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Kazuo Sugawara

Publications and source records attributed to Kazuo Sugawara.

At least 19 recordsLinked to original sources

Defoliation effects on the community structure of arbuscular mycorrhizal fungi based on 18S rDNA sequences.

The effects of defoliation on arbuscular mycorrhizal (AM) associations in the field were investigated in terms of the community structure of AM fungi colonizing roots of grassland plants; the carbohydrate balance of the host plants was also determined. We focused on two plant species dominating Japanese native grasslands: the grazing-intolerant species Miscanthus sinensis and the grazing-tolerant species Zoysia japonica. Community structures of AM fungi were determined from 18S rRNA gene sequences. The dominant fungal group in both plant species was the Glomus clade, which was classified into several phylogenetic groups based on genetic distances and topology. In Miscanthus roots, the Glomus-Ab, Glomus-Ac, and Glomus-Ad groups were detected almost equally. In Zoysia roots, the Glomus-Ab group was dominant. Defoliation effects on the community structure of AM fungi differed between the plant species. In Miscanthus roots, the percentage of root length colonized (%RLC) by the Glomus-Ac and Glomus-Ad groups was significantly reduced by defoliation treatment. On the other hand, AM fungal group composition in Zoysia roots was unaffected by defoliation except on the last sampling date. Decreased %RLC by Glomus-Ac and Glomus-Ad coincided with decreased non-structural carbohydrate (NSC) levels in host plants; also, significant positive correlations were found between the %RLC and some NSC levels. On the other hand, the %RLC by Glomus-Ab in both plant species was unaffected by the NSC level. These results suggest that AM fungal groups have different carbohydrate requirements from host plants.

Andropogon↗

Firm measures are required to effect any significant decrease in the Japanese age-adjusted mortality rate from malignant neoplasms for the 21st century.

The Japanese have the longest lifespan worldwide, but this has been mostly due to reductions in the mortality rates from diseases other than malignant neoplasms. Changes in the age-adjusted mortality rates (AMRs) for malignant neoplasms in Japan from 1950 to 2000 are analyzed to elucidate the overall trend. The overall AMRs for all malignant neoplasms in men increased from 1950 to 2000, and decreased slowly in women during the same period. Changes since 1990 have been small in both genders, but show a hopeful trend towards a decrease in the total AMR since 1995. These trends reflect a balance between the decreased AMR from gastric (both male and female) and uterine cancers and increases in many other malignant neoplasms. However, in the period 1990-2000, the decrease in the AMR from gastric and uterine cancers has shown a trend towards leveling off. Therefore, improving the trend towards reductions in cancer incidence and mortality in the 21st century and beyond will depend on achieving changes in other cancer sites, which can only be realized through the twofold approach of preventative medicine and research as well as improvements in the levels of diagnosis and therapy. Much more emphasis must therefore be placed on primary prevention, in particular on anti-smoking campaigns, as well as stepping-up research into the etiology of, and novel treatments for other malignant neoplasms, especially colorectal and breast cancers.

Adolescent↗

Adverse effects of energy restriction on myogenic enzymes in judoists.

In this study, we examined the effects of weight reduction by restricting energy intake on muscle function and serum concentrations of myogenic enzymes in judoists. Twenty-seven male judoists aged 19.3 +/- 0.6 years (mean +/- s) were divided into three groups based on the extent of body weight reduction: high weight reduction (height 1.70 +/- 0.05 m, body mass 78.5 +/- 13.6 kg), low weight reduction (height 1.70 +/- 0.05 m, body mass 80.7 +/- 13.1 kg) and a group that maintained body weight while continuing to perform exercise training (height 1.78 +/- 0.07 m, body mass 78.7 +/- 8.8 kg). Body composition, blood biochemistry, energy intake and anaerobic power were assessed on four occasions: 20 days (baseline data), 4 days and 1 day before and 7 days after competition. Compared with baseline, body mass and fat-free mass were significantly lower 1 day before competition in the high and low weight reduction groups (both P < 0.01); these changes persisted for 7 days after competition in the high weight reduction group. Serum creatine kinase was significantly elevated 1 day before competition in all groups (all P < 0.05), and remained higher 7 days after competition in both the high and low weight reduction groups. Compared with baseline, maximal anaerobic power was significantly lower 1 day before competition only in the high weight reduction group (P < 0.01). Our results suggest that energy restriction in addition to intense exercise training before major competition has an adverse effect on anaerobic power and elevates serum creatine kinase concentration, leading to an impairment of muscular function and an increased susceptibility of muscle tissue to injury.

