[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.

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.

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.

Bacterial profile of infant feces associated with lactation infectious breasts.

BACKGROUND: Mastitis is a common complication in lactating women. However, the diversity of intestinal bacteria in infant exclusively fed infectious milk remains uncharacterized. Our colleagues recently established a method based on 16S and 23S rRNA-targeted reverse transcription-quantitative PCR (RT-qPCR) for detecting bacteria. MATERIALS AND METHODS: In the present study, the bacteria present in 14 samples of milk and infant feces were characterized using the RT-qPCR method, and concentrations of fecal organic acids were measured during the period of breast massage using HPLC. RESULTS: Streptococcus agalactiae and Str. parasanguinis were detected in milk from mastitis patients, whereas Str. salivarius and Str. thermophilus were the predominant bacteria in milk from engorged breasts. In feces of breastfed infants, Str. salivarius, Str. thermophiles, and Str. parasanguinis were isolated. Levels of lactate were high in fecal samples, whereas the pH of infant feces stabilized during breast massage. The bacterial diversity of milk from lactation infectious breasts was similar to that in feces of infant fed milk from lactation infectious breasts. Streptococcus species isolated from the feces of breastfed infants are related to oral cavity health. CONCLUSION: These results suggest that Streptococcus species, which are part of the healthy oral microflora, may play an important role in preserving the intestinal bacterial flora in infants fed infectious milk.

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.

Lung Sounds in Children before and after Respiratory Physical Therapy for Right Middle Lobe Atelectasis.

BACKGROUND: Chest auscultation is commonly performed during respiratory physical therapy (RPT). However, the changes in breath sounds in children with atelectasis have not been previously reported. The aim of this study was to clarify the characteristics of breath sounds in children with atelectasis using acoustic measurements. METHOD: The subjects of this study were 13 children with right middle lobe atelectasis (3-7 years) and 14 healthy children (3-7 years). Lung sounds at the bilateral fifth intercostal spaces on the midclavicular line were recorded. The right-to-left ratio (R/L ratio) and the expiration to inspiration ratio (E/I ratio) of the breath sound sound pressure were calculated separately for three octave bands (100-200 Hz, 200-400 Hz, and 400-800 Hz). These data were then compared between the atelectasis and control groups. In addition, the same measurements were repeated after treatment, including RPT, in the atelectasis group. RESULT: Before treatment, the inspiratory R/L ratios for all the frequency bands were significantly lower in the atelectasis group than in the control group, and the E/I ratios for all the frequency bands were significantly higher in the atelectasis group than in the control group. After treatment, the inspiratory R/L ratios of the atelectasis group did not increase significantly, but the E/I ratios decreased for all the frequency bands and became similar to those of the control group. CONCLUSION: Breath sound attenuation in the atelectatic area remained unchanged even after radiographical resolution, suggesting a continued decrease in local ventilation. On the other hand, the elevated E/I ratio for the atelectatic area was normalized after treatment. Therefore, the differences between inspiratory and expiration sound intensities may be an important marker of atelectatic improvement in children.