Narumi Nagai

The body mass index (BMI), defined as weight in kilograms divided by height in meters squared, has been widely used to assess thinness and obesity in all age groups, including children and adolescents. However, the validity and utility of BMI as a reliable measure of nutritional health have been questioned. This study discusses the mathematical conditions that support the validity of BMI based on population statistics. Here, we propose a condition defined as allometric uni-scaling to ensure the validity of BMI as an objective height-adjusted measure. Any given centile curve, including the median curve, in a weight-for-height distribution should be approximated using power-law functions with the same scaling exponent. In contrast, when the scaling exponent varies depending on the position of the centile curve, it is called allometric multi-scaling. By introducing a method for testing these scaling properties using quantile regression, we analyzed a large-scale Japanese database that included 7,863,520 children aged 5-17 years. We demonstrated the remarkable multi-scaling properties at ages 5-13 years for males and 5-11 years for females, and the convergence to uni-scaling with a scaling exponent close to 2 as they approached 17 years of age for both sexes. We confirmed that conventional BMI is appropriate as an objective height-adjusted mass measure at least 17 years of age, close to adulthood, for both males and females. However, the validity of BMI could not be confirmed in younger age groups. Our findings indicate that the growth of children’s weight-for-height relation is much more complex than previously assumed. Therefore, a single BMI-type formula cannot be used to assess thinness and obesity in children and adolescents.

Background Precision in evaluating underweight and overweight status among children and adolescents is paramount for averting health and developmental issues. Existing standards for these assessments have faced scrutiny regarding their validity. This study investigates the age and height dependencies within the international standards set by the International Obesity Task Force (IOTF), relying on body mass index (BMI), and contrasts them with Japanese standards utilizing the percentage of overweight (POW). Method We scrutinized a comprehensive database comprising 7,863,520 children aged 5–17 years, sourced from the School Health Statistics Research initiative conducted by Japan's Ministry of Education, Culture, Sports, Science, and Technology. Employing the quantile regression method, we dissected the structure of weight-for-height distributions across different ages and sexes, quantifying the potentially biased assessments of underweight and overweight status by conventional criteria. Results Applying IOFT criteria for underweight assessment revealed pronounced height dependence in males aged 11–13 and females aged 10–11. Notably, a discernible bias emerged, wherein children in the lower 25th percentile were classified as underweight five times more frequently than those in the upper 25th percentile. Similarly, the overweight assessment displayed robust height dependence in males aged 8–11 and females aged 7–10, with children in the lower 25th percentile for height deemed obese four or five times more frequently than their counterparts in the upper 25th percentile. Furthermore, using the Japanese POW criteria for assessment revealed significant age dependence in addition to considerably underestimating the percentage of underweight and overweight cases under the age of seven. However, the height dependence for the POW criterion was smaller than the BMI criterion, and the difference between height classes was less than 3-fold. Conclusion Our findings underscore the intricacies of age-dependent changes in body composition during the growth process in children, emphasizing the absence of gold standards for assessing underweight and overweight. Careful judgment is crucial in cases of short or tall stature at the same age, surpassing sole reliance on conventional criteria results.

Background We have previously reported that female patients with nontuberculous mycobacterial lung disease (NTM-LD) are thinner and eat less than healthy controls. Therefore, we hypothesized that their thinness is associated with body size misperception. The aim of this study was to clarify whether patients’ body size perception (BSP) is associated with body mass index (BMI) independent of potential confounders. Methods In this cross-sectional study, we assessed 81 outpatients for BSP using the Japanese version of Body Image Scale, body composition, dietary intake, and biochemical markers. As a control, we used BSP and self-reported anthropometric data from 111 healthy women collected via a web survey. First, BSP and BMI were compared between the patients and the controls. Second, patient data was compared between patients who overestimated their body size (OE, n = 31) and a control who did not (Non-OE, n = 50). Multiple regression analysis was performed to clarify the association between BSP (independent variable) and BMI (dependent variable), adjusting for potential confounders, such as age, disease duration, and nutritional factors. Results There was a negative correlation between body size distortion and BMI in both patients and controls (p < 0.001, both). In interpatient comparisons, the OE group had significantly lower BMI and body fat percentage (p < 0.001, both), normalized energy (p = 0.037), and protein (p = 0.013) intakes, and significantly greater weight loss from age 20 (p = 0.003) than the Non-OE group. Multiple regression analysis revealed that overestimation of body size was associated with lower BMI independent of confounders, such as longer disease history, longitudinal weight loss, and nutritional factors. Conclusion These findings suggest that body size distortion is an etiological factor for lower BMI in female patients with NTM-LD. Thus, it may be important to understand the patient’s body image when providing dietary advice.