Abstracting and Indexing↗

The prevention of colon carcinogenesis in rats by dietary cellulose is greater than the promotive effect of dietary lard as assessed by repeated endoscopic observation.

We developed a method which we used in the current study to observe the rat colon endoscopically. Our goal was to evaluate the entire course in the development of experimental large bowel tumors through serial observations in the same rat. We compared the effects of dietary lard and cellulose on rat colon tumorigenesis in a 2 x 3 factorial design. Sprague-Dawley rats (n = 90) were divided into 6 diet groups: rats were fed a diet without cellulose that contained 5, 10, and 15 g/100 g lard, or diets containing 15% cellulose diet (15 g cellulose/100 g diet) and the same concentrations of lard. The development of large bowel tumors induced by the administration of 1,2-dimethylhydrazine (25 mg/kg body weight) for 19 wk was examined endoscopically. Tumor induction rates in the 15% cellulose groups were lower than in the 0% cellulose groups (P = 0.008), independent of the lard concentration. These results suggest that the preventive effect of cellulose against large bowel tumorigenesis is greater than the promotive effect of fat under the current experimental conditions.

1,2-Dimethylhydrazine↗

The fermentation of different dietary fibers is associated with fecal clostridia levels in men.

Only a few reports have compared the fermentation of pectin and cellulose using the hydrogen-breath test, and no studies have examined the relation between the hydrogen breathing pattern and colonic microflora. Using breath-hydrogen measurements, we investigated whether different dietary fibers (DFs) were fermented differently and whether there were individual differences after ingestion of the same DF; we also examined the relation between individual fecal microflora and the fermentation of DF. Results of hydrogen tests in 14 men were compared after they had ingested 20 g of pectin, 20 g of cellulose, or 6 g of lactulose (a DF-like substance). We examined the relation between the breath hydrogen results and the subjects' fecal microflora. We defined significant fermentation (i.e., positive cases) as a continuous rise in hydrogen in the expiratory air of >19 ppm. The subjects were divided into 3 groups according to their hydrogen breath test pattern, i.e., positive for lactulose and pectin (Group LP, n = 4); positive for lactulose alone (Group L, n = 7); and negative for pectin, cellulose, and lactulose (Group N, n = 3). Individual differences were noted in subjects from Group LP and Group L. The detection frequency of lecithinase-negative clostridia was higher in Group LP than in the other groups (P < 0.05), and the detection frequency and the number of lecithinase-positive clostridia were higher in Groups LP and L than in Group N (P < 0.05). These findings suggest that the Clostridium species are associated with hydrogen production. The hydrogen breath test results of DFs depend on both the type of DF and the individual colonic microflora. The amount and constitution of colonic microflora might be predicted by the hydrogen-breath test using different DFs.

Adult↗

[Effects of gender-related weight reduction on the physical condition of male and female college judoists].

OBJECTIVE: In order to study the gender-related effects of weight reduction on the physical condition of male and female college judoists during weight reduction periods, we examined changes in anthropometric, nutritional intake and biochemical parameters in 43 male and female college judoists 20 days (pre-weight reduction) before and one day (post-weight reduction) before the game. METHODS: Subjects were divided into two groups. Thirty subjects (22 males, 8 females) who required weight reduction were defined as the weight reduction (WR) group, and the remaining 13 subjects (5 males, 8 females) were defined as the non-reduction (non-WR) group. RESULTS: In both WR groups, anthropometric parameters and nutritional intake significantly decreased after weight reduction compared to the pre-values. The change ratios of nutritional intake during the weight reduction period in the female WR group were higher than those in the male WR group. Serum lipids and electrolytes significantly decreased after the weight reduction compared to the pre-values in both WR groups. In the female WR group, Cr and UA significantly increased after the weight reduction compared to the pre-values. Although it was not significant, Ht increased after the weight reduction compared to the pre-values only in the female WR group. TP, Cr, UA, BUN, CK, LDH and IgA significantly increased after the weight reduction compared to the pre-values in the weight reduction compared to the pre-values in the male WR group. In contrast, in both non-WR groups, these parameters did not change significantly during the research period. CONCLUSIONS: Our findings suggest that nutritional exhaustion and dehydration may be the major effects brought about by energy and fluid restriction in female college judoists during a weight reduction period. On the other hand, in male college judoists undergoing weight reduction, the data suggest that muscle damage and myogenic protein catabolism may be caused chiefly by exercise. These differences may be due to the difference in the method of weight reduction for the different genders, namely, mainly exercise in males and mainly energy and fluid restriction in females.

