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Robert A. Sloan
Social and Behavioral Medicine, Kagoshima University Graduate School of Medical Sciences, Kagoshima, Japan

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Journal article
Published: 05 July 2021 in The Journal of Alternative and Complementary Medicine
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Objectives: There is a paucity of research on the association between yogic breathing and healthy lifestyle factors in working adults. Also, there is very little information about the frequency of yogic breathing practice and its benefits. The authors investigated the relationship between Sudarshan Kriya Yoga (SKY) frequency and the likelihood of leading a healthier lifestyle among practitioners and nonpractitioners.Design: Cross-sectional investigation on non-SKY and SKY practitioners, SKY was categorized into non-, monthly, weekly, and daily practitioners. Confounding variables included age, gender, ethnicity, marital status, and education level. A multivariate logistic regression model was used to compare practice frequencies with the odds of having a healthier lifestyle.Settings: Community centers, community events, workplaces, and universities throughout Singapore Subjects: Of the 531 working adults (54.8% female), 50.1% had a healthier lifestyle ≥ 4 healthy lifestyle factors).Outcome Measure: Having a healthier lifestyle was defined as having ≥ 4 healthy lifestyle factors out of seven (smoking, alcohol, diet, exercise, sleep, stress, and weight).Results: Multivariate analysis demonstrated that those who practiced SKY ≥ 4 days/week had significantly higher odds of having a healthier lifestyle (odds ratio = 3.62; 95% confidence interval = 2.10–6.23). The p for trend analysis demonstrated that as the frequency of practice increased the likelihood of having a healthier lifestyle also increased ( p < 0.001).Conclusion: The practice of yogic breathing may promote a healthier lifestyle in working adults. Further experimental and longitudinal investigations are warranted.

ACS Style

Robert A. Sloan; Divya Kanchibhotla. Association Between Sudarshan Kriya Yoga and Healthy Lifestyle Practices Among Working Adults: A Cross-Sectional Study from Singapore. The Journal of Alternative and Complementary Medicine 2021, 1 .

AMA Style

Robert A. Sloan, Divya Kanchibhotla. Association Between Sudarshan Kriya Yoga and Healthy Lifestyle Practices Among Working Adults: A Cross-Sectional Study from Singapore. The Journal of Alternative and Complementary Medicine. 2021; ():1.

Chicago/Turabian Style

Robert A. Sloan; Divya Kanchibhotla. 2021. "Association Between Sudarshan Kriya Yoga and Healthy Lifestyle Practices Among Working Adults: A Cross-Sectional Study from Singapore." The Journal of Alternative and Complementary Medicine , no. : 1.

Journal article
Published: 20 April 2021 in Preventive Medicine
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The purpose of this study was to examine the associations of cardiorespiratory fitness, general adiposity, and central adiposity with incident intermediate hyperglycemia (IH) in women. We conducted a prospective cohort study of 1534 women aged 20–79 years old who had an annual health check-up with no history of major chronic diseases. At baseline, fitness was assessed by a Balke graded exercise test, and the estimated metabolic equivalents were used to create quartile groups. Women were also grouped based on their body mass index (<25 kg/m2, 25–29.9 kg/m2, and ≥ 30 kg/m2) and waist-to-height ratio (≥0.50 or < 0.50). Cox proportional hazards models were conducted to assess the association of fitness and fatness variables with incident IH defined as fasting glucose of 5.6–6.9 mmol/L. Overall, 18.1% (n = 277) of the women developed IH during an average follow-up of 5.06 years. Fitness, body mass index, and waist-to-height ratio at baseline were the independent predictors of the IH incidence in separate age-adjusted models; yet when all three variables were included in the same model along with confounding variables, only fitness remained significant and demonstrated a clear inverse association with incident IH (P-for-trend <0.001). Health promotion efforts should focus on improving fitness for the prevention of IH in women.

ACS Style

Robert A. Sloan; Youngdeok Kim; Susumu S. Sawada; I-Min Lee; Xuemei Sui; Steven N. Blair. The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study. Preventive Medicine 2021, 148, 106552 .

AMA Style

Robert A. Sloan, Youngdeok Kim, Susumu S. Sawada, I-Min Lee, Xuemei Sui, Steven N. Blair. The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study. Preventive Medicine. 2021; 148 ():106552.

Chicago/Turabian Style

Robert A. Sloan; Youngdeok Kim; Susumu S. Sawada; I-Min Lee; Xuemei Sui; Steven N. Blair. 2021. "The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study." Preventive Medicine 148, no. : 106552.

Journal article
Published: 12 April 2021
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ACS Style

Robert A Sloan; Youngdeok Kim; Susumu S Sawada; I-Min Lee; Xuemei Sui; Steven N Blair. The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study. 2021, 106552 .

AMA Style

Robert A Sloan, Youngdeok Kim, Susumu S Sawada, I-Min Lee, Xuemei Sui, Steven N Blair. The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study. . 2021; ():106552.

Chicago/Turabian Style

Robert A Sloan; Youngdeok Kim; Susumu S Sawada; I-Min Lee; Xuemei Sui; Steven N Blair. 2021. "The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study." , no. : 106552.

Journal article
Published: 10 November 2020 in Sleep and Breathing
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There is a dearth of evidence for the relationship between yogic breathing and sleep quality. Even less is known about practice frequency and benefit. We investigated the association of Sudarshan Kriya Yoga frequency with sleep quality amongst adult practitioners. In a cross-sectional investigation on adult practitioners of Sudarshan Kriya Yoga in Singapore, the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Sleep quality was examined across three categories of practice frequency (monthly, weekly, daily). A multivariate logistic regression model was used to determine association. Of 385 adults (241 women), the mean age (SD) was 42.5 (9.9) years. In total, 32% of the sample (n = 124) was identified as having poor SQ. After adjusting for study covariates, independent analyses revealed an inverse association for higher frequency of practice and lower odds of poor SQ (OR = 0.52; 95% CI = 0.28–0.94). The p for trend was 0.03. The practice of yogic breathing may benefit sleep quality. Further experimental investigations are warranted.

