game use.

Conclusion: Our study indicated that six-year-olds who regularly stayed up late at night used electronic devices more frequently, or for longer, at the age of 12. Parents need to be more aware of links between sleep issues and electronic devices.
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http://dx.doi.org/10.1111/apa.14255DOI Listing
August 2018

Association of maternal age with child health: A Japanese longitudinal study.

PLoS One 2017 24;12(2):e0172544. Epub 2017 Feb 24.

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.

Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children's health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554). We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children's unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers <25 years, odds ratios of hospital admission at 18 months were 0.97 [95% CI: 0.86, 1.09], 0.92 [0.81, 1.05], 0.76 [0.65, 0.90], and 0.71 [0.51, 0.98] for mothers aged 25.0-29.9, 30.0-34.9, 35.0-39.9, and >40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172544PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325269PMC
August 2017

Clinical Evaluation of a Royal Jelly Supplementation for the Restoration of Dry Eye: A Prospective Randomized Double Blind Placebo Controlled Study and an Experimental Mouse Model.

PLoS One 2017 6;12(1):e0169069. Epub 2017 Jan 6.

Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Background: Dry eye is a multifactorial disease characterized by ocular discomfort and visual impairment. Lacrimal gland function has been shown to decrease with aging, a known potent risk factor for dry eye. We have previously found that orally administrated royal jelly (RJ) restored tear secretion in a rat model of dry eye.

Methods And Findings: We examined the effects of RJ oral administration on dry eye in this prospective, randomized, double-blind, placebo-controlled study. Forty-three Japanese patients aged 20-60 years with subjective dry eye symptoms were randomized to an RJ group (1200 mg/tablet, six tablets daily) or a placebo group for 8 weeks. Keratoconjunctival epithelial damage, tear film break-up time, tear secretion volume, meibum grade, biochemical data, and subjective dry eye symptoms based on a questionnaire were investigated at baseline, and at 4 and 8 weeks after intervention. Adverse events were reported via medical interviews. In the RJ group, tear volume significantly increased after intervention (p = 0.0009). In particular, patients with a baseline Schirmer value of ≤10 mm showed a significant increase compared with baseline volume (p = 0.0005) and volume in the placebo group (p = 0.0051). No adverse events were reported. We also investigated the effect of RJ (300 mg/kg per day) administration using a mouse model of dry eye. Orally repeated administration of RJ preserved tear secretion, potentially through direct activation of the secretory function of the lacrimal glands.

Conclusion: Our results suggest that RJ improves tear volume in patients with dry eye.

Trial Registration: Registered NO. the University Hospital Medical Information Network in Japan (UMIN000014446).
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169069PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217957PMC
August 2017

DRESS Syndrome Caused by Cross-reactivity Between Vancomycin and Subsequent Teicoplanin Administration: A Case Report.

Am J Case Rep 2016 Aug 30;17:625-31. Epub 2016 Aug 30.

Department of Pharmaceutical Care and Health Sciences, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan.

BACKGROUND Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening syndrome comprising severe skin eruption, fever, eosinophilia, lymphadenopathy, and involvement of internal organs. Here, we describe a case of DRESS syndrome caused by cross-reactivity between vancomycin and subsequent teicoplanin administration. CASE REPORT A 79-year-old male was admitted to our hospital for the treatment of injuries incurred in a traffic accident. Eosinophilia and lung dysfunction appeared after vancomycin administration. These symptoms were improved temporarily by withdrawal of vancomycin and administration of corticosteroid, but exacerbated by subsequent teicoplanin administration. These symptoms disappeared after discontinuation of teicoplanin. Based on comprehensive assessment of the overall clinical course, we judged that DRESS syndrome was induced by cross-reactivity between vancomycin and subsequent teicoplanin administration. Using the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) scoring system, we categorized DRESS syndrome related to vancomycin and teicoplanin as "probable." We describe, for the first time, DRESS syndrome (defined using the RegiSCAR scoring system) caused by cross-reactivity between vancomycin and subsequent teicoplanin administration. CONCLUSIONS Clinicians should be aware that DRESS syndrome can be induced by cross-reactivity between vancomycin and teicoplanin.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012458PMC
http://dx.doi.org/10.12659/ajcr.899149DOI Listing
August 2016

Children's Media Use and Self-Regulation Behavior: Longitudinal Associations in a Nationwide Japanese Study.

