Background: Dietary intake assessment and subsequent dietary education or intervention in young children is important in decreasing prevalence of various noncontagious diseases in adulthood. Validation of diet assessment questionnaires for preschool children has just started in Japan. In this study, we rearranged the brief-type self-administered diet history questionnaire (BDHQ), a convenient diet assessment questionnaire that is widely used in a range of situations for adults, for use in children aged 3–6 years (BDHQ3y) and then validated the BDHQ3y in Japanese children. Methods: The guardians of 61 children aged 3–4 years completed the BDHQ3y twice at an interval of 1 month, along with a 3-nonconsecutive-day diet record (DR) between the two administrations of the BDHQ3y. Dietary intakes for energy and 42 selected nutrients were estimated using both the DR and the BDHQ3y. Mean intakes estimated by the two methods were compared, and correlation coefficients were calculated. Reproducibility of the BDHQ3y estimates was investigated using intra-class correlation coefficients (ICCs). Results: No significant differences in mean intakes estimated by the DR and the BDHQ3y were observed for one- to two-thirds of energy and examined nutrients. The median of Pearson correlation coefficients between intakes energy-adjusted by the residual method was 0.31 (interquartile range, 0.24 to 0.38). The median ICC was 0.72 (interquartile range, 0.63 to 0.76) for the crude nutrient intakes. Conclusions: Although the BDHQ3y might be a good candidate for dietary intake assessment in Japanese preschool children, its validity is currently moderate to low. Shortcomings should be overcome by obtaining and utilizing more information about children’s dietary habits.
Background: Skipping breakfast has been suspected as a risk factor for type 2 diabetes (T2DM), but the associations are not entirely consistent across ethnicities or sexes, and the issue has not been adequately addressed in the Japanese population. Methods: We followed 4631 participants (3600 men and 1031 women) in a work-site cohort of participants aged 35–66 years in 2002 through 2011 for T2DM development. Frequency of eating breakfast was self-reported and was subsequently dichotomized to breakfast skippers, who eat breakfast 3–5 times/week or less, and to eaters. Cox proportional hazards models were used to adjust for potential confounding factors, including dietary factors, smoking and other lifestyles, body mass index (BMI), and fasting blood glucose (FBG) at baseline. Results: During 8.9 years of follow-up, 285 T2DM cases (231 men and 54 women) developed. Compared to participants who reported eating breakfast every day, maximally-adjusted hazard ratios and 95% confidence intervals (CI) of those with the frequency of almost every day and 3–5, 1–2, and 0 days/week were: 1.06 (95% CI, 0.73–1.53), 2.07 (95% CI, 1.20–3.56), 1.37 (95% CI, 0.82–2.29), and 2.12 (95% CI, 1.19–3.76), respectively. In a dichotomized analysis, breakfast skipping was positively associated with T2DM incidence (maximally-adjusted hazard ratio 1.73; 95% CI, 1.24–2.42). The positive associations were found in both men and women, current and non-current smokers, normal weight and overweight (BMI ≥25 kg/m2), and normal glycemic status and impaired fasting glycemic status (FBG 110 to <126 mg/dL) individuals at baseline (Ps for interaction all >0.05). Conclusions: The present study in middle-aged Japanese men and women suggests that skipping breakfast may increase the risk of T2DM independent of lifestyles and baseline levels of BMI and FBG.
Background: In industrialized countries, assessment of the causal effect of physician supply on population health has yielded mixed results. Since the scope of child vaccination is an indicator of preventive health service utilization, this study investigates the correlation between vaccination coverage and pediatrician supply as a reflection of overall pediatric health during a time of increasing pediatrician numbers in Japan. Methods: Cross-sectional data were collected from publicly available sources for 2010. Dependent variables were vaccination coverage for measles and diphtheria, pertussis, and tetanus (DPT) by region. The primary predictor of interest was number of pediatricians per 10 000-child population (pediatrician density) at the municipality level. Multivariate logistic regression models were used to estimate associations of interest, conditional on a large range of demographic and infrastructure-related factors as covariates, including non-pediatric physician density, total population, per capita income, occupation, unemployment rate, prevalence of single motherhood, number of hospital beds per capita, length of roads, crime rate, accident rate, and metropolitan area code as urban/rural status. The percentage of the population who completed college-level education or higher in 2010 was included in the model as a proxy for education level. Results: Pediatrician density was positively and significantly associated with vaccination coverage for both vaccine series. On average, each unit of pediatrician density increased odds by 1.012 for measles (95% confidence interval, 1.010–1.015) and 1.019 for DPT (95% confidence interval, 1.016–1.022). Conclusions: Policies increasing pediatrician supply contribute to improved preventive healthcare services utilization, such as immunizations, and presumably improved child health status in Japan.
