「日本人の食事摂取基準（2015年版）」，エネルギーの考え方と今後の課題
「日本人の食事摂取基準 (2015年版) 」は, 生活習慣病の重症化予防を視野に入れた策定がなされ, 保健指導レベルの高血圧・脂質異常・高血糖・腎機能低下を有する者や, BMI 30未満の肥満者を対象に含めた。エネルギー摂取量の評価は, 食事アセスメント法の過小評価という限界があり, エネルギー消費量も, 二重標識水法で正確な測定が可能だが, 費用面から汎用は困難である。これに対し, エネルギー出納 (＝エネルギー摂取量－消費量) で変化する体重は, 現場で比較的精度の高い評価が可能である。体重はエネルギー出納の結果として変化するが, 長期的には体重変化によりエネルギー消費量も変化し, エネル...
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| Published in | 日本栄養・食糧学会誌 Vol. 69; no. 3; pp. 109 - 115 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | English Japanese |
| Published |
公益社団法人 日本栄養・食糧学会
2016
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0287-3516 1883-2849 |
| DOI | 10.4327/jsnfs.69.109 |
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| Abstract | 「日本人の食事摂取基準 (2015年版) 」は, 生活習慣病の重症化予防を視野に入れた策定がなされ, 保健指導レベルの高血圧・脂質異常・高血糖・腎機能低下を有する者や, BMI 30未満の肥満者を対象に含めた。エネルギー摂取量の評価は, 食事アセスメント法の過小評価という限界があり, エネルギー消費量も, 二重標識水法で正確な測定が可能だが, 費用面から汎用は困難である。これに対し, エネルギー出納 (＝エネルギー摂取量－消費量) で変化する体重は, 現場で比較的精度の高い評価が可能である。体重はエネルギー出納の結果として変化するが, 長期的には体重変化によりエネルギー消費量も変化し, エネルギー出納の過不足は調整される。したがって, 適切なエネルギー摂取量, 消費量のバランスが維持されている状態を示す指標として, 今回の食事摂取規準はBMIを採用した。18歳以上を年齢で3区分し, 観察疫学研究で総死亡率が最低となるBMIをもとに, 目標とするBMIの範囲を示した。高齢者では, 現状のBMI分布および生活習慣病, 虚弱の予防も考慮し策定した。 |
|---|---|
| AbstractList | 「日本人の食事摂取基準 (2015年版) 」は, 生活習慣病の重症化予防を視野に入れた策定がなされ, 保健指導レベルの高血圧・脂質異常・高血糖・腎機能低下を有する者や, BMI 30未満の肥満者を対象に含めた。エネルギー摂取量の評価は, 食事アセスメント法の過小評価という限界があり, エネルギー消費量も, 二重標識水法で正確な測定が可能だが, 費用面から汎用は困難である。これに対し, エネルギー出納 (＝エネルギー摂取量－消費量) で変化する体重は, 現場で比較的精度の高い評価が可能である。体重はエネルギー出納の結果として変化するが, 長期的には体重変化によりエネルギー消費量も変化し, エネルギー出納の過不足は調整される。したがって, 適切なエネルギー摂取量, 消費量のバランスが維持されている状態を示す指標として, 今回の食事摂取規準はBMIを採用した。18歳以上を年齢で3区分し, 観察疫学研究で総死亡率が最低となるBMIをもとに, 目標とするBMIの範囲を示した。高齢者では, 現状のBMI分布および生活習慣病, 虚弱の予防も考慮し策定した。 |
| Author | 勝川, 史憲 |
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| Copyright | 2016 公益社団法人 日本栄養・食糧学会 |
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| DOI | 10.4327/jsnfs.69.109 |
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| References | 17) 池田 崇, 長澤 弘, 山下哲也, 堀内裕一郎, 内田貴久, 野村千尋, 久合田浩幸, 磯和祐喜子, 石田邦子 (2015) 消費エネルギー量と摂取エネルギー量の出納が介護老人保健施設入所者の転帰に与える影響. 理学療法科学 30, 47-52. 9) Swinburn BA, Sacks G, Lo SK, Westerterp KR, Rush EC, Rosenbaum M, Luke A, Schoeller DA, DeLany JP, Butte NF, Ravussin E (2009) Estimating the changes in energy flux that characterize the rise in obesity prevalence. Am J Clin Nutr 89: 1723-8. 16) Abe E, Hayashi K, Matsumura Y, Sugai Y (2011) Unintentional weight loss in the elderly at a nursing home in Japan: time of onset, changes, and association with mortality. Kitakanto Med J 61: 471-8. 15) Salle A, Ryan M, Ritz P (2006) Underreporting of food intake in obese diabetic and nondiabetic patients. Diabetes Care 29: 2726-7. 3) Leibel RL, Rosenbaum M, Hirsch J (1995) Changes in energy expenditure resulting from altered body weight. N Engl J Med 332: 621-8. 12) Muramoto A, Matsushita M, Kato A, Yamamoto N, Koike G, Nakamura M, Numata T, Tamakoshi A, Tsushita K (2014) Three percent weight reduction is the minimum requirement to improve health hazards in obese and overweight people in Japan. Obes Res Clin Pract 8: e466-75. 