Association between atherosclerotic cardiovascular disease score and skin carotenoid levels estimated via refraction spectroscopy in the Japanese population: a cross-sectional study.

Carotenoids play a role in preventing and impeding the progression of atherosclerotic cardiovascular diseases (ASCVDs) through their anti-oxidative effects. This study evaluated associations between ASCVD risk and skin carotenoid (SC) levels, reflecting dietary carotenoid intake. Participants' ASCVD risk was assessed using the Hisayama ASCVD risk prediction model, and SC levels were measured through a reflection spectroscope (Veggie Meter). The associations between high ASCVD risk and SC levels were analyzed using logistic regression analysis and a restricted cubic spline (RCS) model. A total of 1130 men and women (mean age: 56 years) from participants who underwent a health examination in Seirei Center for Health Promotion and Prevention Medicine in 2019 and 2022 were analyzed. Of these, 4.6% had moderate or high ASCVD risk. Mean SC values were 236, 315, 376, 447, and 606 in quintile Q1 to Q5, respectively. The adjusted odds ratios (95% confidence intervals) of SC quintile for moderate- or high-risk ASCVD was 0.24 (0.12-0.51) in Q5 (495 ≤), 0.42 (0.23-0.77) in Q4, 0.50 (0.29-0.88) in Q3, and 0.68 (0.41-1.12) in Q2 compared to Q1 (< 281). High SC values continuously showed non-linear inverse association with moderate- or high-risk for ASCVD in Japanese adults. Non-invasive SC measurements may be a good indicator for recommending carotenoids to prevent cardiovascular disease.

Regular dental check-up status and related factors among Thai residents in Japan.

The objectives of this online study were to determine the status of regular dental check-ups among Thai nationals living in Japan and to identify barriers to regular dental check-ups by comparing them with general health check-ups. We conducted the online survey twice, in 2021 and 2022, among Thai nationals aged 18 years and older living in Japan via social networking services by an organization that supports Thai nationals living in Japan. Respondents between the ages of 30 and 59 were included in this study. Independent factors included gender, age, length of stay in Japan, family economic status, confidence in Japanese and stay for work purposes. Dependent factors were regular dental check-ups and general health check-ups in the past year. Chi-square tests and multiple logistic regression analyses were used for analysis. 56.6% of respondents had regular dental check-ups. The adjusted odds ratio for the proportion of people with regular dental check-ups was significantly higher for those with high economic status, 2.15 (1.06-4.33), compared with those with low economic status. It was also significantly higher 1.88 (1.10-3.21) for those with confidence in the Japanese language compared with those without. The study suggested the need for Japanese language support in addition to financial support for dental health prevention programs for foreigners living in Japan.

[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.

The Role of School Meal Service Programs.

One in every two school children, or 388 million children from all income levels, receives school meals every day in at least 161 countries. However, school meals are not uniform. It means the contents, timing, and method of offering are different across countries. School feeding has consequences for at least four different sectors. First is social protection as a social safety net to benefit the most vulnerable. Second is education. Sometimes school meals motivate parents to allow their children to attend school, especially in developing countries. Moreover, children who are fed well can concentrate on their studies. Third is agriculture. It promotes sustainable local markets by using the ingredients from the local area in school meals. Finally, school meals contribute toward the health and nutrition of present and prospective children. Nowadays, approximately 80% of countries have a school feeding policy. However, feeding policies differ across countries in respect of the government organization in charge and the order of priority in that country. This symposium provides background information, current situation, and quality improvement of school meals in four Asian countries and the US. We hope that this symposium is useful to learn about the current situation of school meals in various countries and to acquire ideas to improve them in your own country and the world.

Improving Skin Carotenoid Levels in Young Students through Brief Dietary Education Using the Veggie Meter.

