Country：Japan

Publishing type：Research paper (scientific journal)  

DOI： 10.11236/jph.22-056

PubMed

Publishing type：Research paper (scientific journal)  

<p><b>Objective:</b> This study was aimed at elucidating the actual state of nutrition management in childcare centers based on whether they qualify to receive nutrition subsidies.</p><p><b>Methods:</b> Questionnaires were distributed by mail to 1,538 childcare centers in eight cities in Japan, and responses were received from 979 facilities in 2019. Of these centers surveyed, 684 responded that they were privately managed and responded to whether they qualified to receive nutrition subsidies. The survey included 12 items regarding the Plan-Do-Check-Act (PDCA) cycle for food provision and eight items about providing information to parents on nutrition and eating habits in the form of nutrition education.</p><p><b>Results:</b> Regarding the qualification to receive nutrition subsidies, 484 and 200 facilities did and did not qualify, respectively. Compared with the group that did not qualify for nutrition management subsidies, the group that qualified had an odds ratio of 2.36 (95% CI: 1.46~3.82) for the calculation of supplied nutrition among the items applicable to the Plan step of the PDCA cycle for food provision.</p><p><b>Conclusion:</b> The results of the survey indicated that compared with the group that did not qualify for nutrition management subsidies, the group that did more often used the PDCA cycle for food provision to set supplied nutrition target values and calculate supplied nutrition in the Plan step and to revise these supplied nutrition target values in the Act step. The results demonstrated that facilities that qualified for nutrition management subsidies had better nutrition management than those that did not.</p>

DOI： 10.5264/eiyogakuzashi.81.30

Publishing type：Research paper (scientific journal)  

目的 NIPPON DATA2010におけるわが国を代表する一般成人集団を対象に,2020年の新型コロナウイルス感染症緊急事態宣言下における生活習慣の変化を調査し,性,年齢,地域別に分析した。方法 研究対象者は,2010年国民健康・栄養調査に全国300地区から参加し,2020年時点でNIPPON DATA2010追跡調査に参加している30歳から99歳の男女2,244人とした。2020年4～5月の新型コロナウイルス感染症第1波流行中における,それ以前との体重・食生活・身体活動量や受診行動の変化について問う自記式質問調査を2020年10月に実施した。完全な回答が得られた1,926人(男性788人,女性1,138人)について,性別,年齢階級別,居住地域ブロック別に回答を集計し比較した。割合の差の検定はχ2検定およびFisherの正確確率検定を用いた。結果 1kg以上の体重増加者は,男性(17.3%)より女性(27.1%)に多く(p<0.001),身体活動量が減少した者も,男性(23.2%)より女性(31.0%)の方が多かった(p=0.001)。飲酒の頻度や量の増加者,減少者ともに男性において女性より高い割合を示した(p<0.001)。一方,男女ともに,野菜を食べる頻度や量が増えた者は減った者の2倍以上多く,自宅で料理したものを食べる頻度が増えた者は減った者の約6倍であった。年齢階級別にみると,1kg以上の体重増加者は65歳未満(30.8%)で特に多く(p<0.001),「自宅で調理したものを食べる頻度」「スーパーやコンビニの弁当や総菜,テイクアウト,デリバリーの利用頻度」「間食する頻度や量」が増加した者が65歳未満に多かった(いずれもp<0.001)。地域ブロック別では,1kg以上の体重増加者,身体活動量が減った者が,都市部で高い傾向を示した(いずれもp<0.001)。結論 2020年の新型コロナウイルス緊急事態宣言下において,生活習慣や体重は男性よりも女性,高齢者よりも若い世代で大きく変化し,居住地域別では,都市部での変化が大きかった。これらの特徴を踏まえ,自粛生活の長期化による健康影響に注意する必要がある。(著者抄録)

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

DOI： 10.1016/j.jacl.2022.11.003

PubMed

Publishing type：Research paper (scientific journal)  

<p>A dietary survey of 798 children (aged 3 to 6 years) attending nursery schools in seven cities in Japan was conducted using the weighing and recording method on two non-consecutive weekdays and holidays in fall 2019 and fall 2020. Habitual nutrient intakes on weekdays and holidays were calculated and compared with the standards for each indicator in the Dietary Reference Intakes for the Japanese Population (2020 edition). The percentage of preschool children with habitual nutrient intakes below the estimated average requirement (EAR) was significantly higher on holidays than on weekdays for vitamins A, B₁, B₂ and C, as well as potassium, calcium, and iron. These results suggested that nutrient intake was better on weekdays than on holidays. However, the percentage of children below the EAR for calcium was very high on both weekdays and holidays. On weekends, other nutrients were also found to be inadequately consumed, in addition to calcium, vitamins A and B₁, and iron. These results suggest that there is a need to increase the intake of calcium and other deficient nutrients by improving the dietary situation for preschool children when they are at home, as well as to provide adequate lunches and snacks at nursery schools.</p>

DOI： 10.4327/jsnfs.76.33

Publishing type：Research paper (scientific journal)  

<p><b>Aim: </b>A pro-inflammatory diet may increase the risk of cardiovascular disease (CVD) and all-cause mortality. However, this remains inconclusive as there is yet no study using a dietary record method that has been conducted in a large general population. Furthermore, an underestimation of the pro-inflammatory diet may exist due to the unmeasured effect of salt intake. Thus, in this study, we aimed to examine how pro-inflammatory diet is associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population.<b> </b></p><p><b>Methods: </b>A national nutrition survey was conducted throughout Japan in 1980. After considering the exclusion criteria, 9284 individuals (56% women aged 30-92 years) were included in this study. In total, 20 dietary parameters derived from 3-day weighed dietary records were used to calculate the dietary inflammatory index (DII). The causes of death were monitored until 2009. The Cox proportional hazards model was used to determine multivariable-adjusted hazard ratios (HRs). Stratified analysis according to salt intake level was also performed.<b> </b></p><p><b>Results: </b>Compared with the lowest quartile of DII, multivariable-adjusted HRs (95% confidence intervals) in the highest quartile were 1.28 (1.15, 1.41), 1.35 (1.14, 1.60), 1.48 (1.15, 1.92), 1.62 (1.11, 2.38), and 1.34 (1.03, 1.75) for all-cause mortality, CVD mortality, atherosclerotic CVD mortality, coronary heart disease mortality, and stroke mortality, respectively. Stratified analysis revealed stronger associations among individuals with higher salt intake.<b> </b></p><p><b>Conclusions: </b>As per our findings, a pro-inflammatory diet was determined to be positively associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population. Thus, considering both salt intake and pro-inflammatory diet is deemed crucial for a comprehensive assessment of CVD risk.</p>

DOI： 10.5551/jat.64330

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

Publishing type：Research paper (scientific journal)  

DOI： 10.1038/s41440-022-01007-x

PubMed

Publishing type：Research paper (scientific journal)  

【目的】都道府県別の平均寿命の格差について、その要因を生態学的に検討した研究はいくつかあるが、経年的に平均寿命と栄養摂取状況との関連を検討した研究は見当たらない。本研究の目的は、日本国民を代表する標本である国民健康・栄養調査(国民栄養調査)より16年間のデータから5期9年分を抽出して都道府県単位の平均寿命別に栄養摂取状況を生態学的研究により検討することである。【方法】国民健康・栄養調査の食品群分類が共通である2001-2016年の結果について、2001年(2期)、2003-2005年(3期)、2007-2009年(4期)、2012年(5期)、2016年(6期)の9年分を分析対象とした。2000年の平均寿命別に都道府県を4群(平均寿命が長い順に男性はM1からM4、女性はF1からF4)に分類し、栄養素等別・食品群別摂取量の推移を比較した。分析対象は40歳から69歳とし、2010年の10歳階級別人口に基づき年齢調整した値について、年次推移に関する5期と平均寿命による4群をもとに二元配置分散分析と4群それぞれに対して傾向性の検定を行い、傾向性P値を算出した。【結果】炭水化物エネルギー比率はM1、M2、F1～F4で期間中に有意な低下傾向を示した。女性においては平均寿命別でも有意差を認め、平均寿命が長い群は比較的高値で推移した。脂質エネルギー比率はM1～M4、F1～F4のすべての群で期間中に有意な増加傾向を示した。男性においては平均寿命別でも有意差を認め、平均寿命が短い群は比較的低値で推移した。食塩摂取量はすべての群で期間中に有意に低下した。平均寿命別でも有意差を認め、平均寿命が短い群は比較的高値で推移した。野菜摂取量は、男性においては平均寿命が短い群は有意に低下傾向を示した。女性では平均寿命が長い群が有意に低下傾向を示したものの平均寿命別でも有意差を認め、平均寿命が長い群は比較的高値で推移した。果実類摂取量は、すべての群で期間中に有意に低下傾向を示した。魚介類摂取量はすべての群で期間中に有意に低下傾向を示した。男性においては、平均寿命別でも有意差を認め、平均寿命が短い群は比較的高値で推移した。肉類摂取量は男女ともにすべての群で有意に上昇傾向を示したが、平均寿命別では差を認めなかった。【結論】都道府県別の平均寿命の格差を縮小するためには、特に平均寿命が比較的短い都道府県において地域レベルで食塩、野菜の摂取量等を改善することが重点的課題と考えられた。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.3390/nu14173606

PubMed

Publishing type：Research paper (scientific journal)  

目的 地域高齢者の唾液分泌量と口腔機能,心理的状況ならびに食生活との関連について検討する。方法 対象者は2014年7月～2015年9月の間に,愛知県N市介護予防教室に参加した52名(65歳以上の男女)である。調査内容は身体測定(身長,体重・骨格筋量,下腿周囲長,握力),口腔機能[咬合力,咀嚼力,反復唾液嚥下テスト(RSST),唾液分泌量],心理的状況[老年期うつ病評価尺度(GDS-15),主観的健康感,高齢者の主観的幸福感(PGCモラールスケール)],食生活[簡易栄養状態評価(MNA),シニア向け食欲調査(CNAQ-J),食物摂取頻度調査(FFQg ver.3.5)]である。唾液分泌量減少群(0.5mL/min未満)と正常群(0.5mL/min以上)の2群間比較を行った。連続変量はMann-Whitney U検定,離散変量2×2表についてはχ2検定を行った。唾液分泌量と各指標との相関はSpearman順位相関係数を用いた。有意水準はp<0.05(両側)とした。結果 唾液分泌量のデータがない3名を除いた49名(男性20名,女性29名)を解析対象とした。年齢74.0(72.0-77.0)歳[中央値(四分位範囲)],BMI23.0(20.3-24.6)kg/m2,唾液分泌量0.74(0.46-1.03)mL/minであった。26.5%(13名)に唾液分泌減少がみられた。唾液減少群と正常群の2群間比較では,咬合力,GDS-15,PGCモラールスケール,CNAQ-J,菓子類摂取量に有意差がみられ,χ2検定で有意だったのは,口腔乾燥感,うつならびに食欲の有無,主観的健康感の良否であった。唾液分泌量と身長,下腿周囲長,咬合力,たんぱく質,亜鉛,菓子類摂取量の間に有意な相関関係がみられた。結論 唾液分泌量は,咬合力,口腔乾燥感,心理的状況(うつ,主観的健康感,主観的幸福感),食生活状況(食欲,たんぱく質・亜鉛・菓子類摂取量)などとの関連が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

【目的】災害時の食支援における管理栄養士の社会的ニーズは年々高まっており、養成段階における学習が求められている。本取組では、4年次の総合演習において災害時の栄養管理に対する知識・スキルの獲得をねらいとした炊き出し演習を実施し、その教育効果の検討を行った。【方法】2017年4月～12月に本学食品栄養科学科4年生36名を対象に、災害時の栄養管理に関する基礎知識と実際に関する学習、炊き出し献立の検討、試作、屋外炊き出し演習等を実施した。食事内容および食事提供に関する評価は喫食者185名分のアンケート集計により行った。全ての演習終了時に4年生を対象に演習への評価、役に立った専門科目、食支援ボランティアへの意欲に関する無記名自記式質問紙調査を行い、回答が得られた34名分を集計した。【結果】喫食者による評価は、炊き出しの内容、食事提供の流れのいずれについても良好であった。演習の評価として、演習の取組状況は97.0%の学生が積極的に、やや積極的に取り組んだと回答した。食支援ボランティアへの意欲がある者が76.6%であり、73.6%は本演習の影響があったと回答した。【結論】学生は本演習を通じて災害時の栄養管理について理解を深め、専門科目で学んだ知識を活かしながら臨場感のある炊き出しを体験することで、災害時の食支援への関心が高まることが示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

【目的】高血圧者に対する食事指導等の介入によって野菜摂取量の増加が認められたとする報告はこれまでにもあるが、高血圧を指摘されることそれ自体や治療の継続状況と野菜摂取量の関連を検討した報告はない。そこで本研究では、高血圧の指摘や治療の継続状況が、実際の野菜摂取量に影響を与えるのか検討した。【方法】平成22年国民健康・栄養調査及びNIPPON DATA2010の20歳以上の参加者を対象とした。このうち、これまでに医療機関や健康診査で脳卒中、心筋梗塞、腎臓病または腎機能低下と指摘されたことはないが、高血圧の指摘を受けている者もしくは高血圧、糖尿病、脂質異常症のいずれの指摘も受けたことはないが、国民健康・栄養調査の血圧測定値が高血圧(収縮期血圧140mmHg以上または拡張期血圧90mmHg以上の者と定義)であった高値血圧者の男女1,004人を解析対象とした。野菜摂取量が多いこと(1日350g以上)をアウトカムとして、高血圧を指摘されることやその後の治療の継続状況(治療継続、治療中断、未治療)との関連をロジスティック回帰分析にて検討した。【結果】野菜摂取量が多いことと高血圧を指摘されることは男女とも有意な関連はなく、野菜を積極的に摂取しようと心がけることとのオッズ比が男性1.72(95%CI:1.17-2.53)、女性1.51(95%CI:1.04-2.21)と有意な正の関連が認められた。野菜摂取量が多いことと高血圧者における治療の継続状況では、野菜を積極的に摂取しようと心がけることとのオッズ比が男性1.69(95%CI:1.07-2.68)と有意な正の関連、「治療中断」の女性でオッズ比0.37(95%CI:0.15-0.90)と有意な負の関連がみられた。【結論】男女とも野菜の摂取量と高血圧の指摘自体との関連は認められなかったが、女性では治療中断と負の関連が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

