Urinary incontinence (UI) among older people is a common problem. Several treatments are available for older people with UI including surgery, drug therapies, and behavioral interventions. Recently, much attention has been placed on the behavioral treatments for UI, including pelvic floor muscle (PFM) exercise, weight loss exercise, and thermal therapy, as they have few risks, no side effects, and are effective. These therapies are often recommended as first line treatments for older people with UI. PFM exercise programs often incorporate alternations of fast contractions that are usually held for about two to three seconds interspersed with relaxation intervals of four to five seconds, and sustained contractions, where participants hold the contraction for about eight to ten seconds followed by a relaxation interval of ten to twelve seconds between the contractions. While exercise periods vary between 3 to 24 weeks, 8 to 12 weeks seems to be the most effective length for PFM exercise. The effectiveness of PFM exercise for the improvement of UI has been validated by many studies, with improvement rates ranging widely from 17 to 84%. Also, research has shown that UI is associated with obesity. Increases in body weight cause increases in abdominal wall weight, which in turn increases intra-abdominal pressure and intra-vesicular pressure. Therefore, abdominal fat reduction from exercise may decrease intra-abdominal pressure, perhaps causing improvements in urethral sphincter contraction and, hence, decreasing UI risk. Evidence reveals that PFM exercise and fitness training targeted at reducing modifiable risk factors are effective strategies for treating UI in older people, regardless of UI type.

Pelvic floor trauma developing into pelvic frailty is a significant concern in urogynecology or orthopedics. The majority of women who have experienced vaginal childbirth are affected, to a certain extent, by some form of pelvic floor damage, thereby eliciting substantial alterations of functional anatomy in the pelvic cavity which are manifested as urinary incontinence or pelvic organ prolapse (e.g., uterine prolapse). With the above in mind, medical researchers, continence experts, and continence exercise practitioners in the research areas of sports medicine and rehabilitation medicine believe that the coordinated activity of pelvic floor muscles, in association with the abdominal muscles, is a prerequisite for urinary and defecatory continence. Since the pelvic floor forms the base of the abdominal cavity, stronger pelvic floor muscles are crucial in maintaining such capabilities. Opposing action of the abdominal and pelvic floor muscles ensures that exercises for one may also strengthen the other. Appropriate abdominal maneuverability or logical exercise training of the abdominal muscles may thus be beneficial in maintaining not only strength but also coordination, flexibility, and endurance of pelvic floor muscles and abdominal muscles. Such exercises, collectively known as pelvic floor muscle training, may be effective for long-term pelvic cavity care and also in rehabilitating cases of pelvic floor dysfunction. Further research is needed, however, in determining whether pelvic floor muscle function can be truly enhanced or maintained by such exercises in cases of pelvic floor dysfunction and/or decreased urinary continence.

Mitochondria activation factor (MAF) which is high-molecular weight polyphenol contained in black tea and oolong tea can increase the mitochondrial membrane potential. MAF supplementation to mice facilitates endurance running performance after 9-week endurance training and muscle hypertrophy induced by synergist ablation. In this study, we examined the effect of oral MAF supplementation on overall physical fitness (expressed as physical fitness age) in physically active middle-aged and older women. This study is a randomized double-blind placebo-controlled trial implemented between January and May 2019 at three fitness facilities in Ibaraki, Japan. Seventy middle-aged women aged 55 to 69 years were randomly assigned into placebo (n = 35) and MAF groups (n = 35). The placebo participants took cornstarch-containing capsules, and the MAF participants took MAF-containing capsules twice a day for 80 days consecutively. During the intake period, all participants were instructed to follow 30-min circuit training program at least twice a week. Physical fitness age was computed with eight physical fitness items assessing upper-extremity muscle strength, locomotion, and postural change. The physical fitness age decreased by 1.48 years (95% confidence interval [CI]: -2.66, -0.30) in the placebo group and 3.01 years (95% CI: -4.16, -1.86) in the MAF group. The reduction was greater in the MAF group, but did not reach statistical significance (p = 0.06). The combination of 80-day of MAF intake and circuit exercise showed beneficial results. However, our results did not indicate clear effects on physical fitness age because of low statistical power. Further studies are necessary to reveal the effects of MAF supplementation.

This study described 1-year changes in body weight and metabolic syndrome components in middle-aged obese Japanese men participating in a 6-month weight loss program. This study comprised two phases: 6-month weight loss program and 12-month weight maintenance. Data were collected at Tsukuba, between July 2009 and February 2011. Overweight or obese Japanese men aged 40-64 years without any cardiovascular disease history participated. The primary outcome was the 18-month weight change. Secondary outcomes were 18-month changes in metabolic syndrome components. Primary analyses included all participants who had provided baseline data, and all missing follow-up values were replaced with their baseline data. Of the 58 participants, 39 (67.2%) completed all measurement visits. Their body weight decreased significantly immediately after the 6-month weight loss program (-8.0 kg; 95% confidence interval [CI]: -10.2 kg, -5.8 kg). However, it increased significantly, by 3.7 kg (95% CI: 1.4 kg, 6.0 kg), at Month 18 (a year after the program ended). The 18-month weight loss was 4.3 kg (95% CI: 2.1 kg, 6.5 kg). Among the metabolic syndrome components, visceral fat area, systolic blood pressure, and high-density lipoprotein cholesterol levels improved significantly at Month 18. The other components did not improve over the 18 months. In this study, the obese, middle-aged Japanese men experienced modest weight regains after its substantial reduction. Unlike other ethnicities, factors associated with long-term weight loss maintenance remain understudied among Japanese adults. Therefore, accumulating evidence from Japanese studies with longer follow-up is necessary in the future.