Recent reports have associated the use of social networking sites (SNS) with the drive for thinness in young women; however, its influence on their actual body shape and eating behaviors (EB) remains unclear. We aimed to examine the effect of SNS use on body mass index (BMI), body image (BI), and EB in young women. Participants included 196 healthy women (20-29 years) who answered questions about their SNS use, height, weight, BI and EB via a web-based survey. First, the correlation between time spent on SNS and each variable was determined. Participants were then divided into quartiles according to the duration of daily SNS use as long (≥3 h, n = 52) and short (<1 h, n = 54), and the data were then compared between the groups. Correlation analysis showed that the longer the duration of daily SNS use, the significantly lower the BMI, the use of nutrition labels, and the frequency of consumption of milk and dairy products. The long group had significantly lower BMI and ideal BI than the short group. The results suggest that spending more time on SNS in young women may be associated with thinner actual and ideal body shapes and poorer access to health information and healthy foods.

Abstract Background In women, slender body habitus has been reported to be one of the predisposing factors underlying the development and poor prognosis of non-tuberculous mycobacterial lung disease (NTM-LD). Given the lack of nutritional data contributing to treatment strategies, we aimed to clarify the nutritional status of female patients with NTM-LD and its association with disease severity. Methods In this single-center observational study, we enrolled 81 female outpatients with NTM-LD. Data on healthy women of similar ages were selected from our previous survey data and categorized as controls. First, we compared anthropometric and dietary survey data between patients and controls. Second, after the patients were categorized into relatively mild (mild, n = 40) and relatively severe groups (severe, n = 41) based on pulmonary X-ray-image finding scores, body composition, nutritional intake, and biochemical markers were compared between the groups. To identify nutritional factors associated with disease severity, logistic regression analyses were performed. Results Compared with controls, patients with NTM-LD had significantly lower energy intake, body mass index, body fat, and skeletal muscle mass (all p &lt; 0.001). Compared with the mild group, the severe group had significantly lower skeletal muscle mass (p = 0.037), albumin (p = 0.029), transthyretin (prealbumin) (p = 0.002), retinol-binding protein (p = 0.011), and hemoglobin (p = 0.001); however, no between-group differences were observed in energy or nutrient intake. Logistic analyses revealed that transthyretin (p = 0.025) and hemoglobin (p = 0.003) levels were independent factors associated with disease severity. Conclusions This is the first study to comprehensively report the association between NTM-LD severity and nutritional status, including body composition, nutrient intake, and biomarkers. The results suggest that initiating nutritional therapy from the mild stage of the disease to prevent undernutrition is warranted.

For athletes, it is important to acquire lean body mass (LBM) involving the skeletal muscle mass during their growth periods; however, the influence of chronotype on LBM gain remains unclear. We therefore aimed to investigate whether chronotype, sleep-wake cycle on weekdays (SWC-W), and their interaction contribute to LBM gain among adolescent male athletes in a 4-month intervention study. The participants were 45 male high-school baseball players. The intervention, including exercise menu (running and muscle strength training) and nutritional education, was conducted during a 4-month period of season-off training. The chronotype, body composition, lifestyle, and dietary intake were investigated before intervention (baseline) and after 4 months. Among the participants [Morningness (n = 14), Eveningness (n = 15), Intermediate (n = 16); ME score based on the Morningness/Eveningness Scale for Children (MES-C)], the midpoint of sleep on weekdays (MSW) was calculated in the "Morningness" and "Eveningness" participants, respectively. They were divided into 4 groups based on a match/mismatch with the chronotype: Type M-match (n = 8), Type M-mismatch (n = 6), Type E-match (n = 7), and Type E-mismatch (n = 8) groups. The data were compared among the 4 groups. Moreover, multiple regression analysis was conducted using an increase (kg) LBM gain as a response variable. When comparing the data between the "Morningness" and "Eveningness" participants, there were no differences in nutrient intake, the duration of training, or each parameter of body composition (per body weight) at baseline or after 4 months. There were also no differences in the rates of change in the body weight or each parameter of body composition. In groups in which the chronotype was consistent with the SWC-W (the Type M-match and Type E-match groups), the LBM gain were slightly greater than in the Type M-mismatch and Type E-mismatch groups (Type M-match: 3.5 ± 2.0 kg, Type M-mismatch: 1.6 ± 1.7 kg, Type E-match: 3.4 ± 2.2 kg, and Type E-mismatch: 1.2 ± 1.8 kg, p = .057). Multiple regression analysis revealed that an extent of the LBM gain was associated with a match between the chronotype and SWC-W (ß = 0.37, p = .030), independent of a long duration of training (ß = 0.52, p = .004). The results suggested that training-related LBM gain is associated with interactions between the chronotype and SWC-W in adolescent male athletes.Abbreviations: LBM: Lean body mass; SWC-W: Sleep-wake cycle on weekdays; ME score: Morningness-eveningness score; MES-C: Morningness/Eveningness Scale for Children; MSW: Midpoint of sleep on weekdays; MSF: Midpoint of sleep on free days; MSFsc: Midpoint of sleep on free days corrected for sleep debt accumulated through weekdays.