Background: Clinical and immunological studies have consistently shown a possible link between atopy and idiopathic nephrotic syndrome (INS). However, whether allergic diseases occur after INS develops is unknown. Methods: From Taiwan’s National Health Insurance database, 1340 children with newly diagnosed INS and 5360 non-INS matched controls were identified in 2000–2007. By the end of 2008, the incidences and hazard ratios of four allergic diseases (allergic conjunctivitis, allergic rhinitis, atopic dermatitis, and asthma) were calculated. Results: The incidence rates of all four allergic diseases were greater in the INS cohort than in the non-INS cohort in all age groups and decreased sharply as age increased in both cohorts. Children with INS had the highest adjusted hazard ratio (4.13; 95% confidence interval [CI], 2.50–6.83) for atopic dermatitis and the lowest adjusted hazard ratio (1.71; 95% CI, 1.39–2.09) for allergic rhinitis. Most of the allergic diseases appeared within 2–6 months after INS developed, and the incidences declined with increasing follow-up duration. Conclusions: Allergic disorders are common in children with INS, especially within the first year after diagnosis. The role of INS in the development of allergic disorders should be elucidated to establish innovative disease intervention programs.
Background: Although specific foods and nutrients have been examined as potential determinants of serum gamma-glutamyl transferase (GGT) concentrations, the relationship between dietary patterns and GGT remains unknown. The present cross-sectional study aimed to determine relationships between dietary patterns and GGT concentrations, and the effects of lifestyle factors on GGT. Methods: Relationships between dietary patterns and GGT were analyzed in 9803 Japanese individuals (3723 men and 6080 women age 40–69 years) without a history of liver diseases or elevated serum aminotransferase. We examined major dietary patterns by factor analysis of 46 items determined from a validated, short food frequency questionnaire. Results: We defined dietary patterns as healthy, Western, seafood, bread, and dessert. The healthy pattern was inversely related to GGT in men (odds ratio [OR] for highest vs lowest quartile, 0.72; 95% confidence interval [CI], 0.57–0.92; P < 0.01 for trend) and women (OR 0.82; 95% CI, 0.66–1.0; P = 0.05 for trend), whereas the seafood pattern was positively related to GGT in men (OR 1.27; 95% CI, 1.01–1.61; P = 0.03 for trend) and women (OR 1.21; 95% CI, 0.98–1.49; P = 0.05 for trend). Male-specific inverse associations with GGT were found for bread and dessert patterns (OR 0.63; 95% CI, 0.50–0.80 and OR 0.53; 95% CI, 0.41–0.68, respectively; P < 0.01 for both trends). Seafood or bread patterns and alcohol consumption significantly interacted with GGT in men (P = 0.03 and <0.01 for interaction, respectively) and between the dessert pattern and body mass index or smoking habit in women (P = 0.03 and <0.01, respectively, for interaction). Conclusions: Dietary patterns may be important determinants of GGT, and their possible clinical implications warrant further investigation.
Background: Mannose-binding lectin2 (MBL2) is implicated in the host immune response, but there are limited data about MBL2 polymorphisms and hepatocellular carcinoma (HCC) risk. This study aimed to investigate the relationship between the MBL2 rs7096206 polymorphism and HCC risk in a Chinese Han population. Methods: A population-based case-control study of 220 HCC patients and 220 age- and gender-matched healthy control subjects from a Chinese Han population was conducted. Genomic DNA was extracted from blood samples, and the presence of the MBL2 polymorphism rs7096206 was assessed using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry. Conditional logistic regression was performed to assess the risk of HCC by determining odds ratios and 95% confidence intervals (CIs). Results: The odds of HCC among carriers of CG and GG genotypes were 7.33 (95% CI, 2.53–21.29) and 12.48 (95% CI, 2.08–74.90), respectively. In the dominant genetic model, GG+CG carriers had an approximately 8-fold increased risk (95% CI, 2.83–22.62) compared with those with the CC genotype. The G allele was significantly associated with elevated HCC risk, with an odds ratio of 6.83 (95% CI, 2.90–16.10). Conclusions: Our findings suggest that the MBL2 polymorphism rs7096206 is associated with HCC susceptibility and has the potential to serve as a biomarker to detect populations at increased HCC risk.
Background: Although non-communicable diseases (NCDs) have become the predominant health problems of Palauan society, there have been no comprehensive data on NCD risk factors available to develop effective control strategies. Therefore, the first Palauan national STEPwise approach to risk factor Surveillance (STEPS) was completed in mid-2013 to provide information on its adult population aged 25 to 64 years. This study aims to obtain corresponding data from the younger adults aged 18 to 24 years, who remained to be surveyed. Methods: We conducted an epidemiological study, targeting the 18- to 24-year-old age group. A survey station and a mobile team were established to recruit voluntary participants dwelling in Koror. A slightly modified WHO STEPS instrument was used, including a structured questionnaire for behavioral risk factors, physical measurements, and blood tests. Results: A total of 356 young people were recruited during the survey. In both sexes, nearly half of the participants were overweight/obese. The prevalence of hypertension was higher in men than in women (17.6% vs 1.7%). Raised blood glucose and impaired fasting glucose were observed in 3.5% and 5.2% of the total participants, respectively. About 36% of the subjects were observed to have raised levels of total cholesterol. More than 70% of the young people were current tobacco users, in terms of all kinds of tobacco products. Conclusions: The current survey, for the first time, revealed a high prevalence of NCD risk factors, especially overweight/obesity and tobacco use, among young people in Palau. This indicates that swift measures against NCDs are required even in this young age group.