Short Nutritional Assessment Questionnaire as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy: A retrospective study.

PURPOSE: The purpose of this retrospective study was to verify whether the revised Short Nutritional Assessment Questionnaire© (SNAQ), a simplified nutritional assessment, could be comparable with serum albumin (ALB) levels as a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. METHODS: Of 111 patients, 79 patients with baseline ALB levels ≥3.5 g/dL were included in the analysis. Patients completed the revised SNAQ, which evaluated items including appetite loss, weight loss, nutritional supplement usage, age, and body mass index, using a maximum of 12 points (a score of ≥3 was marked as severe undernutrition). ALB levels were then monitored for 1 year using patient medical records. RESULTS: There was a significant difference in event-free survival (EFS) when the SNAQ scores were classified into two groups [i.e., scores of ≤3 (SNAQ3) or scores of ≥4 (SNAQ4)]. The 150-day EFS rate was 86.8% and 57.6% for SNAQ3 and SNAQ4, respectively (hazard ratio: 2.92; 95% confidence interval: 1.31-6.51; p = 0.009). Based on the Cox proportional-hazards analysis, a higher risk of undernutrition was associated with SNAQ4 (compared with SNAQ3), C-reactive protein levels, and serum transthyretin levels. CONCLUSION: The revised SNAQ is a predictor of undernutrition in cancer patients receiving outpatient chemotherapy. In particular, it is important that patients with a SNAQ score of ≥4 receive dietary guidance at an early stage as they are likely to become undernourished within a year.

Urinary sodium/potassium ratio as a screening tool for hyperaldosteronism in men with hypertension.

Among individuals with hypertension, the prevalence of secondary hypertension has been reported to be ≈10%. More than half of individuals with secondary hypertension have associated hyperaldosteronism. However, given the current clinical environment, these patients often remain undiagnosed. We hypothesized that the urinary sodium/potassium ratio (Na/K) could be used as a simple, low-cost method of screening for hyperaldosteronism among individuals with hypertension in primary care and health examination settings. We recruited hypertensive individuals aged 30-69 years old who were not taking any antihypertensive medications from among participants in health examinations. Urinary Na and K were measured using second morning urine samples, and the plasma aldosterone concentration (PAC) was also measured. We evaluated the association of the second morning urine Na/K ratio (SMU Na/K) with a high PAC, defined as ≥90th percentile (24.3 ng/dL), using receiver operating characteristic (ROC) curves. Overall, 160 participants (108 men and 52 women) with a mean age of 54.3 years were eligible for this study. The area under the ROC curve for the relationship between SMU Na/K and high PAC was 0.77 (95% confidence interval [CI]: 0.59-0.95) in men and 0.64 (95% CI: 0.36-0.93) in women. In men, SMU Na/K values <1.0 could detect hyperaldosteronism with a sensitivity of 45.5%, a specificity of 97.9%, a positive predictive value of 71.4%, and a negative predictive value of 94.1%. The use of the urinary Na/K ratio may be appropriate as a method of screening for hyperaldosteronism in hypertensive men.

Estimated 24-hour urinary sodium excretion and sodium-to-potassium ratio among Japanese elementary school teachers and school lunch cooks.

Background:Dietary salt intake is largely responsible for increase in blood pressure that is commonly seen with aging. In our previous study carried out in 2015, we calculated the 24-hour urinary sodium excretion and sodium-to-potassium (Na/K) ratio among elementary school children. In the present study, we aimed to examine the same items among the school children's teachers and lunch cooks.Methods:Of 153 recruited participants, urine samples were collected from 129 subjects (84.3%), and 124 subjects (81.0%; 37 male teachers, 65 female teachers, and 22 female cooks) whose dietary habits were confirmed were included in the final study analysis.Results: The median estimated 24-hour urinary salt excretion (g/day) was 8.2 in male teachers, 7.4 in female teachers, and 8.9 in cooks. The median urinary Na/K ratio (mEq/mEq) was 4.1 in male teachers, 3.6 in female teachers, and 4.0 in cooks. In both male and female teachers and cooks, no association was found between urinary salt excretion or urinary Na/K ratio and an awareness of the need to restrict salt intake. The proportion of subjects with both a urinary salt excretion and Na/K ratio above the median was high in male teachers and cooks, whereas the proportion of subjects who scored below the median in both tests was high in female teachers.Conclusion:It should be considered that elementary school teachers and cooks who have been provided with the results of their own salt excretion could realize the importance of reducing salt consumption from early childhood and the continuous salt intake reduction education for children.