Adolescent↗

Nutritional effects of supplementing liquid-formula diet with dietary fiber on elderly bed-ridden patients.

In the past few decades, the number of bed-ridden elderly patients has been increasing. This group of patients is frequently fed with a liquid formula diet. The aim of this study was to evaluate the usefulness of a liquid formula diet containing dietary fiber (DF) for elderly bed-ridden patients. Eighteen elderly, bed-ridden patients were given L-3 Fiber, a DF-containing liquid formula diet (DF-LFD), for 4 weeks, while a number of parameters were monitored, including serum levels of total cholesterol, triglyceride, total protein, creatinine, uric acid, glucose, sodium, potassium, and calcium, urine protein/sugar, and defecation frequency. Total protein, albumin and total cholesterol significantly increased following the administration of the DF-LFD, associated with an average increase in body weight of 1.94 kg (5.0%). Defecation frequency significantly increased one week after DF-LFD administration was started, but this effect was transient. Although a few patients complained of nausea, vomiting or abdominal pain, no severe side effects were seen. In conclusion, DF-LFD supplementation appears to be beneficial for elderly bed-ridden patients, and can increase nutritional-related parameters, such as body weight, total protein, albumin and total cholesterol, without severe side effects.

Aged↗

A population-based study on defecatory conditions in Japanese subjects: methods for self-evaluation.

We examined the defecatory conditions in a population of Japanese subjects and analyzed the measured parameters as a means for self-evaluation of defecation. Subjects (n=1195) were residents of northern Japan and were all aged over 40 years. The state of defecation and fecal characteristics were assessed with regard to nine parameters including "self-reported bowel habit" and "bowel movement frequency." Logistic regression analysis was carried out to analyze the association between the complaint of constipation and other eight parameters. A higher tendency for constipation was noted in women than in men. The highest value of the odds ratio was "bowel movement frequency"; especially the value "once per three days or more" was noted in both genders (odds ratio: 13.38 and 42.46 in men and women, respectively). In addition, "stool appearance", "length of time for bowel movement", "straining after bowel movement", "alternating diarrhea/constipation/disorder" and "travel-related changes in bowel movements" were significantly related with the complaint of constipation ("self-reported bowel habits") in both genders. In conclusion, the study elucidated that personal and subjective evaluation of bowel habits in normal subjects consisted of various factors under the heading of "bowel movement frequency".

Adult↗

Environmental factors affect colon carcinoma and rectal carcinoma in men and women differently.

BACKGROUND AND AIMS: Colon cancer is thought to be more closely associated with environmental factors than rectal cancer, but evidence is currently insufficient. We examined whether there are differences in the degree of environmental effect on colon cancer and rectal cancer in Japan. METHODS: We performed a birth cohort analysis for colon and rectal cancers using Japanese vital statistics from 1950 to 1998 and analyzed time trends by cancer site and gender. RESULTS: The mean annual increase in age-adjusted mortality rate from colon cancer was greater than that from rectal cancer and was greater in men than in women. In men left colon cancer showed the greatest rate of increase whereas cancer of the right colon showed only a slight change. Although left colon cancer rapidly increased until the middle 1980s and thereafter showed no change, right colon cancer showed no change until the middle 1980s and thereafter rapidly increased in men. However, the rates of increase in left colon cancer were greater than those in right colon cancer until the middle 1980s, after which a reversal in trend was seen in women. Birth cohort analysis indicates that for all cohorts the mortality rates at the same age were higher in the recent cohorts than in the previous ones. This trend was more marked for colon cancer than for rectal cancer and was stronger among men than among women. CONCLUSION: Colon cancer is more closely associated than rectal cancer with environmental factors, and this association is more pronounced in men than in women. Consequently cancers at these two sites should not be combined in studies of the role of lifestyle factors in causing these neoplasms. Furthermore, the causes of these diseases may differ in men and women.