Matern Child Health J 2016 10;20(10):2084-99

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Objective The effect of media use on child behavior has long been a concern. Although studies have shown robust cross-sectional relations between TV viewing and child behavior, longitudinal studies remain scarce. Methods We analyzed the Longitudinal Survey of Babies, conducted by Japan's Ministry of Health, Labour and Welfare since 2001. Among 53,575 families, 47,010 responded to the baseline survey; they were followed up every year for 8 years. Complete data were available for longitudinal analysis among 32,439 participants. Daily media use (TV viewing and video game-playing hours at ages 3, 4, and 5 years) was used as the main exposure. We employed an index of the children's self-regulatory behavior as the outcome variable. Odds ratios and 95 % confidence intervals (CIs) were estimated. Results Among boys, longer TV-viewing times at ages 4 and 5 were related to problematic self-regulatory behavior. Compared with boys who watched just 1-2 h of TV a day, those who watched it 4-5 h had a 1.79-fold greater risk (CI 1.22-2.64) of problematic self-regulatory behavior, according to parental report. Among girls, similar results were evident at ages 4 and 5 (e.g., adjusted odds ratios for 4-5 h daily viewing versus 1-2 h at age 4: 2.59; 95 % CI 1.59-4.22). Video games may have a protective effect on the risk of problematic self-regulatory behavior at ages 3 and 5. Conclusion Longer daily exposure to TV during early childhood (age 4-5) may be associated with subsequent problematic child self-regulatory behavior.
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http://dx.doi.org/10.1007/s10995-016-2031-zDOI Listing
October 2016

Impact of maternal and paternal smoking on birth outcomes.

J Public Health (Oxf) 2017 09;39(3):1-10

Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.

Background: The adverse effects of maternal and paternal smoking on child health have been studied. However, few studies demonstrate the interaction effects of maternal/paternal smoking, and birth outcomes other than birth weight have not been evaluated. The present study examined individual effects of maternal/paternal smoking and their interactions on birth outcomes.

Methods: A follow-up hospital-based study from pregnancy to delivery was conducted from 1997 to 2010 with parents and newborn infants who delivered at a large hospital in Hamamatsu, Japan. The relationships between smoking and growth were evaluated with logistic regression.

Results: The individual effects of maternal smoking are related to low birth weight (LBW), short birth length and small head circumference. The individual effects of paternal smoking are related to short birth length and small head circumference. In the adjusted model, both parents' smoking showed clear associations with LBW (odds ratio [OR] = 1.64, 95% confidence interval [CI] 1.18-2.27) and short birth length (-1 standard deviation [SD] OR = 1.38, 95% CI 1.07-1.79; -2 SD OR = 2.75, 95% CI 1.84-4.10).

Conclusions: Maternal smoking was significantly associated with birth weight and length, but paternal smoking was not. However, if both parents smoked, the risk of shorter birth length increased.
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http://dx.doi.org/10.1093/pubmed/fdw050DOI Listing
September 2017

The association between legal Japanese visual impairment grades and vision-related quality of life.

Jpn J Ophthalmol 2016 May 14;60(3):219-25. Epub 2016 Mar 14.

National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

Purpose: This study examines the relationship between quality of life (QOL) and the legal Japanese grade of visual impairment as defined by the Physically Disabled Persons Welfare Act.

Methods: Participants of this cross-sectional study were 98 Japanese patients legally classified as visually impaired, from six ophthalmology departments. Vision-related QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). The short Japanese version of this questionnaire (VFQ-J11) score was calculated from the VFQ-25 results for each participant. Health utility was measured using the EuroQoL Index (EQ-5D). Data were collected for age, gender, vision-disability level, the corrected visual acuity of each eye, and disease type.

Results: The mean age was 66.8 years (SD = 17.8). Visual impairment grade was significantly associated with VFQ-J11 score and the composite score developed from the VFQ-25 (p < 0.001), but not with the health utility score obtained from the EQ-5D.

