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7\";s:4:\"slug\";s:14:\"contact-form-7\";s:7:\"version\";s:5:\"6.0.5\";s:6:\"author\";s:75:\"<a href=\"https://profiles.wordpress.org/takayukister/\">Takayuki Miyoshi</a>\";s:14:\"author_profile\";s:44:\"https://profiles.wordpress.org/takayukister/\";s:12:\"contributors\";a:1:{s:12:\"takayukister\";a:3:{s:7:\"profile\";s:44:\"https://profiles.wordpress.org/takayukister/\";s:6:\"avatar\";s:120:\"https://secure.gravatar.com/avatar/538487024e649d43dea84ff38d14582d03119e3e7aaaca3b7692443335999133?s=96&d=monsterid&r=g\";s:12:\"display_name\";s:16:\"Takayuki Miyoshi\";}}s:8:\"requires\";s:3:\"6.6\";s:6:\"tested\";s:5:\"6.7.2\";s:12:\"requires_php\";s:3:\"7.4\";s:16:\"requires_plugins\";a:0:{}s:6:\"rating\";i:80;s:7:\"ratings\";a:5:{i:5;i:1434;i:4;i:146;i:3;i:75;i:2;i:68;i:1;i:403;}s:11:\"num_ratings\";i:2126;s:11:\"support_url\";s:52:\"https://wordpress.org/support/plugin/contact-form-7/\";s:15:\"support_threads\";i:194;s:24:\"support_threads_resolved\";i:77;s:15:\"active_installs\";i:10000000;s:12:\"last_updated\";s:21:\"2025-03-11 8:37am GMT\";s:5:\"added\";s:10:\"2007-08-02\";s:8:\"homepage\";s:25:\"https://contactform7.com/\";s:8:\"sections\";a:6:{s:11:\"description\";s:3115:\"<p>Contact Form 7 は自由オープンソースソフトウェアの哲学を信奉するすべての WordPress ユーザーのための実用的なツールとしてデザインされたプラグインです。高度にモジュール化されたアーキテクチャ、独自に開発された<a href=\"https://contactform7.com/ja/schema-woven-validation/\" rel=\"nofollow ugc\">スキーマ織りバリデーション</a>技術が採用されています。</p>\n<h4>ドキュメントとサポート</h4>\n<p><a href=\"https://contactform7.com/ja/\" rel=\"nofollow ugc\">contactform7.com</a> では<a href=\"https://contactform7.com/ja/docs/\" rel=\"nofollow ugc\">使い方</a>や <a href=\"https://contactform7.com/ja/faq/\" rel=\"nofollow ugc\">FAQ</a> など、Contact Form 7 に関する詳細な情報を提供しています。もし FAQ やその他のドキュメンテーションにあなたの疑問の答えを見つけられなかったなら、そのときは WordPress.org の<a href=\"https://ja.wordpress.org/support/topic-tag/contact-form-7/\" rel=\"nofollow ugc\">サポートフォーラム</a>をチェックしましょう。既存のトピックを見ても問題解決できなかったなら、新しいトピックを作成してください。</p>\n<h4>Contact Form 7 はあなたの支援を必要としています</h4>\n<p>このプラグインを維持し続けるためにユーザーのみなさんからの支援を必要としています。<a href=\"https://contactform7.com/ja/contributing/\" rel=\"nofollow ugc\">プロジェクトに貢献する方法</a>はいくつもあります: テストに協力する、コードを書く、あなたのローカル言語に翻訳する、他のユーザーの手助けをする、経済的ドネーション、などなど。方法を問わずすべての貢献者を歓迎します。</p>\n<h4>プライバシーについて</h4>\n<p>このプラグインは、デフォルト設定で使用する場合においては、以下に挙げる動作を行いません:</p>\n<ul>\n<li>こっそりとユーザーを追跡する。</li>\n<li>ユーザーの個人データをデータベースに書き出す。</li>\n<li>外部のサーバーにデータを送る。</li>\n<li>クッキーを利用する。</li>\n</ul>\n<p>このプラグインの特定の機能を有効化している場合、コンタクトフォーム送信者の IP アドレスを含む個人データがサービス提供者に送信される可能性があります。サービス提供者のプライバシーポリシーをよく確認した上で利用してください。これに該当する機能は:</p>\n<ul>\n<li>reCAPTCHA (<a href=\"https://policies.google.com/?hl=ja\" rel=\"nofollow ugc\">Google</a>)</li>\n<li>Akismet (<a href=\"https://automattic.com/privacy/\" rel=\"nofollow ugc\">Automattic</a>)</li>\n<li><a href=\"https://www.constantcontact.com/legal/privacy-center\" rel=\"nofollow ugc\">Constant Contact</a></li>\n<li><a href=\"https://www.brevo.com/legal/privacypolicy/\" rel=\"nofollow ugc\">Brevo</a></li>\n<li><a href=\"https://stripe.com/privacy\" rel=\"nofollow ugc\">Stripe</a></li>\n</ul>\n\";s:12:\"installation\";s:575:\"<ol>\n<li><code>contact-form-7</code> フォルダ全体を <code>/wp-content/plugins/</code> ディレクトリにアップロードします。</li>\n<li><strong>プラグイン</strong> 画面 (<strong>プラグイン &gt; インストール済みプラグイン</strong>) でプラグインを有効化する。</li>\n</ol>\n<p>WordPress 管理画面に <strong>お問い合わせ</strong> メニューが現れるでしょう。</p>\n<p>基本的な使い方は<a href=\"http://contactform7.com/ja/\" rel=\"nofollow ugc\">プラグインのホームページ</a>を参照。</p>\n\";s:3:\"faq\";s:541:\"<p>Contact Form 7 について問題や疑問を抱えていますか? これらのサポート窓口を適切にご利用ください。</p>\n<ol>\n<li><a href=\"https://contactform7.com/ja/docs/\" rel=\"nofollow ugc\">使い方</a></li>\n<li><a href=\"https://contactform7.com/ja/faq/\" rel=\"nofollow ugc\">FAQ</a></li>\n<li><a href=\"https://ja.forums.wordpress.org/tags/contact-form-7?forum_id=5\" rel=\"nofollow ugc\">サポートフォーラム</a></li>\n</ol>\n<p><a href=\"https://contactform7.com/ja/support/\" rel=\"nofollow ugc\">サポート</a></p>\n\";s:9:\"changelog\";s:2107:\"<p>より詳しい情報は <a href=\"https://contactform7.com/ja/category/releases/\" rel=\"nofollow ugc\">Releases</a> を参照。</p>\n<h4>6.0.5</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-605/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-605/</a></p>\n<h4>6.0.4</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-604/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-604/</a></p>\n<h4>6.0.3</h4>\n<ul>\n<li>著作権の年限を2025年に更新。</li>\n<li>「Contact Form 7 は支援を必要としています」のメッセージ本文を更新。</li>\n<li>Constant Contact の非推奨警告を更新。</li>\n</ul>\n<h4>6.0.2</h4>\n<ul>\n<li>nullable な引数から不必要な型宣言を削除し PHP 8.4 での非推奨警告の発生を回避する。</li>\n</ul>\n<h4>6.0.1</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-601/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-601/</a></p>\n<h4>6.0</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-60/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-60/</a></p>\n<h4>5.9.7</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-597/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-597/</a></p>\n<h4>5.9.6</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-596/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-596/</a></p>\n<h4>5.9.5</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-595/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-595/</a></p>\n<h4>5.9.4</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-594/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-594/</a></p>\n<h4>5.9.3</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-593/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-593/</a></p>\n<h4>5.9.2</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-592/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-592/</a></p>\n<h4>5.9</h4>\n<p><a href=\"https://contactform7.com/contact-form-7-59/\" rel=\"nofollow ugc\">https://contactform7.com/contact-form-7-59/</a></p>\n\";s:11:\"screenshots\";s:225:\"<ol><li><a href=\"https://ps.w.org/contact-form-7/assets/screenshot-1.png?rev=1176454\"><img src=\"https://ps.w.org/contact-form-7/assets/screenshot-1.png?rev=1176454\" alt=\"screenshot-1.png\"></a><p>screenshot-1.png</p></li></ol>\";s:7:\"reviews\";s:18387:\"<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Sadly, no emails received (due to the rigid rules)</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中1つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"1\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/taka-shi/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/ec349e87931fcb6b985f5138b494b849565fa917865223536982fc8f48af6c82?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/ec349e87931fcb6b985f5138b494b849565fa917865223536982fc8f48af6c82?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/taka-shi/\" class=\"reviewer-name\">TKO <small>(Taka-shi)</small></a> レビュー日時: <span class=\"review-date\">2月 17, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>I noticed no email has been sent for these years. I spent a lot of time tweaking the Mail Setting due to the rigid rules that won\'t accept email addresses with different URLs, but nothing worked. I have switched to Ninja Forms. While my website using this plugin is not my primary one, I am so sad that I haven\'t received any emails because of this plugin. </p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Easy to use!</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中5つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"5\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/liviafalkner/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/868593ea989bcd66b7adfc5418076ece22dd1929b53bdafebd2445fede32ada0?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/868593ea989bcd66b7adfc5418076ece22dd1929b53bdafebd2445fede32ada0?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/liviafalkner/\" class=\"reviewer-name\">Livia <small>(liviafalkner)</small></a> レビュー日時: <span class=\"review-date\">2月 17, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>This plugin is really simple easy to use for the people who are starting with wordpress. 100% Recommended </p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Best plugin for contact forms</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中5つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"5\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/seller2222/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/56519afac53be7978d16223e9f895a406c25f1ef77e4e6b0cc0ea8fc1b168d57?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/56519afac53be7978d16223e9f895a406c25f1ef77e4e6b0cc0ea8fc1b168d57?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/seller2222/\" class=\"reviewer-name\">seller2222</a> レビュー日時: <span class=\"review-date\">2月 5, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>I tried some other plugins, but <strong>Contact Form 7</strong> is the best.</p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Many thanks from WPHostee Team</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中5つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"5\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/baicu4design/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/dd8f8591390e3f7e9b8f08c3df7879f0efb47bd3006f719f30223700ed6061c8?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/dd8f8591390e3f7e9b8f08c3df7879f0efb47bd3006f719f30223700ed6061c8?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/baicu4design/\" class=\"reviewer-name\">WPHostee <small>(baicu4design)</small></a> レビュー日時: <span class=\"review-date\">1月 30, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>Contact form 7 is an essential WordPress plugin, offering everything from top-notch security and performance improvements to social sharing tools and analytics. At WPHostee.com, our WordPress devs always install Contact Form 7 on every project we take on, as it’s a reliable tool that enhances the overall quality and functionality of our client sites.</p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Simple Contact Form</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中5つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"5\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/rizwanahmed007/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/bcc5766baaf423c6834d7763bd2439e7dcdeb36585ef186f00f5b68ddabeea52?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/bcc5766baaf423c6834d7763bd2439e7dcdeb36585ef186f00f5b68ddabeea52?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/rizwanahmed007/\" class=\"reviewer-name\">Rizwan Khan <small>(rizwanahmed007)</small></a> レビュー日時: <span class=\"review-date\">1月 21, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>I’ve been using <strong>Contact Form 7</strong> for years, and it’s undoubtedly one of the most reliable and versatile plugins for creating contact forms. Its simplicity, compatibility, and lightweight nature make it an excellent choice for WordPress users. The ease of customization and integration with other tools is impressive, and it has served my websites flawlessly.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>That said, I’d love to see a few enhancements to make this plugin even better. Adding a built-in date and calendar feature would simplify creating forms for bookings or appointments. Improving dropdown menu styling options would also be a great touch to enhance form aesthetics. Overall, this plugin remains a must-have for any WordPress site, and I look forward to seeing its future updates!</p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Simple yet Affective Contact Form.</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中5つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"5\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/danishalionline/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/3874b75f6231dd375e4a6960595a54282269b39c5f644b94b3ff89d8e03cbd0e?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/3874b75f6231dd375e4a6960595a54282269b39c5f644b94b3ff89d8e03cbd0e?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/danishalionline/\" class=\"reviewer-name\">Danish Ali <small>(danishalionline)</small></a> レビュー日時: <span class=\"review-date\">1月 9, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>This is the one plugin i used o my every wordpress site. its keeps getting better. However we would to see some more features like Calender and recapthca implementation with this form with ease. </p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Dude what happened</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中1つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"1\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/alexfreixa/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/f9914f8f922eda27cc7167d52b1be04ee58300987cf4c48ed52c2f807eade773?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/f9914f8f922eda27cc7167d52b1be04ee58300987cf4c48ed52c2f807eade773?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/alexfreixa/\" class=\"reviewer-name\">Alex Freixa <small>(alexfreixa)</small></a> レビュー日時: <span class=\"review-date\">1月 3, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>Why it\'s unusable? This plugin was working so fine. Customize it it\'s a nightmare!</p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Lack of support, lack of accessibility</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中1つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"1\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/heggyy/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/84dd541d8963907b9e3fc8406d9e726f54649e658e5ce6d932e769a52e44f92f?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/84dd541d8963907b9e3fc8406d9e726f54649e658e5ce6d932e769a52e44f92f?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/heggyy/\" class=\"reviewer-name\">heggyy</a> レビュー日時: <span class=\"review-date\">1月 3, 2025</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>Overhyped plugin simply because it is free. It is the ultimate barebones of a plugin that people find necessary. There are no features, customizing anything means you are either a) a programmer or b) have to email support (in which case good luck getting help, egos too big). Gets no updates, no features, no accessibility or UX improvements. You\'re better off paying for a plugin than pulling your hair out to get it working as needed.</p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">quick resposne to questions and support tickets</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中5つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"5\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/frankyuyong/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/e256a8b26bc82e4a27d420c11998d37300d62eeba2f3adcd1adc3daa7398722e?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/e256a8b26bc82e4a27d420c11998d37300d62eeba2f3adcd1adc3daa7398722e?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/frankyuyong/\" class=\"reviewer-name\">frankyuyong</a> レビュー日時: <span class=\"review-date\">12月 11, 2024</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>The team is highly responsive and helpful. They arranged a Google Meet session to assist me with an API and JSON data format issue, thoroughly resolving the problem on my end.</p>\n<!-- /wp:paragraph --></div>\n</div>\n<div class=\"review\">\n	<div class=\"review-head\">\n		<div class=\"reviewer-info\">\n			<div class=\"review-title-section\">\n				<h4 class=\"review-title\">Translation issue and nightmare support.</h4>\n				<div class=\"star-rating\">\n				<div class=\"wporg-ratings\" aria-label=\"5つ星中2つ星\" data-title-template=\"5つ星中%sつ星\" data-rating=\"2\" style=\"color:#ffb900;\"><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-filled\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span><span class=\"star dashicons dashicons-star-empty\"></span></div>				</div>\n			</div>\n			<p class=\"reviewer\">\n				レビュアー: <a href=\"https://profiles.wordpress.org/jyria/\"><img alt=\'\' src=\'https://secure.gravatar.com/avatar/f3ffa0afd56f0b53fb075f65fa2657a765d4790567818a3f2c6ac0e2a1126066?s=16&#038;d=monsterid&#038;r=g\' srcset=\'https://secure.gravatar.com/avatar/f3ffa0afd56f0b53fb075f65fa2657a765d4790567818a3f2c6ac0e2a1126066?s=32&#038;d=monsterid&#038;r=g 2x\' class=\'avatar avatar-16 photo\' height=\'16\' width=\'16\' loading=\'lazy\' decoding=\'async\'/></a><a href=\"https://profiles.wordpress.org/jyria/\" class=\"reviewer-name\">Saskia Teichmann <small>(Jyria)</small></a> レビュー日時: <span class=\"review-date\">11月 26, 2024</span>			</p>\n		</div>\n	</div>\n	<div class=\"review-body\"><!-- wp:paragraph -->\n<p>This free plugin is very useful and has done what it was supposed to do for many years. However, there are a few issues that are very annoying and a total deal breaker, if not a show stopper:</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol><!-- wp:list-item -->\n<li>Plugin creator did not comply with WordPress Codex regarding how translations are handled. Thus this plugin will eventually cause problems in a multilingual site.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Forum support by plugin creator is very poor. He replies, yes, but his replies are a joke. He simply doesn\'t care. He doesn\'t read properly nor does he do any testing, even after providing everything he asked for. He is a time stealer.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>My personal resume: I will switch contact forms on all of my clients\' sites. There are better alternatives out there. I am of course willing to pay for support. And this is my suggestion for @takayukister : provide paid support, if you think your time is too valuable, to give a useful reply or provide assistance with your free plugin. Or take that plugin offline or officially state that you won\'t provide support at all and refrain from stealing people\'s time by requesting non sense things and then ignoring them in return.</p>\n<!-- /wp:paragraph --></div>\n</div>\n\";}s:17:\"short_description\";s:78:\"お問い合わせフォームプラグイン。シンプル、でも柔軟。\";s:13:\"download_link\";s:63:\"https://downloads.wordpress.org/plugin/contact-form-7.6.0.5.zip\";s:14:\"upgrade_notice\";a:0:{}s:11:\"screenshots\";a:1:{i:1;a:2:{s:3:\"src\";s:67:\"https://ps.w.org/contact-form-7/assets/screenshot-1.png?rev=1176454\";s:7:\"caption\";s:16:\"screenshot-1.png\";}}s:4:\"tags\";a:2:{s:12:\"contact-form\";s:12:\"contact form\";s:23:\"schema-woven-validation\";s:23:\"schema-woven 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--version=6.8-RC1</code></code></td></tr><tr><td><strong>WordPress Playground</strong></td><td><a href=\"https://playground.wordpress.net/?php=8.0&amp;wp=beta&amp;networking=no&amp;language=&amp;multisite=no&amp;random=y4q1rn88xn\">6.8 RC1 WordPress Playground instance</a>&nbsp;インスタンスを使用する (リリースが準備できてから35分以内に利用可能になります)。ブラウザで直接ソフトウェアをテストできます。個別のサイトやセットアップは必要ありません。</td></tr></tbody></table><figcaption class=\"wp-element-caption\">WordPress 6.8 リリース候補版1は4通りの方法でテストできます。</figcaption></figure>\n\n\n\n<p>WordPress 6.8の最終リリース目標日は<strong>2025年4月15日</strong>に設定されています。もっと詳しく知りたい方は、<a href=\"https://make.wordpress.org/core/6-8/\">6.8リリースサイクル</a>の概略や、<a href=\"https://make.wordpress.org/core/\">Make WordPress Core ブログ</a>の<a href=\"https://make.wordpress.org/core/tag/6-8/\">6.8関連の投稿</a>を確認してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.8 リリース候補版1 (RC1) の見どころ紹介</h2>\n\n\n\n<p>WordPress 6.8の注目機能の概要については、<a href=\"https://ja.wordpress.org/2025/03/06/wordpress-6-8-beta-1/\">ベータ1の告知</a>をご覧ください。ベータ3以降に解決された問題に関する技術的な情報については、以下のリンクを参照してください。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>3月18日以降の<a href=\"https://github.com/WordPress/gutenberg/commits/wp/6.8?since=2025-03-18&amp;until=2025-03-25\">6.8の GitHub コミット一覧</a></li>\n\n\n\n<li>3月18日以降に<a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=03%2F18%2F2025..03%2F25%2F2025&amp;milestone=6.8&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">クローズされた Trac チケット一覧</a></li>\n</ul>\n\n\n\n<p>このリリースの詳細やテクニカルノートを知りたければ、以下の最近の投稿に最新の更新の一部がカバーされています。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https://make.wordpress.org/core/2025/03/06/speculative-loading-in-6-8/\">Speculative Loading in 6.8</a></li>\n\n\n\n<li><a href=\"https://make.wordpress.org/core/2025/02/17/wordpress-6-8-will-use-bcrypt-for-password-hashing/\">WordPress 6.8 will use bcrypt for password hashing</a></li>\n\n\n\n<li><a href=\"https://make.wordpress.org/core/2025/03/12/roster-of-design-tools-per-block-wordpress-6-8-edition/\">Roster of design tools per block (WordPress 6.8 edition)</a></li>\n\n\n\n<li><a href=\"https://make.wordpress.org/core/2025/03/13/more-efficient-block-type-registration-in-6-8/\">More efficient block type registration in 6.8</a></li>\n\n\n\n<li><a href=\"https://make.wordpress.org/core/2025/03/25/updates-to-user-interface-components-in-wordpress-6-8/\">Updates to user-interface components in WordPress 6.8</a></li>\n\n\n\n<li><a href=\"https://make.wordpress.org/core/2025/03/24/interactivity-api-best-practices-in-6-8/\">Interactivity API best practices in 6.8</a></li>\n\n\n\n<li><a href=\"https://make.wordpress.org/core/2025/03/12/i18n-improvements-6-8/\">Internationalization improvements in 6.8</a></li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">コントリビュートの方法</h2>\n\n\n\n<p>WordPress は協働し開発に貢献する人々のコミュニティによって実現されたオープンソースソフトウェアです。以下では、技術的な専門知識の有無を問わず、世界で最も人気のあるオープンソースのウェブプラットフォームを支援するさまざまな方法をご紹介します。</p>\n\n\n\n<h3 class=\"wp-block-heading\">テストに参加する</h3>\n\n\n\n<p>テストは、WordPress のパフォーマンスと安定性の確保に不可欠です。また、誰もが貢献できる有意な方法です。<a href=\"https://make.wordpress.org/test/2025/03/04/help-test-wordpress-6-8/\">この詳細なガイド</a>では、WordPress 6.8のテスト機能について説明します。テストが初めての方は、<a href=\"https://make.wordpress.org/test/handbook/get-setup-for-testing/\">この一般的なテストガイド</a>に従って、セットアップの詳細を参照してください。</p>\n\n\n\n<p>問題に遭遇したかもと思った時は、まずサポートフォーラムの<a href=\"https://wordpress.org/support/forum/alphabeta/\">アルファ・ベータエリア</a>に報告をしてください。再現可能なバグ報告の作成に慣れている方は&nbsp;<a href=\"https://core.trac.wordpress.org/newticket\">WordPress Trac への報告</a>をお願いします。<a href=\"https://core.trac.wordpress.org/tickets/major\">既知のバグ</a>の一覧も Trac で閲覧可能です。</p>\n\n\n\n<p>WordPress リリースのテスト全般について知りたいですか ?&nbsp;<a href=\"https://make.wordpress.org/test/\">Make WordPress Test</a>&nbsp;をフォローする、<a href=\"https://wordpress.slack.com/\">Making WordPress Slack</a>&nbsp;の&nbsp;<a href=\"https://wordpress.slack.com/messages/core-test/\">#core-test</a>&nbsp;チャンネルに参加する、などの方法があります。</p>\n\n\n\n<h3 class=\"wp-block-heading\">脆弱性を見つける</h3>\n\n\n\n<p>現在から、WordPress 6.8の最終リリース (4月15日に予定) まで、<a href=\"https://make.wordpress.org/core/handbook/testing/reporting-security-vulnerabilities/#enhanced-bounty-rewards-during-beta-and-release-candidate-phases\">未発表のセキュリティ脆弱性の報告に対する報奨金</a>の額が2倍になります。報告は <a href=\"https://hackerone.com/wordpress\">HackerOne のページ</a>ならびに<a href=\"https://wordpress.org/about/security/\">セキュリティ白書</a>に記載のセキュリティプラクティスとポリシーに沿った責任ある情報公開手順に従って適切に行なってください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">テーマやプラグインを更新する</h3>\n\n\n\n<p>プラグインやテーマの作者のみなさん、WordPress の機能を拡張し世界中のユーザーにその価値を広める上であなたの作品が果たす役割は重大です。</p>\n\n\n\n<p>WordPress 6.8ベータリリースでテーマやプラグインのテストを続けていただきありがとうございます。引き続き RC1版でテストを実施し、正常な動作が確認できたなら、<a href=\"https://developer.wordpress.org/plugins/wordpress-org/how-your-readme-txt-works/\">readme ファイル</a>の&nbsp;<strong>Tested up to</strong>&nbsp;バージョン指定を 6.8に上げてください。</p>\n\n\n\n<p>互換性の問題を見つけた場合は詳しい情報を<a href=\"https://wordpress.org/support/forum/alphabeta/\">サポートフォーラム</a>に投稿してください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">翻訳にご協力ください</h3>\n\n\n\n<p>英語以外の言語を話せますか ? スペイン語 ? フランス語 ? ポルトガル語 ? ロシア語 ? 日本語 ? ヒンディー語 ? ベンガル語 ?&nbsp;<a href=\"https://translate.wordpress.org/projects/wp/dev/\">100を超す言語への WordPress の翻訳を手伝ってくれませんか ?</a>&nbsp;このリリースマイルストーン (RC1) は、6.8リリースサイクルの「<a href=\"https://make.wordpress.org/polyglots/handbook/glossary/#hard-freeze\">ハードな文字列凍結</a>」ポイントでもあります。</p>\n\n\n\n<h2 class=\"wp-block-heading\">リリースの俳句</h2>\n\n\n\n<p>March fades, nearly there,<br>Six-eight hums—a steady beat,<br>RC greets the world.</p>\n\n\n\n<p>3月もあとわずか、<br>6.8のハミング・ビートが響く<br>RC が世界へ挨拶する</p>\n\n\n\n<p>この投稿にご協力いただいた以下のコントリビューターに感謝します。:<br><a href=\"https://profiles.wordpress.org/joemcgill/\">@joemcgill</a>&nbsp;<a href=\"https://profiles.wordpress.org/benjamin_zekavica/\">@benjamin_zekavica</a>&nbsp;<a href=\"https://profiles.wordpress.org/courane01/\">@courane01</a>&nbsp;<a href=\"https://profiles.wordpress.org/mkrndmane/\">@mkrndmane</a>&nbsp;<a href=\"https://profiles.wordpress.org/audrasjb/\">@audrasjb</a>&nbsp;<a href=\"https://profiles.wordpress.org/areziaal/\">@areziaal</a>&nbsp;<a href=\"https://profiles.wordpress.org/ankit-k-gupta/\">@ankit-k-gupta</a>&nbsp;<a href=\"https://profiles.wordpress.org/krupajnanda/\">@krupajnanda</a>.</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>協力者:&nbsp;<a href=\'https://profiles.wordpress.org/torikumo/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>torikumo</a> <a href=\'https://profiles.wordpress.org/atachibana/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>atachibana</a></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7616\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:1;a:6:{s:4:\"data\";s:57:\"\n		\n		\n		\n		\n		\n				\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:24:\"WordPress 6.8 ベータ3\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:57:\"https://ja.wordpress.org/2025/03/20/wordpress-6-8-beta-3/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Thu, 20 Mar 2025 02:12:31 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:1:{i:0;a:5:{s:4:\"data\";s:11:\"Development\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7608\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:238:\"以下は WordPress.org 公式ブログの記事「WordPress 6.8 Beta 3」を訳したものです。 誤字脱字誤訳などありましたらフォーラムまでお知らせください。 WordPress 6.8ベータ3がリリー [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:15:\"Akira Tachibana\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:7936:\"\n<p>以下は WordPress.org 公式ブログの記事「<a href=\"https://wordpress.org/news/2025/03/wordpress-6-8-beta-3/\">WordPress 6.8 Beta 3</a>」を訳したものです。</p>\n\n\n\n<p>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>WordPress 6.8ベータ3がリリースされました。ダウンロードして、テストをお願いします。</p>\n\n\n\n<p><strong>この WordPress ソフトウェアのベータ版は開発中です。</strong>このバージョンの WordPress を本番環境やミッションクリティカルなウェブサイトでインストール、実行、テストしないでください。テストサーバーやテストサイトで評価してください。</p>\n\n\n\n<p>WordPress 6.8ベータ3は以下の4つの方法でテストできます。</p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>WordPress Beta Tester プラグイン</strong></td><td><a href=\"https://wordpress.org/plugins/wordpress-beta-tester/\">WordPress Beta Tester</a> プラグインをインストールして有効化する。設定では「最前線」チャンネルと「ベータ / RC のみ」ストリームを選択します。</td></tr><tr><td><strong>直接ダウンロード</strong></td><td><a href=\"https://wordpress.org/wordpress-6.8-beta3.zip\">Beta 3 version (zip)</a> をダウンロードして、WordPress ウェブサイトにインストールする。</td></tr><tr><td><strong>コマンドライン (WP-CLI)</strong></td><td><a href=\"https://make.wordpress.org/cli/\">WP-CLI</a> コマンドを実行する。<code>wp core update --version=6.8-beta3</code></td></tr><tr><td><strong>WordPress Playground</strong></td><td><a href=\"https://playground.wordpress.net/?php=8.0&amp;wp=beta&amp;networking=no&amp;language=&amp;multisite=no&amp;random=y4q1rn88xn\">6.8 Beta 3 WordPress Playground instance</a> を使用する。ブラウザで直接ソフトウェアをテストできます。個別のサイトやセットアップは必要ありません。</td></tr></tbody></table></figure>\n\n\n\n<p>WordPress 6.8の最終リリース日は<strong>2025年4月15日</strong>を予定しています。<a href=\"https://make.wordpress.org/core/tag/6-8/\">6.8のリリースサイクルの概要</a>と、今後数週間の&nbsp;<a href=\"https://make.wordpress.org/core/\">Make WordPress Core ブログ</a>の<a href=\"https://make.wordpress.org/core/tag/6-8/\">6.8関連記事</a>をチェックして、追加の詳細情報を確認してください。</p>\n\n\n\n<p><strong>WordPress 6.8の新機能をキャッチアップ:</strong>&nbsp;6.8の詳細とハイライトについては<a href=\"https://ja.wordpress.org/2025/03/06/wordpress-6-8-beta-1/\">ベータ1</a>、および<a href=\"https://ja.wordpress.org/2025/03/12/wordpress-6-8-beta-2/\">ベータ2</a>の告知を参照してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>WordPress 6.8ベータ3をテストする方法</strong></h2>\n\n\n\n<p>WordPress 6.8 のリリースが最高の形で実現するためには、現段階のベータバージョンのテストに協力いただくことが極めて重要です。アップグレードのプロセスをテストいただくことも、また新しく追加された機能を試していただくことも、どちらも等しく重要です。WordPress 6.8の機能テストの手順については、<a href=\"https://make.wordpress.org/test/2025/03/04/help-test-wordpress-6-8/\">こちらのガイド</a>を参照してください。</p>\n\n\n\n<p>問題に遭遇したら、まずサポートフォーラムの<a href=\"https://wordpress.org/support/forum/alphabeta/\">アルファ・ベータエリア</a>に報告をしてください。再現可能なバグ報告の作成に慣れている方は <a href=\"https://core.trac.wordpress.org/newticket\">WordPress Trac</a> への報告をお願いします。<a href=\"https://core.trac.wordpress.org/tickets/major\">既知のバグ</a>の一覧も Trac で閲覧可能です。</p>\n\n\n\n<p>リリースのテスト全般について知りたければ、<a href=\"https://make.wordpress.org/test/\">Make Core におけるテスト関連タスク</a>をフォローし、<a href=\"https://wordpress.slack.com/\">Making WordPress Slack</a> の <a href=\"https://wordpress.slack.com/messages/core-test/\">#core-test チャンネル</a>に参加してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>ベータ &amp; リリース候補期間中は脆弱性報告報奨金が2倍に</strong></h2>\n\n\n\n<p>2025年3月4日にリリースされたベータ1から、2025年4月8日に予定されている最終のリリース候補版 (RC版) までの期間、<a href=\"https://make.wordpress.org/security/2024/06/04/wordpress-6-6-is-coming/\">未発表のセキュリティ脆弱性の報告に対する報奨金</a>が2倍になります。報告は <a href=\"https://hackerone.com/wordpress\">HackerOne のページ</a>ならびに<a href=\"https://wordpress.org/about/security/\">セキュリティ白書</a>に記載のセキュリティプラクティスとポリシーに沿った責任ある情報公開手順に従って適切に行なってください。</p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>WordPress 6.8ベータ3のアップデートとハイライト</strong></h2>\n\n\n\n<p>WordPress 6.8ベータ3にはベータ2のリリース以来、3件のエディターのアップデートと修正と、WordPressコアに関する16件のチケットが含まれています。</p>\n\n\n\n<p>各ベータのサイクルはバグ修正に焦点を当てており、テストを通じた皆さんの支援によりさらに多くの修正が進められています。以下のリンクから、ベータ3以降に対応したすべての問題の技術的な詳細を閲覧することができます。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>2025年3月12日以降の<a href=\"https://github.com/WordPress/gutenberg/commits/wp/6.8?since=2025-03-12&amp;until=2025-03-17\">6.8対象の GitHub コミット一覧</a></li>\n\n\n\n<li>2025年3月12日以降に<a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=10%2F02%2F2024..10%2F07%2F2024&amp;milestone=6.7&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">クローズされた Trac </a><a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=03%2F12%2F2025..03%2F17%2F2025&amp;milestone=6.8&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">チケット</a><a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=10%2F02%2F2024..10%2F07%2F2024&amp;milestone=6.7&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">一覧</a></li>\n</ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>ベータ3の俳句</strong></h3>\n\n\n\n<p>Beta three refines,<br>WordPress shapes with steady hands,<br>Code grows into form.</p>\n\n\n\n<p>ベータ3が洗練する<br>確かな腕で WordPress が形をなす<br>コードは成長する</p>\n\n\n\n<p>校正とレビューに感謝します。<br><em><a href=\"https://profiles.wordpress.org/benjamin_zekavica/\">@benjamin_zekavica</a>&nbsp;<a href=\"https://profiles.wordpress.org/krupajnanda/\">@krupajnanda</a>&nbsp;<a href=\"https://profiles.wordpress.org/ankit-k-gupta/\">@ankit-k-gupta</a>&nbsp;<a href=\"https://profiles.wordpress.org/joemcgill/\">@joemcgill</a></em></p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>協力者: <a href=\'https://profiles.wordpress.org/torikumo/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>torikumo</a>, <a href=\'https://profiles.wordpress.org/nukaga/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>nukaga</a></p>\n\n\n\n<p></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7608\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:2;a:6:{s:4:\"data\";s:57:\"\n		\n		\n		\n		\n		\n				\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:24:\"WordPress 6.8 ベータ2\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:57:\"https://ja.wordpress.org/2025/03/12/wordpress-6-8-beta-2/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 12 Mar 2025 09:56:32 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:1:{i:0;a:5:{s:4:\"data\";s:11:\"Development\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7595\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:238:\"以下は WordPress.org 公式ブログの記事「WordPress 6.8 Beta 2」を訳したものです。 誤字脱字誤訳などありましたらフォーラムまでお知らせください。 WordPress 6.8ベータ2がリリー [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:15:\"Akira Tachibana\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:10165:\"\n<p>以下は WordPress.org 公式ブログの記事「<a href=\"https://wordpress.org/news/2025/03/wordpress-6-8-beta-2/\">WordPress 6.8 Beta 2</a>」を訳したものです。</p>\n\n\n\n<p>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>WordPress 6.8ベータ2がリリースされました。ダウンロードして、テストをお願いします。</p>\n\n\n\n<p><strong>この WordPress ソフトウェアのベータ版は開発中です。</strong>このバージョンの WordPress を本番環境やミッションクリティカルなウェブサイトでインストール、実行、テストしないでください。新機能を試すには、代わりにテスト環境やローカルサイトをセットアップしてください。</p>\n\n\n\n<p>WordPress 6.8ベータ2は以下の4つの方法でテストできます。</p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>WordPress Beta Tester プラグイン</strong></td><td><a href=\"https://wordpress.org/plugins/wordpress-beta-tester/\">WordPress Beta Tester</a> プラグインをインストールして有効化する。設定では「最前線」チャンネルと「ベータ / RC のみ」ストリームを選択します。</td></tr><tr><td><strong>直接ダウンロード</strong></td><td><a href=\"https://wordpress.org/wordpress-6.7-beta2.zip\">Beta 2 version (zip)</a> をダウンロードして、WordPress ウェブサイトにインストールする。</td></tr><tr><td><strong>コマンドライン (WP-CLI)</strong></td><td><a href=\"https://make.wordpress.org/cli/\">WP-CLI</a> コマンドを実行する。<code>wp core update --version=6.8-beta2</code></td></tr><tr><td><strong>WordPress Playground</strong></td><td><a href=\"https://playground.wordpress.net/#%7B%20%22preferredVersions%22:%20%7B%20%22php%22:%20%228.0%22,%20%22wp%22:%20%22https://playground.wordpress.net/plugin-proxy.php?build-ref=a49bf5596f7258375345826dc136bfc589372e37%22%20%7D,%20%22features%22:%20%7B%20%22networking%22:%20true%20%7D,%20%22steps%22:%20%5B%20%7B%20%22step%22:%20%22login%22,%20%22username%22:%20%22admin%22,%20%22password%22:%20%22password%22%20%7D,%20%7B%20%22step%22:%20%22importFile%22,%20%22file%22:%20%7B%20%22resource%22:%20%22url%22,%20%22url%22:%20%22https://raw.githubusercontent.com/wpaccessibility/a11y-theme-unit-test/master/a11y-theme-unit-test-data.xml%22%20%7D%20%7D,%20%7B%20%22step%22:%20%22importFile%22,%20%22file%22:%20%7B%20%22resource%22:%20%22url%22,%20%22url%22:%20%22https://raw.githubusercontent.com/WordPress/theme-test-data/master/themeunittestdata.wordpress.xml%22%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22query-monitor%22%20%7D,%20%22options%22:%20%7B%20%22activate%22:%20false%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22create-block-theme%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22debug-bar%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22health-check%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22test-reports%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22user-switching%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D%20%5D%20%7D\">6.8 Beta 2 WordPress Playground instance</a> を使用する。ブラウザで直接ソフトウェアをテストできます。個別のサイトやセットアップは必要ありません。</td></tr></tbody></table></figure>\n\n\n\n<p>WordPress 6.8の最終リリース日は<strong>2025年4月15日</strong>を予定しています。<a href=\"https://make.wordpress.org/core/tag/6-8/\">6.8のリリースサイクルの概要</a>と、今後数週間の&nbsp;<a href=\"https://make.wordpress.org/core/\">Make WordPress Core ブログ</a>の<a href=\"https://make.wordpress.org/core/tag/6-8/\">6.8関連記事</a>をチェックして、追加の詳細情報を確認してください。</p>\n\n\n\n<p><strong>WordPress 6.8の新機能をキャッチアップ:</strong>&nbsp;<a href=\"https://ja.wordpress.org/2025/03/06/wordpress-6-8-beta-1/\">6.8の詳細とハイライトについてはベータ1の告知を参照してください。</a></p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>WordPress 6.8ベータ2をテストする方法</strong></h2>\n\n\n\n<p>WordPress 6.8 のリリースが最高の形で実現するためには、現段階のベータバージョンのテストに協力いただくことが極めて重要です。アップグレードのプロセスをテストいただくことも、また新しく追加された機能を試していただくことも、どちらも等しく重要です。WordPress 6.8の機能テストの手順については、<a href=\"https://make.wordpress.org/test/2024/10/01/help-test-wordpress-6-7/\">こちらのガイド</a>を参照してください。</p>\n\n\n\n<p>問題に遭遇したら、まずサポートフォーラムの<a href=\"https://wordpress.org/support/forum/alphabeta/\">アルファ・ベータエリア</a>に報告をしてください。再現可能なバグ報告の作成に慣れている方は <a href=\"https://core.trac.wordpress.org/newticket\">WordPress Trac</a> への報告をお願いします。<a href=\"https://core.trac.wordpress.org/tickets/major\">既知のバグ</a>の一覧も Trac で閲覧可能です。</p>\n\n\n\n<p>リリースのテスト全般について知りたければ、<a href=\"https://make.wordpress.org/test/\">Make Core におけるテスト関連タスク</a>をフォローし、<a href=\"https://wordpress.slack.com/\">Making WordPress Slack</a> の <a href=\"https://wordpress.slack.com/messages/core-test/\">#core-test チャンネル</a>に参加してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>ベータ &amp; リリース候補期間中は脆弱性報告報奨金が2倍に</strong></h2>\n\n\n\n<p>2025年3月4日にリリースされたベータ1から、2025年4月8日に予定されている最終のリリース候補版 (RC版) までの期間、<a href=\"https://make.wordpress.org/security/2024/06/04/wordpress-6-6-is-coming/\">未発表のセキュリティ脆弱性の報告に対する報奨金</a>が2倍になります。報告は <a href=\"https://hackerone.com/wordpress\">HackerOne のページ</a>ならびに<a href=\"https://wordpress.org/about/security/\">セキュリティ白書</a>に記載のセキュリティプラクティスとポリシーに沿った責任ある情報公開手順に従って適切に行なってください。</p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>WordPress 6.8ベータ2のアップデートとハイライト</strong></h2>\n\n\n\n<p>WordPress 6.8ベータ2にはベータ1のリリース以来、14件以上のエディターのアップデートと修正と、WordPressコアに関する21以上のチケットが含まれています。</p>\n\n\n\n<p>各ベータのサイクルはバグ修正に焦点を当てており、テストを通じた皆さんの支援によりさらに多くの修正が進められています。以下のリンクから、ベータ1以降に対応したすべての問題の技術的な詳細を閲覧することができます。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>2025年3月4日以降の<a href=\"https://github.com/WordPress/gutenberg/commits/wp/6.8?since=2025-03-05&amp;until=2025-03-10\">6.8 対象の GitHub コミット一覧</a></li>\n\n\n\n<li>2025年3月4日以降に<a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=10%2F02%2F2024..10%2F07%2F2024&amp;milestone=6.7&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">クローズされた Trac </a><a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=03%2F05%2F2025..03%2F10%2F2025&amp;milestone=6.8&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">チケット</a><a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=10%2F02%2F2024..10%2F07%2F2024&amp;milestone=6.7&amp;col=id&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">一覧</a></li>\n</ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>ベータ2の俳句</strong></h3>\n\n\n\n<p>Second wave refines,<br>Lines of code like rivers flow,<br>WordPress finds its form.</p>\n\n\n\n<p>第二の波が洗練する<br>コードを川の流れのように<br>WordPress が形を成していく</p>\n\n\n\n<p>校正とレビューに感謝します。<br><em><a href=\"https://profiles.wordpress.org/ankitkumarshah/\">@ankitkumarshah</a>&nbsp;<a href=\"https://profiles.wordpress.org/vgnavada/\">@vgnavada</a>&nbsp;<a href=\"https://profiles.wordpress.org/krupajnanda/\">@krupajnanda</a>&nbsp;<a href=\"https://profiles.wordpress.org/michelleames/\">@michelleames</a>&nbsp;<a href=\"https://profiles.wordpress.org/audrasjb/\">@audrasjb</a>&nbsp;<a href=\"https://profiles.wordpress.org/marybaum/\">@marybaum</a></em></p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>協力者: <a href=\'https://profiles.wordpress.org/torikumo/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>torikumo</a>, <a href=\'https://profiles.wordpress.org/nukaga/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>nukaga</a></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7595\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:3;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:24:\"WordPress 6.8 ベータ1\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:57:\"https://ja.wordpress.org/2025/03/06/wordpress-6-8-beta-1/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Thu, 06 Mar 2025 00:21:39 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:11:\"Development\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:8:\"Releases\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7588\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:238:\"以下は WordPress.org 公式ブログの記事「WordPress 6.8 Beta 1」を訳したものです。 誤字脱字誤訳などありましたらフォーラムまでお知らせください。 WordPress 6.8ベータ1の準備が [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:13:\"Itsuko Miyake\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:12721:\"\n<p>以下は WordPress.org 公式ブログの記事「<a href=\"https://wordpress.org/news/2025/03/wordpress-6-8-beta-1/\">WordPress 6.8 Beta 1</a>」を訳したものです。</p>\n\n\n\n<p>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>WordPress 6.8ベータ1の準備ができました。ダウンロードして、テストをお願いします。</p>\n\n\n\n<p><strong>この WordPress ソフトウェアのベータ版は開発中です。</strong>このバージョンの WordPress を本番環境やミッションクリティカルなウェブサイトでインストール、実行、テストしないでください。新機能を試すには、代わりにテスト環境やローカルサイトをセットアップしてください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.8ベータ1をテストする方法</h2>\n\n\n\n<p>ベータ1は以下のいずれかの方法でテストできます。</p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>WordPress Beta Tester プラグイン</strong></td><td><a href=\"https://wordpress.org/plugins/wordpress-beta-tester/\">WordPress Beta Tester</a> プラグインをインストールして有効化する。設定では「最前線」チャンネルと「ベータ / RC のみ」ストリームを選択します。</td></tr><tr><td><strong>直接ダウンロード</strong></td><td><a href=\"https://wordpress.org/wordpress-6.8-beta1.zip\">Beta 1 version (zip)</a> をダウンロードして、WordPress ウェブサイトにインストールする。</td></tr><tr><td><strong>コマンドライン (WP-CLI)</strong></td><td><a href=\"https://make.wordpress.org/cli/\">WP-CLI</a> コマンドを実行する。wp core update &#8211;version=6.8-beta1</td></tr><tr><td><strong>WordPress Playground</strong></td><td><a href=\"https://playground.wordpress.net/?php=8.0&amp;wp=beta&amp;networking=no&amp;language&amp;multisite=no&amp;random=r8nny4q18x\">6.8 Beta 1 WordPress Playground instance</a> を使用する。ブラウザで直接ソフトウェアをテストできます。セットアップは必要ありません。クリックするだけで起動します !</td></tr></tbody></table></figure>\n\n\n\n<p>WordPress 6.8の最終リリース日は<strong>2025年4月15日</strong>を予定しています。今後6週間、ベータ版と RC 版のテストにご協力いただくことは、最終リリースを安定した、パワフルで直感的なものにするために必要不可欠です。</p>\n\n\n\n<h2 class=\"wp-block-heading\">あなたのテストが重要です !</h2>\n\n\n\n<p>問題点のテストは、あらゆるソフトウェアの開発において重要です。また、誰もが貢献できる意味のある手段です。経験の有無は関係ありません。<a href=\"https://make.wordpress.org/test/2025/03/04/help-test-wordpress-6-8/\">WordPress 6.8でテストする内容の詳細については、こちらをご覧ください。</a></p>\n\n\n\n<p>問題に遭遇したら、まずサポートフォーラムの<a href=\"https://wordpress.org/support/forum/alphabeta/\">アルファ・ベータエリア</a>に報告をしてください。再現可能なバグ報告の作成に慣れている方は <a href=\"https://core.trac.wordpress.org/newticket\">WordPress Trac</a> への報告をお願いします。<a href=\"https://core.trac.wordpress.org/tickets/major\">既知のバグ</a>の一覧も Trac で閲覧可能です。</p>\n\n\n\n<p>リリースのテスト全般について知りたければ、<a href=\"https://make.wordpress.org/test/\">Make Core におけるテスト関連タスク</a>をフォローし、<a href=\"https://wordpress.slack.com/\">Making WordPress Slack</a> の <a href=\"https://wordpress.slack.com/messages/core-test/\">#core-test チャンネル</a>に参加してください。</p>\n\n\n\n<p>WordPress 6.8には、これまで Gutenberg プラグインでのみ利用できた多くの新機能が追加されます。WordPress 6.7以降の Gutenberg の更新については一連の <a href=\"https://make.wordpress.org/core/tag/gutenberg-new/\">What’s new in Gutenberg</a> 投稿 (<a href=\"https://make.wordpress.org/core/2024/10/09/whats-new-in-gutenberg-15-9-31-may-2/\">19.4</a>, <a href=\"https://make.wordpress.org/core/2024/10/24/whats-new-in-gutenberg-19-5-23-october/\">19.5</a>, <a href=\"https://make.wordpress.org/core/2024/11/06/whats-new-in-gutenberg-15-9-31-may-2-2/\">19.6</a>, <a href=\"https://make.wordpress.org/core/2024/11/20/whats-new-in-gutenberg-19-7-20-november/\">19.7</a>, <a 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href=\"https://core.trac.wordpress.org/query?status=closed&amp;milestone=6.8&amp;group=component&amp;max=500&amp;col=id&amp;col=summary&amp;col=owner&amp;col=type&amp;col=priority&amp;col=component&amp;col=version&amp;order=priority\">WordPress 6.8 Core に関する230件のチケット</a>が反映されています。以下に、近日中に予定されている機能の一部をご紹介します:</p>\n\n\n\n<h3 class=\"wp-block-heading\">エディターの改善</h3>\n\n\n\n<p>データビューでオプションをより簡単に確認できるようになり、クエリーループでは先頭固定表示投稿を無視することも選択可能です。さらに、エディターに多くの小さな改善が加えられています。<br></p>\n\n\n\n<h3 class=\"wp-block-heading\">スタイルブックがクラシックテーマに登場</h3>\n\n\n\n<p>スタイルブックは、構造化されたレイアウトを採用し、サイトカラー、タイポグラフィ、ブロックスタイルをより簡単にプレビューできるようになりました。スタイルブックは、editor-styles または theme.json ファイルを使用してクラシックテーマで使用でき、さらにラベルが明確になり、[外観] &gt; [デザイン] で見つけることができます。</p>\n\n\n\n<h3 class=\"wp-block-heading\">Speculation Browser API のサポート</h3>\n\n\n\n<p>WordPress 6.8 では、<a href=\"https://developer.mozilla.org/en-US/docs/Web/API/Speculation_Rules_API\">Speculation Rules API</a> を活用したネイティブな推測的読み込みをサポートし、サイトのパフォーマンスを向上させます。この機能により、ユーザーの操作 (例: 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href=\"https://make.wordpress.org/core/tag/6-8/\">6.8のリリースサイクルの概要</a>と、今後数週間の <a href=\"https://make.wordpress.org/core/\">Make WordPress Core ブログ</a>の<a href=\"https://make.wordpress.org/core/tag/6-7/\">6.7関連記事</a>をチェックして、追加の詳細情報を確認してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">6.8ベータ1を5.1より古いバージョンでテストする場合の注意点</h2>\n\n\n\n<p>このリリース中にアップグレードルーチンが更新されたため (<a href=\"https://core.trac.wordpress.org/changeset/59803\">r59803</a>参照)、WordPress 5.1より古いバージョンからのアップグレードは失敗します。現在、この問題の解決に取り組んでいますので、ベータ1リリースをテストしている間は、この件に関する報告を控えてください。