ACS Style

Robert A. Sloan; Divya Kanchibhotla. The association of Sudarshan Kriya Yoga frequency with sleep quality: a cross-sectional study from Singapore. Sleep and Breathing 2020, 25, 1665 -1669.

AMA Style

Robert A. Sloan, Divya Kanchibhotla. The association of Sudarshan Kriya Yoga frequency with sleep quality: a cross-sectional study from Singapore. Sleep and Breathing. 2020; 25 (3):1665-1669.

Chicago/Turabian Style

Robert A. Sloan; Divya Kanchibhotla. 2020. "The association of Sudarshan Kriya Yoga frequency with sleep quality: a cross-sectional study from Singapore." Sleep and Breathing 25, no. 3: 1665-1669.

Journal article
Published: 01 July 2020 in Evaluation and Program Planning
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Comprehensive discharge planning provided by interprofessional collaboration is critical for discharging patients from hospitals to home. For effective interprofessional discharge planning, the evaluation that clarifies the differences in assessment viewpoints between various healthcare professionals is needed. This study aimed to clarify the assessment viewpoints of multiple healthcare professional groups when discharging patients from a long-term care hospital (LTCH) to home. We reviewed 102 medical records from an LTCH in Japan, extracted descriptions of discharge planning assessments written by 3 doctors, 13 nurses, 3 physical therapists, 13 care workers, and 2 social workers, linked these to the International Classification of Functioning, Disability and Health, and conducted the statistical analysis. Doctors and nurses significantly focused on “Body Functions”. Physical therapists and care workers significantly focused on “Activities and Participation”. Social workers significantly focused on “Environmental Factors”. We also identified the factors less or missing from assessments in the clinical field of the LTCH. Our findings could be contributed as a base of knowledge to foster a better understanding of different healthcare professionals’ assessment viewpoints. The further development of comprehensive discharge planning assessment tools, service programs, and research on discharge planning methods that could contribute to effective interprofessional discharge planning is needed.

ACS Style

Kimiko Mizuma; Marie Amitani; Midori Mizuma; Suguru Kawazu; Robert A. Sloan; Rie Ibusuki; Toshiro Takezaki; Tetsuhiro Owaki. Clarifying differences in viewpoints between multiple healthcare professionals during discharge planning assessments when discharging patients from a long-term care hospital to home. Evaluation and Program Planning 2020, 82, 101848 .

AMA Style

Kimiko Mizuma, Marie Amitani, Midori Mizuma, Suguru Kawazu, Robert A. Sloan, Rie Ibusuki, Toshiro Takezaki, Tetsuhiro Owaki. Clarifying differences in viewpoints between multiple healthcare professionals during discharge planning assessments when discharging patients from a long-term care hospital to home. Evaluation and Program Planning. 2020; 82 ():101848.

Chicago/Turabian Style

Kimiko Mizuma; Marie Amitani; Midori Mizuma; Suguru Kawazu; Robert A. Sloan; Rie Ibusuki; Toshiro Takezaki; Tetsuhiro Owaki. 2020. "Clarifying differences in viewpoints between multiple healthcare professionals during discharge planning assessments when discharging patients from a long-term care hospital to home." Evaluation and Program Planning 82, no. : 101848.

Journal article
Published: 19 February 2020 in International Journal of Environmental Research and Public Health
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Objectives: To examine the independent, joint, and fully combined associations of sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and cardiorespiratory fitness (CRF) with the odds of poor sleep quality (SQ). Methods: We performed a secondary data analysis on 757 working adults (male = 345) in Singapore, with an average age of 35.2 years. The Pittsburgh Sleep Quality Index was used to assess SQ. Objectively measured MVPA and SB were each obtained using an accelerometer. A non-exercise prediction equation was used to estimate CRF. Logistic regression models were used to determine associations. Results: In total, 13.2% of the sample (n = 100) was identified as having poor SQ. After adjusting for study covariates, independent analyses revealed a clear inverse association for higher CRF and lower odds of poor SQ (OR = 0.50; 95% CI = 0.28–0.91). SB and MVPA demonstrated no independent associations. Joint associations revealed that odds of having poor SQ for those with low CRF was higher regardless of SB level and was further deteriorated by lower MVPA in the fully combined model. The fully combined model also demonstrated that those with lower SB, higher MVPA, and higher CRF had the lowest odds of having poor SQ (OR = 0.28; 95% CI = 0.10–0.78). Conclusions: Physical activity/exercise training programs that aim to improve CRF may be useful in lowering the odds or poor SQ in working adults.

ACS Style

Robert A. Sloan; Youngdeok Kim; Susumu S. Sawada; Akihiro Asakawa; Steven N. Blair; Eric A. Finkelstein. Is Less Sedentary Behavior, More Physical Activity, or Higher Fitness Associated with Sleep Quality? A Cross-Sectional Study in Singapore. International Journal of Environmental Research and Public Health 2020, 17, 1337 .

AMA Style

Robert A. Sloan, Youngdeok Kim, Susumu S. Sawada, Akihiro Asakawa, Steven N. Blair, Eric A. Finkelstein. Is Less Sedentary Behavior, More Physical Activity, or Higher Fitness Associated with Sleep Quality? A Cross-Sectional Study in Singapore. International Journal of Environmental Research and Public Health. 2020; 17 (4):1337.

