ABSTRACT: BACKGROUND: Maternal nutrition status during pregnancy may affect fetal tooth development, formation, and mineralization, and may affect dental caries susceptibility in children. We investigated the association between maternal intake of dairy products and calcium during pregnancy and the risk of childhood dental caries. METHODS: Subjects were 315 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed through a diet history questionnaire. Outcome data was collected at 41-50 months of age. Children were classified as having dental caries if one or more primary teeth had decayed or been filled. RESULTS: Higher maternal cheese intake during pregnancy was significantly inversely associated with the risk of dental caries in children, showing a clear inverse dose-response relationship; the adjusted odds ratio in comparison of the highest tertile with the lowest was 0.37 (95% confidence interval [CI]: 0.17-0.76, P for trend = 0.01). The inverse associations between maternal intake of total dairy products, yogurt, and calcium during pregnancy and the risk of childhood dental caries were of borderline significance: the adjusted ORs for the highest tertile of total dairy products, yogurt, and calcium were 0.51 (95% CI: 0.23-1.09, P for trend = 0.07), 0.51 (95% CI: 0.23-1.10, P for trend = 0.07), and 0.50 (95% CI: 0.23-1.07, P for trend = 0.08), respectively. There was no evident relationship between maternal milk intake and the risk of childhood dental caries. CONCLUSION: These data suggested that high intake of maternal cheese during pregnancy may reduce the risk of childhood dental caries.

Background:  There is no consensus on the most appropriate treatment for patients with large to giant congenital melanocytic naevi (CMN) because of the risk of melanoma development. Surgical excision followed by skin grafting or expanded skin coverage may cause unfavorable scarring. There is a balance to be achieved between minimising the disfiguring appearance and the risk of malignant change. Objectives:  Here, we focused on the pulsed dye laser (PDL), which is commonly used for vascular lesions and which is highly absorbed by melanin and haemoglobin. Its pulse duration is longer than that of Q-switched lasers, which can have non-specific photothermolytic effects on surrounding non-pigmented naevus cells. We treated large to giant CMN with a combination of a PDL and a Q-switched ruby laser (QsRL). Patients and Methods:  Six patients with large to giant CMN were enrolled in this study. Treatment consisted of one pass of PDL treatment followed by one pass of QsRL treatment. Multiple rounds of treatment were applied to all patients. Results:  All patients responded to this combined regimen, and the lesional colour was effectively reduced. The mean number of rounds of laser treatment required to achieve skin lightening was 7.7. No patients suffered severe hypertrophic scarring. No cases of recurrence or malignant transformation were observed. The histological results from the patient who underwent the most laser therapy in this study showed a remarkable reduction in the number of melanocytic naevus cells after treatment. Conclusions:  This technique may enable the removal of most of the pigmented lesion and melanocytic naevus cells with minimal scarring.

The renal prognosis of patients with Wilms' tumor, aniridia, genitourinary anomalies, and mental retardation syndrome (WAGR) is poor. However, the renal histology and its mechanisms are not well understood. We performed renal biopsies in 3 patients with WAGR syndrome who had heavy proteinuria. The complete deletion of one WT1 allele was detected in each patient by constitutional chromosomal deletion at 11p13 using G-banding, high-resolution G-banding, and fluorescence in situ hybridization. The patients exhibited proteinuria at the ages of 6, 10, and 6 years and were diagnosed as having focal segmental glomerulosclerosis (FSGS) at the ages of 7, 16 and 19 years, respectively. They exhibited normal or mildly declined renal function at the time of biopsy. Re-examination of a nephrectomized kidney from 1 patient revealed that some glomeruli showed segmental sclerosis, although he did not have proteinuria at the time of nephrectomy. The other 2 patients did not develop Wilms' tumor and thus did not undergo nephrectomy, chemotherapy, or radiotherapy, thereby eliminating any effect of these therapies on the renal histology. In conclusion, complete deletion of one WT1 allele may induce the development of FSGS. Our findings suggest that haploinsufficiency of the WT1 could be responsible for the development of FSGS.

