Association of household income and education with eating behaviors in Japanese adults: a cross-sectional study

Division of Responsibility in Child Feeding and Eating Competence among Brazilian Caregivers

This cross-sectional study aimed to assess Brazilian child caregivers' eating competence (EC) and their adherence to the division of responsibility (sDOR) in child feeding. The research had national coverage in all Brazilian regions. The sample comprised 549 caregivers of Brazilian children (24 up to 72 months) recruited by social media (snowball method). Data on sDOR and EC were collected using the sDOR.2-6y^TM Portuguese-Brazil (sDOR.2-6y-BR) and ecSI2.0^TMBR, both instruments validated to the Brazilian population. The scores of the sDOR.2-6y-BR were described in terms of means, standard deviations (SD), medians, and interquartile range. Student's t-test and analysis of variance (ANOVA) followed by Tukey's post hoc tests were used to compare the scores of sDOR.2-6y-BR and ecSI2.0^TMBR with interest variables. The association between the sDOR.2-6y-BR and ecSI2.0^TMBR scores was verified by Pearson's correlation coefficient. Most of the participants were female (n = 88.7%), 37.8 ± 5.1 y/o, had a high schooling level (70.31%), and high monthly income (more than 15 minimum wages-MW) (31.69%). The children for whom the participants were responsible were mostly girls (53.19%), with an average age of 3.6 ± 1.3 y/o. The instrument presented good responsiveness (floor and ceiling effects = 0%). Cronbach's Alpha = 0.268. There was no statistical difference in sDOR.2-6y-BR scores between caregiver's gender, age, level of education, number of people living in the household, or by gender or age of the child. Caregivers who reported (n = 100) that their children had some medical diagnosis (e.g., food allergy, autism, or Down syndrome) had lower sDOR adherence scores than caregivers who indicated their children had no medical diagnosis (p = 0.031). There was no statistical difference in ecSI2.0^TMBR scores between the categories of caregiver's gender, age, occupancy, and child's gender and age. Caregivers with income higher than 10 MW, living in houses with more than 3 people, and with graduate schooling showed higher EC scores. Caregivers considered competent eaters by ecSI2.0^TMBR scores differed only for educational level, which was more frequent among graduate participants. The total EC score was positively associated with total and mealtime structure (D1), how food is available to the child (D3), and the parent gives respect to the child's autonomy in eating (D4) sDOR.2-6y^TM domains. There was a negative association with the what is available to the child (D2) sDOR.2-6y^TM domain. In general, the sDOR.2-6y-BR had a positive association with the ecSI2.0^TMBR in all domains and total, with a low but significant correlation. This study enables the investigation of the division of responsibility in feeding and EC of a sample of caregivers of children in Brazil. This is the first study to apply the translated and validated version of the sDOR.2-6y-BR and showed good results, where competent eaters' caregivers adhere more to the principles of sDOR.

Longitudinal patterns and sociodemographic profiles of health-related behaviour clustering among middle-aged and older adults in China and Japan

Given inevitable age-related decreases in physical or mental capacity, studies on health-related behaviour (HRB) clustering in older people provide an opportunity to reduce health-care costs and promote healthy ageing. This study explores the clustering of HRBs and transition probabilities of cluster memberships over time, and compares sociodemographic characteristics of these clusters among Chinese and Japanese middle-aged and older adults. Using the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 (N = 19614) and the Japanese Study of Ageing and Retirement (JSTAR) from 2007 to 2011 (N = 7,080), Latent Transition Analysis was applied to investigate the clustering and change in clustering memberships of smoking, alcohol consumption, physical activity and body mass index. Multivariate logistic regression was used to explore the sociodemographic characteristics of these longitudinal HRB cluster members. We identified four common clusters in CHARLS and JSTAR: ‘smoking’, ‘overweight or obese’, ‘healthy lifestyle’ and ‘current smoking with drinking’, and an additional cluster named ‘ex-smoking with drinking’ in JSTAR. Although HRB cluster members were largely stable in both cohorts, participants in China tended to move towards an unhealthy lifestyle, while participants in Japan did the opposite. We also found that participants who smoked and drank were more likely to be male, younger, less educated and unmarried in both cohorts, but the overweight or obese participants were female, urban and higher income in CHARLS but not JSTAR. Our study not only contributes to the knowledge of longitudinal changes in health-related behavioural clustering patterns in an Asian elderly population, but may also facilitate the design of targeted multi-behavioural interventions to promote healthy lifestyles among older people in both countries.

