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This study evaluated changes in diet quality during the coronavirus disease 2019 (COVID-19) pandemic and its association with variations in attitudes or behavior, as well as health status changes. Participants were Japanese adults aged 20–69 years who resided in 13 prefectures where specific cautions were announced to prevent the spread of the virus. An online survey was conducted in September 2021, and participants were those who shopped for food or prepared meals more than twice a week during the survey. Overall, 2101 participants were analyzed. An improved or worsened diet quality was determined based on changes in food consumption patterns, and participants were categorized into three groups (improved diet quality (IDQ), worsened diet quality (WDQ), and others). The IDQ group participants (10.2%) improved their dietary consciousness during COVID-19, cooked almost everything from ingredients, and increased their balanced meal eating frequency. However, the WDQ participants (11.1%) had worsened dietary consciousness and increased consumption of takeaway meals and alcohol but decreased balanced meal consumption. Cooking frequency changes were not independent determinants of variations in diet quality. Our results show that the diet quality changes during COVID-19 were possibly caused by changes in dietary consciousness or different levels of meal preparation practices.

With the growing interest in healthy and sustainable diets, studying diets with high nutritional quality and low environmental impact is needed. We focused on the nitrogen footprint (NFP)-an indicator of reactive nitrogen loss that causes various environmental impacts-of Japanese diets using individual dietary records and identified the characteristics of lower NFP diets. This cross-sectional study was a secondary data analysis from the 2017 Saitama Prefecture Nutrition Survey. We analyzed the data obtained from a questionnaire and two-day dietary records of 479 men and women aged 30-65 y who had no misreported or missing data. The NFP was calculated using the virtual nitrogen factors of each food group reported in a previous study. After assessing NFP and its contributions, we conducted sub-group analysis for participants with appropriate weight status and adequate protein intake, classifying them into three groups according to tertiles of NFP to protein ratio. We compared NFP, its contributions, and nutrient intake between the groups. The total NFP (kg N/y) was 18.2±5.0 in men and 16.1±4.4 in women. In the sub-group analysis, total NFPs of the lower NFP group were 16.5±3.1 in men and 13.6±2.8 in women. Cereals, pulses, and fish and seafood contributed more significantly to the total NFP in the lower NFP group than in the higher NFP group. These results suggest that adequate protein intake from a variety of food sources is required to lower the environmental impact of adequate diets.

Objective The interim evaluation of Health Japan 21(second term), a national health promotion plan, suggested that improvements in the food environment did not lead to improvements in individual dietary habits. The present study aimed to evaluate the relationship between the dietary behavior targets of Health Japan 21 (second term) and perceived food environment and health literacy.Method We conducted an online cross-sectional survey in March 2019 among adults aged 20-64 years. From the 9,667 registered monitors of the research firm, we collected 2,851 responses (29.5% response rate). The perceived food environment (how people perceive the local food environment) was estimated using the following six questions, namely, availability: easy access to nutritionally balanced meals, accessibility: no inconvenience in daily shopping, affordability: access to nutritionally balanced meals at reasonable prices, accommodation: easy access to food services within business hours, acceptability: satisfaction with the quality of food ingredients, and another form of acceptability: adequate food safety. Health literacy was evaluated using five questions related to information gathering, information selection, information transfer, information judgment, and self-determination. Last, we asked the respondents about two dietary behaviors, namely, the frequency of a balanced diet (defined as comprising the staple food, a main dish, and a side dish) and the quantity of vegetable intake, along with sociodemographic information. The analysis included 2,111 respondents, excluding those whose socioeconomic status was unknown. Multiple logistic regression analyses were performed to determine the relationship between perceived food environment and health literacy on dietary behaviors, while adjusting for sociodemographic factors.Result A balanced diet was associated with the following perceptions of the food environment: "access to nutritionally balanced meals at reasonable prices" (adjusted odds ratio [95% confidence interval] = 1.37 [1.02, 1.82]; women), and "adequate food safety" (1.54 [1.19, 1.98]; men), and health literacy: "information gathering" (0.84 [0.73,0.97]; men) and "self-determination" (1.28 [1.10,1.50], 1.37 [1.14,1.63]; men, women). The quantity of vegetable intake was associated with the following perceptions of the food environment: "easy access to nutritionally balanced meals" (1.54 [1.15,2.06]; men), and "no inconvenience in daily shopping" (1.55 [1.12,2.15]; women), and health literacy: "information transfer" (1.30 [1.10,1.54]; men), and "self-determination" (1.67 [1.38,2.02]; women)).Conclusion To achieve a balanced diet and increased vegetable intake in a population, it is necessary to promote both the acquisition of a higher level of "self-determination" (rather than "information gathering") in health literacy and the creation of a heathy food environment.

Overweight and obesity have reached epidemic proportions worldwide. The COVID-19 pandemic resulted in an increased need for remote implementation of weight-loss interventions; therefore, the effectiveness of web-based interventions needed to be assessed. This study aimed to examine the effectiveness of web-based interventions and their potency in facilitating weight changes in adults who were overweight or obese. We searched PubMed and Ichu-shi Web from the first year of inclusion in each database until the search date (30 September 2020). Among 1466 articles retrieved from the two databases and manual search, 97 were selected to undergo qualitative analysis and 51 articles were subjected to quantitative analysis. Qualitative analysis of 97 articles demonstrated that articles showing significant effectiveness mostly used the following components: social support, self-monitoring for behavior, self-monitoring for the outcome (weight), behavioral goal setting, information about health consequences, and outcome goal setting. Quantitative analysis of 51 articles showed a significant effectiveness of web-based intervention (standardized mean difference, −0.57; 95% confidence interval, −0.75 to −0.40). This study demonstrated the effectiveness of web-based interventions on weight change in adults with overweight and obesity. Subgroup meta-analyses identified personalized information provision and expert advice to be remarkably effective components.

