Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age.

BACKGROUND: Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age. METHODS: This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age. RESULTS: The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05). CONCLUSION: The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.

Japanese school children's intake of selected food groups and meal quality due to differences in guardian's literacy of meal preparation for children during the COVID-19 pandemic.

In 2020, a state of emergency (SOE) was enforced by the Japanese government, which included temporary school closures with the aim of overcoming COVID-19 spread, which prevented access to school lunches. We evaluated the relationship between meal quality and guardians' literacy of meal preparation for a nationally representative sample of 1107 Japanese schoolchildren (aged 10-14 years) before, during, and after the SOE on the basis of 7 questions scored using a 5-point Likert scale. The guardians' literacy of meal preparation for children was divided into quartiles, with Q1 and Q4 including participants with the lowest and highest scores on food literacy, respectively. School lunch menu was handed out monthly to each household by their classroom teacher. The consumption of (i) meat, fish, or eggs and (ii) vegetables at least twice a day indicated "well-balanced dietary intake", which was less frequent in all four quartiles, especially for Q1 and Q2, during compared to before the SOE. The relative risk increases (95% CI) were Q1: -40.6% (-41.4% to -39.8%; p < 0.001), Q2: -34.0% (-34.7% to -33.3%; p < 0.001), Q3: -13.1% (-13.8% to -12.4%; p < 0.001), and Q4: -15.3% (-16.0% to -14.7%; p < 0.001), adjusted for sex, age, BMI, equivalent income adjusted for the number of household members, and educational level of parents. The interaction p was <0.001 for Q1-3 vs. Q4. Guardians with low total scores were significantly more likely to have less time, mental capacity, and financial ability to prepare meals after the SOE. Therefore, schoolchildren's meal quality deteriorated during the SOE, particularly among those with guardians with low food literacy even after adjustment for household income level and guardians' educational level.

Trends in obesity and blood lipid abnormalities in school-age children in Japan.

BACKGROUND: Obesity in children is a public health concern in Japan. To evaluate the current state of the obesity problem and inform future directions, we aimed to provide an updated account of secular trends in the percentage of overweight (POW) children by gender and school grade, and evaluate changes in POW after participation in the obesity health screening. METHODS: The current study utilized aggregated data from the Setagaya Ward, Tokyo, public elementary and middle school populations from 2009 to 2018. Data on the percentage of overweight ≥ 30% (POW-30) and percentage of abnormal blood test results were examined by year, gender, and school grade level. Individual-level data from 2015 to 2017 in children who participated in a follow-up obesity health screening were evaluated for changes in median POW. RESULTS: A decreasing trend in students with a POW-30 was observed from 2009 to 2011, with rates stabilizing thereafter. The highest proportions of POW-30 were observed in 2010 (4.8% in middle school boys; 2.8% in middle school girls). From third grade, the difference in percentage by gender appeared to get increasingly larger until the beginning of middle school. Among obesity health screening participants, abnormal blood tests for total cholesterol and triglycerides showed a slightly increasing trend over time, and changes in POW after screening were greatest for middle school students. CONCLUSIONS: Increases in obesity were not observed in Setagaya Ward public school students since 2010, but disparities exist by gender and grade level, suggesting that tailored intervention strategies may be useful to optimize aspects of the obesity health screening program.

[Achievements and Challenges of a Sakado "Shokuiku (Food and Nutrition Education)" Program Implemented in All Elementary and Middle Schools in Sakado-city, Saitama Prefecture].