<br></p>\n\n\n\n<h2 class=\"wp-block-heading\">ベータ &amp; リリース候補期間中は脆弱性報告報奨金が2倍に</h2>\n\n\n\n<p>WordPress コミュニティは<a href=\"https://make.wordpress.org/security/2024/06/04/wordpress-6-6-is-coming/\">未発表のセキュリティ脆弱性の報告に対する報奨金</a>をスポンサーしています。2024年10月1日のベータ1から2024年11月5日に予定されている最終のリリース候補版 (RC版) までの期間、この報奨金は2倍になります。報告は <a href=\"https://hackerone.com/wordpress\">HackerOne のページ</a>ならびに<a href=\"https://wordpress.org/about/security/\">セキュリティ白書</a>に記載のセキュリティプラクティスとポリシーに沿った責任ある情報公開手順に従って適切に行なってください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">あなたのためにベータ 1で一句</h3>\n\n\n\n<p>March winds shift the tide.<br>Hands unite in open source;<br>WordPress moves ahead.</p>\n\n\n\n<p>三月の風は潮の流れを変え<br>手と手が結ばれオープンソースの世界で<br>WordPress は前へ進み</p>\n\n\n\n<p>この投稿のレビューとコラボレーションに対して感謝します。<br><a href=\"https://profiles.wordpress.org/audrasjb/\"><em>@audrasjb</em></a><em> </em><a href=\"https://profiles.wordpress.org/marybaum/\"><em>@marybaum</em></a><em> </em><a href=\"https://profiles.wordpress.org/mamaduka/\"><em>@mamaduka</em></a><em> </em><a href=\"https://profiles.wordpress.org/michelleames/\"><em>@michelleames</em></a><em> </em><a href=\"https://profiles.wordpress.org/bph/\"><em>@bph</em></a><em> </em><a href=\"https://profiles.wordpress.org/jorbin/\"><em>@jorbin</em></a><em> </em><a href=\"https://profiles.wordpress.org/joemcgill/\"><em>@joemcgill</em></a><em> </em><a href=\"https://profiles.wordpress.org/krupajnanda/\"><em>@krupajnanda</em></a><em> </em><a href=\"https://profiles.wordpress.org/desrosj/\"><em>@desrosj</em></a><em> </em><a href=\"https://profiles.wordpress.org/benjamin_zekavica/\"><em>@benjamin_zekavica</em></a></p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>協力者: <a href=\'https://profiles.wordpress.org/atachibana/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>atachibana</a> <a href=\"https://profiles.wordpress.org/nukaga/\">@nukaga</a></p>\n\n\n\n<p></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7588\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:4;a:6:{s:4:\"data\";s:57:\"\n		\n		\n		\n		\n		\n				\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:45:\"WordPress 6.7.2メンテナンスリリース\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:72:\"https://ja.wordpress.org/2025/02/13/wordpress-6-7-2-maintenance-release/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 12 Feb 2025 15:02:12 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:1:{i:0;a:5:{s:4:\"data\";s:11:\"Development\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7575\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:224:\"以下は WordPress.org 公式ブログの記事「WordPress 6.7.2 Maintenance Release」を訳したものです。 誤字脱字誤訳などありましたらフォーラムまでお知らせください。 WordPr [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:15:\"Akira Tachibana\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:9738:\"\n<p>以下は WordPress.org 公式ブログの記事「<a href=\"https://wordpress.org/news/2025/02/wordpress-6-7-2-maintenance-release/\">WordPress 6.7.2 Maintenance Release</a>」を訳したものです。</p>\n\n\n\n<p>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.7.2が利用可能です !</h2>\n\n\n\n<p>このマイナーリリースには<a href=\"https://make.wordpress.org/core/tag/6-7-2/\">35件のバグフィックス</a>が含まれ、ブロックエディター、HTML API、カスタマイザーを含む複数のコンポーネントに影響を与える問題に対処します。</p>\n\n\n\n<p>WordPress 6.7.2はショートサイクルリリースです。次のメジャーリリースは<a href=\"https://make.wordpress.org/core/6-8/\">バージョン6.8</a>で、2025年4月15日に予定されています。</p>\n\n\n\n<p>自動バックグラウンド更新をサポートするサイトでは、更新プロセスが自動的に始まります。</p>\n\n\n\n<p><a href=\"https://wordpress.org/wordpress-6.7.2.zip\">WordPress 6.7.2は WordPress.org からダウンロードできます。</a>または、WordPress ダッシュボードに移動して、「更新」をクリックし、続いて「今すぐ更新」をクリックします。このリリースの詳細については <a href=\"https://wordpress.org/support/wordpress-version/version-6-7-2\">HelpHub にアクセス</a>してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress コントリビューターの皆さんに感謝</h2>\n\n\n\n<p>本リリースは <a href=\"https://profiles.wordpress.org/jorbin/\">Aaron Jorbin</a> がリードしました。</p>\n\n\n\n<p>WordPress 6.7.2は、以下の方々のコントリビューションなしには実現しませんでした。メンテナンスの修正を安定版リリースとして提供するための地球規模での非同期の連携は、WordPress コミュニティの力と能力の証です。</p>\n\n\n\n<p><a href=\"https://profiles.wordpress.org/jorbin\">Aaron Jorbin</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ajlende\">Alex Lende</a>,&nbsp;<a href=\"https://profiles.wordpress.org/alexandrebuffet\">Alexandre Buffet</a>,&nbsp;<a href=\"https://profiles.wordpress.org/bowedk\">Andreas Pedersen</a>,&nbsp;<a href=\"https://profiles.wordpress.org/azaozz\">Andrew Ozz</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ankitkumarshah\">Ankit Kumar Shah</a>,&nbsp;<a href=\"https://profiles.wordpress.org/apermo\">apermo</a>,&nbsp;<a href=\"https://profiles.wordpress.org/benniledl\">Benedikt Ledl</a>,&nbsp;<a href=\"https://profiles.wordpress.org/bernhard-reiter\">bernhard-reiter</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ironprogrammer\">Brian Alexander</a>,&nbsp;<a href=\"https://profiles.wordpress.org/cbravobernal\">Carlos Bravo</a>,&nbsp;<a href=\"https://profiles.wordpress.org/poena\">Carolina Nymark</a>,&nbsp;<a href=\"https://profiles.wordpress.org/coquardcyr\">Cyrille</a>,&nbsp;<a href=\"https://profiles.wordpress.org/danielpost\">Daniel Post</a>,&nbsp;<a href=\"https://profiles.wordpress.org/darerodz\">darerodz</a>,&nbsp;<a href=\"https://profiles.wordpress.org/dpcalhoun\">David Calhoun</a>,&nbsp;<a href=\"https://profiles.wordpress.org/get_dave\">David Smith</a>,&nbsp;<a href=\"https://profiles.wordpress.org/dmsnell\">Dennis Snell</a>,&nbsp;<a href=\"https://profiles.wordpress.org/dhewercorus\">dhewercorus</a>,&nbsp;<a href=\"https://profiles.wordpress.org/dd32\">Dion Hulse</a>,&nbsp;<a href=\"https://profiles.wordpress.org/dougwollison\">Doug Wollison</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ellatrix\">Ella</a>,&nbsp;<a href=\"https://profiles.wordpress.org/im3dabasia1\">Eshaan Dabasiya</a>,&nbsp;<a href=\"https://profiles.wordpress.org/fabiankaegy\">Fabian Kägy</a>,&nbsp;<a href=\"https://profiles.wordpress.org/gaambo\">Fabian Todt</a>,&nbsp;<a href=\"https://profiles.wordpress.org/flixos90\">Felix Arntz</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ffffelix\">Felix Renicks</a>,&nbsp;<a href=\"https://profiles.wordpress.org/franciscabusas22\">Francis Cabusas</a>,&nbsp;<a href=\"https://profiles.wordpress.org/frankbiganski\">Frank B.</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mamaduka\">George Mamadashvili</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ghinamt\">ghinamt</a>,&nbsp;<a href=\"https://profiles.wordpress.org/glynnquelch\">Glynn Quelch</a>,&nbsp;<a href=\"https://profiles.wordpress.org/gziolo\">Greg Ziółkowski</a>,&nbsp;<a href=\"https://profiles.wordpress.org/jameskoster\">James Koster</a>,&nbsp;<a href=\"https://profiles.wordpress.org/jsnajdr\">Jarda Snajdr</a>,&nbsp;<a href=\"https://profiles.wordpress.org/audrasjb\">Jb Audras</a>,&nbsp;<a href=\"https://profiles.wordpress.org/jdnd\">jdnd</a>,&nbsp;<a href=\"https://profiles.wordpress.org/jeryj\">jeryj</a>,&nbsp;<a href=\"https://profiles.wordpress.org/joedolson\">Joe Dolson</a>,&nbsp;<a href=\"https://profiles.wordpress.org/joemcgill\">Joe McGill</a>,&nbsp;<a href=\"https://profiles.wordpress.org/jonsurrell\">Jon Surrell</a>,&nbsp;<a href=\"https://profiles.wordpress.org/desrosj\">Jonathan Desrosiers</a>,&nbsp;<a href=\"https://profiles.wordpress.org/juanwp22\">juanwp22</a>,&nbsp;<a href=\"https://profiles.wordpress.org/jrf\">Juliette Reinders Folmer</a>,&nbsp;<a href=\"https://profiles.wordpress.org/karthickmurugan\">Karthick</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mt8biz\">Kazuto Takeshita</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ryelle\">Kelly Choyce-Dwan</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ketanniruke\">Ketan Niruke</a>,&nbsp;<a href=\"https://profiles.wordpress.org/0mirka00\">Lena Morita</a>,&nbsp;<a href=\"https://profiles.wordpress.org/levskipg\">levskipg</a>,&nbsp;<a href=\"https://profiles.wordpress.org/maciejmackowiak\">Maciej Ma?kowiak</a>,&nbsp;<a href=\"https://profiles.wordpress.org/santosguillamot\">Mario Santos</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mboynes\">Matthew Boynes</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mayanktripathi32\">Mayank Tripathi</a>,&nbsp;<a href=\"https://profiles.wordpress.org/czapla\">Michal Czaplinski</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mcsf\">Miguel Fonseca</a>,&nbsp;<a href=\"https://profiles.wordpress.org/presstoke\">Mitchell Austin</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mreishus\">mreishus</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mukesh27\">Mukesh Panchal</a>,&nbsp;<a href=\"https://profiles.wordpress.org/assassinateur\">Nadir Seghir a11n</a>,&nbsp;<a href=\"https://profiles.wordpress.org/narenin\">Narendra Sishodiya</a>,&nbsp;<a href=\"https://profiles.wordpress.org/nareshbheda\">Naresh Bheda</a>,&nbsp;<a href=\"https://profiles.wordpress.org/neotrope\">neotrope</a>,&nbsp;<a href=\"https://profiles.wordpress.org/ndiego\">Nick Diego</a>,&nbsp;<a href=\"https://profiles.wordpress.org/oglekler\">Olga Gleckler</a>,&nbsp;<a href=\"https://profiles.wordpress.org/parthvataliya\">Parth vataliya</a>,&nbsp;<a href=\"https://profiles.wordpress.org/swissspidy\">Pascal Birchler</a>,&nbsp;<a href=\"https://profiles.wordpress.org/paullb\">paullb</a>,&nbsp;<a href=\"https://profiles.wordpress.org/peterwilsoncc\">Peter Wilson</a>,&nbsp;<a href=\"https://profiles.wordpress.org/pitamdey\">Pitam Dey</a>,&nbsp;<a href=\"https://profiles.wordpress.org/redkite\">redkite</a>,&nbsp;<a href=\"https://profiles.wordpress.org/rishavdutta\">Rishav Dutta</a>,&nbsp;<a href=\"https://profiles.wordpress.org/robertstaddon\">robertstaddon</a>,&nbsp;<a href=\"https://profiles.wordpress.org/rvoigt\">rvoigt</a>,&nbsp;<a href=\"https://profiles.wordpress.org/mi5t4n\">Sagar Tamang</a>,&nbsp;<a href=\"https://profiles.wordpress.org/sainathpoojary\">Sainath Poojary</a>,&nbsp;<a href=\"https://profiles.wordpress.org/seanlanglands\">seanlanglands</a>,&nbsp;<a href=\"https://profiles.wordpress.org/SergeyBiryukov\">Sergey Biryukov</a>,&nbsp;<a href=\"https://profiles.wordpress.org/coffee2code/\">Scott Reilly</a>,&nbsp;<a href=\"https://profiles.wordpress.org/shyamkariya\">Shyam Kariya</a>,&nbsp;<a href=\"https://profiles.wordpress.org/smerriman\">smerriman</a>,&nbsp;<a href=\"https://profiles.wordpress.org/sabernhardt\">Stephen Bernhardt</a>,&nbsp;<a href=\"https://profiles.wordpress.org/sukhendu2002\">Sukhendu Sekhar Guria</a>,&nbsp;<a href=\"https://profiles.wordpress.org/TobiasBg\">TobiasBg</a>,&nbsp;<a href=\"https://profiles.wordpress.org/hellofromTonya\">Tonya Mork</a>,&nbsp;<a href=\"https://profiles.wordpress.org/vishy-moghan\">Vishy Moghan</a>,&nbsp;<a href=\"https://profiles.wordpress.org/westonruter\">Weston Ruter</a>,&nbsp;<a href=\"https://profiles.wordpress.org/wongjn\">wongjn</a>,&nbsp;<a href=\"https://profiles.wordpress.org/yogeshbhutkar\">Yogesh Bhutkar</a>,&nbsp;<a href=\"https://profiles.wordpress.org/zaoyao\">zaoyao</a></p>\n\n\n\n<p></p>\n\n\n\n<h2 class=\"wp-block-heading\">貢献するには</h2>\n\n\n\n<p>WordPress コアの開発に参画するには、Trac にアクセスし、<a href=\"https://core.trac.wordpress.org/report/6\">チケットを選択</a>し、<a href=\"https://wordpress.slack.com/archives/C02RQBWTW\">#core</a> や <a href=\"https://wordpress.slack.com/archives/C080HLPP2Q6\">#6-8-release-leads</a> チャンネルの会話に参加してください。手助けが必要ですか ?「<a href=\"https://ja.wordpress.org/team/handbook/core/\">コアコントリビュータハンドブック日本語版</a>」をご確認ください。</p>\n\n\n\n<p><em>校正に対する props <a href=\"https://profiles.wordpress.org/joedolson/\">@joedolson</a>,&nbsp;<a href=\"https://profiles.wordpress.org/joemcgill/\">@joemcgill</a>&nbsp;and&nbsp;<a href=\"https://profiles.wordpress.org/audrasjb/\">@audrasjb</a>.</em></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7575\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:5;a:6:{s:4:\"data\";s:57:\"\n		\n		\n		\n		\n		\n				\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:45:\"Codex 日本語版運用終了のお知らせ\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:100:\"https://ja.wordpress.org/2024/12/25/notice-of-the-end-of-operation-of-the-japanese-version-of-codex/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 25 Dec 2024 09:41:01 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:1:{i:0;a:5:{s:4:\"data\";s:12:\"Announcement\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7568\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:276:\"2008年以来2021年まで日本語ユーザーマニュアルとして役割を果たしてきた Codex 日本語版ですが、この度、その運用を終了することとなりました。 運用終了の背景 2021年に WordPress 日本語ユーザーマニ [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:12:\"Junko Nukaga\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:3017:\"\n<p>2008年以来2021年まで日本語ユーザーマニュアルとして役割を果たしてきた Codex 日本語版ですが、この度、その運用を終了することとなりました。</p>\n\n\n\n<h2 class=\"wp-block-heading\">運用終了の背景</h2>\n\n\n\n<p>2021年に <a href=\"https://ja.wordpress.org/2021/09/06/codex-to-helphub/\">WordPress 日本語ユーザーマニュアルの移行について</a>のお知らせを発表いたしましたが、Codex 英語版のコンテンツが WordPress サポートページ (HelpHub) に移行されたことに伴い、日本語版も同様に新しいユーザーマニュアルへ移行が進められてきました。2021年より既に積極的にメンテナンスはされない状態でしたが、この度改めて、 Codex 日本語版を運用終了とするお知らせをいたします。</p>\n\n\n\n<h2 class=\"wp-block-heading\">新しい情報の参照先</h2>\n\n\n\n<p>今後、WordPress に関する情報は以下のサイトをご活用ください。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https://ja.wordpress.org/support/\">WordPress サポートページ (HelpHub)</a></li>\n\n\n\n<li><a href=\"https://ja.wordpress.org/team/handbook/\">ハンドブック一覧</a></li>\n</ul>\n\n\n\n<p>これらのリソースは、より最新の情報を提供しています。</p>\n\n\n\n<h2 class=\"wp-block-heading\">Codex 日本語版の現状</h2>\n\n\n\n<p>Codex 日本語版は現在アクセスできない状態となっております。Codex 日本語版をホスティングしている OSDN サービスが営業譲渡待ちのステータスとなっており、サポート等も回答されず操作がまったくできない状況です。動きがあり次第、サブドメインの削除など必要な対応を進める予定です。</p>\n\n\n\n<p>今後は新しいユーザーマニュアルや開発者リソースをご活用いただけますと幸いです。</p>\n\n\n\n<h2 class=\"wp-block-heading\">ご協力への感謝</h2>\n\n\n\n<p>これまで Codex 日本語版の運用にご尽力いただいたコミュニティメンバーの皆さま、特に翻訳やメンテナンスに携わってくださった方々に心より感謝申し上げます。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>当記事のレビュー、作業にご協力いただいた皆様、ありがとうございました。</p>\n\n\n\n<p><a href=\'https://profiles.wordpress.org/hiromasa/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>hiromasa</a>, <a href=\'https://profiles.wordpress.org/wokamoto/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>wokamoto</a>, <a href=\'https://profiles.wordpress.org/yukinobu/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>yukinobu</a>, <a href=\'https://profiles.wordpress.org/torikumo/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>torikumo</a>, <a href=\'https://profiles.wordpress.org/atachibana/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>atachibana</a></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7568\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:6;a:6:{s:4:\"data\";s:57:\"\n		\n		\n		\n		\n		\n				\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:45:\"WordPress 6.7.1メンテナンスリリース\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:72:\"https://ja.wordpress.org/2024/11/22/wordpress-6-7-1-maintenance-release/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Fri, 22 Nov 2024 13:18:36 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:1:{i:0;a:5:{s:4:\"data\";s:8:\"Releases\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7552\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:224:\"以下は WordPress.org 公式ブログの記事「WordPress 6.7.1 Maintenance Release」を訳したものです。 誤字脱字誤訳などありましたらフォーラムまでお知らせください。 WordPr [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:15:\"Akira Tachibana\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:9266:\"\n<p>以下は WordPress.org 公式ブログの記事「<a href=\"https://wordpress.org/news/2024/11/wordpress-6-7-1-maintenance-release/\">WordPress 6.7.1 Maintenance Release</a>」を訳したものです。</p>\n\n\n\n<p>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.7.1が利用可能です !</h2>\n\n\n\n<p>このマイナーリリースには、<a href=\"https://core.trac.wordpress.org/query?resolution=fixed&amp;milestone=6.7.1&amp;group=component&amp;col=id&amp;col=summary&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=status&amp;col=priority&amp;order=priority\">コア</a>と<a href=\"https://github.com/WordPress/wordpress-develop/pull/7851\">ブロックエディター</a>に関する16件のバグフィックスが含まれます。</p>\n\n\n\n<p>WordPress 6.7.1は、WordPress 6.7で入り込んだバグのみに焦点を当てたフォローリリースです。次のメジャーリリースは<a href=\"https://make.wordpress.org/core/6-8/\">バージョン6.8</a>で、<a href=\"https://make.wordpress.org/core/2024/11/19/proposal-major-releases-for-2025/\">2025年4月に予定</a>されています。</p>\n\n\n\n<p>自動バックグラウンド更新をサポートするサイトでは、更新プロセスが自動的に始まります。</p>\n\n\n\n<p><a href=\"https://wordpress.org/wordpress-6.7.1.zip\">WordPress 6.7.1は WordPress.org からダウンロードできます。</a>または、WordPress ダッシュボードに移動して、「更新」をクリックし、続いて「今すぐ更新」をクリックします</p>\n\n\n\n<p>このリリースの詳細については <a href=\"https://wordpress.org/support/wordpress-version/version-6-7-1\">HelpHub にアクセス</a>してください。このリリースに含まれるメンテナンスアップデートの概要には、<a href=\"https://make.wordpress.org/core/?p=116365\">リリース候補のアナウンス</a>に記載されています。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress コントリビューターの皆さんに感謝</h2>\n\n\n\n<p>本リリースは <a href=\"https://profiles.wordpress.org/desrosj/\">Jonathan Desrosiers</a> と <a href=\"https://profiles.wordpress.org/cbravobernal/\">Carlos Bravo</a> がリードしました。</p>\n\n\n\n<p>WordPress 6.7.1は、以下の方々のコントリビューションなしには実現しませんでした。メンテナンスの修正を安定版リリースとして提供するための地球規模での非同期の連携は、WordPress コミュニティの力と能力の証です。</p>\n\n\n\n<p><a href=\"https://profiles.wordpress.org/abcsun/\">abcsun</a>, <a href=\"https://profiles.wordpress.org/adamsilverstein/\">Adam Silverstein</a>, <a href=\"https://profiles.wordpress.org/ahsankhan316/\">Ahsan Khan</a>, <a href=\"https://profiles.wordpress.org/wildworks/\">Aki Hamano</a>, <a href=\"https://profiles.wordpress.org/albigdd/\">Alexander Bigga</a>, <a href=\"https://profiles.wordpress.org/azaozz/\">Andrew Ozz</a>, <a href=\"https://profiles.wordpress.org/ankitkumarshah/\">Ankit Kumar Shah</a>, <a href=\"https://profiles.wordpress.org/ant1busted/\">Antoine</a>, <a href=\"https://profiles.wordpress.org/bluantinoo/\">bluantinoo</a>, <a href=\"https://profiles.wordpress.org/cbravobernal/\">Carlos Bravo</a>, <a href=\"https://profiles.wordpress.org/poena/\">Carolina Nymark</a>, <a href=\"https://profiles.wordpress.org/charleslf/\">charleslf</a>, <a href=\"https://profiles.wordpress.org/apermo/\">Christoph Daum</a>, <a href=\"https://profiles.wordpress.org/get_dave/\">David Smith</a>, <a href=\"https://profiles.wordpress.org/dhewercorus/\">dhewercorus</a>, <a href=\"https://profiles.wordpress.org/dhruvang21/\">Dhruvang21</a>, <a href=\"https://profiles.wordpress.org/dilipbheda/\">Dilip Bheda</a>, <a href=\"https://profiles.wordpress.org/dooperweb/\">dooperweb</a>, <a href=\"https://profiles.wordpress.org/im3dabasia1/\">Eshaan Dabasiya</a>, <a href=\"https://profiles.wordpress.org/flixos90/\">Felix Arntz</a>, <a href=\"https://profiles.wordpress.org/finntown/\">finntown</a>, <a href=\"https://profiles.wordpress.org/firoz2456/\">Firoz Sabaliya</a>, <a href=\"https://profiles.wordpress.org/mamaduka/\">George Mamadashvili</a>, <a href=\"https://profiles.wordpress.org/glynnquelch/\">glynnquelch</a>, <a href=\"https://profiles.wordpress.org/gziolo/\">Greg Ziółkowski</a>, <a href=\"https://profiles.wordpress.org/abcd95/\">Himanshu Pathak</a>, <a href=\"https://profiles.wordpress.org/jagirbahesh/\">jagirbahesh</a>, <a href=\"https://profiles.wordpress.org/jsnajdr/\">Jarda Snajdr</a>, <a href=\"https://profiles.wordpress.org/audrasjb/\">Jb Audras</a>, <a href=\"https://profiles.wordpress.org/jeffpaul/\">Jeffrey Paul</a>, <a href=\"https://profiles.wordpress.org/joedolson/\">Joe Dolson</a>, <a href=\"https://profiles.wordpress.org/joemcgill/\">Joe McGill</a>, <a href=\"https://profiles.wordpress.org/johnbillion/\">John Blackbourn</a>, <a href=\"https://profiles.wordpress.org/desrosj/\">Jonathan Desrosiers</a>, <a href=\"https://profiles.wordpress.org/jonsurrell/\">Jon Surrell</a>, <a href=\"https://profiles.wordpress.org/juliemoynat/\">Julie Moynat</a>, <a href=\"https://profiles.wordpress.org/juliobox/\">Julio Potier</a>, <a href=\"https://profiles.wordpress.org/laurelfulford/\">laurelfulford</a>, <a href=\"https://profiles.wordpress.org/leecollings/\">Lee Collings</a>, <a href=\"https://profiles.wordpress.org/0mirka00/\">Lena Morita</a>, <a href=\"https://profiles.wordpress.org/luisherranz/\">luisherranz</a>, <a href=\"https://profiles.wordpress.org/mmaattiiaass/\">Matias Benedetto</a>, <a href=\"https://profiles.wordpress.org/mayanktripathi32/\">Mayank Tripathi</a>, <a href=\"https://profiles.wordpress.org/czapla/\">Michal Czaplinski</a>, <a href=\"https://profiles.wordpress.org/mcsf/\">Miguel Fonseca</a>, <a href=\"https://profiles.wordpress.org/369work/\">miroku</a>, <a href=\"https://profiles.wordpress.org/mukesh27/\">Mukesh Panchal</a>, <a href=\"https://profiles.wordpress.org/narenin/\">Narendra Sishodiya</a>, <a href=\"https://profiles.wordpress.org/ntsekouras/\">Nik Tsekouras</a>, <a href=\"https://profiles.wordpress.org/domainsupport/\">Oliver Campion</a>, <a href=\"https://profiles.wordpress.org/swissspidy/\">Pascal Birchler</a>, <a href=\"https://profiles.wordpress.org/peterwilsoncc/\">Peter Wilson</a>, <a href=\"https://profiles.wordpress.org/ramonopoly/\">ramonopoly</a>, <a href=\"https://profiles.wordpress.org/ravigadhiyawp/\">Ravi Gadhiya</a>, <a href=\"https://profiles.wordpress.org/rcreators/\">Rishi Mehta</a>, <a href=\"https://profiles.wordpress.org/room34/\">room34</a>, <a href=\"https://profiles.wordpress.org/roytanck/\">Roy Tanck</a>, <a href=\"https://profiles.wordpress.org/looswebstudio/\">Ryo</a>, <a href=\"https://profiles.wordpress.org/sailpete/\">sailpete</a>, <a href=\"https://profiles.wordpress.org/sainathpoojary/\">Sainath Poojary</a>, <a href=\"https://profiles.wordpress.org/sarthaknagoshe2002/\">Sarthak Nagoshe</a>, <a href=\"https://profiles.wordpress.org/sergeybiryukov/\">Sergey Biryukov</a>, <a href=\"https://profiles.wordpress.org/sirlouen/\">SirLouen</a>, <a href=\"https://profiles.wordpress.org/sppramodh/\">S P Pramodh</a>, <a href=\"https://profiles.wordpress.org/sabernhardt/\">Stephen Bernhardt</a>, <a href=\"https://profiles.wordpress.org/stimul/\">stimul</a>, <a href=\"https://profiles.wordpress.org/sukhendu2002/\">Sukhendu Sekhar Guria</a>, <a href=\"https://profiles.wordpress.org/tigriweb/\">TigriWeb</a>, <a href=\"https://profiles.wordpress.org/timwhitlock/\">Tim W</a>, <a href=\"https://profiles.wordpress.org/tobifjellner/\">tobifjellner (Tor-Bjorn “Tobi” Fjellner)</a>, <a href=\"https://profiles.wordpress.org/twvania/\">Vania</a>, <a href=\"https://profiles.wordpress.org/yogeshbhutkar/\">Yogesh Bhutkar</a>, <a href=\"https://profiles.wordpress.org/yowangdu/\">YoWangdu</a>, <a href=\"https://profiles.wordpress.org/zargarov/\">Zargarov</a>, and <a href=\"https://profiles.wordpress.org/zeelthakkar/\">zeelthakkar</a>.</p>\n\n\n\n<h2 class=\"wp-block-heading\">貢献するには</h2>\n\n\n\n<p>WordPress コアの開発に参画するには、Trac にアクセスし、<a href=\"https://core.trac.wordpress.org/report/6\">チケットを選択</a>し、<a href=\"https://wordpress.slack.com/archives/C02RQBWTW\">#core</a> や <a href=\"https://wordpress.slack.com/archives/C080HLPP2Q6\">#6-8-release-leads</a> チャンネルの会話に参加してください。手助けが必要ですか ?「<a href=\"https://ja.wordpress.org/team/handbook/core/\">コアコントリビュータハンドブック日本語版</a>」をご確認ください。</p>\n\n\n\n<p><em>校正への協力に感謝します。</em><a href=\"https://profiles.wordpress.org/marybaum/\"><em>@marybaum</em></a><em>, </em><a href=\"https://profiles.wordpress.org/aaroncampbell/\"><em>@aaroncampbell</em></a><em>, </em><a href=\"https://profiles.wordpress.org/jeffpaul/\"><em>@jeffpaul</em></a><em>, </em><a href=\"https://profiles.wordpress.org/audrasjb/\"><em>@audrasjb</em></a><em>, </em><a href=\"https://profiles.wordpress.org/cbravobernal/\"><em>@cbravobernal</em></a><em>, </em><a href=\"https://profiles.wordpress.org/ankit-k-gupta/\"><em>@ankit-k-gupta</em></a></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7552\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:7;a:6:{s:4:\"data\";s:57:\"\n		\n		\n		\n		\n		\n				\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"WordPress 6.7 “ロリンズ”\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:44:\"https://ja.wordpress.org/2024/11/13/rollins/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 13 Nov 2024 10:55:36 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:1:{i:0;a:5:{s:4:\"data\";s:8:\"Releases\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7520\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:224:\"以下は WordPress.org 公式ブログの記事「WordPress 6.7 “Rollins”」の翻訳です。 誤字脱字誤訳などありましたらフォーラムまでお知らせください。 WordPress 6.7 “Rollin [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:13:\"Itsuko Miyake\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:78007:\"\n<p>以下は WordPress.org 公式ブログの記事「<a href=\"https://wordpress.org/news/2024/11/rollins/\">WordPress 6.7 “Rollins”</a>」の翻訳です。</p>\n\n\n\n<p>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<h1 class=\"wp-block-heading\">WordPress 6.7 “Rollins”</h1>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https://i0.wp.com/wordpress.org/news/files/2024/11/Release-Edition-Featured-Image.png?resize=1024%2C535&amp;ssl=1\" alt=\"\" class=\"wp-image-18085\" /></figure>\n\n\n\n<p>WordPress の各リリースでは、音楽の世界に消えることのない足跡を残したアーティストを称えています。WordPress 6.7は「Rollins」というコードネームで、伝説的なジャズサックス奏者ソニー・ロリンズ (Sonny Rollins) への敬意を表しています。偉大な即興演奏家であり、ジャズの先駆者として知られるロリンズは、その卓越した技術、革新的な精神、そして音楽表現への大胆なアプローチによって多くの世代のミュージシャンに影響を与えてきました。</p>\n\n\n\n<p>ソニー・ロリンズの作品は、比類のないエネルギーと感情の深さが特徴です。「St. Thomas」、「Oleo」、「Airegin」といった彼の楽曲は、リズムの複雑さや旋律の独創性で称賛される、時代を超えたジャズのスタンダードとなっています。ロリンズの大胆で探求心に満ちたスタイルは、クリエイターがデジタル表現の境界を広げ、新たな可能性を追求できるよう支援する WordPress の姿勢とも響き合っています。</p>\n\n\n\n<p>WordPress 6.7の新機能と強化された機能に夢中になりながら、ロリンズのサウンドを定義する革新と自発性の精神を体感してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">ようこそ、WordPress 6.7 !</h2>\n\n\n\n<p>WordPress 6.7でモダンな Twenty Twenty-Five テーマがデビューし、あらゆる規模のブログに究極のデザインの柔軟性を提供します。新しいフォント管理機能で、サイトのタイポグラフィをかつてないほどコントロールできます。新しいズームアウト機能では、マクロビューでサイトをデザインし、細部から一歩下がって全体像を浮かび上がらせることができます。</p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https://ja.wordpress.org/download/\">WordPress 6.7「Rollins」のダウンロード</a></div>\n</div>\n\n\n\n<h2 class=\"wp-block-heading\">Twenty Twenty-Five の紹介</h2>\n\n\n\n<h4 class=\"wp-block-heading\">複雑さを排除した無限の可能性</h4>\n\n\n\n<p>Twenty Twenty-Five は、柔軟でデザイン重視のテーマであり、簡単に魅力的なサイトを構築できます。豊富なスタイルオプション、ブロックパターン、カラーパレットで、美的感覚をカスタマイズしましょう。必要な要素だけを凝縮したこのテーマは、あなたと共に成長できるテーマです。</p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https://i0.wp.com/s.w.org/images/core/6.7/feature-tt5-2.webp?ssl=1\" alt=\"\" /></figure>\n\n\n\n<h3 class=\"wp-block-heading\">ズームアウトで全体像を把握</h3>\n\n\n\n<h4 class=\"wp-block-heading\">新たな視点からコンテンツを探索する</h4>\n\n\n\n<p>コンテンツ全体をこれまでにない方法で編集、配置できます。サイトの広範なビューにより、パターンの追加、編集、並べ替え、削除が自由自在。あなたの中に眠る建築家を解放してください。</p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https://i0.wp.com/s.w.org/images/core/6.7/feature-zoom-2.webp?ssl=1\" alt=\"\" /></figure>\n\n\n\n<h3 class=\"wp-block-heading\">ブロックとカスタムフィールドを手間 (またはコード) なしで接続</h3>\n\n\n\n<h4 class=\"wp-block-heading\">動的なコンテンツを効率的に作成する方法</h4>\n\n\n\n<p>この機能では、ブロックとカスタムフィールドを接続するための新しい UI が導入され、動的コンテンツのコントロールがエディターで直接行えるようになりました。わずか数クリックでブロックとフィールドをリンクし、構築時の柔軟性と効率を高めます。クライアントはきっとあなたを気に入るでしょう。</p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https://i0.wp.com/s.w.org/images/core/6.7/feature-block-bindings-2.webp?ssl=1\" alt=\"\" /></figure>\n\n\n\n<h3 class=\"wp-block-heading\">内なるフォント好きを解き放とう</h3>\n\n\n\n<h4 class=\"wp-block-heading\">新しいスタイルセクション、新しい可能性</h4>\n\n\n\n<p>スタイルインターフェースに追加された次の機能で、フォントサイズのプリセットを作成、編集、削除、適用できます。 テーマのデフォルトを上書きするか、レスポンシブなフォントスケーリングのための流動的なタイポグラフィを備えた独自のカスタムフォントサイズを作成します。詳細をご覧ください !</p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https://i0.wp.com/s.w.org/images/core/6.7/feature-font-presets-2.png?ssl=1\" alt=\"\" /></figure>\n\n\n\n<h3 class=\"wp-block-heading\">パフォーマンス</h3>\n\n\n\n<p>WordPress 6.7では、パターンの読み込みの高速化、データ ビューコンポーネントのプレビューの最適化、PHP 8+ のサポートの改善と非推奨コードの削除、遅延読み込みされた画像の自動サイズ調整、HTML API でのタグ処理の効率化など、重要なパフォーマンスの更新が提供されます。</p>\n\n\n\n<h3 class=\"wp-block-heading\">アクセシビリティ</h3>\n\n\n\n<p>65以上のアクセシビリティの修正と機能強化は、エディターのユーザーインターフェースコンポーネントとキーボードナビゲーションの改善から、WordPress ログイン画面のアクセシブルな見出しや全体のより明確なラベル付けまで、WordPress 体験の基本的な側面に重点を置いています。</p>\n\n\n\n<h3 class=\"wp-block-heading\">まだまだあります</h3>\n\n\n\n<p>WordPress 6.7の新機能や強化点についての包括的な概要は、フィーチャーショーケースサイトをご覧ください。</p>\n\n\n\n<p><a href=\"https://wordpress.org/download/releases/6-7/\">新機能を確認する</a></p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.7についてさらに学ぶ</h2>\n\n\n\n<p><a href=\"https://learn.wordpress.org/\">Learn WordPress</a> は、初心者から経験豊富な WordPress ユーザーまでを対象とした無料のリソースです。Learn には、WordPress のさまざまな機能の使い方に関するハウツー ビデオ、トピックを詳しく調べるための<a href=\"https://learn.wordpress.org/social-learning/\">インタラクティブなワークショップ</a>、WordPress の特定の領域を深く掘り下げるためのレッスンプランが豊富に用意されています。</p>\n\n\n\n<p>インストール、機能強化、修正された問題、リリースの貢献者、学習リソース、変更されたファイルのリストについては、<a href=\"https://wordpress.org/documentation/wordpress-version/version-6.7\">WordPress 6.7リリースノート</a>をお読みください。</p>\n\n\n\n<p><a href=\"https://make.wordpress.org/core/wordpress-6-7-field-guide/\">WordPress 6.7フィールドガイド</a>をご覧ください。WordPress での構築に役立つ詳細な開発者ノートとともに、このリリースでの変更点について学習します。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.7リリースチーム</h2>\n\n\n\n<p>すべてのリリースには、タスクを軌道に乗せ円滑に進めるために、熱心なコントリビューターから構成された献身的なチームが必要です。6.7を率いたチームは、常にアイデアを支持し、障害を取り除き、問題を解決する、枠を超えたコントリビューターグループです。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>リリースリード: <a href=\"https://profiles.wordpress.org/matt/\">Matt Mullenweg</a></li>\n\n\n\n<li>リリースコーディネーター: <a href=\"https://profiles.wordpress.org/davidbaumwald/\">David Baumwald</a></li>\n\n\n\n<li>コア技術リード: <a href=\"https://profiles.wordpress.org/peterwilsoncc/\">Peter Wilson</a>,&nbsp;<a href=\"https://profiles.wordpress.org/kirasong/\">Kira Schroder</a></li>\n\n\n\n<li>エディター技術リード: <a href=\"https://profiles.wordpress.org/get_dave/\">David Smith</a>,&nbsp;<a href=\"https://profiles.wordpress.org/kevin940726/\">Kai Hao</a>,&nbsp;<a href=\"https://profiles.wordpress.org/noisysocks/\">Robert Anderson</a></li>\n\n\n\n<li>コアトリアージリード: <a href=\"https://profiles.wordpress.org/stoyangeorgiev/\">Stoyan Georgiev</a>, <a href=\"https://profiles.wordpress.org/chaion07/\">Ahmed Kabir Chaion</a></li>\n\n\n\n<li>エディタートリアージリード: <a href=\"https://profiles.wordpress.org/ndiego/\">Nick Diego</a>,&nbsp;<a href=\"https://wordpress.org/support/users/colorful-tones/\">Damon Cook</a></li>\n\n\n\n<li>ドキュメンテーションリード: <a href=\"https://profiles.wordpress.org/fabiankaegy/\">Fabian Kägy</a>,&nbsp;<a href=\"https://profiles.wordpress.org/faguni22/\">Mumtahina Faguni</a></li>\n\n\n\n<li>テストリード: <a href=\"https://profiles.wordpress.org/ankit-k-gupta/\">Ankit K. Gupta</a></li>\n\n\n\n<li>デザインリード: <a href=\"https://profiles.wordpress.org/joen/\">Joen Asmussen</a></li>\n\n\n\n<li>パフォーマンスリード: <a href=\"https://profiles.wordpress.org/mukesh27/\">Mukesh Panchal</a></li>\n\n\n\n<li>デフォルトテーマデザインリード:&nbsp;<a href=\"https://profiles.wordpress.org/beafialho/\">Beatriz Fialho</a></li>\n\n\n\n<li>デフォルトテーマ開発リード:&nbsp;<a href=\"https://profiles.wordpress.org/poena/\">Carolina Nymark</a>,&nbsp;<a href=\"https://profiles.wordpress.org/juanfra/\">Juan Aldasoro</a></li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">コントリビューターのみなさん、ありがとう</h2>\n\n\n\n<p>WordPress はパブリッシングの民主化と<a href=\"https://opensource.org/definition-annotated\">オープンソースに付属する自由</a>を信じています。この考えを支えているのは、ソフトウェアの強化に協力しているグローバルで多様な人々のコミュニティです。</p>\n\n\n\n<p>WordPress 6.7は、世界各国の780人以上の貢献者のたゆまぬ努力と情熱を反映しています。このリリースでは、230人を超える初めての貢献者も迎えました。</p>\n\n\n\n<p>彼らの協力により、340を超える機能強化と修正が行われ、すべての人にとって安定したリリースが保証されました。これは、WordPress オープンソースコミュニティの力と能力の証です。</p>\n\n\n\n<p class=\"has-light-grey-2-color has-dark-blueberry-background-color has-text-color has-background has-link-color wp-elements-175bc502fd1091b1e16f0887279386f0\"><a href=\"https://profiles.wordpress.org/benniledl/\">!Benni</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/75thtrombone/\">75thtrombone</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jorbin/\">Aaron Jorbin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aaronrobertshaw/\">Aaron Robertshaw</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aware/\">Aaron Ware</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aatanasov/\">aatanasov</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/webcommsat/\">Abha Thakor</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/abhi3315/\">abhi3315</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fitehal/\">Abhishek Deshpande</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ababir/\">Abir</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/acafourek/\">acafourek</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/adamkheckler/\">Adam Heckler</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/adamsilverstein/\">Adam Silverstein</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/adamwood/\">Adam Wood</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zieladam/\">Adam Zieliński</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/adarshposimyth/\">Adarsh Akshat</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/adrian2k7/\">Adrian</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aduth/\">aduth</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ah72king/\">ah72king</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ahmarzaidi/\">Ahmar Zaidi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/chaion07/\">Ahmed Kabir Chaion</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/engahmeds3ed/\">Ahmed Saeed</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ajitbohra/\">Ajit Bohra</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/akashdhawade/\">Akash Dhawade</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wildworks/\">Aki Hamano</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/atachibana/\">Akira Tachibana</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/akshat2802/\">Akshat Kakkad</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alaminfirdows/\">Al-Amin Firdows</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alanfuller/\">Alan Fuller</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aljullu/\">Albert Juhé Lluveras</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alessandrotesoro/\">Alessandro Tesoro</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ralessio/\">Alessio</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/xknown/\">Alex Concha</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ajlende/\">Alex Lende</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alexstine/\">Alex Stine</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alex27/\">alex27</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/digitalex11/\">Alexander Frank</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alexandrebuffet/\">Alexandre Buffet</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/harlet7/\">Alexandru Horeanu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alexcu21/\">alexcu21</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ali7ali/\">Ali Ali</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aliaghdam/\">aliaghdam</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/firewatch/\">allilevine</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mrfoxtalbot/\">Alvaro Gómez</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alvitazwar052/\">Alvi Tazwar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/amincharoliya/\">Amin Charoliya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/amirthepiper/\">Amir Abbas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/amitraj2203/\">Amit Raj</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/amjadr360/\">Amjad Ali</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/anthakkar08/\">Anand Thakkar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/afercia/\">Andrea Fercia</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/awetz583/\">Andrea Roenning</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/andraganescu/\">Andrei Draganescu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/euthelup/\">Andrei Lupu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/andreiglingeanu/\">andreiglingeanu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/andrewhayward/\">Andrew Hayward</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/azaozz/\">Andrew Ozz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/andrewserong/\">Andrew Serong</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rarst/\">Andrey “Rarst” Savchenko</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/oandregal/\">André Maneiro</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/afragen/\">Andy Fragen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/la-geek/\">Angelika Reisiger</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aniketpatel/\">Aniket Patel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ankit-k-gupta/\">Ankit K Gupta</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ankit%20k%20gupta/\">Ankit K. Gupta</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ankitkumarshah/\">Ankit Kumar Shah</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/the-ank/\">Ankur Vishwakarma</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/annezazu/\">Anne McCarthy</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/antpb/\">Anthony Burchell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ahortin/\">Anthony Hortin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ant1busted/\">Antoine</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/antonvlasenko/\">Anton Vlasenko</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/antoniosejas/\">Antonio Sejas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/apmeyer/\">apmeyer</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aristath/\">Ari Stathopoulos</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/perezcarreno/\">Armando J. Perez Carreno</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/armandsdz/\">Armands</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/arnaudbroes/\">arnaudbroes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ambrosiawt/\">Art Smith</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/artemiosans/\">Artemio Morales</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/arthur791004/\">Arthur Chu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/arypneta/\">arypneta</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/asafm7/\">asafm7</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/aslamdoctor/\">Aslam Doctor</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nmutua/\">Autumn</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ayeshrajans/\">Ayesh Karunaratne</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bjerke-johannessen/\">Bård Bjerke Johannessen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/beryldlg/\">Béryl de La Grandière</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/balub/\">Balu B</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/barryceelen/\">Barry Ceelen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bartkalisz/\">Bart Kalisz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/beafialho/\">Beatriz Fialho</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/scruffian/\">Ben Dwyer</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rainbowgeek/\">Benjamin Denis</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/benjamin_zekavica/\">Benjamin Zekavica</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/benoitchantre/\">Benoit Chantre</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kau-boy/\">Bernhard Kau</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bernhard%20reiter/\">Bernhard Reiter</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/neoxx/\">Bernhard Riedl</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bernhard-reiter/\">bernhard-reiter</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/berubenic/\">berubenic</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bhaveshdesai13/\">Bhavesh</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bijit027/\">bijit027</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bph/\">Birgit Pauli-Haack</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/blindmikey/\">blindmikey</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bobbyleenoblestudios/\">bobbyleenoblestudios</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bogdannikolic/\">Bogdan Nikolic</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/veryard/\">Brad</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bradley2083/\">brad hogan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bjorsch/\">Brad Jorsch</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kraftbj/\">Brandon Kraft</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/brentjettgmailcom/\">Brent Jett</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/brettshumaker/\">Brett Shumaker</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ironprogrammer/\">Brian Alexander</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bacoords/\">Brian Coords</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bgardner/\">Brian Gardner</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bgosnell/\">Brian Gosnell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/brianhenryie/\">Brian Henry</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/bridgetwes/\">bridgetwes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/brobken/\">brobken</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/freibergergarcia/\">Bruno Freiberger Garcia</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cambabutonono/\">Cambabutonono</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cbravobernal/\">Carlos Bravo</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/carlosgprim/\">Carlos G. P.