Chicago/Turabian Style

Robert A. Sloan; Youngdeok Kim; Susumu S. Sawada; Akihiro Asakawa; Steven N. Blair; Eric A. Finkelstein. 2020. "Is Less Sedentary Behavior, More Physical Activity, or Higher Fitness Associated with Sleep Quality? A Cross-Sectional Study in Singapore." International Journal of Environmental Research and Public Health 17, no. 4: 1337.

Journal article
Published: 30 January 2020 in International Journal of Environmental Research and Public Health
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The health benefits of objectively measured physical activity volume versus intensity have rarely been studied, particularly in non-western populations. The aim of this study was to investigate the association between cardiometabolic risk factors and stepping activity including; volume (step count), intensity (cadence) or inactivity (zero-steps/minute/day), in a multi-ethnic Asian population. Participants clinical data was collected at baseline and their physical activity was monitored for seven days, using an accelerometer (Actigraph GT3X+) in 2016. Tertiles (low, moderate, high) of the mean daily step count, peak one-minute, 30-min, 60-min cadences and time/day spent at zero-steps/minute were calculated. Adjusted linear regressions explored the association between stepping activity tertiles and cardiometabolic risk factors. A total of 635 participants (41% male, 67% Chinese, mean age 48.4 years) were included in the analyses. The mean daily step count was 7605 (median daily step count 7310) and 7.8 h of awake time per day were spent inactive (zero-steps/minute). A greater number of associations were found for step intensity than volume. Higher step intensity was associated with reduced body mass index (BMI), waist circumference, blood pressures and higher high-density lipoprotein (HDL). Future health promotion initiatives should consider the greater role of step intensity to reduce cardiometabolic risk.

ACS Style

Jennifer Sumner; Léonie Uijtdewilligen; Anne Chu Hin Yee; Sheryl Ng Hui Xian; Tiago V Barreira; Robert Alan Sloan; Rob M Van Dam; Falk Müller-Riemenschneider. Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population. International Journal of Environmental Research and Public Health 2020, 17, 863 .

AMA Style

Jennifer Sumner, Léonie Uijtdewilligen, Anne Chu Hin Yee, Sheryl Ng Hui Xian, Tiago V Barreira, Robert Alan Sloan, Rob M Van Dam, Falk Müller-Riemenschneider. Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population. International Journal of Environmental Research and Public Health. 2020; 17 (3):863.

Chicago/Turabian Style

Jennifer Sumner; Léonie Uijtdewilligen; Anne Chu Hin Yee; Sheryl Ng Hui Xian; Tiago V Barreira; Robert Alan Sloan; Rob M Van Dam; Falk Müller-Riemenschneider. 2020. "Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population." International Journal of Environmental Research and Public Health 17, no. 3: 863.

Journal article
Published: 05 May 2018 in Journal of Epidemiology
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The “Physical Activity Reference for Health Promotion 2013” provides “fit” reference values for cardiorespiratory fitness (CRF) for good health. The importance of achieving a fit CRF level for several years on the subsequent prevention of type 2 diabetes mellitus (T2DM) remains to be clarified. This cohort study was conducted in 2,235 nondiabetic males aged 21 to 59 years, enrolled in April 1986 through March 1987. We calculated the ratio of the area under the curve (AUCratio) for actual measured values and the AUC for the reference values of CRF in each individual during an 8-year measurement period before the baseline. According to whether they met a fit CRF level or not, participants were categorized into groups based on the AUCratio (FitAUC or UnfitAUC) and initial CRF (Fitinitial or Unfitinitial), respectively. T2DM was evaluated on health checkups until March 2010. During the follow-up period, 400 men developed T2DM. After adjustment for confounders, as compared with those in the FitAUC group, the hazard ratio (HR) for those in the UnfitAUC group was 1.33 (95% confidence interval [CI], 1.06–1.65). A combined analysis with the categories of initial value and AUCratio showed that, compared with the Fitinitial and FitAUC group, the HRs of Fitinitial and UnfitAUC, Unfitinitial and FitAUC, and Unfitinitial and UnfitAUC groups were 1.41 (95% CI, 0.99–2.00), 1.18 (95% CI, 0.81–1.70), and 1.40 (95% CI, 1.08–1.83), respectively. Achievement of a fit CRF level established in the Japan physical activity guideline for several years was associated with lower subsequent risk of T2DM.

ACS Style

Haruki Momma; Susumu S. Sawada; Robert A. Sloan; Yuko Gando; Ryoko Kawakami; Shin Terada; Motohiko Miyachi; Chihiro Kinugawa; Takashi Okamoto; Koji Tsukamoto; Cong Huang; Ryoichi Nagatomi; Steven N. Blair. Importance of Achieving a “Fit” Cardiorespiratory Fitness Level for Several Years on the Incidence of Type 2 Diabetes Mellitus: A Japanese Cohort Study. Journal of Epidemiology 2018, 28, 230 -236.

AMA Style

Haruki Momma, Susumu S. Sawada, Robert A. Sloan, Yuko Gando, Ryoko Kawakami, Shin Terada, Motohiko Miyachi, Chihiro Kinugawa, Takashi Okamoto, Koji Tsukamoto, Cong Huang, Ryoichi Nagatomi, Steven N. Blair. Importance of Achieving a “Fit” Cardiorespiratory Fitness Level for Several Years on the Incidence of Type 2 Diabetes Mellitus: A Japanese Cohort Study. Journal of Epidemiology. 2018; 28 (5):230-236.

