Relationship between working hours and sleep quality with consideration to effect modification by work style: a community-based cross-sectional study.

BACKGROUND: Although longer working hours are associated with lower sleep quality, it is still necessary to work a certain number of hours to make a living. In this study, we investigated the relationship between working hours and sleep quality in a community setting. We then explored how to manage work style while maintaining the sleep quality of workers without markedly reducing working hours. METHODS: 4388 day-time workers in various occupations living in Ota ward in Tokyo were included in the analysis. The relationship between working hours and sleep quality measured by the Athens Insomnia Scale was examined by ANOVA and linear regression models. Effect modification by work style (work end time, shift in working start and end time, current work from home status, change in work place) on the relationship between working hours and sleep quality was investigated by multivariate linear regression models. RESULTS: Longer working hours were significantly associated with lower sleep quality. The magnitude of the relationship between long working hours and low sleep quality was significantly larger when work end time was later (p for trend of interaction < 0.01) and when working start and end time were shifted later (vs no change, p for interaction = 0.03). The relationship was marginally greater when the proportion of work from home was increased (vs no change, p for interaction = 0.07). CONCLUSIONS: A relationship between longer working hours and lower sleep quality was observed among workers. Leaving work earlier or optimizing the work environment at home may diminish the adverse effect of long working hours on sleep quality.

[Actual usage of Dietary Reference Intakes for Japanese among individuals engaged in work related to food and nutrition: Comparison between workplaces].

Objective　The aim of this study was to compare how Dietary Reference Intakes for the Japanese (DRIs), which are dietary guidelines proposing reference values for the intake of energy and nutrients by healthy Japanese people, are used by personnel whose work involves diet, food, or nutrition.Methods　A web-based questionnaire survey was conducted in July 2023 among those involved in work closely related to diet, food and/or nutrition. The frequency of the use of DRIs in daily work and the details of use, including the chapter used, difficulty of use, information source for revisions, and interest in a revised version, were compared among workplaces (e.g., medical institutions; school and welfare facilities; government institutions; dietitian training schools; companies; and freelancer in community and others).Results　Among 1,030 participants, 58% (n=597) used DRIs "very often" or "often" in their daily work. For example, DRIs were used to prepare institutional meals and facilitate nutrition management and guidance in medical institutions; prepare institutional meals in schools and welfare facilities; ensure nutrition management and guidance for citizens and prepare courses/materials for government institutions; and prepare courses/materials for dietitian training schools. Regarding the main parts of the DRIs used, most respondents chose the chapters entitled "Energy" (66%) and "Macronutrients" (72%). For all participants (n=1,030), the main difficulties in the use of DRIs were "a large number of sentences in the DRIs and an insufficient time to read" (stated by 54% of all respondents; the proportion did not significantly differ among workplaces). The main source of information on revised DRIs was "seminars and workshops by the Japan Dietetic Association" (70% of all respondents). However, many respondents in the government and dietitian training institutions also identified "workshops or public information by the Ministry of Health, Labour and Welfare" as major sources. Regarding participants' main interest in the revised version of the DRIs, general policy (77%) and revised reference values (74%) generated the highest levels of interest. Those working at dietitian training schools had a greater interest in change related to scientific evidence for each reference value than those working elsewhere.Conclusions　DRIs are frequently used by those involved in work related to food and nutrition. In this study, DRI use and related interests differed based on the workplaces surveyed. In future revisions of DRIs, the addition of further descriptions or appendices in line with their use in workplaces may be needed.

Association between sodium and potassium excretion estimated from spot urine and socioeconomic status among primary school children and their mothers in Okinawa, Japan.

