[Evaluation of the relationship between household economic situation and food group intake in children attending nursery school].

Objectives　The relationship between household income and dietary intake among older children and adults in Japan has been studied. However, few studies have examined the relationship in younger children, and we believe that this should be taken into consideration from early childhood to correct health disparities. In this study, we examined the relationship between family income and dietary food group intake, and investigated the adequacy of food intake based on the Japanese Food Guide Spinning Top for young children aged 3 to 6 years attending nursery school. The goal of this study was to obtain trends in food intake that can be used to improve poor dietary intake of young children caused by socioeconomic factors.Methods　A dietary survey using the food weighing or recording method and a self-administered questionnaire on dietary status were conducted on two non-consecutive days, including weekdays and weekends, from October to December 2019 or 2020. The participants were 761 young children (423 boys and 338 girls) attending nursery schools in seven cities in Japan. Equivalent income was calculated from household income and the number of family members indicated in the dietary status survey. Intake of each food group and consistency with the Japanese Food Guide Spinning Top were compared in five quintiles.Results　Compared to the low equivalent income group, the high equivalent income group showed a decreasing trend in cereal intake and an increasing trend in the intake of sugar and sweeteners, green and yellow vegetables, and dairy products. The percentage of the low-income group who did not meet the definition of adequate intake using the Japanese Food Guide Spinning Top was lower for meals that include cereals and grain products, and higher for meals that include meat and fish, vegetable, milk and dairy products, and fruits.Conclusion　The lower income group had higher intake of cereals and lower intake of vegetables and fruits compared to the higher income group. This finding is similar to the results of studies in adults and older children. However, based on the Japanese Food Guide Spinning Top, >90% of young children have a diet that fall below the adequate intake of meals, including vegetable dishes and even on weekdays, which suggests a general vegetable deficiency in young children. Multifaceted support is required to address this concern, including measures to correct disparities of income and to ensure desirable nutrient intake in early childhood.

GFS9 Affects Piecemeal Autophagy of Plastids in Young Seedlings of Arabidopsis thaliana.

Chloroplasts, and plastids in general, contain abundant protein pools that can be major sources of carbon and nitrogen for recycling. We have previously shown that chloroplasts are partially and sequentially degraded by piecemeal autophagy via the Rubisco-containing body. This degradation occurs during plant development and in response to the environment; however, little is known about the fundamental underlying mechanisms. To discover the mechanisms of piecemeal autophagy of chloroplasts/plastids, we conducted a forward-genetics screen following ethyl-methanesulfonate mutagenesis of an Arabidopsis (Arabidopsis thaliana) transgenic line expressing chloroplast-targeted green fluorescent protein (CT-GFP). This screen allowed us to isolate a mutant, gfs9-5, which hyperaccumulated cytoplasmic bodies labeled with CT-GFP of up to 1.0 µm in diameter in the young seedlings. We termed these structures plastid bodies (PBs). The mutant was defective in a membrane-trafficking factor, green fluorescent seed 9 (GFS9), and PB accumulation in gfs9-5 was promoted by darkness and nutrient deficiency. Transmission electron microscopy indicated that gfs9-5 hyperaccumulated structures corresponding to autophagosomes and PBs. gfs9-5 hyperaccumulated membrane-bound endogenous ATG8 proteins, transgenic yellow fluorescent protein (YFP)-ATG8e proteins and autophagosome-like structures labeled with YFP-ATG8e. The YFP-ATG8e signal was associated with the surface of plastids and their protrusions in gfs9-5. Double mutants of gfs9 and autophagy-defective 5 did not accumulate PBs. In gfs9-5, the YFP-ATG8e proteins and PBs could be delivered to the vacuole and autophagic flux was increased. We discuss a possible connection between GFS9 and autophagy and propose a potential use of gfs9-5 as a new tool to study piecemeal plastid autophagy.

[Milk, Daily products and Bone health.Nutritional Value of Milk and Dairy Products.]

Milk has been historically recognized as having great nutritional value;its high nutrient density per energy makes it useful for individuals recovering from malnutrition among others. Milk is composed of an excellent ratio of essential amino acids, with an amino acid score of 100, and enhances the protein content when served with a meal. Additionally, not only is milk rich in calcium, but the absorption rate of calcium contained in the meal increases when milk is served with a meal. Instead of consuming nutritional supplements to make up for a lack of nutrients in the diet, Milk is a representative food that highlights the nutritional value of taking one food in combination with other foods. Moreover, milk costing as little as 100 contains high nutrient density, making it an economically efficient food.

