Excess Na intake and insufficient K intake are well-known risk factors for CVD. International comparative studies have reported that Japan has the highest intake of Na and the lowest intake of K in the world. However, no recent study has precisely assessed Na and K intakes in Japanese adults. In the present study, Na and K intakes were estimated from two 24 h urine collections implemented in twenty-three out of forty-seven prefectures in Japan. Apparently healthy men (n 384) and women (n 376), aged 20 to 69 years, who had been working in welfare facilities were recruited, with data collection conducted in February and March 2013. The mean Na excretion was 206·0 mmol/d in men and 173·9 mmol/d in women. The respective values of K excretion were 51·6 and 47·2 mmol/d. The excretion of both Na and K varied considerably among the prefectures, and was higher in subjects with a higher BMI. In contrast, only K excretion was associated with age. After estimating the usual intakes of Na and K, it was found that none of the male subjects met the recommended Na intake values of the WHO, and that only 3·2 % met those of the Japanese government. The respective values for females were 0·1 and 5·0 %. For K intake, 7·5 % of the total subjects met the recommended values of the WHO and 21·7 % met those of the Japanese government. These findings suggest that there is an urgent need for the development of an effective intervention programme to reduce Na intake and promote K intake in the Japanese population.Key words: Sodium: Potassium: Intake: Japanese adults Recently, the WHO (1,2) published new guidelines for recommended intake levels of Na and K in adults and children. However, most people consume more Na and less K than these recommended values worldwide (3 -5) . Excess Na intake leads to hypertension that is associated with severe adverse health outcomes such as CHD and stroke, and the beneficial effect of salt reduction on these diseases has been confirmed (6,7) . Salt reduction is also a cost-effective means of reducing the risk of CVD (8,9) . Excess Na intake and insufficient K intake independently lead to hypertension and other CVD (10,11) , and higher K intake reduces blood pressure in individuals with hypertension (10,11) .The INTERSALT (3) and INTERMAP studies (5) have reported that Na intake is higher in the East Asian countries of China, the Republic of Korea, and Japan than in other countries. Substantial differences in intake have also been reported between northern and southern China and within Japan (3,5) . Moreover, K intake has been reported to be lower in these East Asian countries than elsewhere (3,5) . Nevertheless, the National Health and Nutrition Survey in Japan reported that Na intake is being continuously decreasing (12) . The reason for this trend is attributed to the Westernisation of the Japanese diet and change in food preservation method, i.e. the change from preservation with salt to the use of home refrigerators. Average Na and K intakes in the 2011 survey were 4287 mg/d (186·4 mmol/d) and...

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Mobile applications are increasingly used in healthcare. We have developed a smartphone healthcare application, CALO mama Plus, that can register daily diet, exercise, mood, and sleep quality, calculate dietary intake, and provide advice using artificial intelligence technology. This 3-month randomized controlled trial tested the hypothesis that CALO mama Plus could promote body weight reduction in Japanese adults with overweight or obesity. We recruited office workers as participants. The key eligibility criteria were an age of 20–65 years and a body mass index of 23–40 kg/m2. The primary outcome was body weight change over 3 months. We enrolled 141 participants and randomly assigned them to the intervention (n = 72) and control (n = 69) groups. The intervention group used CALO mama Plus, and the control group did not receive any intervention. The change in body weight was −2.4 ± 4.0 kg and −0.7 ± 3.3 kg in the intervention and control groups, respectively. An analysis of covariance adjusted for related variables showed a significant between-group difference in body weight change (−1.60 kg; 95% confidence interval −2.83 to −0.38; p = 0.011). The present study suggests that CALO mama Plus effectively promotes weight loss.

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