Long-Term Nutritional Counseling for a Patient with Lipoprotein Lipase Deficiency.

A one-year-and-nine-month-old Japanese boy was admitted with hypertriglyceridemia (fasting triglycerides 2548 mg/dL). After close examination, he was diagnosed with lipoprotein lipase (LPL) deficiency (compound heterozygous) and was immediately started on a fat-restricted dietary therapy. He responded well to the regimen (1200 kcal/day, 20 g fat/day) and his triglycerides decreased to 628 mg/dL within 7 days of starting the dietary therapy. It was decided to manage his illness without using any drugs because he was still an infant and responded well to a fat-restricted diet. During his hospital stay, dietitians provided him with nutritional counseling using a food exchange list, which was designed to easily calculate the fat content by including foods that are commonly served. His family quickly learned the skills to prepare a fat-restricted diet. Moreover, since dietary restrictions may have impaired the child's growth and development, the dietitians continued to intervene regularly after the child was discharged from the hospital. The dietitians confirmed that the patient was receiving nutritional intake appropriate for his growth and discussed the dietary concerns in his daily life and how to participate in school events that involved eating and drinking. Nutritional counseling was provided every 3-4 months from disease onset to age 23 years, except for a 14-month break at age 20 years. The patient grew up without developing acute pancreatitis, a serious complication of LPL deficiency. The long-term intervention of dieticians is necessary to achieve a balance between living on a strict diet for disease management and ensuring appropriate nutritional intakes for growth/development.

Local Governments' Disaster Emergency Communication and Information Collection for Nutrition Assistance.

We examined local governments' disaster emergency communication and information collection and distribution systems. Postal surveys were conducted for all prefectures, cities with public health centers, and specified districts in Tokyo Metropolis in 2005 and 2013. Municipalities were included in the 2013 survey only. The response rate for the 2013 survey was 71.2% (n = 1272). Thirty-six prefectures, 41 cities with health centers, and 16 specified districts in Tokyo Metropolis answered both surveys. A majority of respondents (88.8% in 2005 and 92.1% in 2013) of respondents reported that disaster management radio broadcasting was written into their local disaster management plans, guidelines, or manuals as the main communication tool. The proportion of respondents using computer networks (41.6-60.7%) and cell phones (email) (40.4-62.9%) had significantly increased between the surveys. It was also found that municipalities that had been previously affected by disasters (39.6%) were more likely to have systems to collect information from shelters and affected communities than those without any experience (24.3%), and prefectures that had been previously affected by disasters were more likely to have food supply damage reporting systems (36.4%) than those without such experience (3.3%).