Objective This study aimed to assess the household income changes during COVID-19 pandemic among Japanese adults, and to evaluate how this was related to changes in dietary behaviors and food-related accessibility issues and information needs during the emergency period.Method We conducted an online cross-sectional survey in July, 2020 among residents (aged 20-69 years) of the 13 prefectures under special confinement during the COVID-19 pandemic. Participants were asked about their dietary behaviors before the pandemic (before February 2020) and during the confinement period (April-May 2020), as well as about their food-related accessibility issues and information needs during the confinement period. Data from 2,225 residents were analyzed. Participants were divided into three groups (decreased, unchanged, and increased) based on the household income changes due to COVID-19. Demographics, dietary behaviors, and food-related accessibility issues and information needs were then compared among these three groups. Multiple logistic regression analyses were performed to examine the effect of household income changes on dietary behavior changes, food-related accessibility issues, and food-related information needs, while adjusting for sociodemographic factors. Furthermore, the effect of household income changes and subjective economic status were also analyzed using multiple logistic regression analyses.Result The participant distribution in each group were as follows: decreased (34.6%), unchanged (63.9%), and increased (1.6%). Higher proportion of those who were employed part-time, self-employed, or unemployed during the confinement period were found among the decreased group. The odds ratios (OR) of the decreased group were significantly higher than the unchanged group for lower frequency of eating out, and for higher frequency of home-cooking, consuming ready-to-eat convenience meals, and eating with children during the confinement period. Furthermore, regardless of the subjective economic status, the decreased group experienced difficulties in accessing required foods because of shortages and congestion in grocery stores, as well as increased prices. Additionally, food-related information needs regarding reduction of food expenses were also high among the decreased group.Conclusion Participants with a decreased household income were more likely to experience difficulties with food accessibility and desire information about lowering food-related expenses. Furthermore, they reported lower frequency of eating out, and higher frequency of home-cooking and consuming ready-to-eat convenience meals during the confinement period than before the pandemic. Future studies should evaluate the direction (positive or negative) of these changed food consumption patterns.

The primary aim of this study was to evaluate factors associated with changes in food-preparation practices during the Coronavirus Disease 2019 (COVID-19) pandemic in Japan and its associations to food-group intake. To examine this, a cross-sectional online survey was conducted in July 2020. Participants were 2285 adults aged 20–69 years who resided in any of 13 prefectures in Japan where specific COVID-19 regulations had been implemented. Self-reported changes in food-preparation practices when compared to the pre-COVID-19 pandemic period were measured as “increased” (24.6%), “decreased” (7.3%), and “no change” (68.1%), respectively. Stepwise logistic regression analyses indicated that participants who increased the time and effort for food preparation were younger in age, partially working remotely, experiencing reduced household income due to COVID-19, but highly concerned the importance of diet. On the other hand, participants whose household income decreased, and household economic status worsened, as well as those whose importance of diet deteriorated due to COVID-19 were more likely to decrease time and effort for cooking. Although the increased group were more likely to prepare meals with raw ingredients, the decreased group showed higher frequency of using takeout. These results indicated major determinants of changes in time spending on food preparation in consequence of COVID-19, and highlighted essential targets for future nutrition education.

Objectives Excess salt intake is a major risk factor for hypertension and cardiovascular disease. Modifying workplace environments has been recognized to be important for reducing salt intake. However, studies examining the effects of improving the workplace environment regarding salt reduction are limited. This study aimed to evaluate the effects of workplace dietary intervention on employees' salt intake and sodium‐to‐potassium (Na/K) ratio. Methods A quasi‐experimental study was conducted. Two small business establishments in Saitama Prefecture, Japan, were allocated as the intervention (n = 69) and comparison (n = 68) workplaces, respectively. The 1‐year intervention involving healthy lunch and nutrition education was implemented in the intervention workplace. Spot urine samples, physical assessments, and self‐administered questionnaire data were collected at baseline, 6 months, and 1 year after the start of the intervention. Analysis of covariance was conducted to investigate differences in the salt intake or Na/K ratio between the study workplaces at year 1. Educational status and rotating work schedules were included as covariates. Results Salt intake in the intervention workplace decreased significantly from 10.7 to 9.3 g (−1.4 g change; 95% confidence interval [CI]: “−2.4, −0.5”). The adjusted difference in changes in salt intake between workplaces was statistically significant (−3.7 g change; 95% CI: “−5.2, −2.3”). Although no significant change was observed in the Na/K ratio in the intervention workplace (3.37–3.08; −0.29 change; 95% CI: “−0.59, 0.01”), the adjusted difference in changes between the workplaces was statistically significant (−0.60 change; 95% CI: “−1.03, −0.17”). Conclusions Providing healthy lunch and nutrition education may be effective approaches to reduce employees' salt intake and Na/K ratio.