Hypertension is the greatest and the most preventable risk factor for cardiovascular disease. Excessive sodium (Na) intake and insufficient potassium (K) intake have been identified as risk factors for hypertension. Socioeconomic status (SES) may be related to diet quality. In Japan, few studies have examined the relationship between urinary Na and K excretion and SES in adults, and there are no studies in children. In 2014, 1944 children (1382 households) in all public elementary schools in Yaese town, Okinawa, Japan were recruited to participate in a study. Casual urine specimens were collected to estimate 24-h urinary Na and K excretion and urinary Na/K ratio. Mother's educational background and household incomes were assessed and used as indicators of SES. A total of 236 pairs of children and their mothers were analyzed in this study. Urinary Na and K excretion were not significantly related to educational levels of mothers and household incomes in children. On the other hand, in mothers, lower household income group had higher 24-h estimated urinary Na excretion and urinary Na/K ratio than other groups. There was no significant difference between urinary excretion and educational levels in mothers. Household income disparities in urinary levels seen in mothers were not seen in children. There may be some factors that moderate the dietary inequalities in children.

The Nutritional Characteristics of Usual Lunches Consumed Among Japanese Workers: Comparison Between Different Lunch-Type Groups.

OBJECTIVE: This study investigated whether the nutritional characteristics of lunches consumed by Japanese workers differ by where the meal is usually prepared or eaten. METHODS: This cross-sectional study included 620 employees (aged 20 to 75 years) from eight business offices in Tokyo, Japan. Dietary data were collected using the validated Meal-based Diet History Questionnaire. The Healthy Eating Index 2015 and dietary intakes from lunch were compared between workers classified by usual lunch type: homemade (n = 190), staff canteen (n = 77), restaurant (n = 109), and takeaway (n = 244). RESULTS: Healthy Eating Index 2015 for lunch was highest in the staff canteen group, followed by the homemade group. The staff canteen group had higher intakes of total vegetables, potatoes, fish, and several vitamins from lunch than the restaurant or takeaway groups. CONCLUSIONS: Homemade and canteen lunches are relatively healthy options for lunch for Japanese workers.

The association of highly processed food consumption with food choice values and food literacy in Japanese adults: a nationwide cross-sectional study.

BACKGROUND: Highly processed food (HPF) consumption is increasing globally and has become a prominent public health concern. However, the relationship between HPF consumption and food choice values and food literacy is unknown. This study aimed to examine the association of HPF consumption with food choice values and food literacy. METHODS: This cross-sectional study used data from a nationwide questionnaire survey conducted in 2018 among 2232 Japanese adults aged 18-80 years. We assessed eight food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort, and safety) using a 25-item scale, and food literacy characterised by nutrition knowledge (using a validated 143-item questionnaire), cooking and food skills (using 14- and 19-item scales, respectively), and eight eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness, and slowness in eating, using the 35-item Adult Eating Behavior Questionnaire). HPF consumption was estimated using a validated brief diet history questionnaire. The associations between HPF consumption and age, body mass index, energy intake, and each score on food choice values and food literacy were evaluated by multiple linear regression. RESULTS: In males, one standard deviation increase in scores for cooking skill and satiety responsiveness was associated with an increase in HPF consumption by 22.1 g/4184 kJ (95% confidence interval (CI): 6.6 to 37.5) and 15.4 g/4184 kJ (95% CI: 6.0 to 24.7), respectively. In females, one standard deviation increase in age and scores for safety and nutrition knowledge corresponded to a decrease in HPF consumption by - 16.4 g/4184 kJ (95% CI: - 23.4 to - 9.3), - 9.9 g/4184 kJ (95% CI: - 19.1 to - 0.7), and - 11.1 g/4184 kJ (95% CI: - 17.0 to - 5.3), whereas one standard deviation increase in the satiety responsiveness score corresponded to an increase in HPF consumption by 13.1 g/4184 kJ (95% CI: 6.8 to 19.4). CONCLUSIONS: This cross-sectional study suggests that several aspects of food choice values and food literacy were associated with HPF consumption in Japanese adults. Further studies are needed to confirm our findings in a broader context.

Sex differences in the association between smoking and central sensitization: A cross-sectional study.

