[ English ]・・・

Using your Health Handbook

・・・

Health Handbooks: Part of the Health Promotion Act
・This handbook is an important tool used to manage your health. Manage it withcare and do not lose it.
・You or a family member can ﬁll in the sections pertaining to health screenings,
health education, and health counseling. If you are unsure of what to ﬁll in, speakwith a municipal representative or have them complete it for you.
・When receiving medical care, present this handbook and your medication
handbook to your doctor, dentist, or pharmacist.
・Make sure to bring the handbook with you when receiving a Speciﬁc Health
Checkup.
・You should also bring it with you if taking part in a health class or workshop, or
receiving health counseling.

1contents
Using your Health Handbook

1

Recording Speciﬁc Health Checkups

3

Blood pressure and weight log

7Interpreting the results of a Speciﬁc Health Checkup

9Speciﬁc health guidance

11

Health education

13

Dental disease and osteoporosis screenings

15

Gastric and lung cancer screenings

17

Colorectal cancer screenings

19

Cervical and breast cancer screenings

21

Key points to health development
Extending your healthy life expectancy

23

Preventing lifestyle diseases

24

Eating a balanced diet

25

Pursuing moderate exercise

29

Getting suﬃcient sleep

31

Quitting smoking

32

Consuming alcohol in moderation

33

Maintaining dental and oral health342

・・・ Recording Speciﬁc Health Checkups ・・・

Exam date

/

/

/

/

Height (cm)Weight (kg)
Waist circumference (cm)BMI
Blood pressure(systolic to diastolic) (mmHg)

̶Blood lipid test

Triglycerides(mg/dl)HDL cholesterol(mg/dl)LDL cholesterol(mg/dl)Liver function test

AST (GOT) (U/I)
ALT (GPT) (U/I)γ‒GT (γ‒GTP) (U/I)

Blood glucose test

Fasting blood glucose
level (mg/dl)

Urine test

GlucoseHemoglobin A1c (%)

Protein

3

̶

/

/

̶

/

/

̶

4

/

/

̶

Exam date

/

/

/

/

Erythrocyte countAnemia test

(10,000/mm³)

Hemoglobin(g/dl)

Hematocrit level
(%)

Renal
function test

Creatinine serum(mg/dl)eGFR(ml/min/1.73m²)

ECG

Ophthalmogram

No abnormality found

No abnormality foundPossible abnormality foundPossible abnormality found

No abnormality found

No abnormality foundPossible abnormality foundPossible abnormality foundMetabolic syndrome

Metabolic syndrome

Pre-metabolic syndrome

Pre-metabolic syndrome

Does not meet criteria

Does not meet criteria

Medical history
Medication history
OthersSmoking history
Subjective symptoms
Objective symptoms
Metabolic syndrome
evaluation(circle the appropriate category)

Doctor s opinion andname of doctor

Institution

5

/

/

/

/

/

/

No abnormality found

No abnormality found

No abnormality foundPossible abnormality foundPossible abnormality foundPossible abnormality found

No abnormality found

No abnormality found

No abnormality foundPossible abnormality foundPossible abnormality foundPossible abnormality foundMetabolic syndrome

Metabolic syndrome

Metabolic syndrome

Pre-metabolic syndrome

Pre-metabolic syndrome

Pre-metabolic syndrome

Does not meet criteria

Does not meet criteria

Does not meet criteria

6■ Blood pressure and weight log

WeightBloodpressure

ー110

220

ー100

200

ー 90

180

ー 80

160

ー 70

140

ー 60

120

ー 50

100

Systolic (maximum)
blood pressure

Weight

ー 40

80

ー 30

60 Diastolic (minimum)

ー 20

40

blood pressure

（kg）

20

（mmHg）

Date measured
Bloodpressure

Systolic
Diastolic

Weight (kg)(Example)
4

1

140

8

1

132

70

68

49

51

7

Bloodpressure

Weight220 110 ー
200 100 ー
180

90 ー

160

80 ー

140

70 ー

120

60 ー

100

50 ー

80

40 ー

60

30 ー

40

20 ー

（kg）

20

（mmHg）

Date measured
Systolic
DiastolicBloodpressure

Weight (kg)8

・・・Interpreting the results of a Speciﬁc Health Checkup・・・
Item

Explanation

Waist circumference

A CT scan is performed in order to measure visceral fat in theabdomen. If the total area is over 100cm², this is referred to as
excess accumulation. The standard for men is 85cm, and for
women it is 90cm. This metric is used as a basis to determine
whether a person has metabolic syndrome.

