DSpace コレクション: 2024-01-31

若年健常女性におけるエネルギー量の異なる夕食の糖質制限食が血糖指標に及ぼす影響 : 無作為化比較クロスオーバー試験

2024-12-23T02:01:29Z

タイトル: 若年健常女性におけるエネルギー量の異なる夕食の糖質制限食が血糖指標に及ぼす影響 : 無作為化比較クロスオーバー試験著者: 橘田, 薫; 斎藤, 宥希; 梶山, 静夫; 宮脇, 尚志; 梶山, 真太郎; 今井, 佐恵子抄録: 緒論: 2型糖尿病患者に対するパイロット研究として若年健常女性を対象に，エネルギー量の異なる夕食の糖質制限食が血糖指標に与える影響を無作為化比較クロスオーバー法により検討した。方法: 対象者は，試験期間9日間のうち5日目と7日目の夕食に，主食（白飯200g）のエネルギー量を脂質及びタンパク質で補った糖質制限食，あるいは補わない糖質制限食を，それ以外はすべて標準糖質食を摂取し，間歇スキャン式持続血糖測定器を用いて血糖値を測定した。標準糖質食は1755kcalで炭水化物，脂質，タンパク質のエネルギー比率は，64％，21％，15％，エネルギー補充あり糖質制限食は1743kcalでそれぞれ48％，34％，18％，エネルギー補充なし糖質制限食は1419kcal でそれぞれ58％，25％，17％だった。結果: エネルギー補充の有無にかかわらず糖質制限食を摂取した夕食後の血糖上昇は抑制されたが，糖質制限食摂取翌日に標準糖質食に戻すと，糖質制限食摂取前と同様の標準糖質食を摂取しているにも関わらず，食後血糖値が有意に高くその影響は24時間持続した。エネルギー補充の有無による血糖指標の差はみられなかった。結論: 本研究結果より，2型糖尿病患者に糖質制限食を適応する場合には，急激な血糖上昇や低血糖を起こさないよう留意し，個人の身体状況や病態，ライフスタイルに合わせたより安全で効果的な糖質制限食を選択する必要があると考える。The purpose of this randomized controlled cross-over pilot study is to explore the effect of low-carbohydrate dinners with different energy on glycemic parameters in young healthy women. Participants consumed a lowcarbohydrate dinner replaced 200 g of boiled white rice with fat and protein (LCD) or a low-carbohydrate dinner without energy replacement (nLCD) on day 5 and 7 of the 9-day study period, and consumed standard-carbohydrate diet (SCD) for rest of meals. Blood glucose levels were measured continuously using intermittently scanned continuous glucose monitoring (isCGM). Energy and energy ratio of carbohydrate, fat, and protein were 1755 kcal, 64%, 21%, 15% in SCD, 1743 kcal, 48%, 34%, 18% in LCD, and 1419 kcal, 58%, 25%, 17% in nLCD, respectively. Obviously, consumption of LCD and nLCD dinner suppressed the postprandial blood glucose concentrations. However, in the following day, the mean daily blood glucose, standard deviation of blood glucose, incremental blood glucose of breakfast and lunch, area under the glucose curve, and blood glucose after dinner were all significantly higher than the day before consuming LCD or nLCD and this reverse effect lasted 24 hours, despite the participants consumed the identical SCD meals. Since higher glycemic parameters were observed even in young healthy women when carbohydrates intake was increased after consumption of a low-carbohydrate diet, it might cause hyperglycemia and hypoglycemia in individuals with type 2 diabetes. Therefore, it is important to choose an appropriate lowcarbohydrate diet for body weight, pathological condition, and life-style in individuals with type 2 diabetes.

Chronic Effect of Dietitian-Led Nutrition Therapy of Food Order on Diabetic Complications and Intima Media Thickness in Outpatients with Type 2 Diabetes at Primary Care Clinic after 4 years : Retrospective Cohort Study

2024-12-23T02:01:29Z

タイトル: Chronic Effect of Dietitian-Led Nutrition Therapy of Food Order on Diabetic Complications and Intima Media Thickness in Outpatients with Type 2 Diabetes at Primary Care Clinic after 4 years : Retrospective Cohort Study 著者: Nitta, Ayasa; Kajiayama, Shizuo; Kitta, Kaoru; Miyawaki, Takashi; Matsumoto, Shinya; Kajiyama, Shintaro; Imai, Saeko 抄録: The aim of this retrospective cohort study was to evaluate the effect of 4-year-dietitian-led medical nutrition therapy on diabetic complications and carotid intima media thickness (IMT) in outpatients with type 2 diabetes (T2DM) at a primary care clinic. Eighty-three participants were provided with dietitian-led medical nutrition therapy focusing food order “eating vegetable before carbohydrate” based on the Japan Diet (intervention group) and 78 participants were provided without dietitian-led nutrition therapy (control group). The two groups were compared for progression of diabetic complications and IMT for 4 years. After 4 years significant improvements in HbA1c (8.2 ± 1.4% to 7.6 ± 1.0%, p < 0.01), systolic blood pressure, and diastolic blood pressure were observed in the intervention group, whereas Total Cholesterol and LDL-Cholesterol were improved in the control group. The dietitian-led nutrition therapy with food order was effective to prevent diabetic complications including cerebrovascular disease, hypertension, and dyslipidemia while the ratio of atherosclerosis and cerebrovascular disease increased in the control group after 4 years. Maximum IMT decreased slightly in both groups (intervention group; 1.051 to 1.022 mm, control group; 1.019 to 0.994 mm), although the decrement was neither statistically significant between groups nor before and after the medical treatments. This result indicates that the dietitian-led nutrition therapy with food order was effective on glycemic control and suppression of diabetic complications, such as atherosclerosis, cerebrovascular disease, and hypertension, but both medical nutrition therapy and regular medical treatments are effective in suppressing the progression of IMT for 4 years in individuals with T2DM.

