title: The accumulation of healthy lifestyle behaviors prevents the incidence of chronic kidney disease (CKD) in middle-aged and older males.
abstract: OBJECTIVE
  This study was retrospectively designed to evaluate the influence of healthy lifestyle behaviors on the incidence of chronic kidney disease (CKD) during a 5-year follow-up period in middle-aged and older males.
  
  
  METHODS
  The subjects included 252 males without a history of cardiovascular disease, stroke, renal dysfunction and/or dialysis treatment who were not taking any medications. Their lifestyle behaviors were evaluated using a standardized self-administered questionnaire and defined as follows: (1) habitual moderate exercise, (2) daily physical activity, (3) fast walking speed, (4) slow eating speed, (5) no late-night dinner, (6) no bedtime snacking and (7) no skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions according to the number of healthy lifestyle behaviors (7-6, 5, 4 and ≤3 groups).
  
  
  RESULTS
  After 5 years, the incidence of CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) and/or proteinuria] was observed in 23 subjects (9.1%). The Kaplan-Meier survival curves showed that the cumulative incidence of CKD significantly decreased according to an increase in the number of healthy lifestyle behaviors (log-rank test: p = 0.003). According to a multivariate analysis, habitual moderate exercise [hazard ratio (HR) 0.20, 95% confidence of interval (CI) 0.06-0.69, p = 0.011] and no bedtime snacking (HR 0.19, 95 % CI 0.08-0.48, p = 0.004) were significantly associated with the incidence of CKD.
  
  
  CONCLUSIONS
  These results suggest that the accumulation of healthy lifestyle behaviors, especially those related to habitual moderate exercise and no bedtime snacking, is considered to be important to reduce the risk of CKD.
authors.affiliation: Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. rmichishita@med.uoeh-u.ac.jp.|The Fukuoka University Institute for Physical Activity, Fukuoka, Japan. rmichishita@med.uoeh-u.ac.jp.
authors.forename: Ryoma
authors.initials: R
authors.lastname: Michishita
authors.affiliation: The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.|Department of Rehabilitation, Fukuoka University Hospital, Fukuoka, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.|Laboratory of Exercise Physiology, Faculty of Health and Sports Science, Fukuoka University, Fukuoka, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Kawakami
authors.affiliation: The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.|Laboratory of Exercise Physiology, Faculty of Health and Sports Science, Fukuoka University, Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kiyonaga
authors.affiliation: The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.|Laboratory of Exercise Physiology, Faculty of Health and Sports Science, Fukuoka University, Fukuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Fukuoka University Health Care Center, Fukuoka, Japan.|Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Morito
authors.affiliation: The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.|Laboratory of Exercise Physiology, Faculty of Health and Sports Science, Fukuoka University, Fukuoka, Japan.
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Higaki
mesh_terms: D000368:Aged; D015444:Exercise; D015438:Health Behavior; D000070497:Healthy Lifestyle; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies
keywords: Bedtime snacking; Habitual moderate exercise; Healthy lifestyle behaviors; Incidence of CKD