Conclusions: In general, the Japanese legally designated grading system for visual impairment reflects the degree of vision-related QOL, but does not reflect general health utility as determined by the EQ-5D.
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http://dx.doi.org/10.1007/s10384-016-0437-1DOI Listing
May 2016

Association between Short Maternal Height and Low Birth Weight: a Hospital-based Study in Japan.

J Korean Med Sci 2016 Mar 15;31(3):353-9. Epub 2016 Feb 15.

Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA .

Anthropometry measurements, such as height and weight, have recently been used to predict poorer birth outcomes. However, the relationship between maternal height and birth outcomes remains unclear. We examined the effect of shorter maternal height on low birth weight (LBW) among 17,150 pairs of Japanese mothers and newborns. Data for this analysis were collected from newborns who were delivered at a large hospital in Japan. Maternal height was the exposure variable, and LBW and admission to the neonatal intensive care unit were the outcome variables. Logistic regression models were used to estimate the associations. The shortest maternal height quartile (131.0-151.9 cm) was related to LBW (OR 1.91 [95% CI 1.64, 2.22]). The groups with the second (152.0-157.9 cm) and the third shortest maternal height quartiles (158.0-160.9 cm) were also related to LBW. A P trend with one quartile change also showed a significant relationship. The relationship between maternal height and NICU admission disappeared when the statistical model was adjusted for LBW. A newborn's small size was one factor in the relationship between shorter maternal height and NICU admission. In developed countries, shorter mothers provide a useful prenatal target to anticipate and plan for LBW newborns and NICU admission.
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http://dx.doi.org/10.3346/jkms.2016.31.3.353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779858PMC
March 2016

Dietary Supplementation with a Combination of Lactoferrin, Fish Oil, and Enterococcus faecium WB2000 for Treating Dry Eye: A Rat Model and Human Clinical Study.

Ocul Surf 2016 04 18;14(2):255-63. Epub 2016 Jan 18.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

Purpose: To examine the effect of a combined dietary supplement containing fish oil, lactoferrin, zinc, vitamin C, lutein, vitamin E, γ-aminobutanoic acid, and Enterococcus faecium WB2000 on dry eye.

Methods: A preliminary study in a rat model and a prospective, randomized, double-blind, placebo-controlled study in humans were conducted. Forty Japanese volunteers aged 22 to 59 years were randomized into combined dietary supplement (2 capsules/day; 20 participants) and placebo (vehicle; 19 participants) groups and treated once daily for 8 weeks. Rats received the combined dietary supplement components (10 or 50 mg/kg orally) or vehicle (2% DMSO), and dry eye was mechanically induced for 2 days. Tear production was measured in rats after dry eye was induced. Humans were assessed at baseline and weeks 4 and 8 post-supplementation based on keratoconjunctival epithelial damage; fluorescein tear film breakup time; tear production; biochemical data; information regarding subjective dry eye symptoms by answering a questionnaire; and information regarding adverse events via medical interviews.

Results: Supplementation dose-dependently mitigated the decrease in tear production in rats. Among subjects with confirmed dry eye, clinical symptoms improved at weeks 4 and 8 more significantly in the supplementation group than in the placebo group (P<.05). The rate of increase in the Schirmer value was greater in the supplementation group. No adverse events occurred.

Conclusion: Supplementation improved objective and subjective dry eye symptoms.
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http://dx.doi.org/10.1016/j.jtos.2015.12.005DOI Listing
April 2016

Association of breast feeding with early childhood dental caries: Japanese population-based study.

BMJ Open 2015 Mar 20;5(3):e006982. Epub 2015 Mar 20.

Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA.

Objectives: We investigated the association between breastfeeding duration during the first half year of life and the risk of early childhood caries from the age of 30 to 66 months in Japan.

Design: Observational study of a longitudinal survey.

Setting: A secondary data analysis of the Japanese Longitudinal Survey of Babies in the 21st Century.

Participants: 43,383 infants at the age of 6 months.