BMI

BMI is an acronym for Body Mass Index and is used to determine
the threshold for obesity. Body weight and height are applied to
the following formula.
BMI = weight (kg) / height (m) x height (m)The threshold set by the Japan Society for the Study ofObesity sets a BMI of 22 as the threshold at which a person
is statistically least prone to diabetes, hypertension, anddyslipidemia. A BMI of 25 or higher is considered obese, withobesity ranked across four levels.

Blood pressure

Blood pressure is measured in the systolic and diastolic phases(contraction and release) to determine whether a person has
hypertension. The main cause of hypertension in Japanesepeople is excess sodium consumption. Other causes ofhypertension are obesity, alcohol consumption, and lack of
exercise. Alongside smoking, hypertension is considered a majorrisk factor for lifestyle diseases.

Blood lipid test
Liver function test

Triglycerides

Triglycerides, also called fats, are found in meat, ﬁsh, andcooking oils, as well as in body fat. A high triglyceride content
in the blood is used as a diagnostic criterion for metabolic
syndrome.

HDL cholesterol

Considered the good cholesterol, this form helps prevent
arteriosclerosis. It absorbs excess cholesterol and wipes thevascular walls clean of excess cholesterol, returning it to theliver. Lifestyle habits like smoking and lack of exercise contributeto decreased HDL cholesterol.

LDL cholesterol

Considered the bad cholesterol, it is responsible fortransporting cholesterol produced in the liver to the rest of the
body. Excess LDL cholesterol can cause arteriosclerosis and leadto myocardial infarction and cerebral infarction (stroke).

GOT/GPT

GOT is also called AST, and is an enzyme found in large
quantities in the heart, muscles, and liver. GPT is also called ALT,
and it is an enzyme found in large quantities in the liver. HighGOT and GPT levels can cause acute and chronic hepatitis, fatty
liver, liver cancer, and alcoholic hepatitis.

γ ‒GTPγ ‒GTP is an enzyme that breaks down protein. It is secreted in
the biliary tract and aids the liver in detoxiﬁcation. γ -GTP levels
increase when consuming large amounts of alcohol or due tobiliary tract impairments, so it is used as an indicator of liverfunction.

9

Item

Explanation

Blood glucose test
Urine test
Anemia test
Renal function test

Fasting blood
glucoseGlucose level is also referred to as blood sugar . The riskof diabetes increases twofold when glucose is 100mg/dL or
higher after fasting, so this is used as a metric for Speciﬁc healthguidance.

Hemoglobin
A1c

Hemoglobin A1c is a measure of how much erythrocyte
hemoglobin is bound to glucose (glycated hemoglobin).
Hemoglobin A1c levels change per the blood glucose level from1‒2 months prior, so this serves as an indicator of whether blood
sugar is under control.

GlucoseWhen glucose concentration in the blood is so high that is
cannot be reabsorbed, glucose appears in the urine. Conditions
like diabetes, hyperthyroidism, and renal glucosuria can cause
glucose to appear in the urine.

Protein

When the urine contains above a certain threshold of protein,
it is referred to as albuminuria. The kidneys function by ﬁltering
impurities and producing urine. Proteins required by the body arereabsorbed and returned to the bloodstream, but abnormalitiesof the kidneys, ureter, or other secretory organs can cause
protein to fail to be reabsorbed and release into the urine.

Erythrocyte
count

Erythrocytes convey oxygen throughout the body and absorb
carbon dioxide, sending it to the lungs. Excess erythrocytes may
indicate a condition called polycythemia, and a shortage may
indicate anemia.

Hemoglobin

Hemoglobin is the oxygen-carrying pigment and predominant
protein in the red blood cells. A lack of iron can inhibit the bodyfrom synthesizing hemoglobin and reduce the number of red
blood cells, causing iron deﬁciency anemia and putting you atrisk of palpitations, shortness of breath, fatigue, and headaches.

