Dietary Reference Intakes for Japanese 2010: Energy

Post-Disaster Mental Health and Dietary Patterns among Older Survivors of an Earthquake and Tsunami

OBJECTIVES

Research suggests that cardiometabolic disease risks are elevated among survivors of natural disasters, possibly mediated by changes in diet. Using the Brief Dietary History Questionnaire, we examined (1) dietary patterns among older survivors of the 2011 Great East Japan Earthquake and Tsunami, and (2) the contribution of posttraumatic stress symptoms (PTSS)/depressive symptoms, as well as relocation to temporary housing on dietary patterns and (3) gender differences in the associations.

DESIGN, SETTING AND PARTICIPANTS

Data came from a prospective cohort study of 1,375 survivors aged 65-89 years (44.6% male).

MEASUREMENTS

PTSS/depression onset was evaluated in 2013, 2.5 years after the disaster. Dietary data was collected with a self-administered brief-type diet history questionnaire in 2020. A principal component analysis identified three posterior dietary patterns.

RESULTS

Diet 1 consisted of high intake of vegetables, soy products, and fruits; Diet 2 consisted of carbohydrate-rich foods and snacks/sweets; Diet 3 consisted of high intake of alcoholic beverages, meat, and seafood. Least-squares linear regression revealed that individuals with PTSS/depression were less likely to exhibit Diet 1, while individuals with PTSS were more likely to exhibit Diet 2 and 3. Especially, males who had depression showed an unhealthy dietary pattern. Those who have lived in a trailer-style temporary housing reported less consumption of Diet 3.

CONCLUSION

Survivors of disaster with symptoms of mental illness tended to exhibit less healthy dietary patterns after 9 years. Diet varied by type of post-disaster mental illness, gender, and current social circumstances. We lacked pre-disaster BDHQ data, which is a limitation.

Total energy expenditure among children with motor, intellectual, visual, and hearing disabilities: a doubly labeled water method

OBJECTIVE

Few studies have evaluated the total energy expenditure (TEE) of children with disabilities using the doubly labeled water (DLW) method; however, none have compared it by disability type. Furthermore, no large-scale studies have focused on the severity of motor disability (MD). We aimed to compare TEE in children with disabilities by disability type.

METHODS

In a cross-sectional study design, TEE was measured using the DLW method, anthropometry, and weighted food records. The following comparisons were made: (1) TEEs among four disability types and (2) TEEs of three subgroups classified by MD based on the Gross Motor Function Classification System (GMFCS).

RESULTS

In total, 256 children (138 boys; ages 6-15 years) were studied. The comparison between the four disability types for boys in all age categories revealed that TEE (kJ/d) was lowest in MD, followed by intellectual disability (ID), visual disability, and hearing disability (HD), in that order. TEE/fat-free mass (FFM) (kJ/FFMkg/d) was also lowest in MD and highest in HD. TEE (kJ/d) and TEE/FFM (kJ/FFMkg/d) were also lowest in MD and highest in HD in girls. For both boys and girls, TEE (kJ/d) and TEE/FFM (kJ/FFMkg/d) were higher in the MD subtype GMFCS I-II than in GMFCS III-IV and GMFCS V.

CONCLUSIONS

TEE differed, depending on the disability type, and was the lowest in MD and highest in HD for both boys and girls. Analysis by GMFCS classification revealed that greater severity of motor dysfunction resulted in lower TEE.

Resting Energy Expenditure in the Elderly: Systematic Review and Comparison of Equations in an Experimental Population

Elderly patients are at risk of malnutrition and need an appropriate assessment of energy requirements. Predictive equations are widely used to estimate resting energy expenditure (REE). In the study, we conducted a systematic review of REE predictive equations in the elderly population and compared them in an experimental population. Studies involving subjects older than 65 years of age that evaluated the performance of a predictive equation vs. a gold standard were included. The retrieved equations were then tested on a sample of 88 elderly subjects enrolled in an Italian nursing home to evaluate the agreement among the estimated REEs. The agreement was assessed using the intraclass correlation coefficient (ICC). A web application, equationer, was developed to calculate all the estimated REEs according to the available variables. The review identified 68 studies (210 different equations). The agreement among the equations in our sample was higher for equations with fewer parameters, especially those that included body weight, ICC = 0.75 (95% CI = 0.69-0.81). There is great heterogeneity among REE estimates. Such differences should be considered and evaluated when estimates are applied to particularly fragile populations since the results have the potential to impact the patient's overall clinical outcome.

