Background: Japan’s rapidly aging population has increased the urgency of addressing frailty among older adults. Oral hypofunction and malnutrition are recognized as key contributors to frailty, and both are considered reversible through early interventions. However, little is known about the effectiveness of integrating nutritional guidance and oral function training in community dental clinics. This study aimed to examine the association between dietary variety, oral function, and body composition among outpatients aged 50 years and older, and to evaluate the effects of targeted interventions over a 1-year period. Methods: A total of 74 outpatients (mean age 72.3±9.6 years) were assessed at baseline and after 1 year. Dietary variety was evaluated using the Dietary Variety Score (DVS), and oral function was assessed using seven standardized parameters. Body composition, including weight, body fat percentage, and muscle mass, was assessed using a bioelectrical impedance analyzer. Based on DVS results, registered dietitians provided nutritional counseling, while dental hygienists delivered tailored oral function training. Statistical analyses included the Wilcoxon signed-rank and McNemar’s tests. Results: Significant improvements were observed in eight of the ten DVS food groups, resulting in a higher total DVS score. Tongue coating index and tongue pressure also improved significantly, and the prevalence of oral hypofunction declined. No significant changes were found in body composition. Conclusion Integrating nutritional guidance and oral function training in a community dental setting improved dietary variety and oral function in older adults. These findings suggest that multidisciplinary care in community dental clinics may contribute to health promotion and frailty prevention.

This study aimed to clarify the relationship between serum 25-hydroxyvitamin D concentration body composition by examining male university rugby players in a cross-sectional manner. The subjects were 36 male rugby players (mean age: 20.2 years) who provided us with data regarding their body composition, blood biochemistry examination, and dietary intake frequency. Examination of their serum concentrations of 25-hydroxyvitamin D 【25 (OH) D】 showed that 58% (21/36 subjects) and 42% (15/36 subjects) had sufficient and insufficient intake of vitamin D, respectively. In comparison of serum 25 (OH) D concentrations between players in individual positions, it was suggested that the concentrations were significantly lower in the forward (FW) players compared with the backs (BK) players (p<0.01). The number of FW players with lipid abnormality was significantly higher than that of BK players (p<0.01). Serum 25 (OH) D concentrations showed negative correlations with weight, Body Mass Index (BMI), total body fat amount, and lean body weight. Multiple linear regression analysis suggested that serum 25 (OH) D concentration would be affected by BMI. The average serum 25 (OH) D concentration among obese class II – IV players was 27.8 ng/mL, which was significantly lower than that of players with a normal weight or obese class I (34.2 ng/mL, p<0.01, 33.1 ng/mL, p<0.01). These findings suggest that vitamin D intake among obese class II – IV players was not sufficient, despite the fact that their intake of vitamin D was 14.1 µg, which was much higher than the adequate intake level. In the future, further studies should clarify how increased intake of vitamin D could improve physical characteristics.

A 60-year-old man with type 2 diabetes mellitus and severe obesity (height 170 cm, weight 160 kg, BMI 55) was admitted to our hospital because of acute inferior wall myocardial infarction due to acute thromboembolism of the right coronary artery (RCA). Because of three-vessel coronary diseases, we planned coronary artery bypass grafting after the medical therapy. The patient was intubated, then suffered congestive heart failure and pneumonia, and had a tracheotomy because of obesity hypoventilation syndrome. When his general condition improved after 14 months of medical therapy, we performed the operation. At that time, his weight had decreased to 107.5 kg, and BMI decreased to 37.2. We decided that tracheotomy was necessary to avoid respiratory complications. We chose a thoracoabdominal spiral incision for 2 reasons. Firstly we needed to avoid wound contamination by the tracheotomy stoma. Secondly we decided that the left internal thoracic artery (LITA) and the right gastroepiploic artery (RGEA) were sufficient for bypass grafts to the left anterior descending artery (LAD), the diagonal branches (D1), the posterolateral artery (PL) and the posterior descending artery (PD). Before the operation, epidural anesthesia was performed for postoperative analgesia to prevent respiratory dysfunction. In the right semi-lateral position at 30°, a 4th intercostal space thoracotomy was performed, and the LITA was harvested. The skin incision was extended to the midline of the abdomen and the RGEA was harvested. The end of the LITA was anastomosed with the free RGEA as I composite and the composite was anastomosed to the LAD, the D1, the 14 PL and the 4 PL without cardiopulmonary bypass. Without any perioperative blood transfusion, the patient was discharged with no perioperative complication, including mediastinitis. With this incision, we achieved secure prevention of wound contamination by the tracheotomy stoma, harvesting of a sufficient length of the LITA and RGEA and good visualization of the anastomotic sites with less cardiac displacement than median sternotomy.

Dynamic knee valgus is considered a risk factor of non-contact anterior cruciate ligament (ACL) injury. To identify athletes at a higher risk, we developed a two-dimensional (2D) video-based screening test that determines hip abductor function as well as dynamic hindfoot and knee valgus. The purpose of this study was to validate the accuracy of the indices for dynamic knee valgus derived knee-in distance (KID) and hip-out distance (HOD) from the 2D-video.Twenty healthy university students agreed to participate in this study. Subjects were asked to step off a 30-cm box and land on one leg. This procedure was recorded simultaneously using a 2D video camera in the frontal plane and the Vicon motion capture system. Pearson's correlations examined associations between KID, KID normalized by height (KID/H), HOD, as well as HOD normalized by height (HOD/H) and 3D-valgus (knee valgus) or 3D-IR (tibial internal rotation).Significant correlations were found between the KID and 3D-valgus (r=0.72, p<0.01) and KID/H and 3D-valgus (r=0.73, p<0.01). Associations were not significant between KID and 3D-IR (r=0.08) and between KID/H and 3D-IR (r=0.03). A positive moderate correlation between HOD and 3D-valgus (r=0.46, p<0.05) and HOD/H and 3D-valgus (r=0.50, p<0.05), as well as a negative moderate correlations between HOD and 3D-IR (r=-0.52, p<0.05) and between HOD/H and 3D-IR (r=-0.51, p<0.05) were also observed.We conclude that KID is a reliable alternative for the 3D-valgus and the HOD is for the 3D-valgus and tibial external rotation.