OBJECTIVE: Low birth weight (LBW) is a major public health issue as it increases the risk of noncommunicable diseases throughout life. However, the genome-wide DNA methylation patterns of full-term LBW infants (FT-LBWs) are still unclear. This exploratory study aimed to analyze the DNA methylation differences in FT-LBWs compared with those in full-term normal birth weight infants (FT-NBWs) whose mothers were nonsmokers and had no complications. Initially, 702 Japanese women with singleton pregnancies were recruited. Of these, four FT-LBWs and five FT-NBWs were selected as references for DNA methylation analysis, and 862,260 CpGs were assessed using Illumina Infinium MethylationEPIC BeadChip. Gene ontology enrichment analysis was performed using DAVID v6.8 software to identify the biological functions of hyper- and hypomethylated DNA in FT-LBWs. RESULTS: 483 hyper-differentially methylated genes (DMGs) and 35 hypo-DMGs were identified in FT-LBW promoter regions. Hyper-DMGs were annotated to 11 biological processes; "macrophage differentiation" (e.g., CASP8), "apoptotic mitochondrial changes" (e.g., BH3), "nucleotide-excision repair" (e.g., HUS1), and "negative regulation of inflammatory response" (e.g., NLRP12 and SHARPIN). EREG was classified into "ovarian cumulus expansion" within the "organism growth and organization" category. Our data imply that LBW might be associated with epigenetic modifications, which regulate the immune system and cell maturation.

AIM: Small-for-gestational-age (SGA) status has negative health consequences in neonates and later life. Low socioeconomic status (SES) is a reported risk factor for adverse birth outcomes, such as SGA and preterm birth (PTB). The present study investigated whether maternal SES is associated with adverse outcomes in Japanese pregnant women. METHODS: Retrospective data were collected for 1970 Japanese women with singleton pregnancies who delivered between January 2007 and December 2011 at a single center: low SES group (n = 197); and controls (n = 1773). Low SES was defined according to the criteria of the Japanese pregnant-childbirth hospitalization support policy system. RESULTS: The low SES group included a significantly higher proportion of young women, women with single marital status, greater parity, pre-pregnancy smoking and a lack of regular employment (P < 0.001, respectively). The crude odds ratio (OR) for the association between low maternal SES and SGA was 1.80 (95% confidence interval [CI] 1.15-2.82, P = 0.010). After adjustment for baseline maternal age, parity, body mass index, smoking and gestational weight gain, the adjusted OR for the association between low maternal SES and SGA was 1.92 (95% CI 1.17-3.17, P = 0.010). No significant association was found between maternal SES and PTB. CONCLUSION: The present results suggest that low maternal SES is associated with SGA births in the Japanese population. Mitigation of low maternal SES could be urgent public health to prevent disadvantage birth outcome.

Being born with large birthweight is considered as a risk of non-communicable diseases later in life. However, it is not fully understood what kind of maternal dietary intake during pregnancy affect large birthweight. Therefore, we examined the association of dietary intakes and its changes during pregnancy with large-for-gestational-age (LGA) births in Japanese pregnant women. In the prospective study, 245 pregnant women who visited Kyoto Medical Center were enrolled. Nutrition survey using brief-type self-administered diet history questionnaire (BDHQ) at all trimester was completed in 171 pregnant women. Based on birthweight and gestational age, participants were divided into three groups, such as small-for-gestational-age (<10th, SGA, n=17), appropriate-for-gestational-age (≥10th and <90th, AGA, n=144), and LGA (≥90th, n=10) groups. Compared with those without LGA births, mothers with LGA births showed: 1) greater weight gain during pregnancy (LGA: 14.0±3.2 kg, AGA: 9.9±3.9 kg, SGA: 8.4±3.1 kg, p<0.05); 2) higher energy intake throughout pregnancy (LGA: 310±368 kcal, AGA: 7±490 kcal, SGA: -97±293 kcal, ptrend<0.05); 3) larger changes in plant oil and sucrose consumptions from the 1st to 2nd trimester, probably due to the results of greater consumption of bread, Western confectionery, Japanese confectionery, and mayonnaise and dressing during the same period (ptrend<0.05, respectively). Our results suggest that higher energy intake throughout pregnancy, as well as greater consumption of plant oil and sucrose from the first to second trimester could be associated with LGA births.

Maslinic acid, derived from olive fruit, reduces pro-inflammation cytokines, which are involved in muscle fiber atrophy. Therefore, the maslinic acid ingestion may enhance the muscular response to resistance training through anti-inflammatory action. We therefore conducted a parallel, double-blind, randomized, placebo-controlled trial that examined whether a combination of maslinic acid supplementation and resistance training improve mobility functions in community-dwelling elderly persons. Over a 12-week period, 36 participants underwent moderate resistance training and are assigned to the maslinic acid supplementation (n = 17, 60 mg/day) or the placebo (n = 19) group. At baseline and at 12-weeks, we assessed body composition, grip strength, walking speed, leg strength, mobility functions, and knee pain scores. Following the 12-weeks, skeletal muscle mass, segmental muscle mass (right arm, left arm, and trunk) and knee pain score of the right leg were significantly improved in the maslinic acid group, while there was no change or parameters had worsened in the placebo group. Grip strength of the better side significantly increased only in the maslinic acid group. These results suggest that maslinic acid supplementation combined with moderate resistance training may increase upper muscle mass and grip strength, and reduce knee pain, could be effective for preventing mobility-related disability in elderly persons. Clinical trial registration number: UMIN000017207.