INTRODUCTION: Despite the acknowledged interconnection between smoking and pain, research on the relationship between smoking and central sensitization (CS) is scarce; this pain mechanism has attracted recent research attention. Considering potential sex differences, this cross-sectional study aimed to investigate the association between smoking and CS. METHODS: Overall, 415 adult participants from an outpatient clinic underwent evaluation. The analysis focused on determining the relationship between smoking status and CS by differentiating between sexes. Data were collected on smoking presence or absence (independent variable) and CS (dependent variable) for each sex, with age, education level, drinking history, depression, and anxiety as covariates. CS was evaluated using the Central Sensitization Inventory. Following a descriptive analysis of the study population's characteristics, logistic regression analysis was employed to assess the relationships. RESULTS: The average participant age was 42.3 years, with 59% being women. Among women, a significant association was found between smoking status and higher CS severity (AOR=3.21; 95% CI 1.29-7.99, p<0.01), after accounting for confounding variables. Conversely, no significant association was observed for men (AOR=1.50; 95% CI 0.63-3.60, p=0.36). Interaction by sex on the relationship between smoking and CS was not statistically significant (p=0.23). CONCLUSIONS: This study suggests a potential association between smoking and CS in women, whereas no conclusive relationship was observed among men. These findings indicate the necessity of considering CS when examining the relationship between smoking and pain.

Dietary protein intake and all-cause mortality: results from The Kawasaki Aging and Wellbeing Project.

BACKGROUND: Increased protein intake has been recommended to prevent sarcopenia/frailty, reports on the quantity and quality of protein intake needed and the associated prognosis, particularly in the aging population of Asia, are limited. In this study, we aimed to investigate the relationship between protein intake and mortality in Japanese individuals, aged 85 years and older. METHODS: The data were obtained from The Kawasaki Aging and Wellbeing Project, which is a prospective cohort study of older adults aged between 85 and 89 years with no physical disability at baseline. Of the 1,026 adults in the cohort, 833 were included in the analysis, after excluding those who had not completed a brief, self-administered diet history questionnaire or those who scored less than 24 on the Mini-Mental State Examination. The participants were grouped into quartiles based on protein intake: Q1 (protein < 14.7, %Energy), Q2 (14.7 ≤ protein < 16.7, %Energy), Q3 (16.7 ≤ protein < 19.1, %Energy), and Q4 (≥ 19.1, %Energy). Multivariate Cox proportional hazards models were utilized to evaluate the association between protein intake and all-cause mortality. Kaplan-Meier survival curves were employed to investigate the relationship between protein intake and all-cause mortality. RESULTS: The mean protein intake of our study population was 17.0% of total energy. Animal protein intake, particularly fish intake, increased significantly along with total protein intake. The study had an average observation period of 1,218 days and recorded 89 deaths. After adjusting for age, sex, skeletal muscle mass index, cardiovascular disease, cancer, education, and serum albumin levels, a lower risk of all-cause mortality was observed in the highest protein intake (Q4) group than in the lowest protein intake (Q1) group (hazard ratio: 0.44, 95% confidence interval: 0.22-0.90, p-value: 0.020). CONCLUSION: Protein intake is associated with a reduced risk of all-cause mortality in older adults (aged ≥ 85 years) who engage in independent activities of daily living. This association may impact all-cause mortality independent of muscle mass.

Factors affecting activities of daily living among patients with Wilson disease.

Wilson disease (WD) is a congenital copper metabolism disorder with various manifestations and can be treated with oral medication. This study examined the factors related to decline in activities of daily living (ADL) in patients with WD as research in this area remains limited. We enrolled 308 patients with WD, including patients who participated in a national survey and those who sought cares at the Department of Pediatrics, Toho University Ohashi Medical Center, from 2016 to 2017. We analyzed the association between ADL decline and factors including age at diagnosis, period from diagnosis to survey, hepatic symptoms, neurological signs, and psychiatric presentation at diagnosis. The relative risks (RRs) for ADL decline were estimated for each factor using multivariate modified Poisson regression analysis. Overall, 97 out of 308 (31.5%) patients experienced ADL decline. After adjusting for explanatory variables, regression analysis revealed that factors significantly associated with ADL decline were a period of ≥20 years from diagnosis to survey (adjusted RR = 2.34, 95% confidence interval [CI]: 1.47-3.74), hepatic symptoms with splenomegaly (adjusted RR = 2.57, 95% CI: 1.26-5.24), mild neurological signs (adjusted RR = 3.20, 95% CI: 1.96-5.23), and severe neurological signs (adjusted RR = 3.63, 95% CI: 2.28-5.77). Neurological signs, hepatic symptoms with splenomegaly, and a period of 20 years from diagnosis to survey are associated with ADL decline. Thus, careful assessment of patients for these factors is necessary, and these findings may guide future efforts to improve patient prognosis.