Effect of Mid-Adolescent Dietary Practices on Eating Behaviors and Attitudes in Adulthood

This paper aimed to clarify the association of mid-adolescent dietary practices and experiences with adult eating behavior and attitudes using individual data from the "Survey of Attitudes toward Shokuiku (food and nutrition education), 2019" put forth by the Ministry of Agriculture, Forestry and Fisheries of Japan. We applied conditional mixed-process models to estimate the parameters simultaneously, and used them to predict current eating consciousness, current eating behaviors in a balanced diet, dietary behavior, and attitudes toward preventing or improving lifestyle-related diseases as dependent variables. As a result, compared to those who did not have good dietary practices and experiences in mid-adolescence, participants who had good dietary practices and experiences in the same period displayed greater interest in practicing a healthier diet. These participants frequently consumed a combination of staple foods, main dishes, and side dishes, and were more concerned about preventing or improving lifestyle-related diseases. In conclusion, mid-adolescent dietary practices and experiences had a lasting influence on adult eating behaviors and attitudes in Japanese participants.

Association between the dietary inflammatory index and disability in Japanese older people

OBJECTIVES

To examine the demographic and lifestyle characteristics related to the dietary inflammatory index (DII™) score and to evaluate the association between DII score and disability among older people in Japan.

DESIGN

Cross-sectional design. The DII score was calculated from nutrient intake information obtained from a FFQ. Disability was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence questionnaire. Overall disability and disability in each component of everyday competence, that is, instrumental activities of daily living (IADL), intellectual activities and social participation, were assessed. Those with a deficit in one or more activities were defined as disabled.

SETTING

Five non-urban areas in Japan.

PARTICIPANTS

A total of 1642 Japanese older people aged 65 years or older.

RESULTS

Women, residents of Oga-shi, and those with a higher education and greater frequency of shopping followed a more anti-inflammatory diet, while those living alone and residents of Minamiawaji-shi had higher dietary inflammation. A pro-inflammatory diet was associated with higher odds of overall disability and disability in each component of competence: overall disability, OR (95 % CI) = 1·26 (1·16, 1·36); IADL disability, OR (95 % CI) = 1·16 (1·07, 1·26); disability in intellectual activities, OR (95 % CI): 1·30 (1·20, 1·40); and disability in social participation, OR (95 % CI) = 1·20 (1·11, 1·29).

CONCLUSIONS

Sex, living alone, education, frequency of shopping and area of residence were shown to be determinants of DII score in Japanese older people. DII score was positively associated with disability.

Occupation- and industry-specific cancer mortality among Japanese women from 1980 to 2015

BACKGROUND

The number of women in Japan who continue working after childbirth is on the rise. Over the past few years, Japan's cancer mortality rate has increased. About 50% of all cancer deaths among Japanese women aged 25-64 are caused by lung, gastric, pancreatic and colorectal cancers. This study aims to examine the difference in mortality risk for key cancers among women and explore the effect of the economic crisis in the mid-1990s separately for occupational and industrial categories.

METHODS

Data from 1980 to 2015 were gathered from the Japanese Population Census and National Vital Statistics conducted in the same year. A Poisson regression analysis was used to estimate mortality risk and mortality trends for lung, gastric, pancreatic and colorectal cancer among Japanese working women aged 25-64 years.

RESULTS

Across most industrial and occupational groups, the trends in age-standardised cancer mortality rate for women have declined. Workers in management, security and transportation have a higher cancer mortality risk than sales workers. The risk of death from all four cancers is higher for workers in the mining and electricity industries than for wholesale and retail workers.

CONCLUSION

To improve the health and well-being of employed Japanese women, it is crucial to monitor cancer mortality trends. Using these population-level quantitative risk estimates, industry- and occupation-specific prevention programmes can be developed to target women at higher cancer risk and enable the early detection and treatment of cancer.

