Shigeru Yamamoto

Jumonji University, Саитама, Saitama, Japan

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Publications (152)244.15 Total impact

  • Shigeru Yamamoto · Saiko Shikanai ·
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    ABSTRACT: In this article, we would like to offer some arguments that white rice (WR) per se is the cause neither of diabetes mellitus (DM) nor of obesity. Japanese eat rice as their staple food. Although their per capita intake a day has been dropping from about 330 g in the mid-1960s to about 165 g in 2010, DM in Japan has been increasing from about 10 % in 2006 to about 13 % in 2013. The prevalence of adult obesity (BMI >30) in the last 40 years has increased in the USA from 15 to 33 %, in England from 7 to 25 %, but in Japan from 2 to 3.5 %. From this and other evidence, we concluded that WR can be a cause of DM but only when intake is very high and perhaps with small amount of other foods.
    06/2015; 4(2). DOI:10.1007/s13668-015-0120-z
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    ABSTRACT: We have reported that newly diagnosed type 2 diabetes mellitus (DM) patients in Vietnam have a low body mass index (BMI) of around 23 and that the major factor for this is high white rice (WR) intake. Brown rice (BR) is known to be beneficial in the control of blood glucose levels; however, it has the property of unpleasant palatability. Pre-germinated brown rice (PGBR) is slightly germinated by soaking BR in water as this reduces the hardness of BR and makes it easier to eat. This study was designed to evaluate the effect of a 4-mo PGBR administration on various parameters in Vietnamese women aged 45-65 y with impaired glucose tolerance (IGT). Sixty subjects were divided into a WR or PGBR group. For the first 2 wk, WR was replaced by 50% PGBR, then for 2 wk by 75% PGBR and from the second month 100%. Before the beginning of the study and at the end of the study, 1) anthropometric measurements, 2) a nutrition survey for 3 nonconsecutive days by the 24 h recall method and 3) blood biochemical examinations were conducted. Fasting plasma concentrations of glucose and lipids and the obesity-related measurements and blood pressure were favorably improved only in the PGBR diet group. The present results suggest that replacing WR with PGBR for 4 mo may be useful in controlling body weight as well as blood glucose and lipid levels in Vietnamese women with IGT.
    Journal of Nutritional Science and Vitaminology 08/2014; 60(3):183-187. DOI:10.3177/jnsv.60.183 · 0.83 Impact Factor
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    ABSTRACT: Because of the tastiness of sugars, it is easy to consume more than an adequate amount. There are many research reports that excess sugar intake contributes to dental decay, obesity, diabetes etc. Continuing economic development in Cambodia has made it easier than before for people to consume sugars in their daily life. Currently, isomerized sugar (a mixture of glucose and fructose) made from starches is commonly used in commercial beverages because of its low price. However, in Cambodia and Japan, sugar composition tables that include not only sucrose but also glucose, fructose, lactose and maltose have not been available. Prior to the present nutrition surveys, we made sugar composition tables for both countries. In this study we tried to estimate the intakes of various sugars by children in Cambodia and Japan and to determine the relationship between intake and body weight. Nutrition surveys of children aged 7, 10 and 13 years old were conducted for 3 nonconsecutive days by the 24 h recall method in 89 Cambodian children living in the capital city of Cambodia, Phnom Penh, and 151 Japanese children living in 3 prefectures from north to south. Height and weight of children in Cambodia and Japan were similar until 10 years old but at 13 years old, the Cambodians were shorter and lighter than the Japanese. We could not observe any differences in BMI in either country. The sugar intakes from beverages and snacks were not different among the different gender and age. Thus we combined the mean total sugar intake for Cambodian and Japanese, 28.42 ± 25.28 g and 25.69 ± 16.16 g respectively. These were within the range of WHO recommendations (less than 10% of energy intakes). Cambodian children consumed about 46% of sugars from commercial beverages and snacks and Japanese children 26%. This means that for Cambodians half of the sugars came from isomerized sugar made from starches. Relationships between sugar intake and body weight were not observed in both countries. In conclusion, the Cambodian children consumed about 46% of sugar from glucose and fructose (probably in the form of isomerized sugar), while the Japanese children took 26%; however, the intakes in both countries met the WHO recommendation and there was no relationship to body weight. J. Med. Invest. 61: 72-78, February, 2014.
