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Ensuring proper energy, nutrient intake, and sleep is vital for athlete health and competitiveness. Despite previous studies investigating the nutrient intake among top-level collegiate female athletes in Japan, the status of snack consumption remains unclear. This study addressed this gap by surveying 70 top-level female university athletes. The survey included a self-administered diet history questionnaire, a qualitative food intake frequency survey, and a survey on snack and dietary supplement use. The results revealed a low frequency of snack intake (2.1 ± 2.3 days/week), with 55.7% of athletes reporting snack consumption. The energy intake in the snack-intake group was significantly higher than that in the without-snack-intake group (31.5 ± 10.0 vs. 26.6 ± 9.92 kcal/kg of BM, p = 0.047). Similarly, carbohydrate intake was significantly higher in the snack-intake group than in the without-snack-intake group (4.84 ± 1.71 vs. 3.96 ± 1.65 g/kg of BM/day, p = 0.035). However, neither group reached the recommended value of 5–8 g/kg of BM/day during the medium training period. Overall, this study emphasizes inadequate energy intake even among athletes with a high snack intake frequency, highlighting the necessity to enhance overall food consumption and underscoring the importance of nutritional education for incorporating appropriate complementary meals to improve performance. [ABSTRACT FROM AUTHOR]

Background: Physical activity or biomarker-calibrated energy intake (EI) alone is associated with mortality in older adults; the interaction relationship between the combined use of both factors and mortality has not been examined. We evaluated the relationship between mortality and calibrated EI and step counts in older adults. Methods: This prospective study included 4,159 adults aged ≥65 years who participated in the Kyoto-Kameoka study in Japan and wore a triaxial accelerometer between 1 April and 15 November 2013. The calibrated EI was calculated based on a previously developed equation using EI biomarkers. The step count was obtained from the accelerometer ≥ 4 days. Participants were classified into the following four groups: low EI (LEI)/low step counts (LSC) group (EI: <2,400 kcal/day in men and <1,900 kcal/day in women; steps: <5,000 /day), n = 1,352; high EI (HEI)/LSC group (EI: ≥2,400 kcal/day in men and ≥1,900 kcal/day in women; steps: <5,000 /day), n = 1,586; LEI/high step counts (HSC) group (EI: <2,400 kcal/day in men and < 1,900 kcal/day in women; steps: ≥5,000 /day), n = 471; and HEI/HSC group (EI: ≥2,400 kcal/day in men and ≥1,900 kcal/day in women; steps: ≥5,000 /day), n = 750. Mortality-related data were collected until 30 November 2016. We performed a multivariable Cox proportional hazard analysis. Results: The median follow-up period was 3.38 years (14,046 person-years), and 111 mortalities were recorded. After adjusting for confounders, the HEI/HSC group had the lowest all-cause mortality rate compared to other groups (LEI/LSC: reference; HEI/LSC: hazard ratio [HR]: 0.71, 95% confidence interval [CI]: 0.41–1.23; LEI/HSC: HR: 0.59, 95% CI: 0.29–1.19; and HEI/HSC: HR: 0.10, 95% CI: 0.01–0.76). No significant interaction was observed between the calibrated EI and steps with mortality. The spline model showed that 35–42 kcal/100 steps/day of EI/100 steps was associated with the lowest mortality risk. Conclusions: HR mortality risk was lowest at 35–42 kcal/100 steps/day, suggesting that very high (≥56 kcal) or low (<28 kcal) EI/100 steps are not inversely associated with mortality. Adherence to optimal EI and adequate physical activity may provide sufficient energy balance to explain the inverse association with mortality among older Japanese adults. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the effect of lunches with different caloric contents (Study 1) and nutrient balances (Study 2) on dinner-induced postprandial glucose fluctuation. Methods: Energy trial (Study 1): Thirteen healthy young participants (n = 10 men, n = 3 women) were investigated to determine the effects of different caloric intakes at lunch on glucose level variability. The study was comprised of four trials (no lunch, low lunch, standard lunch, and high-energy lunch). Energy balance trial (Study 2): Fourteen healthy young adults (n = 8 men, n = 6 women) were investigated to determine the effect of different nutrient balances during lunch on glucose level variability. The study consisted of four trials (standard, protein-rich, fat-rich, and carbohydrate-rich). In studies 1 and 2, each trial was spaced at least 24 full hours apart, and breakfast and dinner were tested as meals. The mealtimes for each trial were then aligned. Continuous glucose monitoring was used to assess the blood glucose fluctuations. Results: Study 1: The no-lunch (95% CI 95.5–149.7) and low-energy lunch (95% CI 90.8–143.1) trials had significantly higher values in the incremental area under the curve (iAUC) of postprandial blood glucose at dinner compared to the standard (95% CI 55.4–90.0) and high-energy lunch (95% CI 29.3–54.6) trials (P = 0.006, P = 0.001 vs. none), (P = 0.004, P = 0.001 vs. low-energy trial). Study 2: A significantly higher postprandial blood glucose iAUC for dinner was found in the fat-rich trial (95% CI 58.5–114.0) than that in the protein-rich (95% CI 25.6–63.9) and standard (95% CI 25.6–112.4) trials, (P = 0.006, P = 0.035 vs. fat-rich trial). Conclusions: Our findings indicate that skipping lunch and low-calorie or high-lipid intake increased postprandial blood glucose levels after dinner. [ABSTRACT FROM AUTHOR]

Background: To provide seamless nutritional support from early adulthood to late adulthood in Japan, this study aimed to identify aging-related changes in protein and fat intake and meal types., Methods: Birth cohort analysis was conducted in this study. The protein intake, protein-to-energy ratio, fat intake, and fat-to-energy ratio in men and women from their 20s to 60s in 2001 was calculated using the data of the National Health and Nutrition Survey in Japan between 2001 and 2019 (n = 139,876, 47.0% men, mean age: 54.9 and 55.4 years for men and women, respectively). The intakes were calculated for every subsequent year, the aging-related changes were identified by age group, and the 99 food groups were classified into staple-focused meal types through factor analysis. The weighted average component value per 1 g of each food group was calculated, multiplied by the food weight, and totaled to determine the mean intake by meal type and to confirm the aging-related changes. The year when the slope changed before and after was identified through Joinpoint regression analysis., Results: The protein intake, protein-to-energy ratio, fat intake, and fat-to-energy ratio initially declined or remained unchanged with aging in almost all generations (20s to 60s in 2001) but began to increase after 8-15 years. The food groups were classified into rice, noodle, and bread types. The protein and fat intake from the noodle type initially showed a decreasing trend but began to increase with aging after 8-15 years in almost all generations in both sexes (p < 0.05 for difference in slope)., Conclusions: The increase of protein intake and protein-to-energy ratio and fat intake and fat-to-energy ratio over time observed among Japanese adults may be related to the increased intake of food groups from noodle type meals. Thus, considering the type of staple food (i.e., rice, noodles, or bread) and its combination with other foods when adhering to a balanced diet is necessary., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Background: Psychological characteristics of eating behaviour may be related to dietary habits., Aim: We investigated the association between eating behaviour characteristics and nutrition and food intake adequacy in Japanese adolescents., Methods: This cross-sectional survey was conducted among 136 junior high school students (boys: 90, girls: 46) at a junior high school in Tokyo, Japan. Eating behaviour was categorised into three types (emotional, external, and restrained) using scores on the Japanese version of the Dutch Eating Behaviour Questionnaire. Dietary intake was assessed using a validated, brief self-administered diet history questionnaire. Inadequate nutrient intake was determined by counting the number of nutrients not meeting the dietary reference intake (DRI) for the Japanese population. The statistical analyses included Wilcoxon signed-rank tests, Spearman's rank correlation coefficient, and multiple regression analysis using JMP ver.14 (SAS Institute Inc., Cary, NC, USA). All reported p values are two-tailed, and p < 0.05 was regarded as statistically significant., Results: Multiple regression analysis showed that restrained eating score was inversely associated with the number of nutrients not meeting the DRI ( β  =  - 0.28; p  = 0.0027) and with total weight of snack intake ( β  =  - 0.30; p = 0.0010). Neither emotional nor external eating was significantly associated with the number of nutrients not meeting the DRI and with total weight of snack intake., Conclusions: These results suggest that adolescents with low restrained eating scores may have less self-control over their eating behaviour and may therefore have inadequate dietary intake., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to investigate the effect of Japanese dietary patterns on metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. After excluding factors affecting the diagnosis of hepatic steatosis, 727 adults were analyzed as part of the Health Promotion Project. The dietary patterns of the participants were classified into rice, vegetable, seafood, and sweet based on their daily food intake. Liver stiffness measurements and controlled attenuation parameters were performed using FibroScan. Energy and nutrient intake were calculated using the Brief-type Self-administered Diet History Questionnaire. Univariate and multivariate analyses were used to identify the risk factors for liver fibrosis within the MASLD population. The vegetable group had significantly lower liver fibrosis indicators in the MASLD population than the rice group. The multivariate analysis identified a body mass index ≥ 25 kg/m 2 (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.01-1.83; p = 0.047) and HOMA-IR ≥ 1.6 (OR, 3.18; 95% CI, 1.74-5.78; p < 0.001) as risk factors for liver fibrosis, and vegetable group membership was a significant low-risk factor (OR, 0.38; 95% CI, 0.16-0.88; p = 0.023). The multivariate analysis of nutrients in low-risk foods revealed high intake of α-tocopherol (OR, 0.74; 95% CI, 0.56-0.99; p = 0.039) as a significant low-risk factor for liver fibrosis. This study suggests that a vegetable-based Japanese dietary pattern, through the antioxidant effects of α-tocopherol, may help prevent liver fibrosis in MASLD and the development of MASLD.