Lessons from the health policies for children during the pandemic in Japan

It is everyone's desire to seek the sound growth of children through food education and there is a critical need for fostering an environment for this purpose. Health policies are important for this support. To the present, the Japanese society has been greatly disrupted by COVID-19 pandemic. "Stay at home", "mokusyoku (silent eating)", and mask wearing were encouraged in nationwide campaigns as public health measures to combat COVID-19. There are some papers reporting negative effects of "stay at home" and lockdowns such as weight gain, decrease in physical activities and change in eating habits. In Japan, while benefits and advantages of food education during mealtime were previously well studied, the "mokusyoku" rule may directly run counter to this food education. Moreover, there are several reports showing that nutrients might contribute to prevention of infectious diseases. Japanese children were also encouraged to wear masks all day long. The results of the clinical research, especially randomized control trials, show limited protective effect of masks. On the other hand, negative outcomes of the masks were reported in various scenes. This review focuses on these topics and arousing reconsideration for a better environment for children.

Association of Esophageal Cancer Mortality with Municipal Socioeconomic Deprivation Level in Japan, 2013–2017: An Ecological Study Using Nationwide Data

This study aimed to show geographical differences in esophageal cancer mortality in Japan and reveal an association of esophageal cancer mortality with municipal socioeconomic deprivation level. Esophageal cancer mortality data in the Vital Statistics from 2013 to 2017 for each municipality and corresponding population data were analyzed. The deprivation level was derived from the municipal socioeconomic variables by principal component analysis. Municipalities were classified into five quintiles based on the deprivation level, and an association between the level and esophageal cancer mortality was evaluated using a Bayesian spatial model. As a result of regression analysis, the relative risk of esophageal cancer mortality tended to become larger as the deprivation level increased irrespective of sex, and the relative risk of esophageal cancer mortality was significantly higher in quintile 5 (most deprived) than quintile 1 (least deprived) among men and women. These results suggest that the deprivation level increases the risk of esophageal cancer mortality in Japan.

Prevalence and Sociodemographic Factors Associated with Overweight and Obesity among Adults in Poland: A 2019/2020 Nationwide Cross-Sectional Survey

Detailed characteristics of the weight status of the population is necessary for the effective prevention of health disorders, e.g., through personalized nutrition education. This study aimed to characterize weight status and identify sociodemographic factors associated with overweight/obesity in a representative sample of adult inhabitants of Poland. This cross-sectional study was carried out from July 2019 to February 2020 on a representative nationwide sample of individuals aged 18+ in Poland. The study consisted of two parts: questionnaire survey and anthropometric measurements. The body mass index was calculated. Data on 1831 adults (50.3% females; mean age 51.7 ± 19.9 years) were included in this analysis. The prevalence of overweight was 42.2% (52.4% among males and 32.0% among females). Of the 1831 participants, 16.4% were obese (16.5% of males and 16.2% of females). Out of 11 factors analyzed in this study, only 5 were significantly associated with overweight/obesity. Males, older participants, occupationally active individuals, those living in rural areas and individuals with at least one chronic disease had greater odds of overweight/obesity. This study demonstrated a high prevalence of overweight and obesity among adults in Poland. This is the most up-to-date representative study on nutritional status carried out before the COVID-19 pandemic.

Socioeconomic Predictors of Trends in Cancer Mortality among Municipalities in Japan, 2010-2019

Background:

A study investigating associations between various socioeconomic factors and standardized mortality ratios (SMR) of each type of cancer among municipalities in Japan has not been conducted using the data of the past decade. Herein, we investigated the predictors of a recent trend of municipal SMRs of cancer using the Vital Statistics in Japan and revealed the change in the SMRs depending on the identified predictors.

Methods:

Data on cancer mortality for each municipality in 2010 and 2019 were used. We calculated empirical Bayes SMR (EBSMR) for each municipality by type of cancer and sex and then fitted a multiple linear regression model using possible predictors in 2010 as explanatory variables and the EBSMR in 2019 as the outcome variable. We also classified municipalities into quintiles based on the values of an identified predictor in 2010, and SMRs of each type of cancer in 2010 and 2019 were calculated for each quintile.

Results:

The total population was positively associated with EMSMRs of multiple cancer types, whereas educational level was negatively associated with EMSMRs of multiple cancer types. In addition, SMRs of municipalities with the lowest educational level deteriorated from 2010 to 2019 for many cancer types among men and women, and the difference between municipalities with the highest and lowest educational level for the SMR of cancer in all sites widened in 2019 for men. On the other hand, the SMR of municipalities with the highest educational level or the largest total population tended to be higher than municipalities with lower counterparts in both 2010 and 2019 for women.

Conclusion:

There was a difference in the trend of the SMRs of multiple types of cancer depending on municipal educational level, whereas municipalities with larger population or educational level continued to have higher SMRs of cancer in all sites for women.

Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999-2019

Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.

Preserving cultural heritage through the valorization of Cordillera heirloom rice in the Philippines

For centuries, heirloom rice varieties have been grown on the terraces of the Cordillera Mountains of Luzon, Philippines, terroirs known for their significant historical, cultural, and aesthetic values. However, heritage heirloom rice farming is gradually being abandoned, mainly because of its lower productivity and the struggle of the sector to create a sustainable niche market for heirloom rice by branding its cultural, social, and nutritional values. We propose several demand-side intervention strategies for the valorization of heirloom rice. To support the development of a segmented marketing strategy for heritage farming, we provide evidence on urban consumers' willingness to purchase heirloom rice. We interviewed 500 urban consumers from Metro Manila in July-August 2015, who placed a purchasing bid on a kilogram of heirloom rice. Consumers' bids averaged PHP 72.61 kg^-1 (USD 1.60 kg^-1), which is less than half its current market price. This explains why heirloom rice struggles to gain market share in urban markets in the Philippines. Given this bid price, we estimate a potential market size of PHP 20.3 billion (USD 443 million) that could be created for heirloom rice and tapped into by heritage farmers. Findings further indicate that women, business owners, and consumers who buy packaged rice and eat pigmented rice are willing to pay more for heirloom rice. Finally, our evidence suggests that proper information framing will be necessary to create demand and support the valorization of heirloom rice to preserve cultural heritage and in situ biodiversity of rice landraces in the Philippines.

Household income and the risk of incident hypertension in employees at multiple workplaces in Japan: J-HOPE

This cohort study aimed to investigate the association between household income and incident hypertension in a Japanese employed population. During 2012, a total of 4314 normotensive daytime employees (3153 men and 1161 women) were included in this study. Participants had a wide range of occupations and were employed at one of 12 workplaces from various economic sectors in Japan. After a 2-year follow-up, incident hypertension was compared among groups according to household income: <5.0, 5.0-7.9, 8.0-9.9, and ≥10.0 million Japanese yen (¥)/year. A Cox proportional hazard model was used to calculate the hazard ratio for incident hypertension in each household income group, compared with the group earning <5.0 million ¥/year. The hazard ratios for men were 1.52 (95% confidence interval, 1.08-2.18) for 5.0-7.9 million ¥/year, 1.49 (0.98-2.27) for 8.0-9.9 million ¥/year, and 1.92 (1.23-3.01) for ≥10.0 million ¥/year after adjusting for age, baseline systolic blood pressure, worksite, type of occupation, number of family members, and smoking status. This positive relationship was attenuated but remained significant after further adjustment for alcohol consumption and body mass index, both of which were higher among men with higher household income. Conversely, there was no significant difference for women in the risk of incident hypertension among household income groups, although those with higher household income tended to have a lower risk of incident hypertension. Household income is positively associated with the onset of hypertension in Japanese employed men working daytime hours.

Relationship between the 10-Year Risk for Atherosclerotic Cardiovascular Disease and the Dietary Inflammatory Index among Korean Adults Based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES)

Worldwide, atherosclerotic cardiovascular diseases (ASCVD) are the leading cause of death and are considered a major public health concern. Exposure to repeated inflammation may contribute to the development of ASCVD, and diet plays a vital role in inflammation. In this study, we explored the correlation between the dietary inflammatory index (DII) and the 10-year ASCVD risk in Korean adults. We used multistage, stratified sampling to analyze a representative sample of Korean adults aged 40-64 years from the 7^th Korea National Health and Nutrition Examination Survey data. Logistic regression was carried out to evaluate the association between 10-year high risk for ASCVD and dietary variables including DII. Participants were separated by quartiles, from Q1 to Q4, according to DII scores. Participants in the Q1 group had the lowest DII scores indicating a more anti-inflammatory diet. Participants in the Q4 group had the highest DII scores indicating more proinflammatory diets. Estimated risk of ASCVD results was categorized into the low-risk (less than 7.5% risk) and high-risk (greater than 7.5% risk) groups. In men, participants in the Q3 group had a risk for ASCVD of 1.20 times higher than the Q1 group participants and participants in the Q4 group had a risk of 1.34 times higher than the participants in the Q1 group. In women, ASCVD risk was not significantly associated with DII scores. These results provide systematically analyzed evidence for dietary interventions in ASCVD prevention efforts, especially in men.

