Time Trends in Income-related Differences in Food Group Intakes: The National Health and Nutrition Survey, Japan in 2010, 2014, and 2018.

BACKGROUND: We aimed to clarify whether differences in food group intake according to household income have changed over the last decade in Japanese people aged 20 years or older. METHODS: This cross-sectional study was based on the 2010, 2014, and 2018 National Health and Nutrition Surveys in Japan. Food intake was assessed using a 1-day semi-weighed household dietary record. The participants were categorized into three groups based on their income. The mean of each food intake according to the income group was estimated by adjusting for age, occupation, and number of participants from the same household. The significance of the interaction terms between income and survey year was evaluated to assess the change in income-related differences in food intake over time. RESULTS: Cereal intake was lower in the middle- and the highest-income groups than in the lowest-income group, regardless of sex, and the interaction between income and year was nonsignificant for cereal intake. In the former two surveys, vegetable intake was higher among the highest-income women, while in the 2018 survey, the vegetable intake decreased in the women in the middle- and the highest-income groups. The interaction between income and year was significant for vegetable intake among the women. For other foods, the differences in intake among the income groups did not significantly change over time. CONCLUSION: The tendency for lower cereal intake in the higher-income groups was consistent over time in both the sexes, and the tendency for higher vegetable intake in the highest income women disappeared over time.

[Corrigendum: How accurate are self-reported anthropometrics among the Japanese? A scoping review].

　Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH), Vol. 70 (2023) No. 12 pp.817-827.

Evaluation of protein requirements using the indicator amino acid oxidation method: a scoping review.

BACKGROUND: The indicator amino acid oxidation (IAAO) method has been accepted as an approach to evaluate habitual protein requirements under free-living conditions. OBJECTIVES: This scoping review reports on literature that evaluated protein requirements in humans using the IAAO methods. METHODS: Three databases (PubMed/Medline, Web of Science, and ProQuest) were systematically searched to identify studies that evaluated protein requirements using the IAAO method published in English until 5 June, 2023. We evaluated the study quality using previously developed criteria. We extracted the characteristics of the study design and the results of protein requirements. Two reviewers conducted both reviews and quality assessments independently; any differences among them were resolved by consensus or agreement of all team members. RESULTS: We extracted 16 articles targeting children, young adults (including pregnant women, resistance training athletes, endurance-training athletes, and team sports), and older adults. In quality assessment, 14 studies were evaluated "strong," but the remaining 2 were "moderate." These studies were conducted in only 3 countries and did not include all sexes or life stages. The range of the estimated average protein requirements of each life stage was 1.30 g/kg body weight/d for children, 0.87 to 2.10 (0.87-0.93 for general young adults, 1.22-1.52 for pregnant women, 1.49-2.00 for resistance-trained athletes, 1.65-2.10 for endurance athletes, and 1.20-1.41 for team sports athletes) g/kg body weight/d for young adults, and 0.85 to 0.96 g/kg body weight/d for older adults. CONCLUSIONS: Protein requirements in 14 studies were higher than the current reference for each sex, life stage, and physical activity that are related to protein requirements. In the future, protein requirements of various populations including sex and life stage could be assessed using the IAAO methods worldwide.

Delayed Eating Schedule Raises Mean Glucose Levels in Young Adult Males: a Randomized Controlled Cross-Over Trial.

BACKGROUND: Misalignment of meals to the biological clock may cause adverse effects on glucose metabolism. However, the effects of repeated different eating schedules (early compared with late) on glucose concentration throughout the day are poorly understood. OBJECTIVES: We examined the effects of different eating schedules on the 24-h glucose response using a continuous glucose monitor (CGM). METHODS: Eight young adult males (age, 20.9 ± 3.4 y; body mass index: 21.3 ± 1.8 kg/m2) each followed 2 different eating schedules (early [08:30, 13:30, and 19:30] and late [12:00, 17:00, and 23:00]) in random order. These diet interventions were conducted for 8 d, with an experimental period of 3 d and 2 nights (from dinner on day 7) after 7 d of free living. The 3 meals in each intervention were nutritionally equivalent (55% carbohydrate, 15% protein, and 30% fat). The 24-h mean interstitial glucose concentration on day 8 was obtained under controlled conditions using the CGM (primary outcome). These concentrations were compared among the following 3 schedules using Dunnett's test, with the early eating schedule as reference (1 compared with 2 and 1 compared with 3): 1) early eating schedule (control), 2) late eating schedule according to the clock time (08:00 on day 8 to 08:00 on day 9), and 3) late eating schedule according to the time elapsed since the first meal for 24 h. RESULTS: The 24-h mean ± SD interstitial glucose concentrations when participants followed the late eating schedule were higher than those when they followed the early eating schedule in terms of clock time (91.2 ± 2.9 compared with 99.2 ± 4.6 mg/dL, P = 0.003) and time elapsed (91.2 ± 2.9 compared with 98.3 ± 3.8 mg/dL, P < 0.001). CONCLUSIONS: A late eating schedule increases the mean 24-h interstitial glucose concentration in young adult males. This insight will have useful implications in determining meal timings, especially for those with conditions such as diabetes.