</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/poena/\">Carolina Nymark</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/carstenbach/\">Carsten Bach</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cbirdsong/\">cbirdsong</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mchirag2002/\">Chirag Mathur</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/chrico/\">ChriCo</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jazzs3quence/\">Chris Reynolds</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eclare/\">Chris Trynkiewicz (Sukces Strony)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/apermo/\">Christoph Daum</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cfinke/\">Christopher Finke</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ckanitz/\">Christopher Kanitz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nyiriland/\">Christy Nyiri</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/butterflymedia/\">Ciprian</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/codersantosh/\">codersantosh</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/costdev/\">Colin Stewart</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/coreyw/\">Corey Worrell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/courane01/\">Courtney Robertson</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/craynor/\">craynor</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/creativethemeshq/\">creativethemeshq</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cwhitmore/\">Cullen Whitmore</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cu121/\">Cupid Chakma</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cweiske/\">cweiske</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/coquardcyr/\">Cyrille</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/da5f656f/\">da5f656f</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/xendo/\">Dademaru</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/daleharrison/\">daleharrison</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/colorful-tones/\">Damon Cook</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/colorful%20tones/\">Damon Cook</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/daniguardiola/\">Dani Guardiola</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/talldanwp/\">Daniel Richards</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mte90/\">Daniele Scasciafratte</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/itsdanny/\">Danny</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dannyreaktiv/\">dannyreaktiv</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/darerodz/\">darerodz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/d-signed/\">Dareth NHANG</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nerrad/\">Darren Ethier (nerrad)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/darshitrajyaguru97/\">Darshit Rajyaguru</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/daveagp/\">daveagp</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fac3less/\">David</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dballari/\">David Ballarin Prunera</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/davidbaumwald/\">David Baumwald</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/davidbinda/\">David Biňovec</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/davidabowman/\">David Bowman</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/davidhbrown/\">David Brown</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dpcalhoun/\">David Calhoun</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/davidgodleman10up/\">David Godleman</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dhenriet/\">David Henriet</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dlh/\">David Herrera</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/justlevine/\">David Levine</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/daviedr/\">David Rozando</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dshanske/\">David Shanske</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/get_dave/\">David Smith</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ddewan/\">ddewan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dsas/\">Dean Sas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/debarghyabanerjee/\">DEBARGHYA BANERJEE</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/deepakrohilla/\">Deepak Rohilla</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/deepakvijayan/\">Deepak Vijayan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dekadinious/\">Dekadinious</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dmsnell/\">Dennis Snell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dsmart/\">Derek Smart</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/deryck/\">Deryck</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/designsimply/\">designsimply</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/devansh2002/\">Devansh Chaudhary</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/devspace/\">devspace</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dhananjaykuber/\">Dhananjay Kuber</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dharm1025/\">Dharmesh Patel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dhrumilk/\">Dhrumil Kumbhani</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dhruval04/\">Dhruval Shah</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dhruvang21/\">Dhruvang21</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dilipbheda/\">Dilip Bheda</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dilip2615/\">Dilip Modhavadiya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dd32/\">Dion Hulse</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/divibanks/\">Divi Banks</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/djcowan/\">dj.cowan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/djennez/\">djennez</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cyberorca/\">Doni Kuntoro</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/dorzki/\">Dor Zuberi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/drewapicture/\">Drew Jaynes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/drivingralle/\">Drivingralle</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/drzraf/\">drzraf</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/elrae/\">Earle Davies</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eballeste/\">eballeste</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eclev91/\">eclev91</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/beckej/\">Ed Beck</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ejnwebmaster/\">ejnwebmaster</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/elfu98/\">elfu98</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eliorivero/\">Elio Rivero</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ellatrix/\">Ella van&nbsp;Durpe</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/erichmond/\">Elliott Richmond</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eatse/\">Emmanue ATSÉ</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/manooweb/\">Emmanuel Hesry</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/emmanuel78/\">emmanuel78</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lopo/\">Enrico Battocchi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nrqsnchz/\">Enrique Sánchez</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ericdye/\">Eric Dye</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kebbet/\">Erik</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/erikiva/\">erikiva</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/erikyo/\">erikyo</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eherman24/\">Evan Herman</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/circlecube/\">Evan Mullins</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fabiankaegy/\">Fabian Kägy</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fabiorubioglio/\">Fabio Rubioglio</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fahimmurshed/\">FahimMurshed</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/faisalahammad/\">Faisal Ahammad</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/faisal03/\">Faisal Alvi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fazyshah/\">Faizan Nabi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/iamfarhan09/\">Farhan Ahmed</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fayyazfayzi/\">Fayyaz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/flixos90/\">Felix Arntz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ffffelix/\">Felix Renicks</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fjorgemota/\">Fernando Jorge Mota (a11n)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/firoz2456/\">Firoz Sabaliya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fcoveram/\">Francisco</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/franz00/\">Fransisca H</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fullworks/\">fullworks</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gwallace87/\">Gale Wallace</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gansbrest/\">gansbrest</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/garethelwell/\">Gareth Elwell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/garrett-eclipse/\">Garrett Hyder</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pento/\">Gary Pendergast</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gauravtiwari/\">Gaurav Tiwari</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gauravsingh7/\">gauravsingh7</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/georgwordpress/\">Georg</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mamaduka/\">George Mamadashvili</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/geriux/\">Gerardo Pacheco</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/germanfrelo/\">Germán Freixinós</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gmariani405/\">gmariani405</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/graemef/\">GraemeF</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/grantmkin/\">Grant M. Kinney</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/greentreefrog/\">greentreefrog</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/greenworld/\">GreenWorld</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gziolo/\">Greg Ziółkowski</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wido/\">Guido Scialfa</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gyurmey/\">Gyurmey</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/priethor/\">Héctor Prieto</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/halilesen/\">Halil ESEN</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hanneslsm/\">hanneslsm</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hage/\">Hans-Gerd Gerhards</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hardipparmar/\">Hardip Parmar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hareesh-pillai/\">Hareesh S</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/plaidharper/\">Harper Holsinger</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/harshgajipara/\">Harsh Gajipara</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/harshvaishnav/\">harshvaishnav</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hazdiego/\">Haz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hectorjarquin/\">hectorjarquin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hedgefield/\">hedgefield</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/helen/\">Helen Hou-Sandi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/iamarinoh/\">Henrique Iamarino</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/abcd95/\">Himanshu Pathak</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hirschferkel/\">hirschferkel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hbhalodia/\">Hit Bhalodia</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/h71/\">Hossein</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/htmgarcia/\">htmgarcia</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/huubl/\">huubl</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/huzaifaalmesbah/\">Huzaifa Al Mesbah</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kardi420/\">Ibrahim</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ibrahimriaz/\">Ibrahim Riaz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/imranh920/\">Imran Hossain (a11n)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/isabel_brison/\">Isabel Brison</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/itpathsolutions/\">IT Path Solutions</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/itapress/\">itapress</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ivanottinger/\">Ivan Ottinger</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jpstevens/\">Jack Stevens</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jacobcassidy/\">Jacob Cassidy</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/smithjw1/\">Jacob Smith</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jagirbahesh/\">jagirbahesh</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jainil07/\">Jainil Shah</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jtgreyd/\">Jakob Trost</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jameskoster/\">James Koster</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jamesosborne/\">James Osborne</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jamesros161/\">James Rosado</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jwgoedert/\">James Wesley Goedert</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/janpfeil/\">Jan Pfeil</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/janak007/\">janak Kaneriya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jsnajdr/\">Jarda Snajdr</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jarekmorawski/\">jarekmorawski</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ipajen/\">Jarko Piironen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jasonbahl/\">Jason Bahl</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/madtownlems/\">Jason LeMahieu (MadtownLems)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/javad2000/\">javad2000</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/javiarce/\">Javier Arce</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jawadwp/\">Jawad Malik</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/topdownjimmy/\">Jay</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jayadevankbh/\">Jayadevan k</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/drjosh07/\">jbrya029</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jdahir0789/\">JD Ahir</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/audrasjb/\">Jean-Baptiste Audras</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/krokodok/\">Jeff Chi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jffng/\">Jeff Ong</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/cheffheid/\">Jeffrey de Wit</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jeffpaul/\">Jeffrey Paul</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jenilk/\">Jenil Kanani</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jennifarhat/\">Jennifer Farhat</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jdy68/\">Jenny Dupuy</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jeremyfelt/\">Jeremy Felt</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jeherve/\">Jeremy Herve</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jeryj/\">Jerry Jones</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/skobe/\">Jesko Bendmann</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/luminuu/\">Jessica Lyschik</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jetaldobariya1/\">jetaldobariya1</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jigar9998/\">Jigar Panchal</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jimmyh61/\">jimmyh61</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/joedolson/\">Joe Dolson</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/joehoyle/\">Joe Hoyle</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/joemcgill/\">Joe McGill</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/joen/\">Joen Asmussen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/johnbillion/\">John Blackbourn</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/johnillo/\">John Espiritu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/johnny5/\">John Godley</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/johnjamesjacoby/\">John James Jacoby</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/johnregan3/\">John Regan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lwangaman/\">JohnRDOrazio</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jonsurrell/\">Jon Surrell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/elbsegler/\">Jonas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/psykro/\">Jonathan Bossenger</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/desrosj/\">Jonathan Desrosiers</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/spacedmonkey/\">Jonny Harris</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jonnywatersbb/\">Jonny Waters</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jordesign/\">jordesign</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jorgefilipecosta/\">Jorge Costa</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/josklever/\">Jos Klever</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/josevarghese/\">Jose Varghese</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/chanthaboune/\">Josepha</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/verygoode/\">Joshua Goode</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jossnaz/\">Jossnaz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/juanfra/\">Juan Aldasoro</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/juanmaguitar/\">JuanMa Garrido</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/julianoe/\">julianoe</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/juliemoynat/\">Julie Moynat</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/jrf/\">Juliette Reinders Folmer</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/junedsabaliya/\">Juned Sabaliya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/greenshady/\">Justin Tadlock</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kadamwhite/\">K. Adam White</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kaavyaiyer/\">Kaavya Iyer (woo-hc)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/arkenon/\">Kadim Gültekin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kafleg/\">KafleG</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kevin940726/\">Kai Hao</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kajalgohel/\">Kajal Gohel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ikamal/\">Kamal Hosen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kamran8176/\">Kamran Hussen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/karan4word/\">Karan Gupta</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/karolmanijak/\">Karol Manijak</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/thekt12/\">Karthik Thayyil</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kartikmehta/\">Kartik Mehta</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kartik-suthar/\">Kartik Suthar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kbrownkd/\">kbrownkd (a11n)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/keffr3n/\">Keffr3n</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kel-dc/\">Kel Santiago-Pilarski</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kellenmace/\">Kellen Mace</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ryelle/\">Kelly Choyce-Dwan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/keoshi/\">keoshi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kevinb/\">Kevin Behrens</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ktaron/\">Kevin Taron</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kevinswalsh/\">kevinswalsh</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/khokansardar/\">Khokan Sardar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kirasong/\">Kira Schroder</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kishanjasani/\">Kishan Jasani</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kisquian/\">kisquian</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kjellr/\">Kjell Reigstad</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kkmuffme/\">kkmuffme</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/knutsp/\">Knut Sparhell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kowsar89/\">Kowsar Hossain</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kracked888/\">kracked888</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/krishneup/\">Krishna Neupane</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kristastevens/\">kristastevens</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/krupajnanda/\">Krupa Nanda</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/krupalpanchal/\">Krupal Panchal</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kmadhak/\">Kunal Madhak</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gohelkunjan/\">Kunjan Gohel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kurtpayne/\">Kurt Payne</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kushang78/\">Kushang Tailor</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mlaetitia/\">Lae</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/notlaura/\">Lara Schenck</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lastsplash/\">lastsplash (a11n)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/newyorkerlaura/\">Laura Byrne</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/laurelfulford/\">laurelfulford</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/oncecoupled/\">Lauren</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/laranz/\">Lawrence Joe</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/leemon/\">leemon</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/0mirka00/\">Lena Morita</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lgladdy/\">Liam Gladdy</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lifelightweb/\">lifelightweb</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rudlinkon/\">Linkon Miyan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/linsoftware/\">Linnea Huxford</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/liviopv/\">liviopv</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/louiswol94/\">Louis Wolmarans</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/louwie17/\">Lourens</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lovesoni1999/\">Love Soni</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/crixu/\">Lucas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/gigitux/\">Luigi Teschio</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zaguiini/\">Luis Felipe Zaguini</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/luisherranz/\">luisherranz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lukasbesch/\">lukasbesch</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lukecarbis/\">Luke Carbis</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/madhudollu/\">Madhu Dollu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/madpeter/\">madpeter</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/onemaggie/\">Maggie Cabrera</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nadimcse/\">Mahmudul Haque Nadim</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mai21/\">Mai</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mkrndmane/\">Makarand G. Mane</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/manbo/\">manbo</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/maneshtimilsina/\">Manesh Timilsina</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/targz-1/\">Manuel Schmalstieg</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/manzoorwanijk/\">Manzoor Wani (a11n)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/marianguas/\">María Anguas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mdxfr/\">Marc</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/marc4/\">Marc Armengou</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mardroid/\">Marcel Tannich</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fullofcaffeine/\">Marcelo de Moraes Serpa</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/iworks/\">Marcin Pietrzak</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mciampini/\">Marco Ciampini</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pereirinha/\">Marco Pereirinha</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/marcwieland95/\">marcwieland95</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/igreenie/\">Marek Železný</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/margolisj/\">margolisj</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mariayohana/\">Maria Yohana</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/plari/\">Marie</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/tyxla/\">Marin Atanasov</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/santosguillamot/\">Mario Santos</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/clorith/\">Marius L. J.</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/marius84/\">mariushosting</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/markhowellsmead/\">Mark Howells-Mead</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/markparnell/\">Mark Parnell</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mark-k/\">Mark-k</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mhkuu/\">Martijn van der Klis</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/martinkrcho/\">martin.krcho</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/marybaum/\">marybaum</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mat_/\">mat_</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mmaattiiaass/\">Matias Benedetto</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/matveb/\">Matias Ventura</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/matt/\">Matt Mullenweg</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mattyrob/\">Matt Robinson</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mattormeeple/\">Matt Sherman</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/matteoenna/\">Matteo Enna</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mboynes/\">Matthew Boynes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lonelyvegan/\">Matthew Riley MacPherson</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/kittmedia/\">Matthias Kittsteiner</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mattraines/\">mattraines</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/maurodf/\">maurodf</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mayanktripathi32/\">Mayank Tripathi</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mayur8991/\">Mayur Prajapati</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mcrisp1972/\">mcrisp1972</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hmbashar/\">Md Abul Bashar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mhshohel/\">Md Hossain Shohel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/istiaqhossain/\">Md. Istiaq Hossain</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mdviralsampat/\">mdviralsampat</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/megane9988/\">megane9988</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/iammehedi1/\">Mehedi Hassan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mehulkaklotar/\">Mehul Kaklotar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/melchoyce/\">Mel Choyce-Dwan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/meteorlxy/\">meteorlxy</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mfgmicha/\">Micha Krapp</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/tw2113/\">Michael Beckwith</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/michaelbourne/\">Michael Bourne</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hrkhal/\">Michael James Ilett</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/michaelpick/\">michaelpick</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/michaelwp85/\">michaelwp85</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/czapla/\">Michal Czaplinski</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mielbu/\">Michelle Bulloch</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/miguelaxcar/\">Miguel Axcar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mcsf/\">Miguel Fonseca</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/migueluy/\">Miguel Lezama</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/simison/\">Mikael Korpela</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mmcalister/\">Mike McAlister</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ritterml/\">Mike Ritter</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mikeb8s/\">mikeb8s</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mikeybinns/\">Mikey Binns</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/milamj/\">milamj</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/milana_cap/\">Milana Cap</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/presstoke/\">Mitchell Austin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mklusak/\">mklusak</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mleathem/\">mleathem</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mlf20/\">mlf20</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mobarak/\">Mobarak Ali</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mohitdadhich10/\">Mohit Dadhich</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/morganestes/\">Morgan Estes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mosne/\">Mosne / Paolo Tesei</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mossy2100/\">mossy2100</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mreishus/\">mreishus</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/devmuhib/\">Muhibul Haque</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mujuonly/\">mujuonly</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mukesh27/\">Mukesh Panchal</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/faguni22/\">Mumtahina Faguni</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/assassinateur/\">Nadir Seghir a11n</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/naeemhaque/\">Naeem Haque</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nagpai/\">Nagesh Pai</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/narenin/\">Narendra Sishodiya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nareshbheda/\">Naresh Bheda</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/n8finch/\">Nate Finch</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nateinaction/\">Nate Gay</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nhrrob/\">Nazmul Hasan Robin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nebojsajurcic/\">Nebojša Jurčić</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nek285/\">nek285</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nendeb55/\">nendeb</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/neo2k23/\">neo2k23</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/neotrope/\">neotrope</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/eidolonnight/\">Nicholas Garofalo</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nickbohle/\">Nick Bohle</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ndiego/\">Nick Diego</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/celloexpressions/\">Nick Halsey</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nick_thegeek/\">Nick the Geek</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nicolefurlan/\">Nicole Furlan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nidhidhandhukiya/\">nidhidhandhukiya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nihar007/\">Nihar Ranjan Das</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ntsekouras/\">Nik Tsekouras</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nikitasolanki1812/\">Nikita Solanki</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nirajgirixd/\">Niraj Giri</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/niravsherasiya7707/\">Nirav Sherasiya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nithi22/\">Nithin John</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nithins53/\">Nithin SreeRaj</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/noahtallen/\">Noah Allen</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/noruzzaman/\">Noruzzaman</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nurielmeni/\">nurielmeni</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/obliviousharmony/\">obliviousharmony</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/finalwebsites/\">Olaf Lederer</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/oglekler/\">Olga Gleckler</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/domainsupport/\">Oliver Campion</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/olivierlafleur/\">Olivier Lafleur</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/alshakero/\">Omar Alshaker</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/oscarhugopaz/\">Oscar Hugo Paz</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/prestonwordsworth/\">p15h</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paaljoachim/\">Paal Joachim Romdahl</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/otakupahp/\">Pablo Hernández</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pablohoneyhoney/\">Pablo Honey</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pamprn/\">Pamela Ribeiro</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pander/\">pander</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pls78/\">Paolo L. Scala</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paragoninitiativeenterprises/\">Paragon Initiative Enterprises</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/parinpanjari/\">Parin Panjari</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/parthvataliya/\">Parth vataliya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/swissspidy/\">Pascal Birchler</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/obrienlabs/\">Pat O’Brien</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/patricia70/\">Patricia BT</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/lumiblog/\">Patrick Lumumba</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pbearne/\">Paul Bearne</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pbiron/\">Paul Biron</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paulkevan/\">Paul Kevan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paulschreiber/\">Paul Schreiber</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paulwilde/\">Paul Wilde</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paulcline/\">paulcline</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/paulopmt1/\">Paulo Trentin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pavanpatil1/\">Pavan Patil</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pcarvalho/\">pcarvalho</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pedromendonca/\">Pedro Mendonça</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/perryrylance/\">perryrylance</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/provenself/\">Peter Rubin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/peterwilsoncc/\">Peter Wilson</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/petitphp/\">petitphp</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pevogam/\">pevogam</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/mr2p/\">Phi Phan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/johnstonphilip/\">Phil Johnston</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/tyrannous/\">Philipp Bammes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/philwebs/\">philwebs</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/nekojonez/\">Pieterjan Deneys</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/boniu91/\">Piotrek Boniu</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pitamdey/\">Pitam Dey</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pgeorgiev/\">Plamen Georgiev</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pooja1210/\">Pooja N Muchandikar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pooja9712/\">pooja9712</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/porg/\">porg</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ppolo99/\">ppolo99</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/praful2111/\">Praful Patel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pranitdugad/\">Pranit Dugad</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pratikkry/\">Pratik Kumar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/presskopp/\">Presskopp</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/prettyboymp/\">prettyboymp</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/prionkor/\">prionkor</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/pwtyler/\">pwtyler</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rachelbaker/\">Rachel Baker</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/spanglishwebs/\">Rachel Winspear</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rfischmann/\">Rafael Fischmann</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rafaelgalani/\">Rafael Gallani</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rafiq91/\">Rafiqul Islam</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rahmatgumilar/\">Rahmat Gumilar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rahulharpal/\">rahulharpal</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/imrraaj/\">Raj Patel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rajinsharwar/\">Rajin Sharwar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/shashwatahalder01/\">rajkumar shashwata halder</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rahmohn/\">Ramon Ahnert</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rcorrales/\">Ramon Corrales</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ramon-fincken/\">ramon fincken</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ramonopoly/\">Ramon James</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ramswarup/\">Ramswarup Rathod</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/xyulex/\">Raul Martinez</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/rcneil/\">rcneil</a>&nbsp;·&nbsp;<a 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href=\"https://profiles.wordpress.org/siobhyb/\">Siobhan</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/smerriman/\">smerriman</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/snehapatil02/\">Sneha Patil</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/sophiegy/\">Sophie – a11n</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/souptik/\">Souptik Datta</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/sourabhjain/\">Sourabh Jain</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/sourav08/\">Sourav Pahwa</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/staurand/\">staurand</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ryokuhi/\">Stefano Minoia</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/stein2nd/\">stein2nd</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/sabernhardt/\">Stephen Bernhardt</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/stevenlinx/\">Steven Lin</a>&nbsp;·&nbsp;<a 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href=\"https://profiles.wordpress.org/tomhine/\">tomhine</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/tomllobet/\">tomllobet</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/hellofromtonya/\">Tonya Mork</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/toro_unit/\">Toro_Unit (Hiroshi Urabe)</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zodiac1978/\">Torsten Landsiedel</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/tropicalista/\">tropicalista</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/areziaal/\">Troy Chaplin</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/truptikanzariya/\">Trupti Kanzariya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/tunetheweb/\">tunetheweb</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/twstokes/\">twstokes</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ugyensupport/\">Ugyen Dorji</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/umesh84/\">Umesh 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href=\"https://profiles.wordpress.org/vipulpatil/\">vipulpatil</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/vrajadas/\">Vraja Das</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/vrishabhsk/\">vrishabhsk</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wbdv/\">wbdv</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/webmandesign/\">WebMan Design | Oliver Juhas</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/webwurm/\">webwurm</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wesrapyd/\">wesrapyd</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/westonruter/\">Weston Ruter</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/skorasaurus/\">Will Skora</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/williamalexander/\">William Alexander</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/williampatton/\">williampatton</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wongjn/\">wongjn</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wpeople/\">WPeople</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wpsoul/\">wpsoul</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/wzieba/\">wzieba</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/xipasduarte/\">xipasduarte</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/yaniiliev/\">Yani</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/collet/\">Yann</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/yguyon/\">Yannis Guyon</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/yogeshbhutkar/\">Yogesh Bhutkar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/ytfeldrawkcab/\">ytfeLdrawkcaB</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/fierevere/\">Yui</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/yukinobu/\">Yukinobu Asakawa</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/yuvrajsinh2211/\">Yuvrajsinh Sisodiya</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zackkrida/\">Zack Krida</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zeelthakkar/\">zeelthakkar</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zitaruksergij/\">zitaruksergij</a>&nbsp;·&nbsp;<a href=\"https://profiles.wordpress.org/zunaid321/\">Zunaid Amin</a></p>\n\n\n\n<p>40以上のロケールで WordPress 6.7が各言語に完全に翻訳されており、初日にしてこれまでで最も翻訳されたリリースの1つとなっています。コミュニティの翻訳者は、より多くの翻訳が確実に行われるよう懸命に取り組んでいます。WordPress を200の言語で利用できるようにご協力くださった皆様に感謝いたします。</p>\n\n\n\n<p>最後になりましたが、世界中の WordPress ユーザーからの質問に答えて<a href=\"https://wordpress.org/support/\">サポートフォーラム</a>に貢献してくださるボランティアの皆様に感謝申し上げます。</p>\n\n\n\n<h2 class=\"wp-block-heading\">参加</h2>\n\n\n\n<p>WordPressへの参加はコードに限りません。さらに学び、参加してみたいとお思いであれば、簡単に詳細を調べ、参加することができます。<a href=\"https://make.wordpress.org/\">Make WordPress</a> に集まっているチームを参照し、<a href=\"https://make.wordpress.org/contribute/\">このインタラクティブなツール</a>を使用して自分に合ったチームを選んでください。</p>\n\n\n\n<p>協力者: <a href=\'https://profiles.wordpress.org/nukaga/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>nukaga</a></p>\n\n\n\n<p></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7520\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:8;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:45:\"WordPress 6.7 リリース候補版3 (RC3版)\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:70:\"https://ja.wordpress.org/2024/11/06/wordpress-6-7-release-candidate-3/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 06 Nov 2024 04:36:03 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:11:\"Development\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:8:\"Releases\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7508\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:204:\"以下は WordPress.org Make WordPress Core の記事「WordPress 6.7 Release Candidate 3」を訳したものです。誤字脱字誤訳などありましたらフォーラムまでお知らせ [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:12:\"Junko Nukaga\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:11145:\"\n<p>以下は WordPress.org Make WordPress Core の記事「WordPress 6.7 Release Candidate 3」を訳したものです。<br>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>WordPress 6.7 の3回目のリリース候補版 (RC3) のダウンロードとテストの準備が整いました！</p>\n\n\n\n<p><strong>このバージョンの WordPress ソフトウェアは開発中です。 このバージョンの WordPress を本番サイトや重要なウェブサイトにインストール、実行、テストしないでください。</strong> 新機能を試すには、代わりにテスト環境やローカルサイトをセットアップしてください。</p>\n\n\n\n<p>リリース候補版の公開はリリースサイクルにおけるひとつの重要な節目です。リリース候補版はリリースの水準にあるとも見なせますが、WordPress 6.7を最高の状態で世に出すためには引き続きのテストが欠かせません。</p>\n\n\n\n<p>WordPress 6.7リリース候補版3のテストには次の4通りの方法があります:</p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><th>プラグイン</th><td><a href=\"https://wordpress.org/plugins/wordpress-beta-tester/\">WordPress Beta Tester</a>&nbsp;プラグインをインストールして有効化する。設定では「最前線」チャンネルと「ベータ / RC のみ」ストリームをそれぞれ選択。</td></tr><tr><th>直接ダウンロード</th><td><a href=\"https://wordpress.org/wordpress-6.7-RC3.zip\">リリース候補版3の zip ファイル</a>&nbsp;をダウンロードして WordPress ウェブサイトにインストールする。</td></tr><tr><th>コマンドライン</th><td>次の&nbsp;<a href=\"https://make.wordpress.org/cli/\">WP-CLI</a>&nbsp;コマンドを実行する。<br><code>wp core update --version=6.7-RC3</code></td></tr><tr><th>WordPress Playground</th><td><a href=\"https://playground.wordpress.net/#%7B%20%22preferredVersions%22:%20%7B%20%22php%22:%20%228.0%22,%20%22wp%22:%20%22https://playground.wordpress.net/plugin-proxy.php?build-ref=218cf8089bb18bbb3f4f118d3f79a8a57e26f7a6%22%20%7D,%20%22features%22:%20%7B%20%22networking%22:%20true%20%7D,%20%22steps%22:%20%5B%20%7B%20%22step%22:%20%22login%22,%20%22username%22:%20%22admin%22,%20%22password%22:%20%22password%22%20%7D,%20%7B%20%22step%22:%20%22importFile%22,%20%22file%22:%20%7B%20%22resource%22:%20%22url%22,%20%22url%22:%20%22https://raw.githubusercontent.com/wpaccessibility/a11y-theme-unit-test/master/a11y-theme-unit-test-data.xml%22%20%7D%20%7D,%20%7B%20%22step%22:%20%22importFile%22,%20%22file%22:%20%7B%20%22resource%22:%20%22url%22,%20%22url%22:%20%22https://raw.githubusercontent.com/WordPress/theme-test-data/master/themeunittestdata.wordpress.xml%22%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22query-monitor%22%20%7D,%20%22options%22:%20%7B%20%22activate%22:%20false%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22create-block-theme%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22debug-bar%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22health-check%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22test-reports%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D,%20%7B%20%22step%22:%20%22installPlugin%22,%20%22pluginZipFile%22:%20%7B%20%22resource%22:%20%22wordpress.org/plugins%22,%20%22slug%22:%20%22user-switching%22%20%7D,%20%22progress%22:%20%7B%20%22weight%22:%202%20%7D%20%7D%20%5D%20%7D\">6.7 RC3 WordPress Playground instance</a>&nbsp;インスタンスを使用する (リリースが準備できてから35分以内に利用可能になります)。