Perbedaan Tingkat Keragaman Pangan Balita dan Tingkat Pendidikan Orang Tua di Rumah Tangga Kawasan Rumah Pangan Lestari (KRPL) Dan Non KRPL

Background: Sustainable Reserve Food Garden Area (KRPL) is program that to increase family dietary diversity, such as children. Children’s dietary diversity can affect to nutritional adequacy and can impact to growth process. The factor that can affect successful of KRPL program is parents’ education level.Objectives: The purpose of this study was to identify the difference between children’s dietary diversity level, household income level, and parents’ education level in sustainable reserve food garden area (KRPL) and non KRPL household in Kamal sub-district, Bangkalan district, Madura.  Method: This was an observational study with case control comparative study design was conducted among 25 children in KRPL area and 25 children in non KRPL area with mother or other family member as respondents. Simple random sampling method was used to select the samples. Children and parents’ characteristic were asked to answer structured questionnaire. Children dietary diversity level was asked by Individual Dietary Diversity Score (IDDS) instrument. The data was analyzed with Mann Whitney statistic test. Result: Children that involved in this study, either in KRPL or non KRPL area, was less than the same 35 months old (52%). Children from KRPL area was mostly girls (64%), while children from non KPRL area was mostly boys (56%). Children dietary diversity condition in KRPL area was low (52%), while children dietary diversity level in non KRPL area was sufficient (64%). Children who lived in KRPL area not always have diverse intake. The result showed that there was no difference between children dietary diversity level in KRPL and non KRPL area (p=0.259). Household income level on KRPL area was higher (68%) if compared to household on non KRPL area (44%). Parents’ education level in KRPL area was classified high (father=88%, mother=88%), while that parents’ education level in non KRPL area classified low (father=88%, mother=100%) (p=0.000). Parents in KRPL area have higher education level compare to parents in non KPRL area. Conclusion: Children dietary diversity in KRPL area are not different with non KRPL area. Children who lived in KRPL area not always have diverse intake. There is difference between household’s income level and parents’ education level. Household in KRPL area have higher income and parents in KRPL area have higher education level compare to households and parents in non KPRL area. ABSTRAKLatar Belakang: Kawasan Rumah Pangan Lestari (KRPL) merupakan program yang bertujuan untuk memperbaiki dan meningkatkan keragaman pangan keluarga, salah satunya balita. Keragaman pangan pada balita dapat berpengaruh pada kecukupan kebutuhan gizi dan berdampak pada proses pertumbuhannya. Salah satu faktor yang dapat mempengaruhi keberhasilan program KPRL adalah tingkat pendidikan orang tua.Tujuan: Tujuan dari penelitian ini adalah untuk mengidentifikasi perbedaan tingkat keragaman pangan balita dan tingkat pendapatan keluarga, dan tingkat pendidikan orang tua di rumah tangga Kawasan Rumah Pangan Lestari (KRPL) dan non KRPL Kecamatan Kamal, Kabupaten Bangkalan, Madura.Metode: Penelitian observasional dengan rancang bangun penelitian potong lintang komparatif dilakukan pada subjek penelitian yang terdiri dari 25 balita di wilayah KRPL dan 25 balita di wilayah non KRPL dengan ibu atau anggota keluarga lainnya sebagai responden. Metode simple random sampling digunakan untuk memilih sampel. Karakteristik balita dan orang tua ditanyakan melalui kuesioner. Tingkat keragaman pangan balita ditanyakan melalui instrumen Individual Dietary Diversity Score (IDDS) Data dianalisis menggunakan uji statistik Mann Whitney.Hasil: Balita yang terlibat dalam penelitian ini, baik di area KPRL maupun non KPRL, sebagian besar berusia kurang dari sama dengan 35 bulan (52%). Balita yang berasal dari wilayah KRPL sebagian besar perempuan (64%), sedangkan dari wilayah non KPRL sebagian besar laki-laki (56%). Kondisi tingkat keragaman pangan balita di wilayah KRPL tergolong rendah (52%), sedangkan tingkat keragaman pangan balita di wilayah non KRPL tergolong cukup (64%). Balita yang tinggal di rumah tangga KRPL tidak selalu mengonsumsi makanan yang beragam. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan tingkat keragaman pangan balita di wilayah KRPL dan non KPRL (p=0,259). Tingkat pendapatan keluarga balita di wilayah KRPL lebih tinggi (68%) apabila dibandingkan dengan wilayah non KPRL (44%). Tingkat pendidikan orang tua di wilayah KRPL tergolong tinggi (ayah=88%, ibu=88%), sedangkan tingkat pendidikan orang tua di wilayah non KRPL tergolong rendah (ayah=88%, ibu=100%) (p=0,000).Kesimpulan: Tingkat keragaman pangan balita di area KRPL tidak berbeda dengan balita di area non KPRL. Terdapat perbedaan tingkat pendapatan keluarga dan tingkat pendidikan orang tua balita. Keluarga di wilayah KRPL memiliki tingkat pendapatan yang lebih tinggi dan orang tua di area KRPL memiliki tingkat pendidikan lebih tinggi apabila dibandingkan dengan rumah tangga dan orang tua di wilayah non KPRL.