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.

Associations of food choice values and food literacy with overall diet quality: a nationwide cross-sectional study in Japanese adults.

To date, a limited number of studies have examined aspects of food choice values and food literacy in relation to some aspects of dietary behaviours. The aim of this cross-sectional study was to comprehensively examine the associations of food choice values and food literacy with diet quality. In total, 2231 Japanese adults aged 19-80 years completed questionnaires asking about food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort and safety) and food literacy characterised by nutrition knowledge, cooking skills, food skills and eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness and slowness in eating). As a measure of diet quality, the Healthy Eating Index-2015 (HEI-2015) was calculated using a brief-type diet history questionnaire (BDHQ) or a food combination questionnaire (FCQ). In males, after adjustment for potential confounding factors (including age, BMI and the ratio of reported energy intake to estimated energy requirement), the HEI-2015 derived from BDHQ and that derived from FCQ were associated significantly (P ≤ 0·02) and positively with the food choice values of organic and inversely with food fussiness. In females, the HEI-2015 showed positive associations with the food choice values of health/weight control, nutrition knowledge and cooking skills and an inverse association with food fussiness, irrespective of the dietary assessment questionnaire (P ≤ 0·03). In conclusion, this study suggests that several aspects of food choice values and food literacy were associated with diet quality, and the aspects related differed between males and females.

[How accurate are self-reported anthropometrics among the Japanese? A scoping review].

Objectives　Monitoring of obesity and underweight prevalence in general populations is crucial for the implementation of effective public health measures. Self-reported height and weight values are often used to assess the body mass index (BMI) in such epidemiological surveillance. However, it is known that using self-reported height and weight may underestimate the prevalence of obesity (BMI≥25 kg/m2), while its accuracy for underweight (BMI<18.5 kg/m2) prevalence is not well-understood. The aim of this study was to conduct a scoping review on the accuracy of self-reported anthropometrics in the Japanese population, where both obesity and underweight are prevalent.Methods　Using PubMed and CiNii Research, a literature search was conducted for studies published in English or Japanese by 2022 that were conducted in Japan and compared self-reported and measured height, weight, or/and BMI. The study design and mean reported errors (mean of reported values－mean of measured values) were extracted and tabulated, and differences by BMI categories were also considered.Results　A total of 17 studies, with 11 being published in English, were included in this review. These studies were conducted in nationwide cohort studies (n=4), local populations (n=4), workplaces (n=3), and educational institutions (n=6), with diverse age ranges (10-91 years) and sample sizes (<100 to >30,000). Although the degree of mean reporting error varied between studies, most of the studies reported that height was overreported, weight was underreported, and BMI was underestimated. In the three studies that reported mean reporting errors by BMI category, the direction of reporting error for height remained consistent across all body size categories, while weight and BMI were overreported and overestimated only among the underweight. Four studies in adults showed that 14.2-37.6% of actually obese individuals and 11.1-32.3% of underweight individuals were misclassified as 'normal range' (18.5≤BMI<25 kg/m2) based on self-reporting, while 0.8-5.4% and 1.2-4.1% of individuals actually within the normal range were misclassified as 'underweight' and 'obese' based on self-report, respectively.Conclusion　This study suggests that using BMI based on self-reported height and weight can underestimate the prevalence of both obesity and underweight in the Japanese population. These biases should be taken into consideration when using self-reported anthropometrics in epidemiological studies.

Trends in dietary salt sources in Japanese adults: data from the 2007-2019 National Health and Nutrition Survey.