Chicago/Turabian Style

Haruki Momma; Susumu S. Sawada; Robert A. Sloan; Yuko Gando; Ryoko Kawakami; Shin Terada; Motohiko Miyachi; Chihiro Kinugawa; Takashi Okamoto; Koji Tsukamoto; Cong Huang; Ryoichi Nagatomi; Steven N. Blair. 2018. "Importance of Achieving a “Fit” Cardiorespiratory Fitness Level for Several Years on the Incidence of Type 2 Diabetes Mellitus: A Japanese Cohort Study." Journal of Epidemiology 28, no. 5: 230-236.

Journal article
Published: 23 April 2018 in BMC Public Health
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Accelerometer measured physical activity (PA) studies particularly in non-western populations are lacking. Therefore, this study investigated stepping activity in a multi-ethnic urban Asian population. Adult participants from the Singapore Health Study 2 consented to accelerometer activity monitoring for 7-consecutive days. Mean daily step count, peak stepping intensity (i.e. cadence) over 1-min, 30-min and 60-min and time spent in each cadence band: 0 (non-movement), 1–19, 20–39, 40–59, 60–79, 80–99 and ≥ 100 steps/minute (moderate to vigorous PA) were calculated. A total of 713 participants (42% male, mean age 47.8 years) were included. Overall, the mean daily step count was 7549. Mean daily step count was significantly lower in Indians (7083 adjusted p = 0.02) but not Malays 7140 (adjusted p = 0.052) compared to Chinese (7745 steps). The proportion of Malays, Indians, and Chinese achieving < 5000 daily steps was 26%, 23% and 14%, respectively (p < 0.01). Regardless of ethnicity, approximately half of the recorded time was spent undertaking 0-steps/minute (7.9 h). Greater promotion of brisk walking is required in light of the low step volume and pace observed in this multi-ethnic Asian population. Ethnic differences in stepping activity were also identified which indicates a need for targeted ethnic specific health promotion interventions.

ACS Style

Jennifer Sumner; Léonie Uijtdewilligen; Anne Hy Chu; Sheryl Hx Ng; Tiago V. Barreira; Robert Alan Sloan; Rob M. Van Dam; Falk Müller-Riemenschneider. Stepping volume and intensity patterns in a multi-ethnic urban Asian population. BMC Public Health 2018, 18, 539 .

AMA Style

Jennifer Sumner, Léonie Uijtdewilligen, Anne Hy Chu, Sheryl Hx Ng, Tiago V. Barreira, Robert Alan Sloan, Rob M. Van Dam, Falk Müller-Riemenschneider. Stepping volume and intensity patterns in a multi-ethnic urban Asian population. BMC Public Health. 2018; 18 (1):539.

Chicago/Turabian Style

Jennifer Sumner; Léonie Uijtdewilligen; Anne Hy Chu; Sheryl Hx Ng; Tiago V. Barreira; Robert Alan Sloan; Rob M. Van Dam; Falk Müller-Riemenschneider. 2018. "Stepping volume and intensity patterns in a multi-ethnic urban Asian population." BMC Public Health 18, no. 1: 539.

Research note
Published: 22 March 2018 in BMC Research Notes
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Objective A recent meta-analysis surmised pedometers were a useful panacea to independently reduce sedentary time (ST). To further test and expand on this deduction, we analyzed the ability of a consumer-wearable activity tracker to reduce ST and prolonged sedentary bouts (PSB). We originally conducted a 12-month randomized control trial where 800 employees from 13 organizations were assigned to control, activity tracker, or one of two activity tracker plus incentive groups designed to increase step count. The primary outcome was accelerometer measured moderate-to-vigorous physical activity. Results We conducted a secondary analysis on accelerometer measured daily ST and PSB bouts. A general linear mixed model was used to examine changes in ST and prolonged sedentary bouts, followed by between-group pairwise comparisons. Regression analyses were conducted to examine the association of changes in step counts with ST and PSB. The changes in ST and PSB were not statistically significant and not different between the groups (P < 0.05). Increases in step counts were concomitantly associated with decreases in ST and PSB, regardless of intervention (P < 0.05). Caution should be taken when considering consumer-wearable activity trackers as a means to reduce sedentary behavior. Trial registration NCT01855776 Registered: August 8, 2012

ACS Style

Robert A. Sloan; Youngdeok Kim; Aarti Sahasranaman; Falk Müller-Riemenschneider; Stuart Biddle; Eric A. Finkelstein. The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial. BMC Research Notes 2018, 11, 189 .

AMA Style

Robert A. Sloan, Youngdeok Kim, Aarti Sahasranaman, Falk Müller-Riemenschneider, Stuart Biddle, Eric A. Finkelstein. The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial. BMC Research Notes. 2018; 11 (1):189.

Chicago/Turabian Style

Robert A. Sloan; Youngdeok Kim; Aarti Sahasranaman; Falk Müller-Riemenschneider; Stuart Biddle; Eric A. Finkelstein. 2018. "The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial." BMC Research Notes 11, no. 1: 189.

Journal article
Published: 09 March 2018 in BMC Public Health
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The relationship between the combination of physical activity (PA) and body mass index (BMI) with low back pain (LBP) is unclear. The present study offers a cross-sectional assessment of how combinations of PA and BMI are related to LBP in Japanese men. Participants were 4022 Japanese men (mean age = 47) who underwent regular clinical examinations. PA was measured using a uniaxial accelerometer and divided into tertiles (PAhigh, PAmiddle, PAlow). A self-administered questionnaire was used to report on persistent LBP experience, drinking and smoking habits, and any existing lifestyle diseases. After covariance adjustment, a logistic regression model was used to assess how combinations of PA and BMI are related to persistent LBP. 428 of the participants had persistent LBP. A clear negative dose-response relationship was found between PA levels and persistent LBP (P for linearity = 0.012). Regarding BMI, odd ratios were shown to be higher in the overweight/obese category (BMI ≥ 25 kg/m2) than for the normal weight category (BMI < 25 kg/m2). When the PAhigh was taken as the reference in the normal weight category, odds ratios for PAlow and PAmiddle in the normal weight category were shown to be high. Moreover, in the overweight/obese category, odd ratios for every fitness level were also high as for the normal weight category. The present study showed that both PA and BMI are related to persistent LBP. Also, the prevalence of persistent LBP became higher when PAlow and high BMI are combined rather than the group of PAhigh and low BMI combination.