    The Journal of Medical Investigation 04/2014; 61(1.2):72-8. DOI:10.2152/jmi.61.72
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    ABSTRACT: Soy bean trypsin inhibitor (SBTI) belongs to the family of serpins – serine protease inhibitors widely distributed in the nature. Serpins participate in the regulation of proteolytic reactions underling very important physiological and pathological processes such as digestion, blood clotting, immunity, apoptosis, inflammation, carcinogenesis and so on. Despite the apparent importance of the correction of imbalances of the proteolysis in pathology, in fact only the pancreatic trypsin inhibitor (aprotinin) is used more or less widely as a protease inhibitor drug (Trasisol, Contrical, Gordox etc) in the treatment of some diseases. Being the animal protein aprotinin possesses substantial disadvantages and attempts to develop new drug on the base of plant or recombinant proteins or peptidomimetics are undertaken. SBTI is one of the candidates for such a role.
    SOYBEAN - BIO-ACTIVE COMPOUNDS, Edited by Hany A. El-Shemy, 02/2013: chapter 22: pages 495-512; InTech., ISBN: 978-953-51-0977-8
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    ABSTRACT: OBJECTIVE: To determine the prevalence of and associated factors for overweight, especially to determine the relationship between the intake of monosodium glutamate (MSG) as a seasoning and overweight in Vietnam. DESIGN: A cross-sectional survey was conducted of Vietnamese adults aged ≥20 years in 2008. Dietary intake was assessed by the 24 h recall method for 3 d. MSG intake was evaluated by the weighing method on three consecutive days. Physical activity was assessed based on the Global Physical Activity Questionnaire recommended by the WHO. Overweight was defined as BMI ≥ 23·0 kg/m2. Other characteristics such as age and lifelong occupation were determined by a structured questionnaire. SETTING: Some rural and urban areas of Hanoi, Thua Thien Hue Province and Ho Chi Minh City, Vietnam. SUBJECTS: A total of 1528 adults living in surveyed areas were randomly selected by the multistage cluster sampling method. RESULTS: The prevalence of overweight was 27·9 %, and 81·0 % of participants were MSG users. Average MSG intake was 2·2 (sd 1·8) g/d. Multiple logistic regression analysis revealed that factors associated with overweight were age, region of residence, lifelong occupation, physical activity and intakes of energy, carbohydrates, saturated fat and animal protein. There was no significant association between MSG intake and overweight. CONCLUSIONS: The study demonstrated that overweight was not associated with MSG intake in Vietnamese adults. Further longitudinal studies should be done in different populations to determine the relationship between MSG and overweight.
    Public Health Nutrition 08/2012; 16(5):1-6. DOI:10.1017/S1368980012003552 · 2.68 Impact Factor
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    ABSTRACT: While sugar intake is an important factor for obesity, diabetes and dental caries, sugars are also important energy sources, especially for rapidly growing children. Children like sugar-rich sweet foods. However, intake for Japanese children is not known due to a lack of studies and sugar composition data. This study was designed to determine sugar intakes from snacks and beverages in Japanese school children. A nutrition survey was conducted for 3 weekdays for 283 Japanese school children (7, 10 and 13 y old) in 8 prefectures from different areas of Japan. The methods for the survey were the weighing method for school lunches and the 24-h recall method for other foods. To estimate sugar intakes, the sugar composition table that was recently compiled by us for 135 beverages, cakes and other sweets was used. Height and weight were measured. They were similar to Japanese averages. Energy intakes were also similar to the results of the Japanese National Health and Nutrition Surveys. Sugar eaten outside meals was 24.7±15.5 g/d. From the National Health and Nutrition Surveys conducted in 2009, the mean sucrose intake from meals including some home-made cookies for 7-14-y-old children was 5.5 g/d, suggesting the mean total sugar intake of these children was about 30 g/d. This was within the range of FAO/WHO recommendation (less than 10% of energy intake, 49 g for these children. Mean intakes among age groups were not significantly different (p>0.05), but the intake for girls was lower than for boys in the oldest age group (p<0.05). Contributions of each sugar to total intake were sucrose 64%, fructose 14%, glucose 13% and lactose 9%. Fructose and glucose were mainly from isomerized sugar. Contributions of food groups to total intake were beverages 25%, baked goods 19% and ice cream 17%, respectively, covering 61% of all. In conclusion, we revealed that the average sugar intake of Japanese children was within the range of the FAO/WHO recommendation, though the effects of the kind of sugars on health remain to be clarified.
