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61 巻, 2 号
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「エンパワメント」をとおした「健康な人間・社会・自然のエコシステム」の創造への挑戦村山 伸子2003 年 61 巻 2 号 p. 79-91
発行日: 2003/04/01
公開日: 2010/02/09
ジャーナル フリーThe concept of and method for community nutrition have been addressed following development of the theory and practice of health promotion. The new concept of public nutrition is introduced in this article.
Recent development of the theory and method for health promotion has been focused on empowerment and ecology as the key concepts. The creation of a healthy ecosystem for humans, society and nature is being achieved through empowerment of the individual and community.
The Indaba Declaration of the 2002 World Summit on Sustainable Development emphasizes the nature and quality of food systems, and therefore diet and nutrition are the fundamental determinants of human health and welfare, and of the whole living and natural world.
The goal of community nutrition is to improve the health and nutritional status of people in the community by the government health sector and the community. However, this scope is not enough to achieve a healthy ecosystem for humans, society and nature through empowerment. A new principle is therefore necessary for developing public nutrition that incorporates community nutrition with focus on the policy and decision-making process involving the various stakeholders, sectors and communities, each of which should have different objectives and values.抄録全体を表示PDF形式でダウンロード (2037K) -
広田 孝子2003 年 61 巻 2 号 p. 93-97
発行日: 2003/04/01
公開日: 2010/02/09
ジャーナル フリーThe peak bone mass is acquired at around the age of 16 years in young Japanese women according to the results of a cross-sectional study. We measured the bone mineral content of os calcis once a year for 5 years in girls aged 10 to 17 years and in boys aged 10 to 15 years, and provided medical information about osteoporosis and nutritional guidance to prevent osteoporosis during this period. We found that the peak in bone minerals was reached by the age of 14 years or 2 years post-menarche in girls and was older than 15 years in boys. The increase in bone minerals was associated with an increased intake of fish, soybean, fruit, and vegetables in girls, and with an increased intake of small fish and vegetables and consciousness of bone requirements in boys. We suggest from these results that bone measurement and medical and nutritional education are important for acquiring adequate peak bone mass in adolescence which will be one of the most effective ways to prevent osteoporosis in later life.抄録全体を表示PDF形式でダウンロード (862K) -
若年成人女性の場合亀井 明子, 石田 裕美, 上西 一弘, 鈴木 久乃2003 年 61 巻 2 号 p. 99-108
発行日: 2003/04/01
公開日: 2010/02/09
ジャーナル フリー若年成人女性10名を対象とし, 約7ヶ月間のうち調査可能な145日間の食物摂取調査及び血中の鉄関連指標の測定を8回くり返しおこなった。鉄栄養状態を評価する際の血中の指標及び鉄摂取量の変動を観察し, 血中の鉄栄養状態と比較的長期間の鉄摂取量との関係について検討した。8回の調査期間中, ほぼ問題なしとされる者が3名 (正常群), 貧血ではないがしばしば鉄欠乏を示す者3名 (境界群), 常に貧血あるいは鉄欠乏状態と判定される者4名 (低値群) となった。
五訂日本食品標準成分表を用いた145日間の個人別平均鉄摂取量は, 7.2～9.6mg/日となり, 鉄栄養状態正常群, 境界群, 低値群の3群間で, エネルギー及び栄養素摂取量に有意な違いは認められなかった。しかし, 8回くり返し測定した血清フェリチン濃度の平均値と, 145日間の魚介・肉類由来の1日平均鉄摂取量との間に, 相関係数0.646 (p<0.05) の有意な正の相関が認められた。鉄吸収阻害因子を含む穀類由来の鉄摂取量の影響を除いた魚介・肉類由来の鉄摂取量と血清フェリチンとの間の偏相関係数は0.714 (p<0.05), 同じく豆類由来の鉄摂取量の影響を除いた魚介・肉類由来の鉄摂取量と血清フェリチンとの間の偏相関係数は0.719 (p<0.05) となり, 鉄吸収阻害因子を除いた場合でも, 魚介・肉類由来の鉄摂取量と血清フェリチンとの間に有意な関係が認められた。145日間の1日平均鉄摂取量が7.2～9.6mgであり, 血清フェリチンの8回測定の平均値が10.3～50.2ng/mlにある本対象者では, 長期間の魚介・肉類由来の鉄摂取が貯蔵鉄に関係していることが示された。抄録全体を表示PDF形式でダウンロード (1671K) -
小原 仁, 益田 裕司2003 年 61 巻 2 号 p. 109-115
発行日: 2003/04/01
公開日: 2010/02/09
ジャーナル フリーThe objective of the present study was to clarify the influence of introduction of clinical pathways on the nutritional status of patients undergoing distal gastrectomy. We investigated changes in the nutritional status of the patients at admission and discharge, before and after the introduction of clinical pathways.