Validation of computer software to estimate dietary intake among patients with type 2 diabetes.

Tailored nutritional guidance by a registered dietitian is necessary for feasible, practical application of nutrition therapy. In order to reduce the requirement for estimation by a dietitian and to increase the time available for practical advice, we developed and validated computer software for estimating dietary intake among patients with type 2 diabetes. The study enrolled 46 patients with type 2 diabetes, recruited from an outpatient clinic in 2015. We used the computer software "Syokuseikatsu Shindan System" (SSS; Nissha, Kyoto, Japan). SSS allows the user to choose pictures of dishes and the portions he/she has consumed for each meal. The one-day dietary intake estimations for SSS were validated against a reference estimation of 24-h dietary recall by a registered dietitian. The mean carbohydrate intake as assessed by SSS and 24-h recall was 210.6 ± 55.1 and 215.5 ± 52.9 g/day, with a positive correlation (r = 0.53, p<0.001). Bland-Altman analysis showed that limits of agreement in carbohydrates between the methods were -107.4 to 97.5 g/day. Even though the limits of agreement were wide and non-negligible at the individual level for clinical use, SSS appears to have potential as a dietary estimation tool under registered dietitian supervision.

Astaxanthin-, ß-Carotene-, and Resveratrol-Rich Foods Support Resistance Training-Induced Adaptation.

Resistance training adaptively increases the muscle strength associated with protein anabolism. Previously, we showed that the combined intake of astaxanthin, ß-carotene, and resveratrol can accelerate protein anabolism in the skeletal muscle of mice. The purpose of this study was to investigate the effect of anabolic nutrient-rich foods on muscle adaptation induced by resistance training. Twenty-six healthy men were divided into control and intervention groups. All participants underwent a resistance training program twice a week for 10 weeks. Astaxanthin-, ß-carotene-, and resveratrol-rich foods were provided to the intervention group. Body composition, nutrient intake, maximal voluntary contraction of leg extension, oxygen consumption, and serum carbonylated protein level were measured before and after training. The skeletal muscle mass was higher after training than before training in both groups (p < 0.05). Maximal voluntary contraction was increased after training in the intervention group (p < 0.05), but not significantly increased in the control group. Resting oxygen consumption was higher after training in the intervention group only (p < 0.05). As an oxidative stress marker, serum carbonylated protein level tended to be lower immediately after exercise than before exercise in the intervention group only (p = 0.056). Intake of astaxanthin-, ß-carotene-, and resveratrol-rich foods supported resistance training-induced strength and metabolic adaptations.

Polysorbate 80-induced leaky gut impairs skeletal muscle metabolism in mice.