ブラウザで直接ソフトウェアをテストできます。個別のサイトやセットアップは必要ありません。</td></tr></tbody></table><figcaption class=\"wp-element-caption\">WordPress 6.7 リリース候補版3は4通りの方法でテストできます。</figcaption></figure>\n\n\n\n<p>WordPress 6.7の最終リリース目標日は<strong>2024年11月12日</strong>に設定されています。もっと詳しく知りたい方は、<a href=\"https://make.wordpress.org/core/6-7/\">6.7リリースサイクル</a>の概略や、<a href=\"https://make.wordpress.org/core/\">Make WordPress Core ブログ</a>の<a href=\"https://make.wordpress.org/core/tag/6-7/\">6.7関連の投稿</a>を確認してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.7 RC3 の見どころ紹介</h2>\n\n\n\n<p>WordPress 6.7の注目機能の概要については、<a href=\"https://ja.wordpress.org/2024/10/02/wordpress-6-7-beta-1/\">ベータ1の告知</a>をご覧ください。リリース候補版2 以降に解決された問題に関する技術的な情報については、以下のリンクを参照してください。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>10月29日以降の<a href=\"https://github.com/WordPress/gutenberg/commits/wp/6.7?since=2024-10-29&amp;until=2024-11-05\">6.7の GitHub コミット一覧</a></li>\n\n\n\n<li>10月29日以降に<a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=10%2F29%2F2024..11%2F05%2F2024&amp;milestone=6.7&amp;col=id&amp;col=summary&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">クローズされた Trac チケット一覧</a></li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">コントリビュートの方法</h2>\n\n\n\n<p>WordPress は協働し開発に貢献する人々のコミュニティによって実現されたオープンソースソフトウェアです。以下では、技術的な専門知識の有無を問わず、世界で最も人気のあるオープンソースのウェブプラットフォームを支援するさまざまな方法をご紹介します。</p>\n\n\n\n<h3 class=\"wp-block-heading\">テストに参加する</h3>\n\n\n\n<p>テストは、WordPress のパフォーマンスと安定性の確保に不可欠です。また、誰もが貢献できる有意な方法です。<a href=\"https://make.wordpress.org/test/2024/10/01/help-test-wordpress-6-7/\">この詳細なガイド</a>では、WordPress 6.7 のテスト機能について説明します。テストが初めての方は、<a href=\"https://wordpress.org/news/2024/06/wordpress-6-6-beta-1/\">この一般的なテストガイド</a>に従って、セットアップの詳細を参照してください。</p>\n\n\n\n<p>問題に遭遇したかもと思った時は、まずサポートフォーラムの<a href=\"https://wordpress.org/support/forum/alphabeta/\">アルファ・ベータエリア</a>に報告をしてください。再現可能なバグ報告の作成に慣れている方は&nbsp;<a href=\"https://core.trac.wordpress.org/newticket\">WordPress Trac への報告</a>をお願いします。<a href=\"https://core.trac.wordpress.org/tickets/major\">既知のバグ</a>の一覧も Trac で閲覧可能です。</p>\n\n\n\n<p>WordPress リリースのテスト全般について知りたいですか ?&nbsp;<a href=\"https://make.wordpress.org/test/\">Make WordPress Test</a>&nbsp;をフォローする、<a href=\"https://wordpress.slack.com/\">Making WordPress Slack</a>&nbsp;の&nbsp;<a href=\"https://wordpress.slack.com/messages/core-test/\">#core-test</a>&nbsp;チャンネルに参加する、などの方法があります。</p>\n\n\n\n<h3 class=\"wp-block-heading\">脆弱性を見つける</h3>\n\n\n\n<p>現在から、最後のリリース候補版 (2024年11月12日に予定)まで、<a href=\"https://make.wordpress.org/security/2024/06/04/wordpress-6-6-is-coming/\">未発表のセキュリティ脆弱性の報告に対する報奨金</a>の額が2倍になります。報告は&nbsp;<a href=\"https://hackerone.com/wordpress\">HackerOne のページ</a>ならびに<a href=\"https://wordpress.org/about/security/\">セキュリティ白書</a>に記載のセキュリティプラクティスとポリシーに沿った責任ある情報公開手順に従って適切に行なってください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">テーマやプラグインを更新する</h3>\n\n\n\n<p>プラグインやテーマの作者のみなさん、WordPress の機能を拡張し世界中のユーザーにその価値を広める上であなたの作品が果たす役割は重大です。</p>\n\n\n\n<p>WordPress 6.7ベータリリースでテーマやプラグインのテストを続けていただきありがとうございます。引き続き RC1版でテストを実施し、正常な動作が確認できたなら、<a href=\"https://developer.wordpress.org/plugins/wordpress-org/how-your-readme-txt-works/\">readme ファイル</a>の&nbsp;<strong>Tested up to</strong>&nbsp;バージョン指定を 6.7 に上げてください。</p>\n\n\n\n<p>互換性の問題を見つけた場合は詳しい情報を<a href=\"https://wordpress.org/support/forum/alphabeta/\">サポートフォーラム</a>に投稿してください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">翻訳にご協力ください</h3>\n\n\n\n<p>英語以外の言語を話せますか ? スペイン語 ? フランス語 ? ポルトガル語 ? ロシア語 ? 日本語 ? ヒンディー語 ? ベンガル語 ?&nbsp;<a href=\"https://translate.wordpress.org/projects/wp/dev/\">100 を超す言語への WordPress の翻訳を手伝ってくれませんか ?</a></p>\n\n\n\n<h2 class=\"wp-block-heading\">リリースの俳句</h2>\n\n\n\n<p><em>RC3 arrives,<br>Final polish, last bugs fall,<br>Six point seven calls.</em></p>\n\n\n\n<p>RC3がやってきた、<br>最後の仕上げ、最後のバグ取り、<br>6.7がやってくる</p>\n\n\n\n<p></p>\n\n\n\n<p><em>この投稿にご協力いただいた以下のコントリビューターに感謝します。</em></p>\n\n\n\n<p><em><a href=\'https://profiles.wordpress.org/peterwilsoncc/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>peterwilsoncc</a>, <a href=\'https://profiles.wordpress.org/joedolson/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>joedolson</a></em>.</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>翻訳協力者: <a href=\'https://profiles.wordpress.org/atachibana/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>atachibana</a> <a href=\'https://profiles.wordpress.org/torikumo/\' class=\'mention\'><span class=\'mentions-prefix\'>@</span>torikumo</a></p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:30:\"com-wordpress:feed-additions:1\";a:1:{s:7:\"post-id\";a:1:{i:0;a:5:{s:4:\"data\";s:4:\"7508\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:9;a:6:{s:4:\"data\";s:63:\"\n		\n		\n		\n		\n		\n				\n		\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:4:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:45:\"WordPress 6.7 リリース候補版2 (RC2版)\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:70:\"https://ja.wordpress.org/2024/10/30/wordpress-6-7-release-candidate-2/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 30 Oct 2024 01:05:34 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:3:{i:0;a:5:{s:4:\"data\";s:11:\"Development\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:8:\"Releases\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:2;a:5:{s:4:\"data\";s:3:\"6-7\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:32:\"https://ja.wordpress.org/?p=7497\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:204:\"以下は WordPress.org Make WordPress Core の記事「WordPress 6.7 Release Candidate 2」を訳したものです。誤字脱字誤訳などありましたらフォーラムまでお知らせ [&#8230;]\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:13:\"Itsuko Miyake\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:11015:\"\n<p>以下は WordPress.org Make WordPress Core の記事「<a href=\"https://wordpress.org/news/2024/10/wordpress-6-7-release-candidate-2/\">WordPress 6.7 Release Candidate 2</a>」を訳したものです。<br>誤字脱字誤訳などありましたら<a href=\"https://ja.wordpress.org/support/forum/alphabeta/\">フォーラムまでお知らせください</a>。</p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" />\n\n\n\n<p>WordPress 6.7 の2回目のリリース候補版 (RC2) のダウンロードとテストの準備が整いました！</p>\n\n\n\n<p><strong>このバージョンの WordPress ソフトウェアは開発中です。 このバージョンの WordPress を本番サイトや重要なウェブサイトにインストール、実行、テストしないでください。</strong> 新機能を試すには、代わりにテスト環境やローカルサイトをセットアップしてください。</p>\n\n\n\n<p>リリース候補版の公開はリリースサイクルにおけるひとつの重要な節目です。リリース候補版はリリースの水準にあるとも見なせますが、WordPress 6.7を最高の状態で世に出すためには引き続きのテストが欠かせません。</p>\n\n\n\n<p>WordPress 6.7リリース候補版2のテストには次の4通りの方法があります:</p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><th>プラグイン</th><td><a href=\"https://wordpress.org/plugins/wordpress-beta-tester/\">WordPress Beta Tester</a>&nbsp;プラグインをインストールして有効化する。設定では「最前線」チャンネルと「ベータ / RC のみ」ストリームをそれぞれ選択。</td></tr><tr><th>直接ダウンロード</th><td><a href=\"https://wordpress.org/wordpress-6.7-RC2.zip\">リリース候補版2の zip ファイル</a>&nbsp;をダウンロードして WordPress ウェブサイトにインストールする。</td></tr><tr><th>コマンドライン</th><td>次の&nbsp;<a href=\"https://make.wordpress.org/cli/\">WP-CLI</a>&nbsp;コマンドを実行する。<br><code>wp core update --version=6.7-RC2</code></td></tr><tr><th>WordPress Playground</th><td><a 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RC2 WordPress Playground instance</a>&nbsp;インスタンスを使用する (リリースが準備できてから35分以内に利用可能になります)。ブラウザで直接ソフトウェアをテストできます。個別のサイトやセットアップは必要ありません。</td></tr></tbody></table><figcaption class=\"wp-element-caption\">WordPress 6.7 リリース候補版2は4通りの方法でテストできます。</figcaption></figure>\n\n\n\n<p>WordPress 6.7の最終リリース目標日は<strong>2024年11月12日</strong>に設定されています。もっと詳しく知りたい方は、<a href=\"https://make.wordpress.org/core/6-7/\">6.7リリースサイクル</a>の概略や、<a href=\"https://make.wordpress.org/core/\">Make WordPress Core ブログ</a>の<a href=\"https://make.wordpress.org/core/tag/6-7/\">6.7関連の投稿</a>を確認してください。</p>\n\n\n\n<h2 class=\"wp-block-heading\">WordPress 6.7 RC2 の見どころ紹介</h2>\n\n\n\n<p>WordPress 6.7の注目機能の概要については、<a href=\"https://ja.wordpress.org/2024/10/02/wordpress-6-7-beta-1/\">ベータ1の告知</a>をご覧ください。リリース候補版1 以降に解決された問題に関する技術的な情報については、以下のリンクを参照してください。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>10月22日以降の<a href=\"https://github.com/WordPress/gutenberg/commits/wp/6.7?since=2024-10-22&amp;until=2024-10-29\">6.7の GitHub コミット一覧</a></li>\n\n\n\n<li>10月22日以降に<a href=\"https://core.trac.wordpress.org/query?status=closed&amp;changetime=10%2F22%2F2024..10%2F29%2F2024&amp;milestone=6.7&amp;col=id&amp;col=summary&amp;col=milestone&amp;col=owner&amp;col=type&amp;col=priority&amp;order=id\">クローズされた Trac チケット一覧</a></li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">コントリビュートの方法</h2>\n\n\n\n<p>WordPress は協働し開発に貢献する人々のコミュニティによって実現されたオープンソースソフトウェアです。以下では、技術的な専門知識の有無を問わず、世界で最も人気のあるオープンソースのウェブプラットフォームを支援するさまざまな方法をご紹介します。</p>\n\n\n\n<h3 class=\"wp-block-heading\">テストに参加する</h3>\n\n\n\n<p>テストは、WordPress のパフォーマンスと安定性の確保に不可欠です。また、誰もが貢献できる有意な方法です。<a href=\"https://make.wordpress.org/test/2024/10/01/help-test-wordpress-6-7/\">この詳細なガイド</a>では、WordPress 6.7 のテスト機能について説明します。テストが初めての方は、<a href=\"https://wordpress.org/news/2024/06/wordpress-6-6-beta-1/\">この一般的なテストガイド</a>に従って、セットアップの詳細を参照してください。</p>\n\n\n\n<p>問題に遭遇したかもと思った時は、まずサポートフォーラムの<a href=\"https://wordpress.org/support/forum/alphabeta/\">アルファ・ベータエリア</a>に報告をしてください。再現可能なバグ報告の作成に慣れている方は&nbsp;<a href=\"https://core.trac.wordpress.org/newticket\">WordPress Trac への報告</a>をお願いします。<a href=\"https://core.trac.wordpress.org/tickets/major\">既知のバグ</a>の一覧も Trac で閲覧可能です。</p>\n\n\n\n<p>WordPress リリースのテスト全般について知りたいですか ?&nbsp;<a href=\"https://make.wordpress.org/test/\">Make WordPress Test</a>&nbsp;をフォローする、<a href=\"https://wordpress.slack.com/\">Making WordPress Slack</a>&nbsp;の&nbsp;<a href=\"https://wordpress.slack.com/messages/core-test/\">#core-test</a>&nbsp;チャンネルに参加する、などの方法があります。</p>\n\n\n\n<h3 class=\"wp-block-heading\">脆弱性を見つける</h3>\n\n\n\n<p>現在から、最後のリリース候補版 (11月12日に予定)まで、<a href=\"https://make.wordpress.org/security/2024/06/04/wordpress-6-6-is-coming/\">未発表のセキュリティ脆弱性の報告に対する報奨金</a>の額が2倍になります。報告は&nbsp;<a href=\"https://hackerone.com/wordpress\">HackerOne のページ</a>ならびに<a href=\"https://wordpress.org/about/security/\">セキュリティ白書</a>に記載のセキュリティプラクティスとポリシーに沿った責任ある情報公開手順に従って適切に行なってください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">テーマやプラグインを更新する</h3>\n\n\n\n<p>プラグインやテーマの作者のみなさん、WordPress の機能を拡張し世界中のユーザーにその価値を広める上であなたの作品が果たす役割は重大です。</p>\n\n\n\n<p>WordPress 6.7ベータリリースでテーマやプラグインのテストを続けていただきありがとうございます。引き続き RC1版でテストを実施し、正常な動作が確認できたなら、<a href=\"https://developer.wordpress.org/plugins/wordpress-org/how-your-readme-txt-works/\">readme ファイル</a>の&nbsp;<strong>Tested up to</strong>&nbsp;バージョン指定を 6.7 に上げてください。</p>\n\n\n\n<p>互換性の問題を見つけた場合は詳しい情報を<a href=\"https://wordpress.org/support/forum/alphabeta/\">サポートフォーラム</a>に投稿してください。</p>\n\n\n\n<h3 class=\"wp-block-heading\">翻訳にご協力ください</h3>\n\n\n\n<p>英語以外の言語を話せますか ? スペイン語 ? フランス語 ? ポルトガル語 ? ロシア語 ? 日本語 ? ヒンディー語 ? ベンガル語 ?&nbsp;<a href=\"https://translate.wordpress.org/projects/wp/dev/\">100 を超す言語への WordPress の翻訳を手伝ってくれませんか ?</a></p>\n\n\n\n<h2 class=\"wp-block-heading\">リリースの俳句</h2>\n\n\n\n<p><em>Six point seven’s dawn,<br>RC2 sweeps 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バージョンアップとプラグインインストール\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:234:\"https://ja.wordpress.org/support/topic/%e3%83%90%e3%83%bc%e3%82%b8%e3%83%a7%e3%83%b3%e3%82%a2%e3%83%83%e3%83%97%e3%81%a8%e3%83%97%e3%83%a9%e3%82%b0%e3%82%a4%e3%83%b3%e3%82%a4%e3%83%b3%e3%82%b9%e3%83%88%e3%83%bc%e3%83%ab/#post-11691544\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 26 Mar 2025 07:31:15 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:1308:\"\n						\n						<p>こんにちは。<br />先日本フォーラムに投稿がありました、こちらの件と近いような気がします。</p>\n\n\n\n<p>ワードプレス6.7.2への更新ができない | WordPress.org 日本語 <br /><a href=\"https://ja.wordpress.org/support/topic/%E3%83%AF%E3%83%BC%E3%83%89%E3%83%97%E3%83%AC%E3%82%B96-7-2%E3%81%B8%E3%81%AE%E6%9B%B4%E6%96%B0%E3%81%8C%E3%81%A7%E3%81%8D%E3%81%AA%E3%81%84/\" rel=\"ugc\">https://ja.wordpress.org/support/topic/%E3%83%AF%E3%83%BC%E3%83%89%E3%83%97%E3%83%AC%E3%82%B96-7-2%E3%81%B8%E3%81%AE%E6%9B%B4%E6%96%B0%E3%81%8C%E3%81%A7%E3%81%8D%E3%81%AA%E3%81%84/</a></p>\n\n\n\n<p>一度上記ページの内容をお読みいただき、ご自身の状況にあてはまるか確認いただけますでしょうか。</p>\n\n\n\n<p>解決しない場合は</p>\n\n\n\n<ul>\n<li>お使いのサーバーの種類（利用しているサービスやプラン等）</li>\n\n\n\n<li>サーバーのPHPのバージョン\n<ul>\n<li>PHPバージョンを最近自分で変えたり、レンタルサーバー側の事情で変更されたりしなかったかもあわせて確認</li>\n</ul>\n</li>\n\n\n\n<li>お使いのテーマ・プラグインの状況</li>\n</ul>\n\n\n\n<p>などを確認し、追記いただけると解決に近づけると思います。</p>\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:28:\"のむらけい (Kei Nomura)\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:1;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:234:\"https://ja.wordpress.org/support/topic/%e3%83%90%e3%83%bc%e3%82%b8%e3%83%a7%e3%83%b3%e3%82%a2%e3%83%83%e3%83%97%e3%81%a8%e3%83%97%e3%83%a9%e3%82%b0%e3%82%a4%e3%83%b3%e3%82%a4%e3%83%b3%e3%82%b9%e3%83%88%e3%83%bc%e3%83%ab/#post-11691542\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:60:\"バージョンアップとプラグインインストール\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:234:\"https://ja.wordpress.org/support/topic/%e3%83%90%e3%83%bc%e3%82%b8%e3%83%a7%e3%83%b3%e3%82%a2%e3%83%83%e3%83%97%e3%81%a8%e3%83%97%e3%83%a9%e3%82%b0%e3%82%a4%e3%83%b3%e3%82%a4%e3%83%b3%e3%82%b9%e3%83%88%e3%83%bc%e3%83%ab/#post-11691542\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 26 Mar 2025 02:09:26 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:667:\"\n						\n						<p>バージョンを4.9から最新6.7へアップデートをしようと思い、プラグイン(WP Downgrade)を入れようとしたら、以下のエラー表示が出てきました。 </p>\n\n\n\n<p></p>\n\n\n\n<p>インストールに失敗しました: ダウンロードに失敗しました。 cURL error 60: SSL certificate problem: unable to get local issuer certificate このプラグインに限らず、他のプラグインやテーマを取り込もうとしても出てきます。</p>\n\n\n\n<p></p>\n\n\n\n<p>どうすれば解決できるかお知恵を頂けますでしょうか。どうぞよろしくお願い致します。</p>\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"masu16\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:2;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691540\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:47:\"返信先: 変なコメントが何回も来る\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691540\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Wed, 26 Mar 2025 01:16:25 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:570:\"\n						\n						<p>あとでAkismetプラグイン入れますよ</p>\n\n\n\n<p>2025/03/26 10時追記</p>\n\n\n\n<p>Akismet入れました</p>\n\n\n<ul id=\"bbp-reply-revision-log-11691540\" class=\"bbp-reply-revision-log\">\n\n	<li id=\"bbp-reply-revision-log-11691540-item-11691541\" class=\"bbp-reply-revision-log-item\">\n		この返信は9時間、 52分前に<a href=\"https://ja.wordpress.org/support/users/youmu1948/\" title=\"hazem のプロフィールを表示\" class=\"bbp-author-link\"><span  class=\"bbp-author-name\">hazem</span></a>が編集しました。\n	</li>\n\n</ul>\n\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:5:\"hazem\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:3;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691537\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:47:\"返信先: 変なコメントが何回も来る\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691537\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 25 Mar 2025 11:44:35 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:1936:\"\n						\n						<p>一応はモデレーターなので、一言だけ。<br />サポートフォーラムはディベートする場所でなく、相互に助け合いの場だと思っていますので、皆さんで言葉の表現は気をつけましょう。もちろん私もですが&#8230;.</p>\n\n\n\n<p>その上でですが、<br />回答者の皆さんがご指摘くださっているように、スパムが来るからドメインを変更する（だけ）というのは、本質的に解決していないと思いますので、ご一考ください。<br />しばらくしたら、また同じ状況になるかもしれませんので。</p>\n\n\n\n<ul>\n<li>ブログにコメント欄が必要である → スパムコメントをブロックする仕組みを考えましょう</li>\n\n\n\n<li>ブログにコメント欄が必要でない → プラグインを使ってコメントの機能そのものを停止しましょう</li>\n</ul>\n\n\n\n<p>「ご自分としてはどうしたいか？」を返信してくださると、ここにいる回答者の方はアドバイスがしやすいです。</p>\n\n\n<ul id=\"bbp-reply-revision-log-11691537\" class=\"bbp-reply-revision-log\">\n\n	<li id=\"bbp-reply-revision-log-11691537-item-11691538\" class=\"bbp-reply-revision-log-item\">\n		この返信は23時間、 22分前に<a href=\"https://ja.wordpress.org/support/users/yukinobu/\" title=\"Yukinobu Asakawa のプロフィールを表示\" class=\"bbp-author-link\"><span  class=\"bbp-author-name\">Yukinobu Asakawa</span></a>が編集しました。\n	</li>\n	<li id=\"bbp-reply-revision-log-11691537-item-11691539\" class=\"bbp-reply-revision-log-item\">\n		この返信は23時間、 12分前に<a href=\"https://ja.wordpress.org/support/users/yukinobu/\" title=\"Yukinobu Asakawa のプロフィールを表示\" class=\"bbp-author-link\"><span  class=\"bbp-author-name\">Yukinobu Asakawa</span></a>が編集しました。\n	</li>\n\n</ul>\n\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:16:\"Yukinobu Asakawa\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:4;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:246:\"https://ja.wordpress.org/support/topic/otter-blocks%e3%81%8c%e3%81%a9%e3%81%ae%e3%83%95%e3%82%a1%e3%82%a4%e3%83%ab%e3%82%92%e5%8f%82%e7%85%a7%e3%81%97%e3%81%a6%e3%81%84%e3%82%8b%e3%81%8b%e8%aa%bf%e3%81%b9%e3%82%8b%e6%96%b9%e6%b3%95/#post-11691536\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:72:\"otter Blocksがどのファイルを参照しているか調べる方法\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:246:\"https://ja.wordpress.org/support/topic/otter-blocks%e3%81%8c%e3%81%a9%e3%81%ae%e3%83%95%e3%82%a1%e3%82%a4%e3%83%ab%e3%82%92%e5%8f%82%e7%85%a7%e3%81%97%e3%81%a6%e3%81%84%e3%82%8b%e3%81%8b%e8%aa%bf%e3%81%b9%e3%82%8b%e6%96%b9%e6%b3%95/#post-11691536\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 25 Mar 2025 11:32:59 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:2780:\"\n						\n						<p>たびたびお世話になります。<br />いつも親切な回答をありがとうございます。</p>\n\n\n\n<p>「Create Block Theme」絡みでまた不具合が出てしまい自力で解決できないため、質問させていただきました。<br />ローカルで「otter Blocks」プラグインのアニメーションを使用してサイトを作成していまが、「Create Block Theme」で書き出し（<a href=\"https://ja.wordpress.org/support/topic/%e3%80%8ccreateblocktheme%e3%80%8d%e3%81%ae%e6%97%a2%e5%ad%98%e3%81%ae%e3%83%95%e3%82%a1%e3%82%a4%e3%83%ab%e3%82%92%e4%b8%8a%e6%9b%b8%e3%81%8d%e3%81%99%e3%82%8b%e6%96%b9%e6%b3%95/\" target=\"_blank\" rel=\"noreferrer noopener ugc\">書き出しについてはこちらをご参照ください</a>）を行うたびに「otter Blocks」プラグインのアニメーションのエフェクトが効かなくなってしまいます。<br /><br />ローカルで「Create Block Theme」で書き出しを行う前は「otter Blocks」プラグインのアニメーションは効いています。<br />そして、現在本番環境にまだアップしていないため、現在本番環境でも効いています。<br />本番環境は、<br /><a href=\"https://kitakinki-blog.sakura.ne.jp/enpe_sampleSite1/\" rel=\"nofollow ugc\">https://kitakinki-blog.sakura.ne.jp/enpe_sampleSite1/</a><br />です。<br />（このホームページは自前で作成したサンプルのホームページになります。）<br />しかし、ローカル環境で「Create Block Theme」で書き出しを行うとエフェクトがなくなってしまうのです。</p>\n\n\n\n<p>以下、自分なりに調べた内容を書きます。<br />エフェクトが効いている本番環境を開発ツールで調べると、<br />例えば「Floral Services」という見出しには、「fadeIn」という「otter Blocks」のクラスがついています。<br />これを「要素」タブのスタイルで見ると、<br /><a href=\"https://ja.wordpress.org/support/users/keyframe/\" class=\"mention\" rel=\"nofollow ugc\">@keyframe</a> fadeIn<br />となっていて、<br />ファイルが、enpe_sampleSite1/:48となっています。<br />そこをクリックすると<br />Content unavailable. Resource was not cached<br />となります。<br />まず知りたいのは、この「@keyframe fadeIn」が、何のcssもしくはjsのどのファイルを参照しているか調べる方法です。<br />それが分かれば、functions.phpからリンクをかけたら解決できるのではないかと思っています。<br /><br />ご知見のある方、どうかご教示いただけますと幸いです。<br />よろしくお願いいたします。</p>\n\n\n\n<p></p>\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:10:\"enpekoubou\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:5;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691535\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:47:\"返信先: 変なコメントが何回も来る\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691535\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 25 Mar 2025 10:39:42 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:534:\"\n						\n						<p>解決してなによりです。</p>\n\n\n\n<p>まとめますと、スパムがいっぱい来るようになったので、その対処法としてドメインを変えることで解決したということですね。</p>\n\n\n\n<p>しかしながら、おそらく新しいドメインでもそのうちスパムがいっぱい来るようになるでしょうけれど、その度にドメインを変えていくという、焼畑農業的運用をされていかれるということですね。😇</p>\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:8:\"mokkosan\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:6;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691533\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:47:\"返信先: 変なコメントが何回も来る\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691533\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 25 Mar 2025 09:41:32 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:64:\"\n						\n						<p>また、解決しました。</p>\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:5:\"hazem\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:7;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691532\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:47:\"返信先: 変なコメントが何回も来る\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691532\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 25 Mar 2025 09:22:04 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:160:\"\n						\n						<p>大丈夫かどうか誰も心配はしていません。<br />瀬戸内ことりさんは解決したか否の問いです。</p>\n						\n					\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:5:\"manbo\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:8;a:6:{s:4:\"data\";s:55:\"\n					\n					\n					\n					\n					\n\n					\n\n					\n					\n				\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:2:{s:0:\"\";a:5:{s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691531\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:47:\"返信先: 変なコメントが何回も来る\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:162:\"https://ja.wordpress.org/support/topic/%e5%a4%89%e3%81%aa%e3%82%b3%e3%83%a1%e3%83%b3%e3%83%88%e3%81%8c%e4%bd%95%e5%9b%9e%e3%82%82%e6%9d%a5%e3%82%8b/#post-11691531\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 25 Mar 2025 09:14:18 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脆弱性情報のまとめ（2025/03/13-2025/03/19）\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/19016/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Fri, 21 Mar 2025 01:30:13 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:27:\"WordPress Security Advisory\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=19016\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:657:\"<p>WordPressのプラグイン・テーマの脆弱性情報 ... <a title=\"WordPress テーマ・プラグイン 脆弱性情報のまとめ（2025/03/13-2025/03/19）\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/19016/\" aria-label=\"WordPress テーマ・プラグイン 脆弱性情報のまとめ（2025/03/13-2025/03/19） についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/19016/\">WordPress テーマ・プラグイン 脆弱性情報のまとめ（2025/03/13-2025/03/19）</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:8166:\"\n<p>WordPressのプラグイン・テーマの脆弱性情報を公開している <a href=\"https://www.wordfence.com/help/wordfence-intelligence/v2-accessing-and-consuming-the-vulnerability-data-feed/\">Wordfence</a> から、日本の利用者にも影響がありそうなものを中心にピックアップして紹介します。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>期間: 2025/03/13-2025/03/19 に報告があったもの</li>\n\n\n\n<li>対象: <a href=\"https://www.wordfence.com/help/wordfence-intelligence/v2-accessing-and-consuming-the-vulnerability-data-feed/\">Wordfence</a>が公開しているデータフィードより以下の条件を満たすもの\n<ul class=\"wp-block-list\">\n<li>WordPress.orgにおける \"Active installations\" が 10万 以上である</li>\n\n\n\n<li>日本語の翻訳に対応している</li>\n</ul>\n</li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">深刻度が高い脆弱性: 0件</h2>\n\n\n\n<p>なし</p>\n\n\n\n<h2 class=\"wp-block-heading\">他の脆弱性: 2件</h2>\n\n\n\n<h3 class=\"wp-block-heading\">プラグイン: Custom Twitter Feeds</h3>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>対象製品</strong></td><td>Custom Twitter Feeds</td></tr><tr><td><strong>対象バージョン</strong></td><td>2.2.5までの全てのバージョン</td></tr><tr><td><strong>脆弱性概要</strong></td><td>認証していない攻撃者が、管理者にリンクをクリックさせることで、偽のリクエストを使ってプラグインのキャッシュをリセットすることが可能となる。</td></tr><tr><td><strong>詳細</strong></td><td><a href=\"https://www.wordfence.com/threat-intel/vulnerabilities/id/28d47605-ecb8-42cc-901a-3cf07b946877\">https://www.wordfence.com/threat-intel/vulnerabilities/id/28d47605-ecb8-42cc-901a-3cf07b946877</a></td></tr></tbody></table></figure>\n\n\n\n<h3 class=\"wp-block-heading\">プラグイン: Ad Inserter</h3>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>対象製品</strong></td><td>Ad Inserter</td></tr><tr><td><strong>対象バージョン</strong></td><td>2.8.0までの全てのバージョン</td></tr><tr><td><strong>脆弱性概要</strong></td><td>認証していない攻撃者が、ユーザーにリンクをクリックさせることで、任意のウェブスクリプトを実行するページに挿入できる。</td></tr><tr><td><strong>詳細</strong></td><td><a href=\"https://www.wordfence.com/threat-intel/vulnerabilities/id/9102ecd8-4860-4521-be34-bfcc91408c0c\">https://www.wordfence.com/threat-intel/vulnerabilities/id/9102ecd8-4860-4521-be34-bfcc91408c0c</a></td></tr></tbody></table></figure>\n\n\n\n<h2 class=\"wp-block-heading\">総括</h2>\n\n\n\n<p>この期間内に報告された脆弱性は2件でした。いずれも認証していない攻撃者 (誰でも攻撃できる) 脆弱性です。2つの脆弱性が攻撃者の権限を必要としないにも関わらず、深刻度が高ではありませんでした。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Custom Twitter Feeds\n<ul class=\"wp-block-list\">\n<li>Cross-Site Request Forgery (CSRF) による脆弱性です。</li>\n</ul>\n</li>\n\n\n\n<li>Ad Inserter\n<ul class=\"wp-block-list\">\n<li>Reflected Cross-Site Scripting (Reflected XSS) による攻撃です。</li>\n</ul>\n</li>\n</ul>\n\n\n\n<p>Cross-Site Request Forgery (CSRF) は、ユーザーとサイトの間のセッションの情報を悪用して、別のサイトのリンクをクリックさせることで、サイトに対して本来意図しないリクエストを送信させる攻撃です。<br>CSRFの流れについてはIPAが分かりやすく解説しています。<br><a href=\"https://www.ipa.go.jp/security/vuln/websecurity/csrf.html\">安全なウェブサイトの作り方 - 1.6 CSRF（クロスサイト・リクエスト・フォージェリ）</a></p>\n\n\n\n<p>Cross-Site Scripting (XSS) は、ユーザーに別のサイトのリンクをクリックさせることで、サイトにウェブスクリプトを埋め込み、そのスクリプトから本来意図しない処理を実行させる攻撃です。<br>XSSの流れについても同様IPAが分かりやすく解説しています。<br><a href=\"https://www.ipa.go.jp/security/vuln/websecurity/cross-site-scripting.html\">安全なウェブサイトの作り方 - 1.5 クロスサイト・スクリプティング</a></p>\n\n\n\n<p>Custom Twitter Feedsは攻撃内容が限定的であることが深刻度が高くない理由として考えられます。また、XSSについては Content Security Policy (CSP) をウェブサーバに適切に設定することで防止することができます。サーバの設定が適切に行われているか、定期的に見直すことを検討ください。</p>\n\n\n\n<p></p>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&amp;linkname=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&amp;linkname=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&amp;linkname=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&amp;linkname=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&amp;linkname=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&amp;linkname=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F19016%2F&#038;title=WordPress%20%E3%83%86%E3%83%BC%E3%83%9E%E3%83%BB%E3%83%97%E3%83%A9%E3%82%B0%E3%82%A4%E3%83%B3%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1%E3%81%AE%E3%81%BE%E3%81%A8%E3%82%81%EF%BC%882025%2F03%2F13-2025%2F03%2F19%EF%BC%89\" data-a2a-url=\"https://kusanagi.tokyo/releases/19016/\" data-a2a-title=\"WordPress テーマ・プラグイン 脆弱性情報のまとめ（2025/03/13-2025/03/19）\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/19016/\">WordPress テーマ・プラグイン 脆弱性情報のまとめ（2025/03/13-2025/03/19）</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:1;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:44:\"評価待ち: kusanagi-php84 脆弱性情報\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18988/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 18 Mar 2025 04:27:12 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:17:\"Security Advisory\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18988\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:503:\"<p>概要 公開日時 2025-03-18 深刻度 評価 ... <a title=\"評価待ち: kusanagi-php84 脆弱性情報\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18988/\" aria-label=\"評価待ち: kusanagi-php84 脆弱性情報 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18988/\">評価待ち: kusanagi-php84 脆弱性情報</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:4915:\"<h2>概要</h2>\n<table>\n<tbody>\n<tr>\n<td>公開日時</td>\n<td>2025-03-18</td>\n</tr>\n<tr>\n<td>深刻度</td>\n<td>評価待ち</td>\n</tr>\n<tr>\n<td>モジュール</td>\n<td>kusanagi-php84</td>\n</tr>\n<tr>\n<td>対象</td>\n<td>KUSANAGI 9, Business Edition, Page Speed Technology, Security Edition</td>\n</tr>\n</tbody>\n</table>\n<h2>脆弱性情報</h2>\n<p>kusanagi-php84の脆弱性情報を公開しました。修正した脆弱性は以下の通りとなります。</p>\n<ul>\n<li>Fixed GHSA-rwp7-7vc6-8477 (Reference counting in php_request_shutdown causes Use-After-Free). (CVE-2024-11235)</li>\n<li>Fixed GHSA-p3x9-6h7p-cgfc (libxml streams use wrong `content-type` header when requesting a redirected resource). (CVE-2025-1219)</li>\n<li>Fixed GHSA-hgf5-96fm-v528 (Stream HTTP wrapper header check might omit basic auth header). (CVE-2025-1736)</li>\n<li>Fixed GHSA-52jp-hrpf-2jff (Stream HTTP wrapper truncate redirect location to 1024 bytes). (CVE-2025-1861)</li>\n<li>Fixed GHSA-pcmh-g36c-qc44 (Streams HTTP wrapper does not fail for headers without colon). (CVE-2025-1734)</li>\n<li>Fixed GHSA-v8xr-gpvj-cx9g (Header parser of `http` stream wrapper does not handle folded headers). (CVE-2025-1217)</li>\n</ul>\n<h2>CVE詳細</h2>\n<p>CVSSスコアや脆弱性の報告者等、詳細については、以下の情報を参照してください。<br />なお、CVEの状況によっては情報がまだ公開されていない場合があります。</p>\n<ul>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2024-11235\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2024-11235</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1219\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1219</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1736\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1736</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1861\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1861</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1734\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1734</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1217\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1217</a></li>\n</ul>\n<h2>アップデートしたパッケージ</h2>\n<ul>\n<li><a href=\"https://kusanagi.tokyo/releases/18984\">kusanagi-php84</a></li>\n<li><a href=\"https://kusanagi.tokyo/releases/18994\">kusanagi-php84</a></li>\n</ul>\n\n\n<p></p>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18988%2F&#038;title=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php84%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" data-a2a-url=\"https://kusanagi.tokyo/releases/18988/\" data-a2a-title=\"評価待ち: kusanagi-php84 脆弱性情報\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18988/\">評価待ち: kusanagi-php84 脆弱性情報</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:2;a:6:{s:4:\"data\";s:66:\"\n		\n		\n		\n		\n		\n				\n		\n		\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:50:\"kusanagi-php84 モジュール更新情報 8.4.5-1\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18994/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 18 Mar 2025 04:22:38 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:4:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:16:\"Business Edition\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:2;a:5:{s:4:\"data\";s:10:\"KUSANAGI 9\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:3;a:5:{s:4:\"data\";s:21:\"Page Speed Technology\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18994\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:527:\"<p>KUSANAGI 9 を構成している各モジュールの ... <a title=\"kusanagi-php84 モジュール更新情報 8.4.5-1\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18994/\" aria-label=\"kusanagi-php84 モジュール更新情報 8.4.5-1 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18994/\">kusanagi-php84 モジュール更新情報 8.4.5-1</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:3232:\"<p>KUSANAGI 9 を構成している各モジュールのアップデートを行いました。<br />\nアップデートにより適用される各モジュールのバージョンは、以下のとおりとなります。</p>\n<table>\n<tbody>\n<tr>\n<th>php</th>\n<td>8.4.5-1</td>\n<td>この更新には脆弱性(CVE-2024-11235, CVE-2025-1219, CVE-2025-1736, CVE-2025-1861, CVE-2025-1734, CVE-2025-1217)への対応が含まれます。</td>\n</tr>\n</tbody>\n</table>\n<p>モジュールのアップデートについては、以下のコマンドで適用可能です。</p>\n<pre># dnf upgrade</pre>\n<p>phpを使用している場合は、以下のコマンドで再起動してください。</p>\n<pre># kusanagi php</pre>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18994%2F&#038;title=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1\" data-a2a-url=\"https://kusanagi.tokyo/releases/18994/\" data-a2a-title=\"kusanagi-php84 モジュール更新情報 8.4.5-1\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18994/\">kusanagi-php84 モジュール更新情報 8.4.5-1</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:3;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:54:\"kusanagi-php84 モジュール更新情報 8.4.5-1.el9\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18984/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 18 Mar 2025 03:47:46 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:16:\"Security Edition\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18984\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:539:\"<p>KUSANAGI 9 を構成している各モジュールの ... <a title=\"kusanagi-php84 モジュール更新情報 8.4.5-1.el9\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18984/\" aria-label=\"kusanagi-php84 モジュール更新情報 8.4.5-1.el9 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18984/\">kusanagi-php84 モジュール更新情報 8.4.5-1.el9</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:3503:\"<p>KUSANAGI 9 を構成している各モジュールのアップデートを行いました。<br />\nアップデートにより適用される各モジュールのバージョンは、以下のとおりとなります。</p>\n<table>\n<tbody>\n<tr>\n<th>php</th>\n<td>8.4.5-1.el9</td>\n<td>この更新には脆弱性(CVE-2024-11235, CVE-2025-1219, CVE-2025-1736, CVE-2025-1861, CVE-2025-1734, CVE-2025-1217)への対応が含まれます。</td>\n</tr>\n</tbody>\n</table>\n<p>モジュールのアップデートについては、以下のコマンドで適用可能です。</p>\n<pre># dnf upgrade</pre>\n<p>phpを使用している場合は、以下のコマンドで再起動してください。</p>\n<pre># kusanagi php</pre>\n<p>Security Editionでは、php84を使用していて、かつ、kusanagi autoupdateコマンドにおいて、ミドルウェアの自動更新を有効にしている場合、この修正は自動的に適用されます。</p>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&amp;linkname=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18984%2F&#038;title=kusanagi-php84%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.4.5-1.el9\" data-a2a-url=\"https://kusanagi.tokyo/releases/18984/\" data-a2a-title=\"kusanagi-php84 モジュール更新情報 8.4.5-1.el9\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18984/\">kusanagi-php84 モジュール更新情報 8.4.5-1.el9</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:4;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:44:\"評価待ち: kusanagi-php83 脆弱性情報\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18961/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 18 Mar 2025 03:19:50 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:17:\"Security Advisory\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18961\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:503:\"<p>概要 公開日時 2025-03-18 深刻度 評価 ... <a title=\"評価待ち: kusanagi-php83 脆弱性情報\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18961/\" aria-label=\"評価待ち: kusanagi-php83 脆弱性情報 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18961/\">評価待ち: kusanagi-php83 脆弱性情報</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:4906:\"<h2>概要</h2>\n<table>\n<tbody>\n<tr>\n<td>公開日時</td>\n<td>2025-03-18</td>\n</tr>\n<tr>\n<td>深刻度</td>\n<td>評価待ち</td>\n</tr>\n<tr>\n<td>モジュール</td>\n<td>kusanagi-php83</td>\n</tr>\n<tr>\n<td>対象</td>\n<td>KUSANAGI 9, Business Edition, Page Speed Technology, Security Edition</td>\n</tr>\n</tbody>\n</table>\n<h2>脆弱性情報</h2>\n<p>kusanagi-php83の脆弱性情報を公開しました。修正した脆弱性は以下の通りとなります。</p>\n<ul>\n<li>Fixed GHSA-rwp7-7vc6-8477 (Reference counting in php_request_shutdown causes Use-After-Free). (CVE-2024-11235)</li>\n<li>Fixed GHSA-p3x9-6h7p-cgfc (libxml streams use wrong `content-type` header when requesting a redirected resource). (CVE-2025-1219)</li>\n<li>Fixed GHSA-hgf5-96fm-v528 (Stream HTTP wrapper header check might omit basic auth header). (CVE-2025-1736)</li>\n<li>Fixed GHSA-52jp-hrpf-2jff (Stream HTTP wrapper truncate redirect location to 1024 bytes). (CVE-2025-1861)</li>\n<li>Fixed GHSA-pcmh-g36c-qc44 (Streams HTTP wrapper does not fail for headers without colon). (CVE-2025-1734)</li>\n<li>Fixed GHSA-v8xr-gpvj-cx9g (Header parser of `http` stream wrapper does not handle folded headers). (CVE-2025-1217)</li>\n</ul>\n<h2>CVE詳細</h2>\n<p>CVSSスコアや脆弱性の報告者等、詳細については、以下の情報を参照してください。<br />\nなお、CVEの状況によっては情報がまだ公開されていない場合があります。</p>\n<ul>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2024-11235\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2024-11235</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1219\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1219</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1736\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1736</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1861\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1861</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1734\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1734</a></li>\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1217\" target=\"_blank\" rel=\"noopener noreferrer\">CVE-2025-1217</a></li>\n</ul>\n<h2>アップデートしたパッケージ</h2>\n<ul>\n<li><a href=\"https://kusanagi.tokyo/releases/18957\">kusanagi-php83</a></li>\n<li><a href=\"https://kusanagi.tokyo/releases/18968\">kusanagi-php83</a></li>\n</ul>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18961%2F&#038;title=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php83%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" data-a2a-url=\"https://kusanagi.tokyo/releases/18961/\" data-a2a-title=\"評価待ち: kusanagi-php83 脆弱性情報\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18961/\">評価待ち: kusanagi-php83 脆弱性情報</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:5;a:6:{s:4:\"data\";s:66:\"\n		\n		\n		\n		\n		\n				\n		\n		\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:51:\"kusanagi-php83 モジュール更新情報 8.3.19-1\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18968/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 18 Mar 2025 03:06:30 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:4:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:16:\"Business Edition\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:2;a:5:{s:4:\"data\";s:10:\"KUSANAGI 9\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:3;a:5:{s:4:\"data\";s:21:\"Page Speed Technology\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18968\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:530:\"<p>KUSANAGI 9 を構成している各モジュールの ... <a title=\"kusanagi-php83 モジュール更新情報 8.3.19-1\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18968/\" aria-label=\"kusanagi-php83 モジュール更新情報 8.3.19-1 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18968/\">kusanagi-php83 モジュール更新情報 8.3.19-1</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:3242:\"<p>KUSANAGI 9 を構成している各モジュールのアップデートを行いました。<br />\nアップデートにより適用される各モジュールのバージョンは、以下のとおりとなります。</p>\n<table>\n<tbody>\n<tr>\n<th>php</th>\n<td>8.3.19-1</td>\n<td>この更新には脆弱性(CVE-2024-11235, CVE-2025-1219, CVE-2025-1736, CVE-2025-1861, CVE-2025-1734, CVE-2025-1217)への対応が含まれます。</td>\n</tr>\n</tbody>\n</table>\n<p>モジュールのアップデートについては、以下のコマンドで適用可能です。</p>\n<pre># dnf upgrade</pre>\n<p>phpを使用している場合は、以下のコマンドで再起動してください。</p>\n<pre># kusanagi php</pre>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18968%2F&#038;title=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1\" data-a2a-url=\"https://kusanagi.tokyo/releases/18968/\" data-a2a-title=\"kusanagi-php83 モジュール更新情報 8.3.19-1\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18968/\">kusanagi-php83 モジュール更新情報 8.3.19-1</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:6;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:55:\"kusanagi-php83 モジュール更新情報 8.3.19-1.el9\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18957/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Tue, 18 Mar 2025 02:26:14 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:16:\"Security Edition\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18957\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:542:\"<p>KUSANAGI 9 を構成している各モジュールの ... <a title=\"kusanagi-php83 モジュール更新情報 8.3.19-1.el9\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18957/\" aria-label=\"kusanagi-php83 モジュール更新情報 8.3.19-1.el9 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18957/\">kusanagi-php83 モジュール更新情報 8.3.19-1.el9</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:3513:\"<p>KUSANAGI 9 を構成している各モジュールのアップデートを行いました。<br />\nアップデートにより適用される各モジュールのバージョンは、以下のとおりとなります。</p>\n<table>\n<tbody>\n<tr>\n<th>php</th>\n<td>8.3.19-1.el9</td>\n<td>この更新には脆弱性(CVE-2024-11235, CVE-2025-1219, CVE-2025-1736, CVE-2025-1861, CVE-2025-1734, CVE-2025-1217)への対応が含まれます。</td>\n</tr>\n</tbody>\n</table>\n<p>モジュールのアップデートについては、以下のコマンドで適用可能です。</p>\n<pre># dnf upgrade</pre>\n<p>phpを使用している場合は、以下のコマンドで再起動してください。</p>\n<pre># kusanagi php</pre>\n<p>Security Editionでは、php83を使用していて、かつ、kusanagi autoupdateコマンドにおいて、ミドルウェアの自動更新を有効にしている場合、この修正は自動的に適用されます。</p>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&amp;linkname=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18957%2F&#038;title=kusanagi-php83%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.3.19-1.el9\" data-a2a-url=\"https://kusanagi.tokyo/releases/18957/\" data-a2a-title=\"kusanagi-php83 モジュール更新情報 8.3.19-1.el9\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18957/\">kusanagi-php83 モジュール更新情報 8.3.19-1.el9</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:7;a:6:{s:4:\"data\";s:60:\"\n		\n		\n		\n		\n		\n				\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:44:\"評価待ち: kusanagi-php82 脆弱性情報\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18951/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Mon, 17 Mar 2025 05:59:55 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:2:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:17:\"Security Advisory\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18951\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:503:\"<p>概要 公開日時 2025-03-17 深刻度 評価 ... <a title=\"評価待ち: kusanagi-php82 脆弱性情報\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18951/\" aria-label=\"評価待ち: kusanagi-php82 脆弱性情報 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18951/\">評価待ち: kusanagi-php82 脆弱性情報</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:4898:\"\n<h2 class=\"wp-block-heading\">概要</h2>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>公開日時</td><td>2025-03-17</td></tr><tr><td>深刻度</td><td>評価待ち</td></tr><tr><td>モジュール</td><td>kusanagi-php82</td></tr><tr><td>対象</td><td>KUSANAGI 9, Business Edition, Page Speed Technology, Security Edition</td></tr></tbody></table></figure>\n\n\n\n<h2 class=\"wp-block-heading\">脆弱性情報</h2>\n\n\n\n<p>kusanagi-php82の脆弱性情報を公開しました。修正した脆弱性は以下の通りとなります。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fixed GHSA-p3x9-6h7p-cgfc (libxml streams use wrong `content-type` header when requesting a redirected resource). (CVE-2025-1219)</li>\n\n\n\n<li>Fixed GHSA-hgf5-96fm-v528 (Stream HTTP wrapper header check might omit basic auth header). (CVE-2025-1736)</li>\n\n\n\n<li>Fixed GHSA-52jp-hrpf-2jff (Stream HTTP wrapper truncate redirect location to 1024 bytes). (CVE-2025-1861)</li>\n\n\n\n<li>Fixed GHSA-pcmh-g36c-qc44 (Streams HTTP wrapper does not fail for headers without colon). (CVE-2025-1734)</li>\n\n\n\n<li>Fixed GHSA-v8xr-gpvj-cx9g (Header parser of `http` stream wrapper does not handle folded headers). (CVE-2025-1217)</li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">CVE詳細</h2>\n\n\n\n<p>CVSSスコアや脆弱性の報告者等、詳細については、以下の情報を参照してください。<br>なお、CVEの状況によっては情報がまだ公開されていない場合があります。</p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1219\" target=\"_blank\" rel=\"noreferrer noopener\">CVE-2025-1219</a></li>\n\n\n\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1736\" target=\"_blank\" rel=\"noreferrer noopener\">CVE-2025-1736</a></li>\n\n\n\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1861\" target=\"_blank\" rel=\"noreferrer noopener\">CVE-2025-1861</a></li>\n\n\n\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1734\" target=\"_blank\" rel=\"noreferrer noopener\">CVE-2025-1734</a></li>\n\n\n\n<li><a href=\"https://nvd.nist.gov/vuln/detail/CVE-2025-1217\" target=\"_blank\" rel=\"noreferrer noopener\">CVE-2025-1217</a></li>\n</ul>\n\n\n\n<h2 class=\"wp-block-heading\">アップデートしたパッケージ</h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https://kusanagi.tokyo/releases/18927\">kusanagi-php82</a></li>\n\n\n\n<li><a href=\"https://kusanagi.tokyo/releases/18942/\">kusanagi-php82</a></li>\n</ul>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&amp;linkname=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18951%2F&#038;title=%E8%A9%95%E4%BE%A1%E5%BE%85%E3%81%A1%3A%20kusanagi-php82%20%E8%84%86%E5%BC%B1%E6%80%A7%E6%83%85%E5%A0%B1\" data-a2a-url=\"https://kusanagi.tokyo/releases/18951/\" data-a2a-title=\"評価待ち: kusanagi-php82 脆弱性情報\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18951/\">評価待ち: kusanagi-php82 脆弱性情報</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}}}i:8;a:6:{s:4:\"data\";s:66:\"\n		\n		\n		\n		\n		\n				\n		\n		\n		\n		\n\n					\n										\n					\n		\n		\n			\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";s:5:\"child\";a:3:{s:0:\"\";a:6:{s:5:\"title\";a:1:{i:0;a:5:{s:4:\"data\";s:51:\"kusanagi-php82 モジュール更新情報 8.2.28-1\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"link\";a:1:{i:0;a:5:{s:4:\"data\";s:38:\"https://kusanagi.tokyo/releases/18942/\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:7:\"pubDate\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"Mon, 17 Mar 2025 03:59:00 +0000\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:8:\"category\";a:4:{i:0;a:5:{s:4:\"data\";s:21:\"カテゴリーなし\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:1;a:5:{s:4:\"data\";s:16:\"Business Edition\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:2;a:5:{s:4:\"data\";s:10:\"KUSANAGI 9\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}i:3;a:5:{s:4:\"data\";s:21:\"Page Speed Technology\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:4:\"guid\";a:1:{i:0;a:5:{s:4:\"data\";s:31:\"https://kusanagi.tokyo/?p=18942\";s:7:\"attribs\";a:1:{s:0:\"\";a:1:{s:11:\"isPermaLink\";s:5:\"false\";}}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}s:11:\"description\";a:1:{i:0;a:5:{s:4:\"data\";s:530:\"<p>KUSANAGI 9 を構成している各モジュールの ... <a title=\"kusanagi-php82 モジュール更新情報 8.2.28-1\" class=\"read-more\" href=\"https://kusanagi.tokyo/releases/18942/\" aria-label=\"kusanagi-php82 モジュール更新情報 8.2.28-1 についてさらに読む\">Read more</a></p>\n<p>投稿 <a href=\"https://kusanagi.tokyo/releases/18942/\">kusanagi-php82 モジュール更新情報 8.2.28-1</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> に最初に表示されました。