Japan achieved remarkable economic development after World War II, and the associated urbanization induced the westernization of lifestyle, which has led to an increases in the obesity, dyslipidemia, and diabetes among Japanese population. A decrease in the incidence of hypertension causes marked change in the occurence of stroke as well as in its pathology. Such changes in risk factors of cardiovascular diseases (CAD) have led to epidemiological transition in Japan. Westernization of lifestyle has influenced the cholesterol level in Japanese individuals, which has exhibited a gradual increase from the 1960s to that in the 2000s. Because the development of CAD and occurrence of the resulting cardiovascular events takes place over several decades, an increases in the incidence of CAD in Japan is expected in the future. The purpose of our guidelines is to prevent an increase in CAD in Japan. Although total management of the risk factors such as hypertension, diabetes mellitus, and smoking is important for the prevention of CAD, the management of dyslipidemia may be the most important. Diet is one of major lifestyle factors that determine the incidence of CAD; therefore, a selective review of large scale cohort studies regarding the diet in Japan was performed. Japanese indivisuals have consumed more plant and marine origin foods, but less animal foods with saturated fatty acid (SFA) during 1960-70's than at present. CAD prevention entails adequate control of the total energy with restriction of SFA from animal food and optimum intake of fish and n3-fatty acids, soybean, fruits and vegetables. “Japan diet” may be the reason for the low incidence of CAD.

View full abstract

Objective: To examine the co-occurrence of multiple eating behaviors among Japanese adults by combination of presence and absence of healthy eating behaviors.
Methods: In this cross-sectional study, questionnaire data were collected from 4,861 health insurance union members of a company in Japan, from August to September 2010. The data comprised information on the prevalence of 5 healthy eating behaviors (eating breakfast, eating in moderation, not eating between meals, not eating 2 hours before sleeping, and chewing well when eating), sex and age. Each behavior categorized into 2 groups according to its presence or absence of healthy eating behaviors. Then, χ² tests were performed to examined the differences between sexes. We calculated the number and 2 proportions (observed, expected) of all possible 32 combinations. The ratio of the observed to expected prevalence was used to examine the co-occurrence of multiple eating behaviors.
Results: Among the 3,645 subjects who answered the questionnaire (response rate, 75.0%), 3,525 subjects (1,520 men, 2,005 women) were included in the analysis. In both men and women, the combination of the presence of all healthy eating behaviors was most frequently observed (men: 19.3%, women: 17.5%). The highest ratio of the observed to expected prevalence was demonstrated for the absence of the combination of all healthy eating behaviors (men: 7.6, women: 4.5); the second highest ratio was observed for the prevalence of only “eating breakfast” with the absence of the other eating behaviors (men: 3.1, women: 2.6).
Conclusion: In both men and women, the highest ratio of observed to expected was demonstrated for the absence of all healthy eating behaviors; followed by that for the prevalence of “eating breakfast” alone with the other healthy eating behaviors.

View full abstract

Objective: The purpose of this study was to investigate the factors associated with exclusive breastfeeding of low birth-weight infants at NICU discharge.
Methods: Fifty-nine low birth-weight infants and their 48 mothers who visited the follow-up outpatient clinic at the Nara Prefectural NARA Hospital were enrolled. We interviewed the mothers about their lifestyles and views on breastfeeding. We collected information about the mothers' pregnancy and delivery, and clinical conditions of the infants during NICU hospitalization from their clinical charts.
Results: Twelve (25.0%) mothers and 14 (23.7%) infants were engaged in exclusive breastfeeding at NICU discharge. We divided the participants into exclusive breastfeeding and mixed breastfeeding/artificial milk feeding groups. A univariate analysis revealed that the mother's age at delivery and the date of initiation of oral nutrition were associated with exclusive breastfeeding. In a multivariate analysis, which took all factors into consideration, the prevalence of exclusive breastfeeding was significantly higher in infants with an earlier date of initiation of oral nutrition. Such was also higher significantly in mothers with earlier start of milking and higher frequency of milking per day (more than six times). Implementation of kangaroo-care was significantly higher in the exclusive breastfeeding group, but there was no significant association between exclusive breastfeeding and the frequency of the mother's visits to their infants or their attendance at education classes. Recognizing the importance of breast milk and good milk secretion worked as positive factors for exclusive breastfeeding, whereas poor milk secretion, fatigue, and employment were negative factors.
Conclusions: To accomplish exclusive breastfeeding of low birth-weight infants, preservation of breast milk secretion is necessary; moreover, regular milking and early initiation of oral nutrition are crucial factors.

View full abstract

Objective: The present study aimed to investigate whether off-season nutritional education for female rhythmic gymnasts during their weight reduction periods might help prevent decreased protein intake and anemia.
Methods: Fourteen female rhythmic gymnasts participated in this study, which was conducted from Jun 2009 (before weight reduction) to Aug 2010 (after weight reduction). Nutritional education was provided during the off-season period (Feb-Apr 2010) and included lectures as well as classes on shopping, cooking, and menu planning. Physical characteristics and dietary intake were assessed four times in total before (Jun) and after (Aug) the weight reduction periods in both 2009 and 2010.
Results: No significant differences in physical characteristics, hematological values, and dietary intake were observed between 2009 and 2010 except in terms of body weight, body mass index, lean body weight, and red blood cell counts. There was a significant decrease in the protein-energy ratio and intake of beans and eggs in Aug 2009, and body fat in Aug 2010. In addition, egg intake was significantly higher in Aug 2010 than in Jun 2010. These results show that, compared to 2009, body fat changes during the weight reduction periods significantly decreased in 2010, whereas changes in hematocrit, intake of protein, beans and eggs, and protein-energy ratio significantly increased in 2010.
Conclusions: Off-season nutritional education for female rhythmic gymnasts during their weight reduction periods may help prevent decreased protein intake, but it does not seem to affect the iron status parameters, with the exception of the hematocrit level.

View full abstract

Objective: To examine the relationship between school-lunch food waste and children's body size in elementary schools.
Methods: We administered a self-report questionnaire about school-lunch food waste and weighed this waste from each child on 2 days in May and June 2009 to 112 fifth- and sixth-grade students at an elementary school in Tokyo, and used total number of data. Data about height and weight were from the survey conducted at the same time. The median height, weight, and BMI (body mass index) of the 2 groups that divided according to the percentage of the food waste, “completely eaten” and “not completely eaten”, were compared by using the generalized estimating equation adjusted for sex and grade.
Results: Data from total 218 students (104 (47.7%) boys and 114 (52.3%) girls) were analyzed. In total, 80 (36.7%) were classified into the “not completely eaten” group and 138 (63.3%) were classified into the “completely eaten” group. The percentage of the food waste from the school lunches ranged from 0.2% to 84.3%. The median (25th, 75th percentile) of height, weight, and BMI in the “not completely eaten” group and “completely eaten” group, and the results (p values) after comparing the two groups were as follows: 141.7 (137.1, 145.5) cm vs. 145.4 (139.8, 150.2) cm (p = 0.289); 32.5 (30.0, 37.5) kg vs. 36.0 (32.4, 40.7) kg (p = 0.034); 16.0 (15.6, 17.8) kg/m² vs. 16.9 (16.0, 18.9) kg/m² (p = 0.034).
Conclusion: The weights and BMIs of fifth and sixth grade elementary school students who completely finish their school lunches were greater than those who do not finish their school lunches.

View full abstract