Background: While the Sodium-glucose co-transporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) are widely used for the glycemic control in type 2 diabetes mellitus, the differences in the effects of SGLT2 inhibitors and DPP4 inhibitors on energy intake and diabetes-related indicators are unclear., Methods: This was a subanalysis of the CANTABILE study which compared the effects of canagliflozin and teneligliptin on metabolic factors in Japanese patients with Type 2 diabetes. The changes at 24 weeks from the baseline of the diabetes-related indicators including Hemoglobin A1c (HbA1c), energy intake and body weight were compared between the canagliflozin and teneligliptin groups., Results: Seventy-five patients in the canagliflozin group and 70 patients in the teneligliptin group were analyzed. A significant decrease in HbA1c was observed in both groups. In the teneligliptin group, although energy intake was significantly reduced, there was no significant change in body weight. Conversely, in the canagliflozin group, although energy intake tended to increase, body weight significantly decreased., Conclusion: Canagliflozin and teneligliptin have different effects on the dietary status of patients with Type 2 diabetes. Our result suggests that canagliflozin can manage blood glucose without weight gain, even with increased energy intake., (© 2024. The Author(s).)

Background: Extra energy intake is commonly recommended for pregnant women to support fetal growth. However, relevant data regarding variations in energy intake and expenditure, body mass index and gestational weight gain (GWG) are frequently not considered. This study aimed to investigate how energy intake during pregnancy and gestational weight gain (GWG) are associated with birth weight.Methods: Early pregnant women were recruited into a Japanese nationwide prospective birth cohort study between 2011 and 2014. We analysed data of 89,817 mother-child pairs of live-born non-anomalous singletons after excluding births before 28 weeks or after 42 weeks. Energy intake during pregnancy was estimated from self-administered food frequency questionnaires (FFQ) and was stratified into low, medium, and high. Participants completed the FFQ in mid-pregnancy (mean 27.9 weeks) by recalling food consumption at the beginning of pregnancy. Effects of energy intake on birth weight and mediation by GWG were estimated using the Karlson-Holm-Breen method; the method separates the impact of confounding in the comparison of conditional and unconditional parameter estimates in nonlinear probability models. Relative risks and risk differences for abnormal birth size were calculated.Results: Mean daily energy intake, GWG, and birth weight were 1682.1 (533.6) kcal, 10.3 (4.0) kg, and 3032.3 (401.4) g, respectively. 6767 and 9010 women had small-for-gestational-age and large-for-gestational-age infants, respectively. Relative to low energy intake, moderate and high intakes increased adjusted birth weights by 13 g and 24 g, respectively: 58 and 69% of these effects, respectively, were mediated by GWG. Compared with the moderate energy intake group, the low energy intake group had seven more women per 1000 women with a small-for-gestational-age birth, whereas the high energy intake group had eight more women per 1000 women with a large-for-gestational-age birth.Conclusion: GWG mediates the effect of energy intake on birth weight. All pregnant women should be given adequate nutritional guidance for optimal GWG and fetal growth. [ABSTRACT FROM AUTHOR]

Objective: Self-reported energy intake (EI) estimation may incur systematic errors that could be attenuated through biomarker calibration. We aimed to confirm whether calibrated EI was comparable to total energy expenditure (TEE) measured using the doubly labelled water (DLW) technique. Design: Cross-sectional study. Setting: General older population from the Kyoto–Kameoka Study, Japan. Participants: This study included sub- and main cohorts of 72 and 8058 participants aged≥ 65 years, respectively. EI was evaluated using a validated FFQ, and calibrated EI was obtained using a previously developed equation based on the DLW method. TEE was considered representative of true EI and also measured using the DLW method. We used a Wilcoxon signed-rank test and correlation analysis to compare the uncalibrated and calibrated EI with TEE. Results: In the sub-cohort, the median TEE, uncalibrated EI and calibrated EI were 8559 kJ, 7088 kJ and 9269 kJ, respectively. The uncalibrated EI was significantly lower than the TEE (median difference = –1847 kJ; interquartile range (IQR): –2785 to –1096), although the calibrated EI was not (median difference = 463 kJ; IQR: –330 to 1541). The uncalibrated (r = 0·275) and calibrated EI (r = 0·517) significantly correlated with TEE. The reproducibility was higher for calibrated EI (interclass correlation coefficient (ICC) = 0·982) than for uncalibrated EI (ICC = 0·637). Similar findings were observed when stratifying the sample by sex. For medians, uncalibrated EI was lower (about 17 %) than calibrated EI in the main cohort. Conclusions: Biomarker calibration may improve the accuracy of self-reported dietary intake estimation. [ABSTRACT FROM AUTHOR]

Total daily energy expenditure (TEE) and physical activity level (PAL) are important for adequate nutritional management in athletes. The PAL of table tennis has been estimated to about 2.0: it is categorized as a moderateactivity sport (4.0 metabolic equivalents [METs]) in the Compendium of Physical Activities. However, modern table tennis makes high physiological demands. The aims of the current study were to examine (1) TEE and PAL of competitive table tennis players and (2) the physiological demands of various types of table tennis practice. In Experiment 1, we measured TEE and PAL in 10 Japanese college competitive table tennis players (aged 19.9 ± 1.1 years) using the doubly labeled water (DLW) method during training and with an exercise training log and self-reported energy intake. TEE was 15.5 ± 1.9 MJ⋅day-1 (3695 ± 449 kcal⋅day-1); PAL was 2.53 ± 0.25; and the average training duration was 181 ± 38 min⋅day-1. In Experiment 2, we measured METs of five different practices in seven college competition players (20.6 ± 1.2 years). Three practices without footwork were 4.5-5.2 METs, and two practices with footwork were 9.5-11.5 METs. Table tennis practices averaged 7.1 ± 3.2 METS demonstrating similarities with other vigorous racket sports. In conclusion the current Compendium of Physical Activities underestimates the physiological demands of table tennis practice for competition; the estimated energy requirement should be based on DLW method data. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate the relationship between locomotive syndrome (LS) and insufficient nutrient intake in young and middle-aged adults, independent of energy intake. Design/methodology/approach: The authors conducted a cross-sectional survey of a non-random sample of 219 adults aged 18 to 64 (175 men and 44 women) working in two companies in Japan, between December 2018 and March 2019. LS Stage 0 was classified as No-LS while Stages 1 and 2 were classified as LS. Nutrient intake was assessed using a brief-type self-administered diet history questionnaire and adjusted to the required energy intake for each participant. The criteria for sufficient intake of 22 nutrients were based on the Dietary Reference Intake for Japanese. Logistic regression model was used to analyze the association between LS and insufficient nutrient intake. Findings: In total, 234 employees participated in the LS examinations while 219 of them completed the questionnaire giving a response rate of 93.6%. LS Stages 1 or 2 were present in both men and women in all the age-stratified groups except for the women in their 60s. There was a significant association between LS status and insufficient intake of Vitamin K (odds ratio [95% confidence interval] 16.0 [range: 1.1–407]; p = 0.01) in women, but not in men. Research limitations/implications: The result suggests that attention should be paid to adequate Vitamin K intake in young and middle-aged women with LS. Future studies should be conducted using a larger and more diverse sample. Originality/value: To the best of the authors' knowledge, the present paper is the first study to show an association between LS in young and middle-aged adults and nutrients that are independent of energy intake. [ABSTRACT FROM AUTHOR]

This study explored the impact of varying energy availability (EA) on the 24-h interstitial fluid glucose concentration (IGC) in five elite male Japanese triathletes at a training camp. Measurements of IGC, energy and macronutrient intake, and exercise energy expenditure (EEE) through metabolic equivalents (METs) from training logs were conducted. Three subjects were evaluated over two 4-day periods, and two subjects over one 4-day period. Findings revealed significant correlations of daily mean nocturnal IGC with daily EA (r = 0.553, p = 0.001) and energy intake (EI) (r = 0.595, p < 0.001). However, no significant correlation was found between mean daily nocturnal IGC and EEE (r = -0.278, p = 0.124). Daytime IGC was ≥110 mg/dL for >50% of the time in all subjects, except on 1 day in one subject, and never fell <70 mg/dL. Therefore, daily EA may influence nocturnal IGC in elite male triathletes, although high daytime IGC levels were maintained without hypoglycemia.