Objective　Since 2006, Sakado city in Saitama prefecture, Japan, has been implementing the Sakado "Shokuiku (food and nutrition education)" Program in collaboration with Kagawa Nutrition University. The present study aimed to evaluate the program, and to discuss its achievements and future challenges.Methods　This program targeted all students from the 5th through the 8th grade. Data from surveys conducted with students and teachers during the school year from 2006 through 2014 were to analyze the program's implementation process and to evaluate its impact. For process evaluation, two surveys conducted with teachers were used. Survey A pertained to the status of program implementation and students' reaction towards each lesson conducted at schools. Survey B pertained to school teachers' involvement in the program and changes of teaching content and interest in food and nutrition education after its implementation, to assess their reaction towards the program. For impact evaluation, three surveys conducted with students were used. Specifically, Survey C aimed to confirm the effectiveness of the 4-year program, Survey D assessed the same in each grade, and Survey E examined the attitudes and behaviors of students who completed the 4-year program.Results　More than 70% of the classes were able to implement the program successfully in the fourth year of elementary school and the second year of middle school. Further, 80% of the classes utilized all the educational materials, and more than 50% of the students understood almost all the contents of the program. Teachers in elementary school and male teachers in middle school, who had attended the teacher training program and/or had implemented the program, were more likely to interest in nutrition education. The impact evaluation did not reveal any significant long-term effects on students; however, their dietary attitudes related to Educational Goal 2 ("eat a well-balanced diet considering its health benefits") improved after each year of participation in the program. More than 90% of the 8th grade students answered that they were happy to have participated in this program.Conclusion　The continual implementation of this nutrition program increased teachers' interest in food and nutrition education and improved some dietary attitudes of students. Future challenges include improving program content, promoting continued implementation, and identifying broader approaches to include students' family and significant others from different generations.

Evaluation of species difference in peripheral lymphocyte reduction effect of CS-0777, a sphingosine 1-phosphate receptor modulator, based on a pharmacokinetic/pharmacodynamic model analysis.

Pharmacokinetic (PK) and pharmacodynamic (PD) modeling was conducted for the reduction of peripheral lymphocytes after oral administration of CS-0777 to healthy rats, monkeys and experimental autoimmune encephalomyelitis (EAE) induced rats. The phosphorylated active metabolite of CS-0777, M1, is a selective sphingosine 1-phosphate receptor-1 modulator. A linear one- and two-compartment model with a reversible metabolism process characterized the time courses of CS-0777 and M1 concentrations in rats and monkeys, respectively. The relationship between lymphocyte counts and M1 concentrations in blood was well described by an indirect response model in all animals examined. An Imax of 0.815 and an IC50 of 6.58 nM in healthy rats, an Imax of 0.807 and an IC50 of 5.09 nM in the EAE rats, an Imax of 0.789 and an IC50 of 0.484 nM in monkeys were estimated by the indirect PD model. Since the IC50 values calculated in terms of the unbound plasma concentration in rats and monkeys were within a similar range, after correction of the IC50 in blood described above with the blood to plasma concentration ratio and the plasma free fraction of M1, it was revealed that there is no species difference in the essential activity of M1 against lymphocyte reduction. The sensitivity of the lymphocytes to M1 was not affected by the EAE status. Comparison of the simulated lymphocyte reduction in EAE rats after multiple dosing with CS-0777 and the actual EAE clinical scores implies that the significant suppressive effect on EAE did not require the elimination of all lymphocytes from the blood. Copyright © 2016 John Wiley & Sons, Ltd.

Pharmacokinetics and disposition of CS-0777, a sphingosine 1-phosphate receptor modulator, in rats and monkeys.

1. Disposition and metabolism of CS-0777 (1-{5-[(3R)-3-amino-4-hydroxy-3- methylbutyl]-1-methyl-1H-pyrrol-2-yl}-4-(4-methylphenyl) butan-1-one), a selective sphingosine 1-phosphate receptor-1 modulator under development for autoimmune conditions was investigated following oral and/or i.v. bolus administration to rats and monkeys. 2. After oral administration of [14C]CS-0777, CS-0777 was well absorbed in rats and monkeys with total recoveries of over 90% of the dose, majorly in feces. CS-0777 and phosphorylated pharmacologically active metabolite of CS-0777 (M1) were highly bound to plasma proteins among rats, monkeys and humans (>93%). 3. The structures of 12 metabolites were identified and phosphorylation and two hydroxylation pathways were proposed as primary metabolism. In the blood of rats and monkeys, the major metabolite was M1 and a few phosphorylated metabolites were also detected. Meanwhile, in urine and feces of rats and monkeys, not phosphorylated, but oxidized CS-0777 metabolites and/or those various conjugated metabolites were observed. This suggests that CS-0777 and its oxidized metabolites would be phosphorylated in the body, but their phosphorylated metabolites would revert back to their dephosphorylated form again then be further metabolized and finally eliminated from the body. 4. Pharmacokinetic analysis using a reversible metabolism model revealed that the clearance of phosphorylation was larger than the clearance of dephosphorylation and elimination.

