The number of food allergy patients has been increasing, particularly in the developed nations. Japanese figures indicate that the prevalence of food allergy in infants is approximately 5-10% and approximately 2% in school children¹⁾. It is necessary to establish the best way to manage food allergic children that participate in the school lunch program in nursery schools, kindergartens and higher schools. Registered dietitians therefore have to get the latest knowledge and information on food allergy to provide nutrition counseling for food allergy patients. This review article should be useful for registered dietitians who see food allergy patients so that their quality of life and that of their parents and guardians can be improved.

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The objective of this study was to clarify the risk factors in the development of sleep apnea syndrome (SAS). The subjects were 49 men who agreed to participate as SAS outpatients in our ethical committee-approved study. The clinical background factors of all subjects were an age (mean ± standard deviation) of 51.2 ± 11.0 years, body mass index (BMI) of 28.2 ± 4.3 kg/m², and apnea hypopnea index (AHI) of 35.6 ± 27.0 events/h. The correlation between AHI and age was not significant (r = 0.01, p = 0.95), but that between AHI and BMI was significant (r = 0.41, p = 0.003). The subjects with moderate to severe SAS symptoms had dietary consciousness and behavior leading to obesity, as compared to those having only mild symptoms. The subjects with a smoking habit had significantly higher AHI than those without the habit. The pass analysis demonstrates that the coefficient of determination R² of BMI was 70% and that of AHI was 43%. The factors directly affecting AHI were, in order of magnitude, ‘the habit of smoking’ (0.38), ‘I always feel guilty after overeating’ (0.35), and BMI (0.28). ‘I tend to gain weight more easily than others’ (0.16) indirectly affected AHI through BMI. These results suggest that smoking, dietary consciousness and behavior, and obesity are important risk factors in SAS development.

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The effect was investigated of a combined intake of carbohydrate and protein over a long period immediately after rugby practice on the body composition and physical functions. Seventeen male rugby players were assigned to two groups: the PRO group took a protein supplement (15.2 g of protein, 0.6 g of fat, and 1.6 g of carbohydrate), and the PRO+CHO group took both the protein supplement and a carbohydrate supplement (45.0 g of carbohydrate) immediately after rugby practice. The experimental period was 52 days, during which they practiced rugby and did weight training on 6 days each week. There was a significant time effect on the lean body mass and 1 RM bench press for each group (p < 0.05, 0.01), but no apparent difference between the groups after experimental period. There were also no significant differences in body fat, 1 RM squats and dead lift, girth circumference, skinfold thickness, and blood biochemical values for each group. These results indicate that the combined intake of carbohydrate and protein immediately after rugby practice did not result in any significant differences in body composition and physical functions between the two groups. The relatively short period for the investigation might be the reason why this study did not reproduce the results of previous studies.

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Dietary life recommendations for persons with spinal cord injury (SCI) are thought to differ from those for able-bodied persons because of body characteristics that limit activity and create urination/evacuation disorders. However, little is known about their dietary lives in Japan.
To understand the diet-related factors affecting persons with SCI, ninety-four subjects with SCI (77 males, 45.4 (SD 14.5) years old, and 17 females, 45.4 (SD 13.1) years old) participated in this study. All the subjects completed a dietary questionnaire consisting of basic characteristics, quality of life (QOL), health condition, behavior, knowledge, attitude, skills and environmental factors.
Almost all of the subjects reported a good subjective health condition and diet-related QOL. Twenty-eight percent of the participants skipped breakfast. Although the diet-related attitude was relatively high, diet-related skills were not always adequate. Peer support was reported to be satisfactory. There was significant partial correlation between the three indices of dietary habit assessment (diet-related QOL score, food frequency score, and diet-related self-efficacy score), and such other factors of dietary life as subjective health condition, behavior, attitude, skills and peer support.
The results suggest that the scales developed for young able-bodied subjects could be an effective measurement of dietary life when applied to persons with SCI.

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We propose a method to determine the number of servings (SV) for the Japanese Food Guide Spinning Top (J-FGST), which is based on the Dietary Reference Intakes (DRIs) for Japanese 2005, because a new version of DRIs was announced in 2009. A dish-based database for the dietary intake by a free-living population aged 18-69 years of age was used to calculate reference values for energy and nutrients in one serving of five dish categories according to the definitions of J-FGST. To ensure an intake of energy and selected nutrients appropriate to the new DRIs 2010, we assumed a ratio of energy percent from grain of 45.0-50.0%, protein energy percent of 14.0%, calcium ranging from 500 to 750 mg, SVs for vegetable dishes of 5-7, and energy from other food categories, except for the five dish categories, ranging from 30 to 50 kcal. We then simulated combinations of SVs for five categories covering a range of total energy from 1,200 to 3,200 kcal in 200-kcal steps. The results show a set of SVs that are similar to the present J-FGST, while SVs for meat and fish dishes are slightly more and SVs for grain dishes are slightly less. We propose that our new set of SVs for J-FGST fit more appropriately with the new DRIs 2010 and cover a wide range of energy intake for better application to various subjects

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Preparation conditions of rotation speed and mixer agitation time for an easy-to-eat blender gruel were investigated.
The properties of the prepared gruel were evaluated by a textual profile, particle diameter, and sensory evaluation by healthy persons.
Agitating for 60 seconds at medium or higher speeds were found to be the best conditions to prepare a gruel with the same or softer textures than those currently provided at care centers.
Textual analysis and sensory evaluation showed gruel made by agitating a commercial retort gruel product at a high speed for 60 seconds was significantly softer in textual profile, less coarse, less sticky and easier to swallow than that made without retort treatment with the same agitating conditions.
The results indicate that using commercial retort gruel product that is produced under high temperature and high pressure can be used to make an easy-to-eat blender gruel.