Hematocrit
level

Hematocrit level indicates the percentage of erythrocytes (redblood cells) in the bloodstream. A low hematocrit level can
indicate anemia, while a high level can indicate polycythemia.

CreatinineHigh creatinine serum levels are implicated in decreased renal
function. Even if you do not have subjective symptoms, kidney
function may be signiﬁcantly impaired, so caution is advised.

eGFR

Estimated glomerular ﬁltration rate (eGFR) is computed based on
creatinine serum levels, age, and sex. It is used as an indicator ofkidney function.

10

・・・

Speciﬁc health guidance

Date

Speciﬁc health guidance(circle the applicable category)

/

/

・・・

/

/

Intensive health guidance

Intensive health guidance

Motivational healthguidance

Motivational healthguidance

N/A

N/A

Others(describe natureof support oﬀered)

11

/

/

/

/

/

/

Intensive health guidance

Intensive health guidance

Intensive health guidance

Motivational healthguidance

Motivational healthguidance

Motivational healthguidance

N/A

N/A

N/A

12

Health education

・・・

・・・

Health education log
Date

Enter details (nature of consultation/guidance)

/

/

/

/

/

/

Health consultation log
Date

Enter details (nature of consultation/guidance)

/

/

/

/

/

/

13

Visiting instruction log
Date

Enter details (nature of guidance)

/

/

/

/

/

/

14

・・・Dental disease and osteoporosis screenings・・・
Dental disease screenings/

Exam date///

No abnormalities

No abnormalities

Requires guidanceRequires guidanceRequires comprehensive exam

Requires comprehensive exam

Evaluation

Institution

Comprehensive
exam

Exam date

/

/

/

/

/

/

/

/

Institution

Osteoporosis screenings
Exam date

Evaluation

No abnormalities

No abnormalities

Requires guidanceRequires guidanceRequires comprehensive exam

Requires comprehensive exam

Institution

Comprehensive
exam

Exam date//Institution

15

/

/

Dental disease screenings

/

/

/

/

/

/

No abnormalities

No abnormalities

No abnormalities

Requires guidanceRequires guidanceRequires guidanceRequires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

/

/

/

/

/

/

/

/

/

/

Osteoporosis screenings//

No abnormalities

No abnormalities

No abnormalities

Requires guidanceRequires guidanceRequires guidanceRequires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

