Key result
Specific health guidance eligibility is linked to lower BMI but not major cardiovascular risk factors.
Why the study?
The significance of general health checkups and guidance is controversial, prompting an examination of the effectiveness of Japan's specific health checkup and guidance programs.
Does eligibility for specific health guidance improve BMI, waist circumference, and major cardiovascular risk factors in adults aged 40-64 with cardiometabolic risks?
Observational (n=614,253)
Does eligibility for specific health guidance improve BMI, waist circumference, and major cardiovascular risk factors in adults aged 40-64 with cardiometabolic risks?
Eligibility for Japan's specific health guidance program led to statistically significant but clinically modest reductions in BMI and waist circumference, without robust improvements in major cardiovascular risk factors.
The significance of general health checkups and guidance is controversial. To examine the effectiveness of Japan's specific health checkup (SHC) and specific health guidance (SHG) programs, this study applied a regression discontinuity design (RDD) using the SHC results database collected by a private company. We applied a sharp RDD with a cutoff body mass index (BMI) of 25 kg/m2 for those with a waist circumference (WCF) of <85 cm in men and < 90 cm in women, with risks of hypertension, dyslipidemia or diabetes, and aged between 40 and 64 years. Study outcomes were differences in BMI, WCF, and major cardiovascular risk factors between the baseline year and the following year. We analyzed the data of baseline years of 2015, 2016, and 2017 separately and their pooled data. We judged the results to be robust significant when significant results in the same direction were found in all four analyses. A total of 1,041,607 observations out of 614,253 people were analyzed. We found robust significant results that those eligible for SHG in the baseline year had a lower BMI (both men and women) and lower WCF (men only) in the following year than those not eligible for SHG: BMI for men (−0.12 kg/m2, 95% CI [confidence interval]: −0.15 to −0.09); BMI for women (−0.09 kg/m2, 95% CI: −0.13 to −0.06); and WCF for men (−0.36 cm, 95% CI: −0.47 to −0.28) in the pooled data. Robust significant results were not found in WCF for women or in major cardiovascular risk factors.
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Yoichi Sekizawa (2023) conducted an observational in Risks of hypertension, dyslipidemia or diabetes (n=614,253). Specific health guidance (SHG) eligibility vs. Not eligible for SHG was evaluated on Differences in BMI, waist circumference, and major cardiovascular risk factors between baseline and the following year (Difference in BMI (men) -0.12 kg/m2, 95% CI -0.15 to -0.09). Eligibility for specific health guidance significantly reduced BMI in men (-0.12 kg/m2; 95% CI -0.15 to -0.09) and women, and waist circumference in men, but not major cardiovascular risk factors.
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