Total energy expenditure of 10- to 12-year-old Japanese children measured using the doubly labeled water method

Background

To establish Japanese children's estimated energy requirements, total energy expenditure (TEE) data measured using the doubly labeled water (DLW) method is needed. This study aimed to 1) obtain basic TEE data from Japanese children measured using DLW (TEE_DLW), 2) compare TEE_DLW with TEE estimated by various estimation formulas to calculate their accuracy, and 3) develop a new equation to estimate TEE using body composition and pedometers.

Methods

TEE was measured using DLW in 56 10- to 12-year-old Japanese children (33 boys, 23 girls). Physical activity level (PAL) was calculated by dividing TEE_DLW by estimated resting energy expenditure. To assess their physical activity, participants wore pedometers during the 7-d DLW period. Total body water was calculated from ²H and ¹⁸O; fat-free mass (FFM) and fat mass (FM) were then determined.

Results

In boys and girls of normal weight, TEE_DLW was 2067 ± 230 kcal/d and 1830 ± 262 kcal/d, respectively. Average PAL was 1.58 ± 0.17. FFM was strongly related to TEE (r = 0.702, p < 0.01). After adjusting for FFM and FM, step count was significantly associated with TEE (r = 0.707, p < 0.01). The TEE estimation formula used in the Dietary Reference Intakes (DRI) for the United States and Canada estimated TEE_DLW with high accuracy (bias: 2.0%) in both sexes. We developed new equations for TEE consisting of FFM and step count, which accounted for 68% and 65% of TEE variance in boys and girls, respectively: boys, 47.1 × FFM (kg) + 0.0568 × step count (steps/d) - 122, and girls, 55.5 × FFM (kg) + 0.0315 × step count (steps/d) - 117.

Conclusions

The TEE in 10- to 12-year-old Japanese children measured using DLW was approximately 7% lower for boys and 12% lower for girls compared to the current Japanese DRI. If PAL can be accurately determined, the equation in the DRI for the United States and Canada may be applicable to Japanese children. In addition, TEE could be predicted using FFM and step count.

Association between the frequency of meals combining "Shushoku, Shusai, and Hukusai" (Staple food, main dish, and side dish) and intake of nutrients and food groups among Japanese young adults aged 18-24 years: a cross-sectional study

"Shushoku," "Shusai," and "Hukusai" are staple food, main dish, and side dish, respectively. The recommended meal in Japan is a combination of "Shushoku," "Shusai," and "Hukusai"; however, it remains unclear whether there is an association between the frequency of these meals and intake of nutrients and food groups. This cross-sectional study examined the association between the frequency of meals combining "Shushoku, Shusai, and Hukusai" and intake of nutrients and food groups among 664 Japanese young adults aged 18-24 y. The dietary habits of the subjects during the preceding month were assessed using a validated brief-type self-administered diet history questionnaire. The frequency of meals combining "Shushoku, Shusai, and Hukusai" was self-reported according to four categories: "less than 1 d or 1 d/wk," "2 or 3 d/wk," "4 or 5 d/wk," and "every day." In both women and men, there was an association between the higher frequency of these meals and higher intake of the following food groups: pulses, green and yellow vegetables, other vegetables, mushrooms, seaweeds, fish and shellfish, and eggs. Moreover, there was an association with higher intake of protein, polyunsaturated fat, n-6 and n-3 polyunsaturated fat, total dietary fiber, soluble and insoluble dietary fiber, β-carotene, α-tocopherol, vitamin K, thiamin, riboflavin, folate, pantothenic acid, vitamin C, potassium, calcium, magnesium, iron, and copper, and lower intake of carbohydrate in both women and men. Our findings support the hypothesis that the meals combining "Shushoku, Shusai, and Hukusai" may be associated with intake of many food groups and nutrients among Japanese young adults.