The antioxidant and anti-inflammatory effects of carotenoid have been determined to aid in the prevention of a wide range of oxidative disorders, arteriosclerosis, obesity, and various types of cancers. In order to keep high carotenoid levels in the body, much of the vegetable and fruit (V/F) intake is mandatory. However, the actual intake of V/F is not enough in many countries. The aim of this study was to assess whether brief dietary education using the Veggie Meter (VM) that could measure skin carotenoid (SC) levels could induce the increase in carotenoid levels via V/F intake. Two hundred and sixty-one elementary and junior high school students (ages 7−14 years old) received brief educational session and SC evaluation by VM, and the changes in SC levels were examined after 6 months. The baseline VM scores ranged from 131 to 825, and the average significantly increased from 400.0 ± 124.7 (standard deviation) to 447.4 ± 140.4 at Month 6 (p < 0.0001). The percentage of increase at month 6 was negatively correlated with the baseline values (r = −0.36, p < 0.0001). This finding implies that subjects who became aware of their inferiority tended to make a significant effort to change their behavior. The multivariate logistic regression analysis demonstrated that subjects taking much of green and yellow vegetables, drinking vegetable/tomato juice, and eating any fruit had higher VM scores than the average value. In conclusion, the educational approach using VM was supposed to be an effective method of raising awareness of the V/F shortage and increasing V/F intake that could indue the increase in SC levels.

Fermented soy products intake and risk of cardiovascular disease and total cancer incidence: The Japan Public Health Center-based Prospective study.

BACKGROUND/OBJECTIVES: The association of fermented soy products, separately from total soy products, with cardiovascular disease (CVD) and total cancer has not been reported. We examined this association in a population-based prospective cohort study in Japan. SUBJECTS/METHODS: We studied 79,648 participants (42,788 women; 36,860 men) aged 45-74 years without a history of cancer, myocardial infarction, or stroke. Participants completed a food frequency questionnaire (1995-1998) and were followed to 2009-2012. Cox proportional hazards regression analysis was used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) of incidence of CVD and total cancer according to quartiles of total soy products, nonfermented soy products, fermented soy products, miso soup, natto, total isoflavones from soy products, isoflavones from nonfermented soy products, and isoflavones from fermented soy products. RESULTS: In women, we observed a significant inverse association between fermented soy product intake and the risk of CVD (multivariate HR in the highest compared with the lowest quartile of fermented soy product intake: 0.80; 95% CI: 0.68, 0.95; P for trend = 0.010), and also found significant inverse associations for natto and isoflavones among fermented soy products. In site-specific analysis, we observed a similar, significant inverse association between fermented soy product intake and the risk of stroke in women. We found no significant association between any soy product and risk of CVD in men or total cancer in both sexes. CONCLUSIONS: Intake of fermented soy products such as natto was inversely associated with the risk of CVD in women.

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.

[Milk, Daily products and Bone health.School lunch and calcium intake.]

The nutritional standard for calcium is set to 50%of the recommended dietary allowance because of the difficulty of obtaining it in the Japanese daily diet. Dairy products, vegetables and pulses were the main sources of calcium in school lunch. The consumption of calcium was significantly higher on the days with school lunches and at lunch. The consumption of calcium in the school lunch has changed the distribution of calcium intake upward, and decreased the number of estimated subjects that were below estimated average requirment.

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.

Fermented Soy Product Intake Is Inversely Associated with the Development of High Blood Pressure: The Japan Public Health Center-Based Prospective Study.

Background: Randomized controlled studies have investigated the short-term effect of soy product intake on blood pressure (BP) in normotensive people. To our knowledge, no prospective studies exist on the effect of habitual intake of fermented soy products, separate from total soy products, on BP in the general population.Objective: We examined the association between the habitual intake of soy products, including fermented soy products, and the development of high BP during a 5-y period among participants in a population-based prospective cohort study in Japan.Methods: The study included normotensive participants aged 40-69 y at baseline (926 men and 3239 women) who completed 2 questionnaires and whose BP was measured at the baseline survey between 1993 and 1994 and the 5-y follow-up in the Japan Public Health Center-Based Prospective Study Cohort II. The intake of soy products was assessed with a food-frequency questionnaire. High BP was defined as systolic blood pressure ≥130 mm Hg, diastolic blood pressure ≥85 mm Hg, or antihypertensive medication use. ORs and 95% CIs of high BP by frequency of soy products (miso, natto, and tofu) consumption, intake of total and fermented soy products, and intake of isoflavones from total and fermented soy products were estimated with the use of multiple logistic regression analysis.Results: Multivariable-adjusted ORs of high BP for the highest compared with the lowest tertile of total and fermented soy product intake were 1.03 (95% CI: 0.84, 1.25; P-trend = 0.786) and 0.72 (95% CI: 0.56, 0.92; P-trend = 0.009), respectively. The frequency of nonfermented soy product (tofu) intake was not associated with the development of high BP (P-trend = 0.597).Conclusions: The intake of fermented soy products, but not total or nonfermented soy products, was inversely associated with developing high BP in men and women with normal BP.