The Association Between Eating Quickly and Excessive Gestational Weight Gain.

Objectives: Maintaining an appropriate gestational weight gain (GWG) is essential for a safe pregnancy and delivery. This study aimed to determine the association between the habit of eating quickly and the risk of excessive GWG. Methods: We administered a questionnaire on eating habits to 1246 pregnant Japanese women in their second to third trimesters. We categorized the participants into three groups according to their answers to the question "Do you eat quickly?" Group 1, "always" or "usually"; Group 2, "sometimes"; and Group 3, "rarely" or "never." We assessed GWG according to the "The Optimal Weight Gain Chart" (Ministry of Health, Labor and Welfare, Japan), and those who exceeded the criteria were considered "excessive." Logistic regression analysis was performed with the risk of excess GWG as the dependent variable and quick food intake as the independent variable, to obtain relevant odds ratios (ORs) and 95% confidence intervals (CIs). Model 1 was unadjusted, and Model 2 was adjusted for age, prepregnancy body mass index, energy intake, mother's educational attainment, household income, exercise habits, and childbearing experience. Results: The OR (95% CI) for Groups 2 and 3 in Model 1, compared with Group 1, was 0.80 (0.62-1.05) and 0.61 (0.43-0.88), respectively (p for trend = 0.047). In Model 2, the OR (95% CI) for Groups 2 and 3 were 0.73 (0.55-0.96) and 0.59 (0.40-0.86), respectively (p for trend = 0.003). Conclusion: These results suggest that quick food ingestion increases the risk of excessive GWG.

Evaluating the association between caesarean delivery and weight status in early childhood in a Japanese birth cohort study.

To examine whether the prevailing hypothesis of an association between caesarean section (CS) delivery method and increased weight status in early childhood is observed in Japanese. A total of 1277 mother-infant pairs from a prospective hospital-based mother-infant birth cohort that recruited women in their first trimester from May 2010 to November 2013 were included. We assessed the relationship between delivery method and weight status of delivered children at 1, 3 and 6 years of age. In total, 366 children (28.7%) were delivered by CS. Delivery by CS was not associated with body mass index (BMI) z-score (≥ 75 percentile) at age 1 year, (odds ratio (OR) 0.97, 95% confidence interval (CI) 0.69-1.36), 3 years (OR 0.98, 95% CI 0.67-1.42), and 6 years (OR 0.71, 95% CI 0.45-1.12), and also showed no association with low weight status (< 25th percentile). Supplemental evaluations addressing the influence of preterm births, pre-pregnancy BMI, emergency CS, and modification by breastfeeding were consistent with the primary analyses. Our findings do not support the hypothesis that children born by CS are at risk of being overweight in childhood among the Japanese population.

Convenience Food Options and Adequacy of Nutrient Intake among School Children during the COVID-19 Pandemic.

The COVID-19 pandemic has caused changes in the family food environment, resulting in more families relying on convenience food options. This study aimed to investigate diet quality by convenience food options (namely instant, frozen, and take-out foods) among Japanese school children during the COVID-19 pandemic. We examined the relationship between the frequency of consumption of convenience food options and nutritional status of the school children. The participants (671 children, 10-14 years old) were chosen to form a nationally representative sample of the Japanese population. Using questionnaires completed by the participants' guardians, information was collected on the frequency of instant, frozen, and take-out food consumption. Habitual food and nutrient intake were collected using a validated food frequency questionnaire, completed by the children with help from their guardian(s). "Frequent" consumption was defined as consumption of instant, frozen, and/or take-out foods on more than 5 days per week. Using 19 nutrients and their respective dietary reference intake (DRI) values, an index was created to label each child's nutrient intake as "Adequate", "Inadequate", "Excess", or "Deficient." Compared to children with non-frequent consumption, school children with frequent instant food consumption had significantly higher rates of inadequate nutrient intake (risk ratio (RR) = 3.0 [95% CI: 1.6-5.6]) and excess nutrient intake (RR = 2.3 [95% CI: 1.3-4.2]), while school children with frequent take-out food consumption had significantly higher rates of inadequate nutrient intake (RR = 2.1 [95% CI: 1.3-3.3]). There were no significant differences for children with frequent frozen-food intake. These associations did not change when adjusting for sociodemographic factors. Our results suggest that the frequent consumption of instant or take-out foods among school children results in non-adequate nutritional intake.