Objectives This study aims to develop a dietary consciousness scale and examine its reliability and validity, as well as investigate the changes in psychological aspects that influence diet among Japanese adults during the COVID-19 pandemic and clarify its related factors.Methods An online survey was conducted from July 1, 2020 to July 3, 2020. Participants were adults aged between 20 and 69 years selected from 13 prefectures where the government declared the state of emergency from April to May 2020. All selected participants were shopping or cooking foods for more than 2 days a week at the time of the survey. A total of 2,299 participants were included in the analysis. Dietary consciousness was measured using 12 items, and the construct was examined using factor analysis. Cronbach's alpha was examined as an indicator of internal validity, and the criterion-referenced validity was confirmed using the Kruskal-Wallis test. To determine changes in dietary consciousness, we calculated total scores based on changes in each item of the Dietary Consciousness Scale as follows: no change (0 points), improved (+1 point), and worsening (-1 point). The associations between the changes in dietary consciousness and characteristics or socioeconomic factors of the participants were examined using the chi-squared test and residual analysis.Results Exploratory and confirmatory factor analyses demonstrated that a model consisting of two factors fitted the data (GFI = 0.958, AGFI = 0.938, CFI = 0.931, RMSEA = 0.066). Cronbach's alpha of the first factor (importance of diet) was 0.838 and 0.734 for the second factor (precedence of diet), and the reliability was confirmed at 0.828 for the entire scale. In the examination of criterion-related validity, the higher the stage of change, the higher the total score of the scale, and a significant difference was observed (P0.001). The percentage of participants whose precedence worsened was higher than the importance. Significant differences were observed regarding gender, age group, marital status, employment status, household annual income, and income change during the COVID-19 pandemic considering changes in both the importance and precedence of diet. Those who were in the "worsening tendency" group in both the importance and precedence were men, 20-29 years old, unmarried, full-time employees, with a household income of 4-6 million yen during the past year.Conclusion During the COVID-19 pandemic, the precedence of diet worsened, compared to its importance, and men, young, or unmarried persons show a worsening of dietary consciousness.

Objective Obesity associated with an increased consumption of ultra-processed foods (UPF) has been reported by studies abroad using the NOVA food classification system, an international framework for classifying food according to the degree of processing. However, no such study has been conducted in Japan. In this study, we evaluated the association between UPF consumption, nutrient intake, and obesity using the NOVA system.Method In September 2017, we conducted a survey using a questionnaire of patients who had attended routine health checkups in Manazuru Town, Kanagawa Prefecture and collected their three-day dietary records as well as medical examination results. The final analysis included 169 patients (66 men, 103 women). Food consumed by the respondents were classified into four groups of NOVA systems. The dietary share of UPF (UPF energy ratio) was compared to total energy intake (except alcoholic beverages and eating out). Nutrient intake and obesity risk were compared across the UPF energy ratio tertile (low, middle, and high intake). Covariance and logistic regression analysis were conducted and adjusted based on age, sex, household structure, education, income, and total energy intake (except energy-providing nutrients, macronutrients, and protein intake per body weight) to analyze the association between UPF consumption and nutrient intake. Finally, for obesity, we adjusted for physical activity and smoking status using a similar analysis of the relationship between UPF consumption and energy providing nutrients and macronutrients.Result Approximately 75% of patients investigated were older than 65 years. The average (standard deviation) UPF energy ratio was 29.7% (15.0). There were no significant differences in socioeconomic status among groups according to the UPF energy ratio. The high-UPF group had a significantly greater total energy intake. However, the protein energy ratio, protein intake per body weight, dietary fiber, and vitamins A, E, K, B

This study investigated the genetic and pathogenic variation of the subgroups of clade 2 strains of Shiga toxin (Stx)-producing Escherichia coli (STEC) O157. A total of 111 strains of STEC O157 isolated in Shimane prefecture, Japan, were classified in clade 2 (n = 39), clade 3 (n = 16), clade 4/5 (n = 3), clade 7 (n = 14), clade 8 (n = 17), and clade 12 (n = 22) by single-nucleotide polymorphism analysis and lineage-specific polymorphism assay-6. These results showed a distinct difference from our previous study in which clade 3 strains were the most prevalent strains in three other prefectures in Japan, indicating that the clade distribution of O157 strains was different in different geographic areas in Japan. Phylogenetic analysis using insertion sequence (IS) 629 distribution data showed that clade 2 strains formed two clusters, designated 2a and 2b. Stx2 production by cluster 2b strains was significantly higher than by cluster 2a strains (P

We previously developed a multiplex real-time PCR assay (Rapid Foodborne Bacterial Screening 24 ver.5, [RFBS24 ver.5]) for simultaneous detection of 24 foodborne bacterial targets. Here, to overcome the discrepancy of the results from RFBS24 ver.5 and bacterial culture methods (BC), we analyzed 246 human clinical samples from 49 gastroenteritis outbreaks using RFBS24 ver.5 and evaluated the correlation between the cycle threshold (CT) value of RFBS24 ver.5 and the BC results. The results showed that the RFBS24 ver.5 was more sensitive than BC for Campylobacter jejuni and Escherichia coli harboring astA or eae, with positive predictive values (PPV) of 45.5-87.0% and a kappa coefficient (KC) of 0.60-0.92, respectively. The CTs were significantly different between BC-positive and -negative samples (p ＜ 0.01). All RFBS24 ver.5-positive samples were BC-positive under the lower confidence interval (CI) limit of 95% or 99% for the CT of the BC-negative samples. We set the 95% or 99% CI lower limit to the determination CT (d-CT) to discriminate for assured BC-positive results (d-CTs: 27.42-30.86), and subsequently the PPVs (94.7%-100.0%) and KCs (0.89-0.95) of the 3 targets were increased. Together, we concluded that the implication of a d-CT-based approach would be a valuable tool for rapid and accurate diagnoses using the RFBS24 ver.5 system.