Identifying trends in dietary salt sources is essential for effectively reducing salt/Na intake. This study aimed to examine the trends in dietary salt sources among Japanese adults using the 2007-2019 National Health and Nutrition Survey data collected from 95 581 adults aged ≥ 20 years. Dietary intake was estimated using the 1-d household-based dietary record. Foods reported as potential sources of salt intake in Japan and other countries were categorised into twenty-one groups. Salt intake for each food group was adjusted using the density method based on the energy intake. Trends in dietary salt intake based on food sources by sex and age groups (20-39 years, 40-59 years and ≥ 60 years) were analysed using the Joinpoint Regression Program. Salt intake for each age group in both men and women decreased from 2007 (5·3 g/1000 kcal-6·4 g/1000 kcal) to 2019 (4·9 g/1000 kcal-5·6 g/1000 kcal). The major dietary source of salt continued to be seasonings such as soya sauce and soyabean paste (approximately 70 %). Salt intake from seasonings decreased over time in adults aged ≥ 40 years but did not change in those aged 20-39 years. Additionally, a decreasing salt intake from unprocessed fish and shellfish and an increasing salt intake from unprocessed meat were observed across all age categories for both sexes. This study demonstrated that a strategy targeting different age groups may be needed to reduce salt consumption from seasonings among the Japanese population. Further studies on salt content in seasonings and continued monitoring of trends in dietary salt sources are required.

Association of daily nutrient intake with breakfast and snack consumption among young Japanese adults aged 20-39 years: data from the 2012 National Health and Nutrition Survey.

Eating frequency has been associated with nutrient intake and diet quality. The aim of this study was to examine the association between daily nutrient and food group intake and consumption of breakfast and/or snacks among young Japanese adults, as secondary analysis of the 2012 National Health and Nutrition Survey in Japan involved 1420 men and 1659 women aged 20-39 years. Dietary intake data were collected using a one-day semi-weighed household dietary record. Participants were classified into four groups based their breakfast and snack consumption, defined as the consumption of any food or beverage that contained energy based on participant-defined eating occasions; both breakfast and snack consumption (B+S+), breakfast consumption without snacking (B+S-), breakfast skipping and snack consumption (B-S+) and breakfast skipping without snacking (B-S-). The proportion of breakfast skippers among men and women was 11·8 % and 6·6 %, whereas that of snack consumers among men and women was 55·3 % and 68·2 %, respectively. Energy, Mg potassium (in both sexes), vitamin B2, Ca, (only men) and folate and dietary fibre (only women) intakes were higher among breakfast and snack consumers than in the B+S- group. The nutrient intake level of the B+S- group was similar to that of the B-S+ group, whereas the B-S- group had lower energy (both sexes), Cu, dietary fibre and potassium (only women) intakes than the B+S- group. Snack consumption could supplement nutrients that may not be adequately consumed by three meals among young Japanese adults.

Exacerbating factors and disease burden in patients with atopic dermatitis.

The number of patients with atopic dermatitis is on the rise worldwide, and Japan is no exception. According to recent estimates of the percentage of patients with atopic dermatitis in Japan by age, the majority of patients are between 20 and 44 years old. Because the peak age of onset of atopic dermatitis is during infancy, many patients may experience prolonged symptoms from infancy to adulthood. A prolonged clinical course also increases the burden of atopic dermatitis on affected patients. Decreased productivity due to work disruptions, reduced daily activity, higher direct medical costs, fatigue, and daytime sleepiness due to sleep disturbances are typical burdens on patients with atopic dermatitis. In order to reduce these burdens, it is necessary to shorten its clinical course and achieve long-term control without relying on medications, possibly by using avoidance or coping measures of aggravating factors. Typical aggravating factors of atopic dermatitis include irritant dermatitis, food allergy in children, sweating, and psychological stress in adults. Food allergy places a heavy burden on the quality of life of affected patients and their families. The effectiveness of educational interventions for sweating and psychological stress is unclear. We must also evaluate the economic burden and cost-effectiveness of interventions on the patient as aggravating factors to be addressed.

Association between free sugar intake and nutrient dilution among Japanese children and adolescents: the 2016 National Health and Nutrition Survey, Japan.