21) Ishikawa-Takata K, Tabata I, Sasaki S, Rafamantanantsoa HH, Okazaki H, Okubo H, Tanaka S, Yamamoto S, Shirota T, Uchida K, Murata M (2008) Physical activity level in healthy free-living Japanese estimated by doubly labelled water method and International Physical Activity Questionnaire. Eur J Clin Nutr 62: 885-91. 20) Sergi G, Coin A, Mulone S, Castegnaro E, Giantin V, Manzato E, Busetto L, Inelmen EM, Marin S, Enzi G (2007) Resting energy expenditure and body composition in bedridden institutionalized elderly women with advanced-stage pressure sores. J Gerontol A Biol Sci Med Sci 62: 317-22. 7) Usui C, Takahashi E, Gando Y, Sanada K, Oka J, Miyachi M, Tabata I, Higuchi M (2007) Relationship between blood adipocytokines and resting energy expenditure in young and elderly women. J Nutr Sci Vitaminol 53: 529-35. 8) Casazza K, Fontaine KR, Astrup A, Birch LL, Brown AW, Bohan Brown MM, Durant N, Dutton G, Foster EM, Heymsfield SB, McIver K, Mehta T, Menachemi N, Newby PK, Pate R, Rolls BJ, Sen B, Smith DL Jr, Thomas DM, Allison DB (2013) Myths, presumptions, and facts about obesity. N Engl J Med 368: 446-54. 11) Miyake R, Tanaka S, Ohkawara K, Ishikawa-Takata K, Hikihara Y, Taguri E, Kayashita J, Tabata I (2011) Validity of predictive equations for basal metabolic rate in Japanese adults. J Nutr Sci Vitaminol 57: 224-32. 6) Ruige JB, Ballaux DP, Funahashi T, Mertens IL, Ma-tsuzawa Y, Van Gaal LF (2005) Resting metabolic rate is an important predictor of serum adiponectin concentrations: potential implications for obesity-related disorders. Am J Clin Nutr 82: 21-5. 14) Chong PK, Jung RT, Rennie MJ, Scrimgeour CM (1993) Energy expenditure in lean and obese diabetic patients using the doubly labelled water method. Diabet Med 10: 729-35. 13) Nanri A, Mizoue T, Takahashi Y, Matsushita Y, Noda M, Inoue M, Tsugane S; Japan Public Health Center-based Prospective Study Group (2011) Association of weight change in different periods of adulthood with risk of type 2 diabetes in Japanese men and women: the Japan Public Health Center-Based Prospective Study. J Epidemiol Community Health 65: 1104-10. 22) Swinburn BA, Jolley D, Kremer PJ, Salbe AD, Ravussin E (2006) Estimating the effects of energy imbalance on changes in body weight in children. Am J Clin Nutr 83: 859-63. 19) Fabbri E, An Y, Schrack JA, Gonzalez-Freire M, Zoli M, Simonsick EM, Guralnik JM, Boyd CM, Studenski SA, Ferrucci L (2015) Energy Metabolism and the Burden of Multimorbidity in Older Adults: Results From the Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 70: 1297-303. 10) Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ, Jordan HS, Kendall KA, Lux LJ, Mentor-Marcel R, Morgan LC, Trisolini MG, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr, Tomaselli GF; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 129 (25 Suppl 2) : S102-38. 2) Salvadori A, Fanari P, Mazza P, Agosti R, Longhini E (1992) Work capacity and cardiopulmonary adaptation of the obese subject during exercise testing. Chest 101: 674-9. 