Impaired intestinal permeability can induce systemic inflammation and metabolic disturbance. However, the effect of impaired intestinal permeability on metabolic function in the skeletal muscle is unknown. Dietary polysorbate 80 (PS80), a common emulsifier, has been shown to impair intestinal permeability in mice. Here, we investigated the effect of PS80-induced intestinal permeability on glucose tolerance with metabolic signaling in the skeletal muscle. Male ICR mice were divided into control and PS80 groups. In the PS80 group, PS80 was contained in the drinking water at 1% (w/v). After 4 weeks, plasma fluorescein isothiocyanate (FITC) intensity was measured after orally administering FITC-dextran. Half of the mice in each group underwent running exercises. Metabolic and inflammatory parameters were examined in the blood and skeletal muscle. Plasma FITC and lipopolysaccharide levels were higher in the PS80 group than the control group (p < .01, p = .085). The expression of tumor necrosis factor-α in the skeletal muscle was increased upon PS80 administration (p < .05). Although the homeostasis model assessment ratio was higher in the PS80-fed mice (p < .05), insulin-signaling activity in the muscle did not differ between groups. Muscular pH, mitochondrial cytochrome oxidase activity, and glycogen content after exercise were lower in the PS80 group (p < .05) than the control group. There was a negative correlation between plasma FITC and muscle glycogen levels in the exercised groups (r = -.60, p < .05). These results suggest that daily PS80 intake induces intestinal permeability, leading to glucose intolerance and mitochondrial dysfunction in the skeletal muscle.

Effects of beta-conglycinin intake on circulating FGF21 levels and brown adipose tissue activity in Japanese young men: a single intake study and a randomized controlled trial.

BACKGROUND: Human brown adipose tissue (BAT) activity has beneficial effects on body composition and glucose metabolism. A previous study reported that beta-conglycinin intake induced postprandial fibroblast growth factor 21 (FGF21) secretion, thereby promoting adipose tissue thermogenesis in mice. Since it has not been evaluated whether beta-conglycinin intake is associated with induced FGF21 secretion and BAT thermogenesis in humans, the current study examined the effects of beta-conglycinin intake on circulating FGF21 level and BAT activity. METHODS: Twenty-two healthy young male subjects participated. This study consisted of 2 interventional studies. In one of them, the effects of single beta-conglycinin intake at thermoneutral temperature on circulating FGF21 levels were examined (n = 7). The other study was a single-blinded randomized crossover trial of 2 weeks (n = 14). The subjects were exposed to mild cold conditions using a climatic chamber, and BAT activity was analyzed using thermography. Serum FGF21 level was determined by ELISA in these studies. RESULTS: In the single intake study, serum FGF21 level was the highest before beta-conglycinin intake and gradually and significantly decreased throughout the 2-h experimental period (P < 0.05). The randomized crossover trial showed that 2-week beta-conglycinin intake did not affect serum FGF21 level and BAT activity, whereas changes (Δ) in baseline levels of serum FGF21 were positively correlated with Δ BAT activity (P < 0.05). In addition, analysis of each group revealed that there was significant correlation between the Δ serum FGF21 level and Δ BAT activity in the beta-conglycinin group (P < 0.05), but not in the placebo group. CONCLUSIONS: This study reveals that although serum FGF21 levels are not increased by a single or short-term intake of beta-conglycinin, the Δ basal FGF21 level is associated with Δ BAT activity. These results suggest that human FGF21 responsiveness is different from that of rodents and support the importance of FGF21 in human BAT thermogenesis. TRIAL REGISTRATION: This study is registered with University Hospital Medical Information Network in Japan (number 000038723,  https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043942 ).

Negative Association in Reported Dietary Energy Intake and Physique in Japanese Schoolchildren.

Appropriate dietary assessment and health education are necessary for children to achieve a healthy physique. To explore the relationship between habitual reported dietary energy intake (EI) and physique in elementary schoolchildren by sex and age, we conducted a longitudinal study, in the fiscal year 2011, that included all elementary schools in Omihachiman City, Shiga Prefecture, Japan. The study lasted for four consecutive years, ending in fiscal year 2014, and included 545 7-y-old schoolchildren in the target city. The subjects completed a brief self-administered diet history questionnaire with their guardians. The results of the study demonstrated a negative relationship between energy intake and the estimated energy requirement ratio and body mass index percentile values for both 7-, 9-, and 10-y-old boys and 7- to 10-y-old girls. These results suggest that there is a need to keep in consideration the under-reporting of obese children and over-reporting of lean children for dietary energy evaluation.