[Milk, Daily products and Bone health.Milk and Dairy Products and "Wasyoku" -"New wasyoku"-.]

"Wasyoku;the traditional diets of Japan" refers to foods generally consumed by Japanese people, which is in contrast with the Western diets introduced by Europeans and Americans. The basic Japanese dietary pattern consists of rice as a staple food combined with one soup and two side dishes in a meal, making it easier to achieve a balanced nutritional status. However, salt content tends to be high in "Wasyoku", which negatively affects the overall health of an individual. Recently, Japanese's salt intake has been slowly decreasing;however, a further reduction by approximately 2 g per day is required to prevent hypertension and cardiovascular diseases. To reduce salt intake, while keeping a balanced nutritional status and obtaining adequate amount of energy and nutrients, one should be used to consume a lightly flavored food. However, as Japanese individuals have been accustomed to a high salt diet, which is directly related to a person's good taste or satisfaction level, shifting to lightly flavored foods is extremely difficult. Therefore, one of the methods developed to reduce salt intake is a "New Wasyoku;milk-plus traditional diets of Japan," a recipe utilizing the "koku" or umami taste of milk. The "New Wasyoku" is characterized by adopting to a milk/dairy product-based recipe, which promotes the realization of natural, healthy diets, while maintaining the palatability and nutritional balance of diets.

Household income is associated with food and nutrient intake in Japanese schoolchildren, especially on days without school lunch.

OBJECTIVE: The present study aimed to examine the association between household income and the intake of foods and nutrients by Japanese schoolchildren, and any differences between days with and without school lunch. DESIGN: This was a cross-sectional study. Children, with the support of their parents, kept dietary records with photographs for 4 d (2 d with school lunch and 2 d without). The socio-economic status of each family was obtained from a questionnaire completed by the parents. SETTING: Japan. SUBJECTS: All students in 5th grade (10-11 years old) at nineteen schools in four prefectures and their parents (1447 pairs of students and parents) were invited to take part in the study; 836 pairs of complete data sets were analysed. RESULTS: The average results of four days of dietary records showed that lower income level was associated with a lower intake of fish/shellfish, green vegetables and sugar at the food group level, a lower intake of protein and several micronutrients, and a higher energy intake from carbohydrates at the nutrient level among the children. These associations between income and food/nutrient intake were not significant on days with school lunches, but were significant on days without school lunch. CONCLUSIONS: Our study confirmed an association between household income and the amount of foods and nutrients consumed by Japanese schoolchildren, and suggested that school lunches play a role in reducing disparities in the diets of children from households with various incomes.

Association between vitamin D status and serum parathyroid hormone concentration and calcaneal stiffness in Japanese adolescents: sex differences in susceptibility to vitamin D deficiency.

There is currently insufficient information on serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) concentrations, and bone mineral status in healthy adolescents to allow reference values to be set. This study aimed to provide comparable data on vitamin D status in Japanese adolescents and to assess sex differences in susceptibility to vitamin D insufficiency. Serum 25OHD and PTH concentrations were measured in 1,380 healthy adolescents (aged 12-18 years). Subjects completed a questionnaire on exercise history, diet, and lifestyle factors. Calcaneal stiffness was evaluated by quantitative ultrasound. Serum 25OHD concentrations in boys and girls were 60.8 ± 18.3 and 52.8 ± 17.0 nmol/L, respectively. Approximately 30 % of boys and 47 % of girls had suboptimal 25OHD concentrations (<50 nmol/L). Serum PTH concentration was negatively correlated with serum 25OHD concentration in boys, but negatively correlated with calcium intake rather than serum 25OHD in girls. In contrast, the increment in calcaneal stiffness as a result of elevation of serum 25OHD was higher in girls than in boys. As vitamin D deficiency is common in Japanese adolescents, it was estimated that intakes of ≥12 and ≥14 µg/day vitamin D would be required to reach 25OHD concentrations of 50 nmol/L in boys and girls, respectively. Moreover, the results of the present study indicate that vitamin D deficiency has a greater association with calcaneal stiffness in girls than in boys.

[Analysis of Hepatitis B Virus Reactivation in Fukuoka University Hospital].