/

/

/

/

16

/

/

・・・ Gastric and lung cancer screenings ・・・
Gastric cancer screenings
Exam date

/

/

/

/

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Evaluation

Institution

Comprehensive
exam

Exam date

/

/

/

/

/

/

/

/

Institution

Lung cancer screenings
Exam date

Evaluation

Sputum cytology

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Performed / not performed

Performed / not performed

Institution

Comprehensive
exam

Exam date//Institution

17

/

/

Gastric cancer screenings

/

/

/

/

/

/

No comprehensive exam
necessary

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

/

/

/

/

/

/

/

/

/

/

Lung cancer screenings//

No comprehensive exam
necessary

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

Performed / not performed

Performed / not performed

Performed / not performed

/

/

/

/

18

/

/

Colorectal cancer screenings

・・・

・・・

Colorectal cancer screenings
Exam date

/

/

/

/

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Evaluation

Institution

Comprehensive
exam

Exam date//Institution

19

/

/

Colorectal cancer screenings

/

/

/

/

/

/

No comprehensive exam
necessary

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

/

/

/

/

20

/

/

・・・ Cervical and breast cancer screenings ・・・
Cervical cancer screenings/

Exam date///

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Evaluation

Institution

Comprehensive
exam

Exam date

/

/

/

/

/

/

/

/

Institution

Breast cancer screenings
Exam date

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Evaluation

Institution

Comprehensive
exam

Exam date//Institution

21

/

/

Cervical cancer screenings

/

/

/

/

/

/

No comprehensive exam
necessary

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

健

健
な
制
は
で

平
/

/

/

/

/

/

男
Breast cancer screenings

/

/

/

/

/

/

No comprehensive exam
necessary

No comprehensive exam
necessary

No comprehensive exam
necessary

Requires comprehensive exam

Requires comprehensive exam

Requires comprehensive exam

/

/

/

/

22

/

/

女

【資
○平
○健
総
よ

健康寿命をのばそう

・・・

・・・

・・・ Extending your healthy life expectancy ・・・

What is considered a healthy life expectancy?
康寿命とは？

Healthy life expectancy refers to the length of time one can engage in everyday life
康寿命とは、日常生活に制限のない期間を指します。起床、衣類着脱、食事、入浴
without restrictions. This means being able to rise from bed, change clothes, eat, andどの普段の生活における動作が一人ででき、外出、仕事、家事、学業、運動などに
bathe without assistance, as well as go out of doors, engage in work and chores,
限がない期間です。しかし日本人の平均寿命と健康寿命の差、つまり不健康な期間
studies, and exercise unaided. However, there is a ten-year gap between Japanesepeople s average life expectancy and their healthy life expectancy, implying that
約 10 年もあることがわかっています。平均寿命以上に健康寿命をのばすことが大切
they spend many years inﬁrm. The key is extending one s healthy life expectancy
す。
beyond the average life expectancy.

均寿命と健康寿命（男女別）
Average life expectancy and healthy life expectancy (male/female)
60

性

性

6560
Men

Women

70
65

7075

75

80 80

8585

90（年）
(years)90
平均寿命
Averagelife expectancy

80.21
80.21
71.19

71.19

Healthy
life expectancy
健康寿命9.02 years

9.02年

Diﬀerence
between
平均寿命と健康寿命の差
average life expectancy
and healthy life expectancy
健康寿命をのばして、
この差を縮めましょう。

86.61
86.31
74.21 74.21

12.40 years

12.40年

Increase your healthy
life expectancy tobridge this gap.

Graph created based on:
1. Average life expectancy: Ministry of Health, Labour, and Welfare, 2013 Simpliﬁed Life Expectancy Tables】
2. Healthy life expectancy: Ministry of Health, Labour, and Welfare, 2013 Simpliﬁed Life Expectancy Tables; 2013 Statistical
寿命 : 厚生労働省「平成25 年簡易生命表」
Analysis of Population
Dynamics; 2013 Comprehensive Survey of Living Conditions and Ministry of Internal Aﬀairs andCommunications,2013 Estimated「平成Population
寿命 : 厚生労働省「平成25 年簡易生命表」
25 年人口動態統計」「平成 25 年国民生活基礎調査」、
省「平成 25 年推計人口」
算出

23

・・・

Preventing lifestyle diseases

・・・

What are lifestyle diseases?
Lifestyle diseases are ailments caused by diet, exercise, rest, smoking, and alcohol
consumption habits, and they include conditions like cancer, respiratory diseases,
diabetes, and chronic obstructive pulmonary disease (COPD).
Not only are lifestyle diseases the foremost inhibitor of health and longevity, but they
put a major strain on national healthcare costs. Improving your lifestyle habits canhelp prevent these ailments.

Some lifestyle diseases
Diet related: diabetes, obesity, dyslipidemia (excluding familial), hyperuricemia,
circulatory disorders (excluding congenital), colorectal cancer (excluding familial),
dental disease, etc.
Exercise related: diabetes, obesity, dyslipidemia (excluding familial), hypertension, etc.
Smoking related: cancer, circulatory disease (excluding congenital), chronic
obstructive pulmonary disease (COPD), dental disease, etc.
Alcohol related: cancer, liver disease, diabetes, circulatory diseases, dyslipidemia,
hypertension, dementia, etc.

Preventing lifestyle diseases

Prevention starts
every dayLearn how to structure youreveryday life to keep illness at bay.

Periodically checkyour progress

Get periodic checkups to see
results.

24

Learn more about
the illness

Learn about lifestyle diseases tounderstand them better.

Eating a balanced diet

・・・

・・・

Eat a balanced diet of carbohydrates, main dishes, and side dishes
Preventing lifestyle diseases requires eating a balanced and high-quality diet threetimes a day at regular intervals. Also, trying to maintain good nutrition is quite
important in terms of slowing the decline in physical functions due to the aging.
Combine carbohydrates, main dishes, and side dishes for a balanced diet.

