2021 Volume 70 Issue 1 Pages 28-44
Using published literature, we described the historical transition of the contribution of the National Institute of Public Health (NIPH) to nutrition policies in Japan. We traced changes across five eras: 1) before World War II (1931–1938); 2) during World War II (1939–1946); 3) post-war reconstruction (1947–1960); 4) high economic growth and the asset price bubble (1960–1989); and 5) after the bubble: the Lehman shock and COVID-19 (1990–2020).
Before World War II, 1931–1938: Maternal and infant malnutrition and tuberculosis were leading health problems in this period. In 1937, the pre-war Public Health Center Act was enacted, tasking public health centers with providing guidance on nutrition improvement. In 1938, the Ministry of Health and Welfare (MoHW) was established in Japan, and the NIPH was set up to conduct training for public health personnel and perform research on public health matters. Urban and rural public health centers were established to provide on-site trainings.
During World War II, 1939–1946: Training for dietitians was conducted by the NIPH. The curriculum included lectures, hands-on practice, and on-site training in public health centers. Graduates conducted nutrition improvement activities in local governments. When the war intensified, the trainees collected 3-day dietary records for their families as on-site training. This method and the results became the basic material for the National Nutrition Survey, which has been conducted in Japan since the end of the war.
Post-war reconstruction, 1947–1960: The Nutrition Division was established within the MoHW, and the Dietitians Act was put forward. NIPH training was targeted to staff of model prefectural public health centers. Graduates informed the staff members of all public health centers in the prefecture of the training contents and played a key role in promoting nutritional measures at prefectural and municipal levels. In 1952, the Nutrition Improvement Act was enacted. NIPH training focused on creating a district for nutritional improvement practice that improved food habits by fostering community organizations, and research was conducted to evaluate the effect.
High economic growth and the asset price bubble, 1960–1989: The disease structure in Japan began to change in this period, and the Japanese diet shifted from the so-called Japanese dietary style to the Western dietary style. The MoHW formulated “National Health Promotion Countermeasures” to prevent lifestyle-related diseases. The policy enhanced health checkups and municipal health centers and secured public health nurse and dietitian manpower. Therefore, at the NIPH, collaborative training programs involving multiple professions were conducted to clarify health problems and make recommendations using survey data, with the cooperation of the local government. The NIPH studied and established the curriculum of Public Health Nutrition Course. Subsequently, nutrition in public health came to be known as “kosyu-eiyo” (public health nutrition).
After the bubble: the Lehman shock and COVID-19, 1990–2020: In 2001, the MoHW was merged with the Ministry of Labour and renamed the Ministry of Health, Labour and Welfare. “Health Japan 21” was formulated, and the Health Promotion Act was passed to replace the Nutrition Improvement Act. In 2002, the NIPH was established as a new institution. The NIPH was created by integrating the former Institute of Public Health, the former National Institute of Health Services Management, and part of the Department of Oral Science from the National Institute of Infectious Diseases. ...and more