Adolescent↗

Low-level laser irradiation attenuates production of reactive oxygen species by human neutrophils.

OBJECTIVE: The aim of this study was to examine the effects of low-level laser therapy (LLLT) on production of reactive oxygen (ROS) species by human neutrophils. BACKGROUND DATA: LLLT is an effective therapeutic modality for inflammatory conditions. MATERIALS AND METHODS: The laser device used was the infrared diode laser (GaAlAs), 830-nm continuous wave (150 mW/cm(2)). After irradiation, ROS production by neutrophils was measured using luminol-dependent chemiluminescence (LmCL) and expression of CD11b and CD16 on neutrophil surface was measured by flow cytometry. RESULTS: The LmCL response of neutrophils was reduced by laser irradiation at 60 min prior to the stimulation with opsonized zymosan and calcium ionophore. The attenuating effect of LLLT was larger in neutrophils of smokers than non-smokers, while the amount of produced ROS was larger in neutrophils of smokers. Expression of CD11b and CD16 on neutrophil surface was not affected by LLLT. CONCLUSION: Attenuation of ROS production by neutrophils may play a role in the effects of LLLT in the treatment of inflammatory tissues. There is a possible usage of LLLT to improve wound healing in smokers.

Adult↗

The resistant starch level of heat moisture-treated high amylose cornstarch is much lower when measured in the human terminal ileum than when estimated in vitro.

According to the definition of resistant starch (RS), the true value of foodstuff-derived RS can be assessed only from that found in the contents of the terminal ileum. To date, a few methods exist for in vivo measurement of RS in the terminal ileum, but their accuracy is questionable. The aim of this study was to quantify the level of RS in the terminal ileum to determine its true value as dietary fiber (DF). Volunteers (n = 7 men) were given a test meal containing 10 g of heat moisture-treated high amylose cornstarch (HMT-HAS) containing 8.8 g of RS as measured by Englyst's method. A double-lumen tube was positioned in the terminal ileum using the endoscopic retrograde bowel insertion method (ERBI). Intestinal contents were aspirated, and the amount of RS was measured as the glucose concentration (Englyst's method), and compared with the values for RS administrated orally using the same method. The mean amount of HMT-HAS-derived RS collected in the terminal ileum was 3.37 +/- 0.95 g (mean +/- SD), which was 34.5 +/- 9.7% of the in vitro RS value. Furthermore, there were large individual differences in recoveries, ranging from 22.2 to 47.5%. The measured amount of HMT-HAS-derived RS was much smaller in our in vivo study than that measured in vitro, suggesting that in vitro measurement may inaccurately estimate the RS and DF levels of foodstuffs. The problem is further compounded by the large individual in vivo variations in RS values from subjects consuming identical diets.

Adult↗

Life expectancies in the United Kingdom and Japan.

BACKGROUND: Compared with other developed countries, the United Kingdom has exhibited less of an increase in life expectancy over the past 30 years. METHODS: We compared the chronological changes in the age-adjusted mortality rates (AMRs) from all causes or major causes, and in life expectancy in the United Kingdom and Japan between 1970 and 1997. RESULTS: In both 1970 and 1997 the AMRs for most major causes were higher in the United Kingdom than in Japan; the difference in the AMR between countries was smaller in 1970 than in 1997. The difference in the AMR from all causes between the United Kingdom and Japan in 1997 was mainly due to differences in the AMR for heart diseases. The trend for an increasing difference over time between the United Kingdom and Japan in the AMR from all causes was due to the decreased rate of AMR from heart diseases from 1970 to 1997 in the United Kingdom being lower than those from cerebrovascular diseases in same period in Japan. CONCLUSIONS: These data suggest that mortality rates could be reduced by a change in focus of the National Health Service toward an emphasis on primary rather than secondary prevention and associated clinical interventions. The greatest priority should be placed on reducing the incidence of heart disease by aggressively improving primary prevention.

Adolescent↗

No preventive effect of dietary fiber against colon cancer in the Japanese population: a cross-sectional analysis.