18) Kim S, Welsh DA, Ravussin E, Welsch MA, Cherry KE, Myers L, Jazwinski SM (2014) An elevation of resting metabolic rate with declining health in nonagenarians may be associated with decreased muscle mass and function in women and men, respectively. Gerontol A Biol Sci Med Sci 69: 650-6. 1) 厚生労働省：「日本人の食事摂取基準 (2015年版) 策定検討会」報告書. available at http://www.mhlw.go.jp/stf/shingi/0000041824.html 4) Andersen RE, Franckowiak SC, Bartlett SJ, Fontaine KR (2002) Physiologic changes after diet combined with structured aerobic exercise or lifestyle activity. Metabolism 51: 1528-33. 5) Kadowaki T, Yamauchi T, Kubota N (2008) The physiological and pathophysiological role of adiponectin and adiponectin receptors in the peripheral tissues and CNS. FEBS Lett 582: 74-80. |
| References_xml | – reference: 3) Leibel RL, Rosenbaum M, Hirsch J (1995) Changes in energy expenditure resulting from altered body weight. N Engl J Med 332: 621-8. – reference: 1) 厚生労働省：「日本人の食事摂取基準 (2015年版) 策定検討会」報告書. available at http://www.mhlw.go.jp/stf/shingi/0000041824.html – reference: 2) Salvadori A, Fanari P, Mazza P, Agosti R, Longhini E (1992) Work capacity and cardiopulmonary adaptation of the obese subject during exercise testing. Chest 101: 674-9. – reference: 8) Casazza K, Fontaine KR, Astrup A, Birch LL, Brown AW, Bohan Brown MM, Durant N, Dutton G, Foster EM, Heymsfield SB, McIver K, Mehta T, Menachemi N, Newby PK, Pate R, Rolls BJ, Sen B, Smith DL Jr, Thomas DM, Allison DB (2013) Myths, presumptions, and facts about obesity. N Engl J Med 368: 446-54. – reference: 20) Sergi G, Coin A, Mulone S, Castegnaro E, Giantin V, Manzato E, Busetto L, Inelmen EM, Marin S, Enzi G (2007) Resting energy expenditure and body composition in bedridden institutionalized elderly women with advanced-stage pressure sores. J Gerontol A Biol Sci Med Sci 62: 317-22. – reference: 16) Abe E, Hayashi K, Matsumura Y, Sugai Y (2011) Unintentional weight loss in the elderly at a nursing home in Japan: time of onset, changes, and association with mortality. Kitakanto Med J 61: 471-8. – reference: 15) Salle A, Ryan M, Ritz P (2006) Underreporting of food intake in obese diabetic and nondiabetic patients. Diabetes Care 29: 2726-7. – reference: 21) Ishikawa-Takata K, Tabata I, Sasaki S, Rafamantanantsoa HH, Okazaki H, Okubo H, Tanaka S, Yamamoto S, Shirota T, Uchida K, Murata M (2008) Physical activity level in healthy free-living Japanese estimated by doubly labelled water method and International Physical Activity Questionnaire. Eur J Clin Nutr 62: 885-91. – reference: 14) Chong PK, Jung RT, Rennie MJ, Scrimgeour CM (1993) Energy expenditure in lean and obese diabetic patients using the doubly labelled water method. Diabet Med 10: 729-35. – reference: 4) Andersen RE, Franckowiak SC, Bartlett SJ, Fontaine KR (2002) Physiologic changes after diet combined with structured aerobic exercise or lifestyle activity. Metabolism 51: 1528-33. – reference: 9) Swinburn BA, Sacks G, Lo SK, Westerterp KR, Rush EC, Rosenbaum M, Luke A, Schoeller DA, DeLany JP, Butte NF, Ravussin E (2009) Estimating