Effectiveness of comprehensive health education combining lifestyle education and hot spa bathing for male white-collar employees: a randomized controlled trial with 1-year follow-up.
BACKGROUND
Physical activity is known to prevent obesity and metabolic syndrome in middle-aged and elderly people; however, the effectiveness of a comprehensive health education program for male white-collar employees is uncertain.


METHODS
Forty-three men volunteered to participate in this study and were randomly assigned into 2 groups. The intervention group participated in a 2-hour program comprising comprehensive health education and hot spa bathing, offered once every 2 weeks, in addition to individualized programs once a week, for 24 weeks. The control group received only general health guidance. We compared their lifestyle characteristics and physical and mental health criteria at baseline, immediately after the intervention, and 1 year after the end of the intervention.


RESULTS
Rates of adherence to individualized programs were 60.0 +/- 27.2% and 30.5 +/- 29.6% at the end of the intervention and at 1 year after the end of the intervention, respectively. Significant (P < 0.05) interaction of criteria was observed for cluster of differentiation 4+ (CD4+) cells and the ratio of cluster of differentiation 4+ to 8+ (CD4/8) cells, which were used to represent the participants' immunological function. We divided the intervention group into 2 subgroups on the basis of their attendance. Among the resulting 3 groups, significant interaction of criteria was observed for CD4+ and CD4/8 cells. In addition, the high attendance group had the highest CD4+ count and CD4/8 ratio.


CONCLUSIONS
Participants who attended classes and/or performed the supplementary individualized programs tended to maintain their immunological function and to experience a decrease in body fat percentage. However, few effects were noted in participants with poor adherence, even in the intervention group.
Kamioka
Hiroharu
H
Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo 156-8502, Japan. h1kamiok@nodai.ac.jp
Nakamura
Yosikazu
Y
Okada
Shinpei
S
Kitayuguchi
Jun
J
Kamada
Masamitsu
M
Honda
Takuya
T
Matsui
Yuzuru
Y
Mutoh
Yoshiteru
Y
D000328:Adult; D001452:Balneology / Q000379:methods*; D004651:Employment; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods*; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D015397:Program Evaluation; D012959:Socioeconomic Factors
JAMA. 2001 Apr 18;285(15):1987-91
11308435
Nihon Ronen Igakkai Zasshi. 2007 Jul;44(4):403-14
17853532
Cochrane Database Syst Rev. 2003;(4):CD000518
14583923
Science. 2005 Jan 28;307(5709):584-6
15681386
Prev Med. 2008 Jan;46(1):29-32
17904210
Aviat Space Environ Med. 2000 Jun;71(6):632-9
10870823
Rheumatology (Oxford). 2000 Aug;39(8):894-902
10952746
Int J Epidemiol. 2003 Oct;32(5):809-14
14559755
Int J Obes Relat Metab Disord. 2004 May;28(5):710-8
15007395
J Clin Epidemiol. 2005 Dec;58(12):1233-40
16291467
Age Ageing. 2008 Jan;37(1):57-63
17965045
Circ J. 2007 Nov;71(11):1734-7
17965493
Age Ageing. 2008 Mar;37(2):194-200
18063655
Med Sci Sports Exerc. 2007 Aug;39(8):1423-34
17762377
Prev Med. 2008 Mar;46(3):216-21
18234327
J Epidemiol. 2006 Jan;16(1):35-44
16369107
J Gerontol A Biol Sci Med Sci. 2001 Oct;56 Spec No 2:23-35
11730235
Circulation. 2008 Jun 17;117(24):3062-9
18541738
Prev Med. 2008 Oct;47(4):354-68
18675845
Br J Rheumatol. 1997 Jan;36(1):77-81
9117181
Rheumatol Int. 2005 Apr;25(3):220-4
15257412
J Rheumatol. 1991 Dec;18(12):1775-7
1795308
J Intern Med. 2007 Sep;262(3):273-87
17697152
Complement Ther Med. 2006 Jun;14(2):133-43
16765852
JAMA. 2008 Mar 12;299(10):1139-48
18334689
Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006864
17943920
Eur J Public Health. 2005 Jun;15(3):317-22
15941745
Int Arch Occup Environ Health. 2008 Aug;81(8):1029-36
18175140
Int J Obes (Lond). 2008 May;32(5):837-44
18227844
Acta Physiol Scand. 2000 Jun;169(2):87-94
10848638