Colorectal cancer patients account for the largest proportion of total cancer patients in Japan. With an increase in its surgical cases and relatively higher five-year survival rate, the number of cancer survivors is expected to be increasing. Therefore, primary prevention, surgical therapy and recurrence prevention for colorectal cancer are public health priorities in Japan. General and abdominal obesity (Not only abdominal but also general obesity) are risk factors for colorectal cancer. In addition, accumulated abdominal fat can extend time spent in surgery by hindering operative procedures and surgical field expansion. These factors raise the risk of postoperative complications such as bleeding and surgical site infection, which eventually leads to increased medical expenses. Physical activity is one of protective factors for colorectal cancer. Recent studies showed that exercise intervention in cancer survivors reduces the cancer recurrence risk. Furthermore, it has been suggested that exercise interventions are effective in reducing fatigue, improving immune function, and maintaining physical function. However, the effectiveness of preoperative exercise intervention aimed at reducing weight in colorectal cancer patients remains unknown. In this review article, we discuss necessity for peri-operative weight loss among obese colorectal cancer patients.

It has been reported that physical fitness of breast cancer patients is relatively lower due to the cancer treatment such as surgery, chemotherapy, or endocrine therapy. Previous studies have revealed that not only cardiorespiratory fitness but also muscle strength is lower among breast cancer patients than no disease women and these symptoms may aggravate the health-related quality of life. However, there is no study which has focused the physical fitness level in Japanese breast cancer survivors. The purpose of this study was to investigate the physical fitness level and the relationship between exercise habituation and physical fitness level in Japanese breast cancer survivors. Fifty breast cancer survivors participated in this study. Participants were assigned to either exercise habituation group (n=25) or non-exercise group (n=25). We evaluated exercise habituation using an original questionnaire and examined various physical fitness level. Body weight, body mass index, and percent body fat were significantly lower in the exercise habituation group than non-exercise group. T-score of cardiorespiratory fitness was significantly higher in the exercise habituation group than average Japanese women. These results suggested that exercise habituation is relative to body weight and cardiorespiratory fitness level in Japanese breast cancer survivors.

Most people who go to fitness clubs or sports gyms for weight control, and many co-medicals and physicians believe that an increase in muscle mass and/or basal metabolic rate (BMR) is possible through a combination of regular exercise and optimal protein intake during weight loss. This seems a myth, and the reasons are discussed in this article. First, muscle mass is quite difficult to quantify. The limitations of body composition measurement should be well understood. Second, increasing muscle mass during weight loss is difficult. This might be attained through strict implementation of a protein-rich, low-carbohydrate diet; high-intensity resistance training; and aerobic exercise for a long duration. However, such a strict regimen is not feasible for most people. Finally, a 1-kg increase in muscle mass corresponds to an increase of only 13 kcal of BMR per day. Thus, an increase in muscle mass of 1 kg is difficult to achieve, while the gained BMR is approximately equivalent to a decrease of 13.5 kcal of BMR according to a 3-kg decrease of adipose tissue. Weight loss, unless through an extremely sophisticated weight control program, contributes to a decrease in BMR. However, it is an accomplished fact that women with significantly less muscle mass and lower BMR live longer than men with more muscle mass and higher BMR, regardless of ethnicity. Maintaining activities of daily living and daily activity function might be more essential.

Although it is common to assess visceral adipose tissue (VAT) by CT and MRI with a single slice at the umbilicus or the fourth and fifth lumbar vertebrae (L4-L5), recent studies reported that this single-slice method for determining an individual’s VAT may be inaccurate. Therefore, VAT accumulation should be based on total volume and determined with multiple slices rather than by cross-sectional area. However, obtaining multiple slices is burdensome for both subjects and analysts and lacks versatility despite its accuracy. The purpose of this study was to develop a new equation model for predicting VAT volume while maintaining the measurement accuracy of the multiple-slice method. We analyzed data from 214 Japanese male adults (48.5±9.3 years) and developed multiple, stepwise, linear regressions with VAT volume as a dependent variable and age, BMI, waist circumference and VAT areas (the standard L4-L5 measurement site 0 cm, +5 cm, +10 cm) as independent variables. From these results, we determined the best prediction equation for VAT volume as follows: VAT volume = (30.4×BMI) + (17.9×VAT area at L4-L5+10 cm) – 501.5. The model explained 93.1% of VAT variance and the predicted VAT volume significantly correlated with the measured VAT volume (r=0.97). This study developed a new VAT assessment method with a high level of accuracy. The method is significantly less burdensome in measurement and analysis than the multiple-slice method. Researchers can use this equation when they require an accurate evaluation of VAT accumulation. However, they should bear in mind that this equation was derived from data acquired from middle-aged, overweight and obese male subjects.