Little attention has been devoted to the importance of understanding the association between dietary intake and childhood obesity in Thailand. This study aimed to explore food types affecting the weight status of preadolescents in urban settings, where obesity is remarkably prevalent. This study was conducted in 2015–2016 and assessed the dietary intake of 263 children aged 10–12years from Bangkok Metropolitan Regions through three- nonconsecutive-day 24h recall. Lifestyle and sociodemographic information was obtained using questionnaires. Participants were classified into non-obese and overweight/obese groups based on the WHO child growth standard curve. Foods were categorized into 13 groups based on Thailand's dietary guidelines and food environment context regarding two eating occasions (main and between meals) of children, which resulted in the newly classified “street-side snacks”. Data were examined using analysis of covariance and multiple linear regression analysis. After adjusting for sex and energy misreporting, overweight/obese participants had higher energy and macronutrient intake and consumed more cereal grains, meat/fish, flavored milk, and sugar-sweetened beverages during main meals and street-side snacks and confectioneries during between meals than non-obese participants. The consumption of street-side snacks had the highest beta coefficient on BMI z-scores among the food types in the model, adjusted further for energy intakes. Street-side snacks may be an important predictor of obesity in Thai children. A prospective investigation of the impact of accessibility and availability of this food item is needed. Keywords: Thailand, Preadolescents, Weight status, Dietary intake, Sugar-sweetened beverages, Snacking

Objective:To estimate the consumption of ultra-processed foods and determine its association with dietary quality among middle-aged Japanese adults.Design:Cross-sectional study using data from the Saitama Prefecture Health and Nutrition Survey 2011. Dietary intake was assessed using one- or two-day dietary records. Sociodemographic and lifestyle factors were obtained via self-administered questionnaire. Food items were classified according to the NOVA system into four groups: unprocessed or minimally processed foods; processed culinary ingredients; processed foods; and ultra-processed foods. The dietary share of each NOVA food group and their subgroups was calculated in relation to total energy intake, and the average dietary content of key nutrients was determined across tertiles of the dietary energy share of ultra-processed foods (low, middle and high intake).Setting:Saitama Prefecture in Japan.Participants:Community-dwelling adults aged 30–59 years (256 men, 361 women).Results:Consumption of unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods contributed 44·9 (se 0·8) %, 5·5 (se 0·2) %, 11·3 (se 0·4) % and 38·2 (se 0·9) % of total daily energy intake, respectively. A positive and statistically significant linear trend was found between the dietary share of ultra-processed foods (tertiles) and the dietary content of total and saturated fat, while an inverse relationship was observed for protein, vitamin K, vitamin B6, dietary fibre, magnesium, phosphorus and iron.Conclusions:Our findings show that higher consumption of ultra-processed foods was associated with decreased dietary quality among Japanese adults.

This quasi-experimental study determined whether the nutrition education program we developed to promote chewing food properly influenced children’s chewing habits successfully. Four kindergarten classes in Japan (150 children, aged 5-6 years) were studied; one class received the educational program in the classroom and at home (Group A) and three classes received the program in the classroom only (Group B). The educational program was integrated into the classes’ daily curriculum for five weeks. It included storytelling with large picture books, chewing consciously while eating lunch, singing a song with gestures, and greetings before and after meals (both groups). Group A also used a paper textbook and was provided information by the leaflet to encourage guardians to implement the program at home. Chewing habits before and after intervention were evaluated: (1) guardians completed seven questionnaire items related to chewing habits and chewing movement and (2) the number of chews and time spent eating the test meal were measured by a portable chewing sensor. Both approaches improved the children’s chewing habits; however, no difference was found between the two groups. We concluded that this intervention could be used to improve chewing habits in young children even without active involvement of their guardians.

We previously developed a multiplex real-time PCR assay (Rapid Foodborne Bacterial Screening 24 ver.5, [RFBS24 ver.5]) for simultaneous detection of 24 foodborne bacterial targets. Here, to overcome the discrepancy of the results from RFBS24 ver.5 and bacterial culture methods (BC), we analyzed 246 human clinical samples from 49 gastroenteritis outbreaks using RFBS24 ver.5 and evaluated the correlation between the cycle threshold (CT) value of RFBS24 ver.5 and the BC results. The results showed that the RFBS24 ver.5 was more sensitive than BC for Campylobacter jejuni and Escherichia coli harboring astA or eae, with positive predictive values (PPV) of 45.5-87.0% and a kappa coefficient (KC) of 0.60-0.92, respectively. The CTs were significantly different between BC-positive and -negative samples (p ＜ 0.01). All RFBS24 ver.5-positive samples were BC-positive under the lower confidence interval (CI) limit of 95% or 99% for the CT of the BC-negative samples. We set the 95% or 99% CI lower limit to the determination CT (d-CT) to discriminate for assured BC-positive results (d-CTs: 27.42-30.86), and subsequently the PPVs (94.7%-100.0%) and KCs (0.89-0.95) of the 3 targets were increased. Together, we concluded that the implication of a d-CT-based approach would be a valuable tool for rapid and accurate diagnoses using the RFBS24 ver.5 system.