<p>Objective: To determine the association between household income and changes in the diet of young children during the state of emergency declared in Japan due to COVID-19 from April to May 2020.</p><p>Methods: A cross-sectional survey was conducted using a self-completion questionnaire. We recruited 2,041 parents of children aged 3–5 years enrolled in nursery schools in five districts in Japan, from September to December 2020; 589 parents responded to the survey (response rate: 28.9%). Data were collected for basic demographic information, household income, and dietary changes in young children during the COVID-19 state of emergency. Income per household member was calculated and the households were divided into low-, medium-, and high-income groups. Logistic regression analyses were conducted using dietary changes in young children during the COVID-19 state of emergency as the dependent variable and household income as the independent variable.</p><p>Results: In the low-income group, there were numerous single-parent households as well as those whose education level was lower than high school. Compared to children in the high-income group, significantly more children in the low-income group consumed snacks, sweet drinks, instant foods, and canned foods in the emergency period.</p><p>Conclusion: The results suggest an association between household income and changes in the diet of young children during the emergency period. Households in the low-income group consumed snacks, sweet drinks, and instant foods than households in the high-income group during the emergency period.</p>

DOI： 10.11260/kenkokyoiku.30.14

Publishing type：Research paper (scientific journal)  

<p>In this study, we focused on food intake before and during pregnancy and its effects on birth weight. We conducted a survey of mothers' physical status, smoking, drinking habits, food intake and children's physical status for 1,302 mothers who participated in health checkups for 3 or 4 month-old infants. In the low birth<b> </b>weight infant group, mothers had low weights at non-pregnancy and childbirth. Non-pregnancy BMI, weight gain, height at birth and gestational age were also low and mother’s smoking habits were frequent. Further more, the low birth weight group had lower vegetable food intake scores for both before and during pregnancy in the intake score calculated from the frequency and amount of food intake. Compared with the high score groups of vegetable and milk/dairy product intake on pre-pregnancy, low score groups had higher odds of having low birth weight (OR1.69, 1.58). We suggest the need for proper dietary management before pregnancy to control low birth weight, especially thorough guidance on vegetable intake.</p>

DOI： 10.11379/jjda.65.101

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Objective:</b> We reviewed published literature to assess the quantitative effects of face-to-face dietary guidance in Japan.</p><p><b>Methods:</b> We searched CiNii Articles and PubMed for peer-reviewed journal articles published between January 2010 and December 2020 that analyzed longitudinal data to quantify the effects of dietary guidance for improving adults' lifestyles in Japan. We conducted a scoping review to extract information on research designs and findings.</p><p><b>Results:</b> Our review included 15 articles (five in Japanese and 10 in English). The studies were conducted in local communities (four articles), workplaces (one article), and medical institutions (10 articles). The median number of participants was 108, and participants' main characteristics were diabetes and older age. There were four clinical trials (including three randomized controlled trials) and seven non-randomized inter-group comparative studies. In four articles, no alternative intervention was considered. The most common evaluation periods were 3 months and 6 months. Major evaluation indicators included body weight, dietary intake, blood tests, and quality of life. Fourteen articles reported dietary guidance was effective, and some articles showed the importance of providing dietary guidance more than once.</p><p><b>Conclusion:</b> Various types of face-to-face dietary guidance are effective, but the potential for publication bias requires consideration. It is necessary to construct mechanisms and secure human resources for collaboration between research institutes and people involved in local communities and workplaces to accumulate data on the effect of dietary guidance for healthy adults based on random allocation in quantitative evaluation research.</p>

DOI： 10.5264/eiyogakuzashi.79.365

CiNii Article

Publishing type：Research paper (scientific journal)  

<p>We performed dietary education to female students in dietitian course of a university to change the meal colorfully in order to improve the meal of young women. Their meals were recorded by questionnaires and phots taken with smartphone camera before and after the dietary education to measure the effect of education. Registered dietitians evaluated nutrition intake (serving:SV) seeing the photographs of the meal along the standard five dishes in Japanese Food Guide Spinning Top. After the dietary education, the intake of Fish and Meat dishes (<i>p</i>=0.005) , Vegetable dishes (<i>p</i><0.001) , Milk (<i>p</i>=0.037) and Fruits (<i>p</i><0.001) increased significantly. It was suggested that high score group (meal with 5 colors)took more Fish and Meat dishes (<i>p</i>=0.030) and Vegetable dishes (<i>p</i><0.001) than low score group (meal with less than 5 colors) significantly. The knowledge and consciousness about essential vegetables (<i>p</i>=0.011) and the combinations of well-balanced meals per day (<i>p</i>=0.030) were also improved. Therefore, it was suggested that the meals of young women would be improved by increasing colors of ingredients (<i>p</i><0.001) and making the meal colorfully (<i>p</i><0.001) . It is necessary to verify the effectiveness of this type of dietary education in combination with more precise dietary survey.</p>

DOI： 10.14986/shokuiku.15.147

CiNii Article

Publishing type：Research paper (scientific journal)  

穀類を主食に魚や肉と野菜を組み合わせたバランスの良い食事(バランス食)の摂取頻度と体重増加および耐糖能異常(HbA1c>6.0%)のリスクとの関連について検討した。某事業所の従業員(男性8573名、女性3327名)を対象に、2014、2017年度の健診データ(体重とHbA1c)とバランス食の摂取頻度に関する質問票の回答を解析した。3年間の平均体重変化量は、男性が0.78kg、女性が0.84kgであった。バランス食摂取頻度により対象者を4群に分けて比較すると、男性は摂取頻度が低いほど体重増加が大きかったが(傾向検定P=0.004)、女性では両者間に関連はみられなかった。調査期間中に男性464名、女性115名が耐糖能異常を発症した。男女ともにバランス食の摂取頻度と耐糖能異常発症の間に関連は認められなかった。男性のバランス食摂取頻度と肥満度は耐糖能異常の発症に対し有意な交互作用を示し(交互作用P=0.005)、肥満(BMI≧25kg/m2)男性において、バランス食の低頻度摂取は耐糖能異常リスク上昇と関連した(傾向検定P=0.007)。

Publishing type：Research paper (scientific journal)  

日本人成人男女1090名(年齢40～59歳)を対象に、飲酒量と冠動脈疾患(CHD)危険因子および栄養素摂取量との関連について検討した。1週間のアルコール摂取量により対象者を非飲酒(0g)、軽度飲酒(<100g)、中等度飲酒(100～299g)、高度飲酒(≧300g)の4群に分類し、CHD危険因子の保有状況および24時間思い出し法による栄養素摂取量を比較した。飲酒量が多い群ほど血清HDLコレステロール値と血圧が高く、LDLコレステロール値が低かった。喫煙者割合、一日の喫煙本数、高血圧保有率は飲酒量とJ字型の関係を示し、軽度飲酒群で最も低値であった。また、軽度飲酒群に比べ、非飲酒群で保有率の高いCHD危険因子が複数存在した。飲酒量の多い群ほど炭水化物と食物繊維の摂取量が少なく、タンパク質とコレステロールの摂取量が多かった。こうした関連に性差はみられなかった。以上から、飲酒は複数のCHD危険因子および栄養素摂取量と関連することが明らかになった。

Publishing type：Research paper (scientific journal)  

The purpose of this study was to examine the changes in students' disaster-related knowledge and stockpiling behaviors before and after Comprehensive Practicum on nutrition assistance providing hot meals to support victims in times of disaster in the fourth year of the registered dietitian training course. A self-administered, twotime anonymous questionnaire was administered to 33 fourth-year students in the dietitian training course (education group) at the University of O in April 2018, before the exercise, and in December after the exercise. 140 registered dietetic students from other four public universities acted as the control group by completing the same pre- and post-surveys at the same time for comparison with the education group. In the education group, there was improvement in the knowledge about nutrition assistance in times of disasters (such as nutrient reference values in evacuation centers, allocation of registered dietitians to disaster areas, the rolling-stock method and the required amount of water for storage per person a day). The number of students who took action to stockpile increased after the exercise, while no changes were observed in the control group in knowledge nor behavior. It can be inferred that the differences in the content of education on disasters at each university and the presence or absence of disaster experience affect knowledge and stockpiling behavior.

DOI： 10.11379/jjda.64.701

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Publishing type：Research paper (scientific journal)  

<p>Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40–59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (<100 g/wk), moderate-drinkers (100–299 g/wk), or heavy-drinkers (≥300 g/wk). Detailed macro-/micro-nutrient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.</p>

DOI： 10.3177/jnsv.67.28

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<p><b>Objectives</b>　Social security costs related to the healthcare and long-term care of patients with cardiovascular diseases is a national burden that is expected to grow as Japan's population ages. Nutritional policies for improving the nation's diet could prevent cardiovascular diseases, but scientific evidence on their costs and outcomes is limited. This study gives an overview of health economic evaluation studies on population-wide dietary salt-reduction policies that have been instituted for the purposes of cardiovascular disease prevention. Thus, this study provides background information for the development of evaluation methods that can be utilized in Japan for analyzing the effects of nutritional policies on public health and social security cost containment.</p><p><b>Methods</b>　We extracted representative health economic simulation models that are used for predicting the effects of cardiovascular disease-related interventions: Cardiovascular Disease Policy Model, IMPACT Coronary Heart Disease Policy and Prevention Model, US IMPACT Food Policy Model, Assessing Cost-Effectiveness (ACE) approach to priority-setting, and Prevention Impacts Simulation Model (PRISM). Next, we collected original articles on studies that used these models for assessing the costs and effects of national population-wide dietary salt-reduction policies. We then outlined the background, structure, and applied studies associated with each model.</p><p><b>Results</b>　The five models utilized Markov cohort simulation, microsimulation, proportional multistate life tables, and system dynamics to predict the effect of dietary salt-reduction policies on blood pressure reduction and cardiovascular disease prevention. The models were applied to countries such as Australia, England, and the United States to simulate long-term (10 years to lifetime) costs and effects. These applied studies examined policies that included health promotion campaigns, sodium labels on the front of food packages, and mandatory or voluntary reformulation by the food industry to reduce the salt content of processed foods.</p><p><b>Conclusion</b>　Health economic simulation modeling is actively being used to evaluate scientific evidence on the costs and outcomes of national dietary salt-reduction policies. Similarly, leveraging simulation modeling techniques could facilitate the evaluation and planning of dietary salt-reduction policies and other nutritional policies in Japan.</p>

DOI： 10.11236/jph.20-150

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Publishing type：Research paper (scientific journal)  

【目的】特定健康診断を受検し、特定保健指導積極的支援に該当した者の中で、中性脂肪(TG)の基準に該当した対象者(TG≧150mg/dl)の特徴とTG値に対する特定保健指導の効果を検討することを目的とした。【方法】医療保険者155施設から収集したデータを用いた。2011年度に特定健診を受検して特定保健指導の積極的支援に割り付けられ、さらに翌年の特定健診を受診し、かつ服薬なしであった52,958名(男性82.8%)を解析の対象とした。TG基準該当者のうち、TG500mg/dl未満をTG高値者、500mg/dl以上をTG異常高値者とした。男女別に、TG基準非該当者と該当者、TG高値者と異常高値者の特性を比較した。また、それぞれの翌年のTG値を比較した。【結果】積極的支援該当者の中でTG基準該当者は男女ともに約半数を占めており、生活習慣としてはエネルギー過剰摂取につながるような、早食い、夕食後間食という食習慣がある男性が多く、運動習慣(男性のみ)・身体活動習慣がある者の割合が低いという特徴が明らかとなった。さらにTG異常高値者においては、高値者と比較して男性のみに高い喫煙率とハイリスク飲酒、就寝前夕食が関連していることが明らかとなった。保健指導のTGに対する効果は、減量達成した場合には特にTG減少量が大きくなることが認められた。またTG150ml/dl以上である場合は、BMI低下と独立したTG低下効果が認められ、さらに異常高値群では喫煙・飲酒の改善がTG減少量と関連を示した。【結論】保健指導積極的支援において、TG高値者およびTG異常高値者の特徴が明らかとなった。また特定保健指導にはTG低下効果があり、減量達成や喫煙・飲酒の改善が得られることによって、よりTG低下を促進する可能性が示唆された。今後は生活習慣の変化を踏まえた更なる検討が必要である。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1253/circj.cj-20-0322

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DOI： 10.3390/nu12030787

PubMed

Publishing type：Research paper (scientific journal)  

【目的】働き盛りである中年男女を対象に、就寝前の2時間以内に夕食を摂る習慣(遅い夕食習慣)とメタボリックシンドローム(MetS)発症との関連を検討することを目的とした。【方法】全国の医療保険者等155施設において、2011年度から3年連続で特定健康診査を受診した40歳から59歳の者を対象とした。質問票にて就寝前の2時間以内に夕食を摂ることが週に3回以上あると回答した者を遅い夕食習慣あり、3回未満の者を遅い夕食習慣なしと定義し、回答が各年で異なった者は除外した。このうちベースライン時にMetSを有していない最終的な解析対象者は男性17,880人、女性29,769人であった。MetS構成因子指標であるBody mass index(BMI)・腹囲・収縮期血圧・拡張期血圧・空腹時血糖・中性脂肪(TG)・HDLコレステロール(HDL-C)に加え、LDLコレステロール(LDL-C)についても解析した。さらに、2年後のMetS発症に対する遅い夕食習慣の有無の関連を、ロジスティック回帰分析にて調整オッズ比として算出した。調整因子は、ベースライン時の年齢・生活習慣・特定保健指導実施の有無・各構成因子指標値とした。また、ベースライン時の各MetS構成因子指標の異常の有無別に層別化して、同様に調整オッズ比を算出した。【結果】MetS発症者は、男性で1,055人(5.9%)、女性で227人(0.8%)であった。遅い夕食習慣がある者は、男性ではMetS構成因子である指標の全てが、女性ではBMIとHDL-C以外の全ての指標が有意に悪化していた。遅い夕食習慣がある者のMetS発症調整オッズ比は男性では1.20(1.02-1.40)となったが、女性では1.32(0.82-2.13)となった。MetS構成因子指標の異常の有無別に見ると、男性で異常が無い者に限定しても、遅い夕食習慣があることがMetS発症に有意に関連していた。女性では有意な関連は見られなかった。【結論】中年男性では遅い夕食習慣によって、肥満・高血糖・高血圧・脂肪異常のリスクが高まり、MetS発症に至りやすくなることが示唆された。夜遅く食べる人にはこの点を考慮して、食習慣を管理するよう促す必要がある。また遅い夕食習慣の原因となる長時間労働等の働き方の見直しも必要であると考えられる。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1038/s41440-019-0349-9