The report of Fuchs et al. in 1999 on the protective effects of dietary fiber (DF) against colon carcinogenesis has led many researchers to question the benefits of DF. We analyzed the relationship between dietary intake and mortality from colon cancer in Japan cross-sectionally. Dietary data were taken from the National Nutrition Survey. The standardized mortality ratio (SMR) was calculated using data from "Vital Statistics" and "the Population Census in Japan." Multiple regression analysis (stepwise variable selection method) was performed with the SMR of colon cancer as the objective variable and intake of DF, nutrients, and food groups in 1966 as the explanatory variables. The beta regression coefficient was significantly positive for intakes of fat, protein, and vitamin C and significantly negative for intakes of calcium and vitamin A to the SMR of colon cancer. However, no significant correlation was observed for DF or for any of the various food groups analyzed. In conclusion, our data do not demonstrate any protective effect of DF on colon cancer in subjects with a low fat intake (Japanese subjects), which supports Fuchs' findings in subjects with high fat intake (U.S. subjects).

Colonic Neoplasms↗

Impact of a competitive marathon race on systemic cytokine and neutrophil responses.

PURPOSE: To investigate whether cytokines and neutrophils mediate exercise-related pathogenesis, we examined their responses and possible association after exhaustive exercise. METHODS: Plasma and urine samples were obtained from 10 male runners before and after a 42.195-km marathon race. Major cytokines and neutrophil activation markers [myeloperoxidase (MPO) and lactoferrin (LTF)] were measured by enzyme-linked immunosorbent assays. Functional modulation of standard neutrophils and monocytes by plasma was determined on their luminol-dependent chemiluminescence responses. RESULTS: The race induced peripheral neutrophilia accompanied by an increase in band neutrophils and monocytosis. Plasma MPO and LTF concentrations increased significantly by 1.8 and 1.4 times after the race. There was a greater increase in urine concentrations of MPO and LTF, 12.3 and 3.5 times after exercise, respectively, suggesting that neutrophil activation occurred and that renal clearance exceeded the increase in plasma concentrations. Plasma interleukin (IL)-6, IL-8, IL-10, granulocyte colony-stimulating factor (G-CSF), macrophage CSF (M-CSF), and monocyte chemotactic protein 1 (MCP-1) increased significantly after the race, and urine IL-1beta, IL-6, G-CSF, M-CSF, and MCP-1 increased significantly. The plasma IL-6 responses correlated with the increases of band neutrophil count (r = 0.860, P < 0.01), suggesting IL-6-mediated bone marrow release of neutrophils. Furthermore, the increases in urine MPO concentration were correlated with increases in urine IL-6 (r = 0.868, P < 0.01) and G-CSF (r = 0.875, P < 0.01), suggesting that these cytokines promoted neutrophil activation. However, preincubation of neutrophils and monocytes with postexercise plasma could not cause priming responses, possibly because of the exercise-induced enhancement of plasma antioxidant activity. CONCLUSION: Although many cytokines recruiting and priming neutrophils and monocytes were secreted and functional after exhaustive exercise, overwhelming antioxidant and antiinflammatory defenses were induced, preventing exercise-induced oxidative stress.

Adult↗

Characteristics of attenuating effects of rebamipide, an anti-ulcer agent, on oxidative burst of human neutrophils.

The aim of this study was to characterize the effects of rebamipide on the oxidative burst of human neutrophils. The neutrophil oxidative burst was measured in the presence of rebamipide and cimetidine using lucigenin- or luminol-dependent chemiluminescence (LgCL or LmCL). Rebamipide inhibited the LmCL response stimulated with opsonized zymosan, 12-myristate 13-acetate phorbol, and calcium ionophore in a dose-dependent manner, but the LgCL response was inhibited when neutrophils were stimulated with opsonized zymosan. LmCL response was also dose-dependently attenuated by rebamipide even in the presence of cimetidine. Thus, addition of rebamipide to H(2)-receptor antagonists can be considered for the treatment of gastric mucosal injury associated with oxidative stress.

Adult↗

Exhaustive exercise and type-1/type-2 cytokine balance with special focus on interleukin-12 p40/p70.

