出口 香菜子

Background and Aim: Underweight young adult women are vulnerable to health risks such as menstrual disorders and vitamin deficiencies. Because few seek medical care for low body weight, the underlying causes remain unclear. This study aimed to examine the associations of body type with dietary patterns and gut microbiota diversity in young women. Methods: We enrolled 40 women aged 20-39 years who visited a nutrition evaluation clinic with a BMI < 17.5 at their first consultation (underweight group) and 40 age-matched women with 18.5 ≤ BMI < 25 (control group). Some women in the underweight group were no longer underweight at the time of analysis but were classified based on their initial BMI. Dietary patterns were assessed based on ten major food categories (meat, fish, eggs, dairy products, soybeans, green and yellow vegetables, seaweed, fruit, tubers, and fats and oil) based on the Food Frequency Questionnaire based on Food Groups. Gut microbiota α-diversity was evaluated using the Shannon, Simpson, and Pielou indices, while β-diversity was analyzed by nonmetric multidimensional scaling (NMDS) and redundancy analysis (RDA). Genera contributing to group differences were identified by RDA and ANOVA-Like Differential Expression tool (ALDEx2). Results: Underweight women had significantly lower gut microbiota α-diversity, while no difference was observed in dietary patterns. NMDS revealed significant β-diversity differences in gut microbiota (PERMANOVA: R2 = 0.064, F = 5.31, p = 0.0001) but not in dietary patterns (p = 0.99). RDA showed that body type explained 4.5% of variance (adjusted R2 = 0.032, F = 3.65, p = 0.0005). Bacteroides, Bifidobacterium, Enterocloster, and Erysipelatoclostridium were enriched in underweight women, whereas Fusicatenibacter, Agathobacter, Dorea, and Prevotella were enriched in controls. AldEx2 confirmed increases in Bacteroides, Enterocloster, and Erysipelatoclostridium and a decrease in Dorea. Conclusions: Underweight women demonstrated reduced gut microbiota diversity and enrichment of taxa associated with inflammatory tendencies. Dietary therapies involving not only prebiotics but also probiotics may beneficially modulate gut microbiota and contribute to the management of low body weight.

Background/Aim: To date, there have been no data regarding the reproducibility or agreement of meal duration when a test meal is eaten. To confirm the reproducibility and agreement of the meal duration, number of chews, chewing tempo, and number of bites of a test meal, we performed a prospective observation study. Methods: We measured the duration, number of chews, chewing tempo, and number of bites of a test meal (salmon bento) among 33 participants (male: 15; female: 18) aged 20–60 years who ate twice at 2-week intervals to verify the agreement (by Bland-Altman (BA) analysis) and reproducibility (intraclass correlation coefficient (ICC)) by sex. Results: The meal duration (s) and number of bites (times) were significantly greater in the female group (560.4 (128.7) and 731.9 (266.3), p = 0.023; 17.1 (9.9) vs. 26.4 (13.7), p = 0.036), and the number of chews tended to be greater in the female group (752.5 (203.3) vs. 938.1 (375.9), p = 0.083). Meal duration was positively associated with the number of chews (0.64 [0.53, 0.74], p &lt; 0.001) and bites (10.4 [5.1, 15.8], p &lt; 0.001). For both sexes, the % error calculated via BA analysis was high for meal duration, the number of chews, and the chewing tempo (21.4 and 13.4%; 16.5 and 18.5%; and 6.8 and 5.3%, respectively) and low for the number of bites (37.9 and 68.9%). The ICCs were high for meal duration (0.73 and 0.90), the number of chews (0.76 and 0.89), and the chewing tempo (0.76 and 0.90), and low for the number of bites (0.84 and 0.69). Moreover, systematic and proportional errors were found only for the number of bites in the female group (median_difference with 95% CI: −9.00 (−13.00, −2.00); −0.320 (−0.45, −0.093)). Conclusions: Although the sample size was small due to the exploratory nature of the study, meal duration, number of chews, and chewing tempo had high reproducibility and agreement, at least when this test meal was consumed. These measures may indicate individual-specific eating behavior.

