We examined the dietary intake and sources of isoflavones (daidzein and genistein) among Japanese subjects based on dietary records (DRs). The subjects comprised two groups: 1,232 who completed one-day DRs (Group 1) and 88 men and women who kept four four-day (16-day) DRs. For quantitative data on the level of daidzein and genistein in soy foods, we extensively reviewed the literature, particularly for Japanese soy foods, and adopted the median value for each food. The median intake of daidzein was 12.1 and 9.5 mg/day among Groups 1 and 2, respectively, while the corresponding values for genistein were 19.6 and 14.9 mg/day. The top four foods (tofu, miso, natto, and fried tofu) covered about 90% of the population intake of daidzein and genistein. It did not seem feasible to estimate one's intake of isoflavones by using dietary recording/recall in epidemiological studies, since the day-to-day variation in intake was too large, the within-person coefficient of variation being 89.1% for daidzein and genistein. Therefore, we should use other methods, such as food-frequency questionnaires, focusing on the four major sources of isoflavones, to assess individual isoflavone intake.

We developed a simple food frequency questionnaire (FFQ) based on one-day dietary records (DRs) among 1001 subjects in Nagoya, Japan. A total of 97 foods and dishes were selected through a two-step procedure; first by ranking food items according to the contribution to the population intake of nutrient variables, and second by stepwise multiple regression analyses of individual food items as the independent variables and of total nutrient intake as the dependent variables. For simplicity, questions on portion sizes were not included except for a few selected food items, which resulted in short time (about 20 minutes) to complete the questionnaire. This FFQ was validated for food groups by referring to four 4-day DRs among 88 men and women in central Japan, from 1996 to 1997. The energy-, sex- and age-adjusted test-retest correlation coefficients between the two FFQs administered at an one year interval ranged from 0.34 to 0.78. The de-attenuated, energy-, sex- and age-adjusted correlation coefficients between the second FFQ and the DRs were larger than 0.40 for most food groups, indicating the usefulness of this simple FFQ with its sufficient validity in epidemiological surveys.

A self-administered 97-item simple food frequency questionnaire (FFQ), without portion size questions for most items, was completed twice at an one-year interval by 88 men and women in central Japan to evaluate its reproducibility. This FFQ was further validated by referring to four 4-day weighed dietary records (DRs) which were performed at 3-month intervals. Mean energy and 18 nutrient intakes measured by the first and the second FFQs were quite similar to those measured by the DRs. In our reproducibility study, Pearson and intraclass correlation coefficients, adjusted for energy intake, sex and age, ranged from 0.48 to 0.82 (median =0.67). In the validation study, adjusted and de-attenuated correlation coefficients between the second FFQ and the DRs ranged from 0.42 for iron to 0.83 for calcium (median=0.61). The proportion of subjects classified by the FFQ into the same or adjacent quintiles defined by the DRs was between 65.9% and 83.0% (median=69.9%). These findings essentially suggested that our FFQ is well reproducible and sufficiently valid, and therefore, reasonably useful for nutritional epidemiological studies for Japanese diets, particularly for those of Tokai Area. J Epidemiol, 1999; 9 : 227-234.reproducibility, validity, nutrient, food frequency questionnaire, Japan Food frequency questionnaires (FFQs) have been commonly used in nutritional epidemiology to assess individual intakes of food and nutrients. They can easily cover a larger period than dietary records (DRs) or recalls at much lower cost even in large populations1).However, since FFQs would be less valid than detailed DRs, then energy and nutrient intakes, when estimated by a certain FFQ, should usually be validated". Only a few validation study for FFQs, however, have been conducted in Japan7-9). Recently, we have developed a self-administered, 97-item simple food frequency questionnaire (FFQ), without portion size questions for most items, for epidemiological survey in the middle-aged and the older10). In the present study, we aimed to assess reproducibility and validity of this FFQ in terms of nutrients. MATERIALS AND METHODS Study Design and SubjectsThe design of this validation study has been described in the preceding paper10>. In short, 119 subjects aged 41 to 88 years, were recruited from the family members of students/graduates of the dietitian course. They completed our self-administered FFQ twice at an one-year interval in order to evaluate the reproducibility (the first and the second FFQ are denoted hereafter as FFQ1 and FFQ2). Along with this reproducibility study, the FFQ was validated by referring to four 4-day weighed dietary records (DRs) which were performed at 3-month intervals. Of the 119 subjects, 88 (73.9%, 46 men and 42 women) completed the two FFQs and the four 4-day DRs, and were included in the analysis.The FFQ was designed to assess diets during preceding one year, and to rank individuals according to their nutrient intakes.

Gastrinomas mainly occur in the duodenum and pancreas. Primary hepatic gastrinoma is rare and difficult to diagnose because the liver is a frequent site of metastatic gastrinomas. Clinical factors were assessed in a 28-year-old man with diarrhea and heartburn who was hospitalized for recurrent duodenal ulcers. Abdominal ultrasound, endoscopic ultrasound and computed tomography (CT) could not detect a tumor in the duodenum or pancreas. His gastrin level was 846 pg/mL and magnetic resonance imaging showed a mass 12 mm in diameter in the right robe of the liver. A selective intra-arterial calcium injection (SACI) test and 68-gallium edotreotide positron emission tomography CT (Ga-DOTATOC PET-CT) were therefore performed. Calcium gluconate injection into the proper hepatic artery resulted in a marked increase in serum gastrin concentration in the right hepatic vein, with Ga-DOTATOC PET-CT showing uptake only by the liver mass. Following a diagnosis of primary hepatic gastrinoma, the tumor was resected. A histopathological examination indicated gastrinoma. Six months postoperatively, he has no symptoms, is not taking proton-pump inhibitors and his gastrin level remains within the normal range. The SACI test and the clinical course of this patient strongly suggest that the tumor was a primary hepatic gastrinoma. The SACI test is helpful in the diagnosis of primary hepatic gastrinoma.

We found an association between depressive mood and subsequent suicide in a middle-aged workers. Detailed observation and follow-up of those with depressive mood should be systematically organized with due attention and caution.