It is known that interleukin (IL)-12 p70 promotes the differentiation of type-1 helper T (Th1) cells, which produce type-1 cytokines such as IL-2 and interferon (IFN), thereby supporting cellular immunity, whereas IL-12 p40 acts as an antagonist of IL-12 p70. In contrast, IL-4 and IL-6 promote the differentiation of Th2 cells, which produce type-2 cytokines IL-4, IL-6 and IL-10, induce humoral immunity and are involved in allergic reactions. Exhaustive exercise causes the suppression of T lymphocyte activity while asthmatic and allergic diseases are subclinically more prevalent in athletes. One of the mechanisms behind these observations might be a lower type-1 and higher type-2 cytokine balance, which we previously demonstrated to occur after exhaustive exercise. In the present study, we investigated the type-1/type-2 cytokine balance by measuring plasma concentrations of IL-2, IL-4, IL-5, IL-10, tumor necrosis factor (TNF)-alpha and IFN-gamma with microparticle-based flow cytometric technology. IL-5, IL-6 and IL-13 were measured by enzyme-linked immunosorbent assay (ELISA). IL-12 p40 and p70 were measured separately, also by ELISA. Plasma IL-12 p40 concentration rose significantly after maximal exercise and to an even greater extent after a marathon race. Conversely, plasma IL-12 p70 could not be detected even using two different assays. The marathon race caused a marked increase in the plasma concentrations of IL-6 and IL-10. Their responses were correlated (r = 0.78, p < 0.01), indicating that IL-6 is an inducer of IL-10, and may partly induce the type-1 < type-2 cytokine balance. With the exception of one study involving maximal exercise, other studies have failed to show any change in circulating IL-12 concentration with exercise. The present study demonstrated that IL-12 p40 was present in excess of p70 especially after exercise. This may be one of the mechanisms behind several phenomena including cellular immunosuppression, an increase in the relative proportion of type-2 cytokines following exhaustive exercise, and the higher incidence of infections and allergic disorders in regularly exercising endurance athletes.

Adolescent↗

Comparison of etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West.

BACKGROUND AND AIMS: Colonic diverticula are located predominantly on the right-side in patients in Japan, in contrast to those in Europe and the United States. This study compared the etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West. METHODS: A literature review was conducted from 1950 to 2001 using Medline and Index Medicus. RESULTS: Diverticula occur predominantly in the right-sided colon (over 70%) in Japanese patients, and even among Japanese who emigrate, in contrast with the diverticula in Western. Incidence (detection) rates of colon diverticula have rapidly increased in Japan since World War II with the increased dietary fiber intake. The increased detection rate over time is higher in urban areas than in rural areas, and it corresponds to the distribution of dietary fiber intake. Birth cohort analysis suggests that right-sided diverticula is affected more by environmental factors than other types. Furthermore, the significant relationship of right-sided diverticula with intraluminal pressure in Japan is similar to that of left-sided diverticula in the West, and the pathological feature of these diverticula are similar. CONCLUSION: The etiology of right-sided diverticula in Japan (and perhaps also other Mongolian peoples) is very similar to that of left-sided diverticula in the West. The location may represent a difference in morphology of the large intestine between Mongolians (including Japanese), and Westerners, rather than environmental differences.

Age Distribution↗

Trends in dietary fiber intake in Japan over the last century.

BACKGROUND: Insufficient intake of dietary fiber (DF) is currently a major problem in the overall promotion of health in the general population in Japan. AIM OF THE STUDY: To analyze the time trends in DF intake, including DF density (total DF intake/1,000 kcal), and the ratio of water-insoluble fiber to water-soluble fiber (IS ratio) in Japan. METHODS: The time trend in DF intake in Japan was calculated from data compiled in the Japanese National Nutrition Survey. RESULTS: The mean daily DF intake (total DF intake) in 1952 was 20.5 g/day, which rapidly declined to about 70 % of the 1952 level in 1970, after which there was little change to 1998. DF density in 1952 was 9.7 g/1000 kcal, which declined by about 30 % in 1970, and remained at about the same level to 1998. The IS ratio has remained stable over this period. Whereas total DF intake and DF density in Japan are similar to those in Western countries, the IS ratios are higher in Japan. Therefore, the higher incidence of, and mortality from, colon diverticulosis, coronary heart disease, hyperlipidemia, etc., which are all thought to be related to fiber deficiency, in Western countries compared to Japan might be due to the differences in the IS ratio. CONCLUSIONS: A decline in total DF intake and DF density is predicted for Japan in the future, because these parameters were lower among the younger generation. This may be due to the marked changes in the dietary habits of the younger generation, and is a problematic trend for Japanese health.

Adult↗