Consumption of highly processed foods in relation to overall diet quality among Japanese adults: a nationwide study.

OBJECTIVE: To (i) examine the consumption of highly processed foods (HPF) in relation to diet quality among Japanese adults and (ii) compare the results when dishes prepared away home are disaggregated into food ingredients before classification by processing levels and the results when they are not. DESIGN: Cross-sectional analysis using 4-day dietary record data. Foods were categorised by level of processing using the framework developed by the University of North Carolina at Chapel Hill. Specifically, dishes prepared away from home were classified at both the food level (classified after disaggregation into ingredients) and dish level (classified without disaggregation). Diet quality was assessed using the Healthy Eating Index-2015 and Nutrient-Rich Food Index 9·3. SETTING: Twenty areas in Japan. PARTICIPANTS: Adults aged 20-69 years (n 388). RESULTS: Energy contribution of HPF was higher when dishes prepared away from home were classified at dish level than food level (48·3 % v. 32·9 %, P < 0·0001). Regardless of the classification method, cereals and starchy foods were the top food groups contributing to total energy intake from HPF. After adjusting for potential confounders, participants in higher tertiles of the energy contribution of HPF had lower total scores for Healthy Eating Index-2015 and Nutrient-Rich Food Index 9·3 (P for trend ≤ 0·007 for all), irrespective of the food- or dish-level classification. CONCLUSIONS: HPF accounted for at least one-third of energy intake of Japanese adults. Regardless of the classification methods for dishes prepared away from home, higher consumption of HPF was associated with lower diet quality.

Misreporting of height and weight by primary school children in Japan: a cross-sectional study on individual and environmental determinants.

BACKGROUND: Appropriate body constitution during childhood is important for future health. However, it has been suggested that thinness is increasing among adolescent girls and boys in Japan. Since misreporting of height/weight may be a possible reflection of the child's ideal body image, we investigated the magnitude and direction of height/weight misreporting and its determinants among Japanese young adolescents. METHODS: A total of 1019 children in public primary schools were included in the analysis. Both measured and self-reported values of height/weight were obtained. Misreporting of height/weight was calculated by subtracting the measured value from the self-reported value. The association between misreporting and several variables such as the BMI z-score of individuals and body constitution of surrounding children was explored by multivariate linear mixed models. RESULTS: As BMI z-score increased, 'overreporting' of height by boys and 'underreporting' of height by girls became larger (p = 0.06 in boys, p = 0.02 in girls). Both boys and girls with a larger body size tended to underreport their weight (p < 0.01 in boys, p < 0.01 in girls). Boys who belonged to a school with a larger average BMI z-score were more likely to overreport their weight. This tendency was not observed for girls. CONCLUSIONS: Self-reported height/weight was generally accurate in Japanese primary school children. However, even primary school children misreported their height/weight intentionally like adults, possibly due to social pressure to lose weight or that not to stand out. Thus, health education about appropriate body constitution should be provided from the beginning of adolescence, particularly for girls.

Development of a Diet Quality Score for Japanese and Comparison With Existing Diet Quality Scores Regarding Inadequacy of Nutrient Intake.