Association between Regular Exercise and Dietary Intake among Japanese Young Adults Aged 18-24 Years: A Cross-Sectional Study

The aim of this study was to examine the association between regular exercise and dietary intake in Japanese young adults. A cross-sectional study was performed between May 2013 and July 2013 in universities, colleges, and technical schools located in Ibaraki, Kanagawa, Tokyo, and Nara in Japan. The final sample comprised 654 students, 473 females and 181 males, aged 18-24 y. Regular exercise and dietary intake were assessed using validated self-reported questionnaires. Logistic regression analyses were applied to examine the association between regular exercise and dietary intake. A total of 18% females and 40% males spent ≥5 h per week exercising. Females who spent ≥5 h per week exercising were likely to have a higher intake of fruits (odds ratio (OR), 1.84; 95% confidence interval (CI), 1.09-3.13) and a lower intake of cereals (OR, 0.57; 95% CI, 0.33-0.97) than were those who spent <1 h per week. Males who spent ≥5 h per week exercising were more likely to have a higher intake of fish and shellfish (OR, 2.69; 95% CI, 1.07-6.77) than those who spent <1 h per week. In conclusions, young adults who spent ≥5 h per week exercising had a higher intake of fruits among females, and a higher intake of fish and shellfish among males than those who spent <1 h per week. The present findings suggested food group intakes associated with regular exercise in Japanese young adults.

The relationship of eating until 80% full with types and energy values of food consumed

OBJECTIVE

Eating until one is 80% full is considered a healthy dietary practice in Japan. This study examined the relationship between this behavior and energy intake and types and quantities of foods consumed to examine its beneficial effects.

METHODS

This study relied on dietary records and self-administered questionnaires completed by 330 users of a health-management website in November 2012. ANOVA was performed to examine the relationship between eating until one is 80% full and intake.

RESULTS

Men who always ate until they were 80% full consumed less energy than those who did not (mean [SD]; always: 1997.3 [356.7] kcal; rarely/never: 2448.9 [637.1] kcal; p<0.05). Moreover, men who ate until they were 80% full consumed fewer servings of grain dishes (always: 3.7 [0.9] servings; rarely/never: 5.1 [1.9] servings; p<0.05) and more servings of vegetable dishes (always: 5.9 [2.2] servings; rarely/never: 4.0 [2.3] servings, p<0.05) than those who did not.

CONCLUSION

Men who ate until they were 80% full consumed less energy and more vegetable dishes than those who did not, suggesting that eating until one is 80% full is associated with healthy dietary habits among men.

Estimating free-living human energy expenditure: Practical aspects of the doubly labeled water method and its applications

The accuracy and noninvasive nature of the doubly labeled water (DLW) method makes it ideal for the study of human energy metabolism in free-living conditions. However, the DLW method is not always practical in many developing and Asian countries because of the high costs of isotopes and equipment for isotope analysis as well as the expertise required for analysis. This review provides information about the theoretical background and practical aspects of the DLW method, including optimal dose, basic protocols of two- and multiple-point approaches, experimental procedures, and isotopic analysis. We also introduce applications of DLW data, such as determining the equations of estimated energy requirement and validation studies of energy intake.

Locomotive and non-locomotive activities evaluated with a triaxial accelerometer in adults and elderly individuals

BACKGROUND AND AIMS

Comparative data on locomotive and non-locomotive physical activity (PA) by age and gender are lacking for Japanese adults. The purpose of this study was to investigate objectively the levels of PA in each intensity in adults and older people by both genders living in Japan with triaxial accelerometry with discrimination between locomotive and non-locomotive PA.

METHODS

In 571 women and 315 men aged 18-92 years from the Kanto region, PA was assessed for 6 consecutive days with a triaxial accelerometer (Active style Pro: HJA-350IT), and minutes of light and moderate-to-vigorous physical activity (MVPA) classified by metabolic equivalents were evaluated.

RESULTS

Japanese elderly women over 70 years, spent less time in not only locomotive PA (light and MVPA), but also in non-locomotive MVPA. For non-locomotive light activity, however, there was no significant difference between women over 70 years and younger women. In contrast, for men, non-locomotive light activity and MVPA remained constant with age, while elderly men over 70 years spent less time in locomotive activities (light and MVPA). Women spent more time in non-locomotive activity than men, except for MVPA in elderly individuals, and time in non-locomotive MVPA occupied more than half of the total MVPA in all age groups for women.

CONCLUSIONS

These findings suggest that the intensity and the type of PA for Japanese were obviously affected by age, while locomotive PA for men and non-locomotive light PA for Japanese women were obviously unaffected by age. The finding also indicates gender differences. Thus, evaluation of both locomotive and non-locomotive activity is important in the overall assessment of PA.