The influence of free sugar intake on nutrient intake remains unclear in Japanese children and adolescents with relatively low free sugar intake. This cross-sectional study aimed to investigate the relationship between free sugar and selected nutrient intakes using data from the 2016 National Health and Nutrition Survey, Japan, based on the WHO recommendations (<5 % or <10 % of energy (%E)) for free sugar intake. A 1-d weighed dietary record was assessed in Japanese children and adolescents (aged 1-19 years; n 2919). Mean intakes for selected nutrients and food groups were compared according to free sugar intake categories (<2·5 %E, 2·5 to <5 %E, 5 to <10 %E and ≥10 %E) with adjustment for sex, age and weight status. Inverse associations were observed between intakes of free sugars and twenty-one of twenty-four micronutrients assessed, except for vitamins A and C and Ca. Significantly reduced intakes were identified for twenty-two and fourteen micronutrients in the ≥10 %E and 5 to <0 %E categories, respectively, compared with the lower categories. Mean micronutrient intakes at the <2·5 %E category did not differ from those at the 2·5 to <5 %E category. Free sugar intake had positive associations with intakes of sugars and jams, confectioneries, fruit and vegetable juices, and soft drinks and negative associations with intakes of pulses and nuts and vegetables. This study showed that nutrient dilution was associated with higher free sugar intake among Japanese children and adolescents. The findings suggest that the WHO recommendations might help prevent nutrient dilution in Japanese children and adolescents.

Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003-2017.

Few studies have reported associations between the Na:K ratio and risk factors related to CVD among the general population in Asian countries. This study aimed to investigate the dietary Na:K ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48 800 Japanese participants (19 386 men and 29 414 women) aged ≥20 years, registered in the 2003-2017 National Health and Nutrition Survey. Multivariate OR and 95 % CI for risk of hypertension, high glycated HbA1c levels, hypercholesterolaemia, low serum levels of HDL-cholesterol and high non-HDL-cholesterol levels according to the Na:K ratio were estimated using logistic regression models. Dietary Na:K ratio decreased for both men and women from 2003 to 2017. Higher Na:K ratio and higher hypertension prevalence were observed (multivariate OR (fifth v. first quintiles) 1·27, 95 % CI 1·15, 1·40; Pfor trend < 0·001 for men and 1·12, 95 % CI 1·01, 1·23; Pfor trend = 0·007 for women). Higher Na:K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR 1·56, 95 % CI 1·24, 1·96). Prevalence of low HDL-cholesterol levels was increased with higher Na:K ratio (Pfor trend =0·002 for men and <0·001 for women). No significant associations were found between Na:K ratio and hypercholesterolaemia in men or high non-HDL-cholesterol levels in both men and women. Our findings suggest that dietary Na:K ratio is associated with several CVD risk factors among Japanese adults.

The effects of breaking sedentary time with different intensity exercise bouts on energy metabolism: A randomized cross-over controlled trial.

BACKGROUND AND AIMS: Breaking up sedentary periods, particularly with light activity, increases total energy expenditure (EE), and helps provide better glycemic control. However, the effects of activities of various intensities to interrupt prolonged sedentary time are unclear. The purpose of the present study was to examine potential differences in glycemic control and EE from breaking up sedentary time with short exercise bouts of different intensities. METHODS AND RESULTS: Nine overweight/obesity young men underwent whole body indirect calorimetry at 19:00 on day 1 and stayed overnight. After awakening on day 2, they performed short duration jogging every 30 min over 8 h (16-time bouts in total) under 3 different conditions with the same running distance: (1) lactate threshold (LT) for 2 min, (2) 60% LT for 200 s, and (3) onset of blood lactate accumulation (OBLA) for 75 s. The 24-h EE and interstitial glucose concentration (from 8:00 to 19:00 on day 2) was continuously measured throughout the trials. The standard deviation during intervention and indexes of postprandial of the interstitial glucose concentration was significantly lower at LT and OBLA than at 60% LT (p < 0.05). The 24-h EE was not significantly different among conditions, but EE at OBLA during intervention was slightly but significantly higher than at 60% LT and LT. CONCLUSION: Breaking up sedentary time with short-duration jogging at LT and with OBLA intensities may have better glycemic control and increased use of carbohydrate as a fuel, while short-duration a jogging at OBLA intensity may increase EE. TRIAL REGISTRATION: UMIN000041361.

Consumption of meals prepared away from home is associated with inadequacy of dietary fiber, vitamin C and mineral intake among Japanese adults: analysis from the 2015 National Health and Nutrition Survey.