Objective The present study examined nutritional status and dietary intake of pregnant women in Japan in relation to pre-pregnancy body mass index (BMI).Methods Participants included 141 Japanese women with singleton pregnancies, from the outpatient department of the S hospital, Gunma prefecture, Japan. Two-day food records, dietary assessment questionnaires, and clinical records were obtained at 20 weeks gestation. Nine patients were excluded from the study due to morning sickness. The remaining 132 participants were divided into 3 groups according to pre-pregnancy BMI: underweight, normal weight, and overweight. Nutritional status and dietary intake were analyzed in relation to BMI using the chi-square test, Fisher's exact test, Kruskal-Wallis test, one-way analysis of variance, and analysis of covariance with adjustment for age, employment status, and total energy intake.Results Women who were underweight before pregnancy were more frequently working full-time than normal weight and overweight women. Underweight women were also more frequently anemic (P=0.038, underweight 39.3%, normal weight 24.7%, overweight 0%) and had lower mean hemoglobin (Hb) (P=0.021, underweight 11.3 g/dL, normal weight 11.6 g/dL, overweight 12.1 g/dL) and hematocrit (Hct) levels (P=0.025, underweight 33.7%, normal weight 34.3%, overweight 36.0%). Their dietary intake of protein, iron, magnesium, and folic acid was lower than that of normal weight and overweight women. Their meals tended to include fewer meat, fish, egg, and soybean dishes (underweight, mean of 4.7 servings per day; normal weight, 6.1 servings; overweight, 6.1 servings).Conclusion Pregnant women who were underweight before pregnancy had increased risk of anemia as well as reduced Hb and Hct levels. They had lower dietary intake of protein, iron and folic acid compared to women in the other BMI categories. Anemia and these nutrient deficiencies are known risk factors for low birth weight. Our findings suggest the importance of providing underweight pregnant women with support to improve dietary intake during their pregnancy, especially to increase intake of protein and iron through consumption of fish and meat dishes.

Objectives Aiming at improvement of the Japan Health Insurance Association's Specific Health Guidance initiatives and human resource development, we conducted a qualitative study to clarify the features necessary for and the challenges hindering the achievement of good performance of the initiatives.Methods From November 2014 to January 2015, we conducted 10 focus group interviews, each 90 minutes long, with 64 public health nurses from 10 Japan Health Insurance Association branches. In addition, self-administered questionnaires were administered to obtain the participants' basic characteristics. After we excluded one group for failing to meet our performance targets, we divided the remaining nine focus groups according to two patterns: Maintenance and Progress. The four focus groups fitting the Maintenance pattern had a well-established track record, and the five focus groups fitting the Progress pattern had a track record of good growth. Using open coding of the interview transcripts, we extracted efforts or needs in two domains, individual and branch, Then, we placed codes in eight main categories: [quality], [general practice], [dietary guidance practice], [success factor], [branch system], [training and skill development], [approach to the member office], and [past efforts]. We further extracted important subcategories based on their rates of appearance within branches.Results Data from 56 female public health nurses working at nine branches were included in the analysis. With respect to the individual domain, subcategories such as "building rapport," "creating the physical environment," and "taking the initiative in evaluating one's own lifestyle" in the 〈high emphasis〉 segment of the [general practice] category were common to both patterns. In addition, "increasing opportunities for training" and "enhancement of training program content" were found for both patterns in relation to the 〈demand〉 segment of the [training and skill development] category. However, most participants chose "yes" in response to whether there was ample training opportunity.Conclusion This study showed some common efforts and practices among public health nurses in both patterns, which indicates good performance of the Specific Health Guidance initiatives. However, there is a need to further enhance the training program to strengthen the entire organization. Future studies should focus on understanding the characteristics of and factors involved in low-performing branches.

This study aimed to examine the association of fetal growth and elevated third trimester maternal serum folate due to folic acid (FA) supplement intake. Dietary intake, use of FA supplements, weight, and blood biomarkers of B-vitamins (serum folate, pyridoxal, vitamin B(12), and plasma total homocysteine) were observed in 33 healthy pregnant women at the third trimester (average gestational age 35 wk). Birth outcomes were assessed through hospital birth records. Infant anthropometry and maternal blood biomarkers were followed up at 1 mo postpartum. Fourteen women were taking FA supplements at the third trimester. Dietary intake was similar among FA users and non-users, but serum folate and pyridoxal were significantly higher in users (11.6±6.7 vs. 6.1±3.2 ng/mL, and 13.8±21.7 vs. 3.2±1.4 ng/mL, respectively). Plasma total homocystein (tHcy) was higher in non-users compared to users, but not significantly. Nine FA users and eight non-users had low serum vitamin B(12) values (

よりよい妊娠転帰と児の健全な発育のためには，妊娠期から産褥期にかけて，十分な栄養摂取と食生活および体重管理を確立するための継続的なフォローアップが不可欠である。そこで，料理ベースである“妊産婦のための食事バランスガイド”が，妊婦に対する栄養教育において有効なセルフモニタリングのツールになりうるかどうか検討した。東京都内の産科施設に通院していた妊娠18週までの42名の健康な妊婦から，2007年12月から2008年9月までに，本研究への参加について文書にて同意が得られた。そのうち，妊娠初期・中期・末期の計3回の24時間思い出し法による食事調査と質問紙調査を完了した36名を分析の対象とした。対象者はブロックランダム化割付により，栄養素・食物レベルで指導を行う介入群Aと料理レベルで指導を行う介入群Bに割り付けた。身体状況及び食物摂取状況の変化を検討した。介入群Bでは副菜のサービング数に有意な増加が示され，3回目調査時には望ましい摂取量の範囲にあった。食事のバランスを整えることに対する行動変容ステージ及びセルフエフィカシーは，介入群Bにおいてのみ有意に改善した。本研究により，個別指導に加えて“妊産婦のための食事バランスガイド”を用いたセルフモニタリングは，健康な妊婦における望ましい食行動の確立に有効であることが示唆された。（オンラインのみ掲載）

