The long-term care (LTC) insurance system for the elderly in Japan was launched in 2000 and has quickly expanded during the subsequent five years in the number of service users and the volume of service use. Such growth has been accompanied by significant reforms to the LTC insurance system. In October of 2005, in response to out-of-pocket meal expenses, LTC facilities were introduced into the nutrition care and management (NCM) system. This has dramatically changed the work of the administrative dietician from food servicing to providing nutrition care on an individual basis. In order to deepen our understanding of NCM under the revised LTC insurance system and to be better prepared to address future issues as they arise, we examined the results of the Ministry of Health, Labor and Welfare-funded study, “Research on Nutrition and Food Services Management for the Elderly” (2004-2006; lead researcher, Sugiyama, M.) and “Research on NCM for the elderly” (1996-1999; lead researcher, Matsuda, A.; co-researchers, Koyama, H, and Sugiyama, M.). NCM can be characterized by the introduction of the PDCA cycle as a fundamental principle of management and the managerial procedure of continuous quality improvement (CQI). These are based on the continuous evaluation of outcomes. This program seeks to improve the total function based on assessing the process and system and establishes collaboration activities that go beyond the territory of each department. “Quality” in this program refers to the satisfaction of patient needs and expectations. In a word, CQI is a permanent, continuous program dedicated to pursuing higher quality in LTC. The administrative dietician should be collecting evidence based on the nutrition care process in order to further improve the quality of NCM.

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A risk of life-style related diseases has recently been found in the younger generation. This study identifies the risk factors of life-style related diseases during the last 19 years in young children who have been living in the suburbs of Tokyo. The subjects were 5, 001 children aged 4 to 6 years who attended nursery schools in this city during the period 1984 to 2002. The indicators observed were weight and height, blood pressure, serum biochemical measurements and food intake. Obesity and a high level of serum total cholesterol (TC) were used as risk factors for lifestyle related diseases. The prevalence of obesity varied according to the year by±5-15%, while the prevalence of a high level of TC tended to increase. To assess the relationship between the primary factors for obesity, a principal component analysis was performed in respect of the food intake of meat and fish, while a similar analysis was performed on the primary factors for a high level of TC in respect of the food intake of vegetables and fruit. The results indicate that an excessive intake of saturated fatty acids and cholesterol and lack of antioxidative materials in foods would influence the prevalence of a high level of TC even in young children. It will be important to provide early care and support for children through nutritional education to prevent obesity and a high level of TC.

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This cooperative support activity was for improving children's nutritional intake in Zambia, and we have already reported on the inadequacy of nutrients in their dietary intake. We estimate in this present experiment the intake and content of polyamine from the dietary survey results.
The results show that beans contained a large amount of spermine, and that small fish contained a large amount of putrescine. In terms of the intake of polyamines contained in food, 8-9-year-old children took in the most spermine contained in solweji beans, while 12-year-old children took in the most putrescine contained in kapenta.
Dietary guidance should provide an increased Polyamine intake through an enhanced protein intake from such foods as solweji beans, soy beans, and kapenta.

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Few edible wild plants have their nutritional composition listed in Standard Tables of Food Composition in Japan (fifth revised and enlarged edition). Shi-o-de (Smilax riparia A. DC. var. ussuriensis (Regal) Hara et T. Koyama) is an edible wild plant distributed in various parts of Japan, and its composition is not clear, although it is generally assumed to be similar to that of raw shoots of asparagus, because the shape and taste are similar between the two. The nutritional composition of raw Shi-o-de was analyzed in this study, and the obtained data were compared with the reference data for raw asparagus and royal fern which are listed in the Standard Tables. It was verified that the composition of the three is similar. Although the food composition is influenced by various factors such as the harvest time and place of collection, the data for Shi-o-de found in this study will be helpful for calculating the nutritional value.

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