Background: Japan is a country often subject to natural disasters, influenced by a rapidly increasing aging demographic. The current research aims to analyze the food distribution for elderly evacuees who were relocated to a care facility in Wajima City, administered by the non-profit organization Tokushukai Medical Assistant Team (TMAT), post the Noto Peninsula Earthquake on 1 January 2024. A significant portion of the shelter's inhabitants were elderly individuals., Methods: TMAT's operations began immediately after the calamity, concentrating on evaluating the nutritional content of meals provided during the initial and subsequent phases, along with a thorough nutritional assessment. During this process, researchers examined the meal conditions for evacuees, including the elderly and those with disabilities, observed the actual meal distribution at welfare centers, and discussed the challenges and potential solutions., Result: Throughout the TMAT mission, a total of 700 evacuees received assistance, with 65% being 65 years old or above. An analysis of the nutritional content of the 10 meal varieties served at the shelter revealed inadequate energy and protein levels for elderly individuals, particularly men, indicating the need for future enhancements., Conclusions: Following a detailed evaluation of TMAT's response to the Noto Peninsula earthquake, it was determined that the food provided in the shelters in the affected areas did not meet the nutritional needs of elderly individuals, especially men, based on nutritional analysis. To stress the importance of establishing an effective framework, it is recommended to promptly revise the emergency food provisions for the elderly population, considering they constitute the majority of the affected individuals.

Background: Improving diets requires an awareness of the need to limit foods for which excessive consumption is a health problem. Since there are limited reports on the link between this awareness and mortality risk, we examined the association between awareness of limiting food intake (energy, fat, and sweets) and all-cause mortality in a Japanese cohort study., Methods: Participants comprised 58,772 residents (27,294 men; 31,478 women) aged 35-69 years who completed baseline surveys of the Japan Multi-Institutional Collaborative Cohort Study from 2004 to 2014. Hazard ratios (HRs) for all-cause mortality and 95% confidence intervals (CIs) were estimated by sex using a Cox proportional hazard model, with adjustment for related factors. Mediation analysis with fat intake as a mediator was also conducted., Results: The mean follow-up period was 11 years, and 2,516 people died. Estimated energy and fat intakes according to the Food Frequency Questionnaire were lower in those with awareness of limiting food intake than in those without this awareness. Women with awareness of limiting fat intake showed a significant decrease in mortality risk (HR 0.73; 95% CI, 0.55-0.94). Mediation analysis revealed that this association was due to the direct effect of the awareness of limiting fat intake and that the total effect was not mediated by actual fat intake. Awareness of limiting energy or sweets intake was not related to mortality risk reduction., Conclusion: Awareness of limiting food intake had a limited effect on reducing all-cause mortality risk.

In Japan, nutritional guidance based on food-recording apps and food frequency questionnaires (FFQs) is becoming popular. However, it is not always recognized that different dietary assessment methods have different nutritional values. Here, we compared the compatibility of dietary intake data obtained from an app with those obtained from FFQs in 59 healthy individuals who recorded information regarding their diet for at least 7 days per month using an app developed by Asken (Tokyo, Japan). The diurnal coefficient of variation in total energy and protein intake was 20%, but those for vitamins B 12 and D were >80%, reflecting the importance of 7 days of recording rather than a single day of recording for dietary intake analyses. Then, we compared the results of two FFQs-one based on food groups and one based on a brief self-administered diet history questionnaire-for 7 days, as recorded by the app. There was a correlation coefficient of >0.4 for all the items except salt. Regarding the compatibility between the app and FFQs, the percentage errors for total energy and nutrients were >40-50%, suggesting no agreement between the app and the two FFQs. In conclusion, careful attention should be paid to the impact of different dietary assessment methods on nutrient assessment.

Background & Aims: Track and field sprinters must obtain an optimal body composition to improve sprint performance. To successfully change body composition, it is important to evaluate the estimated energy requirements (EER) and fluctuations in total energy expenditure (TEE). However, methods to accurately evaluate the EER and TEE in sprinters have not been fully investigated. The aim of this study was to compare currently used methods with the doubly labeled water (DLW) method, which is currently the gold standard for evaluating EER and TEE., Methods: Ten male collegiate sprinters participated in the study. We evaluated TEE DLW and compared it with the EER calculated using two equations used by the National Institute of Health and Nutrition (NIHN) and the Japan Institute of Sports Sciences (JISS). In addition, we evaluated the TEE from the activity record (AR) and triaxial accelerometer (ACC)., Results: TEE DLW (3172 ± 415 kcal/day) was not significantly different from EER NIHN (p = 0.076) or EER JISS (p = 0.967). In addition, there were no significant differences between TEE DLW and TEE AR (p = 0.218). However, two accelerometer-derived equations used to evaluate TEE were found to have underestimated (2783 ± 377 kcal/day, p < 0.001) and overestimated (3405 ± 369 kcal/day, p = 0.009) the TEE., Conclusion: Our results suggest that EER NIHN and EER JISS may be useful in evaluating the EER of collegiate male sprinters on a group basis, and AR may be more accurate than ACC in evaluating the TEE. These results may be helpful when considering nutritional support for male collegiate sprinters., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The nutrient intake of persons with diabetes placed on a low-carbohydrate diet remains unclear. This study aimed to assess nutrient intake in persons with type 2 diabetes mellitus treated with a low-carbohydrate diet. The brief-type self-administered diet history questionnaire was used to collect the dietary information of 335 outpatients at Kitasato Institute Hospital, while their clinical characteristics were collected from their electronic medical records. The median age, HbA1c level, and body mass index of the participants were 68 (60-74) years, 49 (45-55) mmol/mol [6.7 (6.3-7.2)%], and 24.0 (21.8-26.7) kg/m 2 , respectively; median energy intake was 1457 (1153-1786) kcal/day; and protein-energy, fat-energy, and available carbohydrate-energy ratios were 18.6 (15.7-21.4)%E, 36.8 (31.6-43.2)%E, and 34.6 (26.0-42.4)%E, respectively. As the available carbohydrate-energy ratio decreased, the fat-energy ratio increased significantly. The total dietary fibre and salt intake were 7.1 (5.6-8.4) g/1000 kcal and 6.5 (5.6-7.5) g/1000 kcal, respectively. Japanese individuals with type 2 diabetes mellitus placed on a low-carbohydrate diet had a fat-to-energy ratio exceeding 30%, while the fat-energy ratio increased as the carbohydrate-energy ratio decreased.

Meals comprising a staple grain, a main, and side dishes (SMS meals) promote good dietary intake, yet limited studies have examined their multifactorial relationship with dietary intake. We investigated how demographic characteristics, lifestyle, and dietary habits affect the relationship between SMS meal frequency and nutrient intake adequacy. This cross-sectional study analyzed survey data from 331 Japanese adults (208 men and 123 women) aged 30-69 years in February 2019. SMS meal frequency was evaluated according to respondents' answers to how many days a week they consumed ≥2 daily SMS meals. Dietary intake was evaluated using the brief self-administered diet history questionnaire. Differences in nutrient intake adequacy among groups according to SMS meal frequency were determined using multiple logistic regression. Less frequent SMS meals correlated with a lower intake of protein, water-soluble vitamins, and certain minerals, with more individuals falling below the estimated average requirement for nutrient intake. However, no relationship was found between SMS meal frequency and nutrient intake concerning tentative dietary goals for preventing lifestyle-related diseases. Our findings indicate that adopting SMS meals could achieve adequate intake of some nutrients and enhance overall diet quality among Japanese adults.

