Real-world survey of eating attitudes and spending behaviors related to healthy foods/supplements in women seeking to become pregnant.

BACKGROUND & AIMS: Since 2022, fertility treatments have been partially covered by insurance in Japan. Women who wish to become pregnant may explore various means of conception as fertility treatments have shown low success rates. Therefore, we aimed to clarify the state of knowledge, behavior, and attitudes toward health foods among women who are actively trying to become pregnant. METHODS: A web-based research company surveyed the eating attitudes and behaviors towards healthy foods of 900 women seeking to become pregnant. Regression analysis for the total amount spent on pregnancy was conducted, with "amount spent on actions undertaken to conceive" as the dependent variable. Multiple regression analysis on actions undertaken to conceive was performed using age, family income, body mass index, duration of hospital visits, duration of actions undertaken to conceive, cumulative amount incurred to conceive, awareness of dietary guidelines, adherence to dietary practices, number of types of health foods and supplements, whether participants considered consumption of nutritious foods and supplements to be important, and cumulative amount spent on healthy foods and supplements. The effect size for the Chi-square test was determined with Cramer's coefficient of association. RESULTS: Increasing age was associated with a longer time to conceive, longer hospital visits, higher conception costs (including fertility treatment), and a higher intake of healthy food products. The number of healthy food types had the greatest impact on the cost incurred to conceive. Folic acid was the most commonly consumed healthy food, followed by iron and calcium. CONCLUSIONS: This study clarified the real-world situation regarding healthy foods for women seeking pregnancy in Japan. The information necessary for pregnant women to select safe healthy foods was clarified, which may lead to the establishment of risk-communication measures to ensure safety.

Development and validation of the gratitude for food scale for Japanese adults.

Gratitude for food is a concept associated with various aspects of healthy and sustainable diet and originates from Buddhism and Shintoism in Japan. Against this background, a scale specifically targeting adults is essential for boosting studies concerning gratitude for food. This study aimed to adapt the Gratitude for Food Scale (GFS), originally developed for Japanese children, to Japanese adults and to examine the reliability and validity of GFS for adults (GFS-A). This cross-sectional study used baseline and one-week follow-up data from a longitudinal survey. The analysis included 1800 Japanese adults at baseline and 1380 at the one-week follow-up based on completion of self-administered questionnaires in February 2023. Construct validity was confirmed using exploratory and confirmatory factor analyses. Further, Spearman's and intraclass correlation coefficients and Cronbach's alpha were calculated to confirm criterion validity and reliability (test-retest and internal consistency). Participants' mean (SD) age was 40.2 (11.2) years (women: n = 900, 50.0%) at baseline. The analysis revealed a one-factor structure comprising five items with good model fit. Criterion validity was confirmed by the correlation coefficients between the total GFS score and the gratitude questionnaire and the sub-score of awareness and appreciation for food, which represents a subscale of the expanded mindful eating scale. Moreover, test-retest reliability and internal consistency were confirmed. From this study's results, we can see that the developed GFS-A is an appropriate scale with good reliability and validity for measuring Japanese adults' gratitude for food.

Diet Therapy Using a Small Rice Bowl among Japanese Men with Diabetes: A Randomized Controlled Trial.

Background: This study aimed to investigate the effectiveness at 1 and 3 months of using a smaller rice bowl for diet therapy among Japanese men with type 2 diabetes. Methods: A parallel-group randomized controlled trial was conducted at a medical clinic in Japan. The participants were men with type 2 diabetes mellitus, aged 20-80 years, with glycosylated hemoglobin <8.5%, and who ate rice one or more times per day at home. The intervention group (36 men) received a small rice bowl from which to eat the usual diet therapy, and the control group (38 men) received only the usual diet therapy. Results: The changes in weight and body mass index among the intervention group at 1 month were significantly higher than those in the control group. There were no significant differences between the two groups at 3 months. Conclusion: The effects of using a small rice bowl were minor and short-term.

Impact of the COVID-19 pandemic on food and drink consumption and related factors: A scoping review.

Background: The lockdown imposed due to the coronavirus disease (COVID-19) pandemic has caused several lifestyle changes. Aim: This scoping review aimed to report the present status of studies conducted on changes and factors related to food and drink consumption worldwide. Methods: Searches were performed in PubMed and EBSCO between August 6 and August 22, 2020 using the following criteria: (1) studies reporting changes in the current individual consumption of specific foods and snacks compared to that before the COVID-19 pandemic; (2) participants aged 18 years or older and without any diagnosable disease; and (3) articles that are peer-reviewed publications available in English. Studies were excluded if they involved an intervention related to diet or investigated the change in COVID-19 incidence. Results: Twelve articles were included in this review. The included studies revealed that there were various changes in food and drink consumption, such as the frequency and amount of consumption of snacks (n = 9), alcohol (n = 7), and vegetables and fruits (n = 5). These changes showed both increasing and decreasing trends. Of the 12 studies, 10 reported factors related to dietary changes, such as age, body mass index, psychological conditions, and residence; however, most of the results regarding these factors were inconsistent. Conclusions: Future studies should investigate long-term dietary changes and examine the factors that influence these changes to determine the pandemic's long-term impact.