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DOI： 10.1038/s41430-019-0424-y

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Publishing type：Research paper (scientific journal)  

【目的】過度の飲酒はアルコールそのものが与える健康障害や循環器疾患の発症リスクのみならず、食事にも大きく影響する。しかし、国を代表する集団において飲酒量が栄養素等摂取量に与えている影響を詳細に検討した報告は限られている。そこで、飲酒日における栄養素等摂取量の特徴について検討した。【方法】平成22年国民健康・栄養調査にあわせて20歳以上の男女を対象に実施されたNIPPON DATA2010に参加した、生活習慣病の関連疾患での服薬がなく、栄養摂取状況調査の項目に欠損がない男性729名を解析対象とした。調査日1日の飲酒量に基づき、生活習慣病のリスクを高める量(純アルコール40g以上)の飲酒者をO群(111名)、適量飲酒者(同5g以上40g未満)をM群(187名)、非飲酒者(同5g未満)をN群(431名)とし、各群の栄養素及び食品群別の摂取量について比較検討した。【結果】血圧、HDL及びLDLコレステロール、AST、γ-GTPは、飲酒量により有意な差が認められた。総エネルギー摂取量及びアルコールエネルギー比率は、O群、M群、N群の順に有意に高かったのに対し、炭水化物エネルギー比率及び脂肪エネルギー比率は、O群、M群、N群の順に有意に低かった。また、たんぱく質エネルギー比率は、O群がM群及びN群と比較して有意に低かった。アルコール由来のエネルギーを除外して算出した場合、たんぱく質エネルギー比率は、O群及びM群がN群と比較して有意に高かった。脂肪エネルギー比率は、M群がN群と比較して有意に高かった。炭水化物エネルギー比率はO群及びM群がN群と比較して有意に低かった。たんぱく質、脂質、カリウム、マグネシウム、リン、ビタミンB2、ナイアシン、葉酸、パントテン酸、ビタミンB12、飽和脂肪酸及びコレステロールについて、飲酒量により摂取量に有意な差が認められた。穀類、豆類、野菜類、果実類、菓子類及び嗜好飲料類について、飲酒量により摂取量に有意な差が認められた。【結論】多量飲酒日にはアルコールの摂取により総エネルギー摂取量が高値を示したが、それとは逆に主として穀類から由来する炭水化物の摂取量は低値を示した。循環器疾患をはじめとした生活習慣病予防において、過度の飲酒を控えることは、アルコールそのものによる影響だけでなく、食事によるエネルギー産生栄養素バランスを整える上でも重要であることが示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

<p><b>目的</b>　妊娠中の推奨体重増加量についての知識の有無と，栄養素等の摂取状況を明らかにすることとした。</p><p><b>方法</b>　三重県S市にある産科医療機関において，2017年8月から2018年3月に受診した妊娠16週未満の妊婦108人を対象に，食生活に関する質問紙調査と，秤量記録法による食事調査を実施した。質問紙調査で推奨体重増加量の知識を問い，適正範囲内の回答の正誤により2群（知識あり群，知識なし群）に分類した。また，サプリメント使用の有無も問い，使用している場合は具体的な種類の回答を求めた。食事調査で算出された総エネルギー量と各栄養素の摂取量，サプリメントの使用と種類について，推奨体重増加量の知識の有無で比較した。</p><p><b>結果</b>　調査対象妊婦は，妊娠週数12.5±1.2（週），平均年齢30.1±4.9（歳），妊娠前のBMI21.1±3.2（kg/m²），初産婦59人（54.6％）であった。推奨体重増加量の知識の有無による栄養素等の比較を行ったところ，エネルギー摂取量は，知識あり群1,547.0±452.4kcal，知識なし群1,660.9±350.5kcalで有意差はなかった。たんぱく質は知識あり群14.9±3.0g・知識なし群14.1±2.4gであった。脂質は知識あり群29.8±7.2g・知識なし群28.7±5.5gであった。炭水化物は知識あり群205.9±63.2g，知識なし群は230.5±50.5gで有意に多かった（p＝0.02）。妊娠中に特に配慮を要する栄養素は，葉酸は知識あり群220.7±76.5㎍・知識なし群236.8±97.0㎍，鉄は知識あり群6.0±2.1mg・知識なし群6.5±2.7mg，カルシウムは知識あり群438.5±167.9mg・知識なし群491.9±248.5mgで両群での有意差はみられなかった。</p><p><b>結論</b>　妊娠中の推奨体重増加量の知識がある妊婦は，知識がない妊婦に比べて，エネルギー摂取量が低く，栄養素摂取量は必要量を下回る割合が多かった。このことから，正しい知識を有する妊婦はエネルギー摂取に対する過剰な意識が，不適切な栄養摂取状況に影響を与えている可能性が示唆された。</p>

DOI： 10.24802/tpha.7.1_151

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Publishing type：Research paper (scientific journal)  

<p><b><i>Background:</i></b>Many studies show that dietary factors such as vegetables, fruit, and salt are associated with cardiovascular disease (CVD) risk. However, a risk assessment chart for CVD mortality according to combinations of dietary factors has not been established.</p><p><b><i>Methods and Results:</i></b>Participants were 9,115 men and women aged 30–79 years enrolled in the National Nutritional Survey of Japan in 1980 with a 29-year follow-up. Dietary intake was assessed using a 3-day weighed dietary record at baseline. Cox regression models were used to estimate the hazard ratio (HR) of CVD mortality stratified by vegetables, fruit, fish, and salt consumption. HRs of CVD mortality according to combinations of dietary factors were color coded on an assessment chart. Higher intakes of vegetables, fruit, and fish, and lower salt intake were associated with lower CVD mortality risk. HRs calculated from combinations of dietary factors were displayed using 5 colors corresponding to the magnitude of the HR. People with the lowest intake of vegetables, fruit, and fish, and higher salt intake had a HR of 2.87 compared with those with the highest intake of vegetables, fruit, and fish, and lower salt intake.</p><p><b><i>Conclusions:</i></b>Vegetables, fruit, fish, and salt intake were independently associated with CVD mortality risk. The assessment chart generated could be used in Japan as an educational tool for CVD prevention.</p>

DOI： 10.1253/circj.cj-18-1002

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重要食品群と塩分の食事摂取に基づいて循環器疾患死亡リスクの評価チャートを構築した。1980年に実施したNational Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged(NIPPON DATA80)のデータを用いた。被験者9115名(男性4002名、女性5113名、平均50.0±12.7歳)が3日間に摂取した全食品と飲料を記録した。食品群として、野菜、果実、魚、穀類、大豆・大豆製品、乳製品、肉類を評価した。被験者を29年間経過観察して死因を判定し、心血管死を調べた。心血管疾患による死亡は1070例あった。循環器疾患死亡リスクは野菜の高摂取よりも低摂取で有意に上昇した。塩分の低摂取と比較して、高摂取が心血管疾患死亡の高リスクに関連した。野菜、果実、魚の高摂取と塩分の低摂取が脳卒中による死亡の低いリスクと有意に関連した。

Publishing type：Research paper (scientific journal)  

<p><b>Aim:</b> The positive relationship between dietary cholesterol and serum cholesterol has been questioned by a set of recent cohort studies. This study aimed to investigate how employment status and education years relate to the association between dietary cholesterol and serum low-density lipoprotein cholesterol (LDL-C) in a Japanese population.</p><p><b>Methods:</b> A population-based, random sample, cross-sectional study (INTERLIPID) was performed. Among 1,145 Japanese individuals aged 40-59 years, 106 were excluded because of special diets, use of lipid-lowering drugs, hormone replacement, and missing data, leaving 1,039 individuals (533 men and 506 women). Dietary cholesterol was assessed from four 24-h dietary recalls, and LDL-C was measured enzymatically with an auto-analyzer. A standard questionnaire inquired about employment status and education years.</p><p><b>Results:</b> In men, a 1 standard deviation (SD) higher dietary cholesterol was associated with 3.16 mg/dL lower serum LDL-C (<i>P</i>=0.009; unadjusted model). After adjustment for covariates, higher serum LDL-C was estimated per 1 SD higher intake of dietary cholesterol in nonemployed men [self-employed, homemakers, farmers, fishermen, and retired employees; β=＋9.08, 95% confidence interval (CI)=＋0.90-＋17.27] and less educated men (β=＋4.46, 95% CI=－0.97-＋9.90), whereas an inverse association was observed in employed men (β=－3.02, 95% CI=－5.49-－0.54) and more educated men (β=－3.66, 95% CI=－6.25-－1.07).</p><p><b>Conclusions:</b> In men who were nonemployed and less educated, a higher intake of dietary cholesterol was associated with elevated concentrations of serum LDL-C, whereas an inverse association was observed in men who were employed and more educated.</p><p></p>

DOI： 10.5551/jat.43075

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CiNii Article

Publishing type：Research paper (scientific journal)  

ベースライン時に心血管疾患(CVD)を認めない30歳以上の日本人7744名(男性3224名、女性4520名、平均52.6±13.8歳)を15年間追跡し、植物性蛋白質摂取量とCVD死の関連を検討した(NIPPON DATA90研究)。追跡期間(平均13.9年、107988人・年)に1213名が死亡し、うち354名(29.2%)がCVD死であった。植物性蛋白質摂取量はCVD死および脳出血死と負に関連し、植物性蛋白質摂取量におけるエネルギーの1%上昇によるハザード比は、CVD死で0.86(95%CI 0.75～0.99)、脳出血死で0.58(95%CI 0.35～0.95)であった。サブグループ解析において、高血圧患者より非高血圧患者のほうが植物性蛋白質摂取量とCVD死の負に関連が強力であり、同ハザード比はCVD死で0.68(95%CI 0.50～0.94)、脳出血死で0.50(95%CI 0.30～0.84)であった。植物性蛋白質摂取により将来のCVDが予防できる可能性が示された。

Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12199-018-0752-x

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1253/circj.CJ-18-0628

Publishing type：Research paper (scientific journal)  

<p><b><i>Background: </i></b>Recently, high-density lipoprotein particles (HDL-P) have been found to be more strongly inversely associated with coronary artery disease (CAD) risk than their counterpart, HDL cholesterol (HDL-C). Given that lifestyle is among the first targets in CAD prevention, we compared the associations of HDL-P and HDL-C with selected lifestyle factors. </p><p><b><i>Methods and Results: </i></b>We examined 789 Japanese participants of the INTERLIPID Study: men (n=386) and women (n=403) aged 40–59 years in 1996–1998. Participants treated for dyslipidemias were excluded. Lifestyle factors included alcohol intake, smoking amount, and body mass index (BMI). Multivariable linear regression was used for cross-sectional analyses of these factors with HDL-P, HDL-C, HDL-P size subclasses (small, medium and large) and mean HDL-P size. In men, higher alcohol intake was associated with higher HDL-P and higher HDL-C. The associations of alcohol, however, were strongest with HDL-P. A higher smoking amount tended to be associated with lower HDL-P and HDL-C. In contrast, BMI was not associated with HDL-P, but was strongly inversely associated with HDL-C. While alcohol intake favored larger mean HDL-P size, smoking and BMI favored a lipid profile with smaller HDL-P subclasses and overall smaller mean HDL-P size. Similar, but generally weaker results were observed in women. </p><p><b><i>Conclusions: </i></b>Although both HDL-P and HDL-C are parameters of HDL, they have different associations with alcohol, smoking and BMI. </p>

DOI： 10.1253/circj.cj-18-0341

PubMed

CiNii Article

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

DOI： 10.1017/S0007114518001927

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1017/S0007114518001162

PubMed

Publishing type：Research paper (scientific journal)  

【背景】特定保健指導による効果検討では保健指導効果に関連する対象者要因はほとんど検討されていない。朝食欠食者に肥満者が多いと報告されており、朝食欠食は保健指導による減量効果に関連している可能性がある。【目的】155の医療保険者および特定保健指導実施機関より収集した平成23-25年度特定健康診査結果に平成23-24年度特定保健指導結果を個人ごとに突合したデータセットを用いて朝食欠食習慣の有無と保健指導効果との関連を検討した。保健指導効果の指標として翌年健診時体重の差(以下、体重差)を用いた。【方法】平成23年、24年に積極的支援に参加し翌年特定健診結果のある10,480名を用いた。内訳は朝食欠食習慣がある者が2,077名(朝食欠食あり群)、朝食欠食習慣のない者が8,403名であった[Total(T-)朝食欠食なし群]である。他の生活習慣の類似した対照を設定するため積極的支援実施前の特定健診結果を用いて朝食欠食の傾向性スコアを計算した。朝食欠食あり群の1名に対し、T-朝食欠食なし群から傾向性スコアが最も近い1名を選択する操作を繰り返し、選択された者をPropensity score matching(Pro-)朝食欠食なし群とした。【結果】現在喫煙や運動習慣がないことなどが朝食欠食習慣と関連していた。体重差の平均値は朝食欠食あり群よりもT-朝食欠食なし群で有意に大きかった(-1.16kg vs.-1.40kg、P=0.002)が、Pro-朝食欠食なし群では-1.30kgであり有意差は消失した(P=0.181)。【結論】朝食欠食あり群とT-朝食欠食なし群の間で観察された保健指導の効果の差は、傾向性スコアを用いて他の生活習慣をマッチさせたPro-朝食欠食なし群との比較では消失した。朝食欠食習慣がない者では、他の良好な生活習慣を併せもつことが、保健指導による減量効果が大きいことと関連したと考えられた。(著者抄録)

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

日本全国心血管予防システムにおける2種類の個別化健康指導(反復および単回カウンセリング)が喫煙者の禁煙を促進するか検討した。年齢40〜74歳の日本人喫煙者4745名を対象に、1年フォローアップ後にカウンセリングを受けた者(サポート群)と受けなかった者(非サポート群)に分け、禁煙率を比較した。傾向スコアマッチング解析を用いて、両群間の特徴を調整後に、禁煙に関する各アプローチの平均処置効果(ATE)を推定した。反復カウンセリングスキームにおいて、サポート群および非サポート群における禁煙の年齢調整比は男性でそれぞれ8.8%および6.3%、女性で9.8%および9.1%であった。単回カウンセリングスキームにおいて、相当する比率は男性でそれぞれ8.4%および7.3%、女性で11.0%および11.7%であった。反復カウンセリングのATEは男性+2.64%(95%信頼区間+1.51%〜+3.77%)、女性+3.11%(同-1.85%〜+8.07%)であった。単回カウンセリングのATEは男性+0.61%(同-1.17%〜+2.38%)、女性-1.06%(同-5.96%〜+3.85%)であった。日本人心血管予防システムにおいて、反復カウンセリングは男性喫煙者の禁煙を促進する可能性が示唆された。