BACKGROUND: Few studies have explored optimal diet quality scores in Japan. OBJECTIVES: We developed a Diet Quality Score for Japanese (DQSJ) and examined the associations of DQSJ and existing diet quality scores with inadequacy of nutrient intake in Japanese adults. METHODS: Candidate components of the DQSJ were extracted from well-established diet quality scores: Healthy Eating Index-2015 (HEI-2015), Alternate Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet score (AMED), and Dietary Approaches to Stop Hypertension (DASH). From candidates, we selected the components of the DQSJ, considering potential health effects of the components (from the Global Burden of Disease Study) and dietary intake in Japan. The DQSJ included 10 components: fruits, vegetables, whole grain, dairy, nuts, legumes, fish, red and processed meat, sugar-sweetened beverages, and sodium. We calculated the DQSJ, HEI-2015, AHEI-2010, AMED, DASH, and Japanese Food Guide Spinning Top score (JFGST) based on 4-d dietary records of 392 Japanese aged 20-69 y. Inadequate intakes of 21 nutrients were assessed using the DRIs for Japanese. Logistic regression was used to examine the prevalence of inadequate nutrient intake according to quartiles of the scores. RESULTS: All examined scores except the JFGST were moderately to strongly correlated with each other (Spearman correlation coefficients: 0.52-0.84). They were inversely associated with the prevalence of inadequate intake of most nutrients (n = 16 for DQSJ and HEI-2015, n = 13 for AHEI-2010 and DASH, n = 17 for AMED, compared with n = 4 for JFGST). AMED was also positively associated with the prevalence of inadequate sodium intake, whereas no such associations were observed for the other scores. CONCLUSIONS: Similar to HEI-2015, AHEI-2010, and DASH, the DQSJ was generally associated with the low prevalence of inadequate intake of most nutrients in Japanese adults. Further evaluations against biomarkers and health outcomes are warranted.

Relationship between dietary patterns and physical performance in the very old population: a cross-sectional study from the Kawasaki Aging and Wellbeing Project.

OBJECTIVES: As the world's population is ageing, improving the physical performance (PP) of the older population is becoming important. Although diets are fundamental to maintaining and improving PP, few studies have addressed the role of these factors in adults aged ≥ 85 years, and none have been conducted in Asia. This study aimed to determine the dietary patterns (DP) and examine their relationship with PP in this population. DESIGN: This cross-sectional study (Kawasaki Aging and Wellbeing Project) estimated food consumption using a brief-type self-administered diet history questionnaire. The results were adjusted for energy after aggregating into thirty-three groups, excluding possible over- or underestimation. Principal component analysis was used to identify DP, and outcomes included hand grip strength (HGS), timed up-and-go test, and usual walking speed. SETTING: This study was set throughout several hospitals in Kawasaki city. PARTICIPANTS: In total, 1026 community-dwelling older adults (85-89 years) were enrolled. RESULTS: Data of 1000 participants (median age: 86·9 years, men: 49·9 %) were included in the analysis. Three major DP (DP1: various foods, DP2: red meats and coffee, DP3: bread and processed meats) were identified. The results of multiple regression analysis showed that the trend of DP2 was negatively associated with HGS (B, 95 % CI -0·35, -0·64, -0·06). CONCLUSIONS: This study suggests a negative association between HGS and DP characterised by red meats and coffee in older adults aged ≥ 85 years in Japan.

Association between dietary patterns and subjective and objective measures of physical activity among Japanese adults aged 85 years and older: a cross-sectional study.

A healthy diet and regular physical activity (PA) are delineated as healthy behaviours. Their implementation is associated with better health outcomes and improved quality of life. There is less evidence of a relationship between dietary patterns (DP) and PA, especially in adults aged ≥ 85. Hence, this cross-sectional study investigates the association between DP and PA in people of this age group, using the data from The Kawasaki Aging and Well-Being Project. Brief-type self-administered diet history questionnaire was used to estimate the intake of fifty-eight types of food. After energy adjustment, principal component analysis was performed to identify DP. PA was measured objectively using an accelerometer and subjectively using a questionnaire validated for this age group. Thousand participants (median age: 86·9 years, men: 49·9 %) were included in the analysis. Three major DP (DP1 'various foods', DP2 'red meats and coffee', DP3 'bread and processed meats') were identified. DP1 'various foods' was similar to DP previously named 'healthy' or 'prudent' and showed a positive association with PA time (PAT) as measured by accelerometer (B, 6·25; 95 % CI 0·13, 12·37) and relatively shorter sedentary behaviour (SB) time. DP2 'red meats and coffee' and DP3 'bread and processed meats' were negatively associated with PAT and positively associated with SB time. This study observed the relationship between diet and PA behaviours in adults aged ≥ 85, with healthier and more food-diverse DP associated with longer PAT and relatively unhealthy DP with shorter PAT.