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Japan's diet and nutrition teacher system began in 2005, and the problems of accepting the teaching practices by diet and nutrition teachers have not been fully investigated. This study compares the characteristics and problems of this acceptance by licensed teachers for diet and nutrition and unlicensed teachers. A questionnaire survey was distributed to 1,627 diet and nutrition teachers and school nutrition personnel in Tokyo. Half of the licensed diet and nutrition teachers were in their 50s and had more than 30 years of experience in nutrition education. Many of the diet and nutrition teachers responded “not true” and “not often true” to the question “I don't have the skills necessary to accept the teaching practices for diet and nutrition teachers.” The percentage response of “I accept” to the question “In the future, will you accept the requests for the teaching practices for diet and nutrition teachers?” was higher from the licensed teachers than from the unlicensed teachers (p < 0.001). The results show that future study is needed on the characteristics and problems of the acceptance of teaching practices by licensed teachers for diet and nutrition and on the methods to reduce them.

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Aim: To investigate the accuracy of measurement of the number of chews by portable equipment, which was developed mainly to promote chewing behavior in usual diet in children. The obtained data can be utilized in the evaluation and relevant studies for the practices of nutrition education in children.
Subjects and methods: We recruited 61 children (5-6 years old) in two kindergartens. We used a portable chewing counter (Nitto Science Co, Japan) to make duplicated measurements of the number of chews taken for the same lunch-time test meal with a two-week interval. The three examiners were engaged in pre-checking, adjusting and attaching the equipment and closely observing the children according to the protocol. We obtained 37 duplicated observations that were eligible for the test-retest analyses. The reproducibility of the measurements was tested by calculating Pearson's correlation coefficients and using the Bland-Altman plot to analyze the degree and tendency toward the differences between the two measurements.
Results: The correlation coefficients for the duplicated measurements in the number of chews (A times), time taken to consume the test meal (B minutes), and chewing rhythm (A/B times per minute) were r = 0.67, r = 0.76, and r = 0.70 (p < 0.001 for all indicators), respectively. The Bland-Altman plot revealed 95% of observations of the number of chews among the 37 subjects were distributed within the range of consistency (Δ; from -367.9 to +276.5).
Conclusions: The results showed good reproducibility of the measurements by the counters, being relatively low cost, small, and easy to operate for evaluation and studies on nutrition education. Obtaining more reliable data will be possible when the users adopt a well-standardized measurement procedure, including training the examiners.

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We analyzed the tailored messages made by registered dietitians in a lifestyle modification program for those subjects who were concerned with the metabolic syndrome. The program was composed of a 4-month program with group sessions and a 2-month correspondence program. Twenty three participants (14 women and 9 men), with a mean age of 52.7 ± 13.1 years and a body mass index of 25.8 ± 3.5 completed the program. They decided their action targets by themselves and kept records of their behavior and body weight every day. They received tailored messages from the registered dieticians by mail monthly during the program. There was a total of 101 tailored messages which were assigned to 11 sub-categories in 3 categories. These categories were the formation of trust (35.74%), behavioral support (40.16%), and psychological support (24.10%). In the sub-categories, “advice” was most frequently used (25.13%). The behavioral support was increased in the correspondence program. Each participant's satisfaction after the program was related to messages rich in “praise” (p < 0.01). Further study is needed to examine the relationships between the elements in tailored messages and their effects on behavioral changes.

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A study on what was being done for children with food allergies was conducted by a questionnaire survey sent twice to 174 nurseries (both public and private) in Kobe. We found that public nurseries served only allergen-free meals for children with allergies, but did not serve substitute meals, although some schools provided substitute snacks. In contrast, private nursery schools provided allergen-free meals as well as substitute meals and snacks. Care was taken in the various stages of preparation from the cooking to serving in order to ensure that children with special dietary requirements were served properly prepared meals. Many schools paid attention to the psychological condition of children with allergies. We also found that transmitting information and maintaining communication among the staff members, as well as among nursery schools, was important. The information learned from the various nursery schools has been fed back, and we expect there will be further improvements in nursery school lunches.

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Soy bean isoflavones are structurally similar to estrogen, and exhibit weak estrogenic activity. In 2006, Food Safety Commission of the cabinet office set the upper limit of isoflavone (aglycone equivalent) intake from Foods for Specified Health Uses (FOSHU) at 30 mg/day for additional consumption with a normal diet. However, the upper limit for isoflavones was not established in the so-called health foods containing soy protein and isoflavones. We evaluated the respective soy protein and isoflavone contents in 10 health foods including 5 FOSHU by the ELISA and HPLC methods. The soy protein content of eight of these foods was determined to be within 90-118% of that reported on the label, and two protein powders for junior use contained about a half of the soy protein content reported on the label. The isoflavone aglycone content in FOSHU containing soy protein was detected to be 90-122% of the labeled content, while the isoflavone content of two soy protein-fortified foods with no label exceeded 30mg per one serving. It might be necessary to pay attention to junior athletes not excessively consuming these soy protein powder foods.

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