Background/Objectives: Dietary patterns vary with age and sex. The aim of this study was to clarify the differences in dietary patterns among young and middle-aged Japanese individuals by age group and sex via statistical methods such as alpha diversity and beta diversity analyses. Methods: Using data from a dietary survey of 10 food items during health checkups of 2743 Fujita Health University employees, we examined the effects of age and sex on alpha diversity (Shannon index) and beta diversity (nonmetric multidimensional scaling (NMDS) and RDA). Unlike principal component analysis which assumes linear relationships, redundancy analysis (RDA) incorporates explanatory variables to directly assess how external factors shape multivariate patterns. Results: The Shannon index increased with age and was greater in males across age groups. Type III ANOVA revealed significant main effects of age (p < 0.001) and sex (p < 0.001), and the effect of the interaction between age and sex approached significance (p = 0.08). Visualization of the NMDS data revealed that women aged 20-29 years and women aged 30 years and older and men aged 20-39 years and men aged 50-59 years have different dietary patterns. The RDA model accounted for 2.01% of the variance (adjusted R2 = 1.94%), with age and sex contributing 56.7% and 43.3%, respectively. RDA1 and RDA2 were correlated with age (r = 0.26, -0.14) and sex (r = 0.15, 0.21). The RDA1 values increased with age and were greater in females, whereas the RDA2 values decreased with age and were greater in females. RDA1 (1.41% of the total variance in food group intake, 70.1% of the constrained variance) was positively associated with fruits, milk, and seaweed and negatively associated with meat and eggs. In RDA2 (0.60% of total variance, 29.9% contribution), fruits, potatoes, and vegetables had positive effects, whereas fish had negative effects. Conclusions: Dietary patterns vary by age and sex, with meat, fish, eggs, and fruit as key determinants. Nutritional guidance must account for variations in dietary patterns influenced by age and sex.

Background/Aim: Skeletal muscle mass index (SMI) and body fat percentage (BF%) are components of body mass index (BMI) but are considered to play independent roles. We aimed to clarify whether SMI and BF% are associated with nutritional markers independent of BMI in underweight women. Methods: This retrospective observational study included a total of 102 women aged 20-65 years who were referred to the outpatient nutrition evaluation clinic from 2022 to 2024 with a body mass index (BMI) < 17.5. We performed a multivariate analysis with SMI and BF% as independent variables and BMI, BMI ratio (present-to-age 20 ratio), grip strength, and biochemical nutritional indicators (vitamin B1 level (ng/mL), cholesterol level (mg/dL), lymphocyte count (/μL), and HbA1c (%) level) as dependent variables, adjusting for age. Results: Women aged 30.9 ± 10.2 years (yo) with a BMI of 17.0 ± 0.7 participated in this study. BMI (kg/m2) was positively associated with SMI (kg/m2) (β (95% CI): 1.6 [1.4, 1.9], p < 0.001) and BF% (0.2 [0.1, 0.2], p < 0.001), and the BMI ratio (present-to-age 20 ratio) was positively associated only with BF% (0.5 [0.05, 0.9], p = 0.03). Grip strength was positively associated with SMI (4.0 [1.4, 6.6], p = 0.003), and lymphocyte count was positively associated with BF% (β (36.2 [6.0, 66.5], p = 0.02). BMI was not associated with grip strength or lymphocyte count. Vitamin B1, cholesterol, and HbA1c were not associated with SMI, BF%, or BMI. Conclusions: These results indicate that SMI reflects BMI and grip strength, whereas BF% reflects BMI, the BMI ratio (present to age 20), and lymphocyte count. In addition to BMI and SMI, changes in BF% should also be noted in underweight women.

BACKGROUND/AIM: Obese individuals are often said to eat fast. Given that obese individuals are often reported to consume fast food more frequently, we hypothesized that fast food can be eaten more quickly. This study aimed to examine the effects of meal type on meal duration, considering meal sequence. METHODS: Meal duration, number of chews and bites, and chewing tempo were measured among 41 participants (18 males, 23 females; average age, 41.1 years) using two meals: pizza (301 kcal) and hamburger steak bento (hamburger, rice and broccoli, 304 kcal; two eating sequences: vegetables first or last). RESULTS: Compared with pizza, bento meals (vegetables first or last) were associated with longer meal durations (sec) (mean differences in pizza-bento (vegetable first): -182 [-245.6, -118.9], p < 0.0001; pizza-bento (vegetables last): -216.0 [-273.3, -158.7], p < 0.0001). In contrast, no differences in meal duration (sec) were observed regardless of the order of vegetable consumption (p = 0.14). These findings were consistent with the number of chews and chewing tempos across both sexes. The number of bites was similar among pizza, bento (vegetable fast), and bento (vegetable last). Meal duration was positively associated with the number of chews and bites and meal type and negatively associated with age and sex. BMI was not associated with meal duration. CONCLUSIONS: Meal type affected meal duration, the number of chews, and the chewing tempo, independent of meal sequence. To eat more slowly, it is important to pay attention to the meal type.