Publishing type：Research paper (scientific journal)  

NIPPON DATA2010に参加した日本人2647名(男性1087名、女性1560名)を対象に、心血管疾患(CVD)予防を目的とした生活習慣改善を社会経済的地位(SES)別に検討した。SESとして、学歴(9年未満、10〜12年、13年以上)、婚姻状況(既婚、離婚、死別、未婚/その他)を評価した。1507名(56.9%)が高血圧、糖尿病、コレステロール上昇、メタボリックシンドローム(MetS)の予防と改善を実践していた。学歴13年以上は9年未満に比べ、年齢とCVDリスク因子の認識を調整後の生活習慣改善のオッズ比が有意に高く、男性で2.86(95%CI 1.96〜4.17)、女性で2.36(95%CI 1.67〜3.33)であった。離婚者は既婚者に比し、高血圧、糖尿病、コレステロール上昇、MetSの予防と改善の実践が有意に不良で、オッズ比は男性で0.46(95%CI 0.22〜0.95)、女性で0.53(95%CI 0.33〜0.86)であった。学歴および婚姻状況により、生活習慣改善に差が生じる可能性が示された。

Publishing type：Research paper (scientific journal)  

NIPPON DATA2010に参加した日本人2637名(男性1145名、女性1492名、20歳以上)を対象に、世帯収入、他の社会経済的地位(SES)指標、主要栄養素摂取の関連性を横断的に検討した。世帯年収により、200万円未満、200〜590万円、600万円以上に分類した。平均年齢は、男性59.9±15.5歳、女性58.5±15.8歳、平均BMIは男性23.8±3.2kg/m2、女性22.7±3.5kg/m2であった。年齢と他のSES変数を調整後、世帯年収は男女ともに、脂肪摂取と正に関連し、炭水化物摂取と負に関連した。Equivalent household expenditure(EHE)と主要栄養素摂取の関連性についても同様であったが、世帯年収についての関連性よりも弱かった。高齢は、高炭水化物/低脂肪摂取と強く関連する因子であり、次に世帯年収、EHE、学歴、職種が続いた。SESは主要栄養素摂取を介して個々の健康状態に影響する可能性が示唆された。

Publishing type：Research paper (scientific journal)  

NIPPON DATA2010に参加した日本人2891名(男性1236名、女性1655名、20歳以上)のベースラインデータを用いて、食品群摂取と社会経済的地位(SES)の関連性を横断的に検討した。学歴は中学以下、高校、大学に分類し、世帯収入は200万円未満、200〜600万円、600万円以上、不明に分類した。男女ともに、equivalent household expenditure(EHE)が低い程、穀物の摂取量が多かった。男性では、EHEが低い程、魚、牛乳、アルコールの摂取量が少なかった。女性では、EHEが低い程、野菜の摂取量が少なかった。男女ともに、学歴が低い程、穀物の摂取量が多かったが、肉の摂取量は少なかった。日本人において、SESが低い程、穀物の摂取量が多く、野菜、魚、肉、牛乳の摂取量が少ないことが示された。

Publishing type：Research paper (scientific journal)  

NIPPON DATA2010に参加した2491名(男性1081名、女性1410名、20歳以上)を対象に、社会経済的地位(SES)と低体重、過体重、肥満の関連を男女別および年齢別に検討した。WHO定義に基づき、BMIが18.5kg/m2未満を低体重、25.0〜29.9kg/m2を過体重、30.0kg/m2以上を肥満に分類した。年齢は、20〜64歳と65歳以上に分類した。学歴以外のSESを調整後、20〜64歳の男性では、低学歴者は高学歴者に比し、肥満リスクが低かったが(オッズ比0.41,95%CI 0.18〜0.96)、同女性では低学歴者で過体重(オッズ比1.67,95%CI 1.07〜2.49)、肥満(オッズ比2.66,95%CI 1.01〜7.01)のリスクが高かった。世帯収入については、20〜64歳の女性における世帯収入200万円未満の人は600万円以上の人に比して過体重(オッズ比2.09,95%CI 1.07〜4.09)と肥満(オッズ比4.84,95%CI 1.36〜17.18)のリスクが高かった。性別と年齢層は、SESと低体重、過体重、肥満の関連に影響することが示された。

Publishing type：Research paper (scientific journal)  

【目的】高血圧は循環器疾患の危険因子であり、適正なエネルギー摂取や食塩摂取がその予防や治療に重要であることは広く知られている。一方で減塩への配慮状況とエネルギーや栄養素摂取量との関連を国レベルで詳細に検討した報告は限られている。そこで、減塩への配慮状況が実際の食塩や栄養素等摂取量とどのように関連するのか検討した。【方法】平成22年国民健康・栄養調査に参加し、NIPPON DATA2010への参加に同意した40～74歳の1,875名を対象とした。性別に循環器疾患の既往(高血圧、脳卒中、心臓病、腎臓病)の有無と減塩に対する配慮の有無により分類し、エネルギー、栄養素、食塩摂取量の関係を比較した。【結果】循環器疾患の既往がある者は男性で325名(39.7%)、女性で286名(27.1%)であり、減塩配慮を行っている者の割合は、男性で367名(44.9%)、女性で583名(55.2%)であり、循環器疾患の既往と減塩配慮の有無に性差が認められた。男性の既往あり群では、減塩配慮あり群が減塩配慮なし群に比べ、ナトリウム摂取密度は少なかった(2,217±55:2,422±85(mg/1,000kcal/day)、p=0.020)。しかし、既往なし群では、減塩配慮あり群と減塩配慮なし群の間に同等の関係は認められなかった。女性では既往の有無に関わらず、何れの群間にもナトリウム摂取密度に差は認められなかった。しかし、Na/K比については、何れも減塩配慮あり群が有意に低値を示していた(既往あり2.92±0.87:3.26±0.13(mol/mol)、p=0.033既往なし2.81±0.57:3.18±0.57(mol/mol)、p<0.001)。【結論】男性では、循環器疾患の既往の有無が減塩配慮と実際の減塩行動とに関連していることが推測された。しかし、女性では既往の有無にかかわらず、差は認められなかった。循環器疾患の既往がない者に対しても、身近で減塩に関する正しい知識を会得できる機会を増やしていくことや、加工食品の低塩化など食品の環境的アプローチも同時に進めることが高血圧予防に必要であると考えられた。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.clnu.2016.11.021

Publishing type：Research paper (scientific journal)  

60歳以上の女性54名を対象に、食事記録に基づく2日間の栄養摂取調査を行った。ナトリウム(Na)とカリウム(K)の摂取量比を従属変数、食品群の摂取量を独立変数として逐次重回帰分析を行った。高レベルのNa摂取に寄与する食品群は漬物(標準偏回帰係数β=0.44)および味噌(β=0.22)であり、高レベルのK摂取に寄与する食品群は果物(β=0.70)およびその他の野菜(β=0.21)であった。醤油(β=0.62)および塩(β=0.35)および漬物(β=0.29)は高いNa/K比に寄与し、果物(β=-0.31)は低いNa/K比に寄与した。N摂取の減少およびK摂取の増加のためには調味料および漬物の摂取を減らし、果物の摂取を増やすことが望ましいと考えられた。

Publishing type：Research paper (scientific journal)  

<p><b>Background:</b> The relationships among socioeconomic status and lifestyle improvements have not yet been examined in a representative Japanese population.</p><p><b>Methods:</b> We analyzed data from 2,647 participants (1,087 men and 1,560 women) who participated in NIPPON DATA2010. This survey inquired about lifestyle improvements and socioeconomic status. Education was categorized as low (≤9 years), middle (10–12 years), and high (≥13 years). Marital status was categorized as married, divorced, widowed, and never married/other. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of lifestyle improvements with the intention of preventing cardiovascular diseases for educational attainment and marital status, with adjustments for age and awareness of cardiovascular disease risk factors.</p><p><b>Results:</b> Overall, 1,507 (56.9%) participants practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome, and the OR of lifestyle improvements was significantly higher with a high education than with a low education in men (OR 2.86; 95% CI, 1.96–4.17) and women (OR 2.36; 95% CI, 1.67–3.33). The number of participants who practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome was significantly lower in divorced than in married men (OR 0.46; 95% CI, 0.22–0.95) and women (OR 0.53; 95% CI, 0.33–0.86).</p><p><b>Conclusions:</b> Specific differences caused by educational attainment and marital status may exist in lifestyle improvements.</p>

DOI： 10.2188/jea.JE20170254

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b><i>Aim</i></b><b>: </b>We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers.</p><p><b><i>Methods</i></b><b>: </b>The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index.</p><p><b><i>Results</i></b><b>: </b>In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was ＋2.64% (95% confidence interval: ＋1.51% to ＋3.77%) for males and ＋3.11% (－1.85% to ＋8.07%) for females. The ATE of single counseling was ＋0.61% (－1.17% to ＋2.38%) for males and －1.06% (－5.96% to ＋3.85%) for females.</p><p><b><i>Conclusions</i></b><b>: </b>In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.</p>

DOI： 10.5551/jat.42051

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Background:</b> A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population.</p><p><b>Methods:</b> This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance.</p><p><b>Results:</b> When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment.</p><p><b>Conclusions:</b> Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits.</p>

DOI： 10.2188/jea.JE20170248

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Background:</b> Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20–64 or ≥65 years) in Japan.</p><p><b>Methods:</b> In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. We divided 2,491 participants (1,081 men and 1,410 women) according to the WHO definitions of underweight, overweight or obesity and performed multinomial logistic analyses using BMI <18.5 kg/m² (underweight), BMI 25.0–29.9 kg/m² (overweight), and BMI ≥30.0 kg/m² (obese) versus BMI 18.5–24.9 kg/m² (normal) as the outcome, with SES groups as the main explanatory variables.</p><p><b>Results:</b> In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio [OR] 0.41; 95% confidence interval [CI], 0.18–0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07–2.49 for overweight and OR 2.66; 95% CI, 1.01–7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36–17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY).</p><p><b>Conclusions:</b> In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.</p>

DOI： 10.2188/jea.JE20170249

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Background:</b> This study examined the relationships among household income, other SES indicators, and macronutrient intake in a cross-sectional study of a representative Japanese population.</p><p><b>Methods:</b> In 2010, we established a cohort of participants in the National Health and Nutrition Survey (NHNS) from 300 randomly selected areas throughout Japan. A total of 2,637 participants (1,145 men and 1,492 women) were included in the study. Data from NHNS2010 and the Comprehensive Survey of Living Conditions 2010 (CSCL2010) were merged, and relationships among macronutrient intake and SES were evaluated. Additionally, socioeconomic factors associated with a risk of a higher carbohydrate/lower fat intake beyond dietary recommendations were evaluated.</p><p><b>Results:</b> Household income was positively associated with fat intake (<i>P</i> = 0.001 for men and <0.001 for women) and inversely associated with carbohydrate intake (<i>P</i> = 0.003 for men and <0.001 for women) after adjustments for age and other SES variables. Similar relationships were observed between equivalent household expenditure (EHE) and macronutrient intake; however, these relationships were weaker than those of household income. Older age was the factor most strongly associated with a high carbohydrate/low fat intake, followed by household income, EHE, education levels, and occupation type.</p><p><b>Conclusions:</b> Older age was the factor most strongly associated with a high carbohydrate/low fat intake, and some aspects of SES, such as household income, EHE, education levels, and occupation type, were independently associated with an imbalanced macronutrient intake. SES may affect the health status of individuals through the intake of macronutrients.</p>

DOI： 10.2188/jea.JE20170250

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Background:</b> Reducing the urinary sodium-to-potassium ratio is important for reducing both blood pressure and risk of cardiovascular disease. Among free-living Japanese individuals, we carried out a randomized trial to clarify the effect of lifestyle modification for lowering urinary sodium-to-potassium ratio using a self-monitoring device.</p><p><b>Methods:</b> This was an open, prospective, parallel randomized, controlled trial. Ninety-two individuals were recruited from Japanese volunteers. Participants were randomly allocated into intervention and control groups. A month-long dietary intervention on self-monitoring urinary sodium-to-potassium ratio was carried out using monitors (HEU-001F, OMRON Healthcare Co., Ltd., Kyoto, Japan). All participants had brief dietary education and received a leaflet as usual care. Monitors were handed out to the intervention group, but not to the control group. The intervention group was asked to measure at least one spot urine sodium-to-potassium ratio daily, and advised to lower their sodium-to-potassium ratio toward the target of less than 1. Outcomes included changes in 24-hour urinary sodium-to-potassium ratio, sodium excretion, potassium excretion, blood pressure, and body weight in both groups.</p><p><b>Results:</b> Mean measurement frequency of monitoring was 2.8 times/day during the intervention. Changes in urinary sodium-to-potassium ratio were −0.55 in the intervention group and −0.06 in the control group (<i>P</i> = 0.088); respective sodium excretion changes were −18.5 mmol/24 hours and −8.7 mmol/24 hours (<i>P</i> = 0.528); and corresponding potassium excretion was 2.6 mmol/24 hours and −1.5 mmol/24 hours (<i>P</i> = 0.300). No significant reductions were observed in either blood pressure or body weight after the intervention.</p><p><b>Conclusions:</b> Providing the device to self-monitor a sodium-to-potassium ratio did not achieve the targeted reduction of the ratio in "pure self-management" settings, indicating further needs to study an effective method to enhance the synergetic effect of dietary programs and self-monitoring practice to achieve the reduction. However, we cannot deny the possibility of reducing sodium-to-potassium ratio using a self-monitoring device.</p>

DOI： 10.2188/jea.JE20160144

CiNii Article

Publishing type：Research paper (scientific journal)  

&emsp;This study was performed with subjects who received active support including specific health guidance, with the aim of clarifying the effects of changes in lifestyle on weight loss. The results are based on the answers that they provided in standard questionnaires before and after the support intervention. The subjects included 4,318 males and 810 females at 155 facilities who were categorized as requiring active support based on the results of special health check-up from April 2011 to March 2013, and completed the health guidance. In the study, a weight loss of 3% or more was considered as a positive outcome.<br>&emsp;The percentage of subjects with a weight loss of 3% or higher was 32.3% and 39.6% in the male and female subjects, respectively. The male and female subjects with a weight loss of 3% or higher accounted for 20% or higher of the subjects who maintained or increased their bad lifestyle habits, and those who maintained or reduced their good lifestyle habits. A reduction in the bad lifestyle habits with the intervention was significantly correlated with a weight loss of 3% or higher. For male subjects, these parameters included &ldquo;having a snack or midnight meal after dinner&rdquo; (odds ratio: 2.01, 95% confidence interval: 1.42-2.84), &ldquo;exercise with light sweating for 30 minutes or longer per day&rdquo; (1.70, 1.41-2.07), &ldquo;pace of eating when compared to others&rdquo; (1.55, 1.23-1.97), &ldquo;high-risk alcohol drinking&rdquo; (1.52, 1.06-2.19), and &ldquo;walking or physical activity for 1 hour or longer per day&rdquo; (1.32, 1.10-1.58). For female subjects, the parameters were &ldquo;not having breakfast&rdquo; (2.56, 1.14-5.73) and &ldquo;exercise with light sweating for 30 minutes or longer per day&rdquo; (1.72, 1.15-2.56). In addition, even after adjustment for the factors of age, BMI, smoking, and high-risk alcohol drinking, similar results were obtained.<br>&emsp;Based on these findings, it was suggested that a certain level of weight loss could be confirmed in the subjects who received active support, and the effects tended to be increased when concrete improvements were made in their lifestyle.