    Journal of Nutritional Science and Vitaminology 07/2012; 58(2):113-7. DOI:10.3177/jnsv.58.113 · 0.83 Impact Factor
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    ABSTRACT: Theoretically, the longer the period of a nutrition survey, the more reliable the results. However, a long survey can impose a burden on subjects and cause the results to become inaccurate. For adults, a 3 non-consecutive day survey is usually recommended; however, for school children, at least in Japan, it has not been determined whether this is necessary. In this study we conducted a survey of 7 days and tried to find the minimum number of days necessary to determine the energy intake. The subjects were about 300 children aged from 6 to 7, 10 to 11 and 13 to 14 years old in a city in the western part of Japan. The weighing method was used for the school lunch and other meals were surveyed by 24-recalling method. For the 6-7 year-old school children, guardians were asked to keep dietary records. The final number of subjects who were able to complete the 7-day survey was 139. Energy intakes for each weekday were not statistically different (p>0.05) and those for each weekend did not differ (p>0.05). Average energy intakes on weekdays were higher than those on weekend days in 10-11 and 13-14 year-old children. The average intakes of energy in 10-11 and 13-14 year-old children were lower than Japanese estimated energy requirements (EER). However, body weight of more than 90% of subjects was within the normal range. The results suggest that a survey of one weekday is reliable for all weekdays and that of one week-end day is reliable for any weekend day and also indicate the necessity of further studies of EER in rapidly growing children.
    The Journal of Medical Investigation 02/2012; 59(1-2):111-5. DOI:10.2152/jmi.59.111
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    ABSTRACT: Protamine is a basic protein whose sulfate is used in medical applications as a carrier for injectable insulin and as a heparin antagonist, while its hydrochloride is used as an antibacterial ingredient for some food products. We previously showed that protamine hydrochloride derived from chum salmon milt inhibited pancreatic lipase and reduced plasma triacylglycerol levels in an oral fat tolerance test in humans. The present study evaluated the effect of chum protamine hydrochloride on lipid metabolism in rats. The single oral administration of protamine hydrochloride (500 mg/kg) reduced plasma triacylglycerol levels in a corn oil tolerance test, and repeated oral administration at a dose of 0, 150, 500, or 1,500 mg/kg with a high fat diet for 7 weeks significantly reduced body weight gain, liver weight, and epididymal adipose tissue, whereas total calorie intakes were not significantly different. These findings could be caused by the suppression of lipid digestibility leading to a significant increase in fecal lipid excretion due to the fact that protamine hydrochloride could bind with bile acids to make a complex that is difficult to digest. Protamine hydrochloride, with a considerable history as food, can be considered to be promising as an anti-obesity functional food material.
    Fisheries Science 11/2011; 77(6). DOI:10.1007/s12562-011-0399-7 · 0.88 Impact Factor
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    Soybean and Health, 09/2011; , ISBN: 978-953-307-535-8
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    ABSTRACT: The aim of the present study was to evaluate the effects of dietary zinc deprivation on zinc concentration, the activity of angiotensin converting enzyme (ACE) and ratio of apo/holo-activities of ACE (ACE ratio) in the serum of mice. Twenty-two male mice were deprived of dietary zinc for up to 9 days. Zinc concentration in the serum was measured by means of atomic absorption spectrometry. Also, the activity of ACE in the serum was measured by HPLC as the activity of holo-ACE. After addition of zinc to the serum in vitro, the increase of ACE activity over the initial value was determined as that of apo-ACE. Finally, the ratio of apo/holo-ACE activities was calculated. There was a significant decrease of zinc concentration, but a slight decrease of the activity of ACE in the serum of mice by intake of zinc-deficient diet for 9 days. ACE ratio tended to increase on day 5 and was significantly increased on day 9 in mice deprived of dietary zinc. These findings suggest that ACE ratio is as sensitive as serum zinc concentration for the evaluation of zinc deficiency and can be used for the biochemical diagnosis of zinc nutritional status in patients with zinc deficiency-induced taste impairment.
