Objective: To assess the validity and reproducibility of a self-administered FFQ with eighty-two food items (FFQW82) for assessing the habitual diet in female adolescents. Design: The validity of the FFQW82 for assessment of nutrient intake was evaluated by comparison with a 7 d weighed food record (7d-FRRI) reported as 'gold standard'. Reproducibility of the FFQW82 was assessed at an interval of 1 month (test-retest method). The first survey (FFQW82 and 7d-FRRI) was conducted in April 2007 and the second FFQW82 survey was conducted in May 2007. Daily consumption of energy from eleven food groups and nine nutrients were calculated from both instruments for breakfast, lunch, dinner and the whole day. Crude and energyadjusted Pearson correlation coefficients were calculated using log-transformed data. Setting: Middle school, Tokyo, Japan. Subjects: Female adolescents aged 12-13 years. Results: Sixty-three female adolescents completed both surveys. The relative difference between the energy intake calculated by the FFQW82 and the 7d-FRRI for the whole day, breakfast, lunch and dinner was 8 %, 10 %, 15 % and 10 %, respectively. As for validity, the correlation coefficient of total energy intake for the whole day was 0?31. The result for breakfast was relatively higher (0?59) compared with that for lunch (0?40) and dinner (0?32). For macronutrients, the energy-adjusted correlation coefficient ranged from 0?28 (carbohydrates) to 0?53 (protein). Reproducibility of total energy intake was 0?62 and ranged from 0?46 (fat) to 0?69 (carbohydrate) for macronutrients. Conclusions: These results suggest that the FFQW82 has proved to have some potential with regard to reproducibility among our study population. Keywords FFQ Validity Reproducibility Female adolescents Nutrition assessmentIn recent years, youth obesity (1,2) and lifestyle-related diseases (3)(4)(5) have increased significantly, as have problems related to a distorted body image (6) . The accurate assessment of nutritional intake is important in epidemiological studies. Although under-reporting of energy intake in young people has been shown (7) , the FFQ is feasible for this purpose (8) , considering the circumstances of young people that prohibit them from weighing foods, such as school attendance, as well as their ability to meticulously record food intake.Thus far, various FFQ have been assessed to determine their validity for use in young people in Western countries (9)(10)(11)(12)(13)(14)(15)(16) . To our knowledge, however, no study has determined the effectiveness of an FFQ in acquiring information on the diets of young people in Japan. Previously, we developed an FFQ with sixty-five food items (FFQW65) to be used in nutritional education for the prevention of diabetes (17) . This instrument assessed energy intake separately for breakfast, lunch and dinner in addition to intake for the entire day and was useful for nutritional education in adults. We reported on the assessment of the effect of nutritional education in a randomized controlled trial ...
TOSHIRO TANGO, PHD 2OBJECTIVE -The aim of this study was to assess the effectiveness of a new dietary education (NDE) program in reducing plasma glucose (PG) levels in Japanese male workers at high risk for type 2 diabetes through a randomized controlled trial.RESEARCH DESIGN AND METHODS -We randomly assigned 173 high-risk men (mean age, 55 years) to either the NDE or the control (conventional dietary education) group. Each subject in the NDE group received two individualized interventions especially aimed at reducing total energy intake at dinner by modifying dietary intake. The control group received conventional group counseling. An "overintake/underintake fraction" for total energy intake was used to measure the status of dietary intake. Our hypothesis was that the NDE group would have a 10% decrease in 2-h PG 1 year after the start of the education. Outcome measures were compared with ANCOVA by adjusting for baseline values.RESULTS -The NDE group had a significantly lower total energy intake at dinner and daily than the control group. The adjusted differences in changes from baseline in the absolute value of the "overintake/underintake fraction" were Ϫ15.3% (95% CI Ϫ24.6 to Ϫ6.0%, P ϭ 0.002) for the NDE group and Ϫ6.0% (Ϫ9.8 to Ϫ2.2%, P ϭ 0.002) for the control group. The NDE group had a decreased 2-h PG after 1 year, whereas that value was increased in the control group. The adjusted difference in the percent change of 2-h PG was significant (Ϫ15.2%, Ϫ22.0 to Ϫ8.4%, P Ͻ 0.001).CONCLUSIONS -The NDE was shown to reduce glucose levels in high-risk subjects for type 2 diabetes. Diabetes Care 26:3209 -3214, 2003T he incidence of type 2 diabetes is increasing worldwide, and its prevalence in adults was estimated to rise to 5.4% by 2025 (1). With the change in recent years from the traditional Japanese lifestyle to a western lifestyle, the prevalence of type 2 diabetes has drastically increased with estimates of no fewer than 6,900,000 cases in Japan (2). This disease leads to vascular complications that result in considerable morbidity and premature mortality (3). Type 2 diabetes incurs serious health problems among the Japanese (4). Dietary education at an early stage may play a key role in preventing diabetes. Considering the poor quality of life that can result from diabetes, effective dietary education that would delay or avoid progression to diabetes in those at high risk is clearly important.Management of diabetes in primary care has been well studied (5-7). In addition, the effects of dietary education as an intervention in high-risk subjects have been the topic of several reports (8 -11). Many Japanese male workers tend to eat and drink a great deal late at night, and changing the habit of excess energy intake during this period might reduce the risk for diabetes. For the purpose of attaining and maintaining optimal blood glucose levels and of modifying dietary intake as appropriate for prevention, we developed a new dietary education (NDE) program based on information on an individual's dietary energy i...
ObjectiveTo determine the effectiveness of a personal support lifestyle education programme (PSMetS) for reducing risk factors in individuals with metabolic syndrome (MetS).DesignA two-arm randomised controlled trial.SettingCompanies in metropolitan Tokyo, Japan.SubjectsMale workers with diagnosed MetS or a high risk for MetS according to the Counselling Guidance Program, Japan (n 193).ResultsThe reduction in the number of risk factors for MetS (as defined according to the criteria published by the Japanese Ministry of Health, Labor and Welfare in April 2007 (MHLW-MetS)) in the PSMetS group was not significantly different from that in the usual care group by van Elteren’s test (baseline-adjusted P=0·075) for intention-to-treat (ITT), while it was significant (baseline-adjusted P=0·038) for per-protocol set (PPS). The proportion of MHLW-MetS was significantly different between groups by van Elteren’s test (baseline-adjusted P=0·031). Two components of MHLW-MetS showed significant reductions in the PSMetS group: waist circumference (baseline-adjusted P=0·001) and BMI (baseline-adjusted P=0·002). PPS and ITT analyses showed similar results.ConclusionsFor male workers with MHLW-MetS or a high risk of MHLW-MetS, PSMetS reduced the number of risk factors for MHLW-MetS.
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