BACKGROUND: Cause-and-effect associations between sevelamer hydrochloride (HCl) and mortality have yet to be clarified. The effects of sevelamer HCl on mortality, lipid abnormality and arterial stiffness were examined in patients with chronic kidney disease stage 5D. METHODS: The effects of sevelamer HCl were studied by a single-center cohort study that was conducted from January 1, 2005 to December 31, 2008 (n = 483). By the end of the study, 172 patients (Sevelamer group) had succeeded in continuing sevelamer HCl for >6 months (median 37 months), and 300 patients (Control group) had received calcium carbonate (n = 264) or no phosphate binder (n = 36). The mortality and other outcomes were compared between these two groups after matching by a propensity score calculated using age, gender, diabetes prevalence, and dialysis vintage. RESULTS: All-cause [hazard ratio (HR) 0.4, P = 0.02] and cardiovascular (CV)-cause [HR 0.29, P = 0.03] cumulative mortality were significantly lower in the matched Sevelamer group than in the matched Control group. The matched Sevelamer group showed increased high-density lipoprotein cholesterol (P = 0.003) and no change in pulse wave velocity (PWV) and ankle-brachial index (ABI), whereas the matched Control group showed increased serum low-density lipoprotein (LDL) cholesterol (P = 0.003), increased PWV (P = 0.03), and decreased ABI (P = 0.0009). Change in serum LDL cholesterol level correlated inversely with sevelamer HCl dosage (P = 0.02). CONCLUSIONS: Reduced mortality in patients with sevelamer HCl may, at least in part, be explained by an improvement in dyslipidemia and arterial stiffness by sevelamer HCl.

OBJECTIVE: This cohort study investigated the association between eating speed and the incidence of type 2 diabetes in middle-aged Japanese men. MATERIALS/METHODS: Participants were 2,050 male employees of a metal products factory in Japan. We measured self-reported categorical eating speed. The incidence of diabetes was determined in annual medical examinations over a 7-year period. The association between eating speed and the incidence of diabetes adjusted for multiple variables (age, family history of diabetes, smoking, alcohol drinking, habitual exercise, and presence of hypertension and hyperlipidemia) was evaluated using Cox proportional hazards models. RESULTS: The prevalence of obesity (BMI≥25kg/m(2)) across the categories of eating speed (slow, medium, and fast) was 14.6, 23.3, and 34.8%, respectively, and a faster eating speed was associated with a higher prevalence of obesity. During the study, 177 participants developed diabetes. Crude incidence rates (/1,000 person-years) across the three categories of eating speed were 9.9, 15.6, and 17.3, respectively. Multivariate-adjusted hazard ratios (95% CI) across the categories were 1.00 (reference), 1.68 (0.93-3.02), and 1.97 (1.10-3.55), respectively, and eating speed was associated with the risk of diabetes (p for trend=0.030). After further adjustment for BMI, a significant association was not observed. CONCLUSIONS: Eating speed was associated with the incidence of diabetes. Since these associations were not significant after adjusting for BMI, eating speed may act via its effect on body weight. Eating speed is a controllable risk factor, and eating slowly could be an acceptable lifestyle intervention for the prevention of diabetes mellitus.

Purpose. To examine behavioral factors related to successful weight maintenance. Methods. Subjects were 90 middle-aged participants who attended a weight loss program and were followed for one year. The subjects were classified into either successful weight maintainers (maintained a weight loss of 5% or more from their initial weight for one year)(SWM) or unsuccessful weight maintainers (USWM), and weight control practice, stress, obstacles, support, and self-efficacy during the program and follow-up period were compared. Results. SWM had mean loss of 12% from their initial weight during the program. They showed a greater improvement in their regularity of eating, walked more, and felt less stress regarding their increased physical activity than the USWM. During the follow-up period, significantly more SWM participants had self-efficacy (for measuring weight, practicing dietary objective, and assessing the practice and keeping records), actually kept records and measured weight more than the USWM participants. In contrast, more USWM participants felt stress about measuring weight. Conclusion. In addition to a substantial initial weight loss due to an increased amount of physical activity, having a higher self-efficacy and consistently keeping records of one's activities, as well as regularly weighing themselves, may be important for successful weight maintenance.

