Trends in Dietary Micronutrient Adequacy in Young Adults Over the Latest 25 Years in Japan.

BACKGROUND: It has been assumed that economically developed countries are well nourished compared to developing countries, but little is known about how economic status affects dietary micronutrient intake in the future childbearing generation. OBJECTIVE: We analyzed the trend of dietary micronutrient adequacy in young adults in Japan, as one of the representative countries with advanced dietary habits and economic progress. METHODS: We conducted a retrospective analysis using 2 web-accessible databases, namely the Japanese National Health and Nutrition Survey and the World Development Indicators. RESULTS: Japan has been facing a progressive insufficiency of dietary vitamins A and C and iron, especially among young adults, over the past 25 years. The hidden progression of silent malnutrition has become more apparent since the 2010s, coinciding with a series of economic recessions and natural disasters. CONCLUSIONS: Given that parental dietary habits play a critical role in ensuring a balanced diet for their children, our findings underscore the importance of proactive nutrition counseling and education, especially for young adults of childbearing age who have been identified as vulnerable to micronutrient deficiencies. In line with this policy, we would like to suggest the use of digital transformation platforms as a potential solution in the future, especially for the digital native population.

Plain language titleMicronutrient deficiencies among young adults in JapanPlain language summaryThe Japanese diet, characterized by relatively high intakes of vegetables, fruits, soya products, seaweed, and fish, played an important role in Japan's rise to the ranks of developed countries after World War II. Over the past 25 years, however, Japan has witnessed a progression of silent malnutrition, especially among young adults. It is possible that the progression of hidden hunger would have a non-negligible effect on the clinical picture of noncommunicable diseases in the developed country. With the 2019 coronavirus disease pandemic and Russia's unprovoked invasion of Ukraine posing a global threat to the world's food supply, we would like to emphasize well-coordinated educational approaches using information technology, especially for such a digital native population.

Long-Term Nutritional Counseling for a Patient with Lipoprotein Lipase Deficiency.

A one-year-and-nine-month-old Japanese boy was admitted with hypertriglyceridemia (fasting triglycerides 2548 mg/dL). After close examination, he was diagnosed with lipoprotein lipase (LPL) deficiency (compound heterozygous) and was immediately started on a fat-restricted dietary therapy. He responded well to the regimen (1200 kcal/day, 20 g fat/day) and his triglycerides decreased to 628 mg/dL within 7 days of starting the dietary therapy. It was decided to manage his illness without using any drugs because he was still an infant and responded well to a fat-restricted diet. During his hospital stay, dietitians provided him with nutritional counseling using a food exchange list, which was designed to easily calculate the fat content by including foods that are commonly served. His family quickly learned the skills to prepare a fat-restricted diet. Moreover, since dietary restrictions may have impaired the child's growth and development, the dietitians continued to intervene regularly after the child was discharged from the hospital. The dietitians confirmed that the patient was receiving nutritional intake appropriate for his growth and discussed the dietary concerns in his daily life and how to participate in school events that involved eating and drinking. Nutritional counseling was provided every 3-4 months from disease onset to age 23 years, except for a 14-month break at age 20 years. The patient grew up without developing acute pancreatitis, a serious complication of LPL deficiency. The long-term intervention of dieticians is necessary to achieve a balance between living on a strict diet for disease management and ensuring appropriate nutritional intakes for growth/development.

Gut Microbiota Associated with Clinical Relapse in Patients with Quiescent Ulcerative Colitis.