Changes in Selected Food Groups Consumption and Quality of Meals in Japanese School Children during the COVID-19 Pandemic.

In 2020, a state of emergency was declared to control the devastating impact of coronavirus, leading to temporary school closures in Japan, meaning that school lunches were not provided to the majority of schoolchildren. Using questionnaires completed by participants' guardians, we examined the relationship between household income and the quality of meals in Japanese schoolchildren before, during, and after the state of emergency. Participants (1111 children, 10-14 years old) were chosen to form a nationally representative sample of the Japanese population. "Well-balanced dietary intake" was defined as the intake of (i) meat, fish, or eggs and (ii) vegetables. The desired prevalence was defined as equal to or more than twice a day. Household income was divided into quartiles. "Well-balanced dietary intake" was lower in all households during the state of emergency compared with before. The proportion of those with a "well-balanced dietary intake" at least twice a day was notably low in both Q3 and Q4 during the state of emergency compared with before the declared state of emergency; relative risk increase (95% CI) were Q1: -19.0% (-19.6% to -18.4%), p < 0.001, Q2: -21.3% (-22.1% to -20.6%) p < 0.001, Q3: -25.4% (-26.1% to -24.7%), p < 0.001, and Q4: -34.8% (-35.6% to -34.0%), p < 0.001. The interaction p (vs. Q1) of Q2, Q3, and Q4 were all <0.001. Guardians from low-income households had significantly higher rates of having less: time, psychological room, and financial position to prepare meals during the state of emergency. Our results suggest that schoolchildren's quality of meals worsened during the state of emergency, especially in low-income households, because school lunches were not provided.

Relationship between Maternal Mood Disorders and Dietary Intake of 3-Year-Olds.

Maternal depression affects parenting and children's early development, but its effect on dietary intake is unknown. While husbands' involvement in parenting and having friends to talk to may reduce childcare stress, this has not been thoroughly studied. In this study, mothers were stratified by the presence or absence of mood disorders, and the effects of support from their husbands and friends on the dietary intake of their 3-year-old children were examined. This cross-sectional analysis included 920 mother-child pairs examined at the National Center for Child Health and Development in Japan. Dietary intake was assessed using a brief dietary history questionnaire, and physical measurements were taken when the children were 3 years old. The Kessler Psychological Distress Scale was used to screen for maternal mood disorders, 3 years after delivery. The presence or absence of the husband's assistance with housework and childcare, mental support, and friends was obtained from a self-administered questionnaire when the child was 3 years old. Differences in the children's physical measurements, energy, and food intake with the presence or absence of support for subjects with or without mood disorders were compared. Mothers with support from husbands or friends had significantly fewer mood disorders. Support from friends and family did not affect the children's physical development and whether or not mothers had mood disorder symptoms. However, children's vegetable intake was higher if mothers were supported. Children of mothers with mood disorders had a significantly higher vegetable intake and fruit intake, depending on the support from friends (P=0.046, P=0.037); thus, such support may increase children's vegetable and fruit intake. The results of this study revealed the importance of supportive friends and family regarding childcare.

[Involvement of local dietetics professionals in risk communication program on food safety in municipal governments and their attitude towards the program].

OBJECTIVES: The objective of this study is to gather statistical references on food safety education that encourages competence of food choice from the view-point of food safety. A survey on the involvement of the risk communication program on food safety in municipal governments and the attitude of local dietetics professionals towards the program was conducted. METHODS: In November, 2006, self-reported questionnaires were mailed to 1990 local dietetics professionals who worked in municipal governments in Japan. Descriptive statistics and cross tables were used for data analysis. RESULTS: 1162 questionnaires were mailed and 1130 available surveys were returned. Among the respondents, 41.5% answered that they inform the community about food safety, but 49.9% answered that they did not get information from the community. Most of the respondents answered that risk communication of food safety was important; 21.8% answered "extremely agree" and 62.3% answered "rather agree" on a scale of four from "extremely agree" to "do not agree". More than one-half of the dietetics professionals answered that their confidence in conducting risk communication was low; 20.5% answered "no confidence" and 52.5% answered "hardly have confidence" on a scale of four from "without confidence" to "with confidence". More than 80% of the respondents answered that they needed "professional knowledge" and "support from professional agencies". CONCLUSION: This study suggests that educating local dietetics professionals about professional knowledge on food safety, and obtaining support from special agencies will be essential in the upgrade of risk communication program on food safety in a community.