ACS Style

Yuko Hashimoto; Ko Matsudaira; Susumu S. Sawada; Yuko Gando; Ryoko Kawakami; Robert A. Sloan; Chihiro Kinugawa; Takashi Okamoto; Koji Tsukamoto; Motohiko Miyachi; Hisashi Naito. Association between objectively measured physical activity and body mass index with low back pain: a large-scale cross-sectional study of Japanese men. BMC Public Health 2018, 18, 341 .

AMA Style

Yuko Hashimoto, Ko Matsudaira, Susumu S. Sawada, Yuko Gando, Ryoko Kawakami, Robert A. Sloan, Chihiro Kinugawa, Takashi Okamoto, Koji Tsukamoto, Motohiko Miyachi, Hisashi Naito. Association between objectively measured physical activity and body mass index with low back pain: a large-scale cross-sectional study of Japanese men. BMC Public Health. 2018; 18 (1):341.

Chicago/Turabian Style

Yuko Hashimoto; Ko Matsudaira; Susumu S. Sawada; Yuko Gando; Ryoko Kawakami; Robert A. Sloan; Chihiro Kinugawa; Takashi Okamoto; Koji Tsukamoto; Motohiko Miyachi; Hisashi Naito. 2018. "Association between objectively measured physical activity and body mass index with low back pain: a large-scale cross-sectional study of Japanese men." BMC Public Health 18, no. 1: 341.

Journal article
Published: 12 January 2018 in Scientific Reports
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Type 2 diabetes is increasing globally and in Asia. The purpose of this study was to examine the association of a fit-fat index (FFI) with diabetes incidence among Japanese men. In total 5,014 men aged 18-64 years old, who had an annual health check up with no history of major chronic disease at baseline from 2002 to 2009 were observed. CRF was estimated via cycle ergometry. Overall, 7.6% of the men developed diabetes. The mean follow-up period was 5.3 years. Hazard ratios, 95% confidence intervals and P trend for diabetes incidence were obtained using the Cox proportional hazards model while adjusting for confounding variables. High FFI demonstrated lower risk 0.54 (0.36-0.82) compared to low BMI 0.63 (0.44-0.90), low WHtR 0.64 (0.41-1.02), and High CRF 0.72 (0.51-1.03). FFI showed a marginally stronger dose response relationship across quartiles (P (trend) =0.001) compared to BMI (P (trend) =0.002), WHtR (P (trend) =0.055), and CRF (P (trend) =0.005). Overall, both fitness and fatness play independent roles in determining diabetes incidence in Japanese men. FFI may be a more advantageous physical fitness measure because it can account for changes in fitness and/or fatness.

ACS Style

Robert A. Sloan; Susumu S. Sawada; Lee I-Min; Yuko Gando; Ryoko Kawakami; Takashi Okamoto; Koji Tsukamoto; Motohiko Miyachi. The Association of Fit-Fat Index with Incident Diabetes in Japanese Men: A Prospective Cohort Study. Scientific Reports 2018, 8, 569 .

AMA Style

Robert A. Sloan, Susumu S. Sawada, Lee I-Min, Yuko Gando, Ryoko Kawakami, Takashi Okamoto, Koji Tsukamoto, Motohiko Miyachi. The Association of Fit-Fat Index with Incident Diabetes in Japanese Men: A Prospective Cohort Study. Scientific Reports. 2018; 8 (1):569.

Chicago/Turabian Style

Robert A. Sloan; Susumu S. Sawada; Lee I-Min; Yuko Gando; Ryoko Kawakami; Takashi Okamoto; Koji Tsukamoto; Motohiko Miyachi. 2018. "The Association of Fit-Fat Index with Incident Diabetes in Japanese Men: A Prospective Cohort Study." Scientific Reports 8, no. 1: 569.

Journal article
Published: 01 May 2017 in Medicine & Science in Sports & Exercise
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ACS Style

Nobumasa Kikuga; Susumu S. Sawada; Munehiro Matsushita; Yuko Gando; Natsumi Watanabe; Yuko Hashimoto; Yoshio Nakata; Robert A. Sloan; Steven N. Blair; Noritoshi Fukushima; Shigeru Inoue. Predictive Indicators of Early Fitness Club Membership Termination in Japan. Medicine & Science in Sports & Exercise 2017, 49, 221 -222.

AMA Style

Nobumasa Kikuga, Susumu S. Sawada, Munehiro Matsushita, Yuko Gando, Natsumi Watanabe, Yuko Hashimoto, Yoshio Nakata, Robert A. Sloan, Steven N. Blair, Noritoshi Fukushima, Shigeru Inoue. Predictive Indicators of Early Fitness Club Membership Termination in Japan. Medicine & Science in Sports & Exercise. 2017; 49 (5S):221-222.

Chicago/Turabian Style

Nobumasa Kikuga; Susumu S. Sawada; Munehiro Matsushita; Yuko Gando; Natsumi Watanabe; Yuko Hashimoto; Yoshio Nakata; Robert A. Sloan; Steven N. Blair; Noritoshi Fukushima; Shigeru Inoue. 2017. "Predictive Indicators of Early Fitness Club Membership Termination in Japan." Medicine & Science in Sports & Exercise 49, no. 5S: 221-222.