The microbiota associated with relapse in patients with quiescent ulcerative colitis (qUC) remains unclear. Our objective was to analyze the fecal microbiota of Japanese patients with qUC and identify the relapse-associated microbiota. In this study, 59 patients with qUC and 59 healthy controls (HCs) were enrolled (UMIN 000019486), and their fecal microbiota was compared using 16S rRNA gene amplicon sequencing. We followed their clinical course up to 3.5 years and analyzed the relapse-associated microbiota. Potential functional changes in the fecal microbiota were evaluated using PICRUSt software and the Kyoto Encyclopedia of Genes and Genomes database. There were significant differences in fecal microbiota diversity between HC and qUC subjects, with 13 taxa characterizing each subject. Despite no significant difference in variation of microbiota in a single sample (α diversity) between patients in sustained remission and relapsed patients, the variation in microbial communities between samples (ß diversity) was significantly different. Prevotella was more abundant in the sustained remission patients, whereas Faecalibacterium and Bifidobacterium were more abundant in the relapsed patients. We clustered the entire cohort into four clusters, and Kaplan-Meier analysis revealed the subsequent clinical course of each cluster was different. We identified 48 metabolic pathways associated with each cluster using linear discriminant analysis effect size. We confirmed the difference in microbiota between patients with qUC and HCs and identified three genera associated with relapse. We found that the clusters based on these genera had different subsequent clinical courses and activated different metabolic pathways.

Deoxycholic acid delays the wound healing of colonic epithelial cells via transmembrane G-protein-coupled receptor 5.

BACKGROUND AND AIM: Efficient intestinal wound healing is essential for good prognoses of ulcerative colitis (UC). Although bile acids and the transmembrane G-protein-coupled receptor (TGR) 5 have been reported to affect wound healing in intestinal epithelial cells, the detailed underlying mechanisms are unclear. Here, we investigated the role of TGR5 in wound healing in the context of colonic epithelial cells in the presence of bile acids. METHODS: The expression of TGR5 in the colonic epithelium of both a dextran sulfate sodium (DSS)-induced colitis mouse model (recovery phase), and UC patients in clinical remission, was evaluated. Young adult mouse colonic epithelial (YAMC) cells were then used to evaluate wound healing after treatment with deoxycholic acid (DCA); TGR5 was silenced in YAMC cells via shRNA-transfection, and a wound-healing assay in the presence of DCA was performed. Furthermore, we investigated the role of the activation of AKT in the context of wound healing. RESULTS: The expression of TGR5 was decreased in the colonic epithelium of both mice with DSS-induced colitis and UC patients. Additionally, DCA significantly delayed wound healing in YAMC cells but not in TGR5 silenced ones. Of note, the DCA-induced activation of AKT signaling in YAMC cells was inhibited by TGR5 silencing, and AKT inhibitors prevented the wound healing delay induced by DCA. CONCLUSIONS: Overall, we show that DCA delays wound healing in the context of colonic epithelial cells through AKT activation. These results may support the development of new therapeutic approaches for epithelial regeneration in UC.

[Survey of nutrient and food-group intake of cancer outpatients given chemotherapy].

A survey of nutrient and food oral intake was undertaken to clarify problems in nourishment support of chemotherapy outpatients with cancer diseases. The ingestion frequency survey (Food Frequency Questionnaire Based on Food Groups: FFQg) of nutrient and food intake was carried out in 54 patients, after chemotherapy at an outpatient clinic in Hyogo Prefectural Nishinomiya Hospital during three weeks from June 25,2007 to July 13,2007. Among them, 50 patients (92.6%) reported a valid response (14 breast, 13 colon, 6 stomach, 9 pancreas, and 8 other cancers). Body mass index (BMI; kg/m2, mean +/-SD) grouped by the type of the cancer was 22.3+/-3.1 in breast, 21.3+/-2.6 in colon, 17.9+/-2.0 stomach, 18.0+/-1.2 in pancreas and 22.6+/-1.8 in other cancers. BMIs in stomach or pancreas cancer patients were significantly low compared to those in patients with breast, colon, or other cancers. Each group's caloric intake per standard weight (kcal: mean+/-SD) was 31.4+/-5.3 in breast, 27.7+/-5.6 in colon, 34.2+/-10.3 in stomach, 29.1+/-5.0 in pancreas, and 26.8+/-6.4 in other cancers. No significant differences were recognized among them. In conclusion, oral intake in chemotherapy outpatients was secured from the result for each type of cancer; however, BMI was low in outpatients with stomach or pancreas cancer in spite of ingestion of food enough to maintain standard weight.