In the present paper, we focused on religion and religiosity using data that had been obtained from the Seven Nations Comparative Survey, the East Asia Values Survey, and the Asia and Pacific Values Survey. In Japan, only about 30% of the population have a religious faith, and this percentage is the lowest among developed countries. On the other hand, 70% think that having a religious mind is important. If we presume that people who either claim to have a specific religious faith or say that religious mind in a generic sense is important as being more or less positive to religion, then we could say that the proportion of people who feel positively about religion in Japan is comparable to that in most other countries. While attempts have been made to investigate the meaning of the term “religious mind” with relatively small data sets in Japan (Hayashi, F. 2007), it is also true that “religiosity” — which carries a different meaning than “religion” as an object of worship — is now being debated in Western countries, too. In this paper, we analyze whether the “religious mind” is a distinctive property of the Japanese or if there is a similar sort of attitude in the West using an international and comparative data set.

The main object of this paper is to investigate the work careers and life careersof Toyo Eiwa University alumnae, and to examine what influenced their decision makingand their feelings about their careers.The authors prepared an original sociological and opinion survey on all 2930alumnae, grouped according to their graduate years. The survey was conducted onan unregistered basis in July 2007. The questionnaires were mailed to the alumnaewhose graduate year is even. Seven hundred sixty two (25% ) of the alumnae respondedto the survey. The response rate was not high enough to come to any definite conclusionon the behavior of and thought concerning the career building of Toyo EiwaUniversity alumunae. However, the authors believe that it is very important to investigatethe results and report on findings that may be useful in reviewing and improvingcolledge education.The alumnae association of Toyo Eiwa University kindly allowed use of its listof members, and Hajime Sasaki, the head officer of the career section of Toyo EiwaUniversity, helped us to elaborate the questionnaires and to contact the alumnae.The paper consists of five sections: 1) the purpose of the study; 2) the report onthe entire survey; 3) the relation between the first job decision making and its results;4) the timing of retirement from the first job and life course; 5) the free opinion of thealumnae and some findings. Sections 1 and 2 were written by Hayashi; Section 3 waswritten by Hasegawa; Section 4 was written by Arita; Section 5 was written by Kawasaki.

An unbalanced diet and low weight in women of childbearing age are becoming more common and are considered as important health problems in Japan. The “Dietary Guideline for Pregnancy and Lactation” was revised in 2006, and shows the proper weight increase during pregnancy based on pre-pregnancy BMI, and nutrition education for the pregnant woman and family. A nationwide survey was conducted among registered dietitians at those medical facilities offering obstetrics and gynecology to identify how nutrition assessment and nutrition education were being applied. The response rate was 16.0% (n=208). The respective application of nutrition assessment to outpatients and inpatients was 22.7% and 30.7%, while 31.8-39.8% received nutrition education based on appropriate energy and nutrients. These results suggest that it may be necessary to revise the system for providing nutrition education to the relevant patients. The answers from the medical facilities show that there was no coordinated system with another organization in 58.7% of cases. Comprehensive action for women of childbearing age and expected mothers is necessary to provide cooperation between the community and medical facilities.

ObjectiveThere is an increasing concern of anaemia in Japanese women, but no national trend data has existed to date. We analysed long-term national trends of anaemia in adult women.DesignSecondary analyses of 15 consecutive cross-sectional nationwide surveys conducted during the period 1989–2003. Analyses were based on 5-year intervals (1989–1993, 1994–1998, 1999–2003).SettingJapan.SubjectsThe subjects included the National Health and Nutrition Survey of Japan (NHNS-J) population. Analyses were based on 50 967 non-pregnant/non-lactating women aged 20 years and over, with complete data sets. We stratified subjects into six age groups (20–29 years, 30–39 years, 40–49 years, 50–59 years, 60–69 years and 70+ years), and three age groups (20–49 years, 50–69 years, 70+ years) for analyses on residential areas (metropolitan, cities and towns).ResultsDecreases in trends of mean haemoglobin values (intravenous) were significant in all age groups. Changes in the prevalence of anaemia were significant only in women aged 30–39 and 40–49 years. Anaemia (haemoglobin < 12.0 g dl−1) increased from 16.8% to 20.6% in women aged 30–39 years, and from 20.2% to 26.9% in women aged 40–49 years, respectively. Prevalence was highest in women aged 70 years and older in all times, but no significant change was observed.ConclusionsHaemoglobin values have declined significantly in all ages in the last 15 years. Anaemia was especially significant in women aged 30–39 years and 40–49 years. Our findings suggest that a large number of young women in Japan are at risk of anaemia, so continuous monitoring and controlling efforts of this trend are needed.