Physical exercise exerts favourable effects on brain health and quality of life of the elderly; some of these positive health effects are induced by the modulation of microbiota composition. We therefore conducted a randomised, double blind, placebo-controlled trial that assessed whether a combination of Bifidobacterium spp. supplementation and moderate resistance training improved the cognitive function and other health-related parameters in healthy elderly subjects. Over a 12-week period, 38 participants (66-78 years) underwent resistance training and were assigned to the probiotic Bifidobacterium supplementation (n=20; 1.25×1010 cfu each of Bifidobacterium longum subsp. longum BB536, B. longum subsp. infantis M-63, Bifidobacterium breve M-16V and B. breve B-3) or the placebo (n=18) group. At baseline and at 12 weeks, we assessed the cognitive function, using the Japanese version of the Montreal Cognitive Assessment instrument (MoCA-J); modified flanker task scores; depression-anxiety scores; body composition; and bowel habits. At 12 weeks, the MoCA-J scores showed a significant increase in both the groups, while the flanker task scores of the probiotic group increased more significantly than those of the placebo group (0.35±0.9 vs -0.29±1.1, P=0.056). Only the probiotic group showed a significant decrease in the depression-anxiety scores (5.2±6.3 to 3.4±5.5, P=0.012) and body mass index (24.0±2.8 to 23.5±2.8 kg/m2, P<0.001), with a significant increase in the defecation frequency (5.3±2.3 to 6.4±2.3 times/5 days, P=0.023) at 12 weeks. Thus, in healthy elderly subjects, combined probiotic bifidobacteria supplementation and moderate resistance training may improve the mental condition, body weight and bowel movement frequency.

The 3111T/C single nucleotide polymorphism (SNP) of Circadian Locomotor Output Cycles Kaput (CLOCK) gene reportedly affects gastric motility before breakfast. It is of interest to know whether this SNP can affect the motility during the daytime. We investigated the association between the CLOCK 3111T/C SNP and several gastric motility parameters during the time period from 8:00 to 20:00 in 34 young women with scheduled meals. There were similar daytime fluctuations in gastric motility before and after the meals between the major (T/T) and minor (T/C) allele carriers. The CLOCK SNP may affect daytime gastric motility less than food stimulation.

<p>The aim of this study was to clarify differences in subjective appetite and gastric motility after ingestion of a solution of either a noncaloric artificial sweetener, sucralose (SR) , or sucrose (S) . Twelve young women began fasting at 10:00 pm on the previous night, then ingested SR and S, or plain water (W) as control, at equivalent temperature, volume (15℃, 150 mL) and sweetness at 9:00 am on different days. The subjects were administered the separate sweet samples (30 mL) orally and instructed to swallow after sufficient mixing in the mouth, which was repeated 5 times. For evaluation of sweet taste, the scores before ingestion, and during ingestion of the 1st and 5th cups of the sample were used. Electrogastrograms, electrocardiograms (heart rate) , and body temperatures were obtained 20 min before and 65 min after sample ingestion. Subjective appetite was evaluated before and every 15 min after ingestion. Both of the sweet-tasting samples, but especially SR, suppressed hunger immediately after ingestion, and postprandial subjective appetite increased according to the perceived sweetness (S and SR) . Differences in electrogastrogram responses were found after ingestion of S and SR; elevated HR was observed only after ingestion of S. Our results suggest that SR increases neither heart rate nor body temperature, but temporarily suppresses subjective appetite and alters gastric motility in comparison with S.</p>

Objective: A previous study on young women showed that, after ingestion of hot soup, palatability enhanced the sense of relief, and soup temperature was associated with postprandial body temperatures. However, the effect of sodium on such physiological responses remains unclear. Here, we studied the effect of sodium (amount for daily consumption) on the sense of relief, thermal sensations, and core/peripheral temperatures after ingestion of soup (S) or salt-free soup (SFS).<br>Methods: Twelve young women, who began fasting from the night before the examination day, were provided with S (Na 440 mg), SFS (Na 61 mg) or Blank (no soup) at 9 a.m. on 3 different days in a randomized order. Immediately after ingestion of soup (65&deg;C, 150 ml), palatability was self-recorded. Core (eardrum) and peripheral (fingertip and toe) temperatures and heart rate (HR) were measured 10 min before and 65 min after ingestion. Subjective parameters were self-reported before and every 15 min after ingestion (6 times) using questionnaires.<br>Results: Palatable score and postprandial toe-temperature were significantly higher after S than after SFS. Multiple regression analysis revealed associate of the increase in toe-temperature with palatable scores. Postprandial sense of relief, thermal sensations, core-temperatures, and HR were higher in S and SFS than in Blank, with no differences between S and SFS.<br>Conclusion: Sodium enhanced the palatability of soup, and may be associated with postprandial peripheral temperature. The remaining parameters showed similar changes after both S and SFS, suggesting a limited effect of sodium.