    Auris, nasus, larynx 08/2011; 39(3):294-7. DOI:10.1016/j.anl.2011.05.007 · 1.14 Impact Factor
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    ABSTRACT: In the present study, we first examined the dietary zinc intake from food groups in 109 healthy Japanese (24-82 years old, 45 male and 64 female) by means of the 72-h recall method. We then used the ratio of apo/holo-activities of angiotensin converting enzyme (ACE ratio) that is a more sensitive index of zinc nutrition than zinc concentration in the serum and examined the correlation between their zinc intake and ACE ratio. Dietary zinc intake in healthy Japanese was maximal from rice and rice products. There were significant inverse correlations between the ACE ratio and dietary zinc intake from rice and rice products and shellfish, and a significant positive correlation between ACE ratio and dietary zinc intake from other beans and bean processed foods. On the other hand, there were no significant correlations between serum zinc concentrations and dietary zinc intake from any food group except processed fish. These findings suggested that rice is a major source of dietary zinc intake in healthy Japanese. It is also suggested that shellfish also has a major impact on zinc nutrition, although dietary zinc intake from this source is minimal. Since beans contain phytic acid, which inhibits the absorption of dietary zinc, it is suggested that intake of beans causes impairment of zinc nutrition.
    The Journal of Medical Investigation 08/2011; 58(3-4):203-9. DOI:10.2152/jmi.58.203
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    ABSTRACT: Vitamin A deficiency (VAD) is known to be a major public health problem among women of reproductive age in South East Asia and Africa. In Ethiopia, there are no studies conducted on serum vitamin A status of HIV-infected pregnant women. Therefore, the present study was aimed at determining the level of serum vitamin A and VAD among pregnant women with and without HIV infection in tropical settings of Northwest Ethiopia. In this cross-sectional study, blood samples were collected from 423 pregnant women and from 55 healthy volunteers who visited the University of Gondar Hospital. Serum concentration of vitamin A was measured by high performance liquid chromatography. After controlling for total serum protein, albumin and demographic variables, the mean ± SD serum vitamin A in HIV seropositive pregnant women (0.96 ± 0.42 μmol/L) was significantly lower than that in pregnant women without HIV infection (1.10 ± 0.45 μmol/L, P < 0.05). Likewise, the level of serum vitamin A in HIV seropositive non-pregnant women (0.74 ± 0.39) was significantly lower than that in HIV negative non-pregnant women (1.18 ± 0.59 μmol/L, P < 0.004). VAD (serum retinol < 0.7 μmol/L) was observed in 18.4% and 17.7% of HIV infected and uninfected pregnant women, respectively. Forty six percent of non-pregnant women with HIV infection had VAD while only 28% controls were deficient for vitamin A (P = 0.002). The present study shows that VAD is a major public health problem among pregnant women in the tropical settings of Northwest Ethiopia. Considering the possible implications of VAD during pregnancy, we recommend multivitamin (which has a lower level of vitamin A) supplementation in the care and management of pregnant women with or without HIV infection.
    BMC Public Health 07/2011; 11(1):569. DOI:10.1186/1471-2458-11-569 · 2.26 Impact Factor
  • Nobuo Yoshiike · Shigeru Yamamoto · Shinkan Tokudome · Makoto Shimizu ·

    Journal of Nutritional Science and Vitaminology 01/2011; 57(4):313-5. DOI:10.3177/jnsv.57.313 · 0.83 Impact Factor
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    ABSTRACT: To express intensity of physical activity, energy expenditure is often divided by either body weight, resting metabolic rate, or fat-free mass. These calculations are used widely as the physical activity index. However, it is unclear how body size influences the valid estimation of intensity of various kinds of activities. In the present study, we investigated whether these indices are able to adjust for body size when calculating energy expenditure in various kinds of activities. In addition, we examined to what extent the error of index is introduced by differences in body size. Resting metabolic rates and energy expenditure during sitting light work, 4 lifestyle and 7 ambulant activities were measured in the postabsorptive state using indirect calorimetry in 71 healthy Japanese adults. We regarded an index as an inappropriate adjustment for body size when there was a significant correlation between it and body weight. Energy expenditure normalized by body weight correlated with body weight in all sedentary states; when normalized by lying resting metabolic rate it correlated with body weight in 3 ambulant activities; when normalized by sitting resting metabolic rate it correlated with body weight in 2 lifestyle and 5 ambulant activities; and when normalized by fat-free mass it correlated with only 1 ambulant activity. The indices caused errors in estimates of activity intensity of less than +/-10% when body weight was more than 10 kg above average. In conclusion, the body weight-normalized index was inappropriate for sedentary activities and the other three indices were inappropriate for ambulant activities. However, the use of any of these indices introduces an error in the estimate of total energy expenditure of considerably less than +/-10% for body weights within the normal range.