Outcome Measures: Early childhood caries--defined as a child's visit to a dentist for treatment of dental caries during the past 12 months--was ascertained from the caregiver from the age of 30 months in the survey. We estimated the risk of dental caries each year according to duration of breast feeding using logistic regression analyses. We controlled for a set of biological factors (birth weight, sex, parity and maternal age at delivery) and socioeconomic factors (maternal educational attainment and smoking status, marital status at delivery, family income and region of birth and residence).

Results: We found that infants who had been breast fed for at least 6 or 7 months, both exclusively and partially, were at elevated risk of dental caries at the age of 30 months compared with those who had been exclusively formula fed. Adjusted ORs were 1.78 (95% CI, (1.45 to 2.17)) for the exclusively breastfed group and 1.39 (1.14 to 1.70) for the partially breastfed group. However, the associations became attenuated through the follow-up period and were no longer statistically significant beyond the age of 42 months for the partially breastfed group and beyond the age of 54 months for the exclusively breastfed group.

Conclusions: We found an association between breast feeding for at least 6 or 7 months and elevated risk of dental caries at age 30 months. However, the association became attenuated as children grew older.
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http://dx.doi.org/10.1136/bmjopen-2014-006982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368903PMC
March 2015

Long-Term Effects of Breastfeeding on Children's Hospitalization for Respiratory Tract Infections and Diarrhea in Early Childhood in Japan.

Matern Child Health J 2015 Sep;19(9):1956-65

Center for Regional Research, Okayama University, 3-1-1 Tsushima-naka, Kita-ku, Okayama, 700-8530, Japan,

Whether or not the protective effects of breastfeeding last during or after a shift to a weaning diet is not clear. In the present study, we examined the effects of breastfeeding on hospitalization for respiratory tract infections and diarrhea in early childhood in Japan. Data were extracted from a nationwide longitudinal survey of Japanese children. We restricted the study participants to singleton children who were born after 37 gestational weeks and whose information on feeding practice during infancy were included (n = 43,367). We used logistic regression models to evaluate the associations of breastfeeding with hospitalization for the two diseases among young children (i.e., between ages 6 and 18 months, between ages 18 and 30 months, and between ages 30 and 42 months, respectively), adjusting for children's factors (sex, birth weight, childcare attendance and presence of siblings) and maternal factors (educational attainment and smoking status). Breastfeeding compared with infant formula was not associated with reduced risk of hospitalization for diarrhea during the periods we examined. Although breastfeeding was not associated with reduced risk of hospitalization for respiratory tract infections between ages 6 and 18 months, breastfeeding showed protective effects after that period: the adjusted odds ratios (95% confidence intervals) of exclusive breastfeeding were 0.82 (0.66-1.01) between ages 18 and 30 months and 0.76 (0.58-0.99) between ages 30 and 42 months. Breastfeeding may have long-term protective effects on hospitalization for respiratory tract infections after infancy, but not for diarrhea.
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http://dx.doi.org/10.1007/s10995-015-1703-4DOI Listing
September 2015

Poor toddler-age sleep schedules predict school-age behavioral disorders in a longitudinal survey.

Brain Dev 2015 Jun 25;37(6):572-8. Epub 2014 Oct 25.

Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Objective: Behavioral problems are often associated with poor sleep habits in children. We investigated whether undesirable toddler-age sleep schedules may be related to school-age behavioral problems.

Methods: We analyzed the data of a nationwide longitudinal survey with available results from 2001 to 2011. The participants were 41,890 children. The predictors were waking time and bedtime at 2years of age, and the outcomes were assessed by determining the presence or absence of three attention problems and four aggressiveness problems at 8years of age. In logistic regression models with adjustments for confounding factors, we estimated odds ratios (ORs) and confidence intervals (CIs) for the association between toddler sleep schedules and behavior during primary-school age years.

Results: The outcomes of attention problems and aggressiveness problems were observed in 1.7% and 1.2% of children, respectively, at 8years of age. The OR of an irregular or late morning waking time at 2years of age with the outcome of aggressiveness problems was 1.52 (95% CI, 1.04-2.22) in comparison to an early waking time. The OR of an irregular or late bedtime with attention problems was 1.62 (95% CI, 1.12-2.36), and the OR of an irregular or late bedtime with aggressiveness problems was 1.81 (95% CI, 1.19-2.77) in comparison to an early bedtime.