Changes in breakfast frequency and composition during adolescence: The Adolescent Nutritional Assessment Longitudinal Study, a cohort from Brazil

OBJECTIVES

To estimate changes over time of breakfast frequency and foods/food groups consumed at breakfast.

METHODS

Cohort of 809 students aged 10-16 years old from Rio de Janeiro, Brazil, enrolled in 2010, and followed for three years. Breakfast skippers were those not eating breakfast. Those with breakfast frequency of 4 or less times per week were considered irregular breakfast eaters. Changes over time of breakfast frequency and breakfast foods/food groups were analyzed by generalized estimating equations.

RESULTS

At baseline, overweight/obese girls had higher prevalence of irregular breakfast than those non-overweight/obese (40% vs. 26%; p = 0.005); among boys, there was no significant difference in the prevalence of irregular breakfast according to weight status. After three years, among girls there was an increase in the risk of irregular breakfast consumption (RR = 1.29; 95% CI: 1.08; 1.54) and breakfast skipping (RR = 1.63; 95% CI: 1.12; 2.38). Also, overweight/obese boys (RR = 1.40, 95% CI: 1.03, 1.89) and non-overweight/obese girls (RR = 1.54, 95% CI: 1.17, 2.04) had higher risk of irregular breakfast in three years, compared to baseline. After three years, boys changed the consumption of foods/food groups at breakfast and presented higher risk of decreased intake of fruits (RR = 1.60, 95% CI: 1.20, 2.13), sandwiches and snacks (RR = 1.58, 95% CI: 1.12, 2.22), chips (RR = 1.43, 95% CI: 1.01, 2.13), and ham (RR = 1.52, 95% CI: 1.12, 2.07), and lower risk of cheese intake (RR = 0.73, 95% CI: 0.53, 1.00). Girls had higher risk of decreased intake of fruits (RR = 2.08, 95% CI: 1.47, 2.95), milk (RR = 1.49, 95% CI: 1.07, 2.08), chocolate powder (RR = 1.54, 95% CI: 1.11, 2.14) and ham (RR = 1.65, 95% CI: 1.16, 2.36).

CONCLUSIONS

Changes in breakfast patterns are different according to sex. Also, different changes in breakfast frequency according to BMI category were found. Consumption patterns of some foods/food groups have a tendency to become changed from initial to middle adolescence.

Association between childhood socioeconomic status and fruit and vegetable intake among older Japanese: The JAGES 2010 study

Fruit and vegetable intake (FVI) contributes to the prevention of non-communicable diseases. Although food preference is considered to be determined early in life, few studies have investigated the association between childhood socioeconomic status (SES) and FVI in older age. Because a school lunch program was initiated in Japan after World War II, we were able in this study to examine this association in an older Japanese population. We used data from a population of physically and cognitively independent adults aged 65years or older who were living independently in the community and were recruited from 27 municipalities in the Japan Gerontological Evaluation Study 2010 project (August 2010-January 2012). Three categories of childhood SES (low, middle, and high) and current FVI were evaluated via a self-reported questionnaire. Poisson regression was used to investigate the association between childhood SES and FVI in 19,920 individuals. After adjustment for age and sex, older people with low childhood SES were 1.36 times more likely (95% CI 1.23-1.52) to have poor FVI than those with high childhood SES. In the fully adjusted model, the significant association disappeared. Further age-stratified analysis revealed a positive association between childhood SES and FVI among people aged 70-76years who were partially exposed to the school lunch program, but not among people aged 65-69years old who were fully exposed to the program. In conclusion, social policy such as school lunches targeting children with low SES could help improve FVI in old age.