Immunosuppressive therapy or chemotherapy-induced hepatitis B virus (HBV) reactivation can cause se- vere hepatitis in inactive HBV carriers or patients with resolved infection. We surveyed patients with measured HBV DNA levels from 2009 to 2014, and analyzed the clinical profile, treatment regimen and the period leading up to HBV reactivation from therapy start date. Between 2009 and 2014, the total number of HBV viral load measurements taken in our hospital increased 2.3-fold. HBV DNA measurements requested by the Department of Gastroenterology and Hepatology ac- counted for 82.8% of the total in 2009; however, this was reduced to 38.0% in 2014, as the number of re- quests from other departments increased. We referred all patients with reactivated HBV infection to a hepatology specialist. The total number of reactivation patients in 2014 was increased to about 8.2 times that observed in 2009. Nineteen males and 24 females were included in our cohort, and the average age was 69±10.1 years old. Thirty-two patients had previously received chemotherapy, and seven had undergone immunosuppressive treatment. A delay of more than 12 months from commencement of therapy to HBV reactivation was observed in 49% of patients. These results indicate that it is very important to monitor HBV DNA and properly enforce pre-treatment examinations according to the guidelines for prevention and treatment of HBV during immunosuppressive therapy. [Original].

Uterine prolapse during late pregnancy in a nulliparous woman.

A pregnancy that is complicated by a uterine prolapse is rare and primarily occurs in multiparous women during their first or second trimester. In the present report, we describe a case of a 31-year-old nulliparous woman who experienced sudden uterine prolapse at 38 weeks' gestation without labor pains. The cervix was congested, the cervical mucosa was partially lacerated, and bleeding was noted; the protruding cervix could not be repositioned into her vagina. Although the cervical congestion worsened over time, she still did not experience any labor pains. She was delivered by emergency cesarean section. Following delivery, the prolapse promptly improved and did not recur before her 1-month postpartum examination. To our knowledge, this is the first case where uterine prolapse occurred in a nulliparous woman during late gestation.

[Emergency medical care and POCT].

Emergency testing is intended to elucidate the patient's condition; therefore, the ideal emergency testing should be able to be implemented quickly and easily at the patient bedside for 24 hours a day, and the time from test order to result should be as short as possible. In other words, a shorter turn around time (TAT) is better. Needless to say, the most effective way to reduce TAT is to omit all other processes except testing from the test procedure, and bring it as close to the measuring time = TAT as possible. Because we think of emergency testing in this way, the concept of point of care testing (POCT) is the essence of emergency testing and does not threaten the emergency testing domain of laboratory technicians but is of medical origin and aims at the rapid appropriate treatment of patients.

[The application of fluorescence in situ hybridization to the peripheral-blood preparations].

The hematologic malignancy with specific chromosomal/genetic abnormality is separately classified by the WHO classification of tumors hematopoietic and lymphoid tissues. The chromosomal abnormalities, t (9; 22), t (8; 21), t (15; 17) and inv (16) are especially important for the establishment of therapeutic strategy and prognostication. We examined in this study, five cases were analyzed, because abnormal cells were recognized by the differential white blood count of the peripheral-blood and specific chromosomal abnormalities were suspected. Whether peripheral-blood preparations after May-Grünwald Giemsa staining could be used for fluorescence in situ hybridization (FISH). The fusion signals were detected in the high rate by using a peripheral-blood specimen in four cases, except for one case that had no specific chromosomal abnormality.

Urinary levels of cross-linked N-terminal telopeptide of type I collagen and nutritional status in Japanese professional baseball players.

The objective of the present study was to investigate the nutritional status from the aspect of bone metabolism in Japanese elite male athletes with increased bone resorption. Urinary levels of a bone resorption marker, cross-linked N-terminal telopeptide of type 1 collagen (NTX), were measured in 71 professional baseball players (age, 18-39 years); the mean urinary NTX level was 65.6 (range, 17.5-269.0) nM BCE/mM Cr. Of 71 athletes, 9 with high levels of urinary NTX (greater than mean + 1 SD) were examined by measuring serum biochemical markers and nutritional assessment (simple food frequency questionnaire). Serum biochemical marker analysis showed that 7 of these 9 athletes had vitamin D insufficiency, as indicated by low serum levels of 25-hydroxyvitamin D, and that all 9 athletes showed vitamin K insufficiency as indicated by low levels of vitamins K(1) and K(2). Nutritional assessment revealed high intakes of protein and low intakes of calcium and vitamin D based on adequate intake (AI). However, daily vitamin K intake achieved the AI. These results suggest that there exist elite male athletes who show increased bone resorption and calcium and vitamin D insufficiency. However, there was a discrepancy between vitamin K intake and serum levels of vitamins K(1) and K(2). The present study raised an issue regarding the nutritional status from the point of view of bone metabolism in elite male athletes such as professional baseball players.