</p>\n\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:32:\"http://purl.org/dc/elements/1.1/\";a:1:{s:7:\"creator\";a:1:{i:0;a:5:{s:4:\"data\";s:6:\"psuser\";s:7:\"attribs\";a:0:{}s:8:\"xml_base\";s:0:\"\";s:17:\"xml_base_explicit\";b:0;s:8:\"xml_lang\";s:0:\"\";}}}s:40:\"http://purl.org/rss/1.0/modules/content/\";a:1:{s:7:\"encoded\";a:1:{i:0;a:5:{s:4:\"data\";s:3639:\"<p>KUSANAGI 9 を構成している各モジュールのアップデートを行いました。<br />\nアップデートにより適用される各モジュールのバージョンは、以下のとおりとなります。</p>\n<table>\n<tbody>\n<tr>\n<th>php</th>\n<td>8.2.28-1</td>\n<td>この更新には脆弱性(CVE-2025-1219, CVE-2025-1736, CVE-2025-1861, CVE-2025-1734, CVE-2025-1217)への対応が含まれます。</td>\n</tr>\n</tbody>\n</table>\n<p>PHP 8.2 と WordPress 6.3 の組み合わせにおいて、管理画面を表示した際に php-fpm がハングアップし、正常に表示できないことが確認されています。<br />\nそのため、 php 8.2.12-1 より /etc/opt/kusanagi/php.d/extensions/10-opcache.ini の以下の値を</p>\n<pre>opcache.jit = 1254\n</pre>\n<p>以下に変更しています。</p>\n<pre>opcache.jit = 1205\n</pre>\n<p>モジュールのアップデートについては、以下のコマンドで適用可能です。</p>\n<pre># dnf upgrade</pre>\n<p>phpを使用している場合は、以下のコマンドで再起動してください。</p>\n<pre># kusanagi php</pre>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" title=\"X\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_linkedin\" href=\"https://www.addtoany.com/add_to/linkedin?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" title=\"LinkedIn\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_hatena\" href=\"https://www.addtoany.com/add_to/hatena?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" title=\"Hatena\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_pocket\" href=\"https://www.addtoany.com/add_to/pocket?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" title=\"Pocket\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_email\" href=\"https://www.addtoany.com/add_to/email?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" title=\"Email\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_dd addtoany_share_save addtoany_share\" href=\"https://www.addtoany.com/share#url=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18942%2F&#038;title=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1\" data-a2a-url=\"https://kusanagi.tokyo/releases/18942/\" data-a2a-title=\"kusanagi-php82 モジュール更新情報 8.2.28-1\"></a></p><p>投稿 <a href=\"https://kusanagi.tokyo/releases/18942/\">kusanagi-php82 モジュール更新情報 8.2.28-1</a> は <a href=\"https://kusanagi.tokyo\">超高速CMS実行環境 KUSANAGI</a> 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8.2.12-1 より /etc/opt/kusanagi/php.d/extensions/10-opcache.ini の以下の値を</p>\n<pre>opcache.jit = 1254\n</pre>\n<p>以下に変更しています。</p>\n<pre>opcache.jit = 1205\n</pre>\n<p>モジュールのアップデートについては、以下のコマンドで適用可能です。</p>\n<pre># dnf upgrade</pre>\n<p>phpを使用している場合は、以下のコマンドで再起動してください。</p>\n<pre># kusanagi php</pre>\n<p>Security Editionでは、php82を使用していて、かつ、kusanagi autoupdateコマンドにおいて、ミドルウェアの自動更新を有効にしている場合、この修正は自動的に適用されます。</p>\n<p><a class=\"a2a_button_facebook\" href=\"https://www.addtoany.com/add_to/facebook?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18927%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1.el9\" title=\"Facebook\" rel=\"nofollow noopener\" target=\"_blank\"></a><a class=\"a2a_button_x\" href=\"https://www.addtoany.com/add_to/x?linkurl=https%3A%2F%2Fkusanagi.tokyo%2Freleases%2F18927%2F&amp;linkname=kusanagi-php82%20%E3%83%A2%E3%82%B8%E3%83%A5%E3%83%BC%E3%83%AB%E6%9B%B4%E6%96%B0%E6%83%85%E5%A0%B1%208.2.28-1.el9\" 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class=\"mail__type-radio-group\">[radio radio-inquiry-type class:mail__type-selector use_label_element default:1 \"プレスリリースの申請\" \"お問い合わせ\"]</div></div>\n<h3 class=\"mail__group-title mail__group-title--pr\">プレスリリースの申請</h3>\n<h3 class=\"mail__group-title mail__group-title--inquiry\">お問い合わせ</h3>\n<div class=\"mail__contact-info\"><label class=\"mail__input-item\"><span class=\"mail__input-title\">お名前<span class=\"hissu\">必須</span></span>[text* your-name autocomplete:name placeholder \"例：山田華子\"]</label><label class=\"mail__input-item\"><span class=\"mail__input-title\">メールアドレス<span class=\"hissu\">必須</span></span>[email* your-email autocomplete:email placeholder \"例：abc@mail.com\"]</label></div>\n[group group-app clear_on_hide class:mail__app]<div class=\"mail__pr mail__input-item\"><div class=\"mail__pr-col-left\"><span class=\"mail__input-title\">送付資料<span class=\"hissu\">必須</span></span></div><div class=\"mail__pr-col-right\"><p class=\"mail__pr-download\"><a href=\"https://geriatrics.jp/wp-content/uploads/2025/03/pressrelease.docx\" target=\"_blank\">【プレスリリース申請書式】</a>はこちらからダウンロード頂けます。<br />※プレスリリースの申請書式に記載し、「ファイル選択」から添付してください</p><div class=\"mail__pr-upload\">[file* file-pressrelease class:mail__file-upload filetypes:docx limit:1mb]</div></div></div><div class=\"mail__remarks mail__input-item\"><span class=\"mail__input-title\">備考欄</span>[textarea your-remarks placeholder \"何かございましたらご入力ください\"]</div>[/group]\n[group group-inquiry clear_on_hide class:mail__inquiry]\n<div class=\"mail__message\"><label class=\"mail__input-item\"><span class=\"mail__input-title\">お問い合わせ内容<span class=\"hissu\">必須</span></span><div class=\"mail__message-grid\"><p class=\"mail__message-note\">症例や個別の医療相談にはお答えいたしませんことをご承知ください</p>[textarea* your-message placeholder \"詳しい内容をご入力ください\"]</div></label></div>\n[/group]\n<div class=\"mail__buttons\">[submit \"送信\"]<input type=\"reset\"></div>'),(2905,801,'_mail','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:58:\"【[_site_title]】[radio-inquiry-type] が届きました\";s:6:\"sender\";s:39:\"[_site_title] <wordpress@geriatrics.jp>\";s:9:\"recipient\";s:19:\"[_site_admin_email]\";s:4:\"body\";s:319:\"差出人: [your-name] [your-email]\n題名: [your-subject]\n\nお問い合わせ種別：[radio-inquiry-type]\n\nメッセージ本文:\n[your-message]\n\n-- \n本メールはあなたのウェブサイト ([_site_title] [_site_url]) のコンタクトフォームに送信があったことをお知らせするものです。\";s:18:\"additional_headers\";s:22:\"Reply-To: [your-email]\";s:11:\"attachments\";s:19:\"[file-pressrelease]\";s:8:\"use_html\";b:0;s:13:\"exclude_blank\";b:0;}'),(2906,801,'_mail_2','a:9:{s:6:\"active\";b:1;s:7:\"subject\";s:79:\"【[_site_title]】[radio-inquiry-type] 受付のお知らせ（自動返信）\";s:6:\"sender\";s:39:\"[_site_title] <wordpress@geriatrics.jp>\";s:9:\"recipient\";s:12:\"[your-email]\";s:4:\"body\";s:445:\"お問い合わせ種別：[radio-inquiry-type]\n\nメッセージ本文:\n[your-message]\n\n-- \nあなたのメールアドレスを使用して、私たちのウェブサイト ([_site_title] [_site_url]) のコンタクトフォームに送信がありましたので、その控えとして本メールを送ります。もしもその送信について心当たりのない場合は、どうぞこのメッセージを無視してください。\";s:18:\"additional_headers\";s:29:\"Reply-To: [_site_admin_email]\";s:11:\"attachments\";s:0:\"\";s:8:\"use_html\";b:0;s:13:\"exclude_blank\";b:0;}'),(2907,801,'_messages','a:22:{s:12:\"mail_sent_ok\";s:75:\"ありがとうございます。メッセージは送信されました。\";s:12:\"mail_sent_ng\";s:84:\"メッセージの送信に失敗しました。後でまたお試しください。\";s:16:\"validation_error\";s:81:\"入力内容に問題があります。確認して再度お試しください。\";s:4:\"spam\";s:84:\"メッセージの送信に失敗しました。後でまたお試しください。\";s:12:\"accept_terms\";s:66:\"メッセージを送信する前に承諾確認が必要です。\";s:16:\"invalid_required\";s:27:\"入力してください。\";s:16:\"invalid_too_long\";s:48:\"入力されたテキストが長すぎます。\";s:17:\"invalid_too_short\";s:48:\"入力されたテキストが短すぎます。\";s:13:\"upload_failed\";s:81:\"ファイルのアップロード時に不明なエラーが発生しました。\";s:24:\"upload_file_type_invalid\";s:66:\"この形式のファイルはアップロードできません。\";s:21:\"upload_file_too_large\";s:63:\"アップロードされたファイルが大きすぎます。\";s:23:\"upload_failed_php_error\";s:72:\"ファイルのアップロード中にエラーが発生しました。\";s:12:\"invalid_date\";s:59:\"YYYY-MM-DD 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05:28:16','',0,'https://geriatrics.jp/?p=661',0,'elementor_library','',0),(663,1,'2024-11-08 17:11:43','2024-11-08 08:11:43','<!-- wp:paragraph -->\n<p>日本の朝は多くの人々が抱える独特のリズムで特徴づけられています。早起きする人々は、朝食を準備したり、仕事や学校に向かうために活動を始めたりします。都市部では、通勤客が駅に詰めかけ、電車を乗り込むために急ぐ様子が見られます。家族にとって、朝食は米、味噌汁、焼き魚、漬物などの伝統的な食材で構成され、健康的な一日のスタートを提供します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>朝のルーティンには、新聞やテレビを通じてニュースをチェックすることが含まれ、個人が現在の出来事についての情報を収集します。多くの家庭では、この時間が家族の絆を深める機会でもあり、朝食を共にしながら一日の計画を話し合います。心のこもった食事の重要性が強調されており、日々の活動の基盤を築きます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>日本では、時間厳守が深く根付いており、朝の活動の正確なタイミングにも反映されています。多くの人々は、十分な準備と通勤のために早起きすることを選びます。朝のルーティンを進める中で、清潔さと秩序の重要性が明らかになり、多くの人々が整然とした家庭やきちんと準備された食事を選択します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>朝のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>駅での早朝ラッシュ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>家族での朝食時間</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ニュースをチェックする人々</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>時間厳守と秩序の重要性</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','Sub1サンプルページ：日本の朝の風景','','inherit','closed','closed','','659-revision-v1','','','2024-11-08 17:11:43','2024-11-08 08:11:43','',659,'https://geriatrics.jp/?p=663',0,'revision','',0),(664,1,'2024-11-08 17:13:21','2024-11-08 08:13:21','<!-- wp:paragraph -->\n<p>Blog記事テスト</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼食の時間は、同僚がリラックスして社交を楽しむ機会です。多くの人々が近くのレストランに行くか、自家製の弁当を持参して休憩を楽しみます。一緒に食事をすることは、職場の関係を強化し、同僚間のコミュニティ感覚を育む方法と見なされています。昼食後、従業員は仕事に戻り、 renewed focus を持ってタスクを続けることが多いです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>都市部では、昼食の時間に賑わいが生まれ、人気のある飲食店には行列ができます。屋台やフードスタンドも、多様な美味しい選択肢を提供しています。仕事が進む中で、労働力の献身と勤勉さが明らかになり、多くの人々が自分の責任を果たすために遅くまで働きます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>昼間のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>階層的な職場文化</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>チームワークの重要性</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の社交と弁当</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の都市部の賑わい</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>日本の昼間の生活と職場文化</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>[searchandfilter fields=\"カテゴリー1\"]</p>\n<!-- /wp:paragraph -->','Sub2','','trash','closed','closed','','sub2%e3%82%b5%e3%83%b3%e3%83%97%e3%83%ab%e3%83%9a%e3%83%bc%e3%82%b8%ef%bc%9a%e6%97%a5%e6%9c%ac%e3%81%ae%e6%98%bc%e9%96%93%e3%81%ae%e7%94%9f%e6%b4%bb%e3%81%a8%e8%81%b7%e5%a0%b4%e6%96%87__trashed','','','2025-03-24 09:52:49','2025-03-24 00:52:49','',2,'https://geriatrics.jp/?page_id=664',0,'page','',0),(665,1,'2024-11-08 17:13:21','2024-11-08 08:13:21','<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼食の時間は、同僚がリラックスして社交を楽しむ機会です。多くの人々が近くのレストランに行くか、自家製の弁当を持参して休憩を楽しみます。一緒に食事をすることは、職場の関係を強化し、同僚間のコミュニティ感覚を育む方法と見なされています。昼食後、従業員は仕事に戻り、 renewed focus を持ってタスクを続けることが多いです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>都市部では、昼食の時間に賑わいが生まれ、人気のある飲食店には行列ができます。屋台やフードスタンドも、多様な美味しい選択肢を提供しています。仕事が進む中で、労働力の献身と勤勉さが明らかになり、多くの人々が自分の責任を果たすために遅くまで働きます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>昼間のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>階層的な職場文化</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>チームワークの重要性</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の社交と弁当</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の都市部の賑わい</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>日本の昼間の生活と職場文化</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->','Sub2サンプルページ：日本の昼間の生活と職場文化','','inherit','closed','closed','','664-revision-v1','','','2024-11-08 17:13:21','2024-11-08 08:13:21','',664,'https://geriatrics.jp/?p=665',0,'revision','',0),(666,1,'2024-11-08 17:16:23','2024-11-08 08:16:23','<!-- wp:paragraph -->\n<p>日本では、仕事や学校が終わった後の時間は、リラックスや余暇活動に捧げられることが多いです。多くの人々は、さまざまな趣味や社交的な集まり、エンターテインメントに参加することでリフレッシュを図ります。長い一日の後、同僚と一緒に居酒屋で飲むことや、友達とカラオケを楽しむことが一般的です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>学生にとっては、放課後のクラブ活動や課外活動が学業を超えた興味を探求する機会を提供します。スポーツ、音楽、アートなど、これらの活動は友情を育み、スキルを発展させます。学生たちは、練習のために学校に遅くまで残ることが多く、コミットメントと忍耐の重要性を強調しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>夕方になると、近隣の人々が集まり、笑い声や会話が響くことで、コミュニティの活気が増します。祭りや季節のイベント、地域の活動も人気があり、個人が文化や伝統とつながる機会を提供します。この時間は、多くの人々が生活の中で目指すべき、仕事と遊びのバランスを思い出させてくれます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>夕方のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>居酒屋やカラオケでの社交</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>放課後のクラブ活動</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>近隣の集まりや祭り</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>仕事と余暇のバランス</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub3サンプルページ：放課後・退勤後の楽しみ方</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>日本では、仕事や学校が終わった後の時間は、リラックスや余暇活動に捧げられることが多いです。多くの人々は、さまざまな趣味や社交的な集まり、エンターテインメントに参加することでリフレッシュを図ります。長い一日の後、同僚と一緒に居酒屋で飲むことや、友達とカラオケを楽しむことが一般的です。</p>\n<!-- /wp:paragraph -->','Sub3サンプルページ：放課後・退勤後の楽しみ方','','trash','closed','closed','','sub3%e3%82%b5%e3%83%b3%e3%83%97%e3%83%ab%e3%83%9a%e3%83%bc%e3%82%b8%ef%bc%9a%e6%94%be%e8%aa%b2%e5%be%8c%e3%83%bb%e9%80%80%e5%8b%a4%e5%be%8c%e3%81%ae%e6%a5%bd%e3%81%97%e3%81%bf%e6%96%b9__trashed','','','2025-03-24 09:52:43','2025-03-24 00:52:43','',2,'https://geriatrics.jp/?page_id=666',0,'page','',0),(667,1,'2024-11-08 17:16:23','2024-11-08 08:16:23','<!-- wp:paragraph -->\n<p>日本では、仕事や学校が終わった後の時間は、リラックスや余暇活動に捧げられることが多いです。多くの人々は、さまざまな趣味や社交的な集まり、エンターテインメントに参加することでリフレッシュを図ります。長い一日の後、同僚と一緒に居酒屋で飲むことや、友達とカラオケを楽しむことが一般的です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>学生にとっては、放課後のクラブ活動や課外活動が学業を超えた興味を探求する機会を提供します。スポーツ、音楽、アートなど、これらの活動は友情を育み、スキルを発展させます。学生たちは、練習のために学校に遅くまで残ることが多く、コミットメントと忍耐の重要性を強調しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>夕方になると、近隣の人々が集まり、笑い声や会話が響くことで、コミュニティの活気が増します。祭りや季節のイベント、地域の活動も人気があり、個人が文化や伝統とつながる機会を提供します。この時間は、多くの人々が生活の中で目指すべき、仕事と遊びのバランスを思い出させてくれます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>夕方のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>居酒屋やカラオケでの社交</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>放課後のクラブ活動</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>近隣の集まりや祭り</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>仕事と余暇のバランス</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub3サンプルページ：放課後・退勤後の楽しみ方</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>日本では、仕事や学校が終わった後の時間は、リラックスや余暇活動に捧げられることが多いです。多くの人々は、さまざまな趣味や社交的な集まり、エンターテインメントに参加することでリフレッシュを図ります。長い一日の後、同僚と一緒に居酒屋で飲むことや、友達とカラオケを楽しむことが一般的です。</p>\n<!-- /wp:paragraph -->','Sub3サンプルページ：放課後・退勤後の楽しみ方','','inherit','closed','closed','','666-revision-v1','','','2024-11-08 17:16:23','2024-11-08 08:16:23','',666,'https://geriatrics.jp/?p=667',0,'revision','',0),(668,1,'2024-11-08 17:17:53','2024-11-08 08:17:53','<!-- wp:paragraph -->\n<p>買い物は日本の日常生活に欠かせない部分であり、便利さと品質が重視されています。スーパーマーケット、コンビニエンスストア、伝統的な市場は多様な商品を提供し、様々な嗜好やニーズに応えています。日本のスーパーマーケットは整然としており、新鮮な農産物、肉類、地域の料理を反映した特産品が豊富です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「コンビニ」として知られるコンビニエンスストアはどこにでもあり、スナックから家庭用品まで多彩な商品を提供しています。彼らの営業時間の長さは、忙しい人々にとって便利な選択肢となっています。食料品のほかにも、請求書の支払い、荷物の配送などのサービスを提供し、多くの住民にとってワンストップショップの役割を果たしています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「商店街」として知られる伝統的なショッピングストリートは、地域の文化や職人技を展示しています。これらの地域はしばしば賑わっており、地元の食材や手作りの商品を販売する業者がいます。これらの市場での買い物は、地域とのつながりを強め、地元のビジネスを支援する重要性を実感させます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>買い物のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>スーパーマーケットでの新鮮な農産物</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>日常の必需品としてのコンビニエンスストア</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>伝統的なショッピングストリートの魅力</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>地元のビジネスを支援すること</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub4サンプルページ：日本の買い物と日常生活</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>買い物は日本の日常生活に欠かせない部分であり、便利さと品質が重視されています。スーパーマーケット、コンビニエンスストア、伝統的な市場は多様な商品を提供し、様々な嗜好やニーズに応えています。日本のスーパーマーケットは整然としており、新鮮な農産物、肉類、地域の料理を反映した特産品が豊富です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','Sub4サンプルページ：日本の買い物と日常生活','','trash','closed','closed','','sub4%e3%82%b5%e3%83%b3%e3%83%97%e3%83%ab%e3%83%9a%e3%83%bc%e3%82%b8%ef%bc%9a%e6%97%a5%e6%9c%ac%e3%81%ae%e8%b2%b7%e3%81%84%e7%89%a9%e3%81%a8%e6%97%a5%e5%b8%b8%e7%94%9f%e6%b4%bb__trashed','','','2025-03-24 09:52:51','2025-03-24 00:52:51','',2,'https://geriatrics.jp/?page_id=668',0,'page','',0),(669,1,'2024-11-08 17:17:53','2024-11-08 08:17:53','<!-- wp:paragraph -->\n<p>買い物は日本の日常生活に欠かせない部分であり、便利さと品質が重視されています。スーパーマーケット、コンビニエンスストア、伝統的な市場は多様な商品を提供し、様々な嗜好やニーズに応えています。日本のスーパーマーケットは整然としており、新鮮な農産物、肉類、地域の料理を反映した特産品が豊富です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「コンビニ」として知られるコンビニエンスストアはどこにでもあり、スナックから家庭用品まで多彩な商品を提供しています。彼らの営業時間の長さは、忙しい人々にとって便利な選択肢となっています。食料品のほかにも、請求書の支払い、荷物の配送などのサービスを提供し、多くの住民にとってワンストップショップの役割を果たしています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「商店街」として知られる伝統的なショッピングストリートは、地域の文化や職人技を展示しています。これらの地域はしばしば賑わっており、地元の食材や手作りの商品を販売する業者がいます。これらの市場での買い物は、地域とのつながりを強め、地元のビジネスを支援する重要性を実感させます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>買い物のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>スーパーマーケットでの新鮮な農産物</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>日常の必需品としてのコンビニエンスストア</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>伝統的なショッピングストリートの魅力</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>地元のビジネスを支援すること</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub4サンプルページ：日本の買い物と日常生活</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>買い物は日本の日常生活に欠かせない部分であり、便利さと品質が重視されています。スーパーマーケット、コンビニエンスストア、伝統的な市場は多様な商品を提供し、様々な嗜好やニーズに応えています。日本のスーパーマーケットは整然としており、新鮮な農産物、肉類、地域の料理を反映した特産品が豊富です。</p>\n<!-- /wp:paragraph -->','Sub4サンプルページ：日本の買い物と日常生活','','inherit','closed','closed','','668-revision-v1','','','2024-11-08 17:17:53','2024-11-08 08:17:53','',668,'https://geriatrics.jp/?p=669',0,'revision','',0),(671,1,'2024-11-08 17:19:04','2024-11-08 08:19:04','<!-- wp:paragraph -->\n<p>買い物は日本の日常生活に欠かせない部分であり、便利さと品質が重視されています。スーパーマーケット、コンビニエンスストア、伝統的な市場は多様な商品を提供し、様々な嗜好やニーズに応えています。日本のスーパーマーケットは整然としており、新鮮な農産物、肉類、地域の料理を反映した特産品が豊富です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「コンビニ」として知られるコンビニエンスストアはどこにでもあり、スナックから家庭用品まで多彩な商品を提供しています。彼らの営業時間の長さは、忙しい人々にとって便利な選択肢となっています。食料品のほかにも、請求書の支払い、荷物の配送などのサービスを提供し、多くの住民にとってワンストップショップの役割を果たしています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「商店街」として知られる伝統的なショッピングストリートは、地域の文化や職人技を展示しています。これらの地域はしばしば賑わっており、地元の食材や手作りの商品を販売する業者がいます。これらの市場での買い物は、地域とのつながりを強め、地元のビジネスを支援する重要性を実感させます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>買い物のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>スーパーマーケットでの新鮮な農産物</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>日常の必需品としてのコンビニエンスストア</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>伝統的なショッピングストリートの魅力</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>地元のビジネスを支援すること</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub4サンプルページ：日本の買い物と日常生活</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>買い物は日本の日常生活に欠かせない部分であり、便利さと品質が重視されています。スーパーマーケット、コンビニエンスストア、伝統的な市場は多様な商品を提供し、様々な嗜好やニーズに応えています。日本のスーパーマーケットは整然としており、新鮮な農産物、肉類、地域の料理を反映した特産品が豊富です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','Sub4サンプルページ：日本の買い物と日常生活','','inherit','closed','closed','','668-revision-v1','','','2024-11-08 17:19:04','2024-11-08 08:19:04','',668,'https://geriatrics.jp/?p=671',0,'revision','',0),(672,1,'2024-11-08 17:22:27','2024-11-08 08:22:27','<!-- wp:paragraph -->\n<p>日本の食文化は、新鮮さ、季節の食材、そして見た目の美しさを重視する点が特徴です。家庭料理は、米、味噌汁、魚、そして様々な野菜の副菜から成り立つことが多く、家族は栄養を与えるだけでなく目も楽しませる食事の準備に誇りを持っています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>多くの家庭では、料理が家族全員の協力によって行われ、各メンバーが調理に関与します。伝統的なレシピは世代を超えて受け継がれており、風味や技法が保存されています。昼食用の弁当作りは、日本料理に込められた創造性と配慮を示す良い例です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「旨味」という概念は、日本料理において重要な役割を果たします。醤油、味噌、だしなどの食材が料理の風味を高め、調和の取れた味わいを生み出します。食事は通常家族で楽しみ、家族間のつながりやコミュニティ感を育みます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>食文化のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>季節の食材の重視</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>家族での協力的な料理</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>弁当作りの技術</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>旨味の重要性</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub5サンプルページ：日本の食文化と家庭料理</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>日本の食文化は、新鮮さ、季節の食材、そして見た目の美しさを重視する点が特徴です。家庭料理は、米、味噌汁、魚、そして様々な野菜の副菜から成り立つことが多く、家族は栄養を与えるだけでなく目も楽しませる食事の準備に誇りを持っています。</p>\n<!-- /wp:paragraph -->','Sub5サンプルページ：日本の食文化と家庭料理','','trash','closed','closed','','sub5%e3%82%b5%e3%83%b3%e3%83%97%e3%83%ab%e3%83%9a%e3%83%bc%e3%82%b8%ef%bc%9a%e6%97%a5%e6%9c%ac%e3%81%ae%e9%a3%9f%e6%96%87%e5%8c%96%e3%81%a8%e5%ae%b6%e5%ba%ad%e6%96%99%e7%90%86__trashed','','','2025-03-24 09:52:54','2025-03-24 00:52:54','',2,'https://geriatrics.jp/?page_id=672',0,'page','',0),(673,1,'2024-11-08 17:20:36','2024-11-08 08:20:36','<!-- wp:paragraph -->\n<p>日本の食文化は、新鮮さ、季節の食材、そして見た目の美しさを重視する点が特徴です。家庭料理は、米、味噌汁、魚、そして様々な野菜の副菜から成り立つことが多く、家族は栄養を与えるだけでなく目も楽しませる食事の準備に誇りを持っています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>多くの家庭では、料理が家族全員の協力によって行われ、各メンバーが調理に関与します。伝統的なレシピは世代を超えて受け継がれており、風味や技法が保存されています。昼食用の弁当作りは、日本料理に込められた創造性と配慮を示す良い例です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>「旨味」という概念は、日本料理において重要な役割を果たします。醤油、味噌、だしなどの食材が料理の風味を高め、調和の取れた味わいを生み出します。食事は通常家族で楽しみ、家族間のつながりやコミュニティ感を育みます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>食文化のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>季節の食材の重視</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>家族での協力的な料理</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>弁当作りの技術</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>旨味の重要性</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>Sub5サンプルページ：日本の食文化と家庭料理</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>日本の食文化は、新鮮さ、季節の食材、そして見た目の美しさを重視する点が特徴です。家庭料理は、米、味噌汁、魚、そして様々な野菜の副菜から成り立つことが多く、家族は栄養を与えるだけでなく目も楽しませる食事の準備に誇りを持っています。</p>\n<!-- /wp:paragraph -->','Sub5サンプルページ：日本の食文化と家庭料理','','inherit','closed','closed','','672-revision-v1','','','2024-11-08 17:20:36','2024-11-08 08:20:36','',672,'https://geriatrics.jp/?p=673',0,'revision','',0),(674,1,'2024-11-11 08:51:21','2024-11-10 23:51:21','<!-- wp:paragraph -->\n<p>これはtopサンプルページです。同じ位置に固定され、(多くのテーマでは) サイトナビゲーションメニューに含まれる点がブログ投稿とは異なります。まずは、サイト訪問者に対して自分のことを説明する自己紹介ページを作成するのが一般的です。たとえば以下のようなものです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:quote -->\n<blockquote class=\"wp-block-quote\"><!-- wp:paragraph -->\n<p>はじめまして。昼間はバイク便のメッセンジャーとして働いていますが、俳優志望でもあります。これは僕のサイトです。ロサンゼルスに住み、ジャックという名前のかわいい犬を飼っています。好きなものはピニャコラーダ、そして通り雨に濡れること。</p>\n<!-- /wp:paragraph --></blockquote>\n<!-- /wp:quote -->\n\n<!-- wp:paragraph -->\n<p>または、このようなものです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:quote -->\n<blockquote class=\"wp-block-quote\"><!-- wp:paragraph -->\n<p>XYZ 小道具株式会社は1971年の創立以来、高品質の小道具を皆様にご提供させていただいています。ゴッサム・シティに所在する当社では2,000名以上の社員が働いており、様々な形で地域のコミュニティへ貢献しています。</p>\n<!-- /wp:paragraph --></blockquote>\n<!-- /wp:quote -->\n\n<!-- wp:paragraph -->\n<p>新しく WordPress ユーザーになった方は、<a href=\"https://geriatrics.jp/wp-admin/\">ダッシュボード</a>へ行ってこのページを削除し、独自のコンテンツを含む新しいページを作成してください。それでは、お楽しみください !</p>\n<!-- /wp:paragraph -->','サンプルページ','','inherit','closed','closed','','2-revision-v1','','','2024-11-11 08:51:21','2024-11-10 23:51:21','',2,'https://geriatrics.jp/?p=674',0,'revision','',0),(675,1,'2024-11-11 08:54:58','2024-11-10 23:54:58','<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">「四季折々の風景」</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>English:</strong> Japan is a country with distinct seasons, each bringing a unique charm to everyday life. Spring is famous for cherry blossoms, while summer festivals light up the night. Autumn brings vibrant red and yellow leaves, and winter blankets the countryside in snow. This cycle of seasons influences everything from food to clothing and daily activities. Experiencing these changes is a cherished part of Japanese culture.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>Japanese Translation:</strong> 日本は四季がはっきりしており、それぞれの季節が日常生活に独自の魅力をもたらします。春は桜で有名で、夏は夜を彩る祭りが開催されます。秋は鮮やかな赤や黄の葉が見られ、冬は田園地帯が雪で覆われます。この季節の移り変わりは、食べ物や服装、日々の活動にまで影響を与えます。この変化を体験することは、日本文化の大切な一部です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cherry blossoms in spring</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Summer festivals</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Colorful autumn leaves</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Snowy winters</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','四季折々の風景','','trash','open','open','','%e5%9b%9b%e5%ad%a3%e6%8a%98%e3%80%85%e3%81%ae%e9%a2%a8%e6%99%af__trashed','','','2025-03-24 10:18:37','2025-03-24 01:18:37','',0,'https://geriatrics.jp/?p=675',0,'post','',0),(676,1,'2024-11-11 08:54:58','2024-11-10 23:54:58','<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">「四季折々の風景」</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>English:</strong> Japan is a country with distinct seasons, each bringing a unique charm to everyday life. Spring is famous for cherry blossoms, while summer festivals light up the night. Autumn brings vibrant red and yellow leaves, and winter blankets the countryside in snow. This cycle of seasons influences everything from food to clothing and daily activities. Experiencing these changes is a cherished part of Japanese culture.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>Japanese Translation:</strong> 日本は四季がはっきりしており、それぞれの季節が日常生活に独自の魅力をもたらします。春は桜で有名で、夏は夜を彩る祭りが開催されます。秋は鮮やかな赤や黄の葉が見られ、冬は田園地帯が雪で覆われます。この季節の移り変わりは、食べ物や服装、日々の活動にまで影響を与えます。この変化を体験することは、日本文化の大切な一部です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cherry blossoms in spring</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Summer festivals</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Colorful autumn leaves</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Snowy winters</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','四季折々の風景','','inherit','closed','closed','','675-revision-v1','','','2024-11-11 08:54:58','2024-11-10 23:54:58','',675,'https://geriatrics.jp/?p=676',0,'revision','',0),(677,1,'2024-11-11 08:55:29','2024-11-10 23:55:29','<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">日本の食文化」</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>English:</strong> Japanese cuisine is known for its seasonal ingredients and delicate presentation. From sushi and sashimi to ramen and tempura, each dish highlights the natural flavors of its ingredients. Japanese people also enjoy traditional tea ceremonies and seasonal sweets. These foods and rituals are more than just meals; they reflect the Japanese appreciation for balance, freshness, and harmony in life.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>Japanese Translation:</strong> 日本の料理は、季節の食材と繊細な盛り付けで知られています。寿司や刺身、ラーメンや天ぷらまで、それぞれの料理が素材の自然な味を引き出しています。また、日本人は伝統的なお茶会や季節の和菓子も楽しみます。これらの食事や儀式は単なる食事ではなく、バランス、鮮度、そして調和への日本人の感謝を反映しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Seasonal ingredients</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Sushi, ramen, and tempura</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Traditional tea ceremonies</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Seasonal sweets</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','日本の食文化','','trash','open','open','','%e6%97%a5%e6%9c%ac%e3%81%ae%e9%a3%9f%e6%96%87%e5%8c%96__trashed','','','2025-03-24 08:20:43','2025-03-23 23:20:43','',0,'https://geriatrics.jp/?p=677',0,'post','',0),(678,1,'2024-11-11 08:55:29','2024-11-10 23:55:29','<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">日本の食文化」</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>English:</strong> Japanese cuisine is known for its seasonal ingredients and delicate presentation. From sushi and sashimi to ramen and tempura, each dish highlights the natural flavors of its ingredients. Japanese people also enjoy traditional tea ceremonies and seasonal sweets. These foods and rituals are more than just meals; they reflect the Japanese appreciation for balance, freshness, and harmony in life.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>Japanese Translation:</strong> 日本の料理は、季節の食材と繊細な盛り付けで知られています。寿司や刺身、ラーメンや天ぷらまで、それぞれの料理が素材の自然な味を引き出しています。また、日本人は伝統的なお茶会や季節の和菓子も楽しみます。これらの食事や儀式は単なる食事ではなく、バランス、鮮度、そして調和への日本人の感謝を反映しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Seasonal ingredients</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Sushi, ramen, and tempura</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Traditional tea ceremonies</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Seasonal sweets</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','日本の食文化','','inherit','closed','closed','','677-revision-v1','','','2024-11-11 08:55:29','2024-11-10 23:55:29','',677,'https://geriatrics.jp/?p=678',0,'revision','',0),(679,1,'2024-11-11 08:55:52','2024-11-10 23:55:52','<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">日常生活の礼儀」</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>English:</strong> Politeness is deeply ingrained in Japanese culture, shaping everyday interactions. Bowing is a common form of greeting, showing respect to others. People often say “itadakimasu” before eating, expressing gratitude for the meal. In crowded cities, maintaining harmony is essential, so people are careful not to disturb others. These customs are a reflection of Japanese respect for others and their surroundings.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>Japanese Translation:</strong> 礼儀は日本文化に深く根付いており、日常のやり取りにも影響を与えています。お辞儀はよく見られる挨拶の一つで、他者への敬意を示します。食事の前には「いただきます」と言い、食事に感謝の意を表します。混雑した都市では、調和を保つことが重要で、人々は他人を邪魔しないように注意を払います。これらの習慣は、他者や環境に対する日本人の敬意を表しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Bowing as a greeting</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>“Itadakimasu” before meals</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Respect for harmony</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mindfulness in crowded places</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','日常生活の礼儀','','trash','open','open','','%e6%97%a5%e5%b8%b8%e7%94%9f%e6%b4%bb%e3%81%ae%e7%a4%bc%e5%84%80__trashed','','','2025-03-24 10:18:35','2025-03-24 01:18:35','',0,'https://geriatrics.jp/?p=679',0,'post','',0),(680,1,'2024-11-11 08:55:52','2024-11-10 23:55:52','<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">日常生活の礼儀」</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>English:</strong> Politeness is deeply ingrained in Japanese culture, shaping everyday interactions. Bowing is a common form of greeting, showing respect to others. People often say “itadakimasu” before eating, expressing gratitude for the meal. In crowded cities, maintaining harmony is essential, so people are careful not to disturb others. These customs are a reflection of Japanese respect for others and their surroundings.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>Japanese Translation:</strong> 礼儀は日本文化に深く根付いており、日常のやり取りにも影響を与えています。お辞儀はよく見られる挨拶の一つで、他者への敬意を示します。食事の前には「いただきます」と言い、食事に感謝の意を表します。混雑した都市では、調和を保つことが重要で、人々は他人を邪魔しないように注意を払います。これらの習慣は、他者や環境に対する日本人の敬意を表しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Bowing as a greeting</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>“Itadakimasu” before meals</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Respect for harmony</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mindfulness in crowded places</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->','日常生活の礼儀','','inherit','closed','closed','','679-revision-v1','','','2024-11-11 08:55:52','2024-11-10 23:55:52','',679,'https://geriatrics.jp/?p=680',0,'revision','',0),(682,1,'2024-11-11 09:35:39','2024-11-11 00:35:39','{\"version\": 3, \"isGlobalStylesUserThemeJSON\": true }','Custom Styles','','publish','closed','closed','','wp-global-styles-twentytwentythree','','','2024-11-11 09:35:39','2024-11-11 00:35:39','',0,'https://geriatrics.jp/2024/11/11/wp-global-styles-twentytwentythree/',0,'wp_global_styles','',0),(683,1,'2024-11-11 09:40:51','2024-11-11 00:40:51','<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼食の時間は、同僚がリラックスして社交を楽しむ機会です。多くの人々が近くのレストランに行くか、自家製の弁当を持参して休憩を楽しみます。一緒に食事をすることは、職場の関係を強化し、同僚間のコミュニティ感覚を育む方法と見なされています。昼食後、従業員は仕事に戻り、 renewed focus を持ってタスクを続けることが多いです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>都市部では、昼食の時間に賑わいが生まれ、人気のある飲食店には行列ができます。屋台やフードスタンドも、多様な美味しい選択肢を提供しています。仕事が進む中で、労働力の献身と勤勉さが明らかになり、多くの人々が自分の責任を果たすために遅くまで働きます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>昼間のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>階層的な職場文化</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>チームワークの重要性</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の社交と弁当</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の都市部の賑わい</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>日本の昼間の生活と職場文化</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->','Sub2','','inherit','closed','closed','','664-revision-v1','','','2024-11-11 09:40:51','2024-11-11 00:40:51','',664,'https://geriatrics.jp/?p=683',0,'revision','',0),(684,1,'2024-11-11 09:48:39','2024-11-11 00:48:39','<!-- wp:paragraph -->\n<p>Blog記事テスト</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼食の時間は、同僚がリラックスして社交を楽しむ機会です。多くの人々が近くのレストランに行くか、自家製の弁当を持参して休憩を楽しみます。一緒に食事をすることは、職場の関係を強化し、同僚間のコミュニティ感覚を育む方法と見なされています。昼食後、従業員は仕事に戻り、 renewed focus を持ってタスクを続けることが多いです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>都市部では、昼食の時間に賑わいが生まれ、人気のある飲食店には行列ができます。屋台やフードスタンドも、多様な美味しい選択肢を提供しています。仕事が進む中で、労働力の献身と勤勉さが明らかになり、多くの人々が自分の責任を果たすために遅くまで働きます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>昼間のハイライト：</strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>階層的な職場文化</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>チームワークの重要性</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の社交と弁当</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>昼食時の都市部の賑わい</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p><strong>日本の昼間の生活と職場文化</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>昼間はほとんどの人々が仕事や学校に従事し、経済や社会に貢献しています。日本の職場文化は、階層やチームワークを重視する傾向があります。従業員は会社に対して忠誠心を示すことが期待され、個人主義よりもグループの調和が優先されます。会議や議論は通常、敬意を持って行われ、全員が意見を述べる機会があります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>[searchandfilter fields=\"カテゴリー1\"]</p>\n<!-- /wp:paragraph -->','Sub2','','inherit','closed','closed','','664-revision-v1','','','2024-11-11 09:48:39','2024-11-11 00:48:39','',664,'https://geriatrics.jp/?p=684',0,'revision','',0),(687,1,'2025-03-14 14:16:44','2025-03-14 05:16:44','<!-- wp:paragraph --><p>高齢者に特有の低栄養、フレイル、サルコペニア、嚥下障害や食欲不振、誤嚥性肺炎、骨粗しょう症、転倒など、幅広い栄養課題を多角的に取り上げます。ポリファーマシーの影響や肥満なども含め、日々の暮らしを支えるために役立つ知識を発信します。人生終盤の栄養や食事介助まで、一人ひとりに寄り添う情報をお届けするサイトです。栄養という側面から健康長寿・豊かな人生を支えたい。LIVE LONG and 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-->\n<p>特集では、高齢者の低栄養問題が社会的課題となっている現状と、その解決に向けた当サイトの取り組みが紹介されました。特に注目されたのは、前田研究室が実施した「高齢者の食事摂取状況と健康指標の関連性」に関する最新調査結果です。この調査では、タンパク質摂取量とサルコペニア（筋肉減少症）の関連性について新たな知見が得られ、高齢者の栄養管理における具体的な指針を提示しています。記事内では、当サイト代表の前田教授へのインタビューも掲載され、「高齢者の栄養問題は単に食事量の問題ではなく、食事の質や食べる環境、さらには心理的要因も大きく影響している」という見解が紹介されました。また、在宅介護における栄養サポートの重要性や、地域コミュニティでの食事会の効果についても言及されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">反響と今後の展開</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>この特集記事の公開後、当サイトへのアクセス数が大幅に増加し、特に介護専門職や医療関係者からの問い合わせが多く寄せられています。また、地域の高齢者支援団体からは、栄養指導プログラムの共同開発についての提案もいただいております。今回のメディア掲載を機に、より多くの方々に高齢者の栄養問題について関心を持っていただけたことを嬉しく思います。当サイトでは引き続き、科学的根拠に基づいた情報提供と、実践的な栄養サポート方法の発信に努めてまいります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">今後の予定</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>来月には、この特集記事の内容をさらに発展させた「高齢者の食事環境改善プロジェクト」の詳細を発表する予定です。このプロジェクトでは、地域の介護施設や在宅介護サービスと連携し、高齢者の栄養状態改善に向けた具体的な取り組みを展開していきます。また、特集記事で紹介された調査結果の詳細レポートを当サイト内で公開予定です。専門家の方々だけでなく、ご家族や介護者の方々にも分かりやすい形で情報提供してまいります。皆様のご支援とご関心に心より感謝申し上げます。今後とも「老年栄養ドットコム」をどうぞよろしくお願いいたします。</p>\n<!-- /wp:paragraph -->','メディアサイト◯◯で紹介されました。','','trash','open','open','','news-2025-03-11-01__trashed','','','2025-03-24 08:13:46','2025-03-23 23:13:46','',0,'https://geriatrics.jp/?p=751',0,'post','',0),(752,1,'2025-03-14 16:25:27','2025-03-14 07:25:27','<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">お知らせ</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>当サイト「老年栄養ドットコム」の取り組みが、健康情報メディア「ヘルスケアトゥデイ」にて特集記事として紹介されました。記事では、高齢者の栄養問題に焦点を当てた当サイトの活動内容や、最新の研究成果に基づいた情報発信の重要性について詳しく取り上げられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">特集内容</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>特集では、高齢者の低栄養問題が社会的課題となっている現状と、その解決に向けた当サイトの取り組みが紹介されました。特に注目されたのは、前田研究室が実施した「高齢者の食事摂取状況と健康指標の関連性」に関する最新調査結果です。この調査では、タンパク質摂取量とサルコペニア（筋肉減少症）の関連性について新たな知見が得られ、高齢者の栄養管理における具体的な指針を提示しています。記事内では、当サイト代表の前田教授へのインタビューも掲載され、「高齢者の栄養問題は単に食事量の問題ではなく、食事の質や食べる環境、さらには心理的要因も大きく影響している」という見解が紹介されました。また、在宅介護における栄養サポートの重要性や、地域コミュニティでの食事会の効果についても言及されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">反響と今後の展開</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>この特集記事の公開後、当サイトへのアクセス数が大幅に増加し、特に介護専門職や医療関係者からの問い合わせが多く寄せられています。また、地域の高齢者支援団体からは、栄養指導プログラムの共同開発についての提案もいただいております。今回のメディア掲載を機に、より多くの方々に高齢者の栄養問題について関心を持っていただけたことを嬉しく思います。当サイトでは引き続き、科学的根拠に基づいた情報提供と、実践的な栄養サポート方法の発信に努めてまいります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">今後の予定</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>来月には、この特集記事の内容をさらに発展させた「高齢者の食事環境改善プロジェクト」の詳細を発表する予定です。このプロジェクトでは、地域の介護施設や在宅介護サービスと連携し、高齢者の栄養状態改善に向けた具体的な取り組みを展開していきます。また、特集記事で紹介された調査結果の詳細レポートを当サイト内で公開予定です。専門家の方々だけでなく、ご家族や介護者の方々にも分かりやすい形で情報提供してまいります。皆様のご支援とご関心に心より感謝申し上げます。今後とも「老年栄養ドットコム」をどうぞよろしくお願いいたします。</p>\n<!-- /wp:paragraph -->','メディアサイト◯◯で紹介されました。','','inherit','closed','closed','','751-revision-v1','','','2025-03-14 16:25:27','2025-03-14 07:25:27','',751,'https://geriatrics.jp/?p=752',0,'revision','',0),(753,1,'2025-03-14 16:26:46','2025-03-14 07:26:46','<!-- wp:paragraph -->\n<p>当サイト「老年栄養ドットコム」の制作準備を始めました。<br>少しずつ記事を増やしてまいります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":750,\"width\":\"445px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/logo-1.png\" alt=\"\" class=\"wp-image-750\" style=\"width:445px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','お知らせ（現在準備中）','','publish','open','open','','news-2025-03-11-02','','','2025-03-24 08:20:15','2025-03-23 23:20:15','',0,'https://geriatrics.jp/?p=753',0,'post','',0),(754,1,'2025-03-14 16:26:46','2025-03-14 07:26:46','<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">お知らせ</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>当サイト「老年栄養ドットコム」の取り組みが、健康情報メディア「ヘルスケアトゥデイ」にて特集記事として紹介されました。記事では、高齢者の栄養問題に焦点を当てた当サイトの活動内容や、最新の研究成果に基づいた情報発信の重要性について詳しく取り上げられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">特集内容</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>特集では、高齢者の低栄養問題が社会的課題となっている現状と、その解決に向けた当サイトの取り組みが紹介されました。特に注目されたのは、前田研究室が実施した「高齢者の食事摂取状況と健康指標の関連性」に関する最新調査結果です。この調査では、タンパク質摂取量とサルコペニア（筋肉減少症）の関連性について新たな知見が得られ、高齢者の栄養管理における具体的な指針を提示しています。記事内では、当サイト代表の前田教授へのインタビューも掲載され、「高齢者の栄養問題は単に食事量の問題ではなく、食事の質や食べる環境、さらには心理的要因も大きく影響している」という見解が紹介されました。また、在宅介護における栄養サポートの重要性や、地域コミュニティでの食事会の効果についても言及されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">反響と今後の展開</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>この特集記事の公開後、当サイトへのアクセス数が大幅に増加し、特に介護専門職や医療関係者からの問い合わせが多く寄せられています。また、地域の高齢者支援団体からは、栄養指導プログラムの共同開発についての提案もいただいております。今回のメディア掲載を機に、より多くの方々に高齢者の栄養問題について関心を持っていただけたことを嬉しく思います。当サイトでは引き続き、科学的根拠に基づいた情報提供と、実践的な栄養サポート方法の発信に努めてまいります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">今後の予定</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>来月には、この特集記事の内容をさらに発展させた「高齢者の食事環境改善プロジェクト」の詳細を発表する予定です。このプロジェクトでは、地域の介護施設や在宅介護サービスと連携し、高齢者の栄養状態改善に向けた具体的な取り組みを展開していきます。また、特集記事で紹介された調査結果の詳細レポートを当サイト内で公開予定です。専門家の方々だけでなく、ご家族や介護者の方々にも分かりやすい形で情報提供してまいります。皆様のご支援とご関心に心より感謝申し上げます。今後とも「老年栄養ドットコム」をどうぞよろしくお願いいたします。</p>\n<!-- /wp:paragraph -->','おしらせ記事サンプル2','','inherit','closed','closed','','753-revision-v1','','','2025-03-14 16:26:46','2025-03-14 07:26:46','',753,'https://geriatrics.jp/?p=754',0,'revision','',0),(755,1,'2025-02-14 16:31:56','2025-02-14 07:31:56','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">準備中です</h1>\n<!-- /wp:heading -->','サンプル - 低栄養診断1','','publish','open','open','','sample-diagnosis-of-low-nutrition-01','','','2025-03-24 12:28:27','2025-03-24 03:28:27','',0,'https://geriatrics.jp/?p=755',0,'post','',0),(756,1,'2025-03-14 16:31:56','2025-03-14 07:31:56','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">低栄養診断とは</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 低栄養診断1','','inherit','closed','closed','','755-revision-v1','','','2025-03-14 16:31:56','2025-03-14 07:31:56','',755,'https://geriatrics.jp/?p=756',0,'revision','',0),(757,1,'2025-03-13 16:34:03','2025-03-13 07:34:03','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">低栄養診断とは</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 低栄養診断2','','trash','open','open','','sample-diagnosis-of-low-nutrition-02__trashed','','','2025-03-24 08:20:31','2025-03-23 23:20:31','',0,'https://geriatrics.jp/?p=757',0,'post','',0),(758,1,'2025-03-03 16:34:43','2025-03-03 07:34:43','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">低栄養診断とは</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 低栄養診断3','','trash','open','open','','sample-diagnosis-of-low-nutrition-03__trashed','','','2025-03-24 08:13:16','2025-03-23 23:13:16','',0,'https://geriatrics.jp/?p=758',0,'post','',0),(759,1,'2025-03-14 16:34:03','2025-03-14 07:34:03','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">低栄養診断とは</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 低栄養診断2','','inherit','closed','closed','','757-revision-v1','','','2025-03-14 16:34:03','2025-03-14 07:34:03','',757,'https://geriatrics.jp/?p=759',0,'revision','',0),(760,1,'2025-03-14 16:34:43','2025-03-14 07:34:43','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">低栄養診断とは</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 低栄養診断3','','inherit','closed','closed','','758-revision-v1','','','2025-03-14 16:34:43','2025-03-14 07:34:43','',758,'https://geriatrics.jp/?p=760',0,'revision','',0),(761,1,'2025-03-14 23:08:02','2025-03-14 14:08:02','<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green 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class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph 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14:16:33','',761,'https://geriatrics.jp/?p=770',0,'revision','',0),(771,1,'2025-03-14 23:22:46','2025-03-14 14:22:46','<!-- wp:paragraph -->\n<p><strong>画像と文章を横並び</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":737,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-15-1-1024x771.webp\" alt=\"\" class=\"wp-image-737\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":723,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-01-1024x585.webp\" alt=\"\" class=\"wp-image-723\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 記事メイン1','','publish','open','open','','sample-text-main-1','','','2025-03-18 19:49:21','2025-03-18 10:49:21','',0,'https://geriatrics.jp/?p=771',0,'post','',0),(772,1,'2025-03-14 23:21:27','2025-03-14 14:21:27','<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":732,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-10-1-1024x683.webp\" alt=\"\" class=\"wp-image-732\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->','記事メイン1 - テキスト左','','publish','closed','closed','','%e3%83%ac%e3%82%a4%e3%82%a2%e3%82%a6%e3%83%882-%e3%83%86%e3%82%ad%e3%82%b9%e3%83%88%e5%b7%a6','','','2025-03-18 19:48:34','2025-03-18 10:48:34','',0,'https://geriatrics.jp/uncategorized/%e3%83%ac%e3%82%a4%e3%82%a2%e3%82%a6%e3%83%882-%e3%83%86%e3%82%ad%e3%82%b9%e3%83%88%e5%b7%a6/',0,'wp_block','',0),(773,1,'2025-03-14 23:21:49','2025-03-14 14:21:49','<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":729,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1-1024x585.webp\" alt=\"\" class=\"wp-image-729\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','記事メイン1 - テキスト右','','publish','closed','closed','','%e3%83%ac%e3%82%a4%e3%82%a2%e3%82%a6%e3%83%882-%e3%83%86%e3%82%ad%e3%82%b9%e3%83%88%e5%8f%b3','','','2025-03-18 19:48:19','2025-03-18 10:48:19','',0,'https://geriatrics.jp/uncategorized/%e3%83%ac%e3%82%a4%e3%82%a2%e3%82%a6%e3%83%882-%e3%83%86%e3%82%ad%e3%82%b9%e3%83%88%e5%8f%b3/',0,'wp_block','',0),(774,1,'2025-03-14 23:22:46','2025-03-14 14:22:46','<!-- wp:paragraph -->\n<p><strong>画像と文章を横並び</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 記事メイン1','','inherit','closed','closed','','771-revision-v1','','','2025-03-14 23:22:46','2025-03-14 14:22:46','',771,'https://geriatrics.jp/?p=774',0,'revision','',0),(775,1,'2025-03-14 23:25:19','2025-03-14 14:25:19','<!