Web-Based Personalized Nutrition System for Delivering Dietary Feedback Based on Behavior Change Techniques: Development and Pilot Study among Dietitians

Given the complex and varied nature of individual characteristics influencing dietary behaviors, personalized dietary advice may be more effective than generalized “one-size-fits-all” advice. In this paper, we describe a web-based personalized nutrition system for improving the quality of overall diet in the general adult population. The development process included identification of appropriate behavior change techniques, modification of dietary assessment method (Meal-based Diet History Questionnaire; MDHQ), selection of dietary components, and a personalized dietary feedback tool. A pilot study was conducted online among 255 dietitians. Each completed the MDHQ, received his/her own dietary feedback report, and evaluated the relevance of the report based on 12 questions using a 5-point Likert scale from “totally disagree” (score 1) to “totally agree” (score 5). The mean value of overall acceptability score of dietary feedback report was 4.2. The acceptability score was, on average, higher in plausible energy reporters (compared with implausible energy reporters), participants who printed out the report (compared with those who did not), and those spending ≥20 min to read the report (compared with those spending <20 min). This is the first attempt to develop a web-based personalized nutrition system in Japan, where dietitians were broadly supportive of the dietary feedback report

Consumption of highly processed foods in relation to overall diet quality among Japanese adults: a nationwide study

Abstract Objective: To (i) examine the consumption of highly processed foods (HPFs) in relation to diet quality among Japanese adults and (ii) compare the results when dishes prepared away home are disaggregated into food ingredients before classification by processing levels and the results when they are not. Design: Cross-sectional analysis using 4-day dietary record data. Foods were categorised by level of processing using the framework developed by the University of North Carolina at Chapel Hill. Specifically, dishes prepared away from home were classified at both the food level (classified after disaggregation into ingredients) and dish level (classified without disaggregation). Diet quality was assessed using the Healthy Eating Index-2015 and Nutrient-Rich Food Index 9.3. Setting: Twenty areas in Japan. Participants: Adults aged 20–69 years (n 388). Results: Energy contribution of HPFs was higher when dishes prepared away from home were classified at dish level than food level (48.3% vs. 32.9%, P<0.0001). Regardless of the classification method, cereals and starchy foods were the top food groups contributing to total energy intake from HPFs. After adjusting for potential confounders, participants in higher tertiles of the energy contribution of HPFs had lower total scores for Healthy Eating Index-2015 and Nutrient-Rich Food Index 9.3 (P for trend ≤0.007 for all), irrespective of the food- or dish-level classification. Conclusions: HPFs account for at least one-third of energy intake of Japanese adults. Regardless of the classification methods for dishes prepared away from home, higher consumption of HPFs was associated with lower diet quality

The Relationship of Eating Rate and Degree of Chewing to Body Weight Status among Preschool Children in Japan: A Nationwide Cross-Sectional Study

There is growing recognition that eating slowly is associated with a lower risk of obesity, and chewing well might be an effective way to reduce the eating rate. However, little is known about these relationships among children. We therefore investigated the associations of eating rate and chewing degree with weight status among 4451 Japanese children aged 5&ndash;6 years. Information on eating rate (slow, medium, or fast), degree of chewing (not well, medium, or well), and nutrient intake of children were collected from guardians using a diet history questionnaire. Weight status was defined using the International Obesity Task Force cut-offs based on BMI calculated from guardian-reported height and weight. The prevalence of overweight and thinness was 10.4% and 14.3%, respectively. A higher eating rate and a lower degree of chewing were associated with being overweight (both p &lt; 0.001). Eating slowly was associated with being thin (p &lt; 0.001), but no association was observed between chewing degree and thinness. These associations were still evident after controlling for potential confounders including parental educational attainment, weight status, and the child&rsquo;s nutrient intake. In conclusion, this cross-sectional study suggested that chewing well, rather than eating slowly, might be a more effective way for healthy weight management among Japanese preschool children

Development of a Digital Photographic Food Atlas as a Portion Size Estimation Aid in Japan