Guardianship dietary and other behavioural factors associated with skipping breakfast in Japanese primary school children: A child-guardian dyad study.

BACKGROUND AND OBJECTIVES: Regular breakfast consumption is widely considered an important component of healthy dietary habits. In this study, we assessed differences in nutrient/food intake between breakfast consumers and skippers. We also investigated behavioural factors related with breakfast skipping utilizing data collected from both children and their guardians. METHODS AND STUDY DESIGN: This cross-sectional study was conducted in 14 public primary schools in Japan. Two questionnaires were distributed: a behavioural questionnaire and a brieftype, self-administered diet history questionnaire. In total, 1816 child (10-12 y/o)-guardian dyads were included in the analysis. Intakes of nutrients and foods were compared between breakfast consumers and skippers by the ttest. The relationship between breakfast skipping and behavioural factors was investigated by logistic regression analysis by child sex. RESULTS: The proportion of breakfast skippers in the children was 9.8%. Daily intakes of nutrients/foods were better in the breakfast consumers. Later bedtime, lower nutrition knowledge level, and frequent incomplete consumption of home meals was significantly or marginally associated with breakfast skipping. Guardians' breakfast skipping was also associated with children's breakfast skipping. Some relationships between behavioural factors and breakfast skipping differed between boys and girls. CONCLUSIONS: Breakfast consumers had a more nutritious meal quality. To increase breakfast consumption, morning time schedules may need to be rearranged to avoid time pressure. Nutritional knowledge and dietary behaviour appear relevant. Guardians played a major role in coping with breakfast avoidance, in part as role models.

[Identification of dietary patterns and their relationship with physical performance in adults of 85 years of age and older -A cross sectional study from The Tokyo Oldest Old survey on Total Health study].

AIM: While the proportion of people of ≥85 years of age is expected to increase, there is limited research on the dietary patterns and physical performance of this population in Japan. The purpose of this study was to identify the dietary patterns of people of ≥85 years of age who live in Tokyo and to examine the relationship with their physical performance. METHODS: Using data from the baseline survey (conducted in 2008-2009) of The Tokyo Oldest Old survey on Total Health study, the estimated 58 food intake items were aggregated into 33 items after energy adjustment, and a principal component analysis was performed. For physical performance, the results of grip strength, chair standing test, and 3 m timed up and go test conducted at normal walking speed were used. A multiple regression analysis was used to adjust for confounders and to examine the relationship between each dietary pattern and physical performance. RESULTS: The subjects of the analysis were 87.3 (86.2-88.8) years of age (median [25-75th percentile] ). From the principal component analysis, three dietary patterns were identified: "various vegetable foods", "fish and mushrooms", and "cooked rice and miso soup". A higher propensity for the "fish and mushrooms" dietary pattern was significantly associated with grip strength (partial regression coefficient, B (95% confidence interval): 0.48 (0.13-0.83) ). CONCLUSIONS: In a population of people of ≥85 years of age in Tokyo, a positive association was observed between hand grip strength and a dietary pattern characterized by fish and mushroom intake.

Estimated Glomerular Filtration Rate and Hearing Impairment in Japan: A Longitudinal Analysis Using Large-Scale Occupational Health Check-Up Data.

Several longitudinal studies have examined associations between renal dysfunction and hearing impairment. Here, we explored the longitudinal association between estimated glomerular filtration rate (eGFR) and hearing impairment among the working-age population in Japan. Participants were 88,425 males and 38,722 females aged 20-59 years, without hearing impairment at baseline (2013), who attended Japanese occupational annual health check-ups from 2013 to 2020 fiscal year. eGFR was categorized into four groups (eGFR upper half of ≥90, lower half of ≥90 (reference), 60-89, and <60 mL/min/1.73 m2). Low- and high-frequency hearing impairment were assessed using data from pure-tone audiometric testing. A Cox proportional hazards model was applied to estimate hazard ratio (HR) values for hearing impairment. Low eGFR did not increase the risk of low- or high-frequency hearing impairment. For males, multivariable-adjusted HR of high-frequency hearing impairment was 1.16 (95% confidence interval, 1.01-1.34) for the upper half of the ≥90 mL/min/1.73 m2; however, this positive association between high eGFR and high-frequency hearing impairment did not appear to be robust in a number of sensitivity analyses. We conclude that, among the Japanese working-age population, eGFR was not generally associated with hearing impairment in people of either sex.

