To identify the appropriate indices for evaluating the effectiveness of nutrition education targeted at masticatory behavior in Japanese children, we systematically reviewed relevant articles published during 1983-2010. We retrieved articles from the Igakuchuozassi and MEDLINE databases, and after reading the screened papers, we finally selected 13 original articles to complete the evidence table through in-depth analyses. In these studies, 3 methods were adopted to measure the indices of masticatory behavior : (1) survey using self-administered questionnaires on masticatory habits ;(2) measurement by a portable chewing counter for children (the number of chews and time taken for eating a test meal);(3) indirect observation using Video Tape Recorder, while 2 methods were used for assessing masticatory ability ;(4) measurement of occlusal force;(5) mastication test by using chewing gum. Each method has its strengths and limitations in terms of validity and applicability(cost, labor, and time) in a large population. We concluded that the combination of methods 1 and 2 was the best option in many genuine settings of nutrition education programs because of their feasibility and acceptable validity. We also illustrated the different natures of masticatory behavior ("won't chew") and masticatory ability ("can't chew"), both of which should be considered when developing appropriate intervention programs to improve masticatory outcome in children.

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