Objective: A previous study on female students with evening preference showed an attenuated activity of the cardiac autonomic nervous system (ANS) in morning and a fluctuated gastric motility caused by mealtime. We further examined the association of morning-evening (ME) preference with morning gastric motility and vital parameters in female high school students who have the same mealtime, as they live in a school dormitory.<br>Methods: Forty-one students were measured in terms of blood pressure, eardrum temperatures, electrocardiography (ECG), and electrogastrography for 10 min before breakfast at temporally setting measurement room in the dormitory. Cardiac ANS activity and averaged heart rate (HR) were calculated from the ECG. To evaluate fasting gastric motility (occurring 3 cycles/min), an action potential was derived from electrodes placed on the abdomen. Thereafter, power and peak frequency was analyzed by a power spectral analysis method. According to total ME scores, calculated from 10 questions (1-5 points, respectively), students were divided into morning (&ge; 28.5 [mean] points) or evening preference groups (< 28.5 points) and the parameters were compared between the groups.<br>Results: As compared to the morning preference group, the evening preference group showed 1) a significantly delayed wake-up time on both weekdays and weekends, 2) a significantly higher HR, and 3) a significantly higher frequency of gastric motility without any differences in gastric contraction power.<br>Conclusion: Female high school students with evening preference showed a high HR after awakening without a diminished gastric motility, possibly suggesting the occurrence of food anticipated activity induced by regular mealtime.

Humans show individual differences of biological rhythm phase, and can be classified into the "morning type" (peak performance being achieved in the early part of the day) or the "evening type" (peak performance towards the end of the day) . We therefore hypothesized that evening-type individuals would show different daytime variations of autonomic nervous activity, gastric motility and appetite sensations, which are under the control of the biological clock. In this study, 34 young women began fasting at 22:00 h on the previous night and ate test meals at a pre-determined time on the test day. Electrogastrography, electrocardiography (cardiac autonomic nerve activity) , appetite sensations, sleepiness, and core (eardrum) temperature were measured from 8:00 to 20:00 h at 1-hour intervals. After completion of all measurements, the subjects completed a morningness-eveningness questionnaire, and were divided into morning- or evening-preference types. Evening-preference individuals demonstrated a higher heart rate, a predominance of sympathetic nerve activity and greater sleepiness in the daytime. Moreover, they had a significantly lower hunger score during the morning, and did not show a significant shift in the frequency of postprandial gastric motility as compared with morning-preference individuals. Our results suggest that an evening-preference lifestyle may be associated with attenuation of appetite and vitality during the morning.

Objective: In nutrition education for the students with special needs, selecting teaching tools that utilize the learners&rsquo; senses are important; however, there has been little research verifying their effectiveness. Since the three-dimensional teaching tools (TDTT) have been widely used in special needs education, we hypothesized that TDTT elicit higher reaction and interest from the students with a various type and degree of the disability as compared to the flat one. The aim of our research was to confirm this hypothesis.<br>Methods: Forty-five students with a primarily physical-disabled, in the elementary to high school sections of S-nursing school, received the nutrition education with the main activity being a pseudo-harvest experience in September 2013. In order to prepare the education tools, a paper was attached to the right half of a B1 size panel, and on the left half, a cloth was attached, thereby creating the appearance of a field. Then, on the right half, flat teaching tools (made of paper) that practically replicated the actual size of the crops were attached, and on the left half, the same number of TDTT (made of cloth) were attached using magic tape. The students came to the lunchroom in the unit of classes (4-6 students) and freely harvested the crops for approximately 15 minutes. The observers recorded the responses of the students and the number of crops harvested, and converted their observations into scores. An evaluation was also conducted from the free descriptions of the teachers.<br>Results: The TDTT showed significantly higher scores for both responses and number of crops harvested than the flat teaching tools. The superiority of the TDTT was also evident from the teacher evaluations.<br>Conclusions: In nutrition education for students with special needs, the findings suggested that TDTT that emphasize discriminative sensations elicit more interest and greater response as compared to flat teaching tools.

The present study focused on the oral stimulatory effect (cooling sensation) of carbonated water. In order to determine the degree to which consumption of carbonated water changes body temperature, and whether such a reaction can occurs through oral stimulation alone, we conducted feeding and sham-feeding (SF) tests employing identical temperatures and volumes of carbonated water and plain water. We conducted 4 types of tests (carbonated water consumption [CW], plain water consumption [W], carbonated water sham-feeding [CW-SF], and plain water sham-feeding [W-SF]) with a randomized crossover design. Thirteen young women began fasting at 10：00 pm on the previous night and samples of water were ingested (15℃, 250 mL) at 9：00 am on different days in a laboratory where the temperature was maintained at 26℃. Electrocardiograms were obtained 20 min before and 40 min after sample ingestion. The subjects' core (eardrum) and peripheral (foot) temperatures were monitored continuously using highly sensitive thermosensors. The eardrum temperature did not change in the W-SF and CW-SF groups, but showed a temporary decrease in the W and CW groups. Foot temperature decreased by approximately 2.5-3℃ in the W and CW groups. Furthermore, while foot temperature decreased by approximately 1℃ in the W-SF group, a decrease of approximately 2.5℃ was observed in the CW-SF group. Heart rate increased temporarily immediately after the end of ingestion in the CW and CW-SF groups. These results suggest that oral stimulation by carbonic acid is solely responsible for changing the heart rate and peripheral temperature.