Factors Associated with Dietary Change since the Outbreak of COVID-19 in Japan.

In Japan, dietary habits have greatly changed since the coronavirus disease (COVID-19) outbreak; we examined factors related to dietary changes. An online cross-sectional questionnaire survey was conducted in November 2020 among 6000 Japanese adults (aged 20-64 years) registered with a research company and gathered data on demographics, socioeconomic factors, medical history, COVID-19 status of the respondent's family and neighbors, fear of COVID-19, and changes in lifestyle and dietary habits since the COVID-19 outbreak. To the question "Have you made healthier changes to your dietary habits compared with the dietary habits before the spread of COVID-19 (1 year ago, November 2019)?", 1215 (20.3%), 491 (8.2%), and 4294 (71.6%) participants answered that their dietary habits were healthier, unhealthier, and unchanged, respectively. Healthier and unhealthier dietary habits were associated with greater fear of COVID-19, altered exercise and sleep times, and smoking. Unhealthy habits were positively associated with living alone, decreasing household income, colleagues with COVID-19, stress, and weight loss/gain. Annual household income, changing household income, COVID-19 in friends, health literacy, exercise frequency, weight loss, and starting smoking were positively associated with healthier dietary changes. The generalizability of these results and strategies to inculcate healthy diets in this "new normal" should be investigated.

The effects of bowl size and portion size on food intake and fullness ratings in a sample of Japanese men.

OBJECTIVE: Portion sizes and bowl sizes may be related to food intake and perceived fullness. The objective of the present study was to investigate the effects of portion size and bowl size and possible interactions between these variables on food intake and fullness in a sample of Japanese men. DESIGN: Participants ate four different experimental meals across four weeks and completed questionnaires about their fullness using a visual analogue scale administered before and after meals. The four meal patterns included consistent portions of several foods commonly eaten together in typical Japanese meals, along with 150 g of rice served in a small rice bowl (diameter of 11·5 cm), 150 g of rice served in a large rice bowl (diameter of 13·5 cm), 250 g of rice served in a small rice bowl or 250 g of rice served in a large rice bowl. SETTING: Tokyo.SubjectTwenty-one adult men participated in the study. RESULTS: Portion size had a significant main effect on rice intake (F (1,20)=83, P<0·001) and fullness (F (1,20)=8·0, P=0·010), but no significant effects of bowl size on the outcome variables were found. The interactions between portion size and bowl size on intake and fullness were not significant. CONCLUSIONS: The sample of Japanese men showed an influence of portion size on food intake. Further research is needed to clarify the combined effects of bowl size and portion size on intake and fullness.

Criterion validity of the visual estimation method for determining patients' meal intake in a community hospital.

BACKGROUND & AIMS: The accuracy of the visual estimation method is unknown, even though it is commonly used in hospitals to measure the dietary intake of patients. We aimed to compare the difference in the validity of visual estimation according to the raters' job categories and tray divisions, and to demonstrate associations between meal characteristics and validity of visual estimation in a usual clinical setting in a community hospital. METHODS: We collected patients' dietary intake data in usual clinical settings for each tray in 3 ways: visual estimation by nursing assistants, visual estimation by dietitians, and weighing by researchers (reference method). Dietitians estimated the dietary intake using 2 divisions, namely, whole tray and food items. Then we compared the weights and visual estimation data to evaluate the validity of the visual estimation method. RESULTS: Mean nutrient consumption of target trays was significantly different when using the visual estimation of target trays than when using the weighed method (visual estimation by nursing assistants [589 ± 168 kcal, 24.3 ± 7.0 g/tray, p < 0.01], dietitians' whole trays [561 ± 171 kcal, 23.0 ± 6.9 g/tray, p < 0.05], food items [562 ± 171 kcal/tray, p < 0.05], and dietitians' food items [23.4 ± 7.3 g/tray, p = 0.63]). Spearman's correlations for both methods were very high for energy (ρ = 0.91-0.98, p < 0.01) and protein intakes (ρ = 0.88-0.96, p < 0.01), respectively. The limits of agreement in the Bland-Altman plot for both dietary intake categories were -121 kcal to 147 kcal/tray and -6.4 g to 7.0 g/tray (nursing assistants, whole division), -122 kcal-106 kcal/tray and -6.7 g to 5.5 g/tray (dietitians, whole divisions), and -82 kcal to 66 kcal/tray and -4.3 g to 3.9 g/tray (dietitians, food items divisions). High intake rate of grains was significantly associated with decreased odds of a difference between two methods based on the nursing assistant's whole tray evaluation (odds ratio [OR]: 0.85; 95% confidence interval [CI]: 0.76-0.94) and the dietitians' whole tray (OR: 0.80; 95% CI: 0.72-0.89) and food items evaluations (OR: 0.64; 95% CI: 0.56-0.73), respectively. In addition, minced meals were also associated with a difference between two methods, for the nursing assistants' whole tray (OR: 3.53; 95% CI: 1.66-7.51) and dietitians' food items (OR: 2.92; 95% CI: 1.37-6.22). CONCLUSIONS: Visual estimation by nursing assistants and dietitians correlated highly with the weighing method although the limits of agreement were wide. Nursing assistants and dietitians should pay attention to low consumption and modified texture meals when evaluating dietary intake using the visual estimation method.

