Modification of lifestyle including nutrition therapy plays a fundamental role in the treatment of type 2 diabetes. Because of the wide diversity in the pathogenesis of diabetes and lifestyle, nutrition therapy needs to be tailored to individual patients. Management of obesity by reduction of body weight is a critical issue for amelioration of insulin resistance. So far, a BMI of 22 has been considered the standard for Japanese, and total energy intake is calculated in order to achieve this. However, energy requirement differs among individuals according to age and physical activity, and a BMI of 22 is not an achievable target for those with an existing BMI of over 30. On the other hand, nutrition therapy should aim to prevent frailty and sarcopenia in elderly patients by ensuring that energy and protein intakes are sufficient. On the basis on these considerations, the Japanese Diabetes Society has proposed new guidelines for nutrition therapy focusing on individualization of energy and macronutrient intakes.

To improve endurance performance, intake of n-3 fatty acid has been investigated, but studies on athletes have been limited. The aim of this study was to investigate the effects of EPA and DHA intake for 24 months on blood fatty acid changes in female long-distance athletes. Twelve subjects took EPA 664 mg and DHA 284 mg daily for 24 months, and blood tests were conducted once a month. It was found that the EPA concentration increased by 126％ (p ＜ 0.01) after 3 months, whereas the AA concentration decreased by 17％ (p ＜ 0.05) a month after the start of the intervention. The EPA/AA ratio was increased by 110％ (p ＜ 0.01) after 3 months (0.86 ± 0.05) compared to that before the intervention (0.41 ± 0.04) and then shifted within the range 0.67‐0.98 (p ＜ 0.05 and p ＜ 0.01). On the other hand, there was no change in the blood levels of DHA. Therefore, it was suggested that daily intake of EPA and DHA may increase the EPA/AA ratio in female long-distance athletes.

The present study examined the effects of a 2-month health program for the elderly focused on mastication, nutrition and exercise guidance. The subjects were 28 women aged 65 years or older. Body weight, arm circumference, calf circumference, occlusal force, grip strength, dietary habits, food consciousness and the Nestle Nutrition Institute Mini Nutritional Assessment (MNA) were examined before and after the intervention. During the program, the subjects continued to eat a piece of Kori-tofu to train their occlusal force and to supply nutrition. After the intervention, the occlusal force, grip strength, and arm circumference of the subjects were significantly increased. The food consciousness score was also significantly higher than at the beginning of the program. The present results indicated that our 2-month lifestyle modification program effectively promoted the health of elderly people.