-- wp:paragraph -->\n<p><strong>画像と文章を縦並び</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"記事メイン2 - 縦並び\"},\"className\":\"single-text-tate\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-text-tate\"><!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"記事メイン1 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 記事メイン2','','publish','open','open','','sample-text-main-2-2','','','2025-03-14 23:25:19','2025-03-14 14:25:19','',0,'https://geriatrics.jp/?p=775',0,'post','',0),(776,1,'2025-03-14 23:24:32','2025-03-14 14:24:32','<!-- wp:group {\"metadata\":{\"name\":\"記事メイン2 - 縦並び\"},\"className\":\"single-text-tate\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-text-tate\"><!-- wp:image {\"id\":728,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-06-1-1024x683.webp\" alt=\"\" class=\"wp-image-728\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','記事メイン2 - 縦並び','','publish','closed','closed','','%e8%a8%98%e4%ba%8b%e3%83%a1%e3%82%a4%e3%83%b32-%e7%b8%a6%e4%b8%a6%e3%81%b3','','','2025-03-18 19:48:04','2025-03-18 10:48:04','',0,'https://geriatrics.jp/uncategorized/%e8%a8%98%e4%ba%8b%e3%83%a1%e3%82%a4%e3%83%b32-%e7%b8%a6%e4%b8%a6%e3%81%b3/',0,'wp_block','',0),(777,1,'2025-03-14 23:25:19','2025-03-14 14:25:19','<!-- wp:paragraph -->\n<p><strong>画像と文章を縦並び</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"記事メイン2 - 縦並び\"},\"className\":\"single-text-tate\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-text-tate\"><!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"記事メイン1 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 記事メイン2','','inherit','closed','closed','','775-revision-v1','','','2025-03-14 23:25:19','2025-03-14 14:25:19','',775,'https://geriatrics.jp/?p=777',0,'revision','',0),(778,1,'2025-03-14 23:27:49','2025-03-14 14:27:49','<!-- wp:paragraph -->\n<p><strong>大きい画像と文章を縦に並べるレイアウト</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2272,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-25-1024x683.webp\" alt=\"\" class=\"wp-image-2272\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2177,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-06-1024x683.webp\" alt=\"\" class=\"wp-image-2177\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 画像メイン1','','publish','open','open','','sample-image-main-1','','','2025-03-14 23:27:50','2025-03-14 14:27:50','',0,'https://geriatrics.jp/?p=778',0,'post','',0),(779,1,'2025-03-14 23:26:53','2025-03-14 14:26:53','<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":731,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-09-1024x768.webp\" alt=\"\" class=\"wp-image-731\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','画像メイン1 - 縦並び','','publish','closed','closed','','%e7%94%bb%e5%83%8f%e3%83%a1%e3%82%a4%e3%83%b31-%e7%b8%a6%e4%b8%a6%e3%81%b3','','','2025-03-18 19:47:42','2025-03-18 10:47:42','',0,'https://geriatrics.jp/uncategorized/%e7%94%bb%e5%83%8f%e3%83%a1%e3%82%a4%e3%83%b31-%e7%b8%a6%e4%b8%a6%e3%81%b3/',0,'wp_block','',0),(780,1,'2025-03-14 23:27:49','2025-03-14 14:27:49','<!-- wp:paragraph -->\n<p><strong>大きい画像と文章を縦に並べるレイアウト</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2272,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-25-1024x683.webp\" alt=\"\" class=\"wp-image-2272\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2177,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-06-1024x683.webp\" alt=\"\" class=\"wp-image-2177\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 画像メイン1','','inherit','closed','closed','','778-revision-v1','','','2025-03-14 23:27:49','2025-03-14 14:27:49','',778,'https://geriatrics.jp/?p=780',0,'revision','',0),(781,1,'2025-03-14 23:29:49','2025-03-14 14:29:49','<!-- wp:paragraph -->\n<p><strong>画像を横に並べるレイアウト</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン2 - 横並び\"},\"className\":\"single-pict2\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2\"><!-- wp:group {\"className\":\"single-pict2-container\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2-container\"><!-- wp:image {\"id\":2180,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-08-1024x683.webp\" alt=\"\" class=\"wp-image-2180\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:image {\"id\":2179,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-15-1024x771.webp\" alt=\"\" class=\"wp-image-2179\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 画像メイン２長いタイトルのテスト用長いタイトルのテスト用','','publish','open','open','','sample-image-main-2','','','2025-03-14 23:29:49','2025-03-14 14:29:49','',0,'https://geriatrics.jp/?p=781',0,'post','',0),(782,1,'2025-03-14 23:29:28','2025-03-14 14:29:28','<!-- wp:group {\"metadata\":{\"name\":\"画像メイン2 - 横並び\"},\"className\":\"single-pict2\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2\"><!-- wp:group {\"className\":\"single-pict2-container\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2-container\"><!-- wp:image {\"id\":749,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-27-1-1024x683.webp\" alt=\"\" class=\"wp-image-749\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:image {\"id\":723,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-01-1024x585.webp\" alt=\"\" class=\"wp-image-723\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','画像メイン2 - 横並び','','publish','closed','closed','','%e7%94%bb%e5%83%8f%e3%83%a1%e3%82%a4%e3%83%b32-%e6%a8%aa%e4%b8%a6%e3%81%b3','','','2025-03-18 19:45:14','2025-03-18 10:45:14','',0,'https://geriatrics.jp/uncategorized/%e7%94%bb%e5%83%8f%e3%83%a1%e3%82%a4%e3%83%b32-%e6%a8%aa%e4%b8%a6%e3%81%b3/',0,'wp_block','',0),(783,1,'2025-03-14 23:29:49','2025-03-14 14:29:49','<!-- wp:paragraph -->\n<p><strong>画像を横に並べるレイアウト</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン2 - 横並び\"},\"className\":\"single-pict2\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2\"><!-- wp:group {\"className\":\"single-pict2-container\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2-container\"><!-- wp:image {\"id\":2180,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-08-1024x683.webp\" alt=\"\" class=\"wp-image-2180\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:image {\"id\":2179,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-15-1024x771.webp\" alt=\"\" class=\"wp-image-2179\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>/u</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"className\":\"ul-b\"} -->\n<ul class=\"wp-block-list ul-b\"><!-- wp:list-item -->\n<li>ul（リスト2 / 下線）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>ふじ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>ジョナゴールド</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list --></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:roneneiyou/blockquote-line {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用1 / 線）\\u003cbr\\u003e\\u003c/strong\\u003eああああああああああああああああああああああああああ\"} /-->\n\n<!-- wp:roneneiyou/blockquote-bg {\"quoteContent\":\"\\u003cstrong\\u003eblockquote（引用2 / 背景）\\u003c/strong\\u003e\\u003cbr\\u003eあああああああああああああああああああああああ\"} /-->','表示サンプル - 画像メイン２長いタイトルのテスト用長いタイトルのテスト用','','inherit','closed','closed','','781-revision-v1','','','2025-03-14 23:29:49','2025-03-14 14:29:49','',781,'https://geriatrics.jp/?p=783',0,'revision','',0),(784,1,'2025-03-14 23:31:01','2025-03-14 14:31:01','<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','記事メイン1 - テキスト右','','inherit','closed','closed','','773-revision-v1','','','2025-03-14 23:31:01','2025-03-14 14:31:01','',773,'https://geriatrics.jp/?p=784',0,'revision','',0),(785,1,'2025-03-14 23:31:22','2025-03-14 14:31:22','<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->','記事メイン1 - テキスト左','','inherit','closed','closed','','772-revision-v1','','','2025-03-14 23:31:22','2025-03-14 14:31:22','',772,'https://geriatrics.jp/?p=785',0,'revision','',0),(786,1,'2025-03-15 11:34:51','2025-03-15 02:34:51','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート1','','trash','open','open','','sample-nutrition-support-01__trashed','','','2025-03-24 08:12:04','2025-03-23 23:12:04','',0,'https://geriatrics.jp/?p=786',0,'post','',0),(787,1,'2025-03-15 11:34:51','2025-03-15 02:34:51','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート1','','inherit','closed','closed','','786-revision-v1','','','2025-03-15 11:34:51','2025-03-15 02:34:51','',786,'https://geriatrics.jp/?p=787',0,'revision','',0),(788,1,'2025-03-15 11:37:34','2025-03-15 02:37:34','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート2','','trash','open','open','','sample-nutrition-support-02__trashed','','','2025-03-24 08:12:02','2025-03-23 23:12:02','',0,'https://geriatrics.jp/?p=788',0,'post','',0),(789,1,'2025-03-15 11:38:34','2025-03-15 02:38:34','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":724,\"width\":\"1280px\",\"height\":\"auto\",\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large is-resized single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-02-1-1024x683.webp\" alt=\"\" class=\"wp-image-724\" style=\"width:1280px;height:auto\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":730,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-08-1-1024x683.webp\" alt=\"\" class=\"wp-image-730\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート3','','publish','open','open','','sample-nutrition-support-03','','','2025-03-24 15:14:19','2025-03-24 06:14:19','',0,'https://geriatrics.jp/?p=789',0,'post','',0),(790,1,'2025-03-15 11:37:34','2025-03-15 02:37:34','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート2','','inherit','closed','closed','','788-revision-v1','','','2025-03-15 11:37:34','2025-03-15 02:37:34','',788,'https://geriatrics.jp/?p=790',0,'revision','',0),(791,1,'2025-03-15 11:38:34','2025-03-15 02:38:34','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート3','','inherit','closed','closed','','789-revision-v1','','','2025-03-15 11:38:34','2025-03-15 02:38:34','',789,'https://geriatrics.jp/?p=791',0,'revision','',0),(792,1,'2025-03-15 11:40:05','2025-03-15 02:40:05','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2272,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-25-1024x683.webp\" alt=\"\" class=\"wp-image-2272\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔1','','publish','open','open','','sample-exercise-nutrition-oral-01','','','2025-03-15 11:45:58','2025-03-15 02:45:58','',0,'https://geriatrics.jp/?p=792',0,'post','',0),(793,1,'2025-03-15 11:40:05','2025-03-15 02:40:05','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":2181,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-10-1024x683.webp\" alt=\"\" class=\"wp-image-2181\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔1','','inherit','closed','closed','','792-revision-v1','','','2025-03-15 11:40:05','2025-03-15 02:40:05','',792,'https://geriatrics.jp/?p=793',0,'revision','',0),(795,1,'2025-03-15 11:40:35','2025-03-15 02:40:35','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2272,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-25-1024x683.webp\" alt=\"\" class=\"wp-image-2272\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔1','','inherit','closed','closed','','792-revision-v1','','','2025-03-15 11:40:35','2025-03-15 02:40:35','',792,'https://geriatrics.jp/?p=795',0,'revision','',0),(796,1,'2025-03-15 11:40:45','2025-03-15 02:40:45','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2272,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-25-1024x683.webp\" alt=\"\" class=\"wp-image-2272\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔1','','inherit','closed','closed','','792-revision-v1','','','2025-03-15 11:40:45','2025-03-15 02:40:45','',792,'https://geriatrics.jp/?p=796',0,'revision','',0),(797,1,'2025-03-15 11:42:19','2025-03-15 02:42:19','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン2 - 横並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/782\"},\"className\":\"single-pict2\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2\"><!-- wp:group {\"className\":\"single-pict2-container\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2-container\"><!-- wp:image {\"id\":2180,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-08-1024x683.webp\" alt=\"\" class=\"wp-image-2180\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:image {\"id\":2179,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-15-1024x771.webp\" alt=\"\" class=\"wp-image-2179\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔2','','publish','open','open','','sample-exercise-nutrition-oral-02','','','2025-03-23 14:08:48','2025-03-23 05:08:48','',0,'https://geriatrics.jp/?p=797',0,'post','',0),(798,1,'2025-03-15 11:43:33','2025-03-15 02:43:33','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">準備中です</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":729,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1-1024x585.webp\" alt=\"\" class=\"wp-image-729\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\"></p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔3','','publish','open','open','','sample-exercise-nutrition-oral-03','','','2025-03-24 12:29:58','2025-03-24 03:29:58','',0,'https://geriatrics.jp/?p=798',0,'post','',0),(799,1,'2025-03-15 11:42:19','2025-03-15 02:42:19','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン2 - 横並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/782\"},\"className\":\"single-pict2\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2\"><!-- wp:group {\"className\":\"single-pict2-container\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2-container\"><!-- wp:image {\"id\":2180,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-08-1024x683.webp\" alt=\"\" class=\"wp-image-2180\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:image {\"id\":2179,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-15-1024x771.webp\" alt=\"\" class=\"wp-image-2179\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔2','','inherit','closed','closed','','797-revision-v1','','','2025-03-15 11:42:19','2025-03-15 02:42:19','',797,'https://geriatrics.jp/?p=799',0,'revision','',0),(800,1,'2025-03-15 11:43:33','2025-03-15 02:43:33','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":2272,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-25-1024x683.webp\" alt=\"\" class=\"wp-image-2272\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔3','','inherit','closed','closed','','798-revision-v1','','','2025-03-15 11:43:33','2025-03-15 02:43:33','',798,'https://geriatrics.jp/?p=800',0,'revision','',0),(801,1,'2025-03-15 15:37:38','2025-03-15 06:37:38','<div class=\"mail__type mail__input-item\"><div class=\"mail__type-title\">お問い合わせ内容<span class=\"hissu\">必須</span></div><div class=\"mail__type-radio-group\">[radio radio-inquiry-type class:mail__type-selector use_label_element default:1 \"プレスリリースの申請\" \"お問い合わせ\"]</div></div>\r\n<h3 class=\"mail__group-title mail__group-title--pr\">プレスリリースの申請</h3>\r\n<h3 class=\"mail__group-title mail__group-title--inquiry\">お問い合わせ</h3>\r\n<div class=\"mail__contact-info\"><label class=\"mail__input-item\"><span class=\"mail__input-title\">お名前<span class=\"hissu\">必須</span></span>[text* your-name autocomplete:name placeholder \"例：山田華子\"]</label><label class=\"mail__input-item\"><span class=\"mail__input-title\">メールアドレス<span class=\"hissu\">必須</span></span>[email* your-email autocomplete:email placeholder \"例：abc@mail.com\"]</label></div>\r\n[group group-app clear_on_hide class:mail__app]<div class=\"mail__pr mail__input-item\"><div class=\"mail__pr-col-left\"><span class=\"mail__input-title\">送付資料<span class=\"hissu\">必須</span></span></div><div class=\"mail__pr-col-right\"><p class=\"mail__pr-download\"><a href=\"https://geriatrics.jp/wp-content/uploads/2025/03/pressrelease.docx\" target=\"_blank\" rel=\"noopener\">【プレスリリース申請書式】</a>はこちらからダウンロード頂けます。<br />※プレスリリースの申請書式に記載し、「ファイル選択」から添付してください</p><div class=\"mail__pr-upload\">[file* file-pressrelease class:mail__file-upload filetypes:docx limit:1mb]</div></div></div><div class=\"mail__remarks mail__input-item\"><span class=\"mail__input-title\">備考欄</span>[textarea your-remarks placeholder \"何かございましたらご入力ください\"]</div>[/group]\r\n[group group-inquiry clear_on_hide class:mail__inquiry]\r\n<div class=\"mail__message\"><label class=\"mail__input-item\"><span class=\"mail__input-title\">お問い合わせ内容<span class=\"hissu\">必須</span></span><div class=\"mail__message-grid\"><p class=\"mail__message-note\">症例や個別の医療相談にはお答えいたしませんことをご承知ください</p>[textarea* your-message placeholder \"詳しい内容をご入力ください\"]</div></label></div>\r\n[/group]\r\n<div class=\"mail__buttons\">[submit \"送信\"]<input type=\"reset\"></div>\n1\n【[_site_title]】[radio-inquiry-type] が届きました\n[_site_title] <wordpress@geriatrics.jp>\n[_site_admin_email]\n差出人: [your-name] [your-email]\r\n題名: [your-subject]\r\n\r\nお問い合わせ種別：[radio-inquiry-type]\r\n\r\nメッセージ本文:\r\n[your-message]\r\n\r\n-- \r\n本メールはあなたのウェブサイト ([_site_title] [_site_url]) のコンタクトフォームに送信があったことをお知らせするものです。\nReply-To: [your-email]\n[file-pressrelease]\n\n\n1\n【[_site_title]】[radio-inquiry-type] 受付のお知らせ（自動返信）\n[_site_title] <wordpress@geriatrics.jp>\n[your-email]\nお問い合わせ種別：[radio-inquiry-type]\r\n\r\nメッセージ本文:\r\n[your-message]\r\n\r\n-- \r\nあなたのメールアドレスを使用して、私たちのウェブサイト ([_site_title] [_site_url]) のコンタクトフォームに送信がありましたので、その控えとして本メールを送ります。もしもその送信について心当たりのない場合は、どうぞこのメッセージを無視してください。\nReply-To: [_site_admin_email]\n\n\n\nありがとうございます。メッセージは送信されました。\nメッセージの送信に失敗しました。後でまたお試しください。\n入力内容に問題があります。確認して再度お試しください。\nメッセージの送信に失敗しました。後でまたお試しください。\nメッセージを送信する前に承諾確認が必要です。\n入力してください。\n入力されたテキストが長すぎます。\n入力されたテキストが短すぎます。\nファイルのアップロード時に不明なエラーが発生しました。\nこの形式のファイルはアップロードできません。\nアップロードされたファイルが大きすぎます。\nファイルのアップロード中にエラーが発生しました。\nYYYY-MM-DD の形式で日付を入力してください。\n入力された日付が早すぎます。\n入力された日付が遅すぎます。\n数値を入力してください。\n入力された数値が小さすぎます。\n入力された数値が大きすぎます。\nクイズの答えが正しくありません。\nメールアドレスを入力してください。\nURL を入力してください。\n電話番号を入力してください。\nskip_mail2_recipient_validation: on','mail-form','','publish','closed','closed','','%e3%82%b3%e3%83%b3%e3%82%bf%e3%82%af%e3%83%88%e3%83%95%e3%82%a9%e3%83%bc%e3%83%a0-1','','','2025-03-25 12:32:24','2025-03-25 03:32:24','',0,'https://geriatrics.jp/?post_type=wpcf7_contact_form&#038;p=801',0,'wpcf7_contact_form','',0),(802,1,'2025-03-15 15:50:28','2025-03-15 06:50:28','','pressrelease','','inherit','open','closed','','pressrelease','','','2025-03-15 15:50:28','2025-03-15 06:50:28','',0,'https://geriatrics.jp/wp-content/uploads/2025/03/pressrelease.docx',0,'attachment','application/vnd.openxmlformats-officedocument.wordprocessingml.document',0),(805,1,'2025-03-16 21:31:21','2025-03-16 12:31:21','<!-- wp:paragraph -->\n<p>ホームページへのご意見、お問い合わせ、プレスリリースのご依頼などは、こちらからお願い致します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">お問い合わせ内容</h2>\n<!-- /wp:heading -->\n\n<!-- wp:shortcode -->\n[contact-form-7 id=\"514c8b9\" title=\"mail-form\"]\n<!-- /wp:shortcode -->','申請・お問い合わせ','','publish','closed','closed','','contact','','','2025-03-18 20:31:25','2025-03-18 11:31:25','',0,'https://geriatrics.jp/?page_id=805',0,'page','',0),(806,1,'2025-03-16 21:31:21','2025-03-16 12:31:21','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">申請・お問い合わせ</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>ホームページへのご意見、お問い合わせ、プレスリリースのご依頼などは、こちらからお願い致します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">お問い合わせ内容</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','お問い合わせ','','inherit','closed','closed','','805-revision-v1','','','2025-03-16 21:31:21','2025-03-16 12:31:21','',805,'https://geriatrics.jp/?p=806',0,'revision','',0),(807,1,'2025-03-16 22:02:53','2025-03-16 13:02:53','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">申請・お問い合わせ</h1>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>ホームページへのご意見、お問い合わせ、プレスリリースのご依頼などは、こちらからお願い致します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">お問い合わせ内容</h2>\n<!-- /wp:heading -->\n\n<!-- wp:shortcode -->\n[contact-form-7 id=\"514c8b9\" title=\"mail-form\"]\n<!-- /wp:shortcode -->','お問い合わせ','','inherit','closed','closed','','805-revision-v1','','','2025-03-16 22:02:53','2025-03-16 13:02:53','',805,'https://geriatrics.jp/?p=807',0,'revision','',0),(808,1,'2025-03-26 20:22:26','2025-03-26 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11:58:54','2025-03-18 02:58:54','',0,'https://geriatrics.jp/?post_type=flamingo_contact&#038;p=811',0,'flamingo_contact','',0),(812,0,'2025-03-17 08:15:58','2025-03-16 23:15:58','テスト太郎\nhirose.cp@gmail.com\nテストです\ndb54c340b870a7f085f1575eb5939dc6\n1\n106.73.142.226\nMozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Safari/537.36 Edg/134.0.0.0\nhttps://geriatrics.jp/mail/\n2025年3月17日\n8:15 AM\n805\nmail\nお問い合わせ\nhttps://geriatrics.jp/mail/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject','','','2025-03-17 08:15:58','2025-03-16 23:15:58','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=812',0,'flamingo_inbound','',0),(813,1,'2025-03-17 10:39:08','2025-03-17 01:39:08','<!-- wp:paragraph -->\n<p>ホームページへのご意見、お問い合わせ、プレスリリースのご依頼などは、こちらからお願い致します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">お問い合わせ内容</h2>\n<!-- /wp:heading -->\n\n<!-- wp:shortcode -->\n[contact-form-7 id=\"514c8b9\" title=\"mail-form\"]\n<!-- /wp:shortcode -->','申請・お問い合わせ','','inherit','closed','closed','','805-revision-v1','','','2025-03-17 10:39:08','2025-03-17 01:39:08','',805,'https://geriatrics.jp/?p=813',0,'revision','',0),(814,0,'2025-03-17 12:06:36','2025-03-17 03:06:36','お問い合わせ\nテスト送信者\nhirose.cp@gmail.com\nテスト\n2\n106.73.142.226\nMozilla/5.0 (Linux; Android 6.0; Nexus 5 Build/MRA58N) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Mobile Safari/537.36 Edg/134.0.0.0\nhttps://geriatrics.jp/mail/\n2025年3月17日\n12:06 PM\n805\nmail\n申請・お問い合わせ\nhttps://geriatrics.jp/mail/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-2','','','2025-03-17 12:06:36','2025-03-17 03:06:36','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=814',0,'flamingo_inbound','',0),(815,0,'2025-03-18 11:58:54','2025-03-18 02:58:54','プレスリリースの申請\n最終テスト\nhirose.cp@gmail.com\ndb54c340b870a7f085f1575eb5939dc6\n3\n106.73.142.226\nMozilla/5.0 (Linux; Android 6.0; Nexus 5 Build/MRA58N) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Mobile Safari/537.36 Edg/134.0.0.0\nhttps://geriatrics.jp/mail/\n2025年3月18日\n11:58 AM\n805\nmail\n申請・お問い合わせ\nhttps://geriatrics.jp/mail/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-3','','','2025-03-18 11:58:54','2025-03-18 02:58:54','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=815',0,'flamingo_inbound','',0),(816,1,'2025-03-18 17:53:15','2025-03-18 08:53:15','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":729,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1-1024x585.webp\" alt=\"\" class=\"wp-image-729\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":2155,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatricsjp.local/wp-content/uploads/2025/03/fig-02-1024x683.webp\" alt=\"\" class=\"wp-image-2155\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔3','','inherit','closed','closed','','798-revision-v1','','','2025-03-18 17:53:15','2025-03-18 08:53:15','',798,'https://geriatrics.jp/?p=816',0,'revision','',0),(817,1,'2025-03-18 17:54:14','2025-03-18 08:54:14','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">運動・栄養・口腔</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/779\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":729,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1-1024x585.webp\" alt=\"\" class=\"wp-image-729\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":733,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-11-1024x768.webp\" alt=\"\" class=\"wp-image-733\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 運動・栄養・口腔3','','inherit','closed','closed','','798-revision-v1','','','2025-03-18 17:54:14','2025-03-18 08:54:14','',798,'https://geriatrics.jp/?p=817',0,'revision','',0),(818,1,'2025-03-18 19:45:14','2025-03-18 10:45:14','<!-- wp:group {\"metadata\":{\"name\":\"画像メイン2 - 横並び\"},\"className\":\"single-pict2\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2\"><!-- wp:group {\"className\":\"single-pict2-container\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict2-container\"><!-- wp:image {\"id\":749,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-27-1-1024x683.webp\" alt=\"\" class=\"wp-image-749\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:image {\"id\":723,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"fit-image\"} -->\n<figure class=\"wp-block-image size-large fit-image\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-01-1024x585.webp\" alt=\"\" class=\"wp-image-723\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','画像メイン2 - 横並び','','inherit','closed','closed','','782-revision-v1','','','2025-03-18 19:45:14','2025-03-18 10:45:14','',782,'https://geriatrics.jp/?p=818',0,'revision','',0),(819,1,'2025-03-18 19:47:42','2025-03-18 10:47:42','<!-- wp:group {\"metadata\":{\"name\":\"画像メイン1 - 縦並び\"},\"className\":\"single-pict\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-pict\"><!-- wp:image {\"id\":731,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-09-1024x768.webp\" alt=\"\" class=\"wp-image-731\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','画像メイン1 - 縦並び','','inherit','closed','closed','','779-revision-v1','','','2025-03-18 19:47:42','2025-03-18 10:47:42','',779,'https://geriatrics.jp/?p=819',0,'revision','',0),(820,1,'2025-03-18 19:48:04','2025-03-18 10:48:04','<!-- wp:group {\"metadata\":{\"name\":\"記事メイン2 - 縦並び\"},\"className\":\"single-text-tate\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-text-tate\"><!-- wp:image {\"id\":728,\"sizeSlug\":\"large\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-large\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-06-1-1024x683.webp\" alt=\"\" class=\"wp-image-728\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph -->\n<p>ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','記事メイン2 - 縦並び','','inherit','closed','closed','','776-revision-v1','','','2025-03-18 19:48:04','2025-03-18 10:48:04','',776,'https://geriatrics.jp/?p=820',0,'revision','',0),(821,1,'2025-03-18 19:48:19','2025-03-18 10:48:19','<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":729,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1-1024x585.webp\" alt=\"\" class=\"wp-image-729\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->','記事メイン1 - テキスト右','','inherit','closed','closed','','773-revision-v1','','','2025-03-18 19:48:19','2025-03-18 10:48:19','',773,'https://geriatrics.jp/?p=821',0,'revision','',0),(822,1,'2025-03-18 19:48:34','2025-03-18 10:48:34','<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":732,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-10-1-1024x683.webp\" alt=\"\" class=\"wp-image-732\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->','記事メイン1 - テキスト左','','inherit','closed','closed','','772-revision-v1','','','2025-03-18 19:48:34','2025-03-18 10:48:34','',772,'https://geriatrics.jp/?p=822',0,'revision','',0),(823,1,'2025-03-18 19:49:20','2025-03-18 10:49:20','<!-- wp:paragraph -->\n<p><strong>画像と文章を横並び</strong>になります。<br>「低栄養診断」「栄養サポート」「運動・栄養・口腔」「CGA・フレイル」<br>「マッスルヘルス・サルコベニア」「摂食嚥下」「工夫・レシピ集」「CGA」「コラム」などのカテゴリーに。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"h2（見出し2 / 黒）\"} /-->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":737,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-15-1-1024x771.webp\" alt=\"\" class=\"wp-image-737\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":723,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-01-1024x585.webp\" alt=\"\" class=\"wp-image-723\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し2\"} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し2（緑）\"} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し3\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し3（緑）\",\"level\":3} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し4\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し4（緑）\",\"level\":4} /-->\n\n<!-- wp:roneneiyou/heading-black {\"content\":\"見出し5\",\"level\":5} /-->\n\n<!-- wp:roneneiyou/heading-green {\"content\":\"見出し5（緑）\",\"level\":5} /-->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table1\"} -->\n<figure class=\"wp-block-flexible-table-block-table table1\"><figcaption>table（表1 / 区切り線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table2\"} -->\n<figure class=\"wp-block-flexible-table-block-table table2\"><figcaption>table（表2 / 区切り線あり）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:flexible-table-block/table {\"captionSide\":\"top\",\"className\":\"table3\"} -->\n<figure class=\"wp-block-flexible-table-block-table table3\"><figcaption>table（表3 / 枠線なし）</figcaption><table class=\"has-fixed-layout\"><tbody><tr><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th><th>見出しセル</th></tr><tr><th>見出しセル</th><td>内容</td><td colspan=\"2\">内容</td></tr><tr><th>見出しセル</th><td rowspan=\"2\">内容</td><td>内容</td><td>内容</td></tr><tr><th>見出しセル</th><td>内容</td><td>内容</td></tr></tbody></table></figure>\n<!-- /wp:flexible-table-block/table -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>ul（リスト1 / 通常）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>イチゴ</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>リンゴ<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- 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<p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  \n  <h2><b>研究費の使用と運用管理について</b></h2>\n  <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n  \n  <h3>研究費管理部門による厳格な運用</h3>\n  <p>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</p>\n  \n  <h3>利益相反の回避</h3>\n  <p>当サイトは営利団体の広告収益などを目的としておらず、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</p>\n  \n  <h2><b>ご支援の活用方法</b></h2>\n  <p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n  \n  <h3>研究活動の充実・発展</h3>\n  <p>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</p>\n  \n  <h3>情報発信の拡充</h3>\n  <p>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</p>\n  \n  <h3>サイト運営の維持</h3>\n  <p>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</p>\n  \n  <h2><b>ご支援の方法</b></h2>\n  <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。<a href=\"https://geriatrics.jp/contact/\">まずは<strong><b>お問い合わせフォーム</b></strong>から</a>お問い合わせください。</p>\n  \n  <h3>寄付（奨学寄付）</h3>\n  <p>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</p>\n  \n  <h3>産学共同研究のご提案</h3>\n  <p>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</p>\n  \n  <h3>その他のご支援</h3>\n  <p>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</p>\n  \n  <h2><b>皆さまへの感謝</b></h2>\n  <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>\n  「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n</div>\n<!-- /wp:html -->\n\n<!-- wp:html -->\n<style>\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  line-height: 1.7;\n  color: #333;\n  max-width: 1000px;\n  margin: 0 auto;\n  padding: 20px;\n}\n.support-container h2 {\n  text-align: center;\n  color: 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class=\"support-message-box\">\n<h2 class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n\n本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および<span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家たちが監修する公益性の高い情報発信の場です。\n\n高齢者の健康課題に対する理解を深め、より良い医療とケアの実現に向けた情報基盤として、多くの方々に活用いただけるよう日々コンテンツの充実に努めています。\n\n</div>\n<h2 class=\"support-message-title\">ご支援いただきたい理由</h2>\n当サイトは公的研究費を主な財源として運営していますが、より充実したコンテンツ提供と持続可能な運営のために、皆様からのご支援をお願いしております。いただいたご支援は以下のような活動に活用させていただきます：\n<div class=\"support-types\">\n<div class=\"support-card\">\n<h3>情報発信の強化</h3>\n最新の研究成果や医療情報を、わかりやすく専門性の高いコンテンツとして発信するための取り組みに活用します。\n\n</div>\n<div class=\"support-card\">\n<h3>教育資料の作成</h3>\n医療従事者向けの教育資料や、一般の方々が高齢者医療について理解を深めるための資料作成に役立てます。\n\n</div>\n<div class=\"support-card\">\n<h3>研究活動の支援</h3>\n高齢者医療の質向上につながる研究活動を支援し、その成果を広く社会に還元する取り組みに活用します。\n\n</div>\n</div>\n<div class=\"support-organization-info\">\n<h3>資金管理について</h3>\nいただいたご支援は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門において、適切に管理・運用されます。支援金の使途については定期的に本サイト上でご報告いたします。\n\n</div>\n<div class=\"support-horizontal-line\"></div>\n<h2 class=\"support-message-title\">ご支援の方法</h2>\nご支援には以下の方法があります。いずれの場合も税制上の優遇措置が適用される場合がございます。詳細は各機関にお問い合わせください。\n<div class=\"support-types\">\n<div class=\"support-card\">\n<h3>企業の皆様</h3>\n奨学寄附金、共同研究、受託研究などの形で支援いただけます。具体的な連携方法についてはご相談ください。\n\n<a class=\"support-btn\" href=\"#\">詳細はこちら</a>\n\n</div>\n<div class=\"support-card\">\n<h3>個人の皆様</h3>\n個人寄付も受け付けております。金額の大小に関わらず、皆様の温かいご支援が活動を支える力となります。\n\n<a class=\"support-btn\" href=\"#\">寄付をする</a>\n\n</div>\n</div>\n<p class=\"support-footer-message\">※本サイトへのご支援は任意です。支援の有無によって提供される情報やサービスに差異はございません。\n皆様のあたたかいご支援を心よりお待ちしております。</p>\n\n</div>\n<style>\n.support-container {<br />\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif !important;<br />\n  line-height: 1.7 !important;<br />\n  color: #333 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/>\n</style>','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 09:19:50','2025-03-24 00:19:50','',849,'https://geriatrics.jp/?p=850',0,'revision','',0),(851,1,'2025-03-24 09:24:26','2025-03-24 00:24:26','<!-- 高齢者医療ご支援募集ページ（本文部分・最終版） -->\n<div class=\"support-container\">\n  <div class=\"support-subtitle\">\n    高齢者医療の発展と情報発信を支える取り組みにご協力ください\n  </div>\n\n  <div class=\"support-message-box\">\n    <h2 class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n    <p>\n      「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を、医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n    </p>\n    <p>\n      本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および\n      <span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家が監修する公益性の高い情報発信の場です。\n    </p>\n    <p>\n      高齢者の健康課題に対する理解を深め、より良い医療とケアの実現を目指すため、日々コンテンツの充実に努めています。\n    </p>\n  </div>\n\n  <h2 class=\"support-message-title\">ご支援いただきたい理由</h2>\n  <p>\n    当サイトは公的研究費を主な財源として運営しておりますが、より充実した情報提供と持続可能な運営のため、皆様からのご支援をお願いしております。いただいたご支援は、以下の各活動に活用させていただきます：\n  </p>\n\n  <div class=\"support-types\">\n    <div class=\"support-card\">\n      <h3>情報発信の強化</h3>\n      <p>\n        最新の研究成果や医療情報を、専門性とわかりやすさを兼ね備えたコンテンツとして発信する取り組みをサポートします。\n      </p>\n    </div>\n    <div class=\"support-card\">\n      <h3>教育資料の作成</h3>\n      <p>\n        医療従事者向けの教育資料や、一般の方々が高齢者医療を理解するための資料作成の支援に充てます。\n      </p>\n    </div>\n    <div class=\"support-card\">\n      <h3>研究活動の支援</h3>\n      <p>\n        高齢者医療の質向上に直結する研究活動を推進し、その成果を広く社会へ還元する取り組みに役立てます。\n      </p>\n    </div>\n  </div>\n\n  <div class=\"support-organization-info\">\n    <h3>資金管理について</h3>\n    <p>\n      いただいたご支援は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門により、適切に管理・運用されます。使途については、定期的に本サイト上でご報告いたします。\n    </p>\n  </div>\n\n  <div class=\"support-horizontal-line\"></div>\n\n  <h2 class=\"support-message-title\">ご支援の方法</h2>\n  <p>\n    ご支援には以下の方法がございます。いずれの場合も税制上の優遇措置が適用される可能性がございますので、詳細は各機関にお問い合わせください。\n  </p>\n\n  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class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を、医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n\n本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および\n<span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家が監修する公益性の高い情報発信の場です。\n\n高齢者の健康課題に対する理解を深め、より良い医療とケアの実現を目指すため、日々コンテンツの充実に努めています。\n\n</div>\n<h2 class=\"support-message-title\">ご支援いただきたい理由</h2>\n当サイトは公的研究費を主な財源として運営しておりますが、より充実した情報提供と持続可能な運営のため、皆様からのご支援をお願いしております。いただいたご支援は、以下の各活動に活用させていただきます：\n<div class=\"support-types\">\n<div class=\"support-card\">\n<h3>情報発信の強化</h3>\n最新の研究成果や医療情報を、専門性とわかりやすさを兼ね備えたコンテンツとして発信する取り組みをサポートします。\n\n</div>\n<div class=\"support-card\">\n<h3>教育資料の作成</h3>\n医療従事者向けの教育資料や、一般の方々が高齢者医療を理解するための資料作成の支援に充てます。\n\n</div>\n<div class=\"support-card\">\n<h3>研究活動の支援</h3>\n高齢者医療の質向上に直結する研究活動を推進し、その成果を広く社会へ還元する取り組みに役立てます。\n\n</div>\n</div>\n<div class=\"support-organization-info\">\n<h3>資金管理について</h3>\nいただいたご支援は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門により、適切に管理・運用されます。使途については、定期的に本サイト上でご報告いたします。\n\n</div>\n<div class=\"support-horizontal-line\"></div>\n<h2 class=\"support-message-title\">ご支援の方法</h2>\nご支援には以下の方法がございます。いずれの場合も税制上の優遇措置が適用される可能性がございますので、詳細は各機関にお問い合わせください。\n<div class=\"support-types\">\n<div class=\"support-card\">\n<h3>企業の皆様</h3>\n奨学寄附金、共同研究、受託研究などの形でご支援いただけます。具体的な連携方法についてはお気軽にご相談ください。\n\n<a class=\"support-btn\" href=\"#\">詳細はこちら</a>\n\n</div>\n<div class=\"support-card\">\n<h3>個人の皆様</h3>\n個人寄付も受け付けております。金額の大小を問わず、皆様の温かいご支援が活動の原動力となります。\n\n<a class=\"support-btn\" href=\"#\">寄付をする</a>\n\n</div>\n</div>\n<p class=\"support-footer-message\">※本サイトへのご支援は任意です。支援の有無にかかわらず、提供される情報やサービスに差異はございません。\n皆様のあたたかいご支援を心よりお待ちしております。</p>\n\n</div>\n<style>\n/* 全体コンテナ */<br />\n.support-container {<br />\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif !important;<br />\n  line-height: 1.7 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00:00:00','',0,'https://geriatrics.jp/?page_id=855',0,'page','',0),(856,1,'2025-03-24 10:20:00','2025-03-24 01:20:00','準備中です','低栄養診断','','inherit','closed','closed','','693-revision-v1','','','2025-03-24 10:20:00','2025-03-24 01:20:00','',693,'https://geriatrics.jp/?p=856',0,'revision','',0),(858,1,'2025-03-24 10:21:41','2025-03-24 01:21:41','<p>準備中です</p>\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養診断','','inherit','closed','closed','','693-revision-v1','','','2025-03-24 10:21:41','2025-03-24 01:21:41','',693,'https://geriatrics.jp/?p=858',0,'revision','',0),(859,1,'2025-03-24 10:35:37','2025-03-24 01:35:37','\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">老年栄養ドットコムとは</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">研究費の使用と運用管理について</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究費管理部門による厳格な運用</strong><br>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>利益相反の回避</strong><br>当サイトは営利団体の<em>広告収益などを目的としておらず</em>、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の活用方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究活動の充実・発展</strong><br>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>情報発信の拡充</strong><br>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>サイト運営の維持</strong><br>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずは<a href=\"https://geriatrics.jp/contact/\">お問い合わせ</a>フォームからお問い合わせください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>寄付（奨学寄付）</strong><br>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>産学<strong>共同研究のご提案</strong><br>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>その他のご支援</strong><br>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">皆さまへの感謝</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n<!-- /wp:paragraph -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 10:35:37','2025-03-24 01:35:37','',849,'https://geriatrics.jp/?p=859',0,'revision','',0),(861,1,'2025-03-24 10:45:43','0000-00-00 00:00:00','','自動下書き','','auto-draft','open','open','','','','','2025-03-24 10:45:43','0000-00-00 00:00:00','',0,'https://geriatrics.jp/?p=861',0,'post','',0),(862,1,'2025-03-24 10:50:06','2025-03-24 01:50:06','<!-- wp:paragraph -->\n<p>テスト記事</p>\n<!-- /wp:paragraph -->','テスト（プレスリリースの場）','','publish','open','open','','%e3%83%86%e3%82%b9%e3%83%88%ef%bc%88%e3%83%97%e3%83%ac%e3%82%b9%e3%83%aa%e3%83%aa%e3%83%bc%e3%82%b9%e3%81%ae%e5%a0%b4%ef%bc%89','','','2025-03-24 10:50:06','2025-03-24 01:50:06','',0,'https://geriatrics.jp/?p=862',0,'post','',0),(863,1,'2025-03-24 10:50:06','2025-03-24 01:50:06','<!-- wp:paragraph -->\n<p>テスト記事</p>\n<!-- /wp:paragraph -->','テスト（プレスリリースの場）','','inherit','closed','closed','','862-revision-v1','','','2025-03-24 10:50:06','2025-03-24 01:50:06','',862,'https://geriatrics.jp/?p=863',0,'revision','',0),(865,1,'2025-03-24 11:35:14','2025-03-24 02:35:14','<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">「研究論文など重要な発表をしても、世間へのアウトリーチが十分ではない」</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>──そんな課題を解決するため、本コーナー「プレスリリースの場」では、老年栄養や関連分野の研究者・専門家が、新たな研究成果をわかりやすく発信できるスペースを提供します。<br>論文が学会や専門誌に掲載されても、一般の方々には十分に届かないことが多いため、メディアや広く社会に向けて情報をまとめ、高齢社会の課題解決に役立つ知見をお届けします。<br>本コーナーが橋渡しとなり、研究の重要性に触れる機会を増やします。ぜひ当コーナーをご活用いただき、研究の価値をさらに広めましょう。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>老年医学、栄養学、臨床栄養学、リハビリテーション医学、老年看護学、緩和医療学、社会科学、心理学など、あらゆる「広義の栄養」に関する論文等のプレスリリースの依頼を承ります。</p>\n<!-- /wp:paragraph -->','プレスリリースの場','','inherit','closed','closed','','831-revision-v1','','','2025-03-24 11:35:14','2025-03-24 02:35:14','',831,'https://geriatrics.jp/?p=865',0,'revision','',0),(866,1,'2025-03-24 11:37:24','2025-03-24 02:37:24','','プレスリリースの場','','inherit','closed','closed','','831-revision-v1','','','2025-03-24 11:37:24','2025-03-24 02:37:24','',831,'https://geriatrics.jp/?p=866',0,'revision','',0),(867,1,'2025-03-24 12:10:31','2025-03-24 03:10:31','<!-- wp:html -->\n <p class=\"right-align\">\n2025/3/24公開　<a href=\"https://researchmap.jp/kskm\">著者：前田圭介</a>\n </p>\n\n  <style>\n    .right-align {\n      text-align: right; /* テキストを右寄せに設定 */\n    }\n  </style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','publish','open','open','','%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96','','','2025-03-24 18:57:41','2025-03-24 09:57:41','',0,'https://geriatrics.jp/?p=867',0,'post','',0),(868,1,'2025-03-24 12:10:31','2025-03-24 03:10:31','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>GLIM基準の構成</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>スクリーニングツール</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>表現型項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．体重減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>２．低BMI</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>３．筋肉量減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong><strong></strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>病因項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．栄養摂取不足・消化吸収不良</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>診断と重症度判定</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:10:31','2025-03-24 03:10:31','',867,'https://geriatrics.jp/?p=868',0,'revision','',0),(869,1,'2025-03-24 12:14:55','2025-03-24 03:14:55','','2307246_s','','inherit','open','closed','','2307246_s','','','2025-03-24 12:14:55','2025-03-24 03:14:55','',867,'https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg',0,'attachment','image/jpeg',0),(870,1,'2025-03-24 12:15:25','2025-03-24 03:15:25','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>GLIM基準の構成</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"width\":\"568px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"right\"} -->\n<figure class=\"wp-block-image alignright size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\" style=\"width:568px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>スクリーニングツール</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>表現型項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．体重減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>２．低BMI</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>３．筋肉量減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong><strong></strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>病因項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．栄養摂取不足・消化吸収不良</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>診断と重症度判定</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:15:25','2025-03-24 03:15:25','',867,'https://geriatrics.jp/?p=870',0,'revision','',0),(872,1,'2025-03-24 12:17:38','2025-03-24 03:17:38','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>GLIM基準の構成</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>スクリーニングツール</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>表現型項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．体重減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>２．低BMI</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>３．筋肉量減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong><strong></strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>病因項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．栄養摂取不足・消化吸収不良</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>診断と重症度判定</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:17:38','2025-03-24 03:17:38','',867,'https://geriatrics.jp/?p=872',0,'revision','',0),(873,1,'2025-03-24 12:18:51','2025-03-24 03:18:51','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>GLIM基準の構成</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>スクリーニングツール</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>表現型項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．体重減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>２．低BMI</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>３．筋肉量減少</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong><strong></strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>病因項目</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><a></a><strong>１．