The impact of coping strategies on weight control in the aftermath of dietary lapses in a high impulsivity group.

OBJECTIVE: Individuals with high impulsivity tend to overeat on impulse. The objective of this study was to examine methods of weight control, focusing on coping with the aftermath of dietary lapses, among those who have high impulsivity. METHODS: Eight hundred adults aged 20-59 years, who were registered with a research company completed a self-reported cross-sectional questionnaire. They were classified into low and high impulsivity groups using the median impulsivity score measured with the Barratt Impulsiveness Scale. We compared coping strategies in the aftermath of dietary lapses between the two groups. We also examined the correlation between coping methods and body mass index (BMI) using multiple regression analysis in the low and high impulsivity groups. RESULTS: The high impulsivity group used more coping strategies, such as self-monitoring, self-reflective thoughts, and positive thoughts. The main finding of this study was that compensation by healthy eating was negatively correlated with BMI in the high impulsivity group. Additionally, positive thoughts were positively correlated with BMI. CONCLUSIONS: The results suggest that compensation with healthy eating in the aftermath of dietary lapses is important to control weight in those with high impulsivity.

Development and evaluation of the Japanese version of the Audit of Diabetes-Dependent Quality of Life for patients with diabetes.

OBJECTIVES: Our objective was to undertake linguistic validation and cultural adaptation of the Japanese version of the Audit of Diabetes-Dependent Quality of Life (JP-ADDQoL) and to evaluate its psychometric properties when completed by Japanese patients with diabetes. METHODS: We followed the standard linguistic validation procedure and subsequently evaluated the reliability (internal consistency) and construct validity (exploratory and confirmatory factor analyses) of the translated version by surveying 239 Japanese patients with diabetes. RESULTS: We translated 19 items for the JP-ADDQoL. The internal consistency was excellent (Cronbach's alpha = 0.933). In the exploratory factor analysis, four factors were extracted, and most of the items in all four factors had high loadings. Forced one-factor analysis revealed all factor loadings other than those for sex life to be >0.40 (sex life: 0.398). Confirmatory factor analysis indicated an acceptable fit for the JP-ADDQoL. CONCLUSIONS: The JP-ADDQoL showed adequate reliability and acceptable validity. Examining not only the impact of diabetes on a specific domain of life but also its importance for each patient leads to more accurate and individualized measurement of the patient's QoL.

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.

Correlations between self-efficacy in resisting six temptations and dietary energy and macronutrient intake at each meal.

Self-efficacy in relation to eating behavior for weight control is commonly defined as having the confidence to control urges to overeat in high-risk situations. Prior researchers have suggested that self-efficacy plays a mediating role in eating behavior for weight loss and maintenance. The current study examined the relationship between self-efficacy in resisting certain temptations and daily dietary intake at each meal. Participants were 83 men and 122 women registered at the health management website "Asken". They administered questionnaires about self-efficacy and dietary records. As results of multiple regression analysis, self-efficacy in resisting negative emotions was negatively related to lunch energy intake in men (ß=-0.308, p=0.023) and total (ß=-0.302, p=0.003), breakfast (ß=-0.334, p=0.004), and snacking (ß=-0.232, p=0.022) energy intake in women. Also, self-efficacy in resisting rewards was negatively related to lunch energy intake in men (ß=-0.218, p=0.040). In men, self-efficacy in resisting hunger was positively related to protein intake (ß=0.148, p=0.021) and relaxation was negatively related to lipid intake (ß=-0.211, p=0.009). Self-efficacy in resisting some temptations, especially negative emotions, and dietary intakes were negatively related. Future research is needed to confirm these results and assess the prospective effects of self-efficacy.