Lifestyle diseases in Japan

The big health buzzword last year and this has been metabolic syndrome, or metabo as it is abbreviated in Japan. For Japanese people to be diagnosed as metabolic syndrome you must have at least three of the following five signs. For men, waist over 90 cm, for women over 80 cm; blood pressure greater than 130/85 mmHg, neutral fat of 150 mg/dL or more; HDL (good cholesterol) of under 40 mg/dL for men, 50 mg/dL for women; and blood sugar over 100 mg/dL. However, there appears to be slight regional variations for these measures. Anyway, DIMSDRIVE Research recently performed a survey to find out about health checks.

Demographics

Between the 23rd and 31st of January 2008 9,863 members of the DIMSDRIVE Monitor pool completed a private internet-based questionnaire. 53.3% of the sample was female, 1.2% in their teens, 14.8% in their twenties, 36.3% in their thirties, 29.1% in their forties, 13.0% in their fifties, and 5.6% aged sixty or older.

All Japanese companies are required to provide regular health checks for their employees; the company I work for once a year gets everyone in for eyes, ears, blood pressure, urine test, poo test and chest xray, and for older people barium meal, ECG, and blood test. In addition they have another annual test of physical strength, with grip strength measurement, bike riding, sit-ups, reaction time, blood vessel hardness and balancing on one leg.

Research results

Q1: Which aspects of your current lifestyle habits do you think are bad or you want to reform? (Sample size=9,863, multiple answer)

Lack of exercise	75.4%
Lack of sleep	40.9%
Using computer for long periods	37.7%
Irregular lifestyle	33.9%
Overeating	33.9%
Unbalanced diet	30.4%
Irregular eating habits	23.4%
Smoking	20.8%
Drinking, drinking too much	13.9%
Overwork, overbusy	13.4%
Other	1.0%
Nothing in particular	4.6%

By sex, most of the worries were pretty balanced, but women were more worried about lack of exercise, eating too much or too much of one thing. Men worried about smoking more than women, 25.8% versus 16.4%, and over twice as many men worried about their drinking.

Q2: Which of the following health checks or examinations have you had? (Sample size=9,863, multiple answer)

Ordinary health check	81.4%
Gynecology check	24.1%
“Ningen Dock” – detailed health check	208%
Home check – mail or convenience store	1.9%
Dental check	50.4%
Vision check	36.4%
Allergy check	18.2%
Anemia check	17.9%
Cancer check	17.1%
Tuberculosis check	8.4%
Other	2.1%
Never had a health check	5.1%
Don’t want to answer	0.9%

Note that the dental check refers to preventative checks, I think, rather than a by-product of a visit for treatment. I’m not sure exactly what the vision check means,though; since almost three in four Japanese wear glasses, perhaps it refers to not explictly going for glasses?

Q2A: Have you ever had a gynecological examination? (Sample size=5,253)

All women	45.1%
Teens	2.9%
Twenties	29.5%
Thirties	47.0%
Forties	52.6%
Fifties	54.1%
Sixty or older	43.6%

Q3: How often do you get health checks? (Sample size=8,8863)

Twice a year or more	9.4%
Once a year	60.6%
Once every two or three years	14.8%
Once every four or five years	5.7%
Once every six to ten years	2.8%
Once every eleven to twenty years	0.9%
Less than that	5.8%

Q4: Which of the following results from health checks are you interested in? (Sample size=8,863, multiple answer)

Cholesterol	51.4%
BMI	50.2%
Neutral fat, fat level in blood	49.0%
Weight	42.1%
Blood pressure	36.8%
Vision	35.7%
Blood sugar	32.5%
Liver function	31.9%
Gynecology	27.9%
ECG	21.4%
Chest X-ray	21.3%
Protein in urine	21.2%
Red, white blood cell count	18.8%
Sugar in urine	18.2%
Urine acidity	18.2%
Stomach X-ray	16.0%
Hearing	15.2%
Height	13.4%
Teeth	12.9%
Stool	11.7%
Blood in urine	11.2%
Prostate	4.9%
Other	0.9%
Nothing in particular	6.7%
Don’t want to answer	0.3%

Q5: Why don’t you go for health checks? (Sample size=1,848, those who hav health checks less than once every three years, multiple answer)

Costs money	45.8%
Workplace doesn’t do such checks, not employed	41.2%
Bothersome	38.4%
No habit of doing so	29.9%
Don’t have time to go	15.6%
Can’t get a suitable appointment	15.0%
Not compulsory (at workplace, etc)	13.3%
Scared of, dislike getting a bad outcome	13.1%
Don’t know how to apply	12.7%
Dislike injections, barium meal, etc	10.5%
Don’t get notification about them	9.8%
Dislike hospitals, doctors	9.8%
Location is far away, difficult to get to	6.9%
Forgot about it	6.4%
Don’t feel any need for it	6.1%
Think I’m healthy	5.8%
Embarrassing	5.2%
Diagnosis not simple for me	4.0%
Diagnosis inaccurate	1.8%
Other	3.5%
No particular reason	6.2%

Q6: Do you think you have metabolic syndrome? (Sample size=9,863)

Think so	16.0%
Think I’m borderline	32.6%
Don’t think so	48.6%
Don’t know, don’t want to answer	2.8%

Men were much more likely to think they were metabo; nearly two-thirds of middle-aged men thought they were there already or on the borderline versus less than half of women of a similar age.

Q7: Do you know about the special health checks and special health guidance programs? (Sample size=9,863)

Know about the details	6.6%
Know it exists	36.9%
Don’t know about it	56.5%

Older people were more aware of it, and men more than women. Similarly, those who had regular health checks were more aware than those who were irregular.

People had the details of these special health checks described; basically for everyone between 40 and 75 a check to see if they have metabolic syndrome.

Q8: In explanations of these special health checks and special health guidance programs, what might you want to learn about? (Sample size=9,863, multiple answer)

Cost	68.6%
Where to get it	45.9%
Details of the examination	45.7%
How to apply	37.1%
When to get it	34.1%
Getting informed of the outcome	29.8%
Medical, insurance fees after it becomes compulsory	23.0%
Whether if people outside the age range can take it	20.9%
What happens if you don’t take the examination	20.5%
Details of health guidance	19.8%
How health guidance is given	17.3%
Whether there will be benefit from following the health guidance	16.1%
Management of private, confidential information	14.4%
What happeds if things don’t improve after following the health guidance	12.8%
If details other than waist size will be taken into account when deciding	10.7%
Other	0.1%
Nothing I particularly want to know	19.3%

Q9: If you took a special health check or special health guidance program, how much do you think you could reform your lifestyle? (Sample size=4,794, metabolic or borderline metabolic people)

Can drastically reform	5.7%
Can reform to some extent	45.1%
Can reform a little	36.9%
Can’t reform	12.3%