栄養摂取不足・消化吸収不良</strong><strong></strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><a></a><strong>診断と重症度判定</strong><strong></strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:18:51','2025-03-24 03:18:51','',867,'https://geriatrics.jp/?p=873',0,'revision','',0),(876,1,'2025-03-24 12:22:52','2025-03-24 03:22:52','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で>5%</strong>、または6か月超で>10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>>10%/6か月または>20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitaliz<sup data-fn=\"8ee20369-cd83-4105-90bc-644462d09e40\" class=\"fn\"><a id=\"8ee20369-cd83-4105-90bc-644462d09e40-link\" href=\"#8ee20369-cd83-4105-90bc-644462d09e40\">1</a></sup>ed patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:22:52','2025-03-24 03:22:52','',867,'https://geriatrics.jp/?p=876',0,'revision','',0),(878,1,'2025-03-24 12:25:44','2025-03-24 03:25:44','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitaliz<sup data-fn=\"8ee20369-cd83-4105-90bc-644462d09e40\" class=\"fn\"><a id=\"8ee20369-cd83-4105-90bc-644462d09e40-link\" href=\"#8ee20369-cd83-4105-90bc-644462d09e40\">1</a></sup>ed patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:25:44','2025-03-24 03:25:44','',867,'https://geriatrics.jp/?p=878',0,'revision','',0),(879,1,'2025-03-24 12:45:31','2025-03-24 03:45:31','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li>Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitaliz<sup data-fn=\"8ee20369-cd83-4105-90bc-644462d09e40\" class=\"fn\"><a id=\"8ee20369-cd83-4105-90bc-644462d09e40-link\" href=\"#8ee20369-cd83-4105-90bc-644462d09e40\">1</a></sup>ed patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 12:45:31','2025-03-24 03:45:31','',867,'https://geriatrics.jp/?p=879',0,'revision','',0),(880,1,'2025-03-24 13:00:08','2025-03-24 04:00:08','','運動・栄養・口腔','','inherit','closed','closed','','697-autosave-v1','','','2025-03-24 13:00:08','2025-03-24 04:00:08','',697,'https://geriatrics.jp/?p=880',0,'revision','',0),(881,1,'2025-03-24 13:43:10','2025-03-24 04:43:10','','page-title2','','inherit','','closed','','page-title2','','','2025-03-24 13:43:10','2025-03-24 04:43:10','',831,'https://geriatrics.jp/wp-content/uploads/2025/03/page-title2.png',0,'attachment','image/png',0),(882,1,'2025-03-24 14:34:34','2025-03-24 05:34:34','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-n\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','publish','closed','closed','','%e4%bd%93%e7%b3%bb%e5%8c%96%e3%81%95%e3%82%8c%e3%81%9f%e6%a0%84%e9%a4%8a%e3%82%b1%e3%82%a2%e3%81%a8%e3%81%af','','','2025-03-26 20:59:13','2025-03-26 11:59:13','',0,'https://geriatrics.jp/?p=882',0,'post','',0),(883,1,'2025-03-24 14:16:36','0000-00-00 00:00:00','','自動下書き','','auto-draft','','','','','','','2025-03-24 14:16:36','0000-00-00 00:00:00','',0,'https://geriatrics.jp/?p=883',0,'post','',0),(884,1,'2025-03-24 14:22:40','2025-03-24 05:22:40','','栄養ケアプロセス','','inherit','','closed','','%e6%a0%84%e9%a4%8a%e3%82%b1%e3%82%a2%e3%83%97%e3%83%ad%e3%82%bb%e3%82%b9','','','2025-03-24 14:22:40','2025-03-24 05:22:40','',882,'https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png',0,'attachment','image/png',0),(885,1,'2025-03-24 14:34:34','2025-03-24 05:34:34','<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、低栄養の患者に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-24 14:34:34','2025-03-24 05:34:34','',882,'https://geriatrics.jp/?p=885',0,'revision','',0),(887,1,'2025-03-24 14:36:37','2025-03-24 05:36:37','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、低栄養の患者に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-24 14:36:37','2025-03-24 05:36:37','',882,'https://geriatrics.jp/?p=887',0,'revision','',0),(888,1,'2025-03-24 14:42:51','2025-03-24 05:42:51','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-24 14:42:51','2025-03-24 05:42:51','',882,'https://geriatrics.jp/?p=888',0,'revision','',0),(889,1,'2025-03-24 16:34:56','0000-00-00 00:00:00','<!-- wp:html -->\n<!-- 高齢者医療ご支援募集ページ（本文部分・最終版） -->\n<div class=\"support-container\">\n  <div class=\"support-subtitle\">\n    高齢者医療の発展と情報発信を支える取り組みにご協力ください\n  </div>\n\n  <div class=\"support-message-box\">\n    <h2 class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n    <p>\n      「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を、医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n    </p>\n    <p>\n      本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および\n      <span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家が監修する公益性の高い情報発信の場です。\n    </p>\n    <p>\n      高齢者の健康課題に対する理解を深め、より良い医療とケアの実現を目指すため、日々コンテンツの充実に努めています。\n    </p>\n  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!important;\n}\n.support-organization-info h3 {\n  color: #2c5e7e !important;\n  margin-top: 0 !important;\n}\n\n/* 区切り線 */\n.support-horizontal-line {\n  border-top: 1px solid #e0e0e0 !important;\n  margin: 40px 0 !important;\n}\n\n/* フッターメッセージ */\n.support-footer-message {\n  text-align: center !important;\n  font-size: 14px !important;\n  color: #666 !important;\n  margin-top: 50px !important;\n}\n\n/* レスポンシブ対応 */\n@media (max-width: 768px) {\n  .support-types {\n    flex-direction: column !important;\n  }\n  .support-message-box {\n    padding: 25px !important;\n  }\n}\n</style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','サンプル - ご支援について','','draft','closed','closed','','sample-your-support','','','2025-03-24 16:34:56','2025-03-24 07:34:56','',0,'https://geriatrics.jp/?page_id=889',0,'page','',0),(891,1,'2025-03-24 14:44:14','2025-03-24 05:44:14','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-24 14:44:14','2025-03-24 05:44:14','',882,'https://geriatrics.jp/?p=891',0,'revision','',0),(892,1,'2025-03-24 14:46:21','2025-03-24 05:46:21','<!-- wp:html -->\n<!-- 高齢者医療ご支援募集ページ（本文部分・最終版） -->\n<div class=\"support-container\">\n  <div class=\"support-subtitle\">\n    高齢者医療の発展と情報発信を支える取り組みにご協力ください\n  </div>\n\n  <div class=\"support-message-box\">\n    <h2 class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n    <p>\n      「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を、医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n    </p>\n    <p>\n      本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および\n      <span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家が監修する公益性の高い情報発信の場です。\n    </p>\n    <p>\n      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class=\"support-container\">\n  <div class=\"support-subtitle\">\n    高齢者医療の発展と情報発信を支える取り組みにご協力ください\n  </div>\n\n  <div class=\"support-message-box\">\n    <h2 class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n    <p>\n      「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を、医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n    </p>\n    <p>\n      本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および\n      <span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家が監修する公益性の高い情報発信の場です。\n    </p>\n    <p>\n      高齢者の健康課題に対する理解を深め、より良い医療とケアの実現を目指すため、日々コンテンツの充実に努めています。\n    </p>\n  </div>\n\n  <h2 class=\"support-message-title\">ご支援いただきたい理由</h2>\n  <p>\n    当サイトは公的研究費を主な財源として運営しておりますが、より充実した情報提供と持続可能な運営のため、皆様からのご支援をお願いしております。いただいたご支援は、以下の各活動に活用させていただきます：\n  </p>\n\n  <div class=\"support-types\">\n    <div class=\"support-card\">\n      <h3>情報発信の強化</h3>\n      <p>\n        最新の研究成果や医療情報を、専門性とわかりやすさを兼ね備えたコンテンツとして発信する取り組みをサポートします。\n      </p>\n    </div>\n    <div class=\"support-card\">\n      <h3>教育資料の作成</h3>\n      <p>\n        医療従事者向けの教育資料や、一般の方々が高齢者医療を理解するための資料作成の支援に充てます。\n      </p>\n    </div>\n    <div class=\"support-card\">\n      <h3>研究活動の支援</h3>\n      <p>\n        高齢者医療の質向上に直結する研究活動を推進し、その成果を広く社会へ還元する取り組みに役立てます。\n      </p>\n    </div>\n  </div>\n\n  <div class=\"support-organization-info\">\n    <h3>資金管理について</h3>\n    <p>\n      いただいたご支援は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門により、適切に管理・運用されます。使途については、定期的に本サイト上でご報告いたします。\n    </p>\n  </div>\n\n  <div class=\"support-horizontal-line\"></div>\n\n  <h2 class=\"support-message-title\">ご支援の方法</h2>\n  <p>\n    ご支援には以下の方法がございます。いずれの場合も税制上の優遇措置が適用される可能性がございますので、詳細は各機関にお問い合わせください。\n  </p>\n\n  <div class=\"support-types\">\n    <div class=\"support-card\">\n      <h3>企業の皆様</h3>\n      <p>\n        奨学寄附金、共同研究、受託研究などの形でご支援いただけます。具体的な連携方法についてはお気軽にご相談ください。\n      </p>\n      <a href=\"#\" class=\"support-btn\">詳細はこちら</a>\n    </div>\n    <div class=\"support-card\">\n      <h3>個人の皆様</h3>\n      <p>\n        個人寄付も受け付けております。金額の大小を問わず、皆様の温かいご支援が活動の原動力となります。\n      </p>\n      <a href=\"#\" class=\"support-btn\">寄付をする</a>\n    </div>\n  </div>\n\n  <p class=\"support-footer-message\">\n    ※本サイトへのご支援は任意です。支援の有無にかかわらず、提供される情報やサービスに差異はございません。<br>\n    皆様のあたたかいご支援を心よりお待ちしております。\n  </p>\n</div>\n<!-- /wp:html -->\n\n<!-- wp:html -->\n<style>\n/* 全体コンテナ */\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif !important;\n  line-height: 1.7 !important;\n  color: #333 !important;\n  max-width: 1000px !important;\n  margin: 0 auto !important;\n  padding: 20px !important;\n}\n\n/* サブタイトル */\n.support-subtitle {\n  font-size: 16px !important;\n  color: #666 !important;\n  margin-bottom: 30px !important;\n  text-align: center !important;\n}\n\n/* メッセージボックス */\n.support-message-box {\n  background-color: #fff !important;\n  border-radius: 10px !important;\n  padding: 40px !important;\n  box-shadow: 0 0 15px rgba(0, 0, 0, 0.05) !important;\n  margin-bottom: 40px !important;\n}\n\n/* セクションタイトル */\n.support-message-title {\n  color: #2c5e7e !important;\n  border-bottom: 1px solid #e0e0e0 !important;\n  padding-bottom: 15px !important;\n  margin-bottom: 25px !important;\n  font-size: 22px !important;\n}\n\n/* 強調テキスト */\n.support-highlight {\n  color: #2c5e7e !important;\n  font-weight: bold !important;\n}\n\n/* サポートカードグリッド */\n.support-types {\n  display: flex !important;\n  flex-wrap: wrap !important;\n  gap: 30px !important;\n  margin: 40px 0 !important;\n}\n\n/* 各サポートカード */\n.support-card {\n  flex: 1 !important;\n  min-width: 280px !important;\n  background-color: #fff !important;\n  border-radius: 8px !important;\n  padding: 25px !important;\n  box-shadow: 0 0 10px rgba(0, 0, 0, 0.05) !important;\n  transition: transform 0.3s ease !important;\n}\n.support-card:hover {\n  transform: translateY(-5px) !important;\n}\n\n/* カード内のタイトル */\n.support-card h3 {\n  color: #2c5e7e !important;\n  font-size: 18px !important;\n  margin-top: 0 !important;\n}\n\n/* ボタン */\n.support-btn {\n  display: inline-block !important;\n  background-color: #2c5e7e !important;\n  color: #ffffff !important;\n  padding: 12px 30px !important;\n  border-radius: 30px !important;\n  text-decoration: none !important;\n  margin-top: 15px !important;\n  transition: background-color 0.3s ease !important;\n}\n.support-btn:hover {\n  background-color: #1f4666 !important;\n}\n\n/* 組織情報 */\n.support-organization-info {\n  background-color: #f3f7fa !important;\n  padding: 25px !important;\n  border-radius: 8px !important;\n  margin-top: 30px !important;\n}\n.support-organization-info h3 {\n  color: #2c5e7e !important;\n  margin-top: 0 !important;\n}\n\n/* 区切り線 */\n.support-horizontal-line {\n  border-top: 1px solid #e0e0e0 !important;\n  margin: 40px 0 !important;\n}\n\n/* フッターメッセージ */\n.support-footer-message {\n  text-align: center !important;\n  font-size: 14px !important;\n  color: #666 !important;\n  margin-top: 50px !important;\n}\n\n/* レスポンシブ対応 */\n@media (max-width: 768px) {\n  .support-types {\n    flex-direction: column !important;\n  }\n  .support-message-box {\n    padding: 25px !important;\n  }\n}\n</style>\n<!-- /wp:html -->','サンプル - ご支援について','','inherit','closed','closed','','889-revision-v1','','','2025-03-24 14:56:48','2025-03-24 05:56:48','',889,'https://geriatrics.jp/?p=893',0,'revision','',0),(894,1,'2025-03-24 15:13:34','2025-03-24 06:13:34','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":724,\"width\":\"1280px\",\"height\":\"auto\",\"aspectRatio\":\"1\",\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large is-resized single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-02-1-1024x683.webp\" alt=\"\" class=\"wp-image-724\" style=\"aspect-ratio:1;width:1280px;height:auto\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":730,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-08-1-1024x683.webp\" alt=\"\" class=\"wp-image-730\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート3','','inherit','closed','closed','','789-revision-v1','','','2025-03-24 15:13:34','2025-03-24 06:13:34','',789,'https://geriatrics.jp/?p=894',0,'revision','',0),(895,1,'2025-03-24 15:14:19','2025-03-24 06:14:19','<!-- wp:heading {\"level\":1} -->\n<h1 class=\"wp-block-heading\">栄養サポート</h1>\n<!-- /wp:heading -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト左\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/772\"},\"className\":\"single-textleft\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textleft\"><!-- wp:paragraph {\"className\":\"single-textleft-text\"} -->\n<p class=\"single-textleft-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":724,\"width\":\"1280px\",\"height\":\"auto\",\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textleft-pict\"} -->\n<figure class=\"wp-block-image size-large is-resized single-textleft-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-02-1-1024x683.webp\" alt=\"\" class=\"wp-image-724\" style=\"width:1280px;height:auto\"/></figure>\n<!-- /wp:image --></div>\n<!-- /wp:group -->\n\n<!-- wp:group {\"metadata\":{\"name\":\"レイアウト2 - テキスト右\",\"categories\":[\"geriatricsjp\",\"layout\"],\"patternName\":\"core/block/773\"},\"className\":\"single-textright\",\"layout\":{\"type\":\"constrained\"}} -->\n<div class=\"wp-block-group single-textright\"><!-- wp:image {\"id\":730,\"sizeSlug\":\"large\",\"linkDestination\":\"none\",\"className\":\"single-textright-pict\"} -->\n<figure class=\"wp-block-image size-large single-textright-pict\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-08-1-1024x683.webp\" alt=\"\" class=\"wp-image-730\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"className\":\"single-textright-text\"} -->\n<p class=\"single-textright-text\">ダミーテキストです。ここは今度いったいその意味社に対するのの以上の行くたん。人知れず今日を使用家はぼうっとその徴ましょんばかりがしてしまいましにはまごまごするますませて、こうには見えるでないたでし。珍で認めありつもりははなはだ今日がもとよりですたない。<br>けっして大森さんに影響賞そう見当に読んた人そんな一道私か試験のというご欠乏ませななけれないから、その当時はあなたか性格人をするて、大森さんの 事に筆のそれでついに同記憶と当てるばあなた国家がごお話を焼いようにいったいお意味から生きあるですが、ざっとざっと存在にしですてありで事で云い た。</p>\n<!-- /wp:paragraph --></div>\n<!-- /wp:group -->\n\n<!-- wp:paragraph -->\n<p>低栄養診断とは、個人の栄養状態が不足している状態を評価・特定するための医学的プロセスです。これは単に「痩せている」という外見的な判断ではなく、科学的根拠に基づいた総合的な評価を指します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態は、高齢者や入院患者、慢性疾患を持つ人々に多く見られますが、一見健康に見える若年層でも発生する可能性があります。特に近年では、無理なダイエットや偏った食生活により、「隠れ低栄養」と呼ばれる状態が社会問題となっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断方法</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の診断には複数の指標が用いられます：</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>身体計測</strong>：体重、BMI、上腕周囲長、皮下脂肪厚などの測定が基本となります。BMIが18.5未満の場合、低栄養のリスクが高まると考えられています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>血液検査</strong>：アルブミン、プレアルブミン、トランスフェリン、総リンパ球数などのタンパク質や免疫関連の指標を測定します。特にアルブミン値は栄養状態を反映する重要な指標とされています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>機能評価</strong>：握力測定や歩行速度などの身体機能評価も重要な診断要素です。栄養不足により筋力低下が起こることが多いためです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取状況</strong>：食事記録や食事歴の聴取を通じて、エネルギーやタンパク質、ビタミン、ミネラルなどの栄養素摂取量を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">低栄養の影響</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養状態が続くと、免疫機能の低下、創傷治癒の遅延、筋力低下、転倒リスクの増加、認知機能の低下など、様々な健康問題を引き起こします。特に高齢者では、サルコペニア（筋肉量減少）やフレイル（虚弱）の原因となり、QOL（生活の質）の著しい低下につながります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">診断の重要性</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低栄養の早期発見・早期介入は、合併症予防や治療効果の向上、入院期間の短縮、医療費削減などにつながります。特に高齢者医療や慢性疾患管理において、栄養スクリーニングは標準的なケアの一部として推奨されています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>近年では、地域包括ケアシステムの中で、多職種連携による栄養ケア・マネジメントの重要性が認識され、医師、管理栄養士、看護師、ケアマネージャーなどが協力して低栄養の予防・改善に取り組んでいます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>適切な低栄養診断は、個々の状態に合わせた栄養サポートの第一歩であり、健康寿命の延伸や生活の質の向上に不可欠な要素といえるでしょう。</p>\n<!-- /wp:paragraph -->','サンプル - 栄養サポート3','','inherit','closed','closed','','789-revision-v1','','','2025-03-24 15:14:19','2025-03-24 06:14:19','',789,'https://geriatrics.jp/?p=895',0,'revision','',0),(896,1,'2025-03-24 15:19:00','0000-00-00 00:00:00','','自動下書き','','auto-draft','','','','','','','2025-03-24 15:19:00','0000-00-00 00:00:00','',0,'https://geriatrics.jp/?p=896',0,'post','',0),(898,1,'2025-03-24 15:28:18','2025-03-24 06:28:18','<!-- wp:html -->\n<!-- HTML Code -->\n<div class=\"content\">\n  <section class=\"intro\">\n    <h2>老年栄養ドットコムとは</h2>\n    <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  </section>\n\n  <section class=\"funding\">\n    <h2>研究費の使用と運用管理について</h2>\n    <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n    <ul>\n      <li><strong>研究費管理部門による厳格な運用:</strong> 研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援いただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</li>\n      <li><strong>利益相反の回避:</strong> 当サイトは営利団体の<em>広告収益などを目的としておらず</em>、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</li>\n    </ul>\n  </section>\n\n  <section class=\"usage\">\n    <h2>ご支援の活用方法</h2>\n    <ol>\n      <li><strong>研究活動の充実・発展:</strong> 高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</li>\n      <li><strong>情報発信の拡充:</strong> 最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</li>\n      <li><strong>サイト運営の維持:</strong> サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</li>\n    </ol>\n  </section>\n\n  <section class=\"support\">\n    <h2>ご支援の方法</h2>\n    <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずはお問い合わせフォームからお問い合わせください。</p>\n    <ul>\n      <li><strong>寄付（奨学寄付）:</strong> ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</li>\n      <li><strong>産学共同研究のご提案:</strong> 高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</li>\n      <li><strong>その他のご支援:</strong> 広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</li>\n    </ul>\n  </section>\n\n  <section class=\"gratitude\">\n    <h2>皆さまへの感謝</h2>\n    <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n  </section>\n</div>\n\n/* CSS Code */\nbody {\n  font-family: \'Helvetica Neue\', Helvetica, Arial, sans-serif;\n  background: #f4f4f4;\n  margin: 0;\n  padding: 20px;\n  color: #333;\n}\n\n.content {\n  max-width: 800px;\n  margin: 0 auto;\n  background: #fff;\n  padding: 30px;\n  box-shadow: 0 4px 12px rgba(0, 0, 0, 0.1);\n  border-radius: 8px;\n}\n\n.content h2 {\n  font-size: 1.8em;\n  color: #2c3e50;\n  border-bottom: 2px solid #ecf0f1;\n  padding-bottom: 10px;\n  margin-bottom: 20px;\n}\n\n.content p {\n  line-height: 1.6;\n  margin-bottom: 20px;\n  text-align: justify;\n}\n\n.content ul,\n.content ol {\n  margin: 20px 0;\n  padding-left: 20px;\n}\n\n.content li {\n  margin-bottom: 10px;\n}\n\n.content strong {\n  color: #2980b9;\n}\n\n.content em {\n  color: #e74c3c;\n}\n\n<!-- /wp:html -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">老年栄養ドットコムとは</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">研究費の使用と運用管理について</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究費管理部門による厳格な運用</strong><br>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>利益相反の回避</strong><br>当サイトは営利団体の<em>広告収益などを目的としておらず</em>、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の活用方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究活動の充実・発展</strong><br>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>情報発信の拡充</strong><br>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>サイト運営の維持</strong><br>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずは<a href=\"https://geriatrics.jp/contact/\">お問い合わせ</a>フォームからお問い合わせください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>寄付（奨学寄付）</strong><br>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>産学<strong>共同研究のご提案</strong><br>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>その他のご支援</strong><br>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">皆さまへの感謝</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 15:28:18','2025-03-24 06:28:18','',849,'https://geriatrics.jp/?p=898',0,'revision','',0),(899,1,'2025-03-24 15:34:01','2025-03-24 06:34:01','<!-- wp:html -->\n<!-- HTML Code -->\n<div class=\"content\">\n  <section class=\"intro\">\n    <h2>老年栄養ドットコムとは</h2>\n    <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  </section>\n\n  <section class=\"funding\">\n    <h2>研究費の使用と運用管理について</h2>\n    <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n    <ul>\n      <li><strong>研究費管理部門による厳格な運用:</strong> 研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援いただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</li>\n      <li><strong>利益相反の回避:</strong> 当サイトは営利団体の<em>広告収益などを目的としておらず</em>、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</li>\n    </ul>\n  </section>\n\n  <section class=\"usage\">\n    <h2>ご支援の活用方法</h2>\n    <ol>\n      <li><strong>研究活動の充実・発展:</strong> 高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</li>\n      <li><strong>情報発信の拡充:</strong> 最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</li>\n      <li><strong>サイト運営の維持:</strong> サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</li>\n    </ol>\n  </section>\n\n  <section class=\"support\">\n    <h2>ご支援の方法</h2>\n    <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずはお問い合わせフォームからお問い合わせください。</p>\n    <ul>\n      <li><strong>寄付（奨学寄付）:</strong> ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</li>\n      <li><strong>産学共同研究のご提案:</strong> 高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</li>\n      <li><strong>その他のご支援:</strong> 広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</li>\n    </ul>\n  </section>\n\n  <section class=\"gratitude\">\n    <h2>皆さまへの感謝</h2>\n    <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n  </section>\n</div>\n\n<style>\n  /* CSS Code */\n  body {\n    font-family: \'Helvetica Neue\', Helvetica, Arial, sans-serif;\n    background: #f4f4f4;\n    margin: 0;\n    padding: 20px;\n    color: #333;\n  }\n\n  .content {\n    max-width: 800px;\n    margin: 0 auto;\n    background: #fff;\n    padding: 30px;\n    box-shadow: 0 4px 12px rgba(0, 0, 0, 0.1);\n    border-radius: 8px;\n  }\n\n  .content h2 {\n    font-size: 1.8em;\n    color: #2c3e50;\n    border-bottom: 2px solid #ecf0f1;\n    padding-bottom: 10px;\n    margin-bottom: 20px;\n  }\n\n  .content p {\n    line-height: 1.6;\n    margin-bottom: 20px;\n    text-align: justify;\n  }\n\n  .content ul,\n  .content ol {\n    margin: 20px 0;\n    padding-left: 20px;\n  }\n\n  .content li {\n    margin-bottom: 10px;\n  }\n\n  .content strong {\n    color: #2980b9;\n  }\n\n  .content em {\n    color: #e74c3c;\n  }\n</style>\n\n<!-- /wp:html -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">老年栄養ドットコムとは</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">研究費の使用と運用管理について</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究費管理部門による厳格な運用</strong><br>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>利益相反の回避</strong><br>当サイトは営利団体の<em>広告収益などを目的としておらず</em>、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の活用方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究活動の充実・発展</strong><br>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>情報発信の拡充</strong><br>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>サイト運営の維持</strong><br>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずは<a href=\"https://geriatrics.jp/contact/\">お問い合わせ</a>フォームからお問い合わせください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>寄付（奨学寄付）</strong><br>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>産学<strong>共同研究のご提案</strong><br>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>その他のご支援</strong><br>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">皆さまへの感謝</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 15:34:01','2025-03-24 06:34:01','',849,'https://geriatrics.jp/?p=899',0,'revision','',0),(901,1,'2025-03-24 15:48:15','2025-03-24 06:48:15','<!-- wp:html -->\n<div class=\"support-container\">\n  <h2><b>老年栄養ドットコムとは</b></h2>\n  <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  \n  <h2><b>研究費の使用と運用管理について</b></h2>\n  <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n  \n  <h3>研究費管理部門による厳格な運用</h3>\n  <p>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</p>\n  \n  <h3>利益相反の回避</h3>\n  <p>当サイトは営利団体の広告収益などを目的としておらず、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</p>\n  \n  <h2><b>ご支援の活用方法</b></h2>\n  <p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n  \n  <h3>研究活動の充実・発展</h3>\n  <p>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</p>\n  \n  <h3>情報発信の拡充</h3>\n  <p>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</p>\n  \n  <h3>サイト運営の維持</h3>\n  <p>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</p>\n  \n  <h2><b>ご支援の方法</b></h2>\n  <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずはお問い合わせフォームからお問い合わせください。</p>\n  \n  <h3>寄付（奨学寄付）</h3>\n  <p>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</p>\n  \n  <h3>産学共同研究のご提案</h3>\n  <p>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</p>\n  \n  <h3>その他のご支援</h3>\n  <p>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</p>\n  \n  <h2><b>皆さまへの感謝</b></h2>\n  <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>\n  「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n</div>\n\n<style>\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  line-height: 1.7;\n  color: #333;\n  max-width: 1000px;\n  margin: 0 auto;\n  padding: 20px;\n}\n.support-container h2 {\n  text-align: center;\n  color: #2c5e7e;\n  border-bottom: 1px solid #e0e0e0;\n  padding-bottom: 10px;\n  margin-top: 40px;\n  margin-bottom: 20px;\n  font-size: 24px;\n}\n.support-container h3 {\n  color: #2c5e7e;\n  margin-top: 30px;\n  margin-bottom: 10px;\n  font-size: 20px;\n}\n.support-container p {\n  margin-bottom: 20px;\n  text-align: justify;\n}\n@media (max-width: 768px) {\n  .support-container {\n    padding: 15px;\n  }\n  .support-container h2 {\n    font-size: 20px;\n  }\n  .support-container h3 {\n    font-size: 18px;\n  }\n}\n</style>\n\n<!-- /wp:html -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">老年栄養ドットコムとは</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">研究費の使用と運用管理について</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究費管理部門による厳格な運用</strong><br>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>利益相反の回避</strong><br>当サイトは営利団体の<em>広告収益などを目的としておらず</em>、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の活用方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list {\"ordered\":true} -->\n<ol class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>研究活動の充実・発展</strong><br>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>情報発信の拡充</strong><br>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>サイト運営の維持</strong><br>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</li>\n<!-- /wp:list-item --></ol>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">ご支援の方法</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずは<a href=\"https://geriatrics.jp/contact/\">お問い合わせ</a>フォームからお問い合わせください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li><strong>寄付（奨学寄付）</strong><br>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>産学<strong>共同研究のご提案</strong><br>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li><strong>その他のご支援</strong><br>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:heading {\"level\":3,\"className\":\"\"} -->\n<h3 class=\"wp-block-heading\">皆さまへの感謝</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph {\"className\":\"\"} -->\n<p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 15:48:15','2025-03-24 06:48:15','',849,'https://geriatrics.jp/?p=901',0,'revision','',0),(902,1,'2025-03-24 15:48:24','2025-03-24 06:48:24','<!-- wp:html -->\n<div class=\"support-container\">\n  <h2><b>老年栄養ドットコムとは</b></h2>\n  <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  \n  <h2><b>研究費の使用と運用管理について</b></h2>\n  <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n  \n  <h3>研究費管理部門による厳格な運用</h3>\n  <p>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</p>\n  \n  <h3>利益相反の回避</h3>\n  <p>当サイトは営利団体の広告収益などを目的としておらず、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</p>\n  \n  <h2><b>ご支援の活用方法</b></h2>\n  <p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n  \n  <h3>研究活動の充実・発展</h3>\n  <p>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</p>\n  \n  <h3>情報発信の拡充</h3>\n  <p>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</p>\n  \n  <h3>サイト運営の維持</h3>\n  <p>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</p>\n  \n  <h2><b>ご支援の方法</b></h2>\n  <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。まずはお問い合わせフォームからお問い合わせください。</p>\n  \n  <h3>寄付（奨学寄付）</h3>\n  <p>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</p>\n  \n  <h3>産学共同研究のご提案</h3>\n  <p>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</p>\n  \n  <h3>その他のご支援</h3>\n  <p>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</p>\n  \n  <h2><b>皆さまへの感謝</b></h2>\n  <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>\n  「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n</div>\n\n<style>\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  line-height: 1.7;\n  color: #333;\n  max-width: 1000px;\n  margin: 0 auto;\n  padding: 20px;\n}\n.support-container h2 {\n  text-align: center;\n  color: #2c5e7e;\n  border-bottom: 1px solid #e0e0e0;\n  padding-bottom: 10px;\n  margin-top: 40px;\n  margin-bottom: 20px;\n  font-size: 24px;\n}\n.support-container h3 {\n  color: #2c5e7e;\n  margin-top: 30px;\n  margin-bottom: 10px;\n  font-size: 20px;\n}\n.support-container p {\n  margin-bottom: 20px;\n  text-align: justify;\n}\n@media (max-width: 768px) {\n  .support-container {\n    padding: 15px;\n  }\n  .support-container h2 {\n    font-size: 20px;\n  }\n  .support-container h3 {\n    font-size: 18px;\n  }\n}\n</style>\n\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 15:48:24','2025-03-24 06:48:24','',849,'https://geriatrics.jp/?p=902',0,'revision','',0),(904,1,'2025-03-24 15:51:40','2025-03-24 06:51:40','<!-- wp:html -->\n<div class=\"support-container\">\n  <h2><b>老年栄養ドットコムとは</b></h2>\n  <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  \n  <h2><b>研究費の使用と運用管理について</b></h2>\n  <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n  \n  <h3>研究費管理部門による厳格な運用</h3>\n  <p>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</p>\n  \n  <h3>利益相反の回避</h3>\n  <p>当サイトは営利団体の広告収益などを目的としておらず、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</p>\n  \n  <h2><b>ご支援の活用方法</b></h2>\n  <p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n  \n  <h3>研究活動の充実・発展</h3>\n  <p>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</p>\n  \n  <h3>情報発信の拡充</h3>\n  <p>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</p>\n  \n  <h3>サイト運営の維持</h3>\n  <p>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</p>\n  \n  <h2><b>ご支援の方法</b></h2>\n  <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。<a href=\"https://geriatrics.jp/contact/\">まずは<strong><b>お問い合わせフォーム</b></strong>から</a>お問い合わせください。</p>\n  \n  <h3>寄付（奨学寄付）</h3>\n  <p>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</p>\n  \n  <h3>産学共同研究のご提案</h3>\n  <p>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</p>\n  \n  <h3>その他のご支援</h3>\n  <p>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</p>\n  \n  <h2><b>皆さまへの感謝</b></h2>\n  <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>\n  「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n</div>\n\n<style>\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  line-height: 1.7;\n  color: #333;\n  max-width: 1000px;\n  margin: 0 auto;\n  padding: 20px;\n}\n.support-container h2 {\n  text-align: center;\n  color: #2c5e7e;\n  border-bottom: 1px solid #e0e0e0;\n  padding-bottom: 10px;\n  margin-top: 40px;\n  margin-bottom: 20px;\n  font-size: 24px;\n}\n.support-container h3 {\n  color: #2c5e7e;\n  margin-top: 30px;\n  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06:52:23','お問い合わせ\ntest\nkskmaeda@aichi-med-u.ac.jp\ntestお問い合わせ\n6\n192.218.116.221\nMozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Safari/537.36\nhttps://geriatrics.jp/contact/\n2025年3月24日\n3:52 PM\n805\ncontact\n申請・お問い合わせ\nhttps://geriatrics.jp/contact/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-6','','','2025-03-24 15:52:23','2025-03-24 06:52:23','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=906',0,'flamingo_inbound','',0),(907,0,'2025-03-24 15:53:22','2025-03-24 06:53:22','プレスリリースの申請\nテスト名前\nkskmaeda@aichi-med-u.ac.jp\nテストプレス\n9dd8890742193deb54a26ddbc0158138\n7\n192.218.116.221\nMozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Safari/537.36\nhttps://geriatrics.jp/contact/\n2025年3月24日\n3:53 PM\n805\ncontact\n申請・お問い合わせ\nhttps://geriatrics.jp/contact/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-7','','','2025-03-24 15:53:22','2025-03-24 06:53:22','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=907',0,'flamingo_inbound','',0),(908,1,'2025-03-24 16:34:56','2025-03-24 07:34:56','<!-- wp:html -->\n<!-- 高齢者医療ご支援募集ページ（本文部分・最終版） -->\n<div class=\"support-container\">\n  <div class=\"support-subtitle\">\n    高齢者医療の発展と情報発信を支える取り組みにご協力ください\n  </div>\n\n  <div class=\"support-message-box\">\n    <h2 class=\"support-message-title\">老年医学の発展と社会貢献へのビジョン</h2>\n    <p>\n      「老年医学ポータルサイト」は、高齢化社会において重要性を増す老年医学の最新知見を、医療従事者や一般の方々に広くお届けすることを目指して運営しています。\n    </p>\n    <p>\n      本サイトは、<span class=\"support-highlight\">愛知医科大学</span>および\n      <span class=\"support-highlight\">国立長寿医療研究センター</span>の研究者を中心に、高齢者医療の専門家が監修する公益性の高い情報発信の場です。\n    </p>\n    <p>\n      高齢者の健康課題に対する理解を深め、より良い医療とケアの実現を目指すため、日々コンテンツの充実に努めています。\n    </p>\n  </div>\n\n  <h2 class=\"support-message-title\">ご支援いただきたい理由</h2>\n  <p>\n    当サイトは公的研究費を主な財源として運営しておりますが、より充実した情報提供と持続可能な運営のため、皆様からのご支援をお願いしております。いただいたご支援は、以下の各活動に活用させていただきます：\n  </p>\n\n  <div class=\"support-types\">\n    <div class=\"support-card\">\n      <h3>情報発信の強化</h3>\n      <p>\n        最新の研究成果や医療情報を、専門性とわかりやすさを兼ね備えたコンテンツとして発信する取り組みをサポートします。\n      </p>\n    </div>\n    <div class=\"support-card\">\n      <h3>教育資料の作成</h3>\n      <p>\n        医療従事者向けの教育資料や、一般の方々が高齢者医療を理解するための資料作成の支援に充てます。\n      </p>\n    </div>\n    <div class=\"support-card\">\n      <h3>研究活動の支援</h3>\n      <p>\n        高齢者医療の質向上に直結する研究活動を推進し、その成果を広く社会へ還元する取り組みに役立てます。\n      </p>\n    </div>\n  </div>\n\n  <div class=\"support-organization-info\">\n    <h3>資金管理について</h3>\n    <p>\n      いただいたご支援は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門により、適切に管理・運用されます。使途については、定期的に本サイト上でご報告いたします。\n    </p>\n  </div>\n\n  <div class=\"support-horizontal-line\"></div>\n\n  <h2 class=\"support-message-title\">ご支援の方法</h2>\n  <p>\n    ご支援には以下の方法がございます。いずれの場合も税制上の優遇措置が適用される可能性がございますので、詳細は各機関にお問い合わせください。\n  </p>\n\n  <div class=\"support-types\">\n    <div class=\"support-card\">\n      <h3>企業の皆様</h3>\n      <p>\n        奨学寄附金、共同研究、受託研究などの形でご支援いただけます。具体的な連携方法についてはお気軽にご相談ください。\n      </p>\n      <a href=\"#\" class=\"support-btn\">詳細はこちら</a>\n    </div>\n    <div class=\"support-card\">\n      <h3>個人の皆様</h3>\n      <p>\n        個人寄付も受け付けております。金額の大小を問わず、皆様の温かいご支援が活動の原動力となります。\n      </p>\n      <a href=\"#\" class=\"support-btn\">寄付をする</a>\n    </div>\n  </div>\n\n  <p class=\"support-footer-message\">\n    ※本サイトへのご支援は任意です。支援の有無にかかわらず、提供される情報やサービスに差異はございません。<br>\n    皆様のあたたかいご支援を心よりお待ちしております。\n  </p>\n</div>\n<!-- /wp:html -->\n\n<!-- wp:html -->\n<style>\n/* 全体コンテナ */\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif !important;\n  line-height: 1.7 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!important;\n  padding: 25px !important;\n  border-radius: 8px !important;\n  margin-top: 30px !important;\n}\n.support-organization-info h3 {\n  color: #2c5e7e !important;\n  margin-top: 0 !important;\n}\n\n/* 区切り線 */\n.support-horizontal-line {\n  border-top: 1px solid #e0e0e0 !important;\n  margin: 40px 0 !important;\n}\n\n/* フッターメッセージ */\n.support-footer-message {\n  text-align: center !important;\n  font-size: 14px !important;\n  color: #666 !important;\n  margin-top: 50px !important;\n}\n\n/* レスポンシブ対応 */\n@media (max-width: 768px) {\n  .support-types {\n    flex-direction: column !important;\n  }\n  .support-message-box {\n    padding: 25px !important;\n  }\n}\n</style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','サンプル - ご支援について','','inherit','closed','closed','','889-revision-v1','','','2025-03-24 16:34:56','2025-03-24 07:34:56','',889,'https://geriatrics.jp/?p=908',0,'revision','',0),(909,1,'2025-03-24 16:35:43','2025-03-24 07:35:43','<!-- wp:html -->\n<div class=\"support-container\">\n  <h2><b>老年栄養ドットコムとは</b></h2>\n  <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  \n  <h2><b>研究費の使用と運用管理について</b></h2>\n  <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n  \n  <h3>研究費管理部門による厳格な運用</h3>\n  <p>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</p>\n  \n  <h3>利益相反の回避</h3>\n  <p>当サイトは営利団体の広告収益などを目的としておらず、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</p>\n  \n  <h2><b>ご支援の活用方法</b></h2>\n  <p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n  \n  <h3>研究活動の充実・発展</h3>\n  <p>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</p>\n  \n  <h3>情報発信の拡充</h3>\n  <p>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</p>\n  \n  <h3>サイト運営の維持</h3>\n  <p>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</p>\n  \n  <h2><b>ご支援の方法</b></h2>\n  <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。<a href=\"https://geriatrics.jp/contact/\">まずは<strong><b>お問い合わせフォーム</b></strong>から</a>お問い合わせください。</p>\n  \n  <h3>寄付（奨学寄付）</h3>\n  <p>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</p>\n  \n  <h3>産学共同研究のご提案</h3>\n  <p>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</p>\n  \n  <h3>その他のご支援</h3>\n  <p>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</p>\n  \n  <h2><b>皆さまへの感謝</b></h2>\n  <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>\n  「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n</div>\n<!-- /wp:html -->\n\n<!-- wp:html -->\n<style>\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  line-height: 1.7;\n  color: #333;\n  max-width: 1000px;\n  margin: 0 auto;\n  padding: 20px;\n}\n.support-container h2 {\n  text-align: center;\n  color: #2c5e7e;\n  border-bottom: 1px solid #e0e0e0;\n  padding-bottom: 10px;\n  margin-top: 40px;\n  margin-bottom: 20px;\n  font-size: 24px;\n}\n.support-container h3 {\n  color: #2c5e7e;\n  margin-top: 30px;\n  margin-bottom: 10px;\n  font-size: 20px;\n}\n.support-container p {\n  margin-bottom: 20px;\n  text-align: justify;\n}\n@media (max-width: 768px) {\n  .support-container {\n    padding: 15px;\n  }\n  .support-container h2 {\n    font-size: 20px;\n  }\n  .support-container h3 {\n    font-size: 18px;\n  }\n}\n</style>\n<!-- /wp:html -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 16:35:43','2025-03-24 07:35:43','',849,'https://geriatrics.jp/?p=909',0,'revision','',0),(910,1,'2025-03-24 16:37:00','2025-03-24 07:37:00','<!-- wp:quote -->\n<blockquote class=\"wp-block-quote\"><!-- wp:paragraph -->\n<p>「研究論文など重要な発表をしても、世間へのアウトリーチが十分ではない」<br><br></p>\n<!-- /wp:paragraph --></blockquote>\n<!-- /wp:quote -->\n\n<!-- wp:paragraph -->\n<p>──そんな課題を解決するため、本コーナー「プレスリリースの場」では、老年栄養や関連分野の研究者・専門家が、新たな研究成果をわかりやすく発信できるスペースを提供します。<br>論文が学会や専門誌に掲載されても、一般の方々には十分に届かないことが多いため、メディアや広く社会に向けて情報をまとめ、高齢社会の課題解決に役立つ知見をお届けします。<br>本コーナーが橋渡しとなり、研究の重要性に触れる機会を増やします。ぜひ当コーナーをご活用いただき、研究の価値をさらに広めましょう。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>老年医学、栄養学、臨床栄養学、リハビリテーション医学、老年看護学、緩和医療学、社会科学、心理学など、あらゆる「広義の栄養」に関する論文等のプレスリリースの依頼を承ります。</p>\n<!-- /wp:paragraph -->','プレスリリースの場','','inherit','closed','closed','','831-revision-v1','','','2025-03-24 16:37:00','2025-03-24 07:37:00','',831,'https://geriatrics.jp/?p=910',0,'revision','',0),(912,1,'2025-03-24 16:39:11','2025-03-24 07:39:11','<!-- wp:html -->\n<div class=\"article-container\">\n  <p class=\"quote\">「研究論文など重要な発表をしても、世間へのアウトリーチが十分ではない」</p>\n  <br><br><br>\n  <p>──そんな課題を解決するため、本コーナー「プレスリリースの場」では、老年栄養や関連分野の研究者・専門家が、新たな研究成果をわかりやすく発信できるスペースを提供します。</p>\n  <p>論文が学会や専門誌に掲載されても、一般の方々には十分に届かないことが多いため、メディアや広く社会に向けて情報をまとめ、高齢社会の課題解決に役立つ知見をお届けします。</p>\n  <p>本コーナーが橋渡しとなり、研究の重要性に触れる機会を増やします。ぜひ当コーナーをご活用いただき、研究の価値をさらに広めましょう。</p>\n  <p>老年医学、栄養学、臨床栄養学、リハビリテーション医学、老年看護学、緩和医療学、社会科学、心理学など、あらゆる「広義の栄養」に関する論文等のプレスリリースの依頼を承ります。</p>\n</div>\n\n<!-- /wp:html -->\n\n<!-- wp:html -->\n<style>\n.article-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  max-width: 900px;\n  margin: 40px auto;\n  padding: 20px;\n  background-color: #fff;\n  border-radius: 10px;\n  box-shadow: 0 4px 15px rgba(0, 0, 0, 0.1);\n  color: #333;\n  line-height: 1.8;\n}\n\n.article-container .quote {\n  font-size: 24px;\n  font-weight: bold;\n  color: #2c5e7e;\n  text-align: center;\n  margin-bottom: 20px;\n}\n\n.article-container p {\n  margin-bottom: 20px;\n  text-align: justify;\n  font-size: 16px;\n}\n\n@media (max-width: 768px) {\n  .article-container {\n    margin: 20px;\n    padding: 15px;\n  }\n  .article-container .quote {\n    font-size: 20px;\n  }\n  .article-container p {\n    font-size: 14px;\n  }\n}\n</style>\n<!-- /wp:html -->','プレスリリースの場','','inherit','closed','closed','','831-revision-v1','','','2025-03-24 16:39:11','2025-03-24 07:39:11','',831,'https://geriatrics.jp/?p=912',0,'revision','',0),(913,1,'2025-03-24 16:41:28','2025-03-24 07:41:28','','プレスリリースの場','','inherit','closed','closed','','831-revision-v1','','','2025-03-24 16:41:28','2025-03-24 07:41:28','',831,'https://geriatrics.jp/?p=913',0,'revision','',0),(914,0,'2025-03-24 16:47:40','2025-03-24 07:47:40','お問い合わせ\nテスト三郎\ninfo@cocoa-project.com\nテスト送信\n8\n106.73.142.226\nMozilla/5.0 (Linux; Android 6.0; Nexus 5 Build/MRA58N) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Mobile Safari/537.36 Edg/134.0.0.0\nhttps://geriatrics.jp/contact/\n2025年3月24日\n4:47 PM\n805\ncontact\n申請・お問い合わせ\nhttps://geriatrics.jp/contact/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-8','','','2025-03-24 16:47:40','2025-03-24 07:47:40','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=914',0,'flamingo_inbound','',0),(916,1,'2025-03-24 16:54:12','2025-03-24 07:54:12','<!-- wp:html -->\n<div class=\"support-container\">\n  <h2><b>老年栄養ドットコムとは</b></h2>\n  <p>「老年栄養ドットコム」は、高齢者の皆さまの健康と栄養に関する最新の情報を、正確かつわかりやすい形でお届けするために開設した非営利の情報サイトです。医療・臨床栄養・介護・地域社会の現場で活躍する専門家や研究者と協力しながら、高齢者の栄養ケアや食生活の大切さを広く発信することを目指しています。</p>\n  \n  <h2><b>研究費の使用と運用管理について</b></h2>\n  <p>当サイトの運営は、愛知医科大学または国立長寿医療研究センターの研究資金管理部門が管理する研究費によって支えられており、非常にクリーンかつ透明性の高い仕組みを整えております。</p>\n  \n  <h3>研究費管理部門による厳格な運用</h3>\n  <p>研究費の使用は、大学・研究センターの適切な審査・報告体制の下で進められています。ご支援をいただいた資金は、当サイトの運営費および関連する研究活動にのみ利用され、個人や営利目的で用いられることは一切ございません。</p>\n  \n  <h3>利益相反の回避</h3>\n  <p>当サイトは営利団体の広告収益などを目的としておらず、研究に基づく公正な情報の提供を最優先としています。ご支援いただきました研究資金は、大学・研究センターの規定に従い管理され、不適切な利益相反状態が作られることはございません。</p>\n  \n  <h2><b>ご支援の活用方法</b></h2>\n  <p>皆さまからお寄せいただくご支援は、以下のような用途に大切に使わせていただきます。</p>\n  \n  <h3>研究活動の充実・発展</h3>\n  <p>高齢者の栄養問題に関する調査や臨床研究を継続し、新しい知見を生み出すための費用として活用されます。</p>\n  \n  <h3>情報発信の拡充</h3>\n  <p>最新研究成果の公開や、わかりやすい解説記事の作成・更新、動画やオンラインセミナーの企画など、より多くの方に役立つコンテンツを提供するために使用します。</p>\n  \n  <h3>サイト運営の維持</h3>\n  <p>サーバーやシステムの保守費用、専門家との連携強化など、サイトを安定的かつ安全に運営するために必要な経費に充てられます。</p>\n  \n  <h2><b>ご支援の方法</b></h2>\n  <p>企業・団体の皆さま、個人の方を問わず、ご協力いただける方法はさまざまです。<a href=\"https://geriatrics.jp/contact/\">まずは<strong><b>お問い合わせフォーム</b></strong>から</a>お問い合わせください。</p>\n  \n  <h3>寄付（奨学寄付）</h3>\n  <p>ご寄付金額にかかわらず、温かいお気持ちをありがたくお受けいたします。愛知医科大学の奨学寄付の枠組みでお申し込みいただきたく存じます。</p>\n  \n  <h3>産学共同研究のご提案</h3>\n  <p>高齢者の栄養問題に関する研究や関連事業など、産学共同で取り組める研究・プロジェクトがございましたらお気軽にご相談ください。</p>\n  \n  <h3>その他のご支援</h3>\n  <p>広報協力や情報提供、イベント開催など、形を問わず様々な形でご協力いただけます。</p>\n  \n  <h2><b>皆さまへの感謝</b></h2>\n  <p>高齢社会の真っただ中にある日本において、適切な栄養ケア・栄養問題の解決は切実に求められる課題です。皆さまからのご支援は、高齢者の健康寿命延伸につながる貴重な情報を広く届ける原動力となり、多くの方々とそのご家族を支える力になります。<br>\n  「老年栄養ドットコム」では、今後とも研究・情報発信の質を高め、より良い社会づくりに貢献できるよう努めてまいります。皆さまの温かいご支援に、心より感謝申し上げます。</p>\n</div>\n<!-- /wp:html -->\n\n<!-- wp:html -->\n<style>\n.support-container {\n  font-family: \'Hiragino Sans\', \'Hiragino Kaku Gothic ProN\', \'Noto Sans JP\', sans-serif;\n  line-height: 1.7;\n  color: #333;\n  max-width: 1000px;\n  margin: 0 auto;\n  padding: 20px;\n}\n.support-container h2 {\n  text-align: center;\n  color: #2c5e7e;\n  border-bottom: 1px solid #e0e0e0;\n  padding-bottom: 10px;\n  margin-top: 40px;\n  margin-bottom: 20px;\n  font-size: 24px;\n}\n.support-container h3 {\n  color: #2c5e7e;\n  margin-top: 30px;\n  margin-bottom: 10px;\n  font-size: 20px;\n}\n.support-container p {\n  margin-bottom: 20px;\n  text-align: justify;\n}\n@media (max-width: 768px) {\n  .support-container {\n    padding: 15px;\n  }\n  .support-container h2 {\n    font-size: 20px;\n  }\n  .support-container h3 {\n    font-size: 18px;\n  }\n}\n</style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','ご支援について','','inherit','closed','closed','','849-revision-v1','','','2025-03-24 16:54:12','2025-03-24 07:54:12','',849,'https://geriatrics.jp/?p=916',0,'revision','',0),(917,1,'2025-03-24 18:40:35','2025-03-24 09:40:35','','プレスリリースの場','','inherit','closed','closed','','831-autosave-v1','','','2025-03-24 18:40:35','2025-03-24 09:40:35','',831,'https://geriatrics.jp/?p=917',0,'revision','',0),(919,1,'2025-03-24 18:44:48','2025-03-24 09:44:48','<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で>5%</strong>、または6か月超で>10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>>10%/6か月または>20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:44:48','2025-03-24 09:44:48','',867,'https://geriatrics.jp/?p=919',0,'revision','',0),(921,1,'2025-03-24 18:46:30','2025-03-24 09:46:30','<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/kskm\">著者：前田圭介</a></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:46:30','2025-03-24 09:46:30','',867,'https://geriatrics.jp/?p=921',0,'revision','',0),(923,1,'2025-03-24 18:48:48','2025-03-24 09:48:48','<!