[Milk, Daily products and Bone health.Effects of School Lunch Programs on Bone Mass.]

In Japan, school lunches are provided to elementary and secondary student, not only for ensuring the intake of well-balanced and nutritious meal, but also hoping to improve their dietary habits. In this article, the authors review the effects of a school lunch program on the bone mass and dietary habits. The school lunch program was divided into 3 groups:a group provided with a complete school lunch, a group provided with only milk supplements, and a group provided with no supplement. The calcaneal bone mass was significantly higher in both primary and the junior high-school students given complete lunches compared with that in the other groups. Moreover, the intake of milk and milk products besides school lunches was more frequent in the groups that received complete lunches. The results suggest that the school lunch program, particularly that providing complete lunches, contributed to increasing the bone mass and improving the dietary habits.

[Osteoporosis Liaison Service and nutrition counseling and education.]

Nutritional counseling as part of the Osteoporosis Liaison Service(OLS)should provide active nutritional counseling and lifestyle guidance by referring to the detailed methods for conducting "nutritional status assessments", an item of OLS-7, a detailed activity outcome measure of the OLS. After conducting adequate nutritional assessments, the goals for each stage of behavior change should be established, aiming to set roughly one goal for a specified period of time and increasing the goals once improvements have been made. Incorporating feedback in the next improvement plan becomes very important. Good nutritional counseling will surely lead to achieving the OLS goals(improvement in treatment rates and treatment continuation rates). Moreover, it will contribute to decreasing the number of patients with fractures, eliminating sequential fractures and prolonging a healthy life expectancy in Japan.

[Bone and joint diseases in children. Nutritional guidance for infants, children, and adolescents].

Childhood is the period when physical growth and development are the most marked in human life. Bone growth is also the most marked during this period. Therefore, appropriate nutrient intakes corresponding to physical growth including bone growth are indispensable during each stage of childhood. In particular, during infancy and the preschool period, nutritional management with monitoring of changes in the physical growth curve of each child is important. It is necessary to guide children toward "eating habits and behavior" appropriate for each stage of childhood and promote the development of self-management for physical and mental health including bone health as a preparation for future life.

Ultrasonography for ureteral stone detection in patients with or without caliceal dilatation.

PURPOSE: To evaluate the relationship between the degree of hydronephrosis and the detection rates of ureteral stones with ultrasonography (US). METHODS: Of 250 consecutive patients with suspected ureterolithiasis, 214 who were diagnosed with ureterolithiasis were enrolled in this study. First, both kidneys were observed by US to evaluate the intrarenal collecting systems. Thereafter, the possible course of the ureters and the bladder were searched to find any stones. RESULTS: Stones were clearly observed in 80 (73%) of 109 patients with caliceal dilatation, whereas stones were clearly observed in 46 (44%) of 105 patients without dilatation (P < 0.05). Of the former 80 patients, 31 (39%) had stones in the ureterovesical junction (UVJ), whereas 51 (64%) had stones in the more proximal ureter. Of the latter 46 patients, 37 (80%) had stones in the UVJ or the bladder, whereas 9 (20%) had stones in the more proximal ureter. CONCLUSION: The US detection rate of ureteral stones was high in patients with caliceal dilatation. The whole ureter should be scanned in patients with caliceal dilatation for detection of ureteral stones. Even when patients have no caliceal dilatation, it is still considered to be useful to scan the UVJ and the bladder.

[Osteoporosis and beverage preference].

Opinions regarding beverage preference ingestion and osteoporosis differ with cultural background as well as by eating habits, food customs and other lifestyle factors in addition to climate, differences in each country and area. Furthermore, it is conceivable that it differs with or depends on life stages of the individual. Currently, beverage preferences are enjoyed as part of the eating habits in, daily life considered an indispensable food to be enjoyed thoroughly. Therefore, it may be important to drink a beverage preferences in moderate but not to indulge in excessive ingestion in order to build a healthy lifestyle contributing to both a sound mind and a sound body at each individual life stage.

[Selection of the supplement in calcium intake].

Adequate calcium intake is one of the most important issues in the prevention and treatment of osteoporosis, which is considered a lifestyle-related disease. However, calcium is a nutrient that is rather difficult to take in appropriate amounts in traditional Japanese eating habits. Therefore, one of the effective means of preventing and treating osteoporosis is to supplement calcium intake, when an insufficient quantity is obtained in the three, daily meals. In addition to increasing the tolerable upper intake levels (UL) of calcium to 2,500 mg/day, and an instruction program for learning how to evaluate the nutritional state, and the right method of utilizing supplements is needed. Furthermore, learning how to balance other nutrients, such as mineral balance, should also be included.