■ Dietary balance guideLiquids are the axis.

The top below represents diet andexercise balance.

Beverages like water and tea are
the axis that keeps the top spinningand are essential to every meal.

The top describes how an imbalanced diet cancause your health to topple, and how keeping
the top spinning well requires ongoing exercise.

Physical
Activity

The top depicts the ﬁve categories of:carbohydrates, side dishes, main dishes,
dairy, and fruits.

water or teas

Pictured are, from above, the quantities of each food groupand their priority. You need moderate carbohydrates, thenside dishes, then main dishes, followed by dairy products
and fruits, the latter two in approximately similar amounts.

y

snac

Enjo

ks,

fe c

for one dayconti o na n d b e v erages

moderately!

Carbohydrates(rice, bread, noodles, and pasta)

Approx. 4 bowls of rice in regular size

Decided by Ministryof Health, Labour andWelfare and Ministry ofAgriculture, Forestry
and Fisheries.

Side dishes(vegetables, mushrooms, tubers and roots,
seaweed)Approx. 5 small dishes

Main dishes(meat, fish, egg and soy-bean)

Sweets andalcoholic beverages
are the cord.
Sweets and alcoholic
beverages are to be
consumed sparingly as
an accompaniment oncein awhile.

Example of dishes or foodSVbowl of rice(small)rice ballSV

1 slice of bread

2 bread rollsSVbowl of rice (regular)

SV

udon

vinegary saladof cucumber
and seaweed

green saladheartymiso soupsoba noodles

spaghetti

boiledsimmeredcookedspinach Hijiki seaweed beans

sauteedmushroomsSVsimmered vegetables

stir-fried vegetables

SVSV
cold tofu

Approx. 3 dishes

simmered taro

natto sunny side up (1 egg)

grilled fish

fish tempura

tuna andsquid sashimi

SV

Dairy

hamburg steak(milk and dairy products)

Approx. a cup of milk

FruitsSV

SV

Approx. 2 pcs of tangerine

pork ginger

milk (1/2 cup)

cheese(1 pc)

tangerine (2 pcs)

apple (1/2)

fried chickenSVcheese (1 slice)

persimmon

yogurt (1 cup)

milk (1 bottle)

pear (1/2) grapes (1/2 bunch) peach (1 pc)* SV is an abbreviation of “Serving”, which is a simply countable number describing
the approximated amount of each dish or food served toEach category depicts what to eat, and how much.
The top pictured below indicates the suggested daily intake ofdiﬀerent good groups and the relative quantities. To check how manydishes you are eating versus the target, check the chart at right.

25

Consume sodium sparingly
Excess sodium consumption puts us at risk for hypertension, which leads tocirculatory diseases, as well as gastric cancers. The Japanese diet has traditionallycontained high quantities of soy sauce, miso paste, pickles, and other salty foods.
Use low-sodium versions of these ingredients or try herbs for ﬂavor in order tocut down on sodium consumption in your everyday life as you become moreaccustomed to less salty food.

Daily sodium consumption
Daily sodium consumption
Men: Up to

7.5
8g g

Women: Up to

6.5
7g g

Source: Ministry of Health,Labour, and Welfare,Japanese dietary intake
standards, 2020
2015.

Average sodium levels

1g

2g

3g

4g

5g

Potage (1 bowl)
1.2g sodium

Pickled daikon radish(2 slices/20g)
1.5g sodiumHam(3 slices)1.5g sodium

Full roasted horse mackerel(1 ﬁsh/60g)
1.2g sodium
Miso soup(1 bowl)
1.5g sodium

Tempura over rice
(Serving for one)
4.1g sodium

Kitsune udon(Serving for one)
5.3g sodium

Rice curry(Serving for one)
3.3g sodium

Pickled plum
(Single plum/10g)
2.0g sodium

Salted salmon(1 slice/40g)
3.5g sodium

Sushi (Serving for one,
including soy sauce)
5.0g sodium* Some portion sizes may vary based on
ingredients and preparation method.
Created based on data from Reduce your sodium!
Advice from the Low-Sodium Committee andTips on reducing sodium intake, and types offoods and cuisine high in sodium, produced by
The Japanese Society of Hypertension.