Cruciferous Vegetable Intake Is Inversely Associated with Lung Cancer Risk among Current Nonsmoking Men in the Japan Public Health Center (JPHC) Study.

Background: Cruciferous vegetables, a rich source of isothiocyanates, have been reported to lower the risk of several types of cancer, including lung cancer. However, evidence from prospective observations of populations with a relatively high intake of cruciferous vegetables is sparse.Objective: We investigated the association between cruciferous vegetable intake and lung cancer risk in a large-scale population-based prospective study in Japan.Methods: We studied 82,330 participants (38,663 men; 43,667 women) aged 45-74 y without a past history of cancer. Participants were asked to respond to a validated questionnaire that included 138 food items. The association between cruciferous vegetable intake and lung cancer incidence was assessed with the use of Cox proportional hazard regression analysis to estimate HRs and 95% CIs (with adjustments for potential confounding factors).Results: After 14.9 y of follow-up, a total of 1499 participants (1087 men; 412 women) were diagnosed with lung cancer. After deleting early-diagnosed cancer and adjusting for confounding factors, we observed a nonsignificant inverse trend between cruciferous vegetable intake and lung cancer risk in men in the highest compared with the lowest quartiles (multivariate HR: 0.85; 95% CI: 0.69, 1.06; P-trend = 0.13). Stratified analysis by smoking status revealed a significant inverse association between cruciferous vegetable intake and lung cancer risk among those who were never smokers and those who were past smokers after deleting lung cancer cases in the first 3 y of follow-up [multivariate HR for never smokers: 0.49 (95% CI: 0.27, 0.87; P-trend = 0.04); multivariate HR for past smokers: 0.59 (95% CI: 0.35, 0.99; P-trend = 0.10)]. No association was noted in men who were current smokers and women who were never smokers.Conclusion: This study suggests that cruciferous vegetable intake may be associated with a reduction in lung cancer risk among men who are currently nonsmokers.

Combined associations of physical activity and dietary intake with health status among survivors of the Great East Japan Earthquake.

BACKGROUND AND OBJECTIVES: Each of the effects of physical activity and dietary intake on health is well known, but combined associations of physical activity and dietary intake on health has not been reported yet. Physical activity and dietary intake are key factors for maintaining health of survivors of the Great East Japan Earthquake in 2011. This study aimed to examine combined associations of physical activity and dietary intake with survivors' health status. METHODS AND STUDY DESIGN: We used data from 6668 participants of a cross-sectional survey taken 3 years (2013) after the disaster. To evaluate combined associations of physical activity and dietary intake, answers to questions regarding these two variables were categorized into four groups: poor physical activity and poor dietary intake (Group 1), poor physical activity and good dietary intake (Group 2), good physical activity and poor dietary intake (Group 3), and good physical activity and good dietary intake (Group 4). Multiple logistic regression analyses were performed by sex, with good self-rated health and good mental health as dependent variables, and age, place of residence, living conditions and physical activity/dietary intake group (with Group 1 as the reference category) as independent variables. RESULTS: Good self-rated health was associated with age in both sexes, and Groups 3 (male: odds ratios (ORs) 1.84 (95% confidence intervals (95% CIs) 1.32-2.57), female: OR 1.82 (95% CI 1.32-2.51)) and 4 (male: OR 1.96 (95% CI 1.39-2.76), female: OR 1.94 (95% CI 1.42-2.64)). Good mental health was associated with Groups 3 (OR 1.48 (95% CI 1.10-1.97)) and 4 (OR 1.86 (95% CI 1.37-1.97)) for male respondents; and living place (other than temporary housing) (OR 1.45 (95% CI 1.26-1.68)) was associated with Group 4 (OR 1.42 (95% CI 1.09-1.85)) for female respondents. CONCLUSIONS: Good physical activity alone or combined with good dietary intake was associated with good self-rated health and good mental health. Further interventions regarding physical activity and dietary intake are needed to improve the health status of survivors.