Objective: The acquisition of the ability for pronunciation is important for hard of hearing preschool children. Nutrition teachers are expected to support children through school-lunch and nutrition education (NE). We therefore conducted a NE program at a school for students with special hearing needs and assessed the program at each stage of the plan-do-check cycle.Methods: Seventeen pairs of children and parents participated in the study. We taught children how to chew using puppets and continued encouraging them to chew well during school-lunchtime. We also educated parents on the benefits of mastication. In the planning assessment, the NE program was checked by teachers, according to the &quot;kindergarten education guidelines.&quot; In the process assessment, we obtained feedback from parents and teachers, and conducted a mid-term evaluation after the summer vacation. In the effect assessment, we obtained information of NE through homeroom teachers regarding children&#039;s chewing behavior during school-lunchtime, and administered questionnaires to parents both before and after NE.Results: The results of the planning assessment were satisfactory. However, in the process assessment, parents&#039; and teachers&#039; feedback indicated difficulties in maintaining proper chewing behavior. In the effect assessment, six of the nine children with chewing problems showed improvement. Moreover, children&#039;s eating habits at home improved, including a reduction in television viewing during meals and an increase in parents&#039; awareness about leaving food crunchy while cooking.Conclusion: Children&#039;s chewing behavior at both school and home improved following NE. However, the results also indicated a regression to original chewing behavior after the summer vacation. Therefore, the contents of NE need to be improved to ensure maintenance of proper chewing behavior.

Objective: Few studies have investigated the change in body temperature after eating a hot meal. We examined the effects of meal temperature on postprandial thermal sensations, and core and peripheral temperatures using soup samples at different temperatures.<br>Methods: Twenty young women were studied using preloads consisting of equivalent amounts (150 ml) of soup at 65&deg;C and 37&deg;C, on separate days at 9 am in a randomized order; the control condition involved no soup ingestion. After overnight fast, each subject wore a t-shirt and short pants and thermal sensations, core (eardrum) and peripheral (a fingertip and a toe) temperatures, and heart rate (HR) were measured 10 min before and 65 min after soup ingestion in a temperature-controlled (26&deg;C) room. Palatable score was measured immediately after consumption (from unpalatable [0] to palatable [10]).<br>Results: The palatable score was significantly higher after 65&deg;C-soup consumption than after 37&deg;C-soup consumption. Postprandial changes in eardrum and toe temperatures, and HR after 65&deg;C-soup consumption were significantly higher than that after 37&deg;C-soup consumption and in the control (Sample effect: p < 0.05, Sample &times; Time: p < 0.05). Post-hoc comparison tests showed that the thermal sensation was significantly higher just after 65&deg;C-soup consumption than after 37&deg;C-soup consumption and in the control; moreover, eardrum (0~20 min) and toe temperatures (0~15 min) were significantly higher after 65&deg;C-soup consumption than after 37&deg;C-soup consumption.<br>Conclusion: Our results suggest that 65&deg;C-soup ingestion increases eardrum and toe temperatures. Not only the energy content of the substrate and palatability, but also the temperature of meals affects thermal sensations and body temperature.

To provide data for improvement of postgraduate education, we investigated the achievement of practical expertise by using 58 competency self-measurement items and rating them on a scale of 1 to 5 in 3,055 registered dietitians( RDs) who were members of Japan Dietetic Association and have a maximum of 10 years' experience. Approximately half of the participants were affiliated with hospitals. The overall participants obtained high scores for motivation, attitude, food poisoning, and treatment of personal data;however, they obtained low scores for public nutrition (epidemiology) and research. The RDs who were educated under the former curriculum( n=787, 91.8% had 5 or more years of experience as RDs or dietitians) obtained the highest scores in 39 of 58 items when compared to the RDs who were educated under the later curriculum, which started in 2002 (RDs-later, n=1,702, 37 . 5%) or the non-graduate RDs (n=530, 83 . 7%). RDs-later showed significantly higher scores in 4 items;elementary competencies (motivation and attitude), general competency (utilization of theory and model of behavioral science), and occupational competency (formulation of medical records based on SOAP). These results raise the possibility that the competency achievement may be associated with years of experience and educational curriculum.