Background/Aim: Slow eating is recommended for obese individuals. We aimed to determine the associations between meal duration and various factors (sex, numbers of chews and bites, eating tempo (including forced rhythm with a metronome) and BMI). Methods: Using a test meal (a quarter slice of pizza), we tested the sex difference of the meal duration, numbers of chews and bites, and eating tempo for thirty three healthy subjects (M: 15; F: 18) aged 37.2 ± 11.1 years via unpaired t tests. Next, factors influencing meal duration were identified via multivariate analysis (adjusted for sex), with meal duration as the dependent variable. Results: The meal duration and numbers of chews and bites differed significantly between sexes (63.1 ± 20.7 vs. 87.4 ± 22.8, p = 0.003; 80.3 ± 28.7 vs. 107.0 ± 36.1, p = 0.02; 2.1 ± 1.1 vs. 4.5 ± 2.6, p = 0.001, respectively), but the chewing tempo was similar (p = 0.32). Meal duration was associated with the number of chews (β = 0.6 [0.4, 0.7], p &lt; 0.001) and bites (5.8 [2.5, 9.2], p = 0.001) but not with BMI (p = 0.52) or chewing tempo (p = 0.99). Finally, when a metronome was used to force rhythmic stimulation (0/40/80/160 bpm), compared with 0 bpm, slow stimulation (40 bpm) resulted in increased meal duration (mean difference [95% CI] = −47.0 [−66.4, −27.7], p &lt; 0.0001), chews (−28.6 [−44.5, 12.8], p = 0.0003), and bites (−4.9 [−7.9, 1.9] p = 0.001) and delayed tempo (10.4 [4.5, 16.3], p = 0.0004). Conclusions: Meal duration was positively associated with the numbers of chews and bites and negatively associated with chewing tempo. Thus, increasing the numbers of bites and chews and slowing the eating tempo may prolong meal duration.

Background/Objectives: Carbohydrate and protein restriction are associated with sarcopenia and osteopenia, but the underlying mechanisms remain unclear. We aimed to determine whether mild protein restriction affects muscle and bone function in wild-type (WT) and homozygous carbohydrate response element binding protein (Chrebp) knockout (KO) mice. Methods: Eighteen-week-old male wild-type and homozygous carbohydrate response element binding protein (Chrebp) knockout (KO) mice were fed a control diet (20% protein) or a low-protein diet (15% protein) for 12 weeks. We estimated the muscle weight and limb grip strength as well as the bone mineral density, bone structure, and bone morphometry. Results: Chrebp deletion and a low-protein diet additively decreased body weight (WT control-KO low-protein: mean difference with 95% CI, 8.7 [6.3, 11.0], p < 0.0001) and epidydimal fat weight (1.0 [0.7, 1.2], p < 0.0001). Chrebp deletion and a low-protein diet additively decreased tibialis anterior muscle weight (0.03 [0.01, 0.05], p = 0.002) and limb grip strength (63.9 [37.4, 90.5], p < 0.0001) due to a decrease in insulin/insulin-like growth factor 1 mRNA and an increase in myostatin mRNA. In contrast, Chrebp deletion increased bone mineral density (BMD) (WT control-KO control: -6.1 [-1.0, -2.3], p = 0.0009), stiffness (-21.4 [-38.8, -4.1], p = 0.011), cancellous bone BV/TV (-6.517 [-10.99, -2.040], p = 0.003), and the number of trabeculae (-1.1 [-1.8, -0.5], p = 0.0008). However, in KO mice, protein restriction additively decreased BMD (KO control-KO low-protein: 8.1 [4.3, 11.9], p < 0.0001), bone stiffness (38.0 [21.3, 54.7], p < 0.0001), cancellous bone BV/TV (7.7 [3.3, 12.2], p = 0.006), and the number of trabeculae (1.2 [0.6, 1.9], p = 0.0004). The effects of mild protein restriction on bone formation parameters (osteoid volume (WT control-WT low-protein: -1.7 [-2.7, -0.7], p = 0.001) and the osteoid surface (-11.2 [-20.8, -1.5], p = 0.02) were observed only in wild-type (WT) mice. The levels of bone resorption markers, such as the number of osteoclasts on the surface, the number of osteoclasts, and surface erosion, did not differ between the groups. Conclusions: Both Chrebp deletion and protein restriction led to a decrease in muscle and bone function; therefore, an adequate intake of carbohydrates and proteins is important for maintaining muscle and bone mass and function. Further studies will be needed to elucidate the mechanisms by which ChREBP deletion and a low-protein diet cause osteosarcopenia.

