The consumption of meat products is considered to be a feasible solution to prevent anemia, which is a critical health problem. The present study assessed hematological parameters and the prevalence of anemia in Japanese children and adolescents, and examined the association with the frequency of meat intake. Data from the Shunan Children Health Cohort Study were analyzed. The participants included male and female residents, 3373 children (aged 10-11 years), and 3085 adolescents (aged 13-14 years). The frequency of meat intake was determined with a questionnaire, and blood samples were analyzed. Anemia was defined according to the criteria of the World Health Organization. The prevalence of anemia in children was 3.6% and 2.5% in girls and boys, respectively, and in adolescents, it was 4.5% in girls and 0.8% in boys. The frequency of meat intake did not show a positive association with the hematological indices or the prevalence of anemia. These results suggest that the promotion of meat consumption is not an effective strategy to decrease anemia, and that other approaches are necessary to prevent anemia in this population.

OBJECTIVES: To investigate breakfast eating habits on daily energy and fish, vegetable, and fruit intake in Japanese adolescents. METHODS: This study was completed as part of the Shunan Child Health Cohort Study. Two types of questionnaires, one on lifestyle habits and the other a brief-type, self-administered questionnaire on diet history, were administered to second-year junior high school students (1,876 boys and 1,759 girls) in Shunan City, Yamaguchi, Japan. The different breakfast habits were compared using the general linear model and the estimated means and P value for trend were calculated, with energy-adjusted food intake as the dependent variable and body mass index, gender, age, residential areas, and living status as covariates. RESULTS: In both males and females, the proportion of those who ate breakfast irregularly was about 10%. The daily intake of fish, vegetables, and fruit was significantly higher in those who ate breakfast with their guardians than in those who ate breakfast alone (P for trend <0.01). The daily intake of fish, seafood, and vegetables was significantly higher in those who less frequently ate cooked foods for breakfast (P for trend <0.01). Those who ate rice more frequently than bread at breakfast had a higher daily intake of fish, seafood, and vegetables (P for trend <0.01). CONCLUSIONS: Eating breakfast with the family, reducing the intake of cooked foods at breakfast, and eating breakfast with rice as a main staple food are suggested to contribute to an improved quality of diet in adolescents.

Background:  The effects of fish consumption and n-3 poly-unsaturated fatty acids (PUFAs) levels on atopic disorders were inconsistent in previous reports, but few studies investigated the effects of both fish and n-3 PUFA. We investigated whether erythrocyte fatty acids and the consumption of fish are associated with atopic diseases and serum total IgE in pre- and early adolescents. Methods:  We selected 135 students with eczema, 136 students with asthma, and 137 healthy control students from fifth- and eighth-grades in Shunan, Japan. Atopic disorders and dietary intake were evaluated with questionnaires, and total serum immunoglobulin E (IgE) was measured using an enzyme-linked immunosorbent assay. In addition, erythrocyte membrane levels of PUFAs were assessed via gas chromatography. Results:  Total IgE was significantly elevated in the atopic subjects (P < 0.001). The intake of fatty and dried fish or seafood was significantly associated with eczema (odds ratios of the highest quartiles were 0.46 with 95% confidence intervals 0.22-0.94, and 0.34 with 0.16-0.71, respectively). Additionally, only erythrocyte eicosapentaenoic acid (EPA) levels had a negative association with eczema (P= 0.048). For asthma, the effect of fish consumption was not significant. Conclusions:  Fish consumption was related to a low prevalence of eczema, but not asthma in Japanese pre- and early adolescents. EPA may be involved in this mechanism.

Background:  Self-reported BMI values have been widely used in epidemiological studies. However, no study thus far has validated the self-reported body mass index (BMI) of Japanese children and adolescents. This study aims to assess the accuracy of self-reported BMI and its use for classification into weight categories. Methods:  Fifth- and eighth-grade students (n = 358) from all schools in Shunan City, Japan, from 2006 to 2010 were included. The BMI was calculated from both self-reported and measured values. Pearson's correlation, Kappa statistics and the number of overweight children, and Bland-Altman plots with 95% limits of agreement were calculated to assess the agreement. Results:  Pearson's correlation between self-reported and measured values ranged between 0.946 and 0.987 for height, 0.978 and 0.992 for weight, and 0.930 and 0.964 for BMI, depending on gender or age. The Kappa statistics was excellent: 0.949 for males, 0.867 for females, 0.897 for 10-11 year old children, 0.928 for 13-14 year old adolescents. The number of overweight children based on self-reported BMI was not significantly different from that based on measured BMI. The 95% limits of agreement were -3.62 and 2.90 cm for height,-2.80 and 2.38 kg for weight,-1.42 and 1.44 kg/m2 for BMI. Conclusions:  Self-reported BMI was generally reliable for predicting the number of overweight Japanese children and adolescents. However, there is slight discrepancy in self-reported BMI and measured BMI, and self-reported BMI should be used with caution keeping the variance and concordance rate in mind.

