The outcome of research has shown that the interdisciplinary approach is the best way to provide effective and efficient health care services. The current medical care system involves many experts of different disciplines to take care of a single patient. Under such circumstances, the “clinical path” approach is an important tool as a common language to be used by those experts involved. The clinical path approach can be used to reorganize the current system with multiple participants to ensure a team effort. Dietetics will make an important contribution to developing patient care in the future, so dietitians are expected to play an important role in such a team. It is therefore necessary for dietitians to establish a professional position in the team and provide medical care together with experts from other disciplines.
The food frequency questionnaire method is more time-, cost- and labor-effective than the 24-h dietary recall and recording method. Such a food frequency questionnaire based on food groups is more convenient than one using a food list, because there are fewer questions. We have developed a food frequency questionnaire (FFQg), which is based on 29 food groups and 10 types of cooking, for estimating the energy and nutrient intakes of an individual subject during the past 1-2 months. This questionnaire was evaluated by comparing with weighted dietary records for 7 continuous days (7-d records) for 66 subjects aged 19-60 years. The correlation coefficients between FFQg and the 7-d records for the energy, protein, fat, carbohydrate and calcium intakes were 0.47, 0.42, 0.39, 0.49 and 0.41, respectively. The intakes of 26 of 31 nutrients were not significantly different by a paired t-test between the two methods (p≥0.05). The ratio of the value obtained by the FFQg method against that by the 7-d record method ranged from 72% (vitamin B12) to 121% (niacin), the average ratio being 104%. The correlation coefficients for the intakes of rice, bread, meat, fish, milk, dairy products, green-yellow vegetables, other vegetables, and fruits were 0.66, 0.76, 0.27, 0.27, 0.72, 0.58, 0.46, 0.53, and 0.64, respectively, between the FFQg and 7-d record methods, and there was significant correlation between the two methods at the p<0.05 level for 22 of the 29 food groups. Apart from those food groups for which “less than once a month or never” was selected by 50% respondents or more, 34% of the respondents could estimate a portion size in the FFQg with an error of less than 25%, indicating that this FFQg is a useful instrument for estimating individual energy and nutrient intakes.
The results of this study clarify the physiological significance of the variation in skin temperature at the shoulder. The skin temperature was found to be reduced by shoulder stiffness, indicating that this decrease in the skin temperature might have been caused by disturbance of the peripheral blood flow. In addition to the effect from shoulder stiffness, ingesting miso soup called “asage” also reduced the skin temperature at shoulder. The addition of bittern prepared at Indonesia to the miso soup accelerated the reduction of skin temperature, suggesting that the salty taste of the miso soup might have been responsible for this reduction. Experiments were conducted to clarify whether or not the bittern increased the salty taste of the miso soup to indicate that the reduction in skin temperature might have been induced by the salty taste. The experimental results clearly indicated that the bittern increased the salty taste of NaCl solution and show that MgCl2 in the bittern was the active principle. These results collectively suggest that reduction in skin temperature associated with shoulder stiffness might have been induced by the reduction of peripheral blood flow and that the addition of the bittern to the miso soup accelerated this reduction in skin temperature.
Obesity during childhood is a matter of growing concern and needs to be continuously monitored in respect of its importance to public health. We examined the prevalence of obesity and its development trends in preschool and school children living in the administrative district of Hyogo prefecture in Japan. The cross-sectional study analyzed routinely collected data, including measurements of height and weight, from between 160, 000 and 530, 000 school children during the period 1981-2000 and from between 46, 000 and 66, 000 preschool children aged 4 and 5yrs during the period 1987-2000. Obesity is defined as being greater than 120% of the standard body mass for height and gender based on the criterion used in National Health and Nutrition Survey of Japan. The prevalence of obese preschool children aged 4 and 5 yrs has increased by 1.5 times from 2.2% to 3.0% during the last 14 years, while that of obese school children has increased nearly 2.5 times from 3.9% to 9.3% during the last 20 years. The recent prevalence of obesity has exceeded 10% in older than third graders. The frequency of obesity tended to increase when the children reached the first and/or third graders. Our data suggest that childhood obesity is maintaining an upward trend, and further imply that preventing and treating obesity beginning at the preschool age is a crucial issue in pediatric public health.
Basic information was obtained from this cross-sectional study for preventing obesity and developing effective public health intervention in male residents. The subjects were 1, 736 men (20-69 years) who had completed the questionnaire on life style in the 1998 Kyoto Citizen's Health and Nutrition Study. The relationship between the life style and body mass index (BMI) was evaluated by a chi-square test and multiple regression analysis of the subjects classified into five-year age bands. BMI was positively associated with regular exercise of less than 2 times per week in the 50-59 years age group (p<0.05). BMI was also positively associated with some types of dietary behavior. In particular, BMI was positively associated in all age groups with a short meal time, and a preference for rich foods and large meal size, suggesting that these factors are important for preventing obesity. In addition, the BMI association with salt intake such as a preference for highly seasoned dishes shows that salt restriction should be actively encouraged in dietary guidance to prevent obesity. Although BMI was positively associated with the intake frequency of some types of food, the overall balance in food intake did not result in any significant difference in BMI.