This study aimed to develop a digital photographic food atlas as a portion size estimation aid. Commonly consumed foods were identified from the 5512-day weighed dietary records of 644 Japanese adults. Portion sizes were determined based on the market research and distribution of food consumption in the dietary records. Each food item was classified into one of two photo types: a series of photographs showing gradually increasing portion sizes or guide photographs representing a range of portion sizes and food varieties in one photograph. Photographs of the food were taken at an angle of 42&deg;, along with appropriate reference objects such as chopsticks. In total, 209 food and dish items were included in the food atlas. Series of photographs were taken for 105 items that are not usually served in predetermined amounts (e.g., rice and pasta), whereas guide photographs were taken for 104 items usually served in predetermined amounts (e.g., bananas and cookies). Moreover, photographs were taken for 12 kinds of household measurement items, such as cups and glasses. The food atlas could be a valuable tool for estimating the portion size in dietary surveys. Evaluating the validity of this food atlas for portion size estimation is warranted

Relative Validity of the Meal-Based Diet History Questionnaire for Estimating Nutrient Intake among Japanese Women and Men aged 30&ndash;76 Years

The purpose of this study was to examine the relative validity of the Meal-based Diet History Questionnaire (MDHQ) for estimating nutrient intake. Dietary data were obtained from 111 Japanese women and 111 Japanese men, using the online MDHQ and the 4-non-consecutive-day weighed dietary record (DR). The number of nutrients (total n = 46) showing no significant mean differences between estimates from the online MDHQ and DR (with energy adjustment by the density model) was 17 among women and 12 among men. The median value (25th and 75th percentiles) of the Pearson correlation coefficients between the online MDHQ and DR estimates was 0.54 (0.35&ndash;0.57) among women and 0.45 (0.25&ndash;0.53) among men. Bland&ndash;Altman plots for energy-providing nutrients indicated wide limits of agreement (and proportional bias for protein) with overall underestimation of protein and fat and overestimation of carbohydrate by the online MDHQ. Similar results were found when the paper version of the MDHQ (completed after the DR) was examined. For example, the median value of the Pearson correlation coefficients was 0.54 for women and 0.45 for men. This study suggests that the MDHQ has an acceptable ability to rank individuals according to intakes of a wide range of nutrients

Identification of Dish-Based Dietary Patterns for Breakfast, Lunch, and Dinner and Their Diet Quality in Japanese Adults

We identified dish-based dietary patterns for breakfast, lunch, and dinner and assessed the diet quality of each pattern. Dietary data were obtained from 392 Japanese adults aged 20&ndash;69 years in 2013, using a 4 d dietary record. K-means cluster analysis was conducted based on the amount of each dish group, separately for breakfasts (n = 1462), lunches (n = 1504), and dinners (n = 1500). The diet quality of each dietary pattern was assessed using the Healthy Eating Index 2015 (HEI-2015) and Nutrient-Rich Food Index 9.3 (NRF9.3). The extracted dietary patterns were as follows: &lsquo;bread-based&rsquo; and &lsquo;rice-based&rsquo; for breakfast; &lsquo;bread&rsquo;, &lsquo;rice-based&rsquo;, &lsquo;ramen&rsquo;, &lsquo;udon/soba&rsquo;, and &lsquo;sushi/rice bowl dishes&rsquo; for lunch; and &lsquo;miscellaneous&rsquo;, &lsquo;meat dish and beer&rsquo;, and &lsquo;hot pot dishes&rsquo; for dinner. For breakfast, the HEI-2015 and NRF9.3 total scores were higher in the &lsquo;rice-based&rsquo; pattern than the &lsquo;bread-based&rsquo; pattern. For lunch, the HEI-2015 and NRF9.3 total scores were relatively high in the &lsquo;rice-based&rsquo; pattern and low in the &lsquo;ramen&rsquo; pattern. For dinner, the HEI-2015 total score was the highest in the &lsquo;meat dish and beer&rsquo; pattern, and the NRF9.3 total score was higher in the &lsquo;hot pot dishes&rsquo; than the &lsquo;miscellaneous&rsquo; pattern. These results suggested that breakfast, lunch, and dinner have distinctive dietary patterns with different diet qualities