the changes in energy flux that characterize the rise in obesity prevalence. Am J Clin Nutr 89: 1723-8. – reference: 7) Usui C, Takahashi E, Gando Y, Sanada K, Oka J, Miyachi M, Tabata I, Higuchi M (2007) Relationship between blood adipocytokines and resting energy expenditure in young and elderly women. J Nutr Sci Vitaminol 53: 529-35. – reference: 11) Miyake R, Tanaka S, Ohkawara K, Ishikawa-Takata K, Hikihara Y, Taguri E, Kayashita J, Tabata I (2011) Validity of predictive equations for basal metabolic rate in Japanese adults. J Nutr Sci Vitaminol 57: 224-32. – reference: 10) Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ, Jordan HS, Kendall KA, Lux LJ, Mentor-Marcel R, Morgan LC, Trisolini MG, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr, Tomaselli GF; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 129 (25 Suppl 2) : S102-38. – reference: 17) 池田 崇, 長澤 弘, 山下哲也, 堀内裕一郎, 内田貴久, 野村千尋, 久合田浩幸, 磯和祐喜子, 石田邦子 (2015) 消費エネルギー量と摂取エネルギー量の出納が介護老人保健施設入所者の転帰に与える影響. 理学療法科学 30, 47-52. – reference: 18) Kim S, Welsh DA, Ravussin E, Welsch MA, Cherry KE, Myers L, Jazwinski SM (2014) An elevation of resting metabolic rate with declining health in nonagenarians may be associated with decreased muscle mass and function in women and men, respectively. Gerontol A Biol Sci Med Sci 69: 650-6. – reference: 6) Ruige JB, Ballaux DP, Funahashi T, Mertens IL, Ma-tsuzawa Y, Van Gaal LF (2005) Resting metabolic rate is an important predictor of serum adiponectin concentrations: potential implications for obesity-related disorders. Am J Clin Nutr 82: 21-5. – reference: 22) Swinburn BA, Jolley D, Kremer PJ, Salbe AD, Ravussin E (2006) Estimating the effects of energy imbalance on changes in body weight in children. Am J Clin Nutr 83: 859-63. – reference: 19) Fabbri E, An Y, Schrack JA, Gonzalez-Freire M, Zoli M, Simonsick EM, Guralnik JM, Boyd CM, Studenski SA, Ferrucci L (2015) Energy Metabolism and the Burden of Multimorbidity in Older Adults: Results From the Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 70: 1297-303. – reference: 5) Kadowaki T, Yamauchi T, Kubota N (2008) The physiological and pathophysiological role of adiponectin and adiponectin receptors in the peripheral tissues and CNS. FEBS Lett 582: 74-80. – reference: 13) Nanri A, Mizoue T, Takahashi Y, Matsushita Y, Noda M, Inoue M, Tsugane S; Japan Public Health Center-based Prospective Study Group (2011) Association of weight change in different periods of adulthood with risk of type 2 diabetes in Japanese men and women: the Japan Public Health Center-Based Prospective Study. J Epidemiol Community Health 65: 1104-10. – reference: 12) Muramoto A, Matsushita M, Kato A, Yamamoto N, Koike G, Nakamura M, Numata T, Tamakoshi A, Tsushita K (2014) Three percent weight reduction is the minimum requirement to improve health hazards in obese and overweight people in Japan. Obes Res Clin Pract 8: e466-75. |
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| Title | 「日本人の食事摂取基準（2015年版）」，エネルギーの考え方と今後の課題 |
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