Combined intake of astaxanthin, ß-carotene, and resveratrol elevates protein synthesis during muscle hypertrophy in mice.

OBJECTIVE: The antioxidant factors, astaxanthin, ß-carotene, and resveratrol, have a potential effect on protein synthesis in skeletal muscle and a combined intake may have a greater cumulative effect than individual intake. The aim of this study was to investigate the combined effects on skeletal muscle mass and protein metabolic signaling during the hypertrophic process from atrophy in mice. METHODS: Male ICR mice were divided into five dietary groups consisting of seven animals each: normal, astaxanthin, ß-carotene, resveratrol, and all three antioxidants. Equal concentrations (0.06% [w/w]) of the respective antioxidants were included in the diet of each group. In the mixed group, three antioxidants were added in equal proportion. One leg of each mouse was casted for 3 wk to induce muscle atrophy. After removal of the cast, the mice were fed each diet for 2 wk. The muscle tissues were collected, weighed, and examined for protein metabolism signaling and oxidative damage. RESULTS: The weight of the soleus muscle was increased in the astaxanthin, ß-carotene, and resveratrol groups to a greater extent than in the normal group; this was accelerated by intake of the mixed antioxidants (P = 0.007). Phosphorylation levels of mammalian target of rapamycin and p70 S6 K in the muscle were higher in the mixed antioxidant group than in the normal group (P = 0.025; P = 0.020). The carbonylated protein concentration was lower in the mixed antioxidant group than in the normal group (P = 0.021). CONCLUSIONS: These results suggested that a combination of astaxanthin, ß-carotene, and resveratrol, even in small amounts, promoted protein synthesis during the muscle hypertrophic process following atrophy.

Characteristic dietary habits associated with high values of estimated 24-hours urinary sodium excretion and sodium-to-potassium ratio assessed by age group among the residents of a rural town in Japan.

Excess salt intake causes hypertension and cardiovascular disease (CVD). We examined estimated 24-h urinary sodium (Na) excretion and sodium-to-potassium (Na/K) ratio and analyzed the association between estimated 24-h urinary salt excretion (urinary salt excretion) and dietary habits by age group to develop effective public health programs to promote salt reduction. A total of 4,051 subjects aged 30-74 years old received information during periodic health checkups. In the analysis, 1,202 subjects without hypertension whose urine samples and dietary habits were confirmed (29.7%; 483 men and 719 women) were included. The median urinary salt excretion was 9.1 g/day in men and 8.6 g/day in women. Daily intake of soups in men aged <50 years old and daily intake of beans, soups, or pickles in women aged ≥70 years old were associated with high values of urinary salt excretion (p = .03, p < .01, p = .01, and p = .02, respectively). The median urinary Na/K ratio (mEq/mEq) was 4.4 in both men and women. Daily intake of vegetables in men aged <50 years old and more than 3 days/week intake of fruit in women aged 50-59 and 60-69 years old were associated with lower values of urinary Na/K ratio (p = .03, p < .01, and p < .01, respectively). These findings revealed that dietary salt reduction should be promoted according to age group with regard to differences in dietary habits associated with high values of estimated 24-h urinary Na excretion and urinary Na/K ratio.

Torula yeast (Candida utilis)-derived glucosylceramide contributes to dermal elasticity in vitro.

