Osteoporotic fractures can involve high medical expenses and care costs. Recently, drugs have been developed, with well-documented efficacy in preventing fractures and their use in high-risk patients is justified. However, in contexts with limited healthcare resources, it is questionable to prescribe the expensive drugs to individuals with low to moderate risk. Vitamin D deficiency leads to rickets and osteomalacia, while even vitamin D insufficiency, which is milder than deficiency, poses a risk of fractures and is extremely common. Many observational studies have shown that vitamin D deficiency increases the risk of fracture, and intervention studies from abroad have shown that vitamin D supplementation prevents fractures. Additionally, it has been demonstrated that a reduction in fracture incidence due to vitamin D intervention is associated with reduction in fracture-related medical expenses that far exceed the intervention cost. Other benefits of vitamin D include the prevention of falls by preserving muscle strength and a lower risk of infectious diseases and certain cancers. Furthermore, the societal impact of disease prevention through vitamin D treatment may be even greater. Although the absolute therapeutic effect of a nutritional intervention is less than that of drug treatment, the cost-effectiveness can be better because it is accessible to a broader population. However, few studies on the social significance of nutritional interventions have been conducted in Japan. This paper describes the social importance of vitamin D-induced fracture prevention and points out the various nutritional interventions that must be considered from this viewpoint.

Objective: Although the body mass index (BMI) is considered a predictor of mortality in the elderly, there are few reports of institutionalized elderly subjects. The present study examined the relationship between BMI and total mortality in a 2-year cohort study of institutionalized elderly subjects and evaluated cut-off values for predicting mortality.

Methods: Subjects were 208 elderly residents from six facilities, excluding those who died less than one month after the start of observation. Anthropometric measurements, dietary surveys, and blood tests were performed. The date and cause of death were obtained from accident reports and hospital records at each facility.

Results: The mean BMI of the subjects was 20.8 ± 3.6 kg/m², and the number of deaths during the 2 years was 40, with a mortality rate of 10 deaths/100 person-years. When comparing mortality rates by BMI quartiles (Q1-Q4), there was a significant reduction in Q3 and higher. Additionally, in Cox regression analysis, adjusted for age, sex, cancer prevalence, and serum albumin level, the hazard ratio with Q4 as the reference was 4.50 (95% CI: 1.43–14.1) for Q1 and 3.36 (95% CI: 1.05–10.8) for Q2. A BMI cut-off value of 20.5 kg/m² was calculated to predict mortality.

Conclusions: The current BMI significantly predicted the mortality risk in institutionalized elderly, and a cut-off value of 20.5 kg/m² was estimated. This demonstrates the importance of determining BMI for nutritional management in the elderly.

Objective: To increase the vegetable intake of female university students, we compared their vegetable and nutrient intakes and examined the relationship between their vegetable intake and vegetable intake self-efficacy (SE) regarding resident status.

Methods: We used the data of sociodemographic characteristics, vegetable intake SE, and vegetable and nutrient intakes based on a brief-type self-administered diet history questionnaire that targeted 218 female university students. Using the χ² test and the Mann–Whitney U test, we compared sociodemographic characteristics and vegetable and nutrient intakes. In addition, we examined the relationship between vegetable intake and vegetable intake SE regarding resident status using Spearman's correlation.

Results: Of the 218 participants, 80 (36.7%) lived alone, and 138 (63.3%) lived with their families or others. Those who lived alone had lower vegetable and nutrient intakes than those who lived with their families or others (p < 0.05). There is a moderately positive correlation between the total vegetable intake and vegetable intake SE regarding resident status (rs = 0.60, p < 0.001) among those living alone, and there is a weakly positive correlation among those living with their families or others (rs = 0.27, p = 0.032).

Conclusions: Female university students living alone had lower vegetable and nutrient intakes than those living with their families or others. It was also suggested that increasing the vegetable intake SE could be used to improve the vegetable intake of those who live alone.

Objective: Dental caries is prevalent in over 90% of young Mongolian children. Therefore, we developed nutritional materials for the prevention of young children dental caries and used them in nutrition education at a Mongolian kindergarten. We aimed to examine the feasibility of the materials for young Mongolian children through stakeholder evaluation.

Methods: After field assessment, we determined the primary issue, and set the learning objective as "acquiring knowledge on how to choose and eat snacks." We developed theatrical materials for young children and a handbook in Mongolian for parents and teachers. A nutrition education class was conducted in a class for 5-year-olds at A public kindergarten. Simultaneously, handbooks were handed out to parents and teachers. To examine the feasibility of the materials, a questionnaire survey was conducted with 7 participants who followed nutrition education using the materials, and with 13 teachers for the handbooks. Moreover, we evaluated the degree of children's participation during the nutrition education class by observing video recordings.

Results: Over 80% of the observers evaluated that both the title and contents of the theatrical materials met the needs and the level of children's understanding, and they hope to use them in the future. As for the handbook, 84.6% of the respondents answered, "it was useful for parents" and "they would like to provide it to parents." Most children responded to the quiz, and the level of participation was evaluated as satisfactory.

Conclusion: The results suggest that teaching materials developed by us can be used in Mongolia in the future.

Objective: This study aimed to clarify the effects of a nutrition education program on vegetable intake of workers, incorporating self-monitoring using a noninvasive skin carotenoid sensor in addition to a seminar to motivate vegetable intake and environmental support through provision of vegetable beverages.

Methods: A randomized parallel-group study was conducted with 145 healthy workers (intervention group: 74; comparison group: 71; average age: 42) in Kanagawa prefecture, Japan. A seminar by a registered dietitian to encourage vegetable intake and four weeks of environmental support of vegetable beverage distribution were provided to both groups. In addition, participants in the intervention group measured their vegetable intake by a noninvasive skin carotenoid sensor for 10 weeks. The primary outcome for program evaluation was the amount of vegetable intake, whereas the secondary outcome was its stage of change using the transtheoretical model (TTM).

Results: The intervention group showed a significant increase in vegetable intake from pre-intervention at both week 4 and week 10. The TTM stage score showed a significant progress at each period in the intervention group, but there were no differences in changed scores between the two groups.

Conclusion: The results suggested that the progress of TTM scores and the increase of vegetable intake was maintained even without the environmental support, due to self-monitoring with a noninvasive skin carotenoid sensor.

Objective: This study aims to evaluate how the provision of dietary materials to a preschool leads to its browsing and utilization using a survey.

Methods: Participants included 74 preschoolers' families. Original dietary education materials introducing "nutrients contained," "preservation methods," "how to recognize freshness," and "recipes" for six vegetable types were distributed in online and print versions. The intervention lasted for six weeks. Before administering the survey, a handout comprising a QR code, a password, and other information necessary to access the materials on the website was distributed and the participants were asked to view it. During the first three weeks, the materials' online version was uploaded on the original website once a week (three times in total). From weeks four to six, printed materials were distributed to the preschool participants once a week (three times in total). After the intervention period, self-administered questionnaires about the materials' utilization for preschoolers' families were distributed and collected.

Results: The ratio between browsing the materials was 93.7% and 37.5% in the print and online versions, respectively. There was a significant difference between the theoretical values of the print and online versions. The materials' most positive aspect was "ease of access" for both versions. Many participants found the print version to be comparatively "easy to use."

Conclusions: While creating dietary education materials for preschoolers' families, it was observed that the rate of browsing of materials increased if the print version's advantages were provided.