A group consisted of 32 patients who had undergone distal gastrectomy before introduction of clinical pathways (22 males and 10 females with the average age of 66.2±12.0) was regarded as the control group, and another group consisted of 31 patients who had undergone distal gastrectomy after introduction of clinical pathways (21 males and 10 females with the average age of 64.2±9.2) was regarded as the pathway group. Both groups were compared on body weight, body mass index (BMI), body weight reduction rate, serum albumin, hemoglobin, energy intake and energy intake adequacy.
While body weight and BMI at the time of discharge significantly reduced in both groups as compared with those at the time of admission (p<0.001), body weight reduction rate was significantly lower in the pathway group, i.e., 8.7±4.0% in the control group and 6.4±4.6% in the pathway group (p<0.05). While the level of serum albumin significantly lowered in both groups at the time of discharge as compared with that at the time of admission (p<0.001), the ratio of hypoalbuminemia at the time of discharge was significantly lower in the pathway group (p<0.05), i.e., 50.0% in the control group and 22.6% in the pathway group. While the hemoglobin level of the control group significantly lowered at the time of discharge as compared with that at the time of admission (p<0.001), no significant difference between those two times was observed in the pathway group. The energy intake was 1, 421±508kcal in the control group and 1, 618±437kcal in the pathway group, and the energy intake adequacy was 84.8±28.8% in the control group and 96.0±28.9% in the pathway group.
Based on the above findings, it is considered that changes in the aspect of hospital management-such as promotion of team medical services, standardization of medical care, and disclosure of information, all of which had been made possible by introduction of clinical pathways-deepened the pathway group's understanding on the diet therapy, and improved their nutritional status through increased nutrient intake; and that, because of this, the nutritional status of the pathway group at the time of discharge was better than that of the control group. Therefore, it is suggested that introduction of clinical pathways restrains the decline of nutritional status of patients after distal gastrectomy.抄録全体を表示PDF形式でダウンロード (1047K) -
多島 早奈英, 市村 喜美子, 片桐 あかね, 瀧本 秀美, 吉池 信男2003 年 61 巻 2 号 p. 117-122
発行日: 2003/04/01
公開日: 2010/02/09
ジャーナル フリーThe present study was conducted to provide basic data for the new method of dietary assessment proposed in the National Nutrition Survey. This newly proposed method incorporates several new codes for ‘school lunch’, ‘fast food’, ‘dishes’, ‘seasoning’, ‘water’, ‘cooking’ and a food code table based on the 5th revision of the food composition table to implement in the 2001 National Nutrition Survey. We tested the coding of food consumption data by using this method and conducted a questionnaire about the introduction of this newly proposed method with dietitians at local public health centers. The percentage of errors for ‘seasoning codes’ (50%) was higher than that for the other new codes, while ‘cooking code’ errors were also high (23%). However, the needs for introducing ‘seasoning codes’ and ‘cooking codes’ in the National Nutrition Survey were considered high (80% and 61%, respectively). The percentage of errors for ‘water codes’ was relatively low compared with the others (39%). These results suggest that the newly proposed method should be improved to adapt more to the National Nutrition Survey, although we expect that such coding errors will be decreased by dietitian training and adjustment to the new method.抄録全体を表示PDF形式でダウンロード (1051K) -
藤倉 純子, 池田 裕美, 武藤 志真子, 堀端 薫, 太田 和枝2003 年 61 巻 2 号 p. 123-128
発行日: 2003/04/01
公開日: 2010/02/09
ジャーナル フリーThis study was conducted to obtain the fundamental resources for developing a new information and education program for nutrition based on the future occupational activities of registered and unregistered dietitians. A survey was conducted on 160 registered and unregistered dietitians who participated in research seminars held in March and June of 2001.
97.7% of the respondents indicated that they were interested in the Internet. Although 90.1% owned a personal computer, they were classified as Laggards according to grading of Everett M. Rogers. The respondents were classified as being in the Late Majority with respect to the Internet and E-mail, and in the Early Majority with respect to multimedia-related equipment.
The frequency of using a personal computer in the workplace was high at 70 days per 100 days. Both the ownership rate and usage frequency for the Internet were higher in the home than in the workplace, this result being similar to that in the report from the information committee of The Japan Dietetic Association.
Personal computers were reported to be frequently used for clerical work and food-service management in the workplace. The rate at which nutrition counseling is performed by using a personal computer was 25.4%, and the rate at which it is performed by using the Internet was 3.6%. Many respondents indicated that the advantages of using a personal computer were “accurate clerical processing ability” and “freedom from clerical processing”. The most frequently indicated responses related to problems associated with the use of personal computers were “time and labor required for data entry”, “inadequate existing software” and “inconvenient unless they can be used by all personnel”.
Approximately 40% of those respondents who sought nutrition software requested that such software be easy to use.
On the basis of these responses, although the level of personal computer use in the services provided by dietitians is increasing, the introduction of multimedia equipment into the nutrition service workplace is still not adequate. It is therefore believed that it will be necessary for future unregistered and nationally registered dietitians to become more involved in the development of multimedia educational tools for nutrition, and that it is necessary to begin this by developing the ability to make use of such tools through better education on nutrition information.抄録全体を表示PDF形式でダウンロード (898K)
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