Objective: We implement a mobile-based nutrition education program to promote good breakfast habits, evaluate the intervention effect, and identify considerations for such novel approaches in the future.<br>Methods: The participants were 209 university freshmen who attended information science lecture at the University of Hyogo. Aspects of their use of the mobile phones were examined, such as the model type and price plan, and they then were classified accordingly into the intervention group (n=104) or control (n=105) group. The participants in the intervention group received information that prompted their access via their mobile phones to a page including four cartoons and some breakfast recipes every Thursday for 8 weeks. Data were collected from website traffic, and pre- and post-intervention surveys concerning breakfast habits.<br>Results: 1) The number of website visitors was the highest during the first week, but gradually decreased after the second. Supplementary mails, which started in the fifth week, increased website traffic, but it deceased again except during the eighth week. 2) Participants were most interested in the recipe contents, and those who liked cooking scored higher after the intervention on healthy breakfast behaviors. 3) The number of participants who had unfavorable breakfast behaviors was significantly increased in the control group, and this change was not significant in the intervention group.<br>Conclusion: The current mobile-based nutrition education program has the potential to prevent the exacerbation of unhealthy breakfast behaviors. The development of simple breakfast recipes in consideration of cost and ease to store, introduction of interactive communication tools, and an information service tailored for subjects on the basis of their individual characteristics are needed for this approach to be more effective in the future.

Studies have shown that approximately half of young Japanese women experience consistent, remarkable coldness in their extremities. The authors previously demonstrated an association of unusual coldness with lower daily energy intake and reduced thermoregulatory sympathetic nervous system (SNS) activity in young women. This led to the hypothesis that the unusual coldness observed among these young women derives from a widening difference between core and peripheral temperatures because of lowered thermogenesis. This study aims to examine this hypothesis. Twenty women aged 18-21 years participated in this study ; ten women consistently suffer severe coldness even at thermoneutral temperature (C-group), and another ten who do not experience such coldness (N-group). Body composition, resting energy expenditure (REE), thermoregulatory SNS evaluated by heart rate variability analysis, body temperature, and cold discomfort scores using visual-analogue scales were measured in a temperature-controlled room (26℃) at 8:30 a.m. after an overnight fast on two different days. As indices of core and peripheral temperatures, eardrum, finger, and toe temperatures were measured using high-sensitivity thermo-sensors for 60 min. C-group showed a significantly lower thermoregulatory SNS and tended to have lower REE per lean body mass as compared to N-group. Eardrum temperature did not differ between the groups. Only C-group showed a significantly increased difference between core and peripheral temperatures (eardrum-finger or eardrum-toe, 0-60 min). A positive correlation was observed between eardrum-toe temperatures and cold discomfort scores at the toe. Our results suggest that women who consistently experience such coldness characteristically have 1) lowered REE. 2) increased difference in core-peripheral temperatures during 60 min, 26℃-environmental exposure despite similar core temperature, and 3) increased coldness due to wider core-peripheral temperatures, thus supporting our hypothesis.

BACKGROUND: Limited studies have shown inconsistent data about the association between the uncoupling protein 1 (UCP1) gene A-3826G polymorphism and high-density lipoprotein (HDL) cholesterol levels. The present study investigated the association between the A-3826G polymorphism and low HDL-cholesterolemia in non-obese and obese subjects. METHODS: Anthropometric and biochemical factors, in addition to genotyping by an allele-specific DNA assay, were measured in 294 community-dwelling Japanese subjects (male/female: 127/167, mean age: 65 years). Obesity was defined as a body mass index (BMI) ≥ 25 kg/m(2), and low HDL-cholesterolemia was defined as < 1.04 mmol/L of HDL-cholesterol. RESULTS: The subjects with the G/G genotype (n = 27) showed a significantly higher prevalence of low HDL-cholesterolemia (37%) than those with the A/A + A/G genotype (13%) in the obese group (n = 102). There was a non-significant difference in the prevalence of low HDL-cholesterolemia between subjects with the G/G genotype (n = 45, 13%) and with the A/A + A/G genotype (15%) in the non-obese group (n = 192). A multivariate-adjusted logistic regression analysis of the presence of low HDL-cholesterolemia revealed that carrying the G/G genotype was an independent and significant factor positively associated with low HDL-cholesterolemia [odds ratio (OR): 6.85, 95% confidence interval (CI): 1.65-28.49] in the obese group, while carrying the G/G genotype exhibited a non-significant but reduced OR, by one-half, for low HDL-cholesterolemia (OR: 0.51, 95% CI: 0.13-1.96) in the non-obese group. CONCLUSIONS: The obesity status could have opposing impacts on the relationship between the G/G genotype and low HDL-cholesterolemia, providing insight into the need to consider the obesity levels when studying the association between the UCP-1 gene A-3826G polymorphism and HDL-cholesterol. KEYWORDS: Obesity; Body mass index; HDL-C; Atherosclerotic risk.