BACKGROUND/OBJECTIVES: The aim of this study is to investigate the association between physical and chemical digestion and nutrition markers (serum albumin (ALB), prealbumin (PAB), and vitamin B12 (B12) levels). METHODS: During a detailed checkup at Fujita Health University, we examined the associations of physical (occlusal force, masticatory performance, and swallowing ability (via the 10-item Eating Assessment Tool, EAT-10)) and chemical (Helicobacter pylori (HP) eradication history, HP antibody levels, and oral antacid (proton pump inhibitors) use) digestion parameters with serum ALB, PAB, and B12 levels in 92 individuals (M:67, F:25). RESULTS: Forty-eight percent of the participants were older than 65 years of age, 19% had decreased occlusal force, 3.2% had decreased masticatory strength, 3.2% had decreased swallowing function, 24% had a history of HP eradication, 23% were HP antibody positive, and 16% were taking oral antacid medication. Additionally, 14% and 11% of the patients had low serum ALB and PAB levels, respectively, and 14% of the patients had B12 deficiency. Multivariate analysis adjusted for age, sex, body mass index, and C-reactive protein levels revealed that there were no significant associations between the physical digestion parameters and the serum PAB, ALB, or B12 levels. On the other hand, there was a significant association between oral antacid use and PAB levels (β = -3.3, p = 0.04). Independent of physical or chemical digestion parameters, serum PAB and B12 levels were significantly associated with protein and B12 intake, respectively. CONCLUSIONS: Oral antacid use may decrease serum PAB levels, indicating protein synthesis.

A conventional questionnaire-based assessment of acetic acid intake is based on the intake of seasonings such as mayonnaise, which could thereby lead to an underestimation. We here determine the relationships of acetic acid intake with nutrient intake estimated using a food recording app (Asken) based on meal recipes. A total of 141 individuals (48 men and 93 women) used the app for at least 7 days per month. The mean daily intake of acetic acid was 0.16 ± 0.19 g and the mean frequency of acetic acid intake was 2.77 ± 1.66 days per week. A multivariate regression analysis adjusted for age, sex, BMI, and energy intake revealed that the amount of acetic acid consumed was significantly and positively associated with the intake of protein (11.9 (5.1, 18.6), p < 0.001), cholesterol (80.7 (4.5, 156.9), p = 0.04), and all vitamins except vitamin K. The frequency of acetic acid intake was significantly and positively associated with protein (1.04 (0.20, 1.87), p = 0.015), vitamin B1 (0.3 (0.02,0.5), p = 0.031), niacin (0.5 (0.04,1.0), p = 0.032), and vitamin B12 (0.4 (0.1,0.7), p = 0.002) intake, suggesting that individuals who frequently consume acetic acid tend to consume more protein and some vitamins. Thus, the amount and frequency of acetic acid may reflect protein and vitamin intake.

Owing to differences in dietary preferences between men and women, the associations between dietary intake frequency and metabolic parameters may differ between the sexes. A retrospective observational study of the checkup findings of 3147 Japanese individuals (968 men, 2179 women) aged 20-59 years was conducted to examine differences in dietary habits and associations between food frequency and blood parameters (eGFR, HbA1c, uric acid, and lipids) by sex and age. Males were more likely to consume meat, fish, soft drinks, and alcohol, whereas women were more likely to consume soybeans, dairy products, vegetables, fruits, and snacks. Multivariate linear regression models adjusted for age and BMI revealed that meat intake frequency was positively associated with HbA1c (β = 0.007, p = 0.03) and negatively associated with eGFR (β = -0.3, p = 0.01) only in males, whereas fish intake frequency was positively associated with eGFR (β = 0.4, p = 0.005) only in females. Egg and soy intake frequencies were positively and negatively associated with non-HDL-C (egg: β = 0.6, p = 0.02; soy: β = -0.3, p = 0.03) only in females. Alcohol consumption frequency was associated with uric acid (M: β = 0.06, p < 0.001; F: β = 0.06, p < 0.001) and HDL-C (M: β = 1.0, p < 0.001; F: β = 1.3, p < 0.001) in both sexes. Future research is needed to determine whether varying the emphasis of dietary guidance by sex and age group is effective, since the effects of dietary preferences on metabolic parameters vary by age and sex.