26

Instant noodles(1 cup/100g)
5.5g sodiumConsume lots of vegetables and moderate fruits
Fruits and vegetables are rich in vitamins and minerals and dietary ﬁber. Daily
consumption can help prevent cancer, circulatory diseases, and diabetes.
Grilling, boiling, or steaming vegetables before eating them reduces their size andmakes them more palatable. Note that you should avoid excess sodium whencooking.

Daily vegetable consumption
Daily vegetable consumption

350 g daily

Source: Ministry of Health,Labour, and Welfare, Healthy
Japan 21 (Secondary Report)

100g of vegetables

1 medium-sized
tomato1/8 daikon radish(root)

1/2 medium-sized head of
lettuce1 cucumber

1/2 sprig ofbroccoli

1/2 medium-sizedcarrot2 medium-sized sprigs ofJapanese mustard spinach

1/2 burdockroot* The above is intended as a sample; vegetable sizes may vary slightly.

27

Daily fruit consumption (approx. 100g)

1 banana

6 strawberries

1 kiwifruit

1/2 grapefruit

1/2 pear

1/2 bunch of grapes

1/2 apple

1 tangerine

1 persimmon* Calories: approx. 50kcal (1 banana contains approx. 100kcal)

Enjoy your meals
Try to make meals more fun. Having more meals with friends and family is healthy forbody and mind.

28

・・・

Pursuing moderate exercise

・・・

Fitness as the key to sound healthProper exercise is essential to maintaining a healthy body. Engaging in regularphysical activity decreases the risk of diabetes, heart disease, stroke, cancer, legpain, depression, dementia, and more. Physical activity and exercise are today
recommended as key to good health, with targets recommended by age group.
Take due precautions when engaging in exercise and up your physical activity.

Healthy exercise goals (based on 2013 Healthy Physical Exercise Standards)
Physical activity (lifestyle and exercise)65+

18 ‒ 64

17 andunder

40 minutes of physicalactivity daily̶

60 minutes of physicalactivity daily

60 minutes of exercise
weekly(any intensity)

Practice a bit
more activity
than you arenow(for example,
10 minutes
more walking)Exercise(more intense thanwalking)(should produce shortnessof breath and sweat)

Additional notes: Children should spend at
least 60 minutes or more of physical activity
daily on activities like playing, everyday
activities, physical ﬁtness, or sports.
Japan Sport Association, Active Child 60 Min.
‒ Guidelines for Physical Activity by Children

Maintaina habit ofregularexercise(30+ minutes
a day,
2+ timesa week)Infants should spend a total of 60 minutes
or more enjoying moving their bodies daily,
predominantly by playing.
Ministry of Education, Culture, Sports,
Science and Technology, Infancy Exercise Guidelines

Safety precautions□ Gradually increase the amount of time you dedicate to exercise; do not
do it all at once.

□ Do not attempt to overdo it if you do not feel well.
□ If you are ill or injured, consult with a doctor or specialist ﬁrst.
29

Practicing +10
Simply engaging in ten more minutes of physical activity each day and moving daily
can reduce the risk of death, lifestyle disease, and cancer by 3‒4%. Practice addingthat +10 to your daily physical activity in a low-stress way.

Beneﬁts of physical activity
If you have metabolic syndrome or mild symptoms of lifestyle disease, you can
incorporate the +10 routine into your life to see beneﬁts. Burning visceral fat helps
slim the abdominal circumference and reduce weight, as well as improve symptomsof hypertension, dyslipidemia, and hyperglycemia.
Ideally, you should practice 30‒60 minutes (per day) of moderate, non-strenuous
exercise, like walking, three or more times a week.
Walking is a great
way to add +10.

Practice abdominal
exercises while
seated at the oﬃce.

Use the stairs!

Sit down and
get up slowly,
practicing squats.

Add an eﬀortless +10 to your daily routine
Avoid staying still for long periods of time. Do some chores around the house or
tend the garden, or incorporate exercise into your daily routine. Make time to moveand stretch the body each day.
Use a chair toexercise while you
watch TV.

Stretching helps ease the body and mind.