Electrogastrography (EGG) is a method for recording gastric myoelectrical activity using cutaneous electrodes from the abdominal surface. To investigate the effects of water temperature and volume on gastric myoelectrical activity, we performed three tests in a randomized parallel design, using the following samples: 15°C/250 mL (Cold250), 65°C/250 mL (Hot250), and 65°C/150 mL (Hot150) in 27 young women at 9 a.m. after an overnight fast. EGG recordings were made before (20 min) and after (35 min) ingestion to determine the frequency and power ratio of normogastria with the band set at around 3 cycles per min. The frequency of normogastria was transiently increased after ingestion of Hot250, but temporarily decreased after Cold250, showing significantly different changes in time courses. No difference in the frequency of normogastria was evident between Hot250 and Hot150. The power ratio of normogastria was equally increased after ingestion of all samples. Our results suggest that hot water (65°C, >150 mL) can increase the frequency of the normal range of gastric motility; moreover, its power was transiently increased after water ingestion, regardless of temperature and volume.

The objective of this cross-sectional study was to evaluate whether nutritional and physiological factors are associated with the skin condition of young women. Data on skin condition, physiological measurements, dietary intake of nutrients (2 days), mental condition, and lifestyle were obtained from 54 female students (aged 20-22 yr) without coexisting skin disease. Skin condition and physiological parameters (body temperature, energy expenditure, and autonomic nervous system [ANS] activity) were measured using noninvasive techniques. Statistically significant associations were found betwe...

The purpose of this study was to examine differences in the feeling of relief (comfort induced by food ingestion) after intake of different types of soup, and the effects of psychological and physiological factors on postprandial sense of relief. Before the examination, a sensory test was performed to classify test samples (corn potage [90 kcal], chicken consommé [43 kcal], and iso-caloric but low-flavor corn and chicken placebo soups) using 6 trained panels. For the main test, 11 women (age 22.6±0.3 yr) consumed a soup as breakfast after an overnight fast on four different days in randomiz...

A dietary educational program with visual aids and tasting is described to reduce the negative image of vegetables and encourage children to eat more vegetables. We ran this dietary educational program named "eating experience class" (a 45-min lecture + 90-min practicum) to 4 classes of sixth graders in elementary school (n = 133). The effects of this dietary education were assessed by investigating the children's attitude and motivation to eat their least favorite vegetables and their experience of vegetable cooking at home with questionnaires presented before and after the period of dietary education. The questionnaire involved a visual analog scale (VAS) to observe a slight change in the negative image of vegetables. The results demonstrated that about twenty children (18.7%) tried to eat more vegetables, and VAS scores showed a significant reduction in the negative image for 16 of 20 vegetables. A significant change in vegetable cooking experience at home was also observed after the dietary education program (p < 0.001). This program could help children to improve their image of vegetables, and induce the motivation to eat and cook vegetables. The VAS principle may be a sensitive method to assess a slight change in the negative image of vegetables in children.

Electrogastrography (EGG) is a noninvasive technique for measurement of gastric motility by recording gastric myoelectrical activity through cutaneous electrodes placed on the abdomen. We performed a one-week skipping breakfast test and a consecutive one-week refeeding test to examine the relationship between consecutive skipping of breakfast and morning gastric motility in 11 women (age 21.5±0.2 yr) who habitually ate breakfast almost every day. On the test days, we measured the subjects’ body composition, self-reported hunger and appetite scores (by using visual analog scales), EGG (to de...

The present study was designed to verify the effect of L-carnitine intake on postprandial hunger feeling in young healthy females. With double-blind, crossover design (1 wk washout), 12 females (21.3±0.3 y) consumed a placebo or L-carnitine containing (300 mg per meal) formula diet as breakfast after overnight fasting. Satiety scores (visual analog scales; VASs), salivary cortisol, serum carnitine concentrations, blood glucose, and autonomic nervous system activity by means of heart rate variability power spectral analysis were measured before and after feeding for 6 h at intervals. Our dat...

This study was designed to investigate the effect of skipping breakfast and macro-nutrient balance on postprandial blood glucose (BG), satiety, energy expenditure (EE), and autonomic nervous system (ANS) activity in healthy subjects with and without polymorphism of the uncoupling protein-1 (UCP 1) gene. Eight healthy young subjects were given breakfast and lunch (CC ; high-carbohydrate meal (HC) + HC, SC ; no breakfast + doubled HC lunch, FF ; high-fat meal (HF) + HF, SF ; no breakfast + doubled HF lunch) at random on four different days. The total calories of each test diet were the same and were adjusted individually to each subject's body-mass (22 kcal/kg). BG, satiety score, EE and ANS activity were measured before breakfast and at 30-minutes intervals for 6 hours after breakfast. During the first 3 hours significantly higher BG, satiety scores, and EE were found after the CC test, than after the FF test. Postprandial thermogenesis during the 6 hours after the CC test was higher than after the other diets. The ANS seemed to play a role in the higher level of satiety and thermogenesis ; however, the difference in ANS activity was not significant. The subjects with the GG allele of the UCP 1 gene showed lower postprandial thermogenesis. In conclusion, a HC meal for breakfast and well-regulated diet can contribute to the prevention of obesity in individuals with normal glucose tolerance. Our results suggest that genetic background is also important to prevention of obesity.