BACKGROUND: Consumption of home-prepared meals may lead to better nutritional intake. Few studies have examined the association between the frequency of consuming meals prepared away from home and the inadequacy of nutritional intake based on nutritional standards and food group intake. We therefore aimed to investigate this issue among Japanese adults. METHODS: This study was a secondary analysis of the 2015 National Health and Nutrition Survey in Japan, involving 921 men and 1300 women aged 18-64 years, conducted as a cross-sectional survey. The frequency of consuming meals prepared away from home was defined using two questions inquiring about the frequency of eating out and take-away meals. Data on dietary intake were collected using a one-day semi-weighed household dietary record. Participants were stratified into three groups based on the frequency of consuming meals prepared away from home (High, Moderate, Low). The inadequacy of each nutrient intake was assessed by comparing estimated average requirement (EAR) level for 14 nutrients and the range of the dietary goal (DG) for seven nutrients according to the 2015 version of the Dietary Reference Intakes for Japanese. Group differences in nutrients adequacy were assessed using the covariate and logistic regression analysis. Food intake was also compared across the groups by classifying each food item into 17 groups based on Standard Tables of Food Composition. RESULTS: The proportion of participants who consumed home-prepared meals almost every day were 34.9% among men and 46.8% among women, and the proportion of those consuming a higher frequency of meals prepared away from home were 14.7 and 6.3%, respectively. A higher frequency of consuming meals prepared away from home was associated with inadequacy of dietary fiber, vitamin C and minerals (iron, magnesium and potassium) intake, and with lower intake of vegetables and higher intake of fat and oils. CONCLUSIONS: High frequency of consuming meals prepared away from home was associated with insufficient intake of dietary fiber, vitamin C and multiple minerals among Japanese adults. These nutrients may be the potential target of interventions aimed at improving nutrient intake in individuals who predominantly eat food prepared away from home.

Management of regional bone bank during declaration of a state of emergency concerning the COVID-19 in Japan.

Bone banks are necessary for providing biological allografts for a series of orthopedic procedures. As nations cope with new realities driven by the 2019 coronavirus disease (COVID-19) pandemic, health-care providers, institutions, and patients share a particular concern about the effect of COVID-19 on organ donation and transplantation. Here, we describe the management of the Kitasato University Bone Bank during the state of emergency declared in response to COVID-19. Living donors received pre-operative screening by PCR, and allograft bone from COVID-19-negative donors was cryopreserved as transplantable tissues. The weekly rate of infection gradually increased from February 2-9 to April 5-11 in the dead donor-derived allograft bone-harvesting region covered by the Bank. It is becoming clear that the virus can be transmitted by asymptomatic patients, and that this route may have facilitated the spread of COVID-19. Therefore, the Bank stopped dead donor donation to consider the safety of medical staff. Three recipients received bone allografts following pre-operative COVID-19 screening by PCR. All patients were asymptomatic after bone allograft. Our experience may provide helpful information for the management of tissue banks.

Factors associated with the development of oral allergy syndrome: A retrospective questionnaire survey of Japanese university students.

BACKGROUND: Oral allergy syndrome (OAS) is an IgE-mediated food allergy. Ingestion of causative antigens leads to the development of local symptoms such as numbness of the oral mucosa in most cases and anaphylaxis in a few cases. The prevalence of OAS including in healthy people has not been investigated. Thus, we conducted a questionnaire survey of Japanese university students. METHODS: We conducted a cross-sectional study of 2688 first-year students using a questionnaire survey in marksheet format and examined the epidemiological characteristics of OAS. RESULTS: Only 2.7% of students were aware of the term "oral allergy syndrome". A total of 143 (5.3%) students had OAS. There were significant associations between OAS and other allergic diseases including allergic rhinitis (AR) (OR: 3.8, 95% CI: 2.7-5.5), atopic dermatitis (AD) (OR: 4.6, 95%CI: 3.3-6.6), and bronchial asthma (BA) (OR: 3.0, 95%CI: 2.0-4.5). The onset age of OAS showed bimodal peaks at 0 and 10 years, and the latter peak coincided with the peak onset age of AR. CONCLUSIONS: Awareness of OAS was low in our study, which will make it difficult to treat properly and prevent its development. This survey confirmed the association between OAS and other allergic diseases, especially AR, which suggests that OAS is involved in the allergic march. A novel finding was that sensitization to antigens for OAS occurred around the same time as sensitization to antigens for AR. These results will help medical professionals diagnose OAS and develop lifestyle guidelines to prevent OAS-related symptoms such as anaphylaxis.