授乳婦の情報入手 : テキストマイニングを用いたインターネット上の情報分析

2024-12-23T02:01:29Z

タイトル: 授乳婦の情報入手 : テキストマイニングを用いたインターネット上の情報分析著者: 廣瀬, 潤子; 隈田, 舞羽; 堤, 梨花; 長尾, 早枝子抄録: インターネット上の情報に対する母親の不安感が指摘されていることから，本研究では授乳婦の情報源およびインターネットにあげられた授乳についての情報内容を分析した。京都府内にある母乳育児を支援している助産院に通院中の授乳婦100名を対象に授乳情報の入手についてのアンケートを実施した。インターネット上の記載内容（Google，2022年11月1日検索，上位30件）はKH Coderによるテキストマイニングで分析した。授乳についての情報源として，9割の授乳婦がインターネットをあげていたが，育児書・雑誌は全くあげられなかった。インターネット検索に用いるキーワードの出現回数は「母乳」，「乳腺炎」，「授乳」，「ミルク」，「量」の順で多かった。初産婦は「授乳回数」と「いつまで」というキーワードを経産婦より多く使用していた。検索キーワード「母乳」の場合，記載内容の根拠が書かれていないことが多かった。検索キーワード「乳腺炎」は助産師等の専門家によってサイトが記載されていることが多かった。検索キーワード数とサイト内での使用語のSubgraph数には一定の傾向がなかった。「母乳＆量」および「ミルク＆量」で検索した時のサイトの記載者が専門家である場合，「診る」や「サイン」という語が多く用いられていた。This study analyzed the information sources of lactating women and the content of information on breastfeeding given on the Internet. One hundred lactating women attending a midwifery center in Kyoto Prefecture that supports breastfeeding were surveyed about their access to lactation information. Internet descriptions (Google, search on November 1, 2022, top 30) were analyzed by text mining with KH Coder. The Internet was mentioned by 90% of lactating women as a source of information on lactation, while no parenting books or magazines were mentioned at all. The most frequently occurring keywords used for Internet searches were“breast milk,” “mastitis,” “lactation,” “milk,” and“quantity,” in that order. Primiparas used the keywords“number of feedings” and“until when” more than multiparas did. In the case of the search keyword“breast milk,” the rationale for the description was often not written, while the site was often described by midwives and other experts for the search keyword“mastitis. The number of search keywords and the number of Subgraphs of terms used in the sites did not tend to be constant. When the search terms“breast milk & quantity” and“milk & quantity” were used, the words“diagnose” and“sign” were used more often when the site was written by a specialist.

京都駅の屋外喫煙所周辺における受動喫煙の状況

2024-12-23T02:01:29Z

タイトル: 京都駅の屋外喫煙所周辺における受動喫煙の状況著者: 木村, 佑来; 三好, 希帆; 中村, 亜紀; 宮脇, 尚志抄録: 緒言: 2020年に改正健康増進法が完全施行され，施設の類型等により敷地内禁煙や原則屋内禁煙が義務づけられた。しかし，屋外で喫煙を行う場合は，「周囲の状況に配慮する」にとどまっている。本調査では，屋外喫煙所周辺において空気中の微小粒子状物質（PM2.5）濃度の測定を行い，周辺の通行人に曝露される受動喫煙の程度を評価することを目的とした。方法: 京都駅にある半オープンスペースの喫煙所周辺において，2019年12月～2020年1月に計3日間，喫煙所から東に3m，10m，南に5.7mにおけるPM2.5の測定を行った。結果: 測定期間中の喫煙所から東に3mの地点におけるPM2.5の最大値は，環境省の注意喚起基準70μg/m3を大幅に上回った。また，PM2.5濃度は喫煙所から東に10mの地点においても高値であり，全ての場所において，環境省の1日平均基準値である35μg/m3を超える時刻が認められた。考察: 喫煙所周辺の通行人は，高濃度の受動喫煙の被害を受けている可能性が示唆された。屋外における受動喫煙の害を防ぐためには，屋外における受動喫煙防止のためのガイドライン策定等の作成が必要であると考えられた。Objective: In 2020, the revised Health Promotion Act came into effect, mandating no smoking on site and, depending on the type of facility and other factors, banning indoor smoking in principle. However, regarding outdoors, the law only states that“consideration should be given to surrounding conditions”. This study measures the concentration of particulate matter (PM2.5) in the air around outdoor smoking areas and evaluates the degree of exposure to passive smoking for passersby in the vicinity. Methods: We measured PM2.5 around a semi-open smoking area at Kyoto station for a total of three days from December 2019 to January 2020 at 3 m and 10 m east and 5.7 m east and south from the smoking area. Results: The maximum value of PM2.5 concentration at a distance of 3 m east significantly exceeded the alert values for air quality standards of 70 μg/m3 set by the Ministry of the Environment. The concentration was also high at a distance of 10 m east, and at all distances, PM2.5 concentration exceeded the Ministry of the Environment’s daily average standard of 35 μg/m3 at times. Conclusion: Passersby in the vicinity of smoking areas may be exposed to high concentrations of passive smoking. To prevent the harm caused by passive smoking outdoors, guidelines for the prevention of passive smoking outdoors and other measures should be developed.