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Shoshani A, Kor A, Bar S. The impact of social media use on psychiatric symptoms and well-being of children and adolescents in the Post-COVID-19 era: a four-year longitudinal study. Eur Child Adolesc Psychiatry 2024; 33:4013-4027. [PMID: 38698136 DOI: 10.1007/s00787-024-02454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
This longitudinal study examined the long-term effects of the COVID-19 pandemic on social media use and its impact on psychiatric symptoms and well-being of 3,697 Israeli children and adolescents aged 8 to 14. Data were collected from October 2019 to June 2023, covering four school years and five measurement points prior to, throughout and post- COVID-19. Social media usage, psychiatric symptoms (depression, anxiety, somatization, and general distress), as well as subjective well-being (positive and negative emotions, and life satisfaction) were assessed. The analysis also probed the extent to which social support and extracurricular activities moderated the associations between social media use and mental health outcomes. The results of the growth mixed-effects models indicated a significant increase in social media use and psychiatric symptoms, and a significant decrease in subjective well-being over time. Greater social media use was related to more psychiatric symptoms and negative emotions, but also to more positive emotions and life satisfaction. Social support buffered the negative effects of excessive social media use on mental health, whereas extracurricular activities increased positive emotions, but also psychiatric symptoms related to social media use. These findings highlight the need for targeted interventions to regulate social media usage, given its lasting consequences on the mental health of children and adolescents in the wake of the COVID-19 pandemic.
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Affiliation(s)
- Anat Shoshani
- Baruch Ivcher School of Psychology, Reichman University, P.O.Box 167, Herzliya, 46150, Israel.
| | - Ariel Kor
- Baruch Ivcher School of Psychology, Reichman University, P.O.Box 167, Herzliya, 46150, Israel
- School of Medicine, Yale University, New Haven, USA
| | - Shira Bar
- Baruch Ivcher School of Psychology, Reichman University, P.O.Box 167, Herzliya, 46150, Israel
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Sitko S, Francín-Gallego M, Pano-Rodríguez Á, Oviedo-Caro MÁ, Mayolas-Pi C, Legaz-Arrese A. Sport practice and depression during adolescence: Special emphasis on performance level and sport discipline. J Sci Med Sport 2024; 27:759-764. [PMID: 39054174 DOI: 10.1016/j.jsams.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/28/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES Depression is one of the most prevalent diseases worldwide, with almost half of the adolescent population affected according to latest research. Given this serious burden of disease, research points toward interventions that could effectively fight this disease in this population subset. One of these pivotal interventions is physical activity, although the effects of different sport types and sport performance level on depression have not yet been studied in adolescent populations. Accordingly, the objective of the current study was to assess the relationship between depressive symptoms, sport type and performance level in a large adolescent population. DESIGN Cross-sectional study assessing a large cohort of adolescents through self-reported data. METHODS 10,248 participants aged 11-19 years old answered questionnaires regarding depressive symptoms and sporting habits and were classified according to their sport performance level: from physically inactive to internationally competitive. RESULTS Girls reported higher incidence of depressive symptoms than boys, difference that further increased during late adolescence. Performance level was related to depressive symptoms: inactive participants reported the highest depressive scores while internationally competitive athletes reported the lowest. However, there were no differences between competitive athletes of different performance levels. Further, sport type had a small influence on depressive symptoms. CONCLUSIONS All these findings result in a potential guideline for future research and community health recommendations: as long as sufficient physical activity levels are met and the adolescent engages in sporting activities, the protection against depressive symptoms remains largely unrelated to the sport type and the level at which he or she performs.