Relationships among Food Group Intakes, Household Expenditure, and Education Attainment in a General Japanese Population: NIPPON DATA2010

BACKGROUND

A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population.

METHODS

This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance.

RESULTS

When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment.

CONCLUSIONS

Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits.

Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial

BACKGROUND

No existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan.

OBJECTIVE

The aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults.

METHODS

In this randomized controlled trial, participants were assessed at three time points-baseline, postintervention (5 weeks later), and a follow-up after 3 months-from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g).

RESULTS

Out of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, P<.001), and a significant interaction (η2=0.01, P=.009). Middle-income participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046).

CONCLUSIONS

This Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to maintain and increase vegetable intake for other groups.

TRIAL REGISTRATION

Current Controlled Trials (UMIN-ICDR): UMIN000019376; https://upload.umin.ac.jp/cgi-open-bin/ icdr_e/ctr_view.cgi?recptno=R000022404 (Archived by WebCite at http://www.webcitation.org/6u9wihBZU).

Physical inactivity associated with the risk of non-communicable diseases in Japanese working mothers with young children: A cross-sectional study in Nagano city, Japan

Physical activity helps to prevent the development of chronic non-communicable diseases. However, childbearing generally reduces parents' level of physical activity, particularly in mothers. Therefore, mothers with young children generally have lower levels of physical activity and have a higher risk of developing non-communicable diseases. The aim of the present study was to examine this risk in Japanese working mothers with young children. A cross-sectional study was conducted in four nursery schools in Nagano city, Japan. All mothers were asked to complete a questionnaire regarding abnormal findings at their proximate annual medical examination, and were asked to record their normal physical activity. A total of 182 mothers completed the questionnaires, and 36 reported having abnormal findings (ABN group). Mothers in the ABN group were significantly older than those without abnormal findings (NOR; P=0.043). No significant differences in physical activity were observed between the two groups; however, mothers in the ABN group spent a significantly longer time sitting than those in the NOR group (P=0.028). Regarding socioeconomic characteristics, mothers in the ABN group had a significantly higher educational background (P=0.040) and a higher annual family income (P<0.001) compared with those in the NOR group, and significantly more mothers held full-time jobs (55.9 vs. 36.0%; P=0.005). Full-time working mothers typically had a significantly higher family income (P<0.001) and spent a significantly longer time sitting (P<0.001) compared with mothers in part-time and other work. Therefore, the results of the present study suggest that sedentary lifestyles, namely the amount of time spent sitting, may increase the risk of Japanese working mothers with young children developing non-communicable diseases.

A randomized-controlled trial focusing on socio-economic status for promoting vegetable intake among adults using a web-based nutrition intervention programme: study protocol

Background

Web-based nutritional education programmes appear to be comparable to those delivered face-to-face. However, no existing web-based nutrition education or similar programme has yet been evaluated with consideration of socio-economic status. The objective of a nutritional education programme of promoting vegetable intake designed a randomized controlled trial (RCT) is to evaluate the results of intervention and to determine how socio-economic status influences the programme effects.

Methods/Design

Participants will be randomly sampled individuals (aged 30–59) stratified according national population statistics for sex, age, and household income. Participants were consented to survey participation (n = 1500), and will be randomly divided into intervention and control groups. The intervention period is 5 weeks with one step of diet-related education per week. The main outcome of the programme is dietary behaviour as eating vegetable (350 g per day, five small bowl). To encourage behavioural changes, the programme contents are prepared using behavioural theories and techniques tailored to the assumed group stages of behavioural change. In the first step, we employ the health belief model to encourage a shift from the pre-contemplative to the contemplative phase; in the second and third steps, social cognitive theory is used to encourage transition to the preparatory phase; in the fourth step, social cognitive theory and strengthening social support are used to promote progression to the execution phase; finally, in the fifth step, strengthening social capital and social support are used to promote the shift to the maintenance phase. The baseline, post intervention and follow-up survey was assessed using a self-administered questionnaire. For process evaluation, we use five items relating to programme participation and satisfaction. A follow-up survey of participants will be carried out 3 months after intervention completion.

Discussion

The fact that this study is an RCT with an established control group is a strong advantage. Information and communications technology is not limited by time or place. If we could show this web-based nutrition education programmes has a positive effect, it may be an appropriate tool for reaching individuals in lower socio-economic state.

Trial registration

Current Controlled Trials UMIN-ICDR UMIN 000019376 (Registered October 16, 2015).