The diet therapy for the toxemia of pregnancy in the third trimester seems to be of considerable importance, although attention has been paid mainly to the use of diuretics for the improvement of symptoms. A study was undertaken to observe the clinical significance of diet therapy of 65 outpatients. Dietitians interviewed these patients at the clinic giving individual instructions on the diet. The daily intake of nutrients of these patients was calculated as follows; at first, menus for three days were prepared by the patients themselves according to the recomendation from the obstetricians and the dietitians. Then, the percentage intakes of individual foods were calculated. Based on the daily intake the appropriate amounts of foods which each patient should take was determined. Clinical effects of the diet therapy were evaluated on the basis of a pregnogram which was designed to indicate body weight, blood pressure, circumferential length of abdomen, proteinuria, etc. In selected cases, blood levels of both cholesterol and triglyceride were determined. It was found that toxemia during late pregnancy was strikingly improved by individual instruction on the diet by the dietitian (82.4% improvement). Serum triglyceride levels in toxemia patients were higher than those in normal pregnants, however, no difference in the cholesterol level was found in both groups. Toxemia patients appeared to have a tendency to consume foods containing cholesterol and sugar.
The effect of dietary cholesterol on the serum cholesterol level was examined with the adult and aged subject. In the first trial, a total of 35 healthy adults were divided into three groups given 5, 7 and 10 eggs daily for 10-15 days. The differences of mean value in serum cholesterol between the initial day and the final day were 7, 9 and 8mg/dl in each group of adults given 5, 7 and 10 eggs, respectively, indicating a tendency of slight elevation in serum cholesterol. However, it should be noted that there were some adult subjects who showed sensitive response to the serum cholesterol level by egg intake. In the next, nineteen healthy aged subjects were divided into two groups given 1 and 2 eggs every day for one month. Average increments of serum cholesterol in each group of aged persons were 3mg/dl for 1 egg and 12mg/dl for 2 eggs. The higher response seen in the aged persons given 2 eggs daily may be caused by their inactive life in comparison with the active adults. Anyway, the effect of egg cholesterol to the serum cholesterol level in human seems to be lower than that resulted from the dietary intake of saturated fatty acid such as butter, tallow and lard etc.
It is well known that diabetes is listed as one of the most serious provoking causes of some blood vessel troubles such as macroangiopathy and microangiopathies. Recently, deaths due to these cardiovascular diseases mentioned above are increasing. The author noted the relation between abnormal metabolism, especially fat metabolism, and foods taken by the diabetic, and intended to prepare food exchange systems for diabetics accompanied with atherosclerosis. From February to May in 1974, thirty cases of diabetes were reported in Kochi Medical Examination Clinic, of which sixteen were accompanied with cardiovascular diseases such as angina pectoris, atherosclerosis, hypertension and renal diseases. Among these cases, those complicated with atherosclerosis belong to IIa and IIb ranks in the K. W. Classification, meaning that they require dietary control. The tentative food exchange systems were therefore, concretely prepared with special reference to lipids and carbohydrates based on “the food exchange systems for the diabetic” arranged by the Nippon Tônyôbyô Gakkai. Moreover, local foods used seasonally in Kôchi Prefecture were investigated in regard to their nutrients and then added to the food exchange systems. These food exchange systems have not yet been put into practical use. More detailed clinical research are, therefore, required for a future study.
For the purpose of finding a guiding principle for better nourishment and improving the menu we made an investigation into the relations between the patients' leavings and likes and dislikes of the meals taken at Uji Ohbaku Hospital. We picked out 532 psychiatric patients and 107 patients from the internal medicine ward 639 in totaling as the subjects from the 8th of September till the 5th of October in 1973. We checked the weight of their lunch and supper before and after meals of each patient. The ratio of the weight of the meal to that of the leavings was called the residue rate. We also made an investigation written into their likes and dislikes during almost the same period. It was then divided into five classes according to the degree, which was represented by numeral points. Thus, we could find out the interrelations between the residue rate and the points of likes and dislikes of the subjects. The results are as follows: 1) The residue rate was very high. 2) It greatly fluctuated according to each day. 3) The fluctuation of the residue rate itself and variation in each day were very different among the wards to which the subjects belong. 4) Some kinds of likes and dislikes were common to the wards; others were not. 5) In the case of female patients there was a relation between likes and dislikes and the residue rate, whereas there was little relation in that of male patients. In conclusion, we think that the difference of patients' likes and dislikes among wards is necessary to take into consideration in order to decrease the residue of meals