Conclusion: Poor toddler-age sleep schedules were found to predict behavioral problems during primary-school age years. Thus, good and regular sleep habits appear to be important for young children's healthy development.
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http://dx.doi.org/10.1016/j.braindev.2014.10.004DOI Listing
June 2015

Breastfeeding and behavioral development: a nationwide longitudinal survey in Japan.

J Pediatr 2014 May 13;164(5):1019-1025.e3. Epub 2014 Feb 13.

Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Objective: To prospectively examine the prolonged effect of breastfeeding on behavioral development.

Study Design: We used a large, nationwide Japanese population-based longitudinal survey that began in 2001. We restricted participants to term singletons with birth weight >2500 g (n = 41 188). Infant feeding practice was queried at age 6-7 months. Responses to survey questions about age-appropriate behaviors at age 2.5 and 5.5 years were used as indicators of behavioral development. We conducted logistic regression analyses, controlling for potential child and parental confounding factors, with formula feeding as the reference group.

Results: We observed a dose-response relationship between breastfeeding status and an inability to perform age-appropriate behaviors at both ages. With a single exception, all ORs for outcomes for exclusive breastfeeding were smaller than those for partial feeding of various durations. The protective associations did not change after adjustment for an extensive list of confounders or in the sensitivity analyses.

Conclusion: We observed prolonged protective effects of breastfeeding on developmental behavior skills surveyed at age 2.5 and 5.5 years. Beneficial effects were most likely in children who were breastfed exclusively, but whether a biological ingredient in breast milk or extensive interactions through breastfeeding, or both, is beneficial is unclear.
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http://dx.doi.org/10.1016/j.jpeds.2014.01.012DOI Listing
May 2014

Social cohesion and mortality: a survival analysis of older adults in Japan.

Am J Public Health 2013 Dec 17;103(12):e60-6. Epub 2013 Oct 17.

Sachiko Inoue, Soshi Takao, and Hiroyuki Doi are with the Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. Sachiko Inoue is also with and Ichiro Kawachi is with the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA. Takashi Yorifuji is with the Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.

Objectives: We examined the association between social cohesion and mortality in a sample of older adults in Japan.

Methods: Data were derived from a cohort study of elderly individuals (65-84 years) in Shizuoka Prefecture; 14 001 participants were enrolled at baseline (1999) and followed up in 2002, 2006, and 2009. Among the 11 092 participants for whom we had complete data, 1427 had died during follow-up. We examined the association between social cohesion (assessed at both the community and individual levels) and subsequent mortality after control for baseline and time-varying covariates. We used clustered proportional hazard regression models to estimate hazard ratios (HRs) and confidence intervals (CIs).

Results: After control for individual characteristics, individual perceptions of community cohesion were associated with a reduced risk of all-cause mortality (HR = 0.78; 95% CI = 0.73, 0.84) as well as mortality from cardiovascular disease (HR = 0.75; 95% CI = 0.67, 0.84), pulmonary disease (HR = 0.66; 95% CI = 0.58, 0.75), and all other causes (HR = 0.76; 95% CI = 0.66, 0.89). However, no statistically significant relationship was found between community cohesion and mortality risk.

Conclusions: Among the elderly in Japan, more positive individual perceptions of community cohesion are associated with reduced risks of all-cause and cause-specific mortality.
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http://dx.doi.org/10.2105/AJPH.2013.301311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828960PMC
December 2013

Associations of preterm births with child health and development: Japanese population-based study.

J Pediatr 2013 Dec 20;163(6):1578-1584.e4. Epub 2013 Aug 20.

Department of Public Health and Public Policy, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address:

Objective: To examine associations between the duration of gestation and health and development outcomes at 2.5 years and 5.5 years using a Japanese population-based longitudinal survey (n = 47 015).