    Journal of PHYSIOLOGICAL ANTHROPOLOGY 05/2010; 29(3):109-17. DOI:10.2114/jpa2.29.109 · 1.27 Impact Factor
  • Shoko Miura · Masumi Yagi · Ophelia L Saavedra · Shigeru Yamamoto ·
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    ABSTRACT: We explored knowledge of osteoporosis and locally available calcium-rich foods among 1,151 urban women in the Philippines and analyzed the cross-sectional associations of their responses to questions about knowledge with their age, educational background, and family income status. In total, 80.3% of the women had heard about osteoporosis; a higher educational background independently predicted this awareness. For knowledge about locally available calcium-rich foods, older age was a positive predictor, whereas higher educational background was a negative predictor. We believe that more emphasis should be placed on locally available foods as part of nutritional education for young urban Filipinos.
    Health Care For Women International 05/2010; 31(5):387-401. DOI:10.1080/07399330903411150 · 0.63 Impact Factor
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    ABSTRACT: To be thin is the desire of many young women because of idealized body images in the media as well as cultural factors. This review summarizes the content of the symposium, "International Comparison of Body Image," which was part of the 15th International Congress of Dietetics held in Yokohama, Japan, on September 8 to 11, 2008. Body image is a term that refers to one's perception of his/her own physical appearance and how that body appears to others. A negative body image usually has unfavorable consequences, such as the development of an eating disorder. The desire for thinness is widespread, even in non-Western countries. For example, young Japanese women have an even stronger desire to be thin than their American or Vietnamese counterparts. Abnormal eating behaviors are common among adolescents in both Western and non-Western countries. Therefore, we should monitor inappropriate weight loss attempts, especially by adolescents in all countries
    Nutrition Today 04/2010; 45(3):113-117. DOI:10.1097/NT.0b013e3181dec6bb
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    ABSTRACT: Although environmental factors are important, there is considerable evidence that genes also have a significant role in the pathogenesis of obesity. We conducted a population-based study to investigate the relationship between candidate genes for obesity (UCP1, UCP2, ADRA2B, ADRB3, LEPR, VDR and ESR1) and adiposity measures (body mass index, body fat percentage, weight, waist circumference and waist-hip ratio) in terms of individual gene and gene x gene interaction in models unadjusted and adjusted for covariates (age, years since menopause, educational level and total energy intake). Postmenopausal women with TC genotype of ESR1 gene had higher body fat percentage than those with TT genotype in the models unadjusted and adjusted for the covariates (P = 0.006 in adjusted model). In multiple logistic regression analysis, BsmI and ApaI SNPs of VDR genes were significantly associated with overweight and obesity. The UCP2-VDR ApaI interaction to susceptibility of overweight and obesity was first observed from logistic regression analysis, and then confirmed in the multifactor dimensionality reduction method unadjusted and adjusted for the covariates. This interaction had 69.09% prediction accuracy for overweight and obesity (P = 0.001, sign test). In conclusion, the study suggests the significant association of ESR1 and VDR genes with adiposity measures and the UCP2-VDR ApaI interaction to susceptibility to being overweight and obesity in postmenopausal Vietnamese women.
    Journal of Genetics 04/2010; 90(1):1-9. DOI:10.1007/s12041-011-0028-3 · 1.09 Impact Factor
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    ABSTRACT: To assess the prevalence of undernutrition, incidence of infectious diseases and the situation of feeding practices to determine the risk factors for undernutrition among children aged 6 to 18 months in rural Vietnam. A cross-sectional study was conducted among one hundred eighty-eight mother-child pairs in Bac Giang, Vietnam. Weight and height of the children were measured and referred to data from the WHO/CDC/NCHS. Incidence of infectious diseases was diagnosed based on the WHO Recommended Surveillance Standards. Data on socio-demographic variables and feeding practices were obtained through a structured questionnaire. The prevalence of underweight, stunting and wasting was 19.7%, 23.4% and 5.3%, respectively. The incidence of diarrhea and acute respiratory infections (ARIs) during the last 14 days of the interview was 12.2% and 20.2%, respectively. Although 99% of the children were breastfed, the prevalence of exclusive breastfeeding in the first 4 mo was 21.3%. Non-exclusive breastfeeding in the first 4 month (OR 3.95, p=0.025) and low birth weight (OR 4.38, p=0.009) were associated with underweight in the children, while incidence of infectious disease was not (OR 1.16, p=0.734). Undernutrition is highly prevalent in the study site and non-exclusive breast feeding is one of the risk factors.