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Affiliation(s)
- Sebastian Sitko
- Faculty of Health and Sport Sciences, University of Zaragoza, Spain; Human Movement Sport Research Group, Spain.
| | - Marina Francín-Gallego
- Human Movement Sport Research Group, Spain; Faculty of Health Sciences, University of San Jorge, Spain
| | | | - Miguel Ángel Oviedo-Caro
- Human Movement Sport Research Group, Spain; Faculty of Education Sciences, University of Sevilla, Spain
| | - Carmen Mayolas-Pi
- Faculty of Health and Sport Sciences, University of Zaragoza, Spain; Human Movement Sport Research Group, Spain
| | - Alejandro Legaz-Arrese
- Faculty of Health and Sport Sciences, University of Zaragoza, Spain; Human Movement Sport Research Group, Spain
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Samsudin N, Bailey RP, Ries F, Hashim SNAB, Fernandez JA. Assessing the impact of physical activity on reducing depressive symptoms: a rapid review. BMC Sports Sci Med Rehabil 2024; 16:107. [PMID: 38720395 PMCID: PMC11077707 DOI: 10.1186/s13102-024-00895-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024]
Abstract
CONTEXT The prevalence of depression among teenagers is a significant issue worldwide, which calls for a thorough investigation of non-drug treatments. This expedited evaluation examines 24 specifically chosen studies to clarify the correlation between physical activity depression symptoms in teenagers, undertaken following PRISMA principles. METHODS A wide range of research methods, including longitudinal studies, surveys, and cross-sectional analyses, were used in different nations to understand the intricate relationship between physical activity, sedentary behaviours, and depression symptoms. The data-gathering methods included standardised questionnaires, accelerometer measurements, and self-report instruments. FINDINGS The review highlights the crucial significance of engaging in physical activity to alleviate depression symptoms. Improved self-esteem consistently acts as a crucial intermediary between participation in physical activity and decreased rates of depression. Engaging in physical activity is a safeguard, particularly for individuals with restricted access to physical activity. In contrast, a sedentary lifestyle greatly increases the probability of developing moderate to severe symptoms of depression. Gender differences are apparent, with females being disproportionately impacted by depression. There are strong connections between engaging in physical activity and reducing symptoms of depression, which can be observed in various situations, such as participating in team sports or engaging in leisure activities. CONCLUSION This study provides insight into the potential of physical activity as a non-pharmacological approach to address adolescent depression. This highlights the significant impact of physical activity, which has important implications for public health programs aimed at improving the mental well-being of adolescents by promoting physical activity. It is crucial to do additional research that considers gender-specific variations and various physical activity circumstances to enhance our comprehension of this important matter.
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Affiliation(s)
- Nadia Samsudin
- Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
| | - Richard Peter Bailey
- Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia.
| | - Francis Ries
- Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
- Department of Physical Education and Sport, Faculty of Educational Sciences, University of Seville, Seville, Spain
| | | | - Janet Ann Fernandez
- Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
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Tao Y, Wu J, Huang L, Zheng K, Liu H, Tian H, Peng L. The relationship between health-promoting behaviors and negative emotions in college freshmen: a cross-lagged analysis. Front Public Health 2024; 12:1348416. [PMID: 38737866 PMCID: PMC11088242 DOI: 10.3389/fpubh.2024.1348416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