SETTING: Epidemiological evidence on the relationship between socio-economic status and allergic disorders has been inconsistent.OBJECTIVES: We examined the associations between maternal employment, maternal job type, household income, and paternal and maternal educational levels and the risk of allergic disorders in Japanese children aged 4.5 years.DESIGN: Subjects were 480 mother-child pairs. Definitions of wheeze and eczema symptoms were based on criteria of the International Study of Asthma and Allergies in Childhood. Data on self-reported doctor-diagnosed asthma and atopic eczema were available.RESULTS: Compared with children whose mothers had received less than 13 years of education, those with mothers with ≥15 years of education had a significantly increased risk of wheeze and doctor-diagnosed asthma: the adjusted ORs were respectively 2.41 (95%CI 1.18-5.17) and 2.70 (95%CI 1.03-8.08). Fifteen years or more of paternal education was independently associated with an increased risk of eczema, but not of doctor-diagnosed atopic eczema (adjusted OR 1.89, 95%CI 1.07-3.42). Mother's employment, mother's job type and household income were not related to any of the outcomes.CONCLUSIONS: Higher maternal educational level may increase the risk of wheeze and asthma, while higher paternal educational level may increase the risk of eczema.

Dietary habits established in early childhood contribute to lifelong dietary pattern and the development of early risk factors for disease in adulthood. Although a large body of epidemiologic data from Western countries show that the dietary pattern of children is influenced by maternal socio-economic and lifestyle characteristics, information on this topic in non-Western countries is absolutely lacking. The present study identified dietary patterns among infants aged 16-24 months, and then examined the influence of maternal socio-economic and lifestyle characteristics on identified dietary patterns. Subjects were 758 Japanese mother-child pairs. Dietary data of infants were collected from the mothers using a questionnaire. Dietary patterns were extracted from the consumption of 15 foods (times week(-1)) by cluster analysis. The following two dietary patterns were identified:'fruits, vegetables and high-protein foods'(n = 483) and 'confectionaries and sweetened beverages'(n = 275) patterns. After adjustment for all other predictors, maternal educational level, number of infants' siblings and maternal dietary patterns were independently associated with dietary patterns of infants. Infants whose mothers had a higher educational level and the 'rice, fish and vegetables' dietary pattern were less likely to belong to the 'confectionaries and sweetened beverages' pattern, whereas infants whose mothers had a higher number of children and the 'wheat product' dietary pattern were more likely to belong to the 'confectionaries and sweetened beverages' than the 'fruits, vegetables and high-protein foods' pattern. In conclusion, the mother's socio-economic position and dietary patterns were associated with the dietary patterns of infants in the Japanese pairs as observed in the Western populations.

ABSTRACT: BACKGROUND: Dietary fat exerts numerous complex effects on proinflammatory and immunologic pathways. Several epidemiological studies have examined the relationships between intake of fatty acids and/or foods high in fat and allergic rhinitis, but have provided conflicting findings. The current cross-sectional study investigated such relationships in Japan. METHODS: Study subjects were 1745 pregnant women. The definition of rhinoconjunctivitis was based on criteria from the International Study of Asthma and Allergies in Childhood. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Adjustment was made for age; gestation; region of residence; number of older siblings; number of children; smoking; secondhand smoke exposure at home and at work; family history of asthma, atopic eczema, and allergic rhinitis; household income; education; and body mass index. RESULTS: The prevalence of rhinoconjunctivitis in the past 12 months was 25.9%. Higher meat intake was significantly associated with an increased prevalence of rhinoconjunctivitis: the adjusted odds ratio between extreme quartiles was 1.71 (95% confidence interval: 1.25-2.35, P for trend = 0.002). No measurable association was found between fish intake and rhinoconjunctivitis. Intake of total fat, saturated fatty acids, monounsaturated fatty acids, n-3 polyunsaturated fatty acids, alpha-linolenic acid, eicosapentaenoic acid, docosahexaenoic acid, n-6 polyunsaturated fatty acids, linoleic acid, arachidonic acid, and cholesterol and the ratio of n-3 to n-6 polyunsaturated fatty acid intake were not evidently related to the prevalence of rhinoconjunctivitis. CONCLUSIONS: The current results suggest that meat intake may be positively associated with the prevalence of rhinoconjunctivitis in young adult Japanese women.

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.