This study aimed to compare the differences in the intake of food groups and nutrients between Japanese adults who consumed the recommended daily vegetable intake (350 g/day) and those who did not. Dietary information was obtained from one-day dietary records collected from the 2016 National Health and Nutrition Survey, which was conducted in 46 prefectures in Japan. The participants aged ≥20 years ( n = 21,606; 53.8% women) were classified into the < and ≥350 g/day groups. Inter-group differences for 17 food groups and 27 nutrients were assessed as percentages of consumers (food groups only) and energy-adjusted intake (units/MJ/d or % of total energy intake). Overall, 29% of participants consumed ≥350 g/day of vegetables. The ≥350 g/day group had a higher percentage of consumers and energy-adjusted intakes for all vegetable subgroups than the <350 g/day group. For other food groups, the ≥350 g/day group had higher percentages of consumers for all food groups, except for cereals, eggs, and condiments and seasonings, which showed no significant differences. However, the ≥350 g/day group had a significantly higher energy-adjusted intake for potatoes and other tubers, mushrooms, meats, and condiments and seasonings but a significantly lower value for cereals, eggs, savoury snacks and confectionaries, and beverages. The ≥350 g/day group had a significantly higher intake of almost all (25/27) nutrients, including sodium, than the <350 g/day group. Participants with vegetable intake ≥350 g/day might have a more favourable intake of food groups and nutrients; however, watching for salt intake is necessary when promoting vegetable intake., Competing Interests: None., (© The Author(s) 2024.)

Objective: Few studies have reported intakes of fermented foods with their clear definitions. This study aimed to identify fermented foods and beverages consumed in Japan based on international definitions and to estimate their intake and contribution to energy and nutrients., Design: Data from a 16-d (four non-consecutive days within each season at 3-month intervals) semi-weighted dietary records (DR) were used. To identify 'entirely fermented foods' and 'partially fermented foods', a literature search on food processing and ingredients was conducted for all foods that appeared in the DR. For 'partially fermented foods', only the weight of the fermented food component was included in the estimation of total fermented food intake., Setting: Four regions in Japan: Osaka, Nagano, Tottori and Okinawa., Participants: Two-hundred forty-two apparently healthy Japanese adults aged 31-81 years., Results: Of the 1396 kinds of unique foods that appeared in the DR, 101 were 'entirely fermented foods' and 104 were 'partially fermented foods'. The mean intake of fermented foods was 438 g/d per person (17 % of the total weight). They were mainly derived from beer, coffee, bread and yogurt. The mean contribution of fermented foods to the total energy intake was 18 %. For nutrients, the contribution to total intake was high to Na (46 %), Mg (22 %) and Ca (20 %)., Conclusions: Fermented foods account for approximately one-fifth of the total weight and energy of dietary intake and are important contributors to some nutrients in Japanese adults.

Background: We aimed to clarify whether differences in food group intake according to household income have changed over the last decade in Japanese people aged 20 years or older., Methods: This cross-sectional study was based on the 2010, 2014, and 2018 National Health and Nutrition Surveys in Japan. Food intake was assessed using a 1-day semi-weighed household dietary record. The participants were categorized into three groups based on their income. The mean of each food intake according to the income group was estimated by adjusting for age, occupation, and number of participants from the same household. The significance of the interaction terms between income and survey year was evaluated to assess the change in income-related differences in food intake over time., Results: Cereal intake was lower in the middle- and the highest-income groups than in the lowest-income group, regardless of sex, and the interaction between income and year was nonsignificant for cereal intake. In the former two surveys, vegetable intake was higher among the highest-income women, while in the 2018 survey, the vegetable intake decreased in the women in the middle- and the highest-income groups. The interaction between income and year was significant for vegetable intake among the women. For other foods, the differences in intake among the income groups did not significantly change over time., Conclusion: The tendency for lower cereal intake in the higher-income groups was consistent over time in both the sexes, and the tendency for higher vegetable intake in the highest income women disappeared over time.

Literature reports suggest that subjective sleep quality is associated with nutrient intake in elderly people and workers. However, few studies have suggested an association between objective sleep quality and dietary intake in adolescents and young women. We hypothesized that objective sleep quality is associated with dietary intake in adolescents and young women. We evaluated the association between energy and nutrient intake and objective sleep quality in adolescents and young Japanese women. In a cross-sectional study of 80 women aged 18-27 years, dietary intake was assessed using the self-administered diet history questionnaire. Objective sleep quality was assessed by actigraphy. Lifestyle characteristics, dietary habits, and mental health were assessed using specific questionnaires. Subjects were classified into 3 groups according to sleep efficiency (SE <80%, 80%-85%, and ≥85%), and the relationships between dietary intake and objective sleep quality were statistically evaluated. No significant differences occurred in lifestyle characteristics, physical activity levels, eating behavior, and mental health status among the 3 SE groups. Energy intake was significantly lower in the low-SE group than in the middle- (P =.004) and high- (P =.015) SE groups. Protein intake was significantly lower in the low-SE group than in the high-SE group (P =.034). The mean energy-adjusted intakes of vitamin K, vitamin B 2 , potassium, magnesium, iron, zinc, copper, and tryptophan were significantly lower in the low-SE group than in the high-SE group. Adequate energy intake and a high-quality diet including vitamins, minerals, and tryptophan may result in high sleep quality and help prevent sleep problems. [ABSTRACT FROM AUTHOR]

Aim: Selecting optimal energy intake during diet therapy for older patients with diabetes mellitus is difficult because of the large differences in physical function and comorbid diseases. In Japan, although requirements for total energy intake are calculated by multiplying a person's standard bodyweight (BW) by the amount of physical activity, evidence supporting the application of this method among older people is limited. Therefore, we aimed to assess optimal energy intake by evaluating the relationship between energy intake and mortality in older patients. Methods: We evaluated data from a 6‐year prospective follow up of 756 older patients with diabetes mellitus, and the association between baseline nutrient intake and mortality. Total energy intake and nutrients were evaluated, and energy intake per actual BW was categorized into quartiles (Q). Cox regression analysis was used for statistical analyses. Energy intake per standard BW or age‐related target BW was statistically analyzed using the same protocol. Results: Analysis of energy intake per actual BW showed that hazard ratios for mortality was significantly higher in Q1 and Q4. Similar associations were found for energy intake per standard or target BW. Subgroup analysis showed that mortality rate was the lowest in Q2 in the young‐old population and in Q3 in the old‐old population. Conclusions: A U‐shaped relationship was observed between energy intake per BW and mortality in older patients with diabetes mellitus, which suggests that the optimal energy intake per actual or target BW should encompass a wide range to prevent malnutrition and excessive nutrition in these patients. Geriatr Gerontol Int 2020; 20: 59–65. [ABSTRACT FROM AUTHOR]

A 76-item food frequency questionnaire (FFQ) was developed to investigate nutritional epidemiology in urban residents in Japan. The authors prepared two food models-a life-size three-dimensional model and a life-size two-dimensional photograph-to assess the FFQ portion size. The validity of the FFQ was verified using the two food models by comparing them with 16-d weighted dietary records (WDRs). Validation was conducted by comparing the FFQ1 findings with those obtained with the WDR, which is regarded as the gold standard, and reproducibility was verified by comparing the findings from FFQ2 and FFQ1. After completion of the WDR, the participants were randomized into two groups. In one group, the FFQ was conducted using life-size three-dimensional models (3D-FFQ) to estimate the portion size. In the other group, the FFQ was administered using life-size photo collection (2D-FFQ). Regarding validity, the median values (range) of Pearson's correlation coefficients for the energy and nutrient intake of the 32 items by the WDR and FFQ1 were r=0.53 (0.30-0.68) in the 3D-FFQ and r=0.57 (0.33-0.87) in the 2D-FFQ. When FFQs with 2D or 3D food models and two different portion sizes were compared with regard to the intake of certain food groups, energy, and nutrients, both the 2D-FFQ and 3D-FFQ provided good correlation coefficients with the WDR.