Physical and social determinants of dietary variety among older adults living alone in Japan.

AIM: Food security and sufficient nutrient intake are critical to longevity and active aging. The present study aimed to elucidate physical and social factors related to dietary variety among single-living older adults in Japanese communities. METHODS: The cross-sectional survey with a self-administrated questionnaire was carried out for all older adults living alone aged 65 years and older in three cities of Japan during 2014. Dietary variety score (DVS) was determined by counting the number of 10 food groups consumed at least once in 2 days using a food frequency questionnaire. Using the data of 704 men and 1366 women, the sex-specific association of low DVS (<4) with age, region, frailty, annual income, social support, distance to the nearest supermarket and car ownership was analyzed. RESULTS: The prevalence of low DVS was 40.9% for men and 18.4% for women. Frailty and low social support were associated with low DVS. A gradient association with income was found for women, whereas men showed a threshold: <1.5 million yen per year was associated with low DVS. The distance to the nearest supermarket was not significantly associated with DVS. CONCLUSIONS: The findings of the present study imply that as well as frailty, poor social support and economic disadvantage are associated with a decline in dietary variety. In particular, frail men with income <1.5 million yen per year had a high risk of decreased dietary variety. Formal and informal support to secure food accessibility for physically and socially vulnerable older adults should be encouraged. Geriatr Gerontol Int 2017; 17: 2232-2238.

Comparison of the nutrient-based standards for school lunches among South Korea, Japan, and Taiwan.

Nutritional standards are important guidelines for providing students with nutritionally-balanced school meals. This study compared nutrient-based school lunch standards regulated by South Korea, Japan, and Taiwan. The data were collected from relevant literature and websites of each country during September 2014. The number of classification groups of target students was 8, 5, and 5 for South Korea, Japan, and Taiwan, respectively. Gender was considered across all age groups in South Korea but only for high school students in Taiwan. Gender was not considered in Japan. Along with energy, the number of nutrients included in the standards for South Korea, Japan and Taiwan was 9, 12, and 4, respectively. The standards for all three countries included protein and fat among macronutrients. The standards for South Korea and Japan included vitamin A, B-1, B-2, and C, while the standards for Taiwan did not include any vitamins. Calcium was the only mineral commonly included in the three standards. The proportions of recommended daily intakes as reference values for each nutrient differed among the countries. Japan differentiated the proportions among 33%, 40%, or 50%, reflecting the target students' intake status of the respective nutrients. Taiwan differentiated either two-fifths or one-third of the recommended daily intakes. South Korea applied the proportion of recommended daily intake as one-third for all selected nutrients. This study could be valuable information for countries in developing nutrient-based standards for school lunches and for South Korea, Japan, and Taiwan in the process of reforming nutrient-based standards.

Associations between Japanese schoolchildren's involvement in at-home meal preparation, their food intakes, and cooking skills.

BACKGROUND/OBJECTIVES: This study aimed to examine the association of Japanese schoolchildren's involvement in at-home meal preparation with food intake and cooking skill. SUBJECTS/METHODS: We included 1,207 fifth-grade children aged 10-11 years and one parent of each child. A cross-sectional survey was used to collect data on involvement in at-home meal preparation. Correspondence analysis was used to classify involvement in at-home meal preparation into three groups: food-related activities (cooking only or with other activities such as shopping, table-setting, clean up, and dishwashing), non-food-related activities (table-setting and/or clean up), and no (helping) activities. Food intake was assessed using a food frequency questionnaire. Logistic regression models were used to examine involvement in at-home meal preparation associations. RESULTS: The sample consisted of 1,207 fifth-grade children. Vegetable intake was lower in the no (helping) activities group than the food-related activities group (95% CI; boys: 1.2, 5.1, girls: 2.0, 8.9). Fewer children in the non-food-related activities group reported they were able to make a portion of their meals compared with the food-related activities group (95% CI; boys: 1.6, 3.5; girls: 1.5, 3.2). CONCLUSIONS: Children in the food-related activities group showed more favorable food intake and cooking skills than children in the no (helping) activities or non-food-related activities group.

Prevalence of Inadequate Nutrient Intake in Japanese Community-Dwelling Older Adults Who Live Alone.

