Every 5 years, the Dietary Reference Intakes (DRI) for Japanese proposes reference values for desirable dietary intake of energy and nutrients in order for Japanese people to maintain and promote their health. The applicable populations were originally healthy individuals and groups. Dietary Reference Intake for Japanese (2015) was issued in May, 2014, and will be applicable for 5 years, from fiscal 2015 to fiscal 2019. In this issue, efforts to prevent lifestyle-related diseases such as hypertension, dyslipidemia, diabetes mellitus, and chronic kidney disease have been intensified. Therefore, the applicable populations include those who are receiving health guidance for hypertension, dyslipidemia, diabetes, or chronic kidney disease in company with healthy individuals and groups. Here, concepts for dietary management designed to protect the Japanese population from progression of lifestyle-related diseases are summarized.

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This review describes a paradigm of energy recommendation which was adopted in the Dietary Reference Intakes for Japanese (2015) (DRIs 2015). DRIs 2015 is designed to prevent the progression as well as onset of chronic diseases such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. It is applied to not only healthy individuals and groups, but also those who are subject to health guidance, being overweight (BMI up to 30) or having chronic diseases. An imbalance between energy intake and expenditure results in a change in body weight. But in the long term, the resulting change in body weight affects energy homeostasis, leading to an energy equilibrium at a certain body weight (BMI). In DRIs 2015, BMI (target BMI range) was adopted as the reference for maintaining an equilibrium between appropriate energy intake and expenditure. The target BMI range was defined for three adult age categories. Basically, the ranges were determined based on BMI with the lowest all-cause mortality reported in observational epidemiological studies. For people aged 70 years and over, a tentative BMI range was determined, considering the actual BMI distribution of this age population and the prevention of both chronic diseases and frailty.

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The effects of dietary fat intake on the risk of incident diabetes remain to be fully elucidated. The purpose of this study was to investigate the relationship between dietary fat intake and diabetes blood markers in Japanese women. A dietary survey was conducted on 122 Japanese women living in Toyama. Blood was sampled in the morning after an overnight fast to analyze serum glucose, insulin and hemoglobin A1c, none of which were found to correlate with total lipid intake. Likewise, no correlations were found between saturated or polyunsaturated fatty acid intake and serum levels of glucose, insulin or hemoglobin A1c. There was a significant negative correlation between hemoglobin A1c and intake of monounsaturated fatty acid. These results suggest that intake of monounsaturated fatty acid may reduce the level of hemoglobin A1c in Japanese women.

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