論文

A lower-than-recommended potassium intake is a well-established risk factor for increased blood pressure. Although the Japanese diet is associated with higher sodium intake and lower potassium intake, few studies have examined the source foods quantitatively. Studies on dietary patterns in association with potassium intake will be useful to provide dietary advice to increase potassium intake. Twenty-four-hour (hr) dietary recall data and 24-hr urinary potassium excretion data from Japanese participants (574 men and 571 women) in the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were used to calculate food sources of potassium and compare food consumption patterns among quartiles of participants categorized according to 24-hr urinary potassium excretion per unit of body weight (UK/BW). The average potassium intake was 2791 mg/day per participant, and the major sources were vegetables and fruits (1262 mg/day), fish (333 mg/day), coffee and tea (206 mg/day), and milk and dairy products (200 mg/day). Participants in the higher UK/BW quartile consumed significantly more vegetables and fruits, fish, and milk and dairy products, and ate less rice and noodles. Conclusion: Advice to increase the intake of vegetables and fruits, fish, and milk may be useful to increase potassium intake in Japan.

Although heavy alcohol consumption has been identified as a risk factor for adverse cognitive functioning, it currently remains unclear whether moderate alcohol consumption exerts similar effects. Observational studies previously reported the potential benefits of moderate alcohol consumption on cognition, particularly in the elderly; however, these effects have not yet been demonstrated in Asian populations. The aim of the present study was to investigate the relationship between alcohol consumption levels and global and domain-specific cognitive functions in cognitively intact elderly Japanese men. Cross-sectional data from the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA), an ongoing prospective, population-based study in Shiga, Japan, were used to examine the relationship between alcohol consumption and cognitive function. Men (n = 585) aged ≥65 years provided information on their weekly consumption of alcohol, and the data obtained were used to construct categories of never, ex- (quit before interview), very light (<14 g/day), light (14–23 g/day), moderate (>23–46 g/day), and heavy (>46 g/day) drinkers. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). A fractional logistic regression model adjusted for age, education, body mass index, smoking, exercise, hypertension, diabetes, and dyslipidemia showed that the CASI scores for global and domain-specific cognitive functions were not significantly different between all subgroups of current drinkers and never-drinkers. However, the CASI score of ex-drinkers (multivariable adjusted mean CASI score [SD]) was significantly lower than that of never-drinkers in the global [never vs. ex: 90.16 (2.21) vs. 88.26 (2.58)] and abstraction and judgment domain [never vs. ex: 9.48 (0.46) vs. 8.61 (0.57)]). The present results do not suggest any beneficial or adverse relationship between current alcohol consumption levels and cognitive functioning (both global and domain specific) in elderly Japanese men; however, low cognitive function among ex-drinkers warrants future investigations to identify the factors causing drinkers to quit.

The consumption of red meat has been recommended for individuals with reduced kidney function. However, red meat intake was recently suspected to increase cardiovascular disease (CVD) risk. We evaluated the association of red meat intake with CVD mortality risk in Japanese with/without reduced kidney function. Overall, 9112 participants of a Japanese national survey in 1980, aged ≥30 years, were followed for 29 years. Red meat intake was assessed using weighed dietary record. Cox proportional hazards models were used to estimate the hazard ratio (HR) of CVD mortality according to sex-specific tertiles of red meat intake. We also performed stratified analyses with/without reduced kidney function defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m2. Red meat intake was not associated with CVD mortality risk in men and women. In stratified analyses, the HR of the highest compared with the lowest tertile of red meat intake was lower only in women with reduced kidney function (0.67, 95% confidence interval 0.46–0.98). In conclusion, there were no clear associations between red meat intake and CVD mortality risk in Japanese population; however, a higher intake of red meat was associated with lower risk of future CVD mortality in women with reduced kidney function.

Lifestyle changes during the coronavirus disease (COVID-19) lockdown have been previously examined, but there is limited understanding about changes after such restrictions were lifted. This study examines changes in lifestyle habits and body weight among the Japanese population with regard to the length of at-home hours both during (April to May) and after (September) the na-tionwide stay-at-home request compared to those before the COVID-19 pandemic (January 2020). An online survey was conducted in September 2020 involving 10,000 Japanese survey monitors, selected according to population distribution. During the stay-at-home request, 34% participants extended their at-home hours. More respondents in the group with extended at-home hours experienced an increase or decrease in total physical activity, snacking, food intake, alcohol drinking, and body weight than those in the group with nonextended at-home hours. Some of these changes had a trend according to age. The prevalence of most of these changes decreased when at-home hours returned to normal after the stay-at-home request period; however, increased alcohol consumption and increased or decreased body weight persisted. Our findings suggest that close monitoring for further health outcomes and age-appropriate measures to encourage favorable health behaviors is needed.

Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40–59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (<100 g/wk), moder-ate-drinkers (100–299 g/wk), or heavy-drinkers (≥300 g/wk). Detailed macro-/micro-nu-trient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.

【目的】高血圧者に対する食事指導等の介入によって野菜摂取量の増加が認められたとする報告はこれまでにもあるが、高血圧を指摘されることそれ自体や治療の継続状況と野菜摂取量の関連を検討した報告はない。そこで本研究では、高血圧の指摘や治療の継続状況が、実際の野菜摂取量に影響を与えるのか検討した。【方法】平成22年国民健康・栄養調査及びNIPPON DATA2010の20歳以上の参加者を対象とした。このうち、これまでに医療機関や健康診査で脳卒中、心筋梗塞、腎臓病または腎機能低下と指摘されたことはないが、高血圧の指摘を受けている者もしくは高血圧、糖尿病、脂質異常症のいずれの指摘も受けたことはないが、国民健康・栄養調査の血圧測定値が高血圧(収縮期血圧140mmHg以上または拡張期血圧90mmHg以上の者と定義)であった高値血圧者の男女1,004人を解析対象とした。野菜摂取量が多いこと(1日350g以上)をアウトカムとして、高血圧を指摘されることやその後の治療の継続状況(治療継続、治療中断、未治療)との関連をロジスティック回帰分析にて検討した。【結果】野菜摂取量が多いことと高血圧を指摘されることは男女とも有意な関連はなく、野菜を積極的に摂取しようと心がけることとのオッズ比が男性1.72(95%CI:1.17-2.53)、女性1.51(95%CI:1.04-2.21)と有意な正の関連が認められた。野菜摂取量が多いことと高血圧者における治療の継続状況では、野菜を積極的に摂取しようと心がけることとのオッズ比が男性1.69(95%CI:1.07-2.68)と有意な正の関連、「治療中断」の女性でオッズ比0.37(95%CI:0.15-0.90)と有意な負の関連がみられた。【結論】男女とも野菜の摂取量と高血圧の指摘自体との関連は認められなかったが、女性では治療中断と負の関連が示唆された。(著者抄録)

【目的】 このレビューの目的は，避難所での食事と栄養問題の改善方法と，日本における自然災害後の健康と栄養を改善するためのさまざまな取り組みを明らかにすることである。【方法】 世界の避難所における栄養問題の改善方法を明らかにするため，PubMedおよびJ-STAGEにて，「災害」および「避難所ORキャンプ」AND「栄養OR食品OR食事」をキーワードとして文献検索した。活動報告，レビュー，方法のない記事，英語と日本語以外の言語で書かれた論文は，本レビューから除外した。また，日本の政府，専門機関，学術研究機関による自然災害後の健康と栄養改善の取り組みに関する情報を整理した。【結果】 条件に合致した7編の論文から，自然災害後の避難所における栄養問題の改善に関連する4つの主要な要素，1）避難所のサイズと設備，2）避難所での食事の提供方法と内容，3）専門家との共同作業，4）避難所間の協力，が抽出された。また，東日本大震災以降に日本で開始された自然災害後の健康・栄養問題改善のための取り組みとして，国の研究機関への災害栄養に特化した部署の設置，災害食の備蓄の推奨や認証制度，人材の開発育成，災害時の栄養基準などがあった。【結論】 本レビューにより，緊急時の避難所における栄養問題の改善に関連する要因と日本における自然災害に伴う栄養と健康の問題を軽減するための様々な取り組みを明らかにした。

The clinical implications of alcohol consumption have been extensively examined; however, its effects on brain structures in apparently healthy community-dwellers remain unclear. Therefore, we investigated the relationship between alcohol consumption and brain gray matter volume (GMV) in community-dwelling Japanese men using voxel-based morphometry (VBM). We recruited cognitively intact Japanese men, aged 40–79 years, from a population-based cohort in Shiga, Japan. Brain magnetic resonance imaging was performed, on average, 2 years after demographic and medical information was obtained in 2010–2014. A multivariable linear regression analysis of 639 men was conducted to elucidate the relationship between the amount of alcohol consumed and GMV. VBM statistics were analyzed by threshold-free cluster enhancement with a family-wise error rate of <0.05. The results obtained demonstrated that the amount of alcohol consumed was associated with lower GMV. The VBM analysis showed lower GMV within the parahippocampal, entorhinal, cingulate, insular, temporal, and frontal cortices and cerebellum in very heavy drinkers (≥42 ethanol g/day) than in non-drinkers. Furthermore, alcohol consumption was associated with a higher white matter lesion volume. These results suggest subclinical structural changes similar to alcohol-related neurological diseases.