Association between parents' work hours and nutrient inadequacy in Japanese schoolchildren on weekdays and weekends.

OBJECTIVES: Evidence is sparse concerning whether the nutrient intake in schoolchildren differs according to parents' work hours. The aim of this study was to investigate the relationship between parents' work hours and nutrient inadequacy among Japanese primary schoolchildren using dietary reference intakes on days with and without a school lunch. METHODS: Participants included 10- to 11-y-old children in grade 5 from 19 public primary schools in four prefectures of east Japan. Data for 699 children were analyzed. Participants completed 24-h dietary records with photographs of their meals for 4 d consecutively, which included of 2 d of weekdays and 2 d of weekends. Their mothers' and fathers' work hours were obtained from questionnaires that were completed by the participants' guardians. Logistic regression analyses were used to estimate the odds ratios for whether participants had poor nutrient intake, with adjustment for confounders. RESULTS: Children whose mothers worked ≥40 h/wk had significantly higher rates of nutrient shortages for vitamins A, E, K, and B6, pantothenic acid, potassium, magnesium, and iron (P = 0.007, 0.003, 0.007, 0.023, 0.021, 0.045, 0.004, and 0.009, respectively) than those in the 0 h/wk group. These differences were not significant based on fathers' working hours, with the exception of vitamin A (≥40 versus 0-39 h/wk, P = 0.032). Additionally, nutrient shortages for children were more pronounced on weekdays than on weekends. CONCLUSIONS: This evidence revealed the necessity to improve nutrition intake in children whose mothers work more than statutory working hours, which would enable children to have adequate nutrient intake, especially on weekdays.

Nutrient adequacy of Japanese schoolchildren on days with and without a school lunch by household income.

BACKGROUND: Evidence for whether the nutrient intakes of Japanese schoolchildren differ according to household income is sparse. OBJECTIVE: We investigated the role of school lunches for nutrient adequacy among Japanese primary school children using dietary reference intakes in a cross-sectional survey. DESIGN: Participants were 10- to 11-year-old (5th grade) children from 19 public primary schools in four prefectures of East Japan, and 836 children were analyzed. The participants completed 24-h dietary records with photographs of their meals for 4 consecutive days, composed of 2 days with and 2 days without a school lunch. -Children's household income was obtained from questionnaires that were completed by the participants' guardians and divided into the following three categories: low (0.2236-2.2361 million yen; n = 319), middle (2.3333-2.8868 million yen; n = 194), and high (3.1305-6.3640 million yen; n = 323). Logistic regression analyses were used to estimate the odds ratios for whether participants had poor nutrient intakes, with adjustment for confounders. RESULTS: On days without a school lunch, the prevalence of nutrient shortages was significantly higher compared with those on days with a school lunch for most macro- and micronutrients among all three levels of household income. Children from low-income households had higher rates of nutrient shortages for vitamin B6, pantothenic acid, K, Mg, P, Fe, and Zn than those from middle-income households on days without a school lunch (P = 0.004, 0.001, 0.001, 0.006, 0.037, <0.001, and 0.015, respectively), but those differences were not significant on days with a school lunch. CONCLUSION: The findings suggest that school lunches are important for achieving adequate nutrient intakes in schoolchildren and reduce disparities of adequate nutrient intake by household income levels.

[Nutrition and bone health. The bone and the foods containing many water-soluble vitamins].

On the Dietary Reference Intakes in Japan, nine kinds of water-soluble vitamins are taken up. Those vitamins are supplied from various food. Food from animal sources and vegetable sources are those vitamins source of supply. Vitamin C participates in generation of collagen. Vitamin C is supplied from vegetables or fruits. Since vitamin C is lost by cooking processing, the content of a raw state is not expectable after cooking. Moreover, the vitamin B group of food origin has combined with protein etc., and free types, such as supplement, differ in the bioavailability.

[Nutrition and bone health. Calcium-rich foods and bone].