The Sakado school-based "shokuiku" food and nutriti education project.

The purpose of this study was to obtain baseline data for a school-based food nutrition education on "how snacks should be eaten". The subjects were 704 fifth-graders (371 boys, 333 girls) from all the primary schools in Sakado City who participated in the study in November 2006. They completed a 'Life Habit Questionnaire' and a 'Food Frequency Questionnaire (BDHQ)'. Based on their answers the subjects were classified into three groups. Statistical methods including chi-square test, and one-way layout ANOVA were used to analyze the relations between Rohrer index by gender, lifestyle groups of above each question, and intake of snacks. There was the significant relation between the Rohrer index by sex and 'helping with domestic chores', 'communication with the families' and 'physical exercise'. The variables 'soft beverage drinking', 'physical exercise' 'time spent on TV and video games' and 'less frequent breakfast intake' consume significantly higher amounts of snacks than others groups. 'Helping with domestic chores' was significant associated with 'communication with the families' and 'physical exercise'. The results suggest that guidance should be given on eating breakfast every day, developing exercise patterns and appropriate eating of snacks.

[Processes of sharing issues among participating groups in the form of a food and nutrition education network: the case of the "S Network"].

OBJECTIVE: To review processes of sharing issues among participating groups in the form of a food and nutrition education network and elucidate how organizations develop commitment and how individuals change their attitudes. METHODS: (1) Process regarding the form of a food and nutrition education network: After discussions by administrative public health nutritionists at public health centers and meetings with faculty members at J University, we encouraged three groups to participate in a network to share information on food and nutrition issues and gave them opportunities to interact with each other. Group A primarily provided food and nutrition information, group B primarily provided foods, and group C provided both. Specifically, these activities included two open community programs and eight volunteer activities. In the first open community program, they identified capacity to be developed through food and nutrition education and volunteers explored possible cooperation among organizations on the basis of the categorization and classification of issues. To provide feedback on the results, a workshop was held during the second open program. (2) Analysis of the process: We documented organizations involved in the form of a food and nutrition education network from 2003 through 2006, the processes and details of their activities, and activities and remarks by participants. These documents were classified by issue, broken down into categories, and listed chronologically with titles for characteristic entries, thereby reviewing the processes. On the basis of these results, we asked participants who were involved in the entire process of the construction of the food and nutrition education network to review their own activities, and we then investigated the changes in their attitudes. RESULTS: (1) A total of 63 persons in 34 organizations participated in open community programs. Local food issues included changing dietary behaviors along with diversification of lifestyle; problems with cooking, eating, and continuation of tradition because of the lack of nutritional knowledge and experience; and the uncontrolled flood of information. Participating organizations were found to engage in different activities to address nutritional issues. In addition, insufficient or low efficiency activities were identified, indicating the need for cooperation. (2) Issue-sharing processes consisted of the following three steps: identification of local nutritional issues, characterization of group activities to address food and nutritional problems, and exploration of possible cooperation among groups. Analysis of attitudes of three persons participating in the entire process of network construction revealed their interest in other organization activities and sympathy with other organizations. DISCUSSION: Factors for promotion of sharing issue include (1) our support to allow them to share food and nutrition issues in the early stages and thereafter, and (2) repeated deliberations within open community programs involving information and feedback from prior identification and analysis of problems, as well as selection of activities.

Correlation of month and season of birth with height, weight and degree of obesity of rural Japanese children.

Month and season of birth are thought to influence height, weight and degree of obesity in schoolchildren. A cross-sectional study was designed to measure the height and weight of all children aged 6-15 years attending primary and junior high schools in Tokushima Prefecture, Japan. Data were standardized (z-scores) and analysed separately by gender and age. The mean z-score for height and weight were the highest in subjects born during the months of spring and the lowest in those born during the months of winter (p < 0.0001), whereas the means were significantly higher in children born during the months of summer than in those born during the months of autumn (p < 0.0001). A gradually decreasing trend of height and weight was observed in children of both genders born between May and Mar (from spring to winter). There was no significant difference in degree of obesity among the four seasons of birth for boys and girls. The highest prevalence of obese boys have born during spring (among 6-year-old boys) and summer (among 7-year-old boys), whereas the highest prevalence of obese girls have born during spring (among 6-year-old girls) and winter (among 10-year-old girls). Our findings suggest that month and season of birth influence height and weight of schoolchildren in Tokushima but not their degree of obesity.