Multicenter study
Published: 01 December 2016 in The Lancet Diabetes & Endocrinology
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Despite the increasing popularity of activity trackers, little evidence exists that they can improve health outcomes. We aimed to investigate whether use of activity trackers, alone or in combination with cash incentives or charitable donations, lead to increases in physical activity and improvements in health outcomes.In this randomised controlled trial, employees from 13 organisations in Singapore were randomly assigned (1:1:1:1) with a computer generated assignment schedule to control (no tracker or incentives), Fitbit Zip activity tracker, tracker plus charity incentives, or tracker plus cash incentives. Participants had to be English speaking, full-time employees, aged 21-65 years, able to walk at least ten steps continuously, and non-pregnant. Incentives were tied to weekly steps, and the primary outcome, moderate-to-vigorous physical activity (MVPA) bout min per week, was measured via a sealed accelerometer and assessed on an intention-to-treat basis at 6 months (end of intervention) and 12 months (after a 6 month post-intervention follow-up period). Other outcome measures included steps, participants meeting 70 000 steps per week target, and health-related outcomes including weight, blood pressure, and quality-of-life measures. This trial is registered at ClinicalTrials.gov, number NCT01855776.Between June 13, 2013, and Aug 15, 2014, 800 participants were recruited and randomly assigned to the control (n=201), Fitbit (n=203), charity (n=199), and cash (n=197) groups. At 6 months, compared with control, the cash group logged an additional 29 MVPA bout min per week (95% CI 10-47; p=0·0024) and the charity group an additional 21 MVPA bout min per week (2-39; p=0·0310); the difference between Fitbit only and control was not significant (16 MVPA bout min per week [-2 to 35; p=0·0854]). Increases in MVPA bout min per week in the cash and charity groups were not significantly greater than that of the Fitbit group. At 12 months, the Fitbit group logged an additional 37 MVPA bout min per week (19-56; p=0·0001) and the charity group an additional 32 MVPA bout min per week (12-51; p=0·0013) compared with control; the difference between cash and control was not significant (15 MVPA bout min per week [-5 to 34; p=0·1363]). A decrease in physical activity of -23 MVPA bout min per week (95% CI -42 to -4; p=0·0184) was seen when comparing the cash group with the Fitbit group. There were no improvements in any health outcomes (weight, blood pressure, etc) at either assessment.The cash incentive was most effective at increasing MVPA bout min per week at 6 months, but this effect was not sustained 6 months after the incentives were discontinued. At 12 months, the activity tracker with or without charity incentives were effective at stemming the reduction in MVPA bout min per week seen in the control group, but we identified no evidence of improvements in health outcomes, either with or without incentives, calling into question the value of these devices for health promotion. Although other incentive strategies might generate greater increases in step activity and improvements in health outcomes, incentives would probably need to be in place long term to avoid any potential decrease in physical activity resulting from discontinuation.Ministry of Health, Singapore.

ACS Style

Eric A Finkelstein; Benjamin A Haaland; Marcel Bilger; Aarti Sahasranaman; Robert Sloan; Ei Ei Khaing Nang; Kelly R Evenson. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. The Lancet Diabetes & Endocrinology 2016, 4, 983 -995.

AMA Style

Eric A Finkelstein, Benjamin A Haaland, Marcel Bilger, Aarti Sahasranaman, Robert Sloan, Ei Ei Khaing Nang, Kelly R Evenson. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. The Lancet Diabetes & Endocrinology. 2016; 4 (12):983-995.

Chicago/Turabian Style

Eric A Finkelstein; Benjamin A Haaland; Marcel Bilger; Aarti Sahasranaman; Robert Sloan; Ei Ei Khaing Nang; Kelly R Evenson. 2016. "Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial." The Lancet Diabetes & Endocrinology 4, no. 12: 983-995.

Research article
Published: 24 June 2016 in PLOS ONE
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The purpose of this study was to examine the impact of combined cardiorespiratory fitness and waist-to-height ratio in the form of a fit-fat index on incident diabetes risk. Additionally, the independent predictive performance of cardiorespiratory fitness, waist-to-height ratio, and body mass index also were estimated and compared. This was a prospective cohort study of 10,381 men who had a normal electrocardiogram and no history of major chronic disease at baseline from 1979 to 2005. Random survival forest models and traditional Cox proportional hazards models were used to predict diabetes at 5-, 10-, and 15-year incidence horizons. Overall, 4.8% of the participants developed diabetes. Receiver operating characteristic curve analyses for incidence risk demonstrated good discrimination using random survival forest models across fitness and fatness measures; Cox models were poor to fair. The differences between fitness and fatness measures across horizons were clinically negligible. Smoothed random survival forest estimates demonstrated the impact of each fitness and fatness measure on incident diabetes was intuitive and graded. Although fitness and fatness measures showed a similar discriminative ability in predicting incident diabetes, unique to the study was the ability of the fit-fat index to demonstrate a better indication of incident risk when compared to fitness or fatness alone. A single index combining cardiorespiratory fitness and waist-to-height ratio may be more useful because it can indicate improvements in either or both of the measures.

ACS Style

Robert A Sloan; Benjamin A Haaland; Susumu S Sawada; I-Min Lee; Xuemei Sui; Duck-Chul Lee; Yassine Ridouane; Falk Müller-Riemenschneider; Steven N Blair. A Fit-Fat Index for Predicting Incident Diabetes in Apparently Healthy Men: A Prospective Cohort Study. PLOS ONE 2016, 11, e0157703 .