Although milk and dairy products are the best sources of calcium, milk consumption tends to decrease after the period of school age in Japan. Therefore, calcium intake has been reported to be short in many Japanese adolescents, adults and elderly people. Green and yellow vegetables, soy beans, and fish are also good sources of calcium. In addition, foods for specified health use (FOSHO) including calcium or other ingredients to improve calcium absorption could be utilized for increasing calcium intake.

[Phosphorus-rich foods and bone].

Phosphorus is present in almost all food. The major sources are grain, meat, sea food and dairy product. However average absorption rate from the intestine is 60 approximately 70%, it differs according to types of food. Recently, increased phosphorus intakes from food additives are seen as a problem. But, the accurate amount is unknown in Japan. It is expected to clarify the exact phosphorus intake and proper recommended intakes considering with other nutrients especially calcium for the best condition of bone, and also show adequate food choice methods.

Relationship between rice consumption and body weight gain in Japanese workers: white versus brown rice/multigrain rice.

Increasing obesity rates have driven research into dietary support for body weight control, but previous studies have only assessed changes in body weight of ±3 kg. We investigated the relationships between white or brown/multi-grain rice consumption and 1-year body weight gain ≥3 kg in Japanese factory workers (n = 437). Routine medical check-up data from a 1-year nutrition and lifestyle cohort study were analysed. Participants were divided into white rice and brown/multi-grain rice consumption groups and further classified by tertile of rice consumption. Multiple logistic regression analyses were performed by tertile. At 1 year, high white rice consumption was significantly associated with increased risk of body weight gain ≥3 kg compared with low white rice consumption, maintained after adjustment for age, sex, and consumption of other obesogenic foods (p = 0.034). In the brown/multi-grain rice consumption group, however, there was no significant difference in risk between high and low consumption, even after multi-variate adjustment (p = 0.387). The consumption of white rice, but not brown rice/multi-grain rice, was positively correlated with the risk of a 1-year body weight gain of 3 kg or more. This suggests that brown rice/multi-grain rice consumption is useful for body weight control among Japanese workers.

Development of a simple food frequency questionnaire to estimate intakes of calcium and other nutrients for the prevention and management of osteoporosis.

There have been no simple methods to estimate dietary nutrient intakes for the prevention and management of osteoporosis. The aim of this study was to develop and validate a new, simple food frequency questionnaire (FFQ) for dietary intake of calcium and other nutrients relevant to the bone health of adult Japanese women. We developed a 28-item FFQ. To validate this, 208 and 72 adult women aged between 18 and 69 y were recruited for testing reliability and reproducibility, respectively. In the 208 women, moderate-to-high Spearman's correlation coefficients between our FFQ and the conventional diet record method were found in intakes of calcium (r=0.668), sodium chloride (NaCl) (r=0.475), vitamin A (r=0.501), vitamin D (r=0.413), vitamin K (r=0.649), and energy (r=0.471). In the 72 women, coefficients of variance of the four repeated measurements of intakes throughout a year were 14.1% for calcium, 7.3% for NaCl, 21.2% for vitamin A, 13.6% for vitamin D, 36.8% for vitamin K, and 9.6% for energy. In conclusion, the FFQ we developed is a useful tool to evaluate the intake of dietary calcium of adult Japanese women. Although it can also measure intakes of dietary vitamin A, vitamin D, vitamin K, NaCl, and energy, further improvement is needed to measure intakes of these nutrients and energy.

The relationship between serum leptin concentration and the percentage of body fat in Japanese high school students.

Leptin is a hormone that is synthesized and secreted by adipocytes. Leptin has been found to participate in a number of regulatory physiological functions. It suppresses food intake and increases energy consumption, increases blood pressure, and improves carbohydrate metabolism. The relationship between serum leptin concentration and percentage of body fat (% BF) in Japanese students in the 1st year of high school (1stHS, n = 889) and the 3rd year of high school (3rdHS, n = 948) was examined in a cross-sectional study. The mean of serum leptin concentrations showed no significant difference between the 1stHS and 3rdHS; it was significantly higher in girls than in boys in both grades. Significant gender differences were observed in both the slope and intercept of the regression lines. These results suggest that the serum leptin concentrations in Japanese high-school students do not differ significantly in the 1stHS and 3rdHS, but change with % BF, regardless of school year and the presence or absence of obesity.