Background The prevalence of mental health issues has been gradually increasing among college students in recent years. Improvements in mental health can be achieved through changes in daily behavior and the use of psychological counseling. This study aims to investigate the relationship between health-promoting behaviors and negative emotions among college freshmen as they enter the university. It also examines the impact of various sub-dimensions of health-promoting behaviors and other factors on the negative emotions (stress, anxiety, and depression) experienced by college freshmen. Methods Using the Negative Emotion and Health-Promoting Behavior scales, a 7-month longitudinal study was conducted on 4,252 college freshmen, with collection of data at two time points (T1: November 12, 2021; T2: June 17, 2022). Out of this longitudinal study, 3,632 valid samples were obtained. This research aimed to explore the association and impact between negative emotions and the level of health-promoting behaviors among college students during their time at the university. Results ① There were significant differences in the levels of health-promoting behaviors and negative emotions over the course of 7 months (P < 0.05). Health-promoting behaviors were found to have a significant negative correlation with negative emotions (P < 0.05). ② Negative emotions at T1 significantly negatively predicted health-promoting behaviors at T2 (β = -0.11, P < 0.01), while health-promoting behaviors at T1 significantly negatively predicted negative emotions at T2 (β = -0.12, P < 0.001). ③ Stress management (β = -0.104, P < 0.05; β = -0.087, P < 0.05), self-actualization (β = -0.282, P < 0.01; β = -0.260, P < 0.05), health responsibility (β = -0.057, P < 0.05; β = -0.088, P < 0.05), and interpersonal relations (β = 0.068, P < 0.01; β = 0.138, P < 0.05) were important components in improving stress and anxiety. Self-actualization (β = -0.437, P < 0.001), exercise (β = 0.048, P < 0.001), nutrition (β = 0.044, P < 0.001), and interpersonal relations (β = 0.065, P < 0.001) were important components in improving depression. ④ Gender, place of household registration, and whether the individual is the only child were significant factors affecting negative emotions in college freshmen. Conclusion The level of health-promoting behaviors is an important indicator for assessing the negative emotional states of college freshmen. Enhancing health-promoting behaviors across various dimensions can help alleviate different types of negative emotions. Gender, place of household registration, and being the only child are significant factors that influence negative emotions.
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Affiliation(s)
- YunFei Tao
- College of Physical Education, Southwest University, Chongqing, China
| | - JinLong Wu
- College of Physical Education, Southwest University, Chongqing, China
| | - Li Huang
- College of Physical Education, Southwest University, Chongqing, China
| | - KangYong Zheng
- Department of Rehabilitation Sciences Institute, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - HaoWei Liu
- College of Physical Education, Southwest University, Chongqing, China
| | - HaoDong Tian
- College of Physical Education, Southwest University, Chongqing, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China
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Martín-Rodríguez A, Gostian-Ropotin LA, Beltrán-Velasco AI, Belando-Pedreño N, Simón JA, López-Mora C, Navarro-Jiménez E, Tornero-Aguilera JF, Clemente-Suárez VJ. Sporting Mind: The Interplay of Physical Activity and Psychological Health. Sports (Basel) 2024; 12:37. [PMID: 38275986 PMCID: PMC10819297 DOI: 10.3390/sports12010037] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
The symbiotic relationship between sports practice and psychological well-being has, in recent times, surged to the forefront of academic and public attention. The aim of this narrative review is to comprehensively explore the intricate pathways linking physical engagement in sports to its subsequent impacts on mental health and synthesize the multifarious effects of sports on psychological health, offering insights for integrating physical and psychological strategies to enhance well-being. From neurobiological underpinnings to therapeutic applications, this comprehensive manuscript provides an in-depth dive into the multifaceted world of sports and psychology. Highlighting evidence-based interventions, this review aspires to offer actionable insights for practitioners, athletes, and individuals alike, advocating for a holistic approach to mental well-being. This manuscript highlights the profound impact of sports on mental health, emphasizing its role in emotional regulation, resilience, cognitive function, and treating psychological conditions. It details how sports induce neurochemical changes, enhance brain functions like memory and learning, and aid against cognitive decline. This review also notes the benefits of regular exercise in mood improvement, stress management, and social skill enhancement, particularly when combined with mindfulness practices. It underscores the importance of considering cultural and gender perspectives in sports psychology, advocating for an integrated physical-psychological approach to promote overall well-being.