Objectives: This study evaluated a simple workplace intervention that used visual messages to create awareness of two highly specific recommendations for good health. Methods: Four worksites were recruited in Iwakuni, Japan. The 4-month intervention used three promotional media-A2-size posters, A4-size flyers and displays on the company intranet. The visual messages were designed with silhouettes, pictograms and slogans. Knowledge acquisition concerning the two recommendations (daily vegetable intake of 350 g and 23 exercises weekly) was evaluated using questionnaires. In addition, recall of media and attitudes toward health behavior were assessed. Results: Of the 2,322 workers, 827 responded to both the pre- and postintervention surveys. Correct responses at the four worksites increased from initial levels of 36-48% to 38-73% for the vegetable intake questions and from 7-14% to 7-59% for the physical activity questions. Media recall results were 35-73% for posters, 20-43% for flyers and 19% for intranet. The workers who recalled the posters and flyers had more correct answers on knowledge questions than those who did not recall the posters or flyers (p<0.01). In multivariate analyses, seeing the visual messages was associated with a positive change in response to physical activity questions (odds ratio=1.49-2.03), and the number of media recalled was also significant (odds ratio=1.16-1.17). Conclusions: Interventions with a combination of media and simple visual messages should be considered for health promotion among general populations at worksites.

BACKGROUND Self-administered questionnaires about physical activity are useful for collecting data to develop public health policies. There is currently no validated physical activity questionnaire, however, for Japanese children and adolescents. The purpose of the present study was to evaluate the validity and reliability of self-administered, physical activity questionnaires for Japanese students. METHODS Fifth- and eighth-grade students were asked to complete two questionnaires that estimated the intensity and time of moderate-to-vigorous physical activities in which they participated, and the frequency and duration spent performing sports activities. Students also wore triaxial accelerometers to compare their actual activity levels to their estimates, to investigate the validity and reliability of the questionnaires. RESULTS The intensity and time spent performing moderate-to-vigorous physical activity that were estimated from the questionnaire were higher than those measured by accelerometry (9-161% of accelerometry). Questionnaire data were highly correlated with accelerometer data for eighth graders (Spearman correlation, 0.642-0.754), but the correlations were lower for fifth graders (≤ 0.331). Furthermore, there was higher repeatability in the data collected from eighth graders (intraclass correlation, 0.625-0.645) than from fifth graders (0.136-0.194). CONCLUSIONS Questionnaires may be useful in epidemiological studies for ranking physical activity levels of adolescents, such as a confounding factor for other lifestyle surveys, but these surveys are less accurate for younger children.

Aberrant transcriptional regulation may be one of the key components of the pathophysiology of mood disorders. DNA methylation generally acts as an epigenetic gene silencing mechanism and is catalyzed by a group of enzymes known as DNA methyltransferases (DNMTs). Several lines of evidence have suggested aberrant DNA methylation in patients with neuropsychiatric disorders and in animal models for psychiatric disorders. However, the involvement of DNMTs in the pathophysiology of mood disorders is not completely understood. In this study, we aimed to determine whether there are alterations in the expression of DNMTs mRNA in mood disorder patients. We used quantitative real-time PCR to measure the mRNA expression of four DNMT isoforms in the peripheral white blood cells of major depressive disorder (MDD) and bipolar disorder (BPD) patients during a depressive and a remissive episode. We found that the levels of DNMT1 mRNA were significantly decreased in a depressive but not in a remissive state of MDD and BPD. In addition, the levels of DNMT3B mRNA in MDD were significantly increased in a depressive but not in a remissive state. Thus, our data suggest that the altered expression of DNMTs is state dependent and that the aberrant epigenetic gene regulations caused by the altered expression of DNMT1 and DNMT3B may be associated with the pathophysiology of mood disorders.