The physical examination content of the Japanese National Health and Nutrition Survey: temporal changes.

BACKGROUND AND OBJECTIVES: Survey items of the Japan National Nutrition Survey (J-NNS) have changed over time. Several papers on dietary surveys have been published; however, to date, there are no in-depth papers regarding physical examinations. Therefore, we investigated changes in the survey items in the physical examinations performed in the J-NNS and the National Health and Nutrition Survey (NHNS), with the aim of incorporating useful data for future policy decisions. METHODS AND STUDY DESIGN: We summarized the description of physical examinations and marshalled the changes of survey items from the J-NNS and NHNS from 1946 to 2012. The physical examination is roughly classified into the following six components: some are relevant to anthropometric measurements, clinical measurements, physical symptoms, blood tests, lifestyle and medication by interview, and others. RESULTS: Items related to nutritional deficiency, such as anaemia and tendon reflex disappearance, and body weight measurements were collected during the early period, according to the instructions of the General Headquarters. From 1989, blood tests and measurement of physical activity were added, and serum total protein, total cholesterol, triglycerides, HDL-cholesterol, blood glucose, red blood corpuscles and haemoglobin measurements have been performed continuously for more than 20 years. CONCLUSIONS: This is the first report on the items of physical examination in the J-NNS and NHNS. Our research results provide basic information for the utilization of the J-NNS and NHNS, to researchers, clinicians or policy makers. Monitoring the current state correctly is essential for national health promotion, and also for improvement of the investigation methods to apply country-by-country comparisons.

Platelet activation biomarkers in Berkeley sickle cell mice and the response to prasugrel.

Vaso-occlusive crisis (VOC) is a common complication that occurs in sickle cell disease (SCD) patients. Although underlying mechanisms of VOC remain unclear, platelet activation has been associated with VOC. In the present study, plasma adenine nucleotide measurements using LC-ESI-MS/MS showed that plasma ADP in the Berkeley murine model of SCD was significantly higher (applox. 2.7-fold increase) compared with control mice. Assessment of platelet activation markers using flow cytometry indicated that in SCD mice at steady state (8 weeks old), circulating platelets were partially activated and this tended to increase with age (15 weeks old). The administration of prasugrel, a thienopiridyl P2Y12 antagonist, did not affect the activation state of circulating platelets suggesting P2Y12 independent mechanism of activation. In this murine SCD model, ex vivo addition of ADP or PAR4 TRAP resulted in further platelet activation as assessed by expression of activated GPIIb/IIIa and P-selectin both at 8 and 15 weeks. In 15 weeks old SCD mice, agonist-induced increases in activation markers were enhanced compared to control mice. Oral administration of prasugrel effectively inhibited ex vivo platelet activation consistent with clinical data in patients with SCD. In conclusion, in the Berkeley murine model of SCD, we found evidence of basal and agonist-stimulated platelet activation which could in part be attenuated by prasugrel. These data are consistent with observations made in patients with SCD and suggest possible utility of this murine model and prasugrel therapy in exploring treatment options for patients with SCD.

Prevalence of metabolic complications in children with severe obesity.

BACKGROUND: The purpose of the present paper was to clarify the prevalence of metabolic complications in severely obese children. METHODS: The subjects of the present study were 367 severely obese Japanese children in Tokushima, who were more than 150% of the standard weight for their sex and height (school grades 1-9; age range, 6-16 years). Data concerning anthropometric and metabolic parameters (body fat %, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid, blood glucose, serum insulin, alanine aminotransferase, and blood pressure) were analyzed. RESULTS: The prevalence of each abnormality in obese children was high compared with that in the general population. Metabolic variables were correlated with each other. A total of 80.4% of severely obese children had at least one complication. CONCLUSION: Severely obese children have various metabolic abnormalities even during their early school years. Intervention by primary physicians in cooperation with schools is needed for the prevention of lifestyle-related diseases.