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Affiliation(s)
- Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | - Laura Augusta Gostian-Ropotin
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | | | - Noelia Belando-Pedreño
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | - Juan Antonio Simón
- Department Ciencias Sociales Act Fis Deporte & Ocio, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Clara López-Mora
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Valencia, Pg. de l’Albereda, 7, 46010 València, Spain;
| | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Liu L, Guo C, Lang F, Yan Y. Association of breakfast, total diet quality, and mental health in adolescents: a cross-sectional study of HBSC in Greece. Eur J Pediatr 2023; 182:5385-5397. [PMID: 37740042 DOI: 10.1007/s00431-023-05180-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/03/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
The emerging field of nutritional psychiatry offers proof that diet quality can be changed to reduce one's risk of developing mental illness. What you eat has a big impact on teenage mental health, and the quality and frequency of breakfast, as well as the different food groups, can affect adolescent mental health. In this study, regression models were employed to analyze four indicators (self-rated health, body satisfaction, life satisfaction, and eight symptoms) of mental health problems as well as demographic factors (gender, age, body mass index, affluence class, physical activity), with forest plots displaying the regression connections. This study, a descriptive cross-sectional survey of 3480 adolescents aged 11 to 15 years, chosen data from the 2018 Greek Health Behaviour in School-aged Children (HBSC) International Study for secondary analysis. The data revealed that high levels of four indicators of mental health (self-rated health, body satisfaction, life satisfaction, and eight symptoms) were significantly related to breakfast quality, total dietary patterns. Students reporting poor total food quality, for example, were more predictive of self-assessment when unhealthy (2.286 95% CI 1.851-2.824), and the largest connections with eating a "bad" breakfast were discovered when the eight symptoms of mental status were the worst (- 0.869 95% CI: - 1.300, - 0.439); physical activity may enhance the positive relationship of diet quality on mental health, while obesity weakens this positive relationship; and age patterns varied by gender, with girls and older individuals showing a higher risk of diet quality and mental health. Conclusions: The findings revealed that each of the four indices of general mental health was correlated with teenage breakfast and overall diet quality. Physical activity and weight were shown to be moderating factors, and obesity had the biggest impact on psychological risk. Gender, age, and family economic inequality were potential explanations for the rise in psychological symptoms. Researchers are urged to focus more on nutritional psychiatry research and look into psychological perception disparities in the future. What is Known: • There is a potential correlation between adolescent dietary patterns or quality and mental health. • Factors such as age, gender, socio-economic status, body weight and physical activity all have an impact on diet and mental health outcomes. What is New: • There have been no studies of the ability to simultaneously predict breakfast quality and overall diet quality for broadly defined mental health complaints [positive (life satisfaction), neutral (body satisfaction, self-rated health) and negative (eight symptoms: depressed mood, irritability, nervousness, difficulty sleeping, dizziness, headache, stomachache and backache)]. • Differences in overall diet quality trends between demographic subgroups remain unclear.
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Affiliation(s)
- Liying Liu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Chaofan Guo
- Shanxi Provincial People's Hospital (Fifth Hospital of Shanxi Medical University), Taiyuan, Shanxi, 030012, China
| | - Fangfang Lang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Yaqiong Yan
- Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital), Taiyuan, Shanxi, 030013, China.