DOI： 10.7143/jhep.45.374

CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Aim:</b> To examine the relationship between the intake of dietary vegetable protein and CVD mortality in a 15-year follow-up study of a representative sample of the Japanese population.</p><p><b>Methods:</b> A total of 7,744 participants aged 30 years or older (3,224 males and 4,520 females) who were free of CVD at baseline were included in this analysis. Vegetable protein intake (% energy) was assessed using a three-day semi-weighed dietary record at baseline. Multivariable-adjusted hazard ratios (HRs) were calculated using Cox's proportional hazards model after adjusting for confounding factors.</p><p><b>Results:</b> The total person-years studied were 107,988 with a mean follow-up period of 13.9 years. There were 1,213 deaths during the follow-up period, among which 354 (29.2%) were due to CVD. Vegetable protein intake was associated inversely with CVD and cerebral hemorrhage mortality, with the HRs for a 1% energy increment in vegetable protein intake being 0.86 (95% CI, 0.75–0.99) and 0.58 (95% CI, 0.35–0.95), respectively. In the subgroup analysis of participants with or without hypertension, the inverse association between vegetable protein intake and CVD mortality was more evident in the nonhypertensive group, with the HRs for CVD and stroke being 0.68 (95% CI, 0.50–0.94) and 0.50 (95% CI, 0.30–0.84), respectively.</p><p><b>Conclusions:</b> Vegetable protein intake may prevent future CVD, particularly in nonhypertensive subjects in the Japanese population. However, further studies are necessary to examine the biological mechanisms of this effect.</p>

DOI： 10.5551/jat.44172

CiNii Article

Publishing type：Research paper (scientific journal)  

<p>It is challenging for individuals to decide and select healthy foods. Recently, some countries in the world have developed nutrient profiling models, which are ranking and/or classifying foods based on their nutrient composition. However, evaluation on foods by using this concept has not been well investigated and applied in Japan to date. Therefore, by utilizing a model, we ranked foods in Standard Tables of Food Composition in Japan 2015 edition. The Nutrient Rich Food Index 9.3 (NRF9.3) for listed foods in Japanese Standard Table was calculated based on 9 nutrients to encourage and 3 nutrient to limit (per 100 kcal). Among the food groups, NRF9.3 indexes decreased in the order of seaweeds, vegetables, mushrooms, beans. Furthermore, in the same food groups, NRF9.3 indexes could clarify nutrient rich foods versus nutrient poor foods. In conclusion, NRF9.3 index would be useful in selecting alternative, more nutrient-rich foods from similar food groups when purchasing foods.</p>

DOI： 10.11379/jjda.61.445

CiNii Article

Publishing type：Research paper (scientific journal)  

日本人の男性バス運転者における体重の自己認識と健康関連行動を調べ、体重認識が健康状態および健康問題に及ぼす影響について検討した。対象は石川県の運送会社に勤務するバス運転手532名(年齢20〜65歳)で、自記式質問票により体重の自己認識と10項目の生活習慣を調べた。自己認識が過体重、正常体重、過小体重であった参加者はそれぞれ342名(64.3%)、123名(23.1%)、67名(12.6%)であった。参加者の56.0%が体重を正確に自覚していた。さらに、多くの参加者の体重自己認識は、実際の体重および臨床検査の成績の影響を受けているようであった。生活習慣のうち「食べる速さ」「運動頻度」「生活習慣改善の意識」の3項目については三つのBMIカテゴリー間で有意差が認められた。しかし、食生活、飲酒、喫煙行動などの健康関連行動は全国調査データよりも不良であった。男性バス運転手の体重の自己認識は検査データと関連しており、体重の良好な自己認識は優れた生活習慣につながることが示唆された。

Publishing type：Research paper (scientific journal)  

DOI： 10.1002/osp4.106

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00394-016-1177-1

Publishing type：Research paper (scientific journal)  

<b>Objective: </b>A study on persons receiving Specific Health Guidance reported that a reduction in weight of at least 3% improved clinical test results. In the present study, we aimed to determine lifestyle habits making it easier for large numbers of people receiving Specific Health Guidance to achieve a decrease in weight. The participants were men receiving active support and we carried out an investigation to see if there was an association between lifestyle habits at the time of the initial specific health check-up and presence or absence of a decrease in weight thereafter. <br><b>Methods: </b>We used data from 155 medical insurer facilities that consented to participate in the present study. The subjects were 4,266 men ranging in age from 40 to 64 years who in 2011 had been determined to require active support and had completed the course of health guidance from among 969,777 individuals who underwent specific health check-up in fiscal 2011, 2012 and 2013. To be determined as "achieved weight reduction" participants had to have a reduction of at least 3%. We examined associations between lifestyle habits determined by the medical interview during the specific health check-up in 2011 and achievement of weight reduction over 2 years using logistic regression analysis. <br><b>Results: </b>After 1 and 2 years 33.2% and 35.4% had achieved a reduction in weight, respectively. A reduction in both years was achieved by 23.2% and those not achieving a reduction accounted for 54.5%. Among lifestyle habits, there was a significant association between "Don't eat dinner in the 2 hours before going to bed" and achievement of weight reduction over 2 years (<i>p</i>=0.006).<br><b>Conclusion: </b>Our findings suggested the possibility that achievement of weight reduction would be enhanced if men receiving Specific Heath Guidance could be persuaded not to eat dinner in the 2 hours before going to bed as a start.

DOI： 10.11320/ningendock.32.456

CiNii Article

Publishing type：Research paper (scientific journal)  

&emsp;<b><i>Objectives:</i></b> This study determined the impact of self-perception of weight and lifestyle on the physical condition and health problems of male Japanese bus drivers.<br>&emsp;<b><i>Subjects and Methods:</i></b> The study participants included 532 male Japanese bus drivers (20-65 years old) working at a transportation company in Ishikawa Prefecture. We used a self-administered questionnaire to assess weight self-perceptions and 10 lifestyle characteristics during health examinations in the summer of 2014. The participants were grouped into three categories based on their self-perception of weight (overweight, normal weight, and underweight). Participants&rsquo; self-perception of weight was compared with actual BMI to assess overestimation, accurate estimation, and underestimation of body weight. We also examined the association between laboratory test results, 10 health-related behaviors, and perceived weight status within the three BMI categories.<br>&emsp;<b><i>Results:</i></b> The percentages of the total participants who perceived themselves as overweight, normal weight, and underweight were 64.3%, 23.1%, and 12.6%, respectively. In Total, 56.0% of total participant accurately perceived their body weight. In addition, the weight perception of many participants appeared to have been affected by actual body weight and laboratory test results. Only three health-related behaviors showed a significant difference among BMI classifications; however, other health-related behaviors, such as dietary habits, alcohol consumption, and smoking behaviors, were worse than national survey data for all groups.<br>&emsp;<b><i>Conclusions:</i></b> The results suggest the possibility that male bus drivers&rsquo; weight self-perception is associated with laboratory test results and that having a good self-perception of weight leads to better lifestyle habits.

DOI： 10.7143/jhep.44.580

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.6133/apjcn.072016.11

Publishing type：Research paper (scientific journal)  

DOI： 10.6133/apjcn.062016.06

Publishing type：Research paper (scientific journal)  

Background<br>In the 1970s, Kawakami primary school, which was located in northern part of Kyoto, was known for pioneering education practice. The practice treated the region community as the object of learning and realized high quality education through cooperation with the people living in the Kawakami area. Furthermore, the Kawakami primary school lunch food education was positioned as part of the education practice and it almost completely achieved the goals of the Japanese food and nutrition education promotive action policy, which was announced in 2016. Although the lunch food education practice at Kawakami primary school was known as a great practice, it remains unknown why the practice was started and how they continued it.<br>Objective<br>To research the history of the Kawakami school lunch food education practice and obtain an important perspective for continuing the practice.<br>Methods<br>The study was conducted using face to face interview and a review of the literature. On October 24, 2016, we conducted face to face interviews with 3 participants who had worked at Kawakami primary school in the 1970s as a vice principal, a teacher and a cook.<br>Results<br>The history of the Kawakami primary school lunch from 1939 to 1980 was divided into three periods: 1) the "Only soup school lunch meal" period, which started in 1939, 2) the "Rice in a lunch box with a side dish that was cooked in school" period, which started in 1960, and 3) the "Rice cooked in school as a staple food and a complete school lunch" period, which started in 1976. The famous food education practice was started after the third period and continued for about 10 years. Two facts are considered to have been critically important for the Kawakami primary school food education practice. One is the Kawakami research, which was conducted in 1970 by residents of Kawakami area and included Kawakami school teachers, in order to clarify their own lifestyle reality. The research revealed their common issues and they shared the necessity of the practice. Furthermore, they deepened the cooperative relationship between the school teachers and the residents of the Kawakami area through the movement and resolution of issues. The other one is the participation of the cook in the educational activities, which was stated in the Kawakami primary school educational policy issued in 1975. According to this policy, the school lunch was clearly positioned as part of school education. Therefore, the operative issues of the practice were shared continuously with each other in the Kawakami primary school.

DOI： 10.11428/kasei.69.0_316

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00394-015-0969-z

Publishing type：Research paper (scientific journal)  

DOI： 10.1111/jdi.12433

Publishing type：Research paper (scientific journal)  

日本人男性における食事中の炭水化物摂取と2型糖尿病発症リスクとの関連を前向きコホート研究により検討した。男性工場労働者2006名(平均45.9歳)を対象とした。各被験者の主要栄養素摂取は自記式食事歴法質問票で調査し、糖尿病の発症は10年間にわたり毎年血液検査を行って判定した。研究期間中に232例が糖尿病を発症した。全エネルギー摂取中の炭水化物摂取率が50.0%未満、50.0～57.4%、57.5～65.0%、65.0%超に層別化した場合の粗糖尿病発症率はそれぞれ16.5、14.4、12.7、17.6であった。全体として、炭水化物摂取は糖尿病のリスクとは関連していなかったが、糖尿病発症に関して炭水化物摂取と肥満の程度の間には有意な相互作用が見られ、BMIが25.0kg/m2以上の被験者においては高い炭水化物摂取は糖尿病リスク上昇と関連していた。また肥満被験者では、炭水化物摂取率が65%を超える被験者の糖尿病リスク多変量調整ハザード比は2.1で、50.0～57.4%の被験者のそれよりも有意に高かった。炭水化物摂取と糖尿病リスクはBMIとともに変化しており、肥満被験者における高い炭水化物摂取は、より大きな糖尿病リスクと関連していたが、非肥満患者では関連は見られなかった。

Publishing type：Research paper (scientific journal)  

バランスのよい食事の必要摂取回数を栄養不足予防の観点から検討した。富山県でのINTERMAP Toyama研究に参加した40〜59歳の日本人(男性149名、女性150名)を、食事調査の結果をもとに、1日のうち主食、主菜、副菜がそれぞれ一つ(serving)以上揃う食事をとる回数によって4群に分け(第1群;1.00回未満、第2群;1.00〜1.49回、第3群;1.50〜1.74回、第4群;1.75回以上)、各群の栄養素摂取量が日本人の食事摂取基準(2015年版)を満たさないリスク比を算出した。その結果、第4群と比較して、第1群はカリウム摂取目安量とビタミンA推奨量を満たさないリスクが高く、第1、2、3群はカルシウムおよびビタミンCの推奨量を満たさないリスクが高かった。以上より、カルシウムおよびビタミンCの摂取不足を防ぐためには、バランスのよい食事を平均1日1.5回以上とる必要があると考えられた。

Publishing type：Research paper (scientific journal)  

野菜および果物摂取行動に関する自己効力感尺度を作成し、信頼性および構成概念妥当性について検討し、行動変容ステージおよび基本的属性との関連より基準関連妥当性について検討した。対象者は新潟県内の八つの企業施設に所属する20歳から69歳の日本人勤労者であった。457名(男性268名、女性189名、平均年齢41.9歳)より有効回答が得られた。因子分析により、自己効力感尺度の下位因子の構造を確認したところ、野菜摂取行動と果物摂取行動はそれぞれ異なる因子に分類された。自己効力尺度のCronbachのα係数は、野菜では0.78、果物では0.83で一定の信頼性が確認された。確証的因子分析により自己効力感尺度のモデル適合性を確認したところ、概ね良好な結果が得られた。自己効力感尺度の得点は、行動変容のステージ間で有意差が見られ、一定の基準関連妥当性を確認できた。勤労者を対象とした場合、作成した尺度は一定の信頼性および妥当性を有することが示唆された。

Publishing type：Research paper (scientific journal)  