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 B12 and D were &gt;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 &gt;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 &gt;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.

The condition of being underweight is a social problem in Japan among women. However, there is a lack of evidence for dietary guidance for underweight women because there has been no comparison of lipids or HbA1c among underweight, normal weight, and overweight women in different age groups. We analyzed the effect of body size and age on the serum lipid and hemoglobin A1c levels in Japanese women in a cross-sectional study. A total of 26,118 women aged >20-65 years underwent physical examinations between 2012 and 2022. Seventeen percent of women aged >20-29 years were underweight, and 8% of those aged 50-65 years were underweight. Total cholesterol and non-HDL-C concentrations increased with age, but the difference between underweight and overweight individuals was lowest among women aged 50-65 years. On the other hand, the differences in HDL-C, TG, and HbA1c levels between underweight and overweight subjects were greatest in the 50-65 age group, but the differences between underweight and normal weight subjects were much smaller. Considering that, unlike HDL-C, TG, and HbA1c, TC and non-HDL-C increase to levels comparable to overweight levels in underweight women in aged 50-65 years, educating people about a diet that lowers non-HDL-C is necessary even in young underweight women.

動物性食品の摂取量増加に伴い、蛋白質に含まれるリン摂取量が多くなったことに加え加工食品には食品添加物としてリン酸塩が多く使用されているため、リン摂取量が増加して生体への影響が懸念される。本報では、リン摂取量の推定において日本食品標準成分表の表示値で代用可能かを検討する目的で、市販3メーカーのカスタードプリンおよびミルクチョコレートのリン含量を測定し、比較した。その結果、プリンでは日本食品標準成分表(2010)の表示値110mg/100gに対して実測値は97.4～107.4mg/100gで有意差は見られないのに対し、ミルクチョコレートでは表示値240mg/100gに対して実測値は133.8～222.6mg/100gであり商品間の差とともに表示値に対しても有意な差が見られた。過去食品でのリン表示の必要性が示唆された。

初めて配食サービスを利用する在宅高齢者の栄養状態と継続状況を調査し、1年間継続することによる栄養状態の変化を明らかにすることを目的に、65歳以上の高齢者169例(男性70例、女性99例、平均年齢78.5±8.2歳、独居あるいは夫婦世帯72%、糖尿病などの栄養管理を必要とする疾患71%)の自宅を訪問し、利用者基本情報、簡易栄養状態評価表(Mini Nutritional Assessment:MNA)、栄養素等摂取量などの調査を行い、継続者には1年後再度訪問し、初回時と同じ調査を行った。その結果、配食サービスの利用は6.8±3.5回/週、途中での中断は136例(80%)で、その理由は入院が34例(25%)で最も多かった。1年間の継続利用は33例で、カルシウム、マグネシウム、鉄、食物繊維の摂取量が有意に増加し、それに伴い、MNAの総合評価得点も20.4±3.6点から22.1±3.3点と有意に改善した。

低栄養状態にある高齢入院患者31名(男性7名、女性24名。平均年齢83.1±7.6歳)を対象に、栄養補助食品を用いた栄養介入を行い、その効果を、ビタミンB群およびBCAAを補強したムース・プリンを補給するM群(18名)とバランスのよいビタミン・ミネラル配合ゼリーを補給するE群(13名)の、開始時、4週および8週後の栄養素摂取量、身体計測、血液検査などの比較から検討した。栄養補助食品の群分けは被保険者番号から行った。その結果、栄養素等の摂取量では、M群では熱量、タンパク質、ビタミンB1、ビタミンB2が4週後、8週後に有意に増加し、E群では熱量、カルシウム、鉄、ビタミンB1が4週後、8週後に有意に増加した。また、M群では、4週後、8週後に体重、血清アルブミン、血清トランスサイレチンの有意な増加が認められた。