Glucosylceramide (GlcCer) is derived from several plants, such as rice, maize, and wheat, and has been reported to retain moisture by functioning as a barrier between the epidermis and the environment. However, there is insufficient research on the effect of GlcCer on dermal elasticity and wrinkles. In this study, we investigated the effects of torula yeast extract and torula yeast-derived GlcCer on dermal elasticity. We measured cell proliferation, collagen production, and collagen gel contraction using human dermal fibroblasts. Torula yeast extract and torula yeast-derived GlcCer increased dermal fibroblast proliferation and collagen production. Collagen gel contraction was promoted by torula yeast extract and torula yeast-derived GlcCer. These results indicate that GlcCer may affect dermal elasticity. Torula yeast extract and torula yeast-derived GlcCer may contribute to the maintenance of dermal elasticity. PRACTICAL APPLICATIONS: In this study, we found that torula yeast-derived glucosylceramide (GlcCer) has an additional function of improving dermal elasticity. With improved elasticity, skin becomes more resilient, thus preventing wrinkles. GlcCer has already been used in cosmetic products to retain skin moisture. Therefore, torula yeast-derived GlcCer can be expected to have several cosmetic applications.

Male Infants Born to Older Pregnant Women Are Affected by Maternal Physique at the Beginning of the Pregnancy through Birth until 18 Months of Age.

We have previously reported a positive correlation between the body mass index (BMI) of mothers and the Kaup index of infants at birth and that this correlation may have a stronger influence on the male infants, born to older mothers. Therefore, in this study, we aimed to clarify the correlation between maternal age and gender of the infants as maternal BMI and the Kaup index of infants from birth till 18 mo of age. This study was conducted from April 2010 to September 2011 in Japan. Public health nurses and registered dietitians interviewed the mothers individually under anonymous conditions, and they transferred the required information from the maternity passbook at the 18-mo health checkup. In male infants, significant positive correlations were demonstrated between maternal BMI at the beginning of pregnancy and the Kaup index of infants in mothers older than 35 y when the infants were at birth, at 4 mo and at 18 mo old. In female infants, there was no correlation between maternal BMI and the Kaup index of infants at birth. However, significant positive correlations were demonstrated between maternal BMI and the Kaup index of infants in mothers in their 20s and older than 35 y old when the infants were 4 and 18 mo old. Women who plan on pregnancy and medical professionals need to know that the maternal physique at the beginning of pregnancy affects the physique of the infants at birth and at 4 mo and 18 mo old by gender of the infants.

Effect of dietary antioxidant-rich foods combined with aerobic training on energy metabolism in healthy young men.

Although supplementation with several antioxidants has been suggested to improve aerobic metabolism during exercise, whether dietary foods containing such antioxidants can exert the metabolic modulation is unclear. This study aimed to investigate the effect of intake of the specific antioxidant-rich foods coupled with exercise training on energy metabolism. Twenty young healthy, untrained men were assigned to antioxidant and control groups: participants in the antioxidant group were encouraged to consume foods containing catechin, astaxanthin, quercetin, glutathione, and anthocyanin. All participants performed cycle training at 60% maximum oxygen consumption for 30 min, 3 days per week for 4 weeks. Maximum work load was significantly increased by training in both groups, while oxygen consumption during exercise was significantly increased in the antioxidant group only. There were positive correlations between maximum work load and fat/carbohydrate oxidations in the antioxidant group. Carbohydrate oxidation during rest was significantly higher in the post-training than that in the pre-training only in the antioxidant group. More decreased levels of serum insulin and HOMA-IR after training were observed in the antioxidant group than in the control group. This study suggests that specific antioxidant-rich foods could modulate training-induced aerobic metabolism of carbohydrate and fat during rest and exercise.

Effect of downhill walking on next-day muscle damage and glucose metabolism in healthy young subjects.

This study aimed to investigate the effect of downhill walking on muscle damage and glucose metabolism in healthy subjects. All ten healthy young men and women (age, 24.0 ± 1.4 years) performed rest, uphill walking, and downhill walking trials. In the exercise trials, uphill (+ 5%) or downhill (- 5%) treadmill walking was performed at 6 km/h for 30 min. On the next day, muscle soreness was significantly higher in the downhill trial than in the uphill trial (P < 0.01). Respiratory metabolic performance did not differ between trials. However, carbohydrate oxidation was negatively correlated with plasma creatine kinase (r = - 0.41) and muscle soreness (r = - 0.47). Fasting blood glucose was significantly lower in the uphill trial than in the rest trial (P < 0.01) but not in the downhill trial. These observations suggest that downhill but not uphill walking causes mild delayed-onset muscle damage, which did not cause marked impairment in glucose metabolism. However, higher muscle damage responders might exhibit lower glucose metabolism.