BACKGROUND The association between the fat mass- and obesity-associated (FTO) gene and a predisposition to obesity is inconsistent in adult Asian populations. We investigated the association of the FTO gene with weight status in Japanese children and adolescents. DESIGN/SETTING Nested case-control study and 3-yr longitudinal study - In the Shunan Child Cohort Study, fifth and eighth grade students attending all schools of Shunan completed the questionnaires. Overweight, including obesity, was defined as a percentage of overweight of 20% or in accordance with the International Obesity Task Force. We recruited 133 obese subjects and randomly selected controls from the 2006 cohort. We genotyped three FTO single nucleotide polymorphisms (SNPs): rs3751812, rs9939609, and rs1558902. RESULTS The three genotyped SNPs were in tight linkage disequilibrium, with the exception of one case. The minor SNP allele of rs3751812 conferred a predisposition to obesity, and its odds ratio was 2.2 [95% confidence interval (CI), 1.5-3.4] in the additive model and 2.7 (95% CI, 1.6-4.4) in the dominant model (p < 0.001). Although blood parameters and some lifestyle behaviors were significantly different between the cases and controls (p < 0.01), these traits were not significantly different among the genotypes. In addition, we did not find an association between the genotypes and body mass index change during the 3 yr. CONCLUSION The FTO gene is associated with the early onset of overweight in the Japanese population as well as in European populations. The results suggest that obesity-related risk factors in fifth and eighth graders appear because of their overweight status.

Sirtuins are a family of NAD+-dependent enzymes that regulate cellular functions through deacetylation of various proteins. Although recent reports have suggested an important role of deacetylases (i.e., histone deacetylases) in mood disorders and antidepressant action, the involvement of sirtuins in the pathophysiology of mood disorders is largely unknown. In this study, we aimed to determine whether there are alterations in sirtuin mRNA expression in peripheral white blood cells of patients with a mood disorder. Also, to examine whether the altered sirtuin mRNA expression is state- or trait-dependent, mood disorder patients who were in a remissive state were assessed. We used quantitative real-time polymerase chain reaction to measure the mRNA levels of seven sirtuin isoforms (SIRT1-7) in peripheral white blood cells of patients with major depressive disorder (MDD) or bipolar disorder (BPD) during depressive and remissive states and in normal healthy subjects. The SIRT1, 2 and 6 mRNA levels in MDD and BPD patients decreased significantly in those who were in a depressive state compared to healthy controls, whereas the expression of those mRNAs in both MDD and BPD of patients in a remissive state were comparable to those in healthy controls. Thus, our data suggest that altered SIRT1, 2 and 6 expression is state-dependent and might be associated with the pathogenesis and/or pathophysiology of mood disorders.

OBJECTIVES Iron plays a pivotal role in adult steatosis, but its role in child and adolescent steatosis is unclear. We investigated the effect of dietary iron, serum iron, and ferritin on serum transaminases and γ-glutamyltransferase in 10- and 13-year-olds. PATIENTS AND METHODS The study included 4894 fifth and eighth graders enrolled between 2006 and 2009 in all schools in Shunan City, Japan. Multiple regression analyses were performed with adjustments for grade, sex, z score of the body mass index, serum lipids, plasma glucose, frequency of sports activities, having a single parent, number of siblings, tobacco smoking behavior, passive smoking at home, resident areas, and schools, using linear mixed models. In addition, we analyzed ferritin and insulin resistance in randomly selected subset of participants. RESULTS Dietary iron intake was positively associated with serum alanine aminotransferase levels (standardized coefficient β = 2.35, P = 0.019). Serum iron concentrations were associated with transaminase and γ-glutamyltransferase levels (β = 3.22, and 4.05, respectively, P < 0.01). In the subset of 421 subjects with further serum analysis, serum ferritin levels were significantly associated with serum enzyme levels (β = 2.43-3.35; P < 0.05) and showed significant odds ratio for the elevated alanine aminotransferase levels (1.05 for 1 SD with 95% confidence intervals 1.02-1.08). However, iron load did not show a positive association with insulin resistance. CONCLUSIONS Although an effect size for iron is small in regression analyses, iron is implicated in increased transaminase levels in prepubertal and pubertal children.