日本人7704名(男3373、女4331、30〜69歳)を1980年から2009年ま29年間追跡調査した。国民栄養調査から得られたデータに基づき、1日の総摂取エネルギー量により参加者を男女別に5群に分けた。男性において総摂取エネルギー量が多いほど総死亡リスクが高かった。死因別にみると、最も少ない群を基準とすると最も多い群で冠動脈疾患による死亡率が高く、ハザード比は男性で2.63、女性で2.91で、男性では癌による死亡率も高く、ハザード比は1.50であった。総摂取エネルギー量の増加は男性の総死亡率および癌による死亡率の上昇と関連し、男性および女性の冠動脈疾患による死亡率上昇と関連すると考えられた。

Publishing type：Research paper (scientific journal)  

<p>We evaluated the impact of a health education program carried out for male employees, employed at small and medium-sized transportation office, on the knowledge and behavior modification of the subjects in terms of weight control and reduction in the incidence of metabolic syndrome. <br/>There were effects to encourage the practice of their possible implementation items of efforts on the eating habits and lunch intake; however, it is difficult to bring about changes in the weight and metabolic syndrome related indicators through short-term health education programs. To spread health education to those with fewer opportunities, it is important for the senior management to recognize the need for health management of employees and the occupational health and safety personnel, and to consider the programs in small-sized workplaces with minimum burden on participants.</p>

DOI： 10.11355/isljsl.92.17

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.6133/apjcn.2016.25.1.10

Publishing type：Research paper (scientific journal)  

A Japanese-style diet consists of meals that include grain (shushoku), fish and meat (shusai), and vegetable dishes (fukusai). Little is known about the association of such meals (designated well-balanced meals hereafter) with nutrient intake. We therefore examined the frequency of well-balanced meals required to prevent nutrient deficiency. Participants were Japanese people, ages 40 to 59 y, from Toyama, recruited for INTERMAP, in an international population-based study. Each person provided 4 in-depth 24-h dietary recalls (149 men, 150 women). The prevalence of risk ratios of not meeting the Dietary Reference Intakes for Japanese (2015) was calculated. Well-balanced diets were assessed by the Japanese Food Guide Spinning Top. We counted the frequencies of meals in which participants consumed 1.0 or more servings of all 3 dishes categories. We divided the frequency of consumption of well-balanced meals into the following 4 groups: <1.00 time/d, 1.00-1.49 times/d, 1.50-1.74 times/d, and ≥1.75 times/d. Compared with participants in the highest frequency group for well-balanced meals, those who consumed well-balanced meals less than once a day had a higher risk of not meeting the adequate intake for potassium and the recommended dietary allowance for vitamin A. Those who consumed well-balanced meals on average less than 1.50 times per day had a higher risk of not meeting the recommended dietary allowance for calcium and vitamin C. Our results suggest that individuals should on average consume well-balanced meals more than 1.5 times per day to prevent calcium and vitamin C deficiencies.

DOI： 10.3177/jnsv.62.101

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.1136/bmjopen-2016-011632

Publishing type：Research paper (scientific journal)  

<p>The objective was to assess associations between food diversity with intakes of nutrients and food groups in independent elderly people. In May 2015, 2-day dietary records were collected from 27 men and 54 women aged more than 60 years living around Kanazawa city. Food diversity was positively and significantly associated with nutrient adequacy of calcium, iron, vitamin A, and C. Mean (standard deviation) food item of men and women who consumed more than tentative dietary goal for preventing life-style related disease for dietary fiber and potassium was 26.3 (2.4) and 27.7 (5.6) items/day, respectively. Mean (standard deviation) food item of men and women who consumed vegetables more than 350 g/day and fruits more than 100 g/day was 25.4 (2.2) and 26.6 (5.1) items/day, respectively. Our results suggested that consumption of various foods led to greater improvements in overall nutrient adequacy.</p>

DOI： 10.11379/jjda.59.676

CiNii Article

Publishing type：Research paper (scientific journal)  

北陸地方に所在する旅客運送業のA企業において、個別面談に応じたバス運転業務従事者42名(平均年齢45.8歳)を対象に、主食、主菜、副菜、牛乳・乳製品、果物の5種類の料理区分の摂取状況を食事の摂取場所別に明らかにするとともに、主食・主菜・副菜の3種類を組み合わせた食事の摂取状況と健康状態について、半構造化インタビュー調査を実施した。現在バス運転業務に従事していない対象者1名を除いて分析を行った。食事の摂取場所については、朝食は自宅の次に待機中車内で摂るものが多く、昼食も社員食堂の次に待機中車内、会社の休憩室、その他の場所で摂るものが多く認められた。朝食を自宅以外で摂るものは、自宅のみで摂るものと比較して、主食、主菜の摂取率が低かった。昼食を社員食堂以外で摂るものは、社員食堂のみで摂るものに比べ、副菜、3種類を組み合わせた食事の摂取率は低かった。牛乳・乳製品、果物は食事の場所に関わらず、摂取されていなかった。

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

自立高齢者における栄養素等摂取状況からみた適正たんぱく質摂取量について検討した。60歳以上の自立高齢者61例を対象とし、栄養素得点の分布から低得点群、中得点群、高得点群に分けた。男性は3群間で摂取エネルギー量に有意差はなかった。女性は栄養素得点が高くなると摂取エネルギーが増加した。男性、女性ともに得点が高いほどカリウム、鉄食物繊維の摂取量が増加した。男性、女性ともに栄養素得点が高いほど、野菜類の摂取量が増加した。女性では得点が高いほど果実類、魚介類、乳類の摂取量が増加した。回帰直線から推定されるたんぱく質摂取量1.06g/kg体重/日の栄養素得点は、男女それぞれ1.8点、2.2点であった。回帰直線から推定される栄養素得点3点のたんぱく質エネルギー比率は、男女それぞれ18.8%、15.0%で、栄養素得点3点のたんぱく質摂取量は男性804g/日、女性は624g/日となった。

Publishing type：Research paper (scientific journal)  

<b>Objectives:</b> The purpose of this study was to understand the actual state of life hours (working time, sleep time, and time of meal intake) and dietary habits of male shift work employees, and to elucidate the impact of working arrangements and dietary habits on their physical condition and health problems. <b>Methods:</b> The subjects were 187 male employees (aged18–64 years) working for an industrial company in Toyama prefecture. We used a self-administered questionnaire to assess dietary habit, lifestyle habits, and life hours at the time of a periodic health examination in April 2013. The subjects were grouped based on their working condition (i.e., day shift, late shift, and late-night shift) into two groups of day shift (n = 107) and shiftwork (n = 80). The proportion of time spent sleeping and feeding was determined in half hour increments, and the incidences of skipping meals (breakfast, lunch and dinner) and midnight snack intake were calculated for each working condition. We also examined the association between the frequency of eating and physical condition for each working condition. <b>Results:</b> The state of life hours of the shiftwork group during the day was similar to that of the day shift group. However, the workers' state of life hours, incidences of skipping meals, and midnight snack intake varied considerably when working at the other shift times. In the shiftwork group, regardless of the working patterns, the BMI and % body fat of the group that ate more than three times a day were significantly lower than those of the group that ate less than twice a day. <b>Conclusions:</b> The results of the present study suggest that it is difficult to ensure the time and opportunity for meals for shift workers. We consider that it is necessary to prevent them skipping of meals, and to support a proper dietary intake during the night.<br>

DOI： 10.1539/sangyoeisei.B15015

CiNii Article

Publishing type：Research paper (scientific journal)  

We examined the differences in employees' eating attitudes with (R-JFGST) and without (NonR-JFGST) recognition of the Japanese Food Guide Spinning Top (JFGST) after maintaining a healthy food environment in employee cafeterias. The study's participants were employees of two offices at K industrial company. We spread the recognition of the JFGST in both groups over three months. Subsequently, we created a continuously targeted group and provided this group with healthy menus (grain dishes, main dishes, and vegetable dishes) based on the JFGST for three years (maintenance of healthy food environment). Another control group was not provided such menus. Both groups completed an anonymous questionnaire. In the continuously targeted group, desirable eating attitudes related to grain dishes, milk and milk products, breakfast and three meals a day were exhibited by significantly more employees with recognition of the JFGST than those without recognition. In the control group, all desirable eating attitudes were exhibited by more employees and there was no significant difference between R-JFGST and NonR-JFGST. Both groups did not significantly differ in any eating attitude, in R-JFGST and NonR-JFGST. An effect of the maintenance of healthy food environment was shown more by the recognition of the JFGST in the continuously targeted group.

DOI： 10.11379/jjda.58.813

CiNii Article

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<b>Objectives:</b> We examined the effects on employee vegetable intake of a long-term intervention in an employee work cafeteria. <b>Methods:</b> The subjects were approximately 1,200 employees (aged 19–61 years) of an industrial company in Fukui prefecture. We promoted the intake of typical Japanese style meals that combined three elements (staple foods, main dishes and vegetable dishes) to increase vegetables intake. We displayed all items on the menus of the employee cafeteria using three colors (yellow, red and green to denote three elements) to indicate healthy food choices for the maintenance of a healthy food environment. We advised employees to choose meals containing the three elements at the time of payment, for nutritional education (appropriate portion choice: APC). We evaluated the ratio of APC at the same time. To calculate the mean daily intake per person, we carried out a questionnaire survey similar to the "semi-quantitative food frequency questionnaire" and asked about the frequency and approximate intake of vegetables. <b>Results:</b> The APC was 63.5% after one year of intervention, significantly increased to 82.1% after two years (<i>p</i> < 0.001), and was 80.0% after three years of intervention (<i>p</i> < 0.001). Vegetable intake at breakfast (<i>p</i> < 0.001), lunch (<i>p</i> < 0.001) and dinner (<i>p</i> = 0.011), and from vegetable juice (<i>p</i> = 0.030) significantly increased after three years of intervention. The consumption of pickles significantly decreased after three years of intervention (<i>p</i> = 0.009). It was estimated that the vegetable intake of men increased from 167.3 g to 184.6 g, and that of women from 157.9 g to 187.7 g. <b>Conclusions:</b> Employee estimated vegetable intake was significantly increased and that of pickles was significantly decreased by a long-term intervention (three years) in the employee work cafeteria.<br>

DOI： 10.1539/sangyoeisei.B14017

CiNii Article

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)   Kind of work：Single Work  

In recent years, many studies have used epidemiological techniques to investigate the relationships of daily energy and nutrition intake to food intake, and to disease onset and treatment or prevention. Therefore, dietary assessments are now being used in various situations. A range of dietary assessment methods exists, and each has advantages and disadvantages. However, there is no absolute and universally applicable dietary assessment method. The most appropriate method or a combination of methods must be selected in accordance with factors such as the objective of a study and the number of subjects. Moreover, it is necessary to interpret dietary assessment results multilaterally and to grasp dietary habits, elements of a daily lifestyle environment, and physical conditions that could influence the diet.

DOI： 10.3177/jnsv.61.S31

CiNii Article

Publishing type：Research paper (scientific journal)  

<b><i>Aim</i></b><b>: </b>In animals, dietary energy restriction is reported to increase longevity, whereas in humans, all cohort studies from Western countries have not shown an association between the low energy intake and longevity. We examined the association between total energy intake and longevity in Japan where dietary pattern is different from that in the West.<br><b><i>Methods</i></b><b>: </b>A total of 7,704 Japanese aged 30–69 years were followed from 1980 to 2009. Participants were divided into the quintiles of total energy (kcal/day) based on data collected from the National Nutrition Survey. Hazard ratios and 95% confidence intervals (CIs) were derived through the use of Cox proportional hazards models to compare the risk of death across and between the quintiles.<br><b><i>Results</i></b><b>: </b>There was a significant association between increased energy intake and all-cause mortality risk in only men (<i>P</i> for linear trend=0.008). In cause-specific analysis, compared with the lowest quintile, there was rise in coronary heart disease (CHD) mortality among men (HR; 2.63, 95%CI; 0.95–7.28, <i>P</i> fro linear trend 0.016) and women (HR; 2.91, 95%CI; 1.02–8.29, <i>P</i> for linear trend 0.032) and cancer mortality among men (HR; 1.50, 95%CI; 0.999–2.24, <i>P</i> for linear trend 0.038) in the top quintile.<br><b><i>Conclusion</i></b><b>: </b>We observed significant associations of high energy intake with all-cause and cancer mortality among men and with CHD mortality among men and women. Further studies are needed to confirm the benefits of caloric restriction.

DOI： 10.5551/jat.29991

CiNii Article

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DOI： 10.1097/HJH.0000000000000341

Publishing type：Research paper (scientific journal)  

DOI： 10.1371/journal.pone.0105198

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血清甲状腺刺激ホルモン(TSH)濃度と肥満の指標が関係するか、その関係に性差がみられるか、また、喫煙状態により影響を受けるかを調べた。2009年春に健康診断を受けた36歳から55歳の工場従業員のうち、正常範囲のTSH濃度を示した2037名を対象とした。肥満指数である体重、BMI(ボディマス指数)およびウエスト周囲径を測定し、血清TSH濃度の4分位値により比較したところ、男性において高いTSH濃度は、高い体重およびBMI値と有意に関係していた。男性のウエスト周囲径および女性の肥満指数とは関係しなかった。また、男性の体重に関してTSH濃度と喫煙状態の有意な相互作用がみられた。これらの結果から、男性においてのみTSH濃度と体重およびBMIとの間に有意な正の関係性があり、TSH濃度と体重の関係は喫煙状態によって影響を受けることが示唆された。

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.atherosclerosis.2013.11.073

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00394-013-0523-9

Publishing type：Research paper (scientific journal)  

Objective This cross-sectional study investigated the associations between the serum thyroid-stimulating hormone (TSH) concentration and indices of obesity in middle-aged Japanese men and women. Methods The participants were 2,037 employees (1,044 men and 993 women; age, 36-55 yr) of a metal products factory in Japan. Clinical examinations were conducted in 2009. We obtained a medical history and anthropometric measurements (body weight, body mass index [BMI] and waist circumference) and measured the serum TSH concentrations. The anthropometric indices were compared across serum TSH quartiles. The associations were evaluated separately according to the smoking status in men. Results The mean body weight (kg), BMI (kg/m2) and waist circumference (cm) were 69.2, 23.7 and 83.2 in men and 55.3, 22.3 and 74.3 in women, respectively. Men with a higher TSH concentration had higher body weight and BMI values (p for trend=0.016 and 0.019, respectively), and these significant associations were observed even after adjusting for age, smoking status and other potential confounders. The TSH level was not associated with waist circumference. We found a significant interaction between the TSH level and the smoking status on body weight (p for interaction=0.013) and a significant association between the TSH level and body weight in nonsmokers, but not in current smokers. No significant associations were observed between the TSH level and the anthropometric indices in women. Conclusion Significant positive associations between the serum TSH concentration, body weight and BMI were detected in men only, and an interaction with the smoking status was observed for this association.

