Intake of allergenic foods at 1.5 years and 3 years of age in a general child population in Japan: a cross-sectional study

BACKGROUND@#Recent studies indicate that the timing of introduction of potentially allergenic food is crucial for the development of food allergy in children. This cross-sectional study aimed to clarify the reality of allergen food intake in a general population of young children in Japan.@*METHODS@#A questionnaire survey of caregivers was conducted at health checkups for 1.5-year (18-month)-old and 3-year-old children in the fall of 2020. The caregivers were asked about (1) the presence/absence of allergic disease symptoms based on the ISAAC questionnaire, and (2) foods that caregivers avoided giving their children. Ordinal logistic regression analyses were periformed to determine factors associated with food avoidance.@*RESULTS@#Questionnaires were distributed to 1720 caregivers, and 1603 (93%) responded. The responders consisted of 771 and 832 caregivers who participated in 1.5-year-old and 3-year-old checkups, respectively. The prevalence of allergic diseases was comparable to recent epidemiological studies in Japan, indicating that the population may be representative. At 1.5 years old, more than 50% of the children were not exposed to peanuts, tree nuts, fish eggs, shellfish, and buckwheat. At 3 years old, the avoidance rates of the foods had decreased but were still between 18.8% and 32.0%. On the other hand, the avoidance rates of chicken egg and cow's milk, the top 2 common allergenic foods in Japan, were much lower at 2.8% and 1.5% at 1.5 years, and they decreased to 1.4% and 0.7% at 3 years old, respectively. Ordinal logistic analysis showed that avoidance of chicken egg, cow's milk, and wheat was associated with food allergy diagnosis and chicken egg avoidance with eczema, but avoidance of other foods showed no associations with any risk factors for food allergy.@*CONCLUSION@#Caregivers avoided giving various foods, independent of allergy risk factors, to their young children. Since delayed introduction of an allergenic food has been reported to increase the risk of developing an allergy to the food, the results warrant future investigation of the development of food allergies in relation to current eating habits and recommendations.

Improvement of Meals for Patients Undergoing Chemotherapy / 日本農村医学会雑誌

In 2010, we at Konan Kosei Hospital introduced a menu with 8 days set as a cycle for inpatients undergoing chemotherapy. We have thus far used it for 258 patients. Over the 6-month period extending from October 2011 and March 2012, we performed a questionnaire survey on 23 patients (8 with lung cancer, 5 with acute myeloid leukemia and 3 with lymphoma) about their meals. On the basis of the findings, we have made a number of improvements in the menu.　　To the question of ease with which to eat, 96% of patients responded the meals were “easy to eat.” When it came to the volume of meals, 29% replied that breakfast was “small,” whereas 83% said lunch and dinner were “just right.” Cold chawan-mushi (custard-like egg and vegetable dish steamed in a cup) was difficult to eat for 7 patients, whereas there were indications that fish meals were also hard to eat.　　Based on this survey, we have increased the volume of breakfast, and replaced cold chawan- mushi with hot chawan-mushi. Furthermore, in order to reduce the smell peculiar to fish, we substituted kaba-yaki (spitchcocks) and ankake (food dressed with a thick, starchy sauce) fish- cooking styles for nitsuke (fish boiled and seasoned with sugar and soy sauce) and mushizakana (steamed fish) styles. Further surveys are necessary to produce a menu suitable for as many patients undergoing chemotherapy as possible.

‘Febrile Children's Menu’ for Children with Fever / 日本農村医学会雑誌

  The incidence of fever in children admitted to general hospitals is very high. Provision of adequate nutrition and fluid supplements to febrile children is very important, but with some children it is difficult to maintain an adequate intake. To address this problem, we devised a new ‘febrile children's menu’, utilizing preparation methods and foods to produce a palatable menu for patients with fever.<br>  We introduced this ‘febrile children's menu‘ on January 6, 2011, providing it to 109 patients (age range: 1 to 8 years, average age: 3.3±1.9 years) over the ensuing 3-month period. We provided a mean 4.0±2.9 meals per day to each patient during their febrile stage (≥37.5°C). To evaluate the usefulness of the ‘febrile children's menu’, we investigated eating rates during the febrile period in all patients who had been provided with the menu, and performed a questiomaire survey on their parents/guardians. The mean eating rates during the febrile period were 39±30% for main meals, and 28±22% for side dishes. No significant difference was seen in the eating rates during the febrile period recorded over the 2-month period prior to introduction of the new menu to 112 febrile children (age range: 1 to 8 years, average age: 3.3±2.1 years), 39±30% for main meals, and 29±22% for side dishes. The questionnaire survey was responded by 43 parents/guardians (a recovery rate of 39%). The ‘febrile children's menu’ was assessed as ‘good’ by 67% of respondents, representing an overall favourable impression from the parents/guardians. With reference to the survey results, we will attempt to further improve the ‘febrile children's menu’ with the aim of increasing eating rates during the febrile period.

Dietary Education for Child Inpatients and their Parents Questionnaire Surveys / 日本農村医学会雑誌

  In recent years, changes in Japanese dietary habits have been associated with the increased incidence of obesity and lifestyle diseases even among children. Dietary education is considered essential for stemming this trend. In this study, we introduced the following initiative in dietary education for children admitted to hospital and their parents from the standpoint of health care workers providing meals to inpatients. We added a ‘Children's Lunch’ to the menu. Designed for the fussy children, it was a nutritionally balanced meal. On traditional seasonal festival days, we wrote an introduction to Japanese seasonal cuisine and showed it to the children. To the parents, we distributed a regular weekly pamphlet outlining the importance of dietary education, with an explanation of the ingredients used in the meals, and recipes.  To assess the results of this initiative, we conducted a questionnaire survey of parents on a weekly basis. The results of the surveys (n=215, recovery rate 87%) taken during the first three months showed that the majority of parents rated all four aspects of the ‘Children's Lunch’ high menu content, presentation, child's response, and the pamphlet contents. The parents displayed a deep interest in our activity, because 93% of those parents said that they were impressed with dietary education. On the other hand, some dietary problems were identified, with tendencies to use only ingredients preferred by the children, and eat out often.  This was a short term initiative, limited to hospitalization, but we were cwetain that we had been able to provide an opportunity for parents to think about their children's diets. We plan to continue this initiative, thereby making a contribution to dietary education for children.