Changes in blood lactic acid density after 10 minutes of 80% VO₂max. bicycle exercise due to bathing in CO₂ water obtained from a newly developed CO₂ water generator (MCH-C80: Maeda Iron Works Co., Ltd.) were compared with changes due to bathing in plain water. The blood lactic acid density increased from 1.6mmol/l to 9.3mmol/l due to the exercise load, but decreased to 3.3mmol/l after 10 minutes of CO₂ water bathing at 38°C and further decreased to 1.9mmol/l after 30 minutes. In the group bathing in plain water, blood lactic acid density decreased to 4.0mmol/l immediately after bathing and to 2.3mmol/l after 30 minutes. The difference in results between the CO₂ water bathing group and plain water groups was significant (p<0.05). No bad effects of CO₂ water bathing were observed. Thus, CO₂ water obtained from this CO₂ water obtained from this CO₂ water generator is useful for enhancing the effect of bathing on recovery from fatigue.

The thermotherapeutic effects of bathing with CO₂ water obtained from a newly developed CO₂ water supply system was studied in comparison with bathing with plain water. After 10min bathing at 39°C, dermal blood flow in the upper arm region was higher in the group bathing with CO₂ water than in that bathing with plain water (p<0.05).
Further, the skin temperature lowering in the forehead region after bathing was slower in the group bathing with CO₂ water than in that bathing with plain water. The subjective sense of being heated and sense of comfort during and after bathing were also higher in the group bathing with CO₂ water. No side effects were found. It is therefore suggested that the CO₂ water obtained from this system is useful for enhancing the thermotherapeutic effect of bathing.

We plotted the distribution of long-lived persons derived from the national register of long-lived persons as of fiscal years of 1980 (N=1, 349) and 2000 (N=17, 740) prepared by the Ministry of Health and Welfare to investigate various factors such as medical climatology and geography on healthy aging. The data were plotted on a map of Japan classified into various living environments, such as coastal areas, forests, and mountainous areas. In addition, we investigated universal elements and transforming elements through year-by-year comparisons over a period of 20 years. Japan was divided into nine climatic districts Hokkaido, the Japan Sea area, the Pacific Ocean area, the Sanriku district, the Tokai district, the inland district, the Seto Inland Sea district, the Northern Kyushu district, the Nankai district, and the South-western Islands.
Consequently, we found a common trend that relatively warm climates and climates in coastal areas are favorable for longevity. However, the following trends were also recognized as transforming elements that cannot be ignored: 1. A remarkable improvements in the rate (number of long-lived people per 100, 000 population) in cold climate regions, i.e., the Japan sea area, inland area, and Hokkaido; 2. A remarkable shift of higher rates from coastal areas, which are contaminated by industrial plants, to inland flat areas.
As a result, it has become clear that research on factors of healthy aging, especially in cold climate regions, have to be made in the future.

The purpose of this study was to examine how constitutions, blood profiles, knee and back pain, and the psychological state of middle-aged and elderly women were influenced by comprehensive health education that consisted of instructions in appropriate ways of bathing in hot springs and education on lifestyle and exercise.
Of the middle-aged and elderly female residents in village A in Nagano prefecture, 266 underwent health check-ups in August and September 2002. Fifty-six of these women voluntarily participated in this study, and were divided into an intervention and a control group randomly. Finally, the intervention group and control groups consisted of 22 and 26 subjects, respectively, who were considered suitable for study purposes.
The intervention group received comprehensive health education once a week for 3 months (total 11 times) between the latter part of September and the middle of December. For the comprehensive health education, subjects participated in hot spa bathing in a salt spring for 20 minutes in all (two 10-minute periods), and lifestyle education and exercise, including stretching, walking, light sports, dietary instruction, etc., during 60-minute sessions. After the series of comprehensive health education was completed, the following improvements were noted in the intervention group. As to blood profiles, the plasma level of uric acid significantly decreased from 4.4±1.1mg/dl to 4.1±1.1mg/dl (p<0.05) and the arterioloscerotic index decreased from 2.85±0.90 to 2.68±0.83 (p=0.07). The intensity of lumbago expressed on a visual analogue scale significantly decreased from 23.5±28.4% to 14.2±21.5% (p<0.01). The intensity of psychological tension decreased from 45.3±6.3 points to 43.2±6.0 points (p=0.06). The mean number of comprehensive health education sessions attended was 9.9±1.4 (range 7 to 11). The number of improvements implemented with regard to a healthy lifestyle significantly increased (p<0.05). Behavior of the subjects in the intervention group appeared to have changed towards a desirable lifestyle.
The results of this study show that even intermittent and brief health education combining “hot spa bathing and lifestyle education and exercise” is effective to maintain and improve health of middle-aged and elderly women.