Effect of Torula Yeast (Candida utilis)-Derived Glucosylceramide on Skin Dryness and Other Skin Conditions in Winter.

Glucosylceramide (GlcCer) is present in foods such as barley, corn, and wheat flour. GlcCer derived from different foods has differences in its physiological effects, depending on the sphingoid backbone and constituent fatty acids. In this study, we investigated the moisturizing and skin conditioning effects of GlcCer derived from torula yeast (Candida utilis) in healthy human subjects. The participants were randomly distributed in a crossover, double-blind comparative manner. Seventeen volunteers were orally administered both 1.8 mg/d of GlcCer derived from torula yeast and a placebo for 4 wk. Before and after oral administration, transepidermal water loss (TEWL) was measured and the objective skin condition observation and a questionnaire on skin condition were conducted. The primary endpoint was TEWL; secondary endpoints included the objective and subjective skin conditions. The change in TEWL over the study period on the forearm was -0.97±0.48 and -1.26±0.46 g/m2•h in the placebo and GlcCer groups, respectively, with significantly lower (p=0.01) TEWL observed in the GlcCer group. Brown spots increased in the placebo group but significantly decreased in the GlcCer group (p=0.04). Although chapped skin worsened in the placebo group, it significantly improved in the GlcCer group (p=0.04). The use of torula yeast-derived GlcCer as a functional cosmeceutical food is a viable option to ameliorate skin conditions, including improvement in skin barrier function, reduction of brown spots, and fixation of chapped skin.

Estimation of salt intake and sodium-to-potassium ratios assessed by urinary excretion among Japanese elementary school children.

Dietary salt intake is largely responsible for the increase in blood pressure with age. It is important to start effective prevention approaches during childhood. In this study, we estimated salt intake and sodium-to-potassium (Na/K) ratios assessed by urinary excretion among elementary school children in Kyoto, Japan. A total of 331 subjects aged 9-11 years participated in school checkups in April 2015. Urinary concentrations of sodium, potassium, and creatinine were measured in first morning urine samples. The subjects' dietary habits were confirmed by questionnaires completed by their parents. The median estimated urinary sodium excretion was 129.0 mmol/day (5.7g/day of salt). In 30.2% of the subjects, their estimated salt intake exceeded their age-specific dietary goal for salt intake recommended by the Dietary Reference Intakes for Japanese 2015. Multivariate linear regression model analysis after adjustment for age revealed a significant positive correlation between seaweeds or fish paste products consumption and the estimated salt intake (p = 0.02 and 0.02, respectively). The median urinary Na/K ratio (mEq/mEq) was 4.5. Multivariate linear regression model analysis revealed a significant negative correlation between fruit consumption and urinary Na/K ratio (p = 0.04). These results suggest that the high sodium intake and the high Na/K ratios occur among Japanese elementary school children, and that the urinary Na/K ratio in children may be reduced by the daily consumption of fruit.

Fruit intake reduces the onset of respiratory allergic symptoms in schoolchildren.

