{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:26:11Z","timestamp":1772504771247,"version":"3.50.1"},"reference-count":54,"publisher":"BMJ","issue":"2","funder":[{"name":"Kanagawa Prefecture"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,12]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The unmitigated incidence of cardiometabolic diseases, such as type 2 diabetes and metabolic syndrome, has gained attention in Japan. \u2018Big data\u2019 can be useful to clarify conflicting observations obtained from studies with small samples and about rare conditions that are often neglected. We epidemiologically address these issues using data from health check-ups conducted in Kanagawa Prefecture, the prefecture with the second largest population in Japan, in the Kanagawa Investigation of the Total Check-up Data from the National Database (KITCHEN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This research consists of a series of population-based cross-sectional studies repeated from 2008\u20132014 and 6-year cohort studies. Since 2017, we have reviewed the data of people living in Kanagawa Prefecture who underwent a health check-up mainly for general health and the prevention of metabolic syndrome. The sample size ranges from 1.2\u2009million to 1.8\u2009million people in the cross-sectional studies and from 370\u2009000 to 590\u2009000 people in the cohort studies. These are people aged 40\u201374 years, whose clinical parameters were measured and who responded individually to a questionnaire. We investigate potential associations and causalities of various aetiologies, including diabetes and metabolic syndrome, using clinical data and lifestyle information. With multidisciplinary analysis, including data-driven analysis, we expect to obtain a wide range of novel findings, to confirm indeterminate previous findings, especially in terms of cardiometabolic disease, and to provide new perspectives for human health promotion and disease prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was received from the Ethics Committee of Kanagawa University of Human Services (10-43). The protocol was approved in December 2016 by the Japanese Ministry of Health, Labour and Welfare (No. 121). The study results will be disseminated through open platforms including journal articles, relevant conferences and seminar presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023323","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T06:28:09Z","timestamp":1550816889000},"page":"e023323","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Kanagawa Investigation of the Total Check-up Data from the National database (KITCHEN): protocol for data-driven population-based repeated cross-sectional and 6-year cohort studies"],"prefix":"10.1136","volume":"9","author":[{"given":"Kei","family":"Nakajima","sequence":"first","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"},{"name":"Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taizo","family":"Iwane","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoko","family":"Higuchi","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michi","family":"Shibata","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"},{"name":"Department of nutrition, St. Marianna University School of Medicine, Kawasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kento","family":"Takada","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Uda","sequence":"additional","affiliation":[{"name":"Graduate School of Health Care Sciences, Jikei Institute, Osaka-shi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mami","family":"Anan","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiko","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teiji","family":"Nakamura","sequence":"additional","affiliation":[{"name":"School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"2025121221274552000_9.2.e023323.1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12098"},{"key":"2025121221274552000_9.2.e023323.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61836-X"},{"key":"2025121221274552000_9.2.e023323.3","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12450"},{"key":"2025121221274552000_9.2.e023323.4","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/ggi.13266","article-title":"Health status of older adults living in the community in Japan: recent changes and significance in the super-aged society","volume":"18","author":"Suzuki","year":"2018","journal-title":"Geriatr Gerontol Int"},{"key":"2025121221274552000_9.2.e023323.5","doi-asserted-by":"publisher","DOI":"10.1017\/BJN20061921"},{"key":"2025121221274552000_9.2.e023323.6","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1097\/EDE.0b013e31819ed4ed","article-title":"Thinness in Japanese young women","volume":"20","author":"Sugawara","year":"2009","journal-title":"Epidemiology"},{"key":"2025121221274552000_9.2.e023323.7","unstructured":"Ministry of Health, Labour and Welfare. 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