To ascertain whether habitual green tea consumption is associated with sarcopenia among Japanese older adults, using the screening tool for sarcopenia (SARC-F). This cross-sectional study in Mukawa, Hokkaido, Japan, was conducted between June and September 2022 and included 364 Japanese participants older than 65 y. Habitual green tea consumption and energy intake were ascertained using a validated self-administered food frequency questionnaire. Sarcopenia was evaluated using the SARC-F. Multivariable logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of sarcopenia risk across participant tertiles of green tea consumption, with adjustments for age, sex, body mass index, living alone, habitual exercise, walking hours, current smoking status, current alcohol consumption status, energy intake, protein intake, vegetable intake, and fruit intake. In this study of 364 participants (154 men and 210 women), the prevalence of sarcopenia risk was 9.3%. The multivariable-adjusted OR [95% CI] of green tea consumption for ≥1 cup/d compared with that of <1 cup/wk of sarcopenia was 0.312 [0.129-0.752]. Higher habitual green tea consumption was inversely associated with sarcopenia among Japanese older adults. Further longitudinal studies are required to confirm these findings.

This study examined the relationship between the frequency of consuming cold or hot meal/drink during summer and the nutritional status, appetite, and energy intake among Japanese older people. The cross-sectional study was conducted in August 2021, targeting 60 adults aged 65 y and older. The Mini Nutritional Assessment (MNA) was used for nutritional status evaluation, the Simplified Nutritional Appetite Questionnaire (SNAQ) for appetite scoring, and food frequency questionnaire to assess energy intake. Participants reported on the frequency of consuming cold or hot meal/drink during the summer. Those who reported consuming hot meals "moderate" (p=0.033) or "frequent" (p=0.005) during summer had a higher BMI than those who reported minimal consumption. Participants who reported "frequent" consumption of hot meals in summer had higher MNA scores than those who reported "minimal" consumption (p=0.014). Participants who reported a "frequent" consumption of hot meals had higher SNAQ scores compared to those who reported "minimal" (p<0.001) or "moderate" (p=0.001). Similarly, participants who reported a "frequent" consumption of hot drinks had higher SNAQ scores than those reporting "minimal" (p=0.021) or "moderate" (p=0.008). The nutritional status and appetite during summer in Japanese older people were associated with the frequency of consuming hot meals and drinks.

Background: Concerns regarding the impact of screen-based sedentary behavior on health have been increasing. Therefore, the present study investigated the longitudinal relationship between multiple screen time and nutrient intake in children and adolescents., Methods: The present study was conducted utilizing 3 years longitudinal data. Study subjects were 740 Japanese children aged between 6 and 12 years at baseline and between 9 and 15 years in the follow-up. Screen-based sedentary behavior was assessed using screen time, including television (TV) viewing, personal computer (PC) use, and mobile phone (MP) use. The main outcomes were the intakes of nutrients. Mixed effect multivariate linear regression analyses were used to examine the longitudinal relationship between screen-based sedentary time and nutrient intake. Covariates included in the multivariable analysis consisted of sex, age, solitary eating, skipping breakfast, staying up late, and body weight status, as confounders, and physical inactivity, as mediator., Results: In boys, a longer total screen time longitudinally correlated with higher intake of energy and lower intakes of protein, dietary fiber, minerals, and vitamins. In girls, longer total screen time longitudinally associated with higher intake of sucrose and lower intakes of protein, minerals, and vitamins. In boys, a longer TV viewing time was associated with higher intake of sucrose and lower intakes of protein, minerals, and vitamins. In girls, a longer TV viewing time was associated with higher intake of carbohydrates and lower intakes of protein, fat, minerals, and vitamins. In boys, relationships were observed between a longer PC use time and higher intakes of energy as well as lower intakes of protein, minerals, and vitamins. Relationship was observed between longer PC use time and lower intakes of minerals in girls. An increased MP use time was associated with higher intakes of energy, and lower intakes of protein, sucrose, dietary fiber, minerals, and vitamins in boys. A longer MP use time was associated with higher intakes of fat, and salt as well as lower intakes of carbohydrates, protein, minerals, and vitamins in girls., Conclusions: The present results revealed that longer screen-based sedentary behaviors were longitudinally associated with nutrient intake in children and adolescents. Future study is needed to elucidate these relationships.

Introduction: The combined effects of energy intake (EI) and physical activity (PA) on obesity have been poorly investigated. We have investigated the combined effects of EI and PA quantitatively in Japanese men and women with type 2 diabetes. Methods: Data on 1395 patients with type 2 diabetes who attended 25 diabetes clinics located throughout Japan, obtained by questionnaire, were analyzed. A logistic regression model was used to calculate the odds ratio for obesity. Results: Multi-adjusted odds ratios for the top versus the bottom tertile of EI and the bottom versus the top tertile of PA were 1.39 (95% confidence interval [CI] 1.02–1.89) and 1.64 (95% CI 1.22–2.22), respectively. The combination of EI (kcal/day) ≥ 1967 and PA (metabolic equivalents [METs] h/week) ≤ 9.9 for men and of EI ≥ 1815 and PA ≤ 8.3 for women were significantly associated with obesity. Conclusions: The existence of "allowable maximum EI" and "required minimum PA" that is significantly associated with "not being obese" is implied, suggesting the need for lifestyle education for Japanese patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Information on a whole array of characteristics associated with dietary misreporting in a representative sample in each country is still limited. Using data from the 2012 National Health and Nutrition Survey, Japan, we investigated the prevalence and characteristics of under- and over-reporting of energy intake among 19,986 Japanese adults aged >=20 years.Methods and Study Design: Each individual's energy intake was calculated based on a 1-day semi-weighed dietary record. Under-, plausible, and over-reporters were identified based on the 95% confidence limits 1) for agreement between the ratio of energy intake to basal metabolic rate and a physical activity level for sedentary lifestyle (1.55), and 2) of the expected ratio of energy intake to estimated energy requirement of 1.0, assuming 'low active' level of physical activity.Results: Almost all subjects (>=92.8%) were classified as plausible reporters by any of the methods applied, with very low percentages of under- and over-reporters (<=6.3% and <=2.0%, respectively). Under-reporting was associated with younger age, overweight and obesity (compared with normal weight), current smoking (compared with never smoking), no alcohol drinking (compared with drinking everyday), and household consisting of a single person (compared with that consisting of two persons). Over-reporting was associated with gender (female), normal weight (compared with overweight), and household consisting of a single person.Conclusions: Overall mean energy intake obtained in this sample of Japanese adults appears to be plausible, but caution should be exercised when assessing the plausibility of energy intake in some subgroups. [ABSTRACT FROM AUTHOR]

Background and Objectives: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of >=30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0 kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown.Methods and Study Design: A retrospective chart review was conducted in patients with BMI of >=25.0 kg/m2 in an emergency intensive care unit (EICU). Patients were categorized into two groups by average daily energy intake during the first week in the EICU, with Group A at <50% of requirement and Group B at >=50%.Results: A total of 72 patients with a median BMI of 27.5 kg/m2 were included in the study. No significant differences between the groups were observed for all-cause mortality, ICU-free days, or length of hospital stay. The number of ventilator-free days (VFDs) was significantly higher in Group A than Group B (20.0 [15.5-24.5] vs 17.0 [2.0-21.0] days; p=0.042). On multiple adjusted analysis, however, we found that %energy intake/requirement was not independently associated with VFDs (regression coefficient=0.019; 95% confidence interval, -0.115-0.076).Conclusions: Energy intake in the first week in the EICU did not influence clinical outcomes in critically ill, overweight Japanese patients. Confirmation of these results in larger, randomized trials is required. [ABSTRACT FROM AUTHOR]

This study assessed the validity of dietary balance scores (DBSs) by investigating the association between DBSs and nutrient adequacy (NA) in two Japanese populations. The participants were 65 community-dwelling Japanese from Tokushima Prefecture and 2,330 community-dwelling Japanese from Aichi Prefecture. Based on food frequency questionnaires or 3-day dietary records, we obtained 18 food groups. The NA score integrates nine beneficial nutrients and two nutrients that should be limited. We calculated four different DBSs: DBS1 consisted of five food groups (score range:0?20), DBS2 consisted of nine food groups (score range:0?36), DBS3 consisted of eight food groups (score range:0?32), and DBS4 consisted of 10 food groups (score range:0?40). Both the Spearman rank correlation coefficient with NA and the area under the receiver operating characteristic curve (AUC-ROC) for the nine beneficial nutrients were then estimated to test the performance of each DBS in predicting nutrient intake. The results showed that DBS1 and DBS4 were positively correlated with NA, while the AUC-ROC showed that DBS4 could moderately discriminate individuals with adequate intake levels of all nine nutrients. These findings suggest DBSs (especially DBS4) are useful in assessing dietary balance in middle-aged and older community-dwelling Japanese. J. Med. Invest. 70 : 377-387, August, 2023.