Effect of the Cleanliness of Spray Nozzle on the Concentration of Microorganisms in the Spray Water in Warm-Water Bidet Toilet Seats.

Bidet-toilets are widely used in households and public spaces in Japan. The effect of nozzle cleanliness on spray water quality of warm-water bidet toilet seats is unknown. We conducted a long-term experimental model-based study (2015-2016) and two survey-based studies (A: 2018-2019 and B: 2020-2021) at a university campus. Survey A measured the effect of nozzle cleansing on total viable count (TVC) and heterotrophic plate counts (HPCs) in spray water. Survey B measured the total organic carbon, residual chlorine concentration, TVC, and HPC of different fractions of sprayed water. We found no upstream migration of microbes from the nozzle to water tanks. While daily cleaning of the nozzle surface could reduce bacterial count in spray water, continuous discharge of water washed away bacterial contamination. Fecal indicator bacteria were in traces in spray water, indicating proper maintenance of these toilet seats.

Relationship between Dietary Patterns and Subjectively Measured Physical Activity in Japanese Individuals 85 Years and Older: A Cross-Sectional Study.

High-quality diets and regular physical activity (PA) are considered healthy behaviors (HBs). HBs are associated with many health outcomes and are expected to improve quality of life. Although implementing HBs is important, the relationship between dietary patterns (DPs) and PA has not been well investigated, especially among those aged ≥ 85. This study used data from the Tokyo Oldest Old survey on Total Health study to examine the relationship between DPs and PA in a cross-sectional study. The dietary survey used the brief self-administered diet history questionnaire to estimate the intake of 58 foods. After energy adjustment, principal component analysis was performed to identify major DPs. A validated questionnaire was used to evaluate PA, and linear regression analysis was used to investigate the association between DPs and PA, considering confounders. A total of 519 participants were included. Three major DPs ('Various plant foods', 'Fish and mushrooms', 'Cooked rice and miso soup') were identified. 'Various plant foods' was similar to DPs previously named 'Healthy' or 'Prudent', and its trend was positively associated with higher PA. This study observed the implementation of HBs even among those aged ≥ 85, suggesting that a trend toward a healthier diet is associated with higher PA.

Development of a Digital Photographic Food Atlas as a Portion Size Estimation Aid in Japan.

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

Food and nutrient intake in dietary supplement users: a nationwide school-based study in Japan.

Dietary supplements can be used to compensate for an inadequate diet. However, some studies indicate that supplement users consume healthier diets than non-users, although such data are lacking in Japanese children. The aim of the present study was to investigate the food and nutrient intake of dietary supplement users among school-aged children in Japan. A nationwide school dietary survey was conducted at fourteen elementary schools and thirteen junior high schools in twelve prefectures in Japan. Three-day non-consecutive semi-weighed dietary records were obtained on two weekdays and one weekend day. Analysis of covariance was performed to investigate differences in food and nutrient intake from meals consumed at school and outside of school between dietary supplement users and non-users, adjusted for socio-demographic and health-related characteristics. Of the 910 children included in this analysis, 80 (8⋅8 %) reported supplement use. Based on 3-d dietary records, dietary supplement users consumed higher mean amounts of oils and lower amounts of fruits and vegetables than non-users. In school lunches, users consumed significantly higher amounts of oils and lower amounts of protein than non-users. In meals consumed outside of school, dietary supplement users consumed significantly higher amounts of confectioneries and lower amounts of fruits and vegetables, folate, vitamin C and dietary fibre than non-users. Collectively, our findings indicate that dietary supplement users consumed less healthy diets than non-users. Additional studies are warranted to confirm these results and identify factors contributing to poorer dietary habits in supplement users.