BACKGROUND: In 2000 the Japanese Ministry of Health, Labour, and Welfare initiated a new health promotion program, Health Japan 21, in which obesity control is one of the prioritized objectives. For the program's effective implementation, it is important to enhance individual nutritional education as well as to identify the socioeconomic and environmental factors affecting obesity-related lifestyle habits. This study aimed to investigate the secular changes in dietary and exercise habits between sexes and among four types of residential areas in Japan.METHODS: The datasets of annual national nutrition surveys (1976-2003) were used for the secondary analyses. Data on the dietary and exercise habits of 385,559 persons aged 15 years and older were analyzed. Residential areas were divided into four groups: metropolitan areas, large cities, small cities, and small towns.RESULTS: Similar trends were observed in the proportions of people skipping breakfast and eating out lunch/dinner, with those living in metropolitans having the highest proportions. The secular trend showed that the proportions of people eating dinner out were highest in the early 1990s, which corresponds to the “bubble period” in Japan.CONCLUSIONS: Our findings suggest that dietary habits could be greatly influenced by the country's economic situation, especially in metropolitan areas. Thus, area-specific population approaches should be enhanced to promote appropriate lifestyle habits, especially for the young to middle-aged.

Non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes are the leading cause of death worldwide. To decrease the global burden of NCDs and strengthen national efforts to combat NCDs, the World Health Organization (WHO) released the Global Action Plan for the Prevention and Control of NCDs 2013-2020. This plan provides established procedures and several policy options for member countries and other partners. Although many countries recognize that prevention of NCDs is an important health priority, their governments currently face a challenge: How do they adopt a multi-sectoral approach to promoting a healthy lifestyle among their populations? For this, all sectors of the food system (primary production, food processing, distribution, marketing, retail, catering, and food service) need to coordinate with each other for future governance. Since regulatory policy intervention areas for diet-related NCDs are widespread throughout the global food system, for future perspectives, comprehensive and coordinated approaches are needed for policy development and implementation across all levels of governments and food sectors in order to ensure sustainable policy action.

「健康日本21」において解決すべき課題として挙げられている肥満, 糖尿病といった生活習慣病の予防の観点から, 2000年に当時の文部省・厚生省・農林水産省により策定された「食生活指針」が示す10の望ましい食生活のあり方について, 具体的に「何をどれだけ食べたらよいか」を示す視覚的媒体「食事バランスガイド」が, 2005年7月に厚生労働省・農林水産省より発表された。一方, 深刻な肥満問題に取り組む米国では, 科学的根拠に基づき5年ぶりに改定された2005年版の“アメリカ人のための食生活指針”の内容を受けて, 具体的な行動変容を促すための教育ツールであるフードガイドを十数年ぶりに改定し, 2005年4月に“マイピラミッド”を発表した。従来のフードガイドよりも, より個人を意識した内容となり, インターネットを介した情報発信やガイダンスを行っている。それぞれが国民に伝えるためにとったアプローチ手法は対照的ではあるが, シンプルに相手の興味を引き, さらに長続きできるような行動変容を支援していくことを目指している点は同じである。栄養教育に従事する管理栄養士等においては, それぞれの特徴や理論的背景等を理解し, 実践の場でぜひ柔軟に活用していただきたい。

In the contemporary world conflicts of different cultures among different nations and regions have become a serious problem. Specifically, religions exist as the basis for different cultures. In our Cross-national survey results, it was found that only 30% of the Japanese have religious faith but 70% think that religious feeling is important and that the meaning of religion is different between the Japanese and Westerners based on our cross-national surveys. The meaning of religion can be understood in the relation between religious attitudes and other social attitudes. The structure of thinking about religion and its relation to other items in our East Asia Value Survey were analyzed using multivariate analysis. The results concerning the differences among these areas were as follows. In Japan, Korea and Hong-Kong, satisfaction about daily life and religious feeling are related positively, whereas in Beijing, Shanghai and Taiwan, these are related negatively. Concerning attitudes toward science and technology, in some areas, including Japan, the medium attitude is related to religious feeling. We are continuing our on-going analysis toward seeking the meaning of religion in contemporary societies by including the results of seven Western nations' surveys.

We sent a questionnaire to 48 pharmacy schools in Japan to evaluate the status of undergraduate palliative care education in fiscal 2003, and replies were obtained from 36 of them.Eighteen schools provided classes in palliative care but in all of them, it was not an independent subject but taught alongside other subjects. They mostly provided palliative care classes for 1 or 2 hours in the 3 rd year or later. Only 3 of the colleges considered that the present number of hours for palliative care classes was adequate. Regarding the 18 schools without palliative care classes, 14 considered that palliative care education is necessary, but only 2 had a plan to introduce them.Irrespective of whether pharmacy schools had palliative care classes or not, the following 7 items were taught in more than 50% of them : team medicine, WHO cancer pain relief, characteristics of opioids depending on dosage form, management of adverse drug reactions, pharmaceutical counseling services, different uses of NSAIDs, neuropathic pain, and drugs that aid analgesics.Nine schools provided palliative care classes in their graduate schools, and one of them provided practical training in palliative care for four weeks.Overall, palliative care classes were considered to be necessary because they provide the opportunity to learn about life ethics and drug treatment, and the reason for the absence of classes was a full curriculum. The revision of the curriculum accompanying the change to a 6-year course in pharmaceutical education should facilitate the provision of widespread systematic palliative care education.