Association between free sugars intake and nutrient dilution among Japanese adults: the 2016 National Health and Nutrition Survey, Japan.

PURPOSE: The association between free sugars and nutrient intake is unclear in Japanese adults with relatively low free sugars intake. This cross-sectional study aimed to elucidate this relationship using data from the 2016 National Health and Nutrition Survey, Japan, and according to the current World Health Organization (WHO) guidelines for the prevention of nutrient dilution [< 5% or < 10% of energy (%E)]. METHODS: Dietary intake of Japanese adults (aged ≥ 20 years; n = 16,652) was assessed using a 1-day weighed dietary record. Mean intakes for selected nutrients and food groups were compared among categories of free sugars intake (i.e., < 2.5%E, 2.5 to < 5%E, 5 to < 10%E, and ≥ 10%E) by adjusting for sex, age, weight status, smoking status, habitual drinking, and occupation. RESULTS: Free sugars intake was inversely associated with the intake of 16 of 24 micronutrients investigated. Compared to its lower categories of free sugars intake, significant reductions in intake were identified for almost all micronutrients at ≥ 10%E, whereas ten micronutrients were reduced at 5 to < 10%E. The intake of dietary fibre, sodium, potassium, calcium, and iron was lower at < 2.5%E than at 2.5 to < 5%E and/or 5 to < 10%E. Free sugars intake was also positively associated with sugars and jams, confectionaries, fruit and vegetable juices, and soft drinks and inversely with pulses and nuts and vegetables. CONCLUSIONS: This study identified nutrient dilution among Japanese adults with higher free sugars intake and confirmed the significance of the WHO guidelines for preventing nutrient dilution in Japanese.

Nutrition knowledge related to breakfast skipping among Japanese adults aged 18-64 years: a cross-sectional study.

OBJECTIVE: Breakfast skipping is regarded as a public health issue among adults worldwide. Nutrition knowledge has been reported to be one of predictors of dietary behaviour. Therefore, the aim of the present study was to examine the association between nutrition knowledge and breakfast skipping. DESIGN: Data regarding nutrition knowledge were obtained by using a validated, self-administered general nutrition knowledge questionnaire for Japanese adults (JGNKQ). Participants were classified into three nutrition knowledge level groups according to total JGNKQ score: Low, Middle and High. In addition, participants reported the frequency of meal consumption per week and rated the difficulty in finding time to eat breakfast, lunch and dinner in the lifestyle questionnaire. The differences in frequency of breakfast, lunch and dinner consumption among Low, Middle and High nutrition knowledge groups were determined by using ANCOVA adjusted for potential confounding factors. SETTING: Kanto region, Japan.ParticipantsJapanese adults aged 18-64 years (n 1165, 57·3% women). RESULTS: Mean age of the participants was 43·8 (sd 8·9) years. There were no significant differences found in the proportion of respondents reporting difficulty in finding time to eat each meal among the three groups. However, the frequency of breakfast consumption was significantly different among Low, Middle and High groups, while lunch and dinner frequency did not differ among the three groups. CONCLUSIONS: The present study suggests that nutrition knowledge level is related to breakfast skipping among Japanese adults.

Gastric emptying time after breakfast in healthy adult volunteers using ultrasonography.

There is little evidence of gastric excretion after ingestion of solids. We examined gastric emptying times after ingesting normal breakfast in healthy adult volunteer using ultrasonography. Eight adult volunteers fasted for 8 h, and we examined the gastric antral area in the right lateral decubitus position using ultrasonography. Sixteen adult volunteers ingested normal breakfast. We evaluated the gastric antral area in the same manner at two consecutive time points before lunch. Gastric volume was calculated by using an approximation formula based on the antral area. Correlation coefficients between gastric volume and fasting time were calculated. The calculated gastric volume from the gastric antral area after 8 h fasting was 53.1 ml. The gastric volume correlated significantly with fasting time (r = - 0.811, P < 0.001). The time when the attenuation line obtained from two measurements between breakfast to lunch in each subject overlapped the fasting stomach volume (53.1 ml) was taken as gastric empty time. The calculated gastric emptying time was 276.4 ± 58.9 min. This result shows that gastric emptying time was lower than 5 h average after a typical breakfast that contains various food in healthy adult volunteers. However, further research is necessary to establish the clinical safety implications of these findings.