30

・・・

Getting suﬃcient sleep

・・・

Rest and healthWe spend one third of our lives sleeping. Healthy sleep is what allows our bodies totruly rest and unwind. Healthy sleep requires a regular sleep schedule. The body has
an internal clock that controls not only when we feel sleepy, but the secretion of
hormones and other biological processes. Leading a proper schedule in your daily
life will ensure that you get better sleep.
Practicing regular exercise and bathing 2‒3 hours before bed leads to higher quality
sleep. Getting enough sunlight as soon as you wake up also helps reset the bodyclock, leading to better sleep. In addition, it is key to have good bedding equipment
to keep your body in a comfortable, stress-free position.

Habits conducive to better sleep

Avoid meals, coﬀee, green tea, alcohol,and smoking before bed

Avoid bright lights at nightand use warm-colored
ﬂuorescent lights

Go to bedat the same time each day

Ideally, bathe 2‒3 hours
before bed

Incorporate exercise
in your life
‒ ideally at night

0
21
Night

18

6

Day

15

Short naps canrefresh you

Get up at the same timeand reset your body clockby getting sunlight3

9

Energize the mind
with a good breakfast

12
Exercise and get sunlightduring the day
to feel sleepy at night

Source: Ministry of Health, Labour,and Welfare e-Health Net: Sleep and Lifestyle

31

・・・

Quitting smoking

・・・

How tobacco aﬀects your healthTobacco smoke contains approximately 200 hazardous substances, among them
nicotine and tar, as well as approximately 70 cancer-causing agents. These substances
cause harm to the DNA and inﬂame the cells, as well as cause reactive oxygens to be
produced. These produce a range of negative eﬀects and ailments in the human body.
In particular, the risk of cancer, ischemic heart disease (angina pectoris, myocardial
infarction), and chronic obstructive pulmonary disease (COPD*1) are much moreelevated; these are considered to be the three major smoking-related ailments.
*1 What is chronic obstructive pulmonary disease (COPD)?
Continued exposure over many years to the hazardous substances in tobacco can cause chronic inﬂammationof the bronchial tubes and destruction of the alveoli*2. This leads to decreased pulmonary function anddiﬃculty breathing, with a shortage of oxygen. Once the alveoli are damaged, they cannot be repaired, so
rapid detection, smoking cessation, and proper treatment can prevent further worsening.
*2 The pulmonary alveolus is a small pouch-shaped structure at the back of the lungs through which inhaled air
travels from the bronchi. It is responsible for converting carbon dioxide in the blood into oxygen.

The risks of second-hand smoking
The hazardous substances found in tobacco are more plentiful in the smoke that wafts oﬀ
of the tobacco than that inhaled by the smoker. Inhaling this smoke is called second-handsmoking, and it carries major risks. Do your best to not expose yourself to tobacco smoke.

Take advantage of smoking cessation assistanceIn April of 2006, health insurance in Japan became applicable to smoking cessation
treatment. Patients meeting the threshold for treatment can receive care at clinics
while covered by insurance. Use of smoking patches and medication can help thepatient wean themselves oﬀ of tobacco.
■ Main health problems caused by tobacco
First-hand smoking
CancerNasal and paranasal cavity cancer,
oral/pharyngeal cancer, laryngeal cancer,
esophagus cancer, lung cancer,
liver cancer, gastric cancer, pancreaticcancer, bladder cancer, cervical cancer

Second-hand smoking
Pregnancy andchildbirthPremature birth,
low birth weight,
fetal development
delay

Other ailments
Stroke, nicotine dependence, dental disease, chronic obstructive
pulmonary disease (COPD), decreased respiratory function,
tuberculosis (death), ischemic heart disease, abdominal aortic
aneurysm, peripheral arteriosclerosis, type 2 diabetes

32

AdultsStroke, nasal and odor sensitivity,
lung cancer, ischemic heart disease
ChildrenHistory ofasthmaPregnant women
Sudden infant death
syndrome (SIDS)

Ministry of Health, Labour and Welfare,
Report on Health Eﬀects of Smoking
and Health・・・

Consuming alcohol in moderation

・・・

Health problems caused by drinking
Alcohol is generally absorbed into the small intestine and then enters the
bloodstream, where it is sent throughout the body. Alcohol aﬀects not only thekidneys, but the entire body, and can aﬀect the health in various ways. Therefore,
simply having a low γ -GTP level on a health screening may not necessarily be anindicator that one is free of health concerns.
■ Main health problems
caused by alcohol

