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In Japan, fees for nutritional management (NM) was introduced in April 2009 to improve nutritional care for persons with disabilities residing in welfare facilities. The present study aimed to clarify (1) the nutritional status as well as eating-related functions and behaviors of such residents and (2) status of incorporating claim fees for NM and oral maintenance in facilities supporting persons with disabilities. This cross-sectional study approached 2,510 welfare facilities for persons with disabilities across Japan. Anonymous questionnaire surveys were conducted in August 2018. Among the 1,543 responses, 1,538 (61.3%) were valid for analysis. The median number of residents in a facility was 50. Among all residents (n=80,322), 16.9% were underweight (body mass index [BMI]18.5) and 14.5% were obese (BMI≥25.0). Of the residents, 38.9% adjusted food form and 15.2% had eating behavior-related problems. In total, 723 (47.0%) and 54 (3.5%) facilities, claimed the fees for NM and oral maintenance, respectively. The main reasons for not implementing the claim fees for NM was the lack of time for nutritional care and management (NCM; 30.2%), absence of a registered dietitian (29.3%), and difficulty in assessing swallowing function (24.1%). Our results revealed that the implementation rates of claim fees for NM and oral maintenance were low despite most respondents having problems with the double burden of malnutrition and necessity of oral care, suggesting the importance of securing time for NCM, appointing registered dietitians, and evaluating swallowing function.

Objective: We investigated whether barley with a high β-glucan content (7.2 g per 100 g) improves postprandial plasma glucose levels and fluctuations using a meal tolerance test and Continuous Glucose Monitoring (CGM) in patients with type 2 diabetes. Methods: A meal tolerance test (500 kcal) was conducted using two types of test meals: one with white rice (WR diet) and one with white rice mixed 1:1 with high β-glucan-containing barley (BR diet). Both meals included the same side dish. Plasma glucose changes over 180 minutes were compared after ingestion of the test meals. In addition, participants wore a CGM device for the 2 study days, to measure the daily variations in glucose levels when the WR or BR diet as staple food was provided 3 times a day with the same side dish in both meals. Results: Twenty-nine patients with type 2 diabetes (age 52.5 ± 15.1 years, BMI 27.5 ± 4.7 kg/m2, HbA1c 8.1 ±1.8 %) were included in this study. The incremental area under the curve of plasma glucose levels after BR diet ingestion was significantly lower than that after WR diet ingestion (7934.0 ± 4151.2 vs 9434.0 ± 4701.2 mg·min/dL). CGM showed a 24-hour standard deviation of blood glucose after the BR diet was significantly lower than that after the WR diet. Conclusion: These results suggest that postprandial plasma glucose elevation and fluctuation in patients with type 2 diabetes are suppressed by adding high-β-glucan barley to white rice in meals.

The aim of our study was to investigate whether high β-glucan-containing barley (7.2 g per 100 g) improves postprandial plasma glucose levels and suppresses postprandial insulin levels during a meal tolerance test in type 2 diabetic patients. A meal tolerance test (500 kcal) was conducted using two types of test meals: a test meal with white rice (WR) alone (WR diet) and a test meal with WR mixed with 50% barley (BR diet) as staple food. The side dish was the same in the both meals. The changes in plasma glucose and serum C-peptide immunoreactivity (CPR) levels for 180 minutes after ingestion of the test meals were compared. Ten patients with type 2 diabetes (age 52.5 ± 15.1 years, and 7 males and 3 females) were included in this study. The mean HbA1c level and body mass index were 8.8 ± 1.4%, and 29.7 ± 4.5 kg/m2, respectively. Plasma glucose levels after ingestion of the WR diet or BR diet peaked at 60 minutes, which showed no significant differences between the two types of test meals. However, the incremental area under the curve (IAUC) of plasma glucose levels after ingestion of BR diet was significantly lower than that of WR diet. The serum CPR levels at 180 min and their IAUC over 180 minutes after ingestion of BR diet were significantly lower than those of WR diet. Conclusion: Increase in postprandial plasma glucose and insulin levels was suppressed by mixing high-β-glucan barley with WR in type 2 diabetic patients.

The effect of white rice (WR) mixed with high β-glucan-containing barley at 50% on improvement of postprandial blood glucose levels was assessed by meal tolerance test and continuous glucose monitoring (CGM) in 15 healthy subjects with normal glucose tolerance (age 31.6 ± 12.9 years old, 4 males and 11 females). A meal tolerance test (500 kcal) was conducted using 2 types of test meals: a test meal only with WR and a test meal WR mixed 50% barley, and the side dish was the same in both meals. Blood glucose levels of the subjects 180 minutes after ingestion of the test meals were compared. In addition, a CGM device was attached to the subjects for 2 days when the WR or barley as a staple food was provided 3 times a day for consecutive days, and the daily variation of glucose was investigated. The glucose levels 30 minutes after dietary loads and the area under the blood concentration-time curve over 180 minutes were significantly decreased in the barley consumption group. In CGM, 24-hour mean blood glucose and 24-hour standard deviation of blood glucose were also significantly decreased after ingestion of the barley. Postprandial glucose level elevation was suppressed by mixing high-β-glucan barley with WR in subjects with normal glucose tolerance.

Objectives. To determine the prevalence and effect of dietary habits on functional constipation in preschool and early elementary school children in Japan. Study Design. A total of 3595 children aged 3 to 8 years from 28 nursery schools and 22 elementary schools in Yokohama City, Kanagawa Prefecture, Japan, were evaluated. The subjects were divided into a functional constipation group and a nonfunctional constipation group according to the Rome III criteria. Dietary intake data were collected using a brief-type, self-administered, diet-history questionnaire validated for Japanese preschool-aged children. Results. Of the 3595 subjects evaluated, 718 (20.0%) had functional constipation. The association between functional constipation and gender was not statistically significant (p=0.617). A decrease in bowel frequency was observed in 15.9% of those with functional constipation. There was no significant difference in the proportion of participants in the constipation group by age (p=0.112). Binomial logistic regression analysis indicated that only fat per 100 kcal positively correlated with functional constipation [odds ratio = 1.216, 95% confidence interval: 1.0476–1.412]. Conclusions. Functional constipation is common among children in preschool and early elementary school in urban areas of Japan. Parents should pay attention to constipation-related symptoms other than defecation frequency. A high-fat diet should be avoided to prevent functional constipation.