Balneotherapy includes several modalities of treatments and wellness programs, such as physiological and pharmacological effects of hot spring bathing and aqua-exercise, relaxing and biorhythm adjusting effects of staying in the urban climates and educational instruction for healthier life style. We examined health promoting effects of the comprehensive balneotherapy as a whole by the randomized controlled study. 89 women, who had no medical care, and were aged 40-65 years (mean +/- SD age: 59.0 +/- 8.0 years), volunteered for this investigation. Subjects were assigned at random to three groups; group 1 was the control group without any intervention; group 2 with exercise for 60min and educational guidance; group 3 with exercise for 30min and balneotherapy including aquaexercise for 30min and bathing in hot spring for 30min in addition to educational guidance. Each group followed the prescribed program twice a week for 3 months. There was no significant difference in age, body mass index (BMI), blood pressure, heart rate, %FAT, diet/exercise custom and psychological conditions among the three groups. Before and after the program, the physiological, biochemical and psychological measurements were performed: body weight, blood pressure, heart rate, physical strength using ergometer, serum lipids, liver function and questionnaires with profile of mood state (POMS) and self relating depression scale (SDS). After excluding 4 subjects who were dropped out because of their convenience, the results were compared. In group 2 (N=28) and 3 (N=28), body weight, BMI, blood pressure and heart rate were significantly decreased and their physical strength and psychological condition were improved significantly (p<0.05). Furthermore only in group 3, serum total cholesterol, atherogenic index and triglyceride were significantly decreased (p<0.05). The difference between these two groups was not due to changing of their diet and estimated energy consumption by daily activities during 3 months. These data suggest the efficacy of balneotherapy with hot spring bathing and aqua-exercise for health promotion.

The Ministry of Health and Welfare inaugurated an official recognition system for spa-based health promotion facilities in 1988 as part of its health promotion program. As a result, those facilities gradually increased across the country until the number of the recognized facilities reached 17 by February 1995.
The Japan Health & Research Institute has performed factfinding surveys on the use of these recognized spa-based health promotion facilities every year from the beginning of the recognition system. This paper reports the survey results obtained during these 5 years.
During the past 5 years, 275 males and 138 females used these spa-based health promotion facilities (with tax deductions applied to madical expenses). The number of male patients was about twice as large as that of female patients. Most males used the facilities because of diseases in the field of internal medicine, and most females, because of diseases in the field of orthopedic surgery.
We are planning to prepare a manual for evaluating the effects of spa therapy and assess the efficacy of spa therapy by including a new survey item of “clinical effects of spa therapy” in a questionnaire for a nationwide survey.

This study attempted to clarify the effects of 3- and 6-month comprehensive health education programs based on hot spa bathing, lifestyle education and physical exercise on physique, psychological vigor, blood properties, pains in the knee and back, and mental and psychological aspects of women. We examined middle-aged and elderly women who were randomly divided into two groups and followed up until six months and one year later, respectively.
Spa programmers, an exercise instructor, and a dietician instructed subjects to one hour of life-style education and physical exercise (lecture on behavior modification, walking, rhythmic exercise, cooking practice, etc.) and one hour (including time for changing clothes and washing body) of a half bath (salt spring, temperature at 41.5) once a week. The program for the 3-month group (n=19) was repeated in the 6-month group (n=14).
The evaluation items were BMI, PWC75%HRmax (by a bicycle ergometer as aerobic capacity), blood properties (total cholesterol, HDL cholesterol, arteriolosclerotic index, uric acid, and HbAlc), profile of mood states, self-rating depression scale, subjective happiness, and pains in the knee and back.
Compared with pre-intervention data (26.3±3.6), the BMI decreased significantly (p<0.05) immediately after the intervention (25.7±3.5) and at the follow up six months later (25.7±3.3) in the group of 6-month intervention. In addition, the PWC75%HRmax, HbAlc, pains in the back, vigor, depression, and subjective happiness remained significantly improved (p<0.05), as measured at the 6-month follow-up. On the other hand, some of the items improved in the 3-month intervention group immediately after the intervention, but returned to nearly the same levels as those before intervention at the 1-year follow-up. Significant differences (p<0.05) were found in the PWC75%HRmax, HbAlc, and fatigue between the two groups, all of which were improved in the 6-month intervention group.
These results suggest that a low frequency, once-a-week intervention requires duration longer than three months to maintain the effects, and that the effects should be monitored over years for a correct assessment.