Background: Although the distribution of energy intake throughout the day appears to impact overall daily energy intake, little is known about the ad libitum distribution of energy intake. Objective: Our aim was to investigate associations between the distribution of energy intake during the day and subsequent or overall energy intake, and food choice in free-living adults. Design: A total of 119 women and 116 men completed 16-day semi-weighed dietary records. The longitudinal dietary intake data for each participant were analyzed using a mixed model to examine the effect of energy intake at various times of day on subsequent or overall energy intake. Results: Mean proportion of total energy intake in the morning (4:00 a.m.–10:29 a.m.), afternoon (10:30 a.m.–4:59 p.m.) and evening (5:00 p.m.–3:59 a.m.) meal was 22.6%, 33.8% and 43.6% in men, and 24.7%, 36.5%, 38.8% in women, respectively. Proportion of energy intake (%) in the morning meal was significantly and negatively associated with energy intake (kcal) in the subsequent afternoon and evening meals, and consequently in the whole day in both sexes. This significant and negative association was also observed for proportion of energy intake (%) of fat, but not of carbohydrate or protein, in both sexes. Proportion of energy intake (%) in the morning meal was negatively associated with overall energy intake (kcal) from the group of meats, fish, and eggs in both sexes, and from the group of confectioneries and soft drinks in women. Conclusions: More energy in the morning meal may reduce energy intake, especially that from fat, in the subsequent meals, and consequently in the whole day. [ABSTRACT FROM AUTHOR]

White rice is a dominant grain-based food in Japan, but excess intake of polished rice may cause obesity. Barley is a grain-based food, similar to white rice, but it has the potential to control appetite and reduce energy intake. We investigated the effect of cooked white rice with high β-glucan barley on appetite and energy intake. The study was conducted as a randomized crossover design with twenty-one healthy Japanese women [mean ± standard deviation body mass index (BMI) 23.3 ± 0.7 kg/m]. Subjects consumed a breakfast of cooked white rice with high β-glucan barley (BAR) or white rice (WR), followed by an ad libitum lunch and dinner. Energy intake was measured at the lunch and the dinner using plate waste. Subjects' perception scores on hunger, fullness, satiety, and prospective food consumption were assessed using a visual analogue scale (VAS) before and after the breakfast, lunch and dinner. BAR significantly reduced the VAS scores of hunger and prospective food consumption, and increased fullness before lunch compared to WR ( P = 0.032, 0.019 and 0.038, respectively). Energy intake at lunch and the cumulative energy intake (lunch + dinner) subsequent to BAR consumption were significantly lower than WR ( P = 0.035 and 0.021, respectively). BAR was able to modulate appetite and reduce energy intake. The combination of white rice with high β-glucan barley could play a beneficial role in preventing and treating obesity and other obesity-related metabolic diseases. [ABSTRACT FROM AUTHOR]

Purpose: Weight retention during the postpartum period is critical for the later development of obesity in women. Traditional physical activity is frequently discontinued because of incompatibility with mothers' agenda (i.e., baby care). In the present study, active video games (AVG) are proposed for postpartum women to improve their body composition. Methods: Thirty-four postpartum women (body mass index = 24.5 ± 3.4 kg•m) were randomized to an AVG group or a control group. Subjects assigned to the AVG group were given a Wii Nintendo console with the game Wii Fit Plus for 40 d. The two groups were tested for weight, body mass index, body fat mass, waist and hip circumferences, and other anthropometric parameters. Physical fitness, energy expenditure, energy intake, and adverse events were also investigated. Results: The AVG group lost more weight than the control group (-2.2 ± 0.9 vs. -0.5 ± 0.7 kg, P < 0.001). They also exhibited more important reductions of BMI, waist and hip circumferences, and body fat (P < 0.05). During the 40-d period, subjects expended an estimated 4682 ± 2874 kcal just by playing AVG. Daily energy intake was reduced by 206 ± 559 kcal. There were significant positive correlations between playing frequency, total playing time, total energy expenditure during the 40-d period, and decrease in daily energy intake respectively, and weight loss (P < 0.05). Playing time data suggested no conflict with baby care activities. Conclusions: AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relative validity of the Meal-based Diet History Questionnaire (MDHQ) for estimating nutrient intake. Dietary data were obtained from 111 Japanese women and 111 Japanese men, using the online MDHQ and the 4-non-consecutive-day weighed dietary record (DR). The number of nutrients (total n = 46) showing no significant mean differences between estimates from the online MDHQ and DR (with energy adjustment by the density model) was 17 among women and 12 among men. The median value (25th and 75th percentiles) of the Pearson correlation coefficients between the online MDHQ and DR estimates was 0.54 (0.35-0.57) among women and 0.45 (0.25-0.53) among men. Bland-Altman plots for energy-providing nutrients indicated wide limits of agreement (and proportional bias for protein) with overall underestimation of protein and fat and overestimation of carbohydrate by the online MDHQ. Similar results were found when the paper version of the MDHQ (completed after the DR) was examined. For example, the median value of the Pearson correlation coefficients was 0.54 for women and 0.45 for men. This study suggests that the MDHQ has an acceptable ability to rank individuals according to intakes of a wide range of nutrients.

Unlike in many industrialised countries, the high proportion of young women who are underweight in Japan has been a long-term problem. We evaluated trends in food group intake according to body size among young Japanese women using data from the National Health and Nutrition Survey 2001-2019. Overall, 13,771 Japanese women aged 20-39 years were included. A 1-day household-based dietary record was used to estimate food intake. Foods were classified into 34 groups based on the Standard Tables of Food Composition in Japan. The trend of food group intake was analysed using the Joinpoint Regression Program. The proportion of young women who were underweight was consistently around 20%, while obesity among young women increased between 2001 (10%) and 2019 (13%). A decreased trend in fish and shellfish and seaweed intake and an increased trend in meat and soft drink intake were observed among young women. Decreased trends in the intake of fruit and dairy products were observed in young women who were not obese. An increased trend in the intake of confectionaries was observed in young women who were obese. This study suggests that the types of unhealthy eating habits may differ according to body size among young Japanese women.

This cross-sectional study aimed to investigate the relationship between food sources of free sugars and weight status among children and adolescents aged 2-19 years in Japan (1438 males and 1340 females) from the 2016 National Health and Nutrition Survey, Japan. We estimated the percentage of energy intake (% E) from free sugars from total food sources (FS total ), solid foods (FS solids ), and beverages (FS liquids ), using one-day weighed dietary record data. Weight status was determined based on body mass index (BMI) z-scores and the prevalence of overweight and obesity. The mean energy intakes of FS total , FS solids , and FS liquids were 5.8%, 4.1%, and 1.8% in males and 6.2%, 4.6%, and 1.6% in females, respectively. After controlling for potential confounding factors, including energy intake, there was no association of free sugars intake from all food sources with BMI z-scores or with the prevalence of overweight and obesity, except for a marginal association between higher FS solids and lower estimated BMI z-scores in females ( p = 0.05). The present findings indicate that among children and adolescents in Japan, who have a relatively low mean intake of free sugars, consuming free sugars from any food source is unlikely to have an adverse effect on weight status.

(1) Background: Dietary intake may have a remarkable effect on sleep because skipping breakfast and having a late dinner affects many sleep parameters. Breakfast is the most important meal of the day for children and adults to maintain morning chronotype. We examine whether breakfast style is associated with nutrient intake and sleep factors. (2) Methods: This cross-sectional analysis, with a large sample size of 2671 (766 men and 1805 women aged 20-60 years after data brush-up), was based on data obtained from an online survey. Correlation analysis was performed using Spearman's rank correlation test. The Kruskal-Wallis's test followed by post hoc Dunn's multiple comparison test was used to evaluate the interaction between sleep factors and breakfast categories. Multiple regression analyses were performed to identify variables associated with multiple confounding factors. Dietary data were analyzed using approximately one-month average dietary records from the application. The basic characteristics of the participants (age, sex, and BMI) and other lifestyle-related factors (sleep and physical activity) were obtained accordingly. Sleep parameters including the timing of weekday sleep onset, weekday wake-up, weekend (free day) sleep onset, weekend wake-up, sleep, and midpoints of sleep phase were calculated for each participant. We categorized participants' breakfast types into five groups: (1) Japanese meal, where breakfast may contain Japanese ingredients such as rice; (2) Western meal, where breakfast may contain bread; (3) alternating eating patterns of Japanese and Western meals; (4) cereals and supplements, where breakfast may contain cereals or supplements and energy bars; and (5) skipped breakfast (no breakfast). (3) Results: The midpoint values of the sleep phase on weekends adjusted for sleep debt on work days (MSFsc) related to chronotype were higher in women, suggesting that they may prefer eveningness. Participants with obesity, young age, and low physical activity preferred eveningness with longer sleep durations. Intake of Japanese-style breakfast was significantly associated with early wake-up time on both weekdays and weekends. Cereal-style breakfast intake was significantly associated with late wake-up on both weekdays and weekends. Intake of macronutrients such as protein, fat, carbohydrate, and sodium at breakfast time was positively and strongly associated with the intake of Japanese breakfast, whereas macronutrients were negatively associated with the intake of cereal breakfast. Among micronutrients, vitamin K was positively correlated with Japanese breakfast and negatively correlated with cereal breakfast; (4) Conclusions: Japanese-style breakfast is associated not only with morning preference but also with high intake of macro- and micronutrients.