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Chou FY, Chiu TF, Huang FW, Hsu TY, Liu CY, Lin CH, Huang PY, Lin KM, Wu SH. The effect of exercise on the risk of metabolic syndrome associated with sleep insufficiency: a cross-sectional study. Front Cardiovasc Med 2023; 10:1192241. [PMID: 37808885 PMCID: PMC10556234 DOI: 10.3389/fcvm.2023.1192241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Sleep disturbance and insufficient sleep have been linked to metabolic syndrome, increasing cardiovascular disease and mortality risk. However, few studies investigate the joint effect of sleep and exercise on metabolic syndrome. We hypothesized that regular exercise can mitigate the exacerbation of metabolic syndrome by sleep insufficiency. Objective The aim of this study was to investigate whether exercise can attenuate or eliminate the relationship between sleep insufficiency and metabolic syndrome. Method A total of 6,289 adults (mean age = 33.96 years; women: 74.81%) were included in the study, a cross-sectional study conducted based on the results of employee health screening questionnaires and databases from a large healthcare system in central Taiwan. Participants reported sleep insufficiency or not. Self-reported exercise habits were classified into 3 levels: no exercise, exercise <150 min/week, and exercise ≧150 min/week. Multiple logistic regression and sensitivity analyses were conducted to understand the joint associations of sleep patterns and exercise with metabolic syndrome with exposure variables combining sleep duration/disturbances and PA. Results Compared with the reference group (sufficient sleep), individuals with sleep insufficiency had a higher risk for metabolic syndrome [adjusted odds ratio (AOR) = 1.40, 95% confidence interval (95% CI): 1.01-1.94, p < 0.05] in females aged 40-64 years, but not in other populations. Sleep insufficiency was not associated with the risk of metabolic syndrome among individuals achieving an exercise level of <150 min/week, and in particular among those achieving ≧150 min/week in all populations in our study. Conclusion Sleep insufficiency was related to a higher risk of metabolic syndrome in female healthcare staff aged 40-64 years. Being physically active with exercise habits in these individuals, the risk of metabolic syndrome was no longer significant.
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Affiliation(s)
- Fan-Ya Chou
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Fa Chiu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Fen-Wei Huang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Tai-Yi Hsu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chien-Yu Liu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chin-Han Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Yao Huang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Kuei-Ming Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Hao Wu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
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Yamaguchi S, Kawasaki Y, Oura A, Kimura S, Horii M, Watanabe S, Sasho T, Ohtori S. Differential Associations of Sports Participation With Self-Rated Health and Depressive Symptoms Among Japanese Adolescents. Cureus 2023; 15:e43776. [PMID: 37731422 PMCID: PMC10508711 DOI: 10.7759/cureus.43776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION We aimed to evaluate the associations of sports participation with self-rated health and depressive symptoms in a nationally representative sample of Japanese adolescents. METHODS A questionnaire survey was conducted with 1,658 adolescents aged between 12 and 21 years. Sports participation levels were divided into high-frequency, moderate-frequency, low-frequency, and no-participation groups. Self-rated health was evaluated using a four-grade scale. Depressive symptoms were assessed using the Japanese version of the Patient Health Questionnaire-8. Other lifestyle behaviors were also surveyed. The associations of sports participation with self-rated health and depressive symptoms were examined using multiple logistic regression analysis. RESULTS The participants in the high- (odds ratio (OR), 0.45) and moderate-frequency (OR, 0.46) groups were less likely to self-report poor health than those in the non-participation group. By contrast, a U-shaped association was found between sports participation and depression, in which the participants in the moderate-frequency group (OR, 0.52) were less likely to have depressive symptoms. The OR for the high- (0.89) and low-frequency (0.91) groups were not significant. Furthermore, eating regular breakfasts, six or more days/week, and having shorter screen times of less than two hours/day were negatively associated with poor self-reported health and depressive symptoms. CONCLUSION Moderate- to high-frequency sports activities are associated with a reduced risk of poor self-rated health among Japanese adolescents. However, only moderate-frequency activities were associated with a reduced risk of depression. Participation in optimal sports activities may effectively lower the risk of poor health in adolescents.
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Affiliation(s)
- Satoshi Yamaguchi
- Graduate School of Global and Transdisciplinary Studies, Chiba University, Chiba, JPN
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, JPN
| | - Yohei Kawasaki
- Epidemiology and Public Health, Institute for Assistance of Academic and Education, Tokyo, JPN
| | - Ayako Oura
- Epidemiology and Public Health, Institute for Assistance of Academic and Education, Tokyo, JPN
| | - Seiji Kimura
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, JPN
| | - Manato Horii
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, JPN
| | - Shotaro Watanabe
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, JPN
| | - Takahisa Sasho
- Center for Preventive Medical Sciences, Chiba University, Chiba, JPN
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, JPN
| | - Seiji Ohtori
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, JPN
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