Study Design: Hospitalization was used as an indicator of physical health, and responses to questions about age-appropriate behaviors were used as an indicator of behavioral development. We conducted logistic regression analyses controlling for a set of neonatal and family factors. We also estimated population-attributable fractions.

Results: We observed a steady increase toward shorter duration of gestation in the risk of hospitalizations at age 2.5 years and 5.5 years and developmental delays at 2.5 years (Plinear trend < .001 for all outcomes). We found associations only between extremely preterm birth and delayed behavioral development at age 5.5 years.

Conclusion: There is a linear relationship between shorter duration of gestation and increased risk of later health and developmental problems. In line with Rose's "population paradox," the population-attributable risks for these problems are greater for moderately preterm infants compared with extremely preterm infants.
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http://dx.doi.org/10.1016/j.jpeds.2013.07.004DOI Listing
December 2013

Breastfeeding and obesity among schoolchildren: a nationwide longitudinal survey in Japan.

JAMA Pediatr 2013 Oct;167(10):919-25

Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

Importance: Although it is suggested that breastfeeding is protective against obesity in children, the evidence remains inconclusive because of possible residual confounding by socioeconomic status or children's lifestyle factors. Most of the participants in the previous studies were children in Western developed countries, so studies in a different context are awaited.

Objective: To examine the associations of breastfeeding with overweight and obesity among schoolchildren in Japan, with adjustment for the potential confounders.

Design: Secondary data analyses of a nationwide longitudinal survey ongoing since 2001, with results collected from 2001 to 2009.

Setting: All over Japan.

Participants: A total of 43,367 singleton children who were born after 37 gestational weeks and had information on their feeding during infancy.

Exposures: Five mutually exclusive infant feeding practice categories.

Main Outcomes And Measures: Underweight, normal weight (referent group), overweight, and obesity at 7 and 8 years of age defined by using international cutoff points of body mass index by sex and age.

Results: In multinomial logistic regression models with adjustment for children's factors (sex, television viewing time, and computer game playing time) and maternal factors (educational attainment, smoking status, and working status), exclusive breastfeeding at 6 to 7 months of age was associated with decreased risk of overweight and obesity compared with formula feeding. The adjusted odds ratios were 0.85 (95% CI, 0.69-1.05) and 0.55 (95% CI, 0.39-0.78) for overweight and obesity, respectively, at 7 years of age. Similar results were observed at 8 years of age.

Conclusions And Relevance: Breastfeeding is associated with decreased risk of overweight and obesity among schoolchildren in Japan. Therefore, it would be better to encourage breastfeeding even in developed countries.
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http://dx.doi.org/10.1001/jamapediatrics.2013.2230DOI Listing
October 2013

Association of birth length and risk of hospitalisation among full-term babies in Japan.

Paediatr Perinat Epidemiol 2013 Jul 3;27(4):361-70. Epub 2013 Jun 3.

Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Japan.

Background: Barker's fetal programming hypothesis suggests that disproportionate size at birth may have a lifelong impact on one's health. However, the literature on birth length is considerably more sparse compared with birthweight. We, therefore, examined the relationship between birth length and hospitalisation early in life among Japanese children.

Methods: We used the nationwide Longitudinal Survey of Babies in 21st Century and restricted the study subjects to full-term singleton babies (n = 44,057). We estimated the effects of birth length and birthweight on the risk of hospitalisation using log linear regression models. We controlled for a set of neonatal and maternal factors.

Results: Birth length was associated with the chance of hospitalisation due to all causes between 6 and 18 months of age. In addition, the association was stronger than that with birthweight. Adjusted risk ratios showed that the relationship between birth length and hospitalisation was U-shaped: 1.16 [95% confidence intervals, 1.08, 1.25] at 30-48 cm, 1 [Reference] at 49 cm, 1.13 [1.04, 1.22] at 50 cm, and 1.11 [1.02, 1.20] at 51-60 cm. Short babies with low or high weight, as well as long babies with low weight, seem to be at increased risk of hospitalisation.

Conclusions: We found a U-shaped relationship between birth length and risk of hospitalisation due to all causes during the period from 6 to 18 months.
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http://dx.doi.org/10.1111/ppe.12062DOI Listing
July 2013