We examined the relative validity of food intake for each meal type (breakfast, lunch, dinner, and snacks) and overall food intake obtained through the Meal-based Diet History Questionnaire (MDHQ). In total, 222 Japanese adults (111 for each sex) aged 30-76 years completed the web version of the MDHQ and then the 4-non-consecutive-day weighed dietary record (DR). The number of major food groups ( n = 24 in total) for which no statistically significant difference was observed between median intakes estimated using the DR and MDHQ ranged from 8 (snacks) to 12 (dinner) among women, and from 8 (breakfast) to 13 (lunch) among men. The median values of the Spearman's correlation coefficients between the MDHQ and DR estimates ranged from 0.28 (dinner) to 0.54 (breakfast) among women, and from 0.24 (dinner) and 0.60 (breakfast) among men. Bland-Altman analyses generally showed wide limits of agreement and proportional bias. Similar results were obtained using the paper version of the MDHQ, which was completed after conducting the DR. In conclusion, the MDHQ has a satisfactory ability to estimate median intake and rank individuals according to consumption for many food groups, despite a limited ability to estimate food group intakes on an individual level.

Increased vegetable intake contributes to better health for people. The distribution of not-for-sale vegetables is an important source of vegetable intake in Japan. This study examined the impact of prefecture-level yield of not-for-sale vegetables on vegetable intake in Japan. This study regarded the increase in yield of not-for-sale Chinese cabbage in Nagano Prefecture in 2012 as a natural experiment. The years 2012 and 2016 were the large-scale survey years of the Japanese National Health and Nutrition Survey. Therefore, the effect of the change in prefecture-level yield of not-for-sale vegetables on vegetable intake was evaluated by comparing the changes in Chinese cabbage intake in Nagano between 2012 and 2016 with those of other prefectures classified in the same regional block as Nagano. Statistical analysis was performed using general linear models to examine the interaction of year and prefecture with Chinese cabbage intake. Consequently, the regression coefficient for the interaction term was -3.38 (95% CI, -9.59-2.83), that of the model adjusted for basic characteristics and energy intake was -2.99 (95% CI, -9.22-3.24), and that of the model adding health-related variables was -5.03 (95% CI, -12.40-2.34). The prefecture-level yield of not-for-sale vegetables typically had a minor effect on vegetable intake.

Objectives: The aim of the present study was to identify the habitual dietary intake and stress fractures history among sport types and to determine the factors related to the risk of stress fractures among Japanese female collegiate athletes., Methods: This study involved 589 Japanese female collegiate athletes. We investigated habitual dietary intake (food frequency questionnaire), eating attitude (EAT-26), demographics, training status, participation in sports events, history of injury in their career, and menstrual status using a self-reported questionnaire. A multivariate logistic regression analysis was conducted to determine the risk factors associated with stress fractures., Results: Thirty percent of the total participants had a history of stress fractures, although most participants had no risk of eating disorders. Most Japanese female collegiate athletes consumed less than the dietary reference intake levels for the general Japanese female population aged 18-29 years and the athletes' dietary guideline for key bone-health nutrients such as calcium and vitamin D. The multivariate logistic regression analysis revealed body mass index (BMI; OR, 0.91; 95% CI, 0.82-0.99) and energy intake (EI; OR, 0.99; 95% CI, 0.99-0.99) as significant and independent factors in the history of stress fractures among Japanese female collegiate athletes ( p  = 0.047 and p  = 0.039, respectively)., Conclusions: Japanese female collegiate athletes failed to meet energy and nutrient recommendations; BMI and EI were significantly associated with stress fractures, a diet that includes an appropriate amount of energy is essential.

Objective: Although there is growing evidence suggesting that eating patterns are important determinants of health status, comprehensive information on patterning of eating behaviours is almost lacking. The aim of this cross-sectional study was to describe eating patterns in Japan., Design: Information on actual eating behaviours was collected using 2-d dietary record in each season over a year (total 8 d). Eating occasions were defined as any discrete intake occasion (with a discrete start clock time and name) except for eating occasions consisting of water only, which were excluded., Setting: Japan., Participants: A nationwide sample of 4032 Japanese aged 1-79 years., Results: The mean value of eating frequency of meals (i.e. breakfast, lunch and dinner), snacks and total eating occasions was 2·94, 1·74 and 4·68 times/d, respectively. The mean clock time for the start of breakfast, lunch and dinner was 07.24, 12.29 and 19.15 h, respectively. The mean time spent consuming breakfast, lunch, dinner and snacks was 19, 25, 34 and 27 min/d, respectively. On average, variability (i.e. average of absolute difference from mean) of meal frequency was small compared with that of snack frequency and total eating frequency. Both mean variability of clock time for the start of eating (<1 h) and mean variability of time spent on meals (<10 min/d) were also small. Conversely, mean variability of time spent on snacks was large (>18 min/d)., Conclusion: The present findings serve as both a reference and an indication for future research on patterning of eating behaviours.

This study aimed to develop a digital photographic food atlas as a portion size estimation aid. Commonly consumed foods were identified from the 5512-day weighed dietary records of 644 Japanese adults. Portion sizes were determined based on the market research and distribution of food consumption in the dietary records. Each food item was classified into one of two photo types: a series of photographs showing gradually increasing portion sizes or guide photographs representing a range of portion sizes and food varieties in one photograph. Photographs of the food were taken at an angle of 42°, along with appropriate reference objects such as chopsticks. In total, 209 food and dish items were included in the food atlas. Series of photographs were taken for 105 items that are not usually served in predetermined amounts (e.g., rice and pasta), whereas guide photographs were taken for 104 items usually served in predetermined amounts (e.g., bananas and cookies). Moreover, photographs were taken for 12 kinds of household measurement items, such as cups and glasses. The food atlas could be a valuable tool for estimating the portion size in dietary surveys. Evaluating the validity of this food atlas for portion size estimation is warranted.

Abstract: Objective: Evidence on factors associated with misreporting of energy intake in children and adolescents is sparse, particularly in non-Western countries. We examined the characteristics of under- and over-reporters of energy intake in Japanese children and adolescents. Methods: This study included 25 761 Japanese boys and girls 6 to 15 y old. Energy intake was assessed using a self-administered diet history questionnaire developed for Japanese children and adolescents. Estimated energy requirement was calculated from self-reported body weight with the use of equations from the Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU) Expert Consultation Report on Human Energy Requirements. Under-reporters, acceptable reporters, and over-reporters of energy intake were identified based on the ratio of energy intake to estimated energy requirement (<0.76, 0.76 to 1.24, and >1.24, respectively). The risk of being an under- or over-reporter of energy intake compared with being an acceptable reporter was analyzed using logistic regression. Results: The percentages of under-, acceptable, and over-reporters of energy intake were 31.6%, 53.2%, and 15.2%, respectively. Under-reporting was associated with female sex, older age, overweight and obesity, low parental education, and completion of the dietary questionnaire without the cooperation of parent(s)/caregiver(s). Over-reporting was associated with younger age, normal weight, low parental education, and completion of the dietary questionnaire by the child/adolescent alone (compared with completion by the child/adolescent and parent[s]/caregiver[s]). Conclusions: Although under- and over-reporting of energy intake were common and differential in this study of Japanese children and adolescents, the cooperation of parent(s)/caregiver(s) in answering the dietary questionnaire seemed to improve the quality of dietary intake data. [Copyright &y& Elsevier]