AMA Style

Robert A Sloan, Benjamin A Haaland, Susumu S Sawada, I-Min Lee, Xuemei Sui, Duck-Chul Lee, Yassine Ridouane, Falk Müller-Riemenschneider, Steven N Blair. A Fit-Fat Index for Predicting Incident Diabetes in Apparently Healthy Men: A Prospective Cohort Study. PLOS ONE. 2016; 11 (6):e0157703.

Chicago/Turabian Style

Robert A Sloan; Benjamin A Haaland; Susumu S Sawada; I-Min Lee; Xuemei Sui; Duck-Chul Lee; Yassine Ridouane; Falk Müller-Riemenschneider; Steven N Blair. 2016. "A Fit-Fat Index for Predicting Incident Diabetes in Apparently Healthy Men: A Prospective Cohort Study." PLOS ONE 11, no. 6: e0157703.

Journal article
Published: 24 November 2015 in Health and Quality of Life Outcomes
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There is limited data examining the association of combined fitness and central obesity with health related quality of life (HRQoL) in adults. We examined the association of combined cardiorespiratory fitness (CRF) and waist-to-height ratio (WHtR) in the form of a fit-fat index (FFI) with the Physical Component Summary (PCS) and Mental Component Summary (MCS) HRQoL scores in United States Navy servicemen. As part of a health fitness assessment, a total of 709 healthy males aged 18–49 years completed a submaximal exercise test, WHtR measurement, and HRQoL survey (SF-12v2) between 2004 and 2006. FFI level was classified into thirds with the lowest FFI tertile serving as the referent group. PCS and MCS scores ≥50 were taken to indicate average or better. Logistic regression was used to obtain odds ratios (OR) and 95 % confidence intervals (CI). The prevalence of average or better HRQoL scores was lowest in the referent FFI tertile, PCS 60.2 % and MCS 57.6 %. Compared with the lowest FFI group in multivariate analyses, the OR (95 % CI) of having average or better PCS was 1.63 (1.09–2.42) and 3.12 (1.95–4.99) for moderate and high FFI groups respectively; MCS was 1.70 (1.13–2.55) and 4.89 (3.03–7.89) for moderate and high FFI groups respectively (all P < 0.001). Consistent and progressive independent associations were observed between age and MCS, and also between CRF and MCS. Among males in the United States Navy, higher levels of FFI were independently and more consistently associated with having average or better HRQoL (physical and mental) than other known predictors of HRQoL.

ACS Style

Robert A. Sloan; Susumu S. Sawada; Corby K. Martin; Benjamin Haaland. Combined association of fitness and central adiposity with health-related quality of life in healthy Men: a cross-sectional study. Health and Quality of Life Outcomes 2015, 13, 1 -9.

AMA Style

Robert A. Sloan, Susumu S. Sawada, Corby K. Martin, Benjamin Haaland. Combined association of fitness and central adiposity with health-related quality of life in healthy Men: a cross-sectional study. Health and Quality of Life Outcomes. 2015; 13 (1):1-9.

Chicago/Turabian Style

Robert A. Sloan; Susumu S. Sawada; Corby K. Martin; Benjamin Haaland. 2015. "Combined association of fitness and central adiposity with health-related quality of life in healthy Men: a cross-sectional study." Health and Quality of Life Outcomes 13, no. 1: 1-9.

Journal article
Published: 01 June 2015 in Singapore Medical Journal
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Formed in 1959, the Singapore Medical Association (SMA) is the national medical organisation representing the majority of medical practitioners in both the public and private sectors

ACS Style

Yung Seng Lee; S Biddle; Mf Chan; A Cheng; M Cheong; Yap Seng Chong; Ll Foo; Ch Lee; Sc Lim; Ws Ong; J Pang; S Pasupathy; Robert Sloan; M Seow; G Soon; B Tan; Tc Tan; Sl Teo; Kw Tham; Rm Van Dam; J Wang. Health Promotion Board–Ministry of Health Clinical Practice Guidelines: Obesity. Singapore Medical Journal 2015, 57, 292 -300.

AMA Style

Yung Seng Lee, S Biddle, Mf Chan, A Cheng, M Cheong, Yap Seng Chong, Ll Foo, Ch Lee, Sc Lim, Ws Ong, J Pang, S Pasupathy, Robert Sloan, M Seow, G Soon, B Tan, Tc Tan, Sl Teo, Kw Tham, Rm Van Dam, J Wang. Health Promotion Board–Ministry of Health Clinical Practice Guidelines: Obesity. Singapore Medical Journal. 2015; 57 (6):292-300.

Chicago/Turabian Style

Yung Seng Lee; S Biddle; Mf Chan; A Cheng; M Cheong; Yap Seng Chong; Ll Foo; Ch Lee; Sc Lim; Ws Ong; J Pang; S Pasupathy; Robert Sloan; M Seow; G Soon; B Tan; Tc Tan; Sl Teo; Kw Tham; Rm Van Dam; J Wang. 2015. "Health Promotion Board–Ministry of Health Clinical Practice Guidelines: Obesity." Singapore Medical Journal 57, no. 6: 292-300.