    The Journal of Medical Investigation 02/2010; 57(1-2):45-53. DOI:10.2152/jmi.57.45

  • Asian biomedicine 01/2010; 4(6):869-875. · 0.13 Impact Factor
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    ABSTRACT: Difructose anhydride III (DFAIII) is an indigestible disaccharide and has been shown to enhance iron absorption in animal studies; however, the effect has not been investigated in anemic subjects. We investigated the efficacy of co-administration of DFAIII with water-insoluble iron in the treatment of iron deficiency anemia in Vietnamese women. One hundred sixty-eight moderately anemic women (80 g/L<hemoglobin (Hb)<120 g/L) participated in a double-blinded, placebo-controlled study with daily supplementation of iron for 6 mo. The volunteers were randomly assigned into four groups, i.e., Group A: received 15 mg Fe as ferric pyrophosphate; Group B: received 15 mg Fe as ferric pyrophosphate and 1.25 g DFAIII; Group C: received 15 mg Fe as ferrous sulfate; Group D: received a placebo. Hb and iron status were measured at baseline and after 2, 4 and 6 mo of intervention. The ratio of transferrin receptor to ferritin was used to estimate stored and functional body iron (BI). One hundred sixteen (69.0%) women completed the trial. After 6 mo, mean (+/-SE) Hb concentration was higher in Group A (121.6+/-1.7 g/L), Group B (126.4+/-1.5 g/L) and Group C (126.8+/-1.6 g/L) compared to Group D (107.0+/-1.7 g/L, p<0.0001). Mean change in BI was twofold greater in Group B (5.0+/-0.5 mg/kg) than that in Group A (2.5+/-0.6 mg/kg, p=0.008). The percentage of anemia was significantly reduced in Group B (18.8%) compared to Group D (95.8%, p<0.0001) and Group A (39.1%, p=0.033). Co-administration of DFAIII enhances Hb concentration and iron stores more than single administration of water-insoluble iron in anemic Vietnamese women.
    Journal of Nutritional Science and Vitaminology 01/2010; 56(3):191-7. DOI:10.3177/jnsv.56.191 · 0.83 Impact Factor

Publication Stats

2k Citations
244.15 Total Impact Points


  • 2011-2012
    • Jumonji University
      Саитама, Saitama, Japan
  • 2007-2011
    • Ochanomizu University
      • Graduate School of Humanities and Sciences
      Tōkyō, Japan
  • 1998-2009
    • The University of Tokushima
      • • Department of International Public Health Nutrition
      • • Institute of Health Biosciences (HBS)
      • • School of Medicine
      Tokusima, Tokushima, Japan
  • 2008
    • University of Shizuoka
      • Department of Food and Nutritional Sciences
      Sizuoka, Shizuoka, Japan
  • 2006
    • Osaka Prefecture University
      • Department of Clinical Nutrition
      Sakai, Ōsaka, Japan
  • 2005
    • Biotechnology Center of Ho Chi Minh City
      Thành phố Hồ Chí Minh, Ho Chi Minh City, Vietnam
  • 2004
    • University of Texas Health Science Center at Houston
      • School of Public Health
      Houston, TX, United States
  • 2000
    • Michigan State University
      Ист-Лансинг, Michigan, United States
    • National Institute of Health and Nutrition
      Edo, Tōkyō, Japan
  • 1991-1998
    • University of the Ryukyus
      • • Faculty of Medicine
      • • Department of Health Sciences
      Okinawa, Okinawa, Japan
  • 1997
    • Nakamura Gakuen University
      Hukuoka, Fukuoka, Japan
  • 1996
    • St Louis University Hospital
      • Department of Surgery
      San Luis, Missouri, United States
  • 1993
    • The University of Okinawa
      Okinawa, Okinawa, Japan
    • Kumamoto University
      Kumamoto, Kumamoto, Japan