Dietary assessment of community-dwelling Japanese older adults who live alone using Dietary Reference Intakes (DRIs) is limited. The present study aimed to estimate the prevalence of inadequate nutrient intake among Japanese community-dwelling older adults by sex and young-old and old-old population groups to identify the most vulnerable groups that need support. A cross-sectional survey was conducted from October 2012 to October 2013 with community-dwelling adults aged 65 y or older who lived alone. Participants were drawn from six cities in four Japanese prefectures. We used two days of dietary survey data to estimate participants' usual intake. The proportion of inadequate intake was assessed using the Estimated Average Requirement (EAR) cut-point method, Tolerable Upper Intake Level, and the tentative dietary goal for preventing life-style related diseases (DG) based on DRIs for Japanese, 2015. Data for 494 participants (162 male, 332 female) over 988 d were examined to assess nutrient intake. We calculated the proportion of inadequate intake between males and females and between young-old and old-old population groups (65-74 y and ≥75 y) using chi-square or Fisher's exact tests. For six nutrients, the estimated proportion of participants with a usual intake below EAR was higher in males than females. In addition, a higher estimated proportion of female participants was within the DG range for the percentage of energy from protein, fat, and carbohydrates, and had a usual intake of two nutrients above DG than males. Our findings showed that among Japanese older adults, males were more vulnerable in terms of inadequate nutrient intake compared with females.

Stockpiles and food availability in feeding facilities after the Great East Japan Earthquake.

Food stockpiles and methods of ensuring food availability after the Great East Japan Earthquake of March 11, 2011 have been studied. Questionnaires were sent to 1911 registered dietitians and general dietitians who were members of the Japan Dietetic Association in August 2012. Four hundred thirty-five dietitians (22.8%) completed the questionnaire about work involved in feeding facilities, types and administration of meals, and food stockpiles. Methods of ensuring food availability, preparation, and accommodating food for special dietary uses were recorded for the three-day period immediately following the earthquake, and the period from 4 days to one month after the earthquake. Three days after the earthquake, differences in administration of meals at feeding facilities providing three meals daily, food stockpiles, organization, contactable facilities, and how to contact them for food items were assessed. Sixty-nine percent of all feeding facilities in this study had stockpiles of food before the Great East Japan Earthquake. Administration of meals in feeding facilities and the possibility of contact with cooperative feeding facilities were found to correlate positively with ensuring the availability of food groups. Food scores were higher in facilities providing three meals daily by direct administration of meals and with accessible public administrators, cooperative facilities and suppliers, and facilities that were contactable by landline telephone, mobile phone, fax or email. The necessity for natural disaster-readiness through continuous stockpiling food at feeding facilities is confirmed. Each prospective feeding facility must be required to plan its stockpiles, their turnover and replaceability to maximise food security in the face of disaster.

How does fortification affect the distribution of calcium and vitamin B1 intake at the school lunch for fifth-grade children?

The purpose of this study was to estimate the usual intake distribution of calcium and vitamin B(1) of fifth-grade children based on a 3-d dietary survey and to assess nutrient intake using Dietary Reference Intakes (DRIs 2010). A cross-sectional study was undertaken from October 2007 to February 2008 in schools located in Tokyo and Okayama, Japan. A total of 94 fifth-grade children attending 5 elementary schools participated in the study. The weighed plate waste method and observation were used to collect data on the school lunches and dietary records by children, accompanied by photographs used to collect data on meals at home. The study lasted 3 d, 2 non-consecutive days with school lunches and 1 d without. The estimated proportion of subjects below the Estimated Average Requirement (EAR) for calcium intake with milk in the school lunch decreased by 40% compared to the calcium intake without milk in the school lunch. Vitamin B1 intake from less than 0.45 mg/1,000 kcal fortified rice was estimated to be 0%. The intake distribution of calcium has increased by 150 mg by taking milk and the intake distribution of vitamin B1 has increased 0.20 mg by taking fortified rice in the school lunch. Calcium and vitamin B1 intake in the school lunch has changed the distribution of calcium and vitamin B1 intake upward, and decreased the number of estimated subjects that were below EAR. However, the distribution was not shifted across the board and the shape of the distribution has changed.