The term “shokuiku, which means food and nutrition education and promotion”, has recently come into nationwide use. However, its concepts and aims seem to be ambiguous. The officially stated concepts and aims of “shokuiku” are reviewed and analyzed in this paper. This analysis is based on the many definitions and descriptions specifying “shokuiku” in relation to understanding the importance of food and nutrition, choosing foods considered nutritional and safe, and developing eating behavior that will improve physical and mental health and human development. These objectives are reasonably consistent with the aims that have been applied to nutrition education. This analysis is examined by using “Shokuiku matrix”. Some descriptions place emphasis on the historical train of food production, transportation, disposition and reuse in the community. It is therefore necessary to approach “shokuiku” from the perspectives of both building dietary capability to develop a global image of nutrition and food choices, and of creating a supportive nutritional environment. We have defined “shokuiku” (nutrition education) as the effort for better and more harmonious coexistence between people's quality of life (QOL) and quality of environment (QOE) by educating on the whole aspects of food and nutrition history, building dietary capability and creating a practical nutritional environment. The expression food and nutrition history' includes that at the individual level, family and peer level, and community level. It is the role of the Japanese Society of Nutrition and Dietetics to provide further research and education for people in this context.
In April 2002, the medical insurance allowances for certain practices were revised, and repayment of the cost of dialysis meals to outpatients undergoing dialysis was abolished. One month later, a proposal was made for the early retirement of nutritionists and administrative nutritionists in 30.8% of all clinics. One year after the revision to these medical insurance allowances, dialysis meals were still being provided to 66.6% of the dialysis patients: 73.7% of those undergoing dialysis during in the morning, 81.8% of those undergoing dialysis during the night, 73.9% of those living alone, and 76.7% of those with a dialysis history of 10 years or more. The most frequent reason for the continuing dialysis meals was “The time of the meal overlaps with the dialysis time.” The required patient payment was 600-650yen, and 13.7% of patients discontinued dialysis meals due to this “high” required payment. One hundred and seven dialysis patients were classified into those continuing with dialysis meals (71 patients) and those who had discontinued (36 patients), and their nutritional state was compared. Those who had discontinued meals showed a lower Karnofsky activity scale and a higher blood cholesterol level than those who had continued meals. The BMI, hematocrit level, and serum albumin level did not significantly differ between the two groups. One year after the revision to meal provision, those who had discontinued meals showed a significant increase in body weight gain during the period of dialysis compared with that before the revision (p<0.05) and they also drank significantly more water than those who continued with meals (p<0.05). Of those patients who continued with the dialysis meals, 85.9% considered that the meal content provided useful information on dietary control for preparing their daily meals. The meals provided during dialysis may play an important role in nutritional education and nutritional management.
Aging is a highly individualized process, resulting in large differences in health and function. The importance of physical activity for maintaining health and successful aging is gaining recognition, and an increasing number of elderly people are now engaged in recreational physical activity. Although very limited, some are involved in sports and competitive athletic events. The present study examines the nutritional status of elite elderly Japanese athletes aged between 74 and 90 years (8 females 80.4±3.6 years; 7 males 84.7±2.2 years), including four world record holders in their age category. Dietitians recorded the diets of the subjects for three consecutive days at their homes, and the nutritional contents of their diets were estimated according to the Standard Tables of Food Composition in Japan. Compared with age-matched individuals in the 2001 National Nutritional Survey of Japan (NNSJ), all nutrient intake, except for vitamin A by the females, was more than that of the sedentary individuals. Large individual differences were apparent in the intake in terms of food groups. However, the nutrient intake per 1, 000 kcal by the elderly athletes was similar to that by the age-matched individuals obtained by NNSJ. These results indicate that an enhanced energy intake enables the elderly athletes to achieve a high level of nutrient intake.