DOI： 10.2169/internalmedicine.53.1387

CiNii Article

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We examined 853 registered dietitians and dietitians who participated in the training about Dietary Reference Intakes for Japanese 2010, with regard to implementation of nutrition assessment and monitoring of the application of Dietary Reference Intakes 2010 in individuals and groups they usually encountered during work and the understanding of these dietitians regarding this reference. This study was conducted at clinical facilities and individual support-centered facilities for the elderly and disabled. We evaluated the implementation of assessment and monitoring of four items primarily pertaining to the understanding of physical measurement data in addition to information and clinical laboratory test results from different healthcare professionals. On the basis of their understanding of physical measurement data, employees at nursery schools, kindergartens, schools, and offices, who were primarily engaged in food service management, assessed an average of two items by surveying group intake and leftovers. Differences in assessment and monitoring were influenced by differences in characteristics of subjects and groups as well as by regulations and structures related to work. In addition, these differences were associated with plans and efforts of registered dietitians attempting to perform multilateral assessment and monitoring. Furthermore, in the self-assessments, we found that subjects tended to claim that their understanding of the Dietary Reference Intakes progressed with more items they assessed and monitored during work.

DOI： 10.11379/jjda.57.522

CiNii Article

Publishing type：Research paper (scientific journal)  

Effects of providing workers with healthy menus and related information based on the Japanese Food Guide Spinning Top for three years was examined by focusing primarily on behavior modification of company cafeteria users. The study's subjects were company cafeterias and employees of Offices (continuously targeted group and control group). Step1: Healthy menus were developed based on the Japanese Food Guide Spinning Top and they were provided once a week for three months along with related information. Also, relevant materials were distributed, and health- and nutrition-related consultation was provided. Step2: Office continuously targeted group provided them five days a week for three years along with related information. The pre-existing menus were provided at Office control group. After three years, recognition of the Japanese Food Guide Spinning Top was increased in the continuously targeted group. The utilization of the set meal thing was increased. The control group's recognition of the Japanese Food Guide Spinning Top was not increased. It was demonstrated that continuously providing healthy menus and related information based on the Japanese Food Guide Spinning Top for three years im proved the company cafeteria users' knowledge and behavior to meal choice.

DOI： 10.11379/jjda.57.597

CiNii Article

Publishing type：Research paper (scientific journal)  

CiNii Article

Publishing type：Research paper (scientific journal)   Kind of work：Single Work  

Preventive measures for lifestyle diseases in the working generation, who are majorly responsible for economic stability in society, are important and affect the medium- and long-term medical and insurance systems in Japan, in addition to having short-term social and economic consequences. Nutritional epidemiological studies on the prevention of lifestyle diseases attempt to accurately record and objectively evaluate the factors that influence nutrition and dietary habits and the physical status of individuals or groups. Therefore, thorough research design and quality control are required to improve study reliability and validity.<br>There is a close relationship between nutrition and dietary habits and the daily lifestyles of working men. For example, compared to individuals with no or low alcohol consumption, those with habitual high alcohol consumption tend to consume fewer calories from food sources other than alcoholic drinks, despite the increase in their overall apparent energy intake. Therefore, it becomes difficult for such individuals to maintain a balanced diet, and liver function and blood pressure, which are indicators of physical health, deteriorate. Long-term cohort studies have reported that individuals with habitual high alcohol consumption have a higher rate of elevated blood pressure than those with no or low alcohol consumption.<br>Preventive measures for lifestyle diseases in adult employees should include evaluation of and improvements in health status over a specified period, together with nutrition-related educational media with content tailored to the occupational field, and individual motivation and understanding. Combined implementation of population and high-risk approaches is required.

DOI： 10.5264/eiyogakuzashi.72.221

CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jjcc.2014.01.005

Publishing type：Research paper (scientific journal)  

地域自立高齢者76名を対象に主食・主菜・副菜を組み合わせた食事回数と栄養素等摂取量を比較検討した。2013年5月の2日間に食事記録法による栄養調査を実施した。主食・主菜・副菜の出現頻度を食事バランスガイドの0.5 SV以上の料理を摂取している場合に「あり」と定義し, 3種の料理が揃う回数を個別に算出し, 2日間の平均回数を算出した。3種の料理が揃う回数により1.5回以下, 2回, 2.5回以上の3群に分け栄養素等摂取量を比較した。男女ともに3種の料理が揃う回数が多いと食塩相当量が増加し, 女性ではビタミンCと食物繊維も増加した。3種の料理が揃う回数が多いと炭水化物を目標量範囲内に摂取する者の割合が増加した。主食・主菜・副菜の組み合わせた食事を増加させることは, 女性ではビタミンCや食物繊維摂取量の増加につながることが示唆された。

DOI： 10.4327/jsnfs.67.299

CiNii Article

Publishing type：Research paper (scientific journal)  

For offering school lunches based on the principle of "Standards of School Lunch Intake", it is necessary to prepare the standards for respective facilities. We obtained Estimated Energy Requirements (EER) from anthropometric measurements of children and pupils, and reviewed the steps to determine the energy requirements to be offered by school lunches based on the median of each group. Subjects were 2,114 children and pupils to whom meals were provided by primary and junior high schools and food service centers. EER was obtained based on the standards of provision of school lunches by applying the physical activity levels; 1.65 (6 to 7 years of age) and 1.7 (8 to 14 years of age. Subjects were grouped by the ages 6 – 7, 8 – 9, 10 – 11, and 12 – 14, and studied of the EER distribution. Medians of 33% of EER were 503 kcal, 617 kcal, 731 kcal, and 815 kcal respectively. Percentages of those within the +/- of the medians were 61%, 53%, 51% and 60% respectively. Degrees of variance and those falling outside the median could be specified, suggesting that school lunch programs adapted to individual needs could be realized. The result suggests that examples of nutrition management adapted to the needs of respective facilities should be established and the data accumulated.

DOI： 10.11379/jjda.57.433

CiNii Article

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CiNii Article

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DOI： 10.1038/hr.2013.105

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DOI： 10.1038/hr.2013.102

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60歳以上の健常高齢者84例(男性27例、女性57例)を対象に、カルシウム(Ca)摂取量とそれに関連する食事要因について検討した。その結果、男性、女性ともにカリウムや鉄の摂取量は高Ca摂取群が低Ca摂取群と比べ有意に高く、食物繊維の摂取量は高Ca摂取群で高い傾向を示した。それらの結果から、高Ca摂取群の方が野菜類や果実類を多く摂取し、健康意識がより高いことが示唆された。

Publishing type：Research paper (scientific journal)  

DOI： 10.1136/heartjnl-2012-303496

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DOI： 10.1111/jdi.12033

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Publishing type：Research paper (scientific journal)  

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Publishing type：Research paper (scientific journal)  

The purpose of this study was to estimate the usual intake distribution of calcium and vitamin B₁ of fifth-grade children based on a 3-d dietary survey and to assess nutrient intake using Dietary Reference Intakes (DRIs 2010). A cross-sectional study was undertaken from October 2007 to February 2008 in schools located in Tokyo and Okayama, Japan. A total of 94 fifth-grade children attending 5 elementary schools participated in the study. The weighed plate waste method and observation were used to collect data on the school lunches and dietary records by children, accompanied by photographs used to collect data on meals at home. The study lasted 3 d, 2 non-consecutive days with school lunches and 1 d without. The estimated proportion of subjects below the Estimated Average Requirement (EAR) for calcium intake with milk in the school lunch decreased by 40% compared to the calcium intake without milk in the school lunch. Vitamin B₁ intake from less than 0.45 mg/1,000 kcal fortified rice was estimated to be 0%. The intake distribution of calcium has increased by 150 mg by taking milk and the intake distribution of vitamin B₁ has increased 0.20 mg by taking fortified rice in the school lunch. Calcium and vitamin B₁ intake in the school lunch has changed the distribution of calcium and vitamin B₁ intake upward, and decreased the number of estimated subjects that were below EAR. However, the distribution was not shifted across the board and the shape of the distribution has changed.

DOI： 10.3177/jnsv.59.22

CiNii Article

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DOI： 10.1016/j.numecd.2011.01.003

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DOI： 10.1016/j.metabol.2012.04.005

Publishing type：Research paper (scientific journal)   Kind of work：Single Work  

In this article, we attempted to organize and make suggestions about the need to conduct various investigations and utilize data through cooperation between prefectural governments (supervising bureaus and public health centers) and city governments, from several perspectives by referring to existing research results and other information. Such cooperation is necessary to improve the quality of public nutrition activities.Since the enforcement of the Community Health Law, operations involving personal contacts were assigned to city governments. Prefectural governments' public health centers have not dealt with individuals in communities and it is difficult for them to independently investigate issues related to health and nutrition within their jurisdictions. On the other hand, city governments do not have enough dieticians in relation to the amount of work that needs to be done, and do not have sufficient time to fully understand and evaluate objective data. Also, some dieticians lack the skills needed to collect and evaluate data.More than 80% of administrative dieticians working for city governments have expectations regarding improved cooperation with, and receiving more support from, registered dieticians at public health centers. In particular, many of them hope to have more opportunities to exchange opinions, and attend study sessions and workshops with registered dieticians at public health centers in order to gain a better understanding of each other's roles and improve their skills.Through such cooperation, registered dieticians at public health centers and city governments' administrative dieticians can complement or reinforce each other's strengths and weaknesses in the utilization of the existing data. They will also be able to obtain an objective understanding of the issues related to health and nutrition in communities by undertaking new investigations in the course of their regular administrative activities. This will result in public nutrition activities based on management cycles.

CiNii Article

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目的 国民健康・栄養調査のデータは健康日本21の最終評価等に活用され,健康増進施策の推進,評価のために貴重な資料となっている。本研究は,国民健康・栄養調査の調査地区が国民生活基礎調査の調査地区から抽出されることを利用して,世帯および個人単位で国民健康・栄養調査の協力率とそれに関連する要因を検討することにより,統計学的な代表性を評価することを目的とした。方法 平成15年から19年の国民健康・栄養調査の調査地区について,国民生活基礎調査と国民健康・栄養調査のレコードリンケージを行った。世帯単位の協力率については,世帯単位でレコードリンケージを行い,国民健康・栄養調査の協力率および協力率に関連する要因を検討した。個人単位の協力率については,国民生活基礎調査に協力した世帯の20歳以上の世帯員を対象に個人単位でレコードリンケージを行い,国民健康・栄養調査の協力率を身体状況調査およびその一部の血液検査と,栄養摂取状況調査,生活習慣調査の各々について検討した。結果 世帯単位の協力率は平成15年から19年の平均で66.4%であり,世帯人員が1人の世帯,特に男性の単独世帯で低かった。個人単位の協力率は身体状況調査が53.2%,血液検査が34.4%,栄養摂取状況調査が61.3%,生活習慣調査が63.1%であり,身体状況調査,特に血液検査で低かった。性別にみると,いずれの調査も男性より女性の協力率が高く,特に身体状況調査と血液検査で男女の差が大きかった。年齢階級別にみると,いずれの調査も20歳代が最も低く,男性では60歳代と70歳以上が,女性では60歳代が高かった。配偶者の有無別にみると,男女のいずれの年齢階級でも配偶者なし(未婚・死別・離別)の者に比べて配偶者ありの者の協力率が高かった。結論 世帯や個人の特性により国民健康・栄養調査の協力率に差がみられたことは,統計学的な代表性が損なわれてきている可能性を示唆している。また,調査の種類によっても協力率に大きな差がみられた。今後,国民健康・栄養調査の協力率を向上させるためには,調査の種類ごとに対象者の特性に応じた方法を検討する必要があると考えられる。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.metabol.2011.05.015

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<b>Objective:</b> We investigated how subjects involved with food service management theory (including nutrition care) have been taught at registered dietitian training institutions in order to improve the capabilities of registered dietitians at specific food service facilities in order to understand the dynamics of the issue and to reveal any problems.<br><b>Methods:</b> A questionnaire survey was distributed to 125 registered dietitian training institutions via mail. The response rate was 55.2%.<br><b>Results:</b> In the courses on food service management theory at registered dietitian training institutions, the curriculum (two classes in theoretical training or one laboratory course is prescribed according to specified regulations for such programs) at 66.7% of all institutions (<i>n</i> = 69) offered only the minimum required classes. Students in food service management practice gain experience in "producing meals." Subjects included in food service management theory tend to be taught in the same period as instruction in the use of' Dietary Reference Intakes (DRIs) and other basic knowledge. More than 20% of institutions do not teach food planning, menu planning, DRIs, or food sanitation before teaching the subject of food service management practice. Although menu planning and meal planning are basic topics, 27.5% of training institutions teach menu planning only in the courses on food management theory, and 33.3% teach meal planning in these same courses.<br><b>Conclusion:</b> There is a need to discuss the curriculum and programs within the registered dietitian training courses to improve the education of dietitians.

DOI： 10.5264/eiyogakuzashi.70.253

CiNii Article

Publishing type：Research paper (scientific journal)  

This study aimed to investigate the recognition of subjective size of vegetables and fruits and discuss factors which relate with recognition of subjective size. We recruited 151 adults aged 20s-60s years from April to March 2009. The subjects were asked to answer using scale of five stages (SS to LL) for 23 types of vegetables and fruits (food models).The subjects answered three stages for four food models and five stages for five food models.There was no difference between answers of recognition of subjective size and BMI. Our findings of a difference in the recognition of subjective size of vegetables and fruits suggest the possibility of unbridgeable gulf among recognition of subjective size. According to recognition of subjective size, there is a possibility to underestimate or overestimate food intake which affect the results and interpretation of dietary survey.

