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A start of the

Healthy People in Japan 21

Campaign to Promote Better Health in the 21st Century

The Ministry of Health and Welfare recently announced a new approach called the “Healthy Japan 21” campaign to promote better health of each citizen who will live in Japan in the 21st century. In the “Healthy Japan 21” the Ministry picked up the important items for improvement with respect to, among others, nutrition, physical exercise, mental health, smoking, alcohol, dental hygiene, diabetes mellitus, cardiovascular diseases and cancer by analyzing the present health situations of the people, and setting the levels of target values for each of them to be achieved over the next ten years up to the year 2010.

In the sector of nutrition traditional Japanese dietary meals which mainly depended upon high salt, high carbohydrate and low animal protein have gradually been improved over the past fifty years since the World War?, and as a result, the number of disease such as infections, cerebral hemorrhage have a decreased. On the contrary, the number of lifestyle-related diseases such as heart-attack, apoplexy, diabetes mellitus have increased. It is considered that these trends are closely related to the changes of nutrition intake and dietary habits.

Together with the changes of social environment affecting dietary habits in Japan, new problems have been arising. They are among, others, an increasing ratio of skipping breakfast , higher dependence on fast food meals and unbalanced nutrient food, excessive diet-behavior. In other words, in order to realize better nutrition and dietary habits, it is important for those concerned to establish an adequate pattern of life behavior for individuals, and to work for the promotion of new environment that supports it. In this connection, the “Healthy People Japan 21” campaign includes all these contents (Table-1). In implementing the “Healthy People Japan 21” campaign, it is an imperative task for dietitians how much they can participate in and contribute to the promotion activity of human health in the future.

Table-1 Summary of the Levels of Target Values

Relationship to disease and health: nutritional status and nutrient (food) intake level

Increase the proportion of persons maintaining optimal weight

Reduce the proportion of obese adults (BMI 25.0)

Target values: 15% or less for men aged 20-69, 20% or less for women aged 40-69
Reference values: 24.3% for men aged 20-69, 25.2% for women aged 40-69 (National Nutrition Survey 1997)

Reduce the propotion of obese schoolchildren (more than 20% above standard weight based on the Hibi method

Target value: 7% or less
Reference value: 10.7% (National Nutrition Survey 1997)

Reduce underweight (BMI < 18.5) problems among women aged 20-29

Target value: 15% or less
Reference value: 23.3% (National Nutrition Survey 1997)

Reduce average daily fat energy ratio in persons aged 20-49

Target value: 25% or less
Reference value: 27.1% (National Nutrition Survey 1997)

Reduce average daily salt intake in adults

Target value: less than 10g
Reference value: 13.5g (National Nutrition Survey 1997)

Increase average daily vegetable intake in adults

Target value: 350g or more
Reference value: 292g (National Nutrition Survey 1997)

Increase average daily intake of calcium-rich foods (milk and daily products, beans, and deep-colored vegetables) in adults

Target value:

130g or more for milk and daily products, 100g or more for beans, 120g or more for deep-colored vegetables

Reference value:

107g milk and daily products, 76g for beans, 98g for deep-colored vegetable (National Nutrition Survey 1997)

Factors contributing to behavior change: knowledge, attitude, and behavior

Increase the proportion of persons who are aware of their own optimal weight and control weight.

Note:

Optimal weight: Standard based on [Height (m)]²×22 (using BMI=22).

Target value:

90% or more

Reference value:

62.6% for males aged 15 or older, 80.1% for females aged 15 or older (National Nutrition Survey 1997)

Reduce the proportion of persons who skip breakfast

Target value:

15% or less males aged 20-39, 0% for junior high school/high school students

Reference value:

32.9% or less males aged 20-29, 20.5% for males aged 30-39, 6.0% for junior high school/high school students (National Nutrition Survey 1997)

Increase the proportion of persons who eat balanced meals in terms of quality and size

Increase the proportion of persons who eat balanced meals at least once a day, in the company of 2 or more persons, such as family members, and spend 30 or more minutes per meal

Note:

Balanced meal: Meal that meets established requirements in daily calorie intake and concentrations of various nutrients.

In the company of 2 or more persons, such as family members: Meals as a means for communication among the family are important for children’s healthy growth and for the development of the ability to practice good eating habits throughout life.
Target value: 70% or more
Reference value: Proportion of persons who take moderate-sized meals with friends or family at a slow pace: 56.3% for adults (National Nutrition Survey 1996)

Increase the proportion of persons who read nutrition labels when dining out or purchasing food

Reference value:

(National Nutrition Survey 1999)

Increase the proportion of persons who know the appropriate size of meal for maintaining optimal weight

Target value:

80% or more

Reference value:

Proportion of persons who know the size and quality of meal appropriate for themselves: 65.6% for adult males, 73.0% for adult females (National Nutrition Survey 1996)

Increase the proportion of persons who desire dietary improvement among those who believe there are problems in their diet

Target value:

80% or more

Reference value:

Proportion of persons who believe there are problems in their diet: 31.6% for adult males, 33.0% for adult females; Proportion of persons who desire dietary improvement among those:55.6% for adult males, 67.7% for adult females (National Nutrition Survey 1996)

Environment-building for support of behavioral change: environment level

Increase the availability and users of healthy menus in cafeterias at workplaces etc., restaurants, and food retailers.

Reference value:

(2000 Survey)

Increase the opportunities to obtain information on health and nutrition in the community and at the work place and increase the number of people participating (particularly young people).

Reference value:

(2000 Survey)

Increase the number of voluntary groups involved in study and activities related to health and nutrition in the community and at the workplace.

Reference value:

(2000 Survey)

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