The importance of dominance status to foraging and ultimately survival or reproductive success in wild primates is known; however, few studies have addressed these variables simultaneously. We investigated foraging and social behavior among 17 adult female Japanese macaques ( Macaca fuscata) on Kinkazan Island, northern Japan, from September to November in 2 consecutive years (2004 and 2005) to determine whether interannual variation in food availability was related to variation in agonistic interactions over food resources and the feeding behavior of individuals of different dominance rank. We compared energy obtained with daily energy requirements and also examined the effect of variation in feeding behavior on female survival and reproductive success. Fruiting conditions differed considerably between the 2 yr: of four nut-producing species, the nuts of only Torreya nucifera fruited in 2004, whereas all four species, particularly Fagus crenata, produced nuts in abundance in 2005. The abundance and average crown size of trees of Torreya nucifera were smaller than those of Fagus crenata, and there was a higher frequency of agonistic interactions during 2004, when dominant, but not subordinate, individuals were able to satisfy daily energy requirements from nut feeding alone through longer nut feeding bouts. In contrast, all macaques, regardless of their dominance rank, were able to satisfy their energy requirements by feeding on nuts in 2005. Subordinate macaques appeared to counter their disadvantage in 2004 by moving and searching for food more and maintaining larger interindividual distances. Several lower-ranking females died during the food-scarce season of 2004, and only one dominant female gave birth the following birth season. In contrast, none of the adult females died during the food-scarce season of 2005, and 12 females gave birth the following birth season. These findings suggest that an interaction between dominance rank and interannual variation in food availability are related to macaque behavior, survival, and reproduction. [ABSTRACT FROM AUTHOR]

Genome-wide association studies have identified the cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) gene as a novel risk factor for type 2 diabetes mellitus. Application of this genetic marker for prevention of type 2 diabetes and metabolic syndrome (MetS) in healthy populations has not yet been evaluated. The authors examined the effects of a CDKAL1 polymorphism (rs9465871) on metabolic phenotype and of gene-lifestyle (CDKAL1-energy intake) interaction on MetS in a cohort of apparently healthy Japanese men examined in 2003. The CC genotype of the CDKAL1 variant was associated with elevated glycosylated hemoglobin A1c (HbA1c) levels. The prevalence of MetS was 25.6% for CC and 16.3% for TT + CT (odds ratio = 2.18, 95% confidence interval: 1.06, 4.48; P = 0.035). When dietary energy intake was accounted for, the variant's effect on HbA1c was observed in the highest energy-intake group (mean: CC, 5.6% (standard deviation, 1.7); TT + CT, 5.0% (standard deviation, 0.5); P = 0.025). In addition, the positive association between HbA1c and energy intake was stronger in subjects with the CC genotype than in subjects with TT + CT. These results suggest that the interaction between the CDKAL1 polymorphism and dietary energy intake influences the dysglycemic phenotype leading to MetS, possibly through impaired insulin secretion. The CDKAL1 polymorphism may be a marker for MetS in the Japanese population. [ABSTRACT FROM PUBLISHER]

Objective: Little is known about the relationship of dietary cost to health status. The present cross-sectional study examined the association between the monetary cost of dietary energy (Japanese yen/4184 kJ) and several metabolic risk factors. Design: Monetary cost of dietary energy was estimated based on dietary intake assessed by a self-administered diet history questionnaire and retail food prices. Body height and weight, from which BMI was derived, waist circumference and blood pressure were measured and fasting blood samples were collected for biochemical measurements. Setting: A total of fifteen universities and colleges in Japan. Subjects: A total of 1136 female Japanese dietetic students aged 18-22 years. Results: After adjustment for potential confounding factors, monetary cost of dietary energy was significantly and negatively associated with BMI (P for trend = 0.0024). Monetary cost of dietary energy also showed a significant and negative association with waist circumference independently of potential confounding factors, including BMI (P for trend = 0.0003). No significant associations were observed for other metabolic risk factors examined (P for trend = 0.10-0.88). Conclusions: The monetary cost of dietary energy was independently and negatively associated with both BMI and waist circumference, but not other metabolic risk factors, in a group of young Japanese women. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine relationships between speed of eating and insulin resistance. Methods: Cross-sectional study of 2704 male (mean age and BMI: 48.2 y and 23.3 kg/m2) and 761 female (46.3 y and 21.8 kg/m2) non-diabetic Japanese civil servants, 75% clerical, and 25% manual laborers, using a two-part questionnaire on life-style factors and diet history with self-assessment of categorical speed of eating and energy intake over a 1-month period. We measured BMI, blood glucose and insulin concentrations and calculated insulin resistance using the homeostasis model assessment of insulin resistance: (HOMA-IR). Results: BMI correlated with eating rate in both sexes, and with daily energy intake in men. Multiple regression analysis of log HOMA-IR by categorical speed of eating, adjusting for age, energy intake and lifestyle factors showed a statistically significant gradual increase in HOMA-IR with increases in relative eating rate in men (p <0.001, for trend) and in women (p <0.01). Adjusting for BMI, this positive relationship appeared only in men (p =0.03). Conclusions: Our results suggest that eating fast is independently associated with insulin resistance in middle-aged Japanese men and women. [Copyright &y& Elsevier]

Objectives: The present analysis was initiated to examine possible gender-dependency, geographic variation, and time-dependent changes in dietary intake of cadmium (Cd-F) among general populations in Cd-non-polluted areas in Japan. The role of rice as Cd-F source was also within the scope. Methods: Two databases on Cd and nutritional analyses were re-visited. Both databases were established through collection of 24-h food duplicate portion samples from residents in areas with no known Cd pollution, and contained information on Cd and energy contents in the duplicate portion, together with daily rice consumption, the gender, the age and the location of the residence of each sample donor. The first and the second databases were established through surveys in the years around 1980 on 564 cases and around 1995 on 702 cases, respectively. The two databases were combined for evaluation by multiple regression (MRA) and other analyses. Results: The analyses showed that men tended to take more Cd than women, more clearly so in the 1980 survey than in the 1995 survey. When Cd-F in the 1995 survey was compared with that in the 1980 survey, a substantial decrease was observed, e.g. by 30% (from 37.5 to 26.2 μg/day) in case of women. Cd-F values varied subject to the survey sites in a wide range (e.g. from 20 to 86 μg/day among women in the 1980 survey). In MRA with Cd-F as a dependent variable and survey sites and food intake factors (e.g. rice and energy intakes) as independent variables, the survey sites could explain more than 53% and 35% of total variation in Cd-F in the 1980 and 1995 surveys, respectively. Rice consumption was also influential to Cd-F in both surveys with partial correlation coefficients of 0.36 and 0.21, respectively, the influence being stronger in the 1980 survey than in the 1995 survey. A significant correlation was detected between the 1980 and 1995 survey results both in Cd-F and in rice consumption. Conclusion: Geographic and gender-related differences, and time-dependent decrease in dietary Cd intake in Japan were detected through analyses of food duplicate-based databases. The leading role of rice as dietary Cd source was also observed. [Copyright &y& Elsevier]

Objective: To characterise different meal types by examining the contribution of specific meals to the total intakes and the nutritional quality of each meal., Design: A cross-sectional analysis was conducted based on dietary data collected using 4-d dietary record. Diet quality was assessed by the Healthy Eating Index-2015 and Nutrient-Rich Food Index 9.3., Setting: Japan., Participants: Adults aged 20-81 years (n 639)., Results: Diet quality was, on average, highest for dinner, followed, in order, by lunch, breakfast and snacks. Breakfast, lunch, dinner and snacks, on average, accounted for 21 %, 32 %, 40 % and 11 % of total energy intake, respectively. For many nutrients, the percentage contribution to total intake did not vary within each meal, broadly in line with that for energy: 18-24 % for breakfast, 26-35 % for lunch, 35-49 % for dinner and 4-15 % for snacks. However, intakes of many foods largely depended on one meal type. The foods mainly eaten at dinner were potatoes, pulses, total vegetables, fish, meat and alcoholic beverages (52-70 %), in contrast to noodles (58 %) at lunch and bread (71 %) and dairy products (50 %) at breakfast. The foods mainly eaten at snacks were confectioneries (79 %) and sugar-sweetened beverages (52 %). Conversely, rice and eggs were more evenly distributed across three main meals (19-41 % and 30-38 %, respectively), while fruit and non-energetic beverages were more evenly distributed across all meal types (17-30 % and 19-35 %, respectively)., Conclusions: These findings provide the background information on each meal type in Japanese and may help inform the development of meal-based guidelines and public health messages.