DOI： 10.11379/jjda.55.200

CiNii Article

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DOI： 10.1186/1758-5996-3-30

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DOI： 10.1136/jech.2011.142976n.53

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The consumption of nutrients and food groups on days with or without school lunches was assessed among 5^th grade elementary school students. The distribution of meals in one day was also compared. A cross-sectional study was conducted from October 2007 to February 2008 in Tokyo and Okayama. Weighing and observation were used to collect data on the school lunches, while dietary records by children accompanied by photographs were used to collect data on meals at home. The study lasted three days, two non-consecutive days with school lunches (weekdays) and one day without (Saturdays or Sundays). The subjects were 82 children with a normal obesity index. The consumption of calcium, vitamin B₁, vegetables, and dairy products was significantly higher on the days with school lunches, while the consumption of salt and seasonings was significantly lower on the days with school lunches. The consumption of calcium, vitamin B₁, and vitamin B₂ at lunch accounted for a larger percentage on the days with school lunches. The results indicate that eating or not eating school lunches affected the consumption of nutrients and food groups for a child's entire day.

DOI： 10.5264/eiyogakuzashi.68.298

CiNii Article

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DOI： 10.4162/nrp.2010.4.5.400

PubMed

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中年の日本人男女を対象として、食後の血糖上昇指数(GI)/血糖負荷(GL)と血清脂質の関連について検討した。日本国内の金属製品工場の従業員(年齢35歳以上の男性2257名および女性1598名)を対象とした。自己記入式食事歴調査票を使用して、食後のGIおよびGLを評価した。年齢、BMI、アルコール摂取、喫煙、身体活動量、閉経の状態、食事の摂取による総エネルギー、飽和脂肪酸、単不飽和脂肪酸、ポリ不飽和脂肪酸、コレステロール、線維で補正した血清脂質濃度を、男女のGI/GLの五分位点と比較した。男性、女性のいずれにおいても、GIと補正済み血清脂質の間に有意な関連は観察されなかった。一方、GLは男女ともHDLコレステロールと逆相関し、女性では非HDLコレステロール、LDLコレステロール、トリグリセリドと正の相関を示した。しかし、飲酒はこれらの関連に影響を及ぼし、男性の非飲酒者ではGLと血清脂質の間に関連はなく、女性の非飲酒者ではGLとLDLコレステロールの間に関連はなかった。女性では、GLの高い食事は、これらの血清脂質異常を通してアテローム生成的に作用すると考えられた。

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PubMed

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DOI： 10.1007/s00125-010-1803-z

Publishing type：Research paper (scientific journal)  

生活様式の変更が適用できるメタボリックシンドローム(血圧、脂質、グルコース)および腹部肥満に関連する軽度異常が、心血管疾患のリスクに及ぼす個別のおよび集団の影響について検討した。1996年から2007年の11年間経過観察されている35〜59歳の日本人男性2685名に関するコホート研究に基づき、軽度代謝異常に起因する心血管疾患の相対リスクを算出した。軽度代謝異常の被験者を、代謝異常または腹部肥満のない被験者と比較した。これらの異常の心血管疾患に対する人口寄与割合も推定した。ベースラインにおいて、腹部肥満を有するおよび有しない軽度代謝異常は、それぞれ母集団の9.8%および21.8%であり、代謝異常を有しない腹部肥満単独は7.5%であった。腹部肥満を有する軽度代謝異常、腹部肥満を有しない軽度代謝異常、腹部肥満単独により、心血管疾患リスクはそれぞれ2.68倍、1.49倍、2.36倍になった。母集団全体の心血管疾患の約20%は、軽度代謝異常または腹部肥満単独に起因していた。特に軽度代謝異常および/または腹部肥満は心血管疾患に関するpopulation burdenの約20%を占めることから、生活様式の変更の重要性を認識するべきであると思われた。

Publishing type：Research paper (scientific journal)  

PubMed

Publishing type：Research paper (scientific journal)  

日本人1004名(40〜59歳)を対象として、食事性多価不飽和脂肪酸と飽和脂肪酸の比率(P/S)と心血管危険因子およびメタボリックシンドロームとの関係を検討した。重回帰分析によりP/SとヘモグロビンA1c、血圧、血清中トリグリセリド、LDLおよび総コレステロール(C)、HDL-Cとの関係を解析した。食事性P/Sは総C、LDL-Cと負の関係を示した。P/Sと単独の代謝危険因子或いはメタボリックシンドロームの有病率との間に有意な相関は認められなかった。P/Sの管理は血清中LDL-Cの調節には重要であるが、P/Sを上げても代謝危険因子は改善しない。メタボリックシンドロームの予防には、体重管理、運動、禁煙などの他の対策が推奨される。

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jada.2010.02.007

PubMed

Publishing type：Research paper (scientific journal)  

NIPPON DATAと国民栄養調査(NNSJ)の個々の記録を比較し、統合した。各参加者の栄養素および食品群の摂取量を、各個人の年齢と性別を考慮に入れた上で、NNSJの各世帯における摂取量を分布させて算出した。国際共同疫学研究(INTERMAP)の結果を活用して、NNSJ80では75種類の栄養素、NNSJ90では70種類の栄養素の摂取量を推定した。INTERMAPデータを活用して算出した栄養素摂取量を、NNSJデータセットにおける同摂取量と比較した。NIPPON DATA80/90データセットは、詳細なベースライン栄養素摂取量データによって強化された(合計参加者数はNIPPON DATA80および90でそれぞれ10422名、8342名であった)。INTERMAPデータを活用して算出した平均栄養素摂取量と、NNSJデータセットから算出した同摂取量は同等で、算出値は、NNSJから算出した値と強く相関した。詳細な栄養素摂取量を補完した。NIPPON DATAの参加者に関するNNSJデータセットから算出した栄養素摂取量は、ベースライン時の栄養素摂取量データとして適切であった。強化されたコホートデータセットは、ベースライン時の食習慣やその結果として生じる健康状態に関する調査に適していると思われた。

Publishing type：Research paper (scientific journal)  

1980年と1990年の日本の国民栄養調査に登録された日本人におけるBMIと全エネルギー摂取量ならびに三大栄養素摂取量との関係性について検討した。無作為に選定された地域300ヶ所から30歳以上の参加者計10422名(男性4585名、女性5837名)と8342名(男性3488名、女性4854名)が、それぞれ1980年、1990年の日本の循環障害に関する全国調査と国民栄養調査に参加した。栄養調査は、各世帯に対して連続3日間、秤量記録法で行った。個別に推定した全エネルギー摂取量と三大栄養素摂取量(炭水化物、蛋白質、脂質)をBMIのカテゴリー別および10歳毎の年齢層別に比較した。男性では、全エネルギー摂取量(kcal/日)、三大栄養素摂取量(g/日)、対蛋白質および対脂質のエネルギー摂取比(%)は、各年齢層でBMIの増加に伴って増加したのに対し、対炭水化物のエネルギー摂取比(%)は減少した。女性では、全エネルギー摂取量、三大栄養素摂取量、対蛋白質のエネルギー摂取比は、BMIの増加に伴って増加した。1990年には、女性の対炭水化物および対脂質のエネルギー摂取比は、BMIの増加に伴って減少した。参加者を男女別のグループにおいて、全エネルギー摂取量によって4つに分類した場合、1980年および1990年に男性のBMIは全エネルギー摂取量の増加に伴って増加した。日本人男性のBMIと全エネルギー摂取量の間に正の相関が認められた。その相関は、日本人女性の方が弱かった。

Publishing type：Research paper (scientific journal)  

1980年に実施された日本の循環障害に関する全国調査と国民栄養調査の両方に参加した30歳以上の参加者10422名(男性4585名、女性5837名)のデータを使用し、各世帯に対して連続3日間、秤量記録法で栄養調査を行った。血圧(BP)と栄養素および食物の摂取量は、推定した個人の1日あたりの塩分摂取量の五分位によって比較した。その五分位によって多変量補正平均BP値を算出する目的で、共分散分析法を使用した。塩分摂取量の多い参加者は、大豆/豆類、果物類、その他の野菜類、魚貝類の摂取量が多かった。蛋白質、カリウム、カルシウム、鉄分、マグネシウム、繊維の摂取量は、塩分摂取量の五分位が高い方が多かった。男性では、補正収縮期BPが塩分摂取量の五分位が高い方が高く、最低五分位と最高五分位の間の多変量補正収縮期BPに4.3mmHgの差があった。女性の補正平均収縮期BPには、塩分摂取量の五分位間で統計的な差はなかった。大規模な代表的日本人集団において、男性でBPに対する食塩摂取量の正の相関が認められた。

Publishing type：Research paper (scientific journal)  

食品レベルでの食事と血中脂質との関連性について検討した。1980年と1990年に実施されたNIPPON DATAと日本の国民栄養調査の統合データセットを解析に使用した。血清総コレステロール濃度と食品群摂取量の関連性を、年齢、BMI、全エネルギー摂取量について補正したデータを用いて性別および調査年別に重回帰分析により検討した。1980年の調査より1990年の調査の方が、米、糖類、菓子類、果物、緑黄色野菜以外の野菜の摂取量は少なく、緑黄色野菜、きのこ類、海藻類、卵、牛乳の摂取量は多かった。肉類、牛乳、卵の摂取量は、男女共に血清総コレステロール濃度と正の相関を示したのに対し、豆類の摂取量は、1980年および1990年において男性のみで、負の相関を示した。1980年と1990年の性別および年齢別の食品群摂取量が明らかとなり、日本人集団の血清総コレステロール濃度と食品群摂取量に正および負の相関が判明した。

Publishing type：Research paper (scientific journal)  

PubMed

Publishing type：Research paper (scientific journal)  

健康な日本人労働者においてBMIを考慮しながら、Gamam-glutamyltransferase(GGT)または飲酒と糖尿病(DM)発生率との関係を検証した。研究開始時にDMではなかった男性3095人を4年間追跡調査した。複数の補正ハザード比(HR)は、Cox比例モデルを用いて算出した。その結果、GGTが高い(27IU/L以上)参加者は、BMI値が低くても糖尿病の発症リスクが増加した。飲酒と糖尿病発症との間にはU字関係がみられたにもかかわらず、軽度〜中度飲酒者(alcohol量23g/日未満)の場合、過体重(BMI≧25kg/m2)、高GGT、またはその両方があると、高GGTではなく、体重が超過していない非飲酒者と比較して、糖尿病発症リスクは低くなかった。高GGTは、飲酒習慣や肥満と関係なく、高いDM発症率と関連していた。飲酒と糖尿病発症との間にはU字関係がみられたが、軽度〜中度の飲酒者の場合は、過体重かGGTが高いと糖尿病発症リスクは低くなかった。

Publishing type：Research paper (scientific journal)  

Aims: This study investigated the association between dietary glycemic index (GI)/glycemic load (GL) and serum lipids in middle-aged Japanese men and women.<BR>Methods: The study participants were employees of a metal products factory in Japan: 2,257 men and 1,598 women aged 35 years or older. Dietary GI and GL were assessed using a self-administered diet history questionnaire. Serum lipid levels, adjusted for age, body mass index, alcohol consumption, smoking, physical activity, menopause status, and dietary intake of total energy, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol and fiber, were compared among GI/GL quintiles for each gender.<BR>Results: No significant associations were observed between GI and adjusted serum lipids in men or women. In contrast, GL was inversely associated with HDL-cholesterol in men and women (<i>p</i> for trend=0.001 for men and < 0.001 for women), and positively associated with non-HDL-cholesterol (<i>p</i> for trend=0.010), LDL-cholesterol (<i>p</i> for trend=0.035) and triglycerides (<i>p</i> for trend=0.011) in women; however, alcohol drinking affected these associations; there was no association between GL and serum lipids in male nondrinkers and between GL and LDL-cholesterol in female nondrinkers.<BR>Conclusion: GL was inversely associated with HDL-cholesterol and positively associated with non-HDL-cholesterol in Japanese women. These associations in men were not observed in nondrinkers. A high-GL diet for women may have an atherogenic effect through these serum lipid abnormalities.

DOI： 10.5551/jat.4101

CiNii Article

Publishing type：Research paper (scientific journal)  

PubMed

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PubMed

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PubMed

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PubMed

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PubMed

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DOI： 10.1016/j.atherosclerosis.2009.01.043

PubMed

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PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1017/S1368980007000274

PubMed

Publishing type：Research paper (scientific journal)  

PubMed

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PubMed

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PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1161/01.ATV.0000225701.20965.b9

PubMed

Publishing type：Research paper (scientific journal)  

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/BF02900808

PubMed

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Book type：Scholarly book

CiNii Books

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Kind of work：Single Work  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Kind of work：Single Work  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Kind of work：Single Work  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Kind of work：Single Work  

最近の十数年間をみると、わが国の全体的な飲酒量は減少傾向が認められるが、個別では依然として多量飲酒者が一定の割合で認められる。過剰飲酒は高血圧の要因であるため、高血圧者に過度の飲酒が疑われる場合には、適正な飲酒量を指導し、実践してもらうことが必要である。また、過度飲酒は食事や栄養素摂取にも悪い影響を与える。このため、成人男性では1日に日本酒1合程度の飲酒量とし、週に1〜2回の休肝日を設けることが望まれる。また、習慣化した飲酒量を減らすことは困難である場合が多いため、日常の飲酒にかかわる要因を確認し、可能な部分から改善・工夫をしながら飲酒量を減らし、血圧低下に結びつけることが求められる。(著者抄録)

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本稿では、公衆栄養活動の質的向上を目指すうえで求められる、都道府県(主管部局・保健所)と市区町村との連携による各種調査の実施とデータ活用の必要性について、既存の調査結果等を参考としながら、いくつかの視点により整理・提案を試みた。地域保健法の施行以降、対人業務は市町村の役割となり、都道府県型の保健所では、地域住民に対する個別対応を行うことはなく、単独で管轄地域内での健康・栄養問題を調査することは難しい状況にある。一方、市町村においては、業務量に比して栄養士の配置が少ないため、客観的なデータを十分に把握・評価する時間的なゆとりがない。また、一部ではデータを収集したり評価するスキルが十分ではない者も散見される。保健所管理栄養士と市町村行政栄養士が連携することで、互いの強みと弱みを補完し合いながら、既存のデータを活用したり、通常の行政対応の中に新たな調査を入れ込むことによって、地域における健康・栄養問題を客観的に把握することが可能となり、マネージメントサイクルに基づく公衆栄養活動に結びつくものと考察される。市町村に勤務する行政栄養士の80%以上は、保健所管理栄養士との連携強化や業務支援に期待感をもっている。特に保健所管理栄養士と間で、意見交換、勉強会、研修会などを強化して、互いの理解を深め、スキルアップにつなげることを望んでいる者が多数認められている。(著者抄録)

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Kind of work：Single Work