The main object of this study is to examine the life course and attitude of alumni that would be notably influenced by what they had learned and experienced in Toyo-Eiwa University. We prepared a unique socio-economic and opinion survey on entire 3, 192 alumni, conducted on unregistered basis in June, 2003. Five hundred forty-two (17.9%) alumni responded to the survey and 19 alumni allowed us for having further hearings from them. Note that the response rate in this study is not high enough to come to any definite conclusions capable to represent their behavior and thoughts after the graduation. However, we still believe that some results provide significant and useful resource for us to review how the college education has been affecting the choices and attitudes at various stages of their life. The survey consists of four main subjects ; (1) the degree of satisfaction with the college life and the sense of self-respect as Toyo-Eiwa alumni ; (2) individual demographic characteristics (e. g., age and family status including marriage/divorce status, and birth, etc) ; (3) the history of socioeconomic status (e. g., current and past employment status, wage, working hours, qualifications, living status, and health status, etc) ; and (4) the attitude of life course (e. g., marriage, family life, and various social activities, etc). Our results reveal that most alumni who responded to the survey feel impressed and affected by what they studied and experienced in their college-age. They have been trying to survive with self-respect as Toyo-Eiwa alumni, under the socio-economic circumstances getting severer through 1 990's. Finally, we are really grateful for alumni who spent long hours to complete our survey sheet, in particular, for those who kindly agreed to further face-to-face interview conducted by some undergraduates. Without their collaboration and a number of useful remarks on this study, we would not have been capable to continue and accomplish the research.

One of the most important issues confronting human beings nowadays is the problem of the environment, including the basic concern regarding what the relationship between man and nature should be. Using the results of several opinion surveys, this paper considers the way Japanese, especially the younger generation, think about nature.Looking at the changes that have occurred in opinions concerning nature, as reflected in the time series nationwide survey, the opinion that man must follow nature has been increasing, while the large number of the people surveyed still have a spiritual feeling for nature. A look at the results for the younger generation reveals that the percentage of people who have a spiritual feeling is smaller, but the percentage of people who think that man must follow nature is larger than in the upper age groups. A pre-test surveyed at Toyo Eiwa University and the Faculty of Agriculture at S. University shows that the percentage of people having spiritual feeling about nature is greater than the percentage of people in their twenties from the nation-wide survey. There were also some differences between the two universities in students'responses to a few questions.In order for mankind to coexist with nature, we may need to preserve and develop the spiritual side of the relationship. It is also necessary to consider the necessity of educating people early enough both in a spiritual sense and in a wide informative sense, including knowledge about ecosystems, and practical issues related to the preservation and protection of nature.

In this article, we are examining the data of5different sets of interview and telephone surveys, which were conducted by Yomiuri Newspaper from May 1994 through January 1995. In each sets, both telephone and interview survey data were collected with the identical sampling design, on the same interviewing dates and at the same interview points. According to our comparative examination, demographic distribution of the samples did not differ significantly from telephone surveys to interview surveys, but the response pattern were clearly different on some questions. Therefore, it can tentatively be concluded that the different response patterns between the two interview methods are most likely due to the interview environment created by telephones as media of interview. As these findings could only be obtained through an empirical examination, we need to continue our empirical examination and comparison of this new survey method.

A qualitative analysis was conducted to identify factors important for weight loss through a specific health guidance program and to understand the processes that were crucial in achieving success.Twenty-six male workers aged 41-59 years from five corporate health insurance societies in four prefectures who had lostor = 4% weight by attending the six-month specific health guidance program were invited to participate in the in-depth interviews. Data were collected between October and December 2009. We audio taped the 30-minute interviews and performed qualitative analysis on the transcripts using a grounded theory. The discussion by the expert panel strengthened the validity of the analysis.The mean age was 49.9 +/- 5.6 years, and the average weight loss was 6.8 +/- 2.5%. All subjects were somewhat concerned about their health status and body shape before the first appointment, but two major prosesses, "critical feeling" and "sense of obligation," were identified after the first appointment. We also identified innovative efforts in all subjects during the process. Those who reported a "sense of obligation" at the beginning and those who had a negative perception during the program were found to have higher risks of weight rebound after the program was over. We considered personality, values, attitudes toward the program, and support from both family and workplace as the intervening conditions for behavior modification.Since everyone aged 40-74 years with a certain risk of metabolic syndromes is obligated by law to participate in the specific health guidance program, weight loss is challenging for those who are not motivated enough to change their behaviors. Therefore, the initial assessment of one's motivations, followed by interventions taken in consideration of one's lifestyle and social background, are crucial for the success of a weight loss program, as is the use of a client-centered approach.

Objective This study examined whether the experience of enjoyable mealtimes at home during childhood was related to eating behaviors and subjective diet-related quality of life in adulthood. Methods The study used data (n = 2,936) obtained from a research program about Shokuiku (food and nutrition education) conducted by the Cabinet Office in Japan in November and December 2009. The study employed logistic regression adjusted for all predictor variables. Results Enjoyable eating experiences in childhood were positively associated with a balanced diet (meals with 3 dishes; odds ratio [OR]: 1.78, 95% confidence interval [CI]: 1.45-2.19), eating vegetable dishes (OR: 1.71, 95% CI: 1.37–2.12), and subjective diet-related quality of life scores (OR: 3.84, 95% CI: 3.14-4.70) in adulthood. Conclusions and Implications This study suggests that enjoyable eating experiences at home during childhood appear to promote healthy eating habits and the development of a positive diet-related quality of life in the future.