Teiji Nakamura

Anti‐hypoalbuminemic effect of branched‐chain amino acid granules in patients with liver cirrhosis is independent of dietary energy and protein intake

Aim:  A multicenter prospective intervention study was conducted in 204 patients with uncompensated liver cirrhosis to explore the influence of dietary intake and patient clinical characteristics on improvement of hypoalbuminemia at weeks 12 and 24 of treatment with branched‐chain amino acid (BCAA) granules.

Norlichexanthone Isolated from Fungus P16 Promotes the Secretion and Expression of Adiponectin in Cultured ST-13 Adipocytes

Adiponectin, an adipose-derived protein, shows insulin-sensitizing, anti-diabetic and anti-atherogenic activities, which implies that the protein represents a potential target to improve lifestyle-related diseases like type 2 diabetes. Based on our hypothesis that agents that cause adipocyte differentiation could also act as adiponectin secretion enhancers, we screened butanol extracts of 96 fungus culture extracts for their differentiation-inducing activity in ST-13 preadipocytes. We found that the butanol extract of a fungus P16 culture extract possessed such an activity, and isolated norlichexanthone as an active compound through activity-guided fractionation. Oil red O staining showed that norlichexanthone induced adipogenesis in ST-13 cells. Its differentiation-inducing activity was supported by the observation that norlichexanthone dose-dependently increased the mRNA expression of fatty acid-binding protein and peroxisome proliferator activated receptor γ (PPARγ), markers of adipocyte differentiation. Western blot analysis demonstrated that the compound enhanced the secretion of adiponectin protein in a dose-dependent manner. An increase in mRNA expression of adiponectin was also observed in the norlichexanthone-treated ST-13 cells. Actinomycin D treatment blocked the enhancement of adiponectin mRNA expression by norlichexanthone, suggesting that it is the result of increased transcription. A luciferase reporter assay indicated that norlichexanthone was unlikely to be an agonist of PPARγ, implying that its action of mechanism might differ from those of thiazolidinediones which upregulate adiponectin expression via activation of PPARγ. These findings suggest the possibility that norlichexanthone has the potential to treat and/or prevent lifestyle-related diseases, including metabolic syndrome, type 2 diabetes, atherosclerosis and cardiovascular diseases.

Evaluation of Postprandial Glucose Excursion Using a Novel Minimally Invasive Glucose Area-Under-the-Curve Monitoring System

OBJECTIVE To develop a minimally invasive interstitial fluid extraction technology (MIET) to monitor postprandial glucose area under the curve (AUC) without blood sampling, we evaluated the accuracy of glucose AUC measured by MIET and compared with that by blood sampling after food intake. METHODS Interstitial fluid glucose AUC (IG-AUC) following consumption of 6 different types of foods was measured by MIET. MIET consisted of stamping microneedle arrays, placing hydrogel patches on the areas, and calculating IG-AUC based on glucose levels in the hydrogels. Glycemic index (GI) was determined using IG-AUC and reference AUC measured by blood sampling. RESULTS IG-AUC strongly correlated with reference AUC (R = 0.91), and GI determined using IG-AUC showed good correlation with that determined by reference AUC (R = 0.88). CONCLUSIONS IG-AUC obtained by MIET can accurately predict the postprandial glucose excursion without blood sampling. In addition, feasibility of GI measurement by MIET was confirmed.

The effect of fast eating on the thermic effect of food in young Japanese women

Abstract The relationship between eating speed and the thermic effect of food (TEF) remains unclear. We investigated the difference in the TEF when meals containing the same amount of energy were eaten in 5 min (fast eating) or 15 min (regular eating). Subjects were nine non-obese young women. Following a 350 kcal (1464 kJ) meal, energy expenditure and autonomic nervous system activity were measured. The frequency of mastication was also calculated. The TEF for the 15-min period after the start of eating with fast eating was significantly lower than with regular eating (p < 0.01). There was a significant positive correlation between the low-frequency/high-frequency ratio and TEF at 5-min intervals up to 20 min after the start of eating and between total mastication frequency and TEF during ingestion. Fast eating may reduce the TEF, potentially because a decrease in mastication frequency decreases sympathetic nervous system activity.

A System for Nutritional Consulting Using Quick Questionnaires on Diet and Unidentified Complaints

The aging of society and ongoing health care cost-control policy set the trend for the self-medication which leads to the growing interest in health promotion and prolongation of healthy life expectancy through self-health management. We developed a self-medication support system to provide comprehensive support to consumers at pharmacies and drug stores. This system facilitates the effective use of information and knowledge based on medicine and health. This self-medication support system comprised a set of two terminals connected network server in the data center: a user terminal for consumers use and an advisor terminals for specialized advisor, pharmacists, registered dieticians, and etc. This system enables specialized sales people to provide the appropriate advice based on the factors of consumer’s problem, and to make suggestions for improving his/her lifestyle: eating habit, doing exercise, and having relaxation time. As a result of the trial use of this system at pharmacy stores, a certain degree of correlation between the results of a questionnaire on unidentified complaints and dietary patterns causing potential micronutrient deficiency was demonstrated.

Present conditions and the future role of hospital dietitians in Japan

The primary role of dietitians in Japan has been as leaders in solving the food shortages caused by World War II. After 1970, dietitians were educated to promote health education and teach chronic disease prevention to the public. They have undertaken the responsibility to improve nutritional status of the community. Approximately 80% of dietitians in Japan are graduates of twoyear colleges. They work in food services and their job activities consist mainly of food-related activities and nutrition guidance to patients. They are not in charge of patients’ nutrition assessment or any other clinical dietetic practice. Recently, a number of attempts have been made to educate those who need to learn more about the clinical aspects of nutrition and to foster the development of clinical dietitians in Japan. Unfortunately, many problems remain to be solved in order to dramatically reform the education and practice of dietitians in this country.

Perioperative nutrition management as an important component of surgical capacity in low- and middle-income countries

Needs for surgical care are growing in low‐ and middle‐income countries. Existing surgical care capacity indicators, focusing on the availability of equipment, personnel, and operation and anaesthetic skills, are not intended to evaluate perioperative nutrition management, which influences surgical outcomes. In this narrative review, we describe the prevalence of malnutrition and its clinical consequences among surgical patients in low‐ and middle‐income countries, suggest potential measures to improve nutrition management and discuss the necessity of considering nutrition management as a component of surgical care capacity.