BACKGROUND: Previous studies have shown that dietary pattern is associated with allergy prevention. METHODS: We conducted a prospective cohort study on all primary schools in Omihachiman City, Shiga Prefecture, Japan. Questionnaires regarding allergic symptoms and diet were distributed to the parents of all 759 7-year-old schoolchildren for 4 consecutive years, from 2011 to 2014. Specific immunoglobulin E to inhalant allergens was measured at 10 years of age. Participants were then categorized as low, medium, or high intake during the study period for four food groups (fruits, vegetables, fish, and beans). Logistic regression analysis was performed to estimate odds ratios and 95% confidence intervals. RESULTS: A total of 520 children (68.5%) whose parents responded to the questionnaires all 4 years were included in the analysis. The prevalence of asthma, rhinitis, and any allergic symptoms at age 10 was significantly decreased with increases in fruit intake. In addition, the onset of any allergic symptoms during the study period was significantly decreased with increases in fruit intake (33.3%, 28.3%, and 14.3% in children with low, medium, and high fruit intake, respectively; P for trend =.01). The sensitization rate to ragweed at age 10 was significantly decreased with increases in fruit intake (P for trend =.046). No significant effect was observed for the other three food groups, except for the association between fish intake and new-onset asthma symptoms. CONCLUSIONS: These findings suggest that higher intake of fruit can help prevent respiratory allergic symptoms in schoolchildren.

Validity of the Short Nutritional Assessment Questionnaire for Japanese Patients with Cancer Undergoing Outpatient Chemotherapy.

PURPOSE: To investigate the utility of the Short Nutritional Assessment Questionnaire (SNAQ) in the nutritional evaluation of patients with cancer undergoing outpatient chemotherapy. METHODS: We included 229 patients with cancer who were undergoing outpatient chemotherapy between October 2015 and April 2016. The SNAQ and the revised SNAQ (addition of age and body mass index) were implemented, and their relationships with Controlling Nutritional Status (CONUT), an indicator of bionutritional assessment, were examined. RESULTS: The cutoff value of the SNAQ score corresponding to moderate-to-severe undernourishment in CONUT values was 0.5, with a sensitivity of 87.5% and a specificity of 65.9%, and the corresponding values for the revised SNAQ score were 2.5, 91.7%, and 62.9%, respectively. This cutoff value and the corresponding positive prediction value for the revised SNAQ were superior to those of SNAQ. Binary logistic regression analysis with the revised SNAQ and sex as independent variables and the CONUT value as the dependent variable revealed that the higher the SNAQ score, the more likely it was that CONUT moderate-to-severe undernourishment would be identified (odds ratio, 1.48;, 1.34-1.96). CONCLUSION: Nutritional evaluation with the revised SNAQ can predict moderate-to-severe undernourishment according to CONUT in patients with cancer undergoing outpatient chemotherapy. J. Med. Invest. 64: 117-121, February, 2017.

High Maternal Age and Low Pre-Pregnancy Body Mass Index Correlate with Lower Birth Weight of Male Infants.

In Japan, the percentage of leanness has been increasing in young women, and the percentage of low birth weight infants (< 2,500 g) has increased. Moreover, the average age of primiparas rose 3.5 years during the last 30 years. The purpose of this study was to clarify the relationship between maternal age and the influence of maternal pre-pregnancy physique on the neonatal physique of infants. Questionnaires were issued to the participants and collected when they submitted their gestational notifications at their local ward office in Kyoto Prefecture. After delivery, we obtained information on the course of the pregnancy and the neonatal physique of the infants from the participant's maternal passbooks. A total of 454 mothers (age 20 ≥) were analyzed: 161 young mothers (aged 20 to 29 years), 185 mothers (aged 30 to 34 years), and 108 older mothers (age ≥ 35). Overall, the mean rate of leanness (pre-pregnancy BMI < 18.5) was 23.8%. We found that birth weight was significantly lower in female infants, born to lean young mothers, compared to non-lean young mothers, whereas no significant difference was detected in other mothers (age ≥ 30), irrespective of pre-pregnancy BMI. By contrast, male infants, born to older lean mothers (age ≥ 35), showed significantly lower birth weight. Thus, maternal pre-pregnancy BMI exerts differential effects on the fetal growth (neonatal physique), depending on the maternal age and the sex of infants. We need to improve BMI in pre-pregnancy women, especially those in the twenties and 35 years old or over.