HangoverBrain atrophy, dementia, cerebral vasculardisorders (vessel breakage or clogging)

Dyslipidemia, hyperuricemia,
hypertension, diabetes

Pneumonia

Esophagitis, gastritis,
diarrhea, undernutrition

Oral cancer, pharyngeal cancer, laryngeal
cancer, esophageal cancer, liver cancer,
colorectal cancer, (female) breast cancer

Angina pectoris, myocardial
infarction, arrhythmia

Peripheral neuropathy (especiallynumbness of the legs)

Fetal alcohol syndrome (developmental
disorders in the fetus due to alcohol
consumption while pregnant)
Impotence

Depression, panic
attacks, alcoholism

Anemia, decreased immune
function (more prone to colds)

Osteoporosis,
fracture

Impairment of liver function,
cirrhosis, pancreatitis

Those who consume strong alcohol straight cause the oral cavity and esophageal
surface to be covered in alcohol, which can produce inﬂammations that lead tocancer. Furthermore, those who experience ﬂushing* when consuming alcohol(including those who have greater tolerance now but had ﬂushing in the past) are
believed to be more at risk of cancer from alcohol consumption.
* What is ﬂushing?
Flushing refers to redness of the face, nausea, palpitations, drowsiness, and headaches following
consumption of small quantities of alcohol like one cup of beer. This often occurs in those with a weakness
to aldehyde dehydrogenase, the enzyme produced when alcohol is broken down.

Using alcohol wisely
The Ministry of Health, Labour, and Welfare suggests that a moderate amount ofdaily consumption is on average 20 grams. 20 grams corresponds to one mediumsized bottle of beer, one serving (0.1804L) of sake, one 350mL can of shochu
highball, or one glass of a double whisky shot. People prone to ﬂushing after
drinking, such as women and the elderly, should consume less than the above.
33

・・・

Maintaining dental and oral health・・・

Practice the 8020 plan to maintain healthy teeth
8020 is an initiative to help the elderly maintain 20 or more teeth even after reachingage 80, allowing people to enjoy eating food without dentures for the entirety of
their lives. Having 20 or more teeth allows for biting even hard foods with relative
ease. Achieving this goal requires everyone, from children to adults, understanding
how to prevent cavities and dental disease and doing their best to preserve theirnatural teeth.

Preventing tooth decay
Successfully preventing tooth decay requires practicing self-care at home by brushingyour teeth daily, as well as receiving professional care in the form of cleanings bydentists and dental hygienists, and the use of ﬂuoride-enriched toothpaste and rinses.

Preventing dental disease
Dental disease is caused when bacteria penetrates the space between the gums
(dental pockets) and produces an inﬂammation, as well as breaks down the bones(alveolar bones) supporting the teeth, causing loosening. Unlike caries, it is not
generally painful, so it proceeds without the person noticing, eventually leading to
bleeding or teeth falling out. Properly brushing the teeth daily and having plaqueperiodically removed are essential to preventing dental disease.

Dental disease self-check
If any of the symptoms below apply to you, you may be at risk of dental disease.
Consult with a dental clinic to get a screening.

□ My mouth feels sticky when I wake up. □ My gums are sometimes inﬂamed.
□ I bleed when brushing my teeth.
□ My gum line has receded,and I have gaps between my teeth.
□ I struggle to bite hard objects.
□ I have bad breath.
□ My teeth are loose.
The categories below are known to be at- risk groups for dental disease.

□ Those aged 45 and older □ Pregnant women□ Those with diﬃculty
brushing their teeth□ Smokers□ Those with diabetes
34Personal notes
Male

Name

Date of birth

Female(YYYY‒MM‒DD)( Rh + ‒ )Blood type

Address

Workplace

Emergency
contact

Attending doctor:

Insurance card
numberZip code:
Telephone:
Name of workplace:
Telephone:Contact name:
Telephone:
Medical institution:
Telephone:
Medicalcoverage
Nursing
coverage

Health records(medical history,
abnormalities, etc.)35