Randomized controlled trial
Published: 01 March 2015 in Contemporary Clinical Trials
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Non-communicable diseases (NCDs) are emerging as the predominant global health challenge of this century. Physical inactivity is one of the primary risk factors for NCDs. Therefore, increasing physical activity levels is a public health imperative. The arrival of affordable wearable technologies, such as wireless pedometers, provides one strategy for encouraging walking. However, the effectiveness of these technologies in promoting sustained behavior change has not been established. Insights from economics suggest that incentives may be a useful strategy for increasing maintenance and effectiveness of behavior change interventions, including physical activity interventions that rely on wearable technologies. The aim of this trial is to test the effectiveness of a common wireless pedometer with or without one of two types of incentives (cash or donations to charity) for reaching weekly physical activity goals. We present here the design and baseline characteristics of participants of this four arm randomized controlled trial. 800 full-time employees (desk-bound office workers) belonging to 15 different worksites (on average, 53 (sd: 37) employees at each worksite) were successfully randomized to one of four study arms. If shown to be effective, wearable technologies in concert with financial incentives may provide a scalable and affordable health promotion strategy for governments and employers seeking to increase the physical activity levels of their constituents.

ACS Style

Eric A. Finkelstein; Aarti Sahasranaman; Geraldine John; Benjamin A. Haaland; Marcel Bilger; Robert Sloan; Ei Ei Khaing Nang; Kelly R. Evenson. Design and baseline characteristics of participants in the TRial of Economic Incentives to Promote Physical Activity (TRIPPA): A randomized controlled trial of a six month pedometer program with financial incentives. Contemporary Clinical Trials 2015, 41, 238 -247.

AMA Style

Eric A. Finkelstein, Aarti Sahasranaman, Geraldine John, Benjamin A. Haaland, Marcel Bilger, Robert Sloan, Ei Ei Khaing Nang, Kelly R. Evenson. Design and baseline characteristics of participants in the TRial of Economic Incentives to Promote Physical Activity (TRIPPA): A randomized controlled trial of a six month pedometer program with financial incentives. Contemporary Clinical Trials. 2015; 41 ():238-247.

Chicago/Turabian Style

Eric A. Finkelstein; Aarti Sahasranaman; Geraldine John; Benjamin A. Haaland; Marcel Bilger; Robert Sloan; Ei Ei Khaing Nang; Kelly R. Evenson. 2015. "Design and baseline characteristics of participants in the TRial of Economic Incentives to Promote Physical Activity (TRIPPA): A randomized controlled trial of a six month pedometer program with financial incentives." Contemporary Clinical Trials 41, no. : 238-247.

Review article
Published: 01 January 2015 in Frontiers in Pharmacology
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Complementary and alternative medicine (CAM) including Japanese Kampo is known to have anticancer potential. An increasing number of cancer survivors are using CAM for disease prevention, immune system enhancement, and symptom control. Although there have been abundant previous clinical reports regarding CAM, scientific investigations aimed at acquiring quantifiable results in clinical trials, as well as basic research regarding CAM, have only recently been undertaken. Recent studies suggest that CAM enhancement of immune function is related to cytokines. This review provides a translational aspect of CAM, particularly Hozai in Kampo from both scientific and clinical points of view for further development of CAM for cancer treatment.

ACS Style

Marie Amitani; Haruka Amitani; Robert A. Sloan; Hajime Suzuki; Nanami Sameshima; Akihiro Asakawa; Yasuhito Nerome; Tetsuhiro Owaki; Akio Inui; Etsuo Hoshino. The translational aspect of complementary and alternative medicine for cancer with particular emphasis on Kampo. Frontiers in Pharmacology 2015, 6, 1 .

AMA Style

Marie Amitani, Haruka Amitani, Robert A. Sloan, Hajime Suzuki, Nanami Sameshima, Akihiro Asakawa, Yasuhito Nerome, Tetsuhiro Owaki, Akio Inui, Etsuo Hoshino. The translational aspect of complementary and alternative medicine for cancer with particular emphasis on Kampo. Frontiers in Pharmacology. 2015; 6 ():1.

Chicago/Turabian Style

Marie Amitani; Haruka Amitani; Robert A. Sloan; Hajime Suzuki; Nanami Sameshima; Akihiro Asakawa; Yasuhito Nerome; Tetsuhiro Owaki; Akio Inui; Etsuo Hoshino. 2015. "The translational aspect of complementary and alternative medicine for cancer with particular emphasis on Kampo." Frontiers in Pharmacology 6, no. : 1.

Review
Published: 23 October 2013 in Obesity Reviews
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Singapore's obesity prevalence among adult Singapore residents aged 18–69 increased from 6.9% (2004) to 10.8% (2010). Among school‐going children, the prevalence of overweight and severely overweight (body weight > 120% standard weight for height) increased from 1.4% (1976) to 12.7% (2006) for primary 1 students, and 2.2% to 15.9% for primary 6 students. Fundamentally, obesity is a function of excess energy intake (food consumption) and insufficient energy expenditure (physical activity). In 2010, about 40% did not have sufficient physical activity, and about 60% consumed excess energy. For students in the mainstream schools, only a fifth consumed at least two servings of fruits and vegetables every day, and a tenth were physically active for at least 60 min on 5 or more days a week. From a public health perspective, the most powerful levers for influencing population health lie in interventions that make healthy living convenient and an unconscious choice by targeting the social and environmental context. Recognizing this, the Health Promotion Board has in recent years made a strategic shift away from just public education campaigns aimed at individual behaviours, to focus on creating a ground‐up social movement to enable and empower individuals to live out a healthy lifestyle.

ACS Style

L. L. Foo; K. Vijaya; R. A. Sloan; A. Ling. Obesity prevention and management: Singapore's experience. Obesity Reviews 2013, 14, 106 -113.

AMA Style

L. L. Foo, K. Vijaya, R. A. Sloan, A. Ling. Obesity prevention and management: Singapore's experience. Obesity Reviews. 2013; 14 ():106-113.

Chicago/Turabian Style

L. L. Foo; K. Vijaya; R. A. Sloan; A. Ling. 2013. "Obesity prevention and management: Singapore's experience." Obesity Reviews 14, no. : 106-113.