-- wp:code -->\n<pre class=\"wp-block-code\"><code>2025/3/24公開　<a href=\"https://researchmap.jp/kskm\">著者：前田圭介</a></code></pre>\n<!-- /wp:code -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:48:48','2025-03-24 09:48:48','',867,'https://geriatrics.jp/?p=923',0,'revision','',0),(925,1,'2025-03-24 18:50:27','2025-03-24 09:50:27','<!-- wp:html -->\n<div class=\"text-align-right\">\n2025/3/24公開　<a href=\"https://researchmap.jp/kskm\"著者：前田圭介</a>\n</div>\n<style>\n.text-align-left {\n  text-align: left;\n  padding: 0.5em 1em;\n  margin: 2em 0;\n  background: #f0f7ff;\n  border: dashed 2px #5b8bd0;\n}\n\n.text-align-center{\n  text-align: center;\n  padding: 0.5em 1em;\n  margin: 2em 0;\n  background: #f0f7ff;\n  border: dashed 2px #5b8bd0;\n}\n\n.text-align-right{\n  text-align: right;\n  padding: 0.5em 1em;\n  margin: 2em 0;\n  background: #f0f7ff;\n  border: dashed 2px #5b8bd0;\n}\n</style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:50:27','2025-03-24 09:50:27','',867,'https://geriatrics.jp/?p=925',0,'revision','',0),(926,1,'2025-03-24 18:50:42','2025-03-24 09:50:42','<!-- wp:html -->\n<div class=\"text-align-right\">\n2025/3/24公開　<a href=\"https://researchmap.jp/kskm\">著者：前田圭介</a>\n</div>\n<style>\n.text-align-left {\n  text-align: left;\n  padding: 0.5em 1em;\n  margin: 2em 0;\n  background: #f0f7ff;\n  border: dashed 2px #5b8bd0;\n}\n\n.text-align-center{\n  text-align: center;\n  padding: 0.5em 1em;\n  margin: 2em 0;\n  background: #f0f7ff;\n  border: dashed 2px #5b8bd0;\n}\n\n.text-align-right{\n  text-align: right;\n  padding: 0.5em 1em;\n  margin: 2em 0;\n  background: #f0f7ff;\n  border: dashed 2px #5b8bd0;\n}\n</style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:50:42','2025-03-24 09:50:42','',867,'https://geriatrics.jp/?p=926',0,'revision','',0),(928,1,'2025-03-24 18:55:08','2025-03-24 09:55:08','<!-- wp:html -->\n<div>\n2025/3/24公開　<a href=\"https://researchmap.jp/kskm\">著者：前田圭介</a>\n</div>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:55:08','2025-03-24 09:55:08','',867,'https://geriatrics.jp/?p=928',0,'revision','',0),(930,1,'2025-03-24 18:57:41','2025-03-24 09:57:41','<!-- wp:html -->\n <p class=\"right-align\">\n2025/3/24公開　<a href=\"https://researchmap.jp/kskm\">著者：前田圭介</a>\n </p>\n\n  <style>\n    .right-align {\n      text-align: right; /* テキストを右寄せに設定 */\n    }\n  </style>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>低栄養（malnutrition）は入院患者や外来患者、高齢者施設の入所者など様々な場面で患者に悪影響を及ぼし、治療効果の低下や合併症リスクの増加を通じて臨床転帰の悪化と密接に関連します​。しかし、これまで国際的に統一された低栄養の診断基準がなく、国や地域ごとの基準の差異が研究や対策の妨げとなっていました​。<br>この問題を解決するために世界各国の主要な臨床栄養関連学会が協力して策定したのが<strong>GLIM基準</strong>（Global Leadership Initiative on Malnutrition）です。2018年に提唱された成人の低栄養診断基準で、従来の摂取不足による低栄養に加えて疾患に関連する低栄養も考慮した、世界共通の評価基準として位置付けられています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>このGLIM基準の構成要素と臨床での活用方法について、初心者から中級者の医療従事者向けに分かりやすく解説します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※主要な栄養関連学会とは、ESPEN, ASPEN, PENSA, FELANPEです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":869,\"sizeSlug\":\"full\",\"linkDestination\":\"none\",\"align\":\"center\"} -->\n<figure class=\"wp-block-image aligncenter size-full\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg\" alt=\"\" class=\"wp-image-869\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>GLIM基準の構成</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は低栄養を診断するための<strong>三段階アプローチ</strong>を特徴としています​。<br>まず第1段階で<strong>スクリーニング</strong>（栄養リスクのふるい分け）を行い、低栄養のリスクが高い患者を抽出します。続いて第2段階で抽出された患者（スクリーニング陽性患者）に対し<strong>5項目のアセスメントで診断</strong>を行い、低栄養かどうかを診断します​。低栄養と診断された場合は、第3段階として<strong>重症度分類</strong>に進みます。スクリーニング➡アセスメントと診断➡重症度判定という流れです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断に用いるアセスメント項目は<strong>表現型（phenotypic）3項目と病因（etiologic）2項目の計5項目</strong>で構成され、それぞれのカテゴリーから少なくとも1項目ずつ該当する場合に低栄養と診断します​。表現型1項目以上、病因1項目以上が該当（異常）すると低栄養です。<br>低栄養と診断後は、表現型項目の程度に基づいて<strong>中等度または重度の低栄養か</strong>を重症度判定します​。<br>このようにGLIM基準は、スクリーニングからアセスメント・診断・重症度分類まで一貫した流れを提供する枠組みになっています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>スクリーニングツール</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>栄養スクリーニング</strong>では、検証済みのツールを用いて全患者を評価し、低栄養リスクの有無を確認します​。GLIM基準では特定の方法に限定せず、各現場で利用可能な<strong>信頼性の高いスクリーニングツール</strong>を使用できます​。検証済みとは、信頼性・再現性（誰がやっても似た結果になる）と妥当性（測るべきものをみている）が検証済みであることを指しています。勝手に項目を追加・変更したツールは検証されていないツールですので、使用を控え、かならず検証済みのツールを用いるように配慮します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>代表的なツールとして、<strong>MUST</strong>（Malnutrition Universal Screening Tool）、<strong>NRS-2002</strong>（Nutrition Risk Screening 2002）、<strong>MNA-SF</strong>（Mini Nutritional Assessment-Short Form）などが挙げられます​。それぞれ多少異なりますが、体重やBMIの評価、最近の体重減少の有無、食事摂取量の減少、疾患の重症度などを組み合わせてリスク判定する<strong>検証済みのスクリーニングツール</strong>です。<br><strong>MUST</strong>は汎用性が高く外来から入院まで幅広く用いられ、<strong>NRS-2002</strong>は入院患者での疾病重症度も考慮したツールとしてESPEN（欧州臨床栄養代謝学会）ガイドラインで推奨されています。構造化された実践的RCTで採用が最も多いのはNRS-2002です。一方、<strong>MNA-SF</strong>は高齢者の栄養スクリーニングに特化しており、簡便な質問で短時間に評価できる点が利点です。MNA-SFは許可の関係で内容を改変なく提示しなくてはならないですので、本ページには詳細を提示することを控えています（Web検索で容易に見つけることができますので、各自検索をお願いします）。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>現場では患者の対象集団や利用しやすさに応じて適切なツールを選択します。スクリーニングの結果、低栄養リスクありと判断された場合に次の評価ステップ（GLIM診断基準の適用）へ進みます​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※<strong>低栄養リスクあり</strong>とは、低栄養かもしれないとスクリーニングツールで判定されたということを指し本稿では使用しました。一方で、「低栄養リスク」という言葉は、今は低栄養ではないが将来低栄養になるリスクがあるという意味でも用いられる表現です。文脈に注意が必要です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>表現型項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>スクリーニングで低栄養リスク（低栄養かもしれない・スクリーニング陽性）と示唆された患者には、GLIM基準の<strong>表現型項目</strong>である3つの指標を評価します。アセスメントラウンドです。表現型項目では、患者の身体状態に現れる低栄養の兆候を評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．体重減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>意図しない体重減少</strong>は低栄養の重要な徴候です。GLIM基準では一定以上の体重減少を低栄養の表現型として定義しており、例えば<strong>過去6か月で&gt;5%</strong>、または6か月超で&gt;10%の体重減少が該当します​。非意図的な減少を指し、患者や家族からの問診やカルテ上の体重記録から把握します。日常診療では体重測定値の推移を確認し、浮腫の変動など体液バランスの影響も考慮しながら評価します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>かかりつけ患者であればカルテに過去の体重が記録されていることが多いですが、初診患者では過去の体重を聞き取り情報を得ることが一般的です（セルフレポート）。適切に時期を問い、患者が把握している自身の体重を聞き出すとよいでしょう。要介護高齢者等であれば、介護サービス利用中の記録に体重が残っています。セルフレポートできない場合は、労を惜しまずにかかりつけ介護サービス事業所またはケアマネージャーにコンタクトをとることをお勧めします。かかりつけ医からの診療情報として過去の体重が提供される可能性が高いとは言えませんが、今後電子カルテの共用が標準化されれば、記録された体重を利用することができるようになります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>２．低BMI</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>低体重（低BMI）も低栄養の指標の一つです。BMI（体格指数）は体重(kg)を身長(m)二乗で割った値で、一般に18.5 kg/m2未満が痩せとされますが、GLIM基準では年齢や地域に応じた閾値が提案されています。アジア人の場合、70歳未満では<strong>BMI&lt;18.5</strong>、70歳以上では<strong>BMI&lt;20</strong>をアセスメント時のカットオフとしています​。この基準に該当するかを確認するため、身長と体重を測定してBMIを算出します。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>入退院センター等の面談のタイミングで実測できることが理想ですが、実臨床では実測以外に身長の自己申告ということもあり得ます。日本人の自己申告身長は精度が高く、系統的レビュー（doi: 10.11236/jph.23-020)によると、平均差はおおむね1cm未満（わずかに過大報告）だったとの報告を踏まえると、自己申告体重がGLIM低栄養診断（低栄養か否か・重症度はどうか）に及ぼす影響は非常に小さいことが想像できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>３．筋肉量減少</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>骨格筋量の減少</strong>は、低栄養に伴う体組成の変化を反映する代表的な指標です。1970年代に提唱されたSGAにも筋肉量減少をみることが含まれていますし、近年の他の低栄養診断基準のすべてに低骨格筋量アセスメントの重要性が強調されています。GLIM基準では客観的な身体組成評価による筋肉量減少の存在を優先して評価します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>評価方法としては、DEXA（二重エネルギーX線吸収法）やBIA（生体インピーダンス法）、超音波、CT/MRI画像解析などが挙げられます​。これらの精密測定が難しい場合、または対象者に適用しやすいカットオフ値の根拠が乏しい場合は、代替として下腿周囲長や上腕周囲長の測定値で判断することがすすめられます。または、代替として身体診察（physical examination）によって筋量減少を判断できます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>GLIM基準で低栄養を診断するプロセスにおける筋肉量減少の評価方法については、別のコラムでもう少し詳しく解説します。</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>※身体診察はトレーニングされた臨床栄養専門家が実施するアセスメント手法の一つです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>病因項目</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準で低栄養を診断するには、表現型項目に加えて<strong>病因項目</strong>（原因に関する項目）の評価が必要です。病因項目には、低栄養を引き起こす要因を評価する項目として、<strong>栄養摂取不足・消化吸収不良</strong>と<strong>炎症・疾患負荷</strong>の2つが挙げられています​。低栄養は栄養素・熱量摂取不足または需要の増大の結果引き起こされますので、該当する原因が存在することが、低栄養状態を裏付ける条件となります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\"><strong>１．栄養摂取不足・消化吸収不良</strong></h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>食事摂取量の低下</strong>や消化・吸収障害は、低栄養の主要な原因の一つです。十分な熱量や栄養素が摂取できない状況が持続すると、健常者でも体重が減少、体組成が変化して低栄養に陥ります。GLIM基準では具体的には「必要量の&lt;50%の摂取が1週間以上続く」あるいは「何らかの摂食量低下が2週間超続く」こと、または<strong>慢性的消化管疾患による栄養吸収障害</strong>があることを基準としています​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>食事量の推定は正確にできません。（正確であることを求めすぎる必要もないと思います。）しかし、最善の方法の一つとして自己申告に基づく摂食量の変化（普段の食事量に比べてどうなのか）、多角的な意見（家族等食事をともにする人の主観）、管理栄養士による食事状況問診などを奨めます。消化吸収の面では、慢性膵炎や短腸症候群、炎症性腸疾患など栄養吸収に影響を及ぼす疾患の有無にも留意します。持続する下痢や高度の便秘・嚥下障害・通貨障害も消化吸収に影響する疾病といえます。栄養摂取量を減らすような消化器疾患なのか、病名ではなく病態で考えます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading {\"level\":3} -->\n<h3 class=\"wp-block-heading\">２．炎症・疾患関連要因</h3>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p><strong>疾患に伴う炎症や代謝亢進</strong>も低栄養の重要な要因です。慢性または急性の疾患によって生じる全身性炎症反応や代謝ストレスは、食事摂取量が確保されていても体タンパクの異化亢進を招き、体重減少や筋肉量減少を引き起こします​。GLIM基準では、<strong>慢性疾患</strong>（がん、慢性心不全、COPD、慢性腎不全、肝硬変、リウマチ性疾患など）による炎症状態や、<strong>急性疾患・外傷</strong>（重症感染症、大手術、熱傷、外傷など）に伴う高度の炎症・ストレス状態が該当します​。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>例えばがん患者や重症感染症患者ではサイトカイン産生を伴う炎症反応により食欲低下や安静時代謝量増加が生じ、栄養状態の悪化が加速します。また心不全やCOPDなどでは慢性的な炎症や筋タンパク分解亢進（悪液質の一因）が見られます。こうした<strong>疾患関連低栄養</strong>では、原疾患の治療と併行して栄養介入を行うことで臨床転帰の改善が期待できます。なお、炎症や疾患負荷の有無は血液検査（CRPやアルブミン値など）や臨床所見から総合的に判断します。CRPやアルブミン値のような炎症関連<strong><u>バイオマーカーが異常かどうかだけで判断しないように</u></strong>気を付けてください。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>また、GLIM公式論文では、様々な疾患を炎症・疾患関連要因として挙げています。病名の存在だけで判断するのではなく、栄養状態を悪化させるほどの状態かという視点も大切です。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>診断と重症度判定</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準に基づく低栄養の診断プロセスをまとめると、まずスクリーニングで低栄養リスク患者（低栄養かもしれない患者）を見いだした後、表現型項目（体重減少・低BMI・筋肉量減少）のうち少なくとも1つと、病因項目（摂取量/消化吸収低下・炎症/疾患）のうち少なくとも1つが当てはまれば<strong>低栄養と確定診断</strong>します​。<br>診断時には各項目の該当状況をチェックリストのように確認し、どの組み合わせで基準を満たしたかを記録すると実践的です。日本の栄養管理計画書例として、厚労省は既にGLIM基準の該当項目を記載する例を示しています。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>診断後は、表現型項目の程度から<strong>重症度（Stage 1: 中等度低栄養、Stage 2: 重度低栄養）</strong>を判定します​。<br>重症度判定は表現型項目である<strong>体重減少率、BMI、筋肉量の3つで行い</strong>、いずれか一つでも重度基準に該当すれば重度低栄養と判定できます。まだアジア人向けの完全な重症度診断カットオフ値が明らかになっているわけではありませんが、以下の値を用いた大規模研究では、日本人を対象としたGLIM基準適用の妥当性が報告されていますので、以下の値は活用する価値があると思われます。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>体重減少</td><td>&gt;10%/6か月または&gt;20%/6か月超</td></tr><tr><td>低BMI</td><td>70歳未満では17.0 kg/m2, 70歳以上では17.8 kg/m2</td></tr><tr><td>低筋肉量</td><td>中等度低栄養の値から10%小さい値（下腿周囲長を活用した場合）</td></tr></tbody></table><figcaption class=\"wp-element-caption\">参考文献３の研究で適用した低栄養重症度評価基準</figcaption></figure>\n<!-- /wp:table -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\"><strong>まとめ</strong></h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>GLIM基準は、世界共通の低栄養診断フレームワークとして、初心者でも段階的にアプローチしやすい構成になっています。まず適切なスクリーニングでリスク患者を逃さず拾い上げ、次に表現型・病因の両面から評価して低栄養かどうかを判断します。最後に重症度を見極めることで、患者ごとのリスクに応じた栄養管理計画を立てる指針となります。GLIM基準を臨床で使いこなすことで、低栄養状態の見逃しを減らし、栄養介入による患者予後の改善に繋げていきましょう。​</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1.Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9.<br>2. Barazzoni R, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022 Jun;41(6):1425-1433.<br>3. Mori N, et al. Prognostic implications of the global leadership initiative on malnutrition criteria as a routine assessment modality for malnutrition in hospitalized patients at a university hospital. Clin Nutr. 2023 Feb;42(2):166-172.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','低栄養の世界基準-GLIM基準-','','inherit','closed','closed','','867-revision-v1','','','2025-03-24 18:57:41','2025-03-24 09:57:41','',867,'https://geriatrics.jp/?p=930',0,'revision','',0),(932,0,'2025-03-25 12:04:38','2025-03-25 03:04:38','お問い合わせ\nテストメール名前\nkskmaeda1701@gmail.com\nテストメールの文章1行目\r\n2行目\r\n3行目\n9\n153.201.194.12\nMozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Safari/537.36\nhttps://geriatrics.jp/contact/\n2025年3月25日\n12:04 PM\n805\ncontact\n申請・お問い合わせ\nhttps://geriatrics.jp/contact/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-9','','','2025-03-25 12:04:38','2025-03-25 03:04:38','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=932',0,'flamingo_inbound','',0),(933,0,'2025-03-25 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PM\n805\ncontact\n申請・お問い合わせ\nhttps://geriatrics.jp/contact/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-11','','','2025-03-25 12:30:59','2025-03-25 03:30:59','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=934',0,'flamingo_inbound','',0),(935,0,'2025-03-25 12:32:50','2025-03-25 03:32:50','お問い合わせ\nまえだ\nkskmaeda1701@gmail.com\nｋｋｋｋ\r\n\r\nｋｋｋ\r\n\r\nｋｋｋ\n12\n153.201.194.12\nMozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/134.0.0.0 Safari/537.36\nhttps://geriatrics.jp/contact/\n2025年3月25日\n12:32 PM\n805\ncontact\n申請・お問い合わせ\nhttps://geriatrics.jp/contact/\nkskmaeda1701@gmail.com\nkskmaeda1701@gmail.com\n老年栄養ドットコム\nhttps://geriatrics.jp\nkskmaeda1701@gmail.com','[your-subject]','','publish','closed','closed','','your-subject-12','','','2025-03-25 12:32:50','2025-03-25 03:32:50','',0,'https://geriatrics.jp/?post_type=flamingo_inbound&p=935',0,'flamingo_inbound','',0),(936,1,'2025-03-26 20:50:34','2025-03-26 11:50:34','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul>\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト2 / 下線 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-b\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','publish','closed','closed','','test-01','','','2025-03-26 20:51:11','2025-03-26 11:51:11','',0,'https://geriatrics.jp/?p=936',0,'post','',0),(937,1,'2025-03-25 15:26:18','2025-03-25 06:26:18','','テスト用 -','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 15:26:18','2025-03-25 06:26:18','',936,'https://geriatrics.jp/?p=937',0,'revision','',0),(938,1,'2025-03-25 15:28:22','2025-03-25 06:28:22','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 15:28:22','2025-03-25 06:28:22','',936,'https://geriatrics.jp/?p=938',0,'revision','',0),(939,1,'2025-03-25 15:31:27','2025-03-25 06:31:27','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 15:31:27','2025-03-25 06:31:27','',936,'https://geriatrics.jp/?p=939',0,'revision','',0),(940,1,'2025-03-25 15:54:16','2025-03-25 06:54:16','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 15:54:16','2025-03-25 06:54:16','',936,'https://geriatrics.jp/?p=940',0,'revision','',0),(941,1,'2025-03-25 15:56:49','2025-03-25 06:56:49','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html -->\n<ul class=\"wp-block-list\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 15:56:49','2025-03-25 06:56:49','',936,'https://geriatrics.jp/?p=941',0,'revision','',0),(942,1,'2025-03-25 16:17:07','2025-03-25 07:17:07','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html -->\n<ul class=\"wp-block-list\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 16:17:07','2025-03-25 07:17:07','',936,'https://geriatrics.jp/?p=942',0,'revision','',0),(943,1,'2025-03-25 16:19:55','2025-03-25 07:19:55','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"カスタムリスト\"}} -->\n<ul class=\"wp-block-list\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 16:19:55','2025-03-25 07:19:55','',936,'https://geriatrics.jp/?p=943',0,'revision','',0),(944,1,'2025-03-25 16:23:50','2025-03-25 07:23:50','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"カスタムリスト\"}} -->\n<ul class=\"wp-block-list\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 16:23:50','2025-03-25 07:23:50','',936,'https://geriatrics.jp/?p=944',0,'revision','',0),(945,1,'2025-03-25 16:24:29','2025-03-25 07:24:29','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"カスタムリスト\"}} -->\n<ul class=\"wp-block-list\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:list {\"className\":\"ul-n\"} -->\n<ul class=\"wp-block-list ul-n\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 16:24:29','2025-03-25 07:24:29','',936,'https://geriatrics.jp/?p=945',0,'revision','',0),(946,1,'2025-03-25 16:27:57','2025-03-25 07:27:57','<!-- wp:html {\"metadata\":{\"name\":\"カスタムリスト\"}} -->\n<ul class=\"wp-block-list ul-n\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->','ul（リスト1 / 通常 / HTML）','','publish','closed','closed','','ul%ef%bc%88%e3%83%aa%e3%82%b9%e3%83%881-%e9%80%9a%e5%b8%b8-html%ef%bc%89','','','2025-03-25 16:27:57','2025-03-25 07:27:57','',0,'https://geriatrics.jp/news/ul%ef%bc%88%e3%83%aa%e3%82%b9%e3%83%881-%e9%80%9a%e5%b8%b8-html%ef%bc%89/',0,'wp_block','',0),(947,1,'2025-03-25 16:30:05','2025-03-25 07:30:05','<!-- wp:html {\"metadata\":{\"name\":\"カスタムリスト\"}} -->\n<ul class=\"wp-block-list ul-b\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->','ul（リスト2 / 下線 / HTML）','','publish','closed','closed','','ul%ef%bc%88%e3%83%aa%e3%82%b9%e3%83%882-%e4%b8%8b%e7%b7%9a-html%ef%bc%89','','','2025-03-25 16:30:05','2025-03-25 07:30:05','',0,'https://geriatrics.jp/news/ul%ef%bc%88%e3%83%aa%e3%82%b9%e3%83%882-%e4%b8%8b%e7%b7%9a-html%ef%bc%89/',0,'wp_block','',0),(948,1,'2025-03-25 16:30:14','2025-03-25 07:30:14','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-n\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"カスタムリスト\"}} -->\n<ul class=\"wp-block-list ul-b\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 16:30:14','2025-03-25 07:30:14','',936,'https://geriatrics.jp/?p=948',0,'revision','',0),(949,1,'2025-03-25 16:55:00','2025-03-25 07:55:00','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-n\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト2 / 下線 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-b\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-25 16:55:00','2025-03-25 07:55:00','',936,'https://geriatrics.jp/?p=949',0,'revision','',0),(950,1,'2025-03-26 20:28:49','2025-03-26 11:28:49','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:28:49','2025-03-26 11:28:49','',882,'https://geriatrics.jp/?p=950',0,'revision','',0);
INSERT INTO `wp_posts` VALUES (951,1,'2025-03-26 20:49:43','2025-03-26 11:49:43','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','てすと','','trash','closed','closed','','%e3%81%a6%e3%81%99%e3%81%a8__trashed','','','2025-03-26 20:50:04','2025-03-26 11:50:04','',0,'https://geriatrics.jp/?p=951',0,'post','',0),(953,1,'2025-03-26 20:49:43','2025-03-26 11:49:43','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','てすと','','inherit','closed','closed','','951-revision-v1','','','2025-03-26 20:49:43','2025-03-26 11:49:43','',951,'https://geriatrics.jp/?p=953',0,'revision','',0),(954,1,'2025-03-26 20:51:11','2025-03-26 11:51:11','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul>\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト2 / 下線 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-b\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-revision-v1','','','2025-03-26 20:51:11','2025-03-26 11:51:11','',936,'https://geriatrics.jp/?p=954',0,'revision','',0),(955,1,'2025-03-26 20:52:09','2025-03-26 11:52:09','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul>\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li></li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p></p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:52:09','2025-03-26 11:52:09','',882,'https://geriatrics.jp/?p=955',0,'revision','',0),(956,1,'2025-03-26 20:53:25','2025-03-26 11:53:25','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:list -->\n<ul><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item -->\n</ul>\n<p><!-- wp:list --></p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --></p>\n<li></li>\n<p><!-- /wp:list-item --></ul>\n<p><!-- /wp:list --></p>\n<p><!-- wp:paragraph --></p>\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:table --></p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>[EFFORT研究における体系的な栄養ケアの流れ]<br />１．入院当日の栄養スクリーニング<br />　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br />　　・低栄養リスクがある患者を特定<br />２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br />　　・管理栄養士が個別の栄養目標を設定<br />　　・定期的なモニタリングを実施<br />３．栄養介入の具体的な手順<br />　　・まずは経口摂取で目標達成を目指す<br />　　・経腸栄養の併用（経口摂取が不足する場合）<br />　　・静脈栄養の併用（さらに不足する場合）<br />４．リアセスメントの実施<br />　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p><!-- /wp:table --></p>\n<p><!-- wp:paragraph --></p>\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:paragraph --></p>\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:paragraph --></p>\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} --></p>\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<p><!-- /wp:image --></p>\n<p><!-- wp:paragraph {\"align\":\"right\"} --></p>\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:paragraph --></p>\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:table --></p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>対象者</td>\n<td>介入までの時間制限</td>\n<td>臨床転帰</td>\n</tr>\n<tr>\n<td>腹部外科術後患者（ICU） <sup>3)</sup></td>\n<td>24h</td>\n<td>術後合併症と死亡率低下</td>\n</tr>\n<tr>\n<td>化学療法中の胃がん患者<sup>4)</sup></td>\n<td>24h</td>\n<td>栄養状態とQoL改善</td>\n</tr>\n<tr>\n<td>化学放射線療法中の 食道がん患者<sup>5)</sup></td>\n<td>24h</td>\n<td>有害事象とうつ症状の軽減、QoLの改善</td>\n</tr>\n<tr>\n<td>高齢患者<sup>6)</sup></td>\n<td>24h</td>\n<td>栄養状態改善、在院日数短縮</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>7)</sup></td>\n<td>24h</td>\n<td>在院日数短縮</td>\n</tr>\n<tr>\n<td>化学療法中の大腸がん患者<sup>8)</sup></td>\n<td>24h</td>\n<td>プレアルブミンの改善</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>9)</sup></td>\n<td>24h</td>\n<td>栄養摂取量増加、QoL改善</td>\n</tr>\n<tr>\n<td>大腿骨頸部骨折高齢者<sup>10)</sup></td>\n<td>24h</td>\n<td>せん妄期間と在院日数短縮、褥瘡の減少</td>\n</tr>\n<tr>\n<td>股関節骨折高齢女性患者<sup>11)</sup></td>\n<td>24h</td>\n<td>死亡率低下</td>\n</tr>\n<tr>\n<td>成人患者<sup>12)</sup></td>\n<td>36h</td>\n<td>栄養摂取量増加、在院日数短縮</td>\n</tr>\n<tr>\n<td>高齢患者<sup>13)</sup></td>\n<td>72h</td>\n<td>在院日数短縮、再入院率減少</td>\n</tr>\n<tr>\n<td>高齢患者<sup>14)</sup></td>\n<td>72h</td>\n<td>死亡率低下、栄養状態改善</td>\n</tr>\n<tr>\n<td>成人患者<sup>15)</sup></td>\n<td>72h</td>\n<td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p><!-- /wp:table --></p>\n<p><!-- wp:paragraph --></p>\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:heading --></p>\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<p><!-- /wp:heading --></p>\n<p><!-- wp:paragraph --></p>\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br />2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br />3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br />4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br />5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br />6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br />7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br />8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br />9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br />10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br />11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br />12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br />13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br />14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:paragraph --></p>\n<p><!-- /wp:paragraph --></p>\n<p><!-- wp:paragraph --></p>\n<p><!-- /wp:paragraph --></p>','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:53:25','2025-03-26 11:53:25','',882,'https://geriatrics.jp/?p=956',0,'revision','',0),(958,1,'2025-03-26 20:55:52','2025-03-26 11:55:52','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html -->\n<UL>\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</UL>\n<!-- /wp:html -->\n\n<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item -->\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<!-- /wp:list-item --></ul>\n<!-- /wp:list -->\n\n<!-- wp:list-item -->\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>有害事象発生率の低下（OR 0.79）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<!-- /wp:list-item -->\n\n<!-- wp:list-item -->\n<li>QOLの改善（OR 3.06）</li>\n<!-- /wp:list-item -->\n\n</ul>\n<p>\n\n<!-- wp:list -->\n</p>\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n</p>\n<li></li>\n<p>\n<!-- /wp:list-item -->\n</ul>\n<p>\n<!-- /wp:list -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:table -->\n</p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>[EFFORT研究における体系的な栄養ケアの流れ]<br />１．入院当日の栄養スクリーニング<br />　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br />　　・低栄養リスクがある患者を特定<br />２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br />　　・管理栄養士が個別の栄養目標を設定<br />　　・定期的なモニタリングを実施<br />３．栄養介入の具体的な手順<br />　　・まずは経口摂取で目標達成を目指す<br />　　・経腸栄養の併用（経口摂取が不足する場合）<br />　　・静脈栄養の併用（さらに不足する場合）<br />４．リアセスメントの実施<br />　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p>\n<!-- /wp:table -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n</p>\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<p>\n<!-- /wp:image -->\n\n</p>\n<p>\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n</p>\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:table -->\n</p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>対象者</td>\n<td>介入までの時間制限</td>\n<td>臨床転帰</td>\n</tr>\n<tr>\n<td>腹部外科術後患者（ICU） <sup>3)</sup></td>\n<td>24h</td>\n<td>術後合併症と死亡率低下</td>\n</tr>\n<tr>\n<td>化学療法中の胃がん患者<sup>4)</sup></td>\n<td>24h</td>\n<td>栄養状態とQoL改善</td>\n</tr>\n<tr>\n<td>化学放射線療法中の 食道がん患者<sup>5)</sup></td>\n<td>24h</td>\n<td>有害事象とうつ症状の軽減、QoLの改善</td>\n</tr>\n<tr>\n<td>高齢患者<sup>6)</sup></td>\n<td>24h</td>\n<td>栄養状態改善、在院日数短縮</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>7)</sup></td>\n<td>24h</td>\n<td>在院日数短縮</td>\n</tr>\n<tr>\n<td>化学療法中の大腸がん患者<sup>8)</sup></td>\n<td>24h</td>\n<td>プレアルブミンの改善</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>9)</sup></td>\n<td>24h</td>\n<td>栄養摂取量増加、QoL改善</td>\n</tr>\n<tr>\n<td>大腿骨頸部骨折高齢者<sup>10)</sup></td>\n<td>24h</td>\n<td>せん妄期間と在院日数短縮、褥瘡の減少</td>\n</tr>\n<tr>\n<td>股関節骨折高齢女性患者<sup>11)</sup></td>\n<td>24h</td>\n<td>死亡率低下</td>\n</tr>\n<tr>\n<td>成人患者<sup>12)</sup></td>\n<td>36h</td>\n<td>栄養摂取量増加、在院日数短縮</td>\n</tr>\n<tr>\n<td>高齢患者<sup>13)</sup></td>\n<td>72h</td>\n<td>在院日数短縮、再入院率減少</td>\n</tr>\n<tr>\n<td>高齢患者<sup>14)</sup></td>\n<td>72h</td>\n<td>死亡率低下、栄養状態改善</td>\n</tr>\n<tr>\n<td>成人患者<sup>15)</sup></td>\n<td>72h</td>\n<td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p>\n<!-- /wp:table -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:heading -->\n</p>\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<p>\n<!-- /wp:heading -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br />2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br />3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br />4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br />5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br />6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br />7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br />8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br />9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br />10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br />11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br />12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br />13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br />14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:55:52','2025-03-26 11:55:52','',882,'https://geriatrics.jp/?p=958',0,'revision','',0),(959,1,'2025-03-26 20:56:49','2025-03-26 11:56:49','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html -->\n<UL>\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</UL>\n\n<!-- wp:paragraph -->\n</p>\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<p>\n<!-- /wp:paragraph -->\n<!-- wp:table -->\n</p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>[EFFORT研究における体系的な栄養ケアの流れ]<br />１．入院当日の栄養スクリーニング<br />　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br />　　・低栄養リスクがある患者を特定<br />２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br />　　・管理栄養士が個別の栄養目標を設定<br />　　・定期的なモニタリングを実施<br />３．栄養介入の具体的な手順<br />　　・まずは経口摂取で目標達成を目指す<br />　　・経腸栄養の併用（経口摂取が不足する場合）<br />　　・静脈栄養の併用（さらに不足する場合）<br />４．リアセスメントの実施<br />　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p>\n<!-- /wp:table -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n</p>\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<p>\n<!-- /wp:image -->\n\n</p>\n<p>\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n</p>\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:table -->\n</p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>対象者</td>\n<td>介入までの時間制限</td>\n<td>臨床転帰</td>\n</tr>\n<tr>\n<td>腹部外科術後患者（ICU） <sup>3)</sup></td>\n<td>24h</td>\n<td>術後合併症と死亡率低下</td>\n</tr>\n<tr>\n<td>化学療法中の胃がん患者<sup>4)</sup></td>\n<td>24h</td>\n<td>栄養状態とQoL改善</td>\n</tr>\n<tr>\n<td>化学放射線療法中の 食道がん患者<sup>5)</sup></td>\n<td>24h</td>\n<td>有害事象とうつ症状の軽減、QoLの改善</td>\n</tr>\n<tr>\n<td>高齢患者<sup>6)</sup></td>\n<td>24h</td>\n<td>栄養状態改善、在院日数短縮</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>7)</sup></td>\n<td>24h</td>\n<td>在院日数短縮</td>\n</tr>\n<tr>\n<td>化学療法中の大腸がん患者<sup>8)</sup></td>\n<td>24h</td>\n<td>プレアルブミンの改善</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>9)</sup></td>\n<td>24h</td>\n<td>栄養摂取量増加、QoL改善</td>\n</tr>\n<tr>\n<td>大腿骨頸部骨折高齢者<sup>10)</sup></td>\n<td>24h</td>\n<td>せん妄期間と在院日数短縮、褥瘡の減少</td>\n</tr>\n<tr>\n<td>股関節骨折高齢女性患者<sup>11)</sup></td>\n<td>24h</td>\n<td>死亡率低下</td>\n</tr>\n<tr>\n<td>成人患者<sup>12)</sup></td>\n<td>36h</td>\n<td>栄養摂取量増加、在院日数短縮</td>\n</tr>\n<tr>\n<td>高齢患者<sup>13)</sup></td>\n<td>72h</td>\n<td>在院日数短縮、再入院率減少</td>\n</tr>\n<tr>\n<td>高齢患者<sup>14)</sup></td>\n<td>72h</td>\n<td>死亡率低下、栄養状態改善</td>\n</tr>\n<tr>\n<td>成人患者<sup>15)</sup></td>\n<td>72h</td>\n<td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p>\n<!-- /wp:table -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:heading -->\n</p>\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<p>\n<!-- /wp:heading -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br />2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br />3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br />4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br />5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br />6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br />7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br />8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br />9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br />10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br />11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br />12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br />13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br />14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:56:49','2025-03-26 11:56:49','',882,'https://geriatrics.jp/?p=959',0,'revision','',0),(960,1,'2025-03-26 20:56:57','2025-03-26 11:56:57','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html -->\n<UL>\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</UL>\n<!-- wp:html -->\n<!-- wp:paragraph -->\n</p>\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<p>\n<!-- /wp:paragraph -->\n<!-- wp:table -->\n</p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>[EFFORT研究における体系的な栄養ケアの流れ]<br />１．入院当日の栄養スクリーニング<br />　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br />　　・低栄養リスクがある患者を特定<br />２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br />　　・管理栄養士が個別の栄養目標を設定<br />　　・定期的なモニタリングを実施<br />３．栄養介入の具体的な手順<br />　　・まずは経口摂取で目標達成を目指す<br />　　・経腸栄養の併用（経口摂取が不足する場合）<br />　　・静脈栄養の併用（さらに不足する場合）<br />４．リアセスメントの実施<br />　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p>\n<!-- /wp:table -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n</p>\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<p>\n<!-- /wp:image -->\n\n</p>\n<p>\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n</p>\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:table -->\n</p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>対象者</td>\n<td>介入までの時間制限</td>\n<td>臨床転帰</td>\n</tr>\n<tr>\n<td>腹部外科術後患者（ICU） <sup>3)</sup></td>\n<td>24h</td>\n<td>術後合併症と死亡率低下</td>\n</tr>\n<tr>\n<td>化学療法中の胃がん患者<sup>4)</sup></td>\n<td>24h</td>\n<td>栄養状態とQoL改善</td>\n</tr>\n<tr>\n<td>化学放射線療法中の 食道がん患者<sup>5)</sup></td>\n<td>24h</td>\n<td>有害事象とうつ症状の軽減、QoLの改善</td>\n</tr>\n<tr>\n<td>高齢患者<sup>6)</sup></td>\n<td>24h</td>\n<td>栄養状態改善、在院日数短縮</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>7)</sup></td>\n<td>24h</td>\n<td>在院日数短縮</td>\n</tr>\n<tr>\n<td>化学療法中の大腸がん患者<sup>8)</sup></td>\n<td>24h</td>\n<td>プレアルブミンの改善</td>\n</tr>\n<tr>\n<td>低栄養患者<sup>9)</sup></td>\n<td>24h</td>\n<td>栄養摂取量増加、QoL改善</td>\n</tr>\n<tr>\n<td>大腿骨頸部骨折高齢者<sup>10)</sup></td>\n<td>24h</td>\n<td>せん妄期間と在院日数短縮、褥瘡の減少</td>\n</tr>\n<tr>\n<td>股関節骨折高齢女性患者<sup>11)</sup></td>\n<td>24h</td>\n<td>死亡率低下</td>\n</tr>\n<tr>\n<td>成人患者<sup>12)</sup></td>\n<td>36h</td>\n<td>栄養摂取量増加、在院日数短縮</td>\n</tr>\n<tr>\n<td>高齢患者<sup>13)</sup></td>\n<td>72h</td>\n<td>在院日数短縮、再入院率減少</td>\n</tr>\n<tr>\n<td>高齢患者<sup>14)</sup></td>\n<td>72h</td>\n<td>死亡率低下、栄養状態改善</td>\n</tr>\n<tr>\n<td>成人患者<sup>15)</sup></td>\n<td>72h</td>\n<td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td>\n</tr>\n</tbody>\n</table>\n</figure>\n<p>\n<!-- /wp:table -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:heading -->\n</p>\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<p>\n<!-- /wp:heading -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br />2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br />3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br />4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br />5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br />6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br />7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br />8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br />9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br />10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br />11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br />12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br />13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br />14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>\n<p>\n\n<!-- wp:paragraph -->\n</p>\n<p>\n<!-- /wp:paragraph -->\n\n</p>','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:56:57','2025-03-26 11:56:57','',882,'https://geriatrics.jp/?p=960',0,'revision','',0),(962,1,'2025-03-26 20:58:58','2025-03-26 11:58:58','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-n\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト2 / 下線 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-b\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','テスト用 - 体系化された栄養ケアとはのコピー','','inherit','closed','closed','','936-autosave-v1','','','2025-03-26 20:58:58','2025-03-26 11:58:58','',936,'https://geriatrics.jp/?p=962',0,'revision','',0),(963,1,'2025-03-26 20:59:12','2025-03-26 11:59:12','<!-- wp:heading {\"textAlign\":\"right\",\"level\":6} -->\n<h6 class=\"wp-block-heading has-text-align-right\">2025/3/24公開　<a href=\"https://researchmap.jp/1412519abc\">著者：上島順子</a></h6>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>入院患者に対する体系的な栄養ケアの重要性が広く認識されています。これは、低栄養リスクのある患者に適切なサポートを提供し、個別化された栄養管理を実施するために必要な体制です。2019年に、低栄養リスクを有する入院患者への体系的な栄養ケアの効果を検証したランダム化比較試験<sup>1)</sup>が発表されました。「EFFORT研究」と呼ばれるこの研究では、栄養介入群は通常ケア群と比較して、以下のような有意な改善が認められました。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:html {\"metadata\":{\"name\":\"ul（リスト1 / 通常 / HTML）\"}} -->\n<ul class=\"wp-block-list ul-n\">\n<li>エネルギー摂取量の増加（+290kcal/日）</li>\n<li>たんぱく質摂取量の増加（+10g/日）</li>\n<li>身体機能低下（10%以上）の抑制（OR 0.62）</li>\n<li>有害事象発生率の低下（OR 0.79）</li>\n<li>入院30日以内の死亡率の低下（HR 0.65）</li>\n<li>QOLの改善（OR 3.06）</li>\n</ul>\n<!-- /wp:html -->\n\n<!-- wp:paragraph -->\n<p>本研究の重要なポイントは、体系化された栄養ケアシステムが実践されていることです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>[EFFORT研究における体系的な栄養ケアの流れ]<br>１．入院当日の栄養スクリーニング<br>　　・NRS 2002（栄養リスクスクリーニングツール）を用いて実施<br>　　・低栄養リスクがある患者を特定<br>２．詳細な栄養アセスメントと栄養介入の実施（48時間以内）<br>　　・管理栄養士が個別の栄養目標を設定<br>　　・定期的なモニタリングを実施<br>３．栄養介入の具体的な手順<br>　　・まずは経口摂取で目標達成を目指す<br>　　・経腸栄養の併用（経口摂取が不足する場合）<br>　　・静脈栄養の併用（さらに不足する場合）<br>４．リアセスメントの実施<br>　　・24～48時間ごとに評価し、5日以内に目標達成を目指す</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>このように、スクリーニングから栄養アセスメント、栄養目標設定を行い、栄養の専門家（管理栄養士などの単独の職種またはチーム）による個別化された栄養介入とモニタリングの流れを、時間の期限を決めて実践することは、低栄養を認める入院患者の予後に良い影響をもたらすことが明らかとなったわけです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>米国栄養士会（Academy of Nutrition and Dietetics）は、2000年代にAcademy of Nutrition and Dietetics modelsとしての栄養ケアプロセス<sup>2)</sup>を提唱しました。栄養ケアプロセスは、患者の栄養状態を評価し、適切な栄養介入を計画・実施・評価するための体系的な手順であり、主に管理栄養士が活用し、個別化された栄養管理を提供するために用いられます(図1)。この栄養ケアプロセスやEffort研究のように、体系化された栄養管理体制を実践することで、栄養介入の効果が証明されたランダム化比較試験が複数存在します（表1）。低栄養患者のみだけでなく、化学療法や放射線療法などの抗がん治療患者、高齢患者や外科手術患者などが対象です。体系化された栄養ケアの提供により、術後合併症などの有害事象発生率低下や再入院率低下、死亡率低下、QoL改善、在院日数の短縮、栄養素摂取量増加、栄養状態の改善などの効果を認めました。これら研究でも、介入は入院後または栄養の専門家に紹介後72時間以内になされています。個人的には、栄養介入までの時間的制約が大変重要と感じています。なぜなら介入に時間的制約を設けることで、<a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の患者</a>に早期に介入すること、低栄養リスク患者に、低栄養にならないよう予防的に介入することが可能となるからです。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p>図1.　<strong>栄養ケアプロセスの流れ</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:image {\"id\":884,\"width\":\"781px\",\"height\":\"auto\",\"sizeSlug\":\"full\",\"linkDestination\":\"none\"} -->\n<figure class=\"wp-block-image size-full is-resized\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png\" alt=\"\" class=\"wp-image-884\" style=\"width:781px;height:auto\"/></figure>\n<!-- /wp:image -->\n\n<!-- wp:paragraph {\"align\":\"right\"} -->\n<p class=\"has-text-align-right\">Hammond MI,<sup> </sup>et al. <em>J Acad Nutr Diet. 2014.</em>より引用作図</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:paragraph -->\n<p><strong>表1.　体系化された栄養ケアの効果</strong></p>\n<!-- /wp:paragraph -->\n\n<!-- wp:table -->\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>対象者</td><td>介入までの時間制限</td><td>臨床転帰</td></tr><tr><td>腹部外科術後患者（ICU） <sup>3)</sup></td><td>24h</td><td>術後合併症と死亡率低下</td></tr><tr><td>化学療法中の胃がん患者<sup>4)</sup></td><td>24h</td><td>栄養状態とQoL改善</td></tr><tr><td>化学放射線療法中の 食道がん患者<sup>5)</sup></td><td>24h</td><td>有害事象とうつ症状の軽減、QoLの改善</td></tr><tr><td>高齢患者<sup>6)</sup></td><td>24h</td><td>栄養状態改善、在院日数短縮</td></tr><tr><td>低栄養患者<sup>7)</sup></td><td>24h</td><td>在院日数短縮</td></tr><tr><td>化学療法中の大腸がん患者<sup>8)</sup></td><td>24h</td><td>プレアルブミンの改善</td></tr><tr><td>低栄養患者<sup>9)</sup></td><td>24h</td><td>栄養摂取量増加、QoL改善</td></tr><tr><td>大腿骨頸部骨折高齢者<sup>10)</sup></td><td>24h</td><td>せん妄期間と在院日数短縮、褥瘡の減少</td></tr><tr><td>股関節骨折高齢女性患者<sup>11)</sup></td><td>24h</td><td>死亡率低下</td></tr><tr><td>成人患者<sup>12)</sup></td><td>36h</td><td>栄養摂取量増加、在院日数短縮</td></tr><tr><td>高齢患者<sup>13)</sup></td><td>72h</td><td>在院日数短縮、再入院率減少</td></tr><tr><td>高齢患者<sup>14)</sup></td><td>72h</td><td>死亡率低下、栄養状態改善</td></tr><tr><td>成人患者<sup>15)</sup></td><td>72h</td><td>栄養状態とQoL改善、合併症と感染症、 再入院率の低下</td></tr></tbody></table></figure>\n<!-- /wp:table -->\n\n<!-- wp:paragraph -->\n<p>日本でも病院での体系的な栄養ケアの提供が求められています。令和6年度の診療報酬改定では、入院患者に対し標準的な栄養スクリーニングを含む栄養状態の評価、栄養管理計画、退院時を含む定期的な評価等の栄養管理手順を作成し、病院内の栄養管理体制の整備を行うことが明記されました。エビデンスに基づいた栄養管理体制を整える事が入院患者の栄養サポートを行う上で重要になります。</p>\n<!-- /wp:paragraph -->\n\n<!-- wp:heading -->\n<h2 class=\"wp-block-heading\">参考文献</h2>\n<!-- /wp:heading -->\n\n<!-- wp:paragraph -->\n<p>1. P Schuetz,R Fehr,V Baechli, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321.<br>2. MI Hammond,EF Myers,N Trostler. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet 2014; 114: 1879-1894.<br>3. KM Im,EY Kim. Reducing In-Hospital and 60-Day Mortality in Critically Ill Patients after Surgery with Strict Nutritional Supplementation: A Prospective, Single-Labeled, Randomized Controlled Trial. Nutrients 2023; 15:<br>4. L Chen,M Zhao,L Tan, et al. Effects of Five-Step Nutritional Interventions Conducted by a Multidisciplinary Care Team on Gastroenteric Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial. Nutr Cancer 2023; 75: 197-206.<br>5. Y Qiu,J You,K Wang, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition 2020; 69: 110558.<br>6. Y Sharma,CH Thompson,B Kaambwa, et al. Investigation of the benefits of early malnutrition screening with telehealth follow up in elderly acute medical admissions. Qjm 2017; 110: 639-647.<br>7. EA Cano-Torres,LE Simental-Mendía,LA Morales-Garza, et al. Impact of Nutritional Intervention on Length of Hospital Stay and Mortality among Hospitalized Patients with Malnutrition: A Clinical Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 235-239.<br>8. JX Lin,XW Chen,ZH Chen, et al. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96: e7373.<br>9. U Rüfenacht,M Rühlin,M Wegmann, et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60.<br>10. B Olofsson,M Stenvall,M Lundström, et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038.<br>11. DG Duncan,SJ Beck,K Hood, et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153.<br>12. N Johansen,J Kondrup,LM Plum, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 2004; 23: 539-550.<br>13. M Holyday,S Daniells,M Bare, et al. Malnutrition screening and early nutrition intervention in hospitalised patients in acute aged care: a randomised controlled trial. J Nutr Health Aging 2012; 16: 562-568.<br>14. I Feldblum,L German,H Castel, et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17. 15. J Starke,H Schneider,B Alteheld, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201.</p>\n<!-- /wp:paragraph -->','体系化された栄養ケアとは','','inherit','closed','closed','','882-revision-v1','','','2025-03-26 20:59:12','2025-03-26 11:59:12','',882,'https://geriatrics.jp/?p=963',0,'revision','',0);
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media for the post.\",\"type\":\"integer\",\"required\":false},\"comment_status\":{\"description\":\"Whether or not comments are open on the post.\",\"type\":\"string\",\"enum\":[\"open\",\"closed\"],\"required\":false},\"ping_status\":{\"description\":\"Whether or not the post can be pinged.\",\"type\":\"string\",\"enum\":[\"open\",\"closed\"],\"required\":false},\"meta\":{\"description\":\"Meta fields.\",\"type\":\"object\",\"properties\":[],\"required\":false},\"template\":{\"description\":\"The theme file to use to display the post.\",\"type\":\"string\",\"required\":false},\"alt_text\":{\"description\":\"Alternative text to display when attachment is not displayed.\",\"type\":\"string\",\"required\":false},\"caption\":{\"description\":\"The attachment caption.\",\"type\":\"object\",\"properties\":{\"raw\":{\"description\":\"Caption for the attachment, as it exists in the database.\",\"type\":\"string\",\"context\":[\"edit\"]},\"rendered\":{\"description\":\"HTML caption for the attachment, transformed for display.\",\"type\":\"string\",\"context\":[\"view\",\"edit\",\"embed\"],\"readonly\":true}},\"required\":false},\"description\":{\"description\":\"The attachment description.\",\"type\":\"object\",\"properties\":{\"raw\":{\"description\":\"Description for the attachment, as it exists in the database.\",\"type\":\"string\",\"context\":[\"edit\"]},\"rendered\":{\"description\":\"HTML description for the attachment, transformed for display.\",\"type\":\"string\",\"context\":[\"view\",\"edit\"],\"readonly\":true}},\"required\":false},\"post\":{\"description\":\"The ID for the associated post of the attachment.\",\"type\":\"integer\",\"required\":false}}},{\"methods\":[\"DELETE\"],\"args\":{\"id\":{\"description\":\"Unique identifier for the post.\",\"type\":\"integer\",\"required\":false},\"force\":{\"type\":\"boolean\",\"default\":false,\"description\":\"Whether to bypass Trash and force deletion.\",\"required\":false}}}]},\"\\/wp\\/v2\\/media\\/(?P<id>[\\\\d]+)\\/post-process\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"POST\"],\"endpoints\":[{\"methods\":[\"POST\"],\"args\":{\"id\":{\"description\":\"Unique identifier for the attachment.\",\"type\":\"integer\",\"required\":false},\"action\":{\"type\":\"string\",\"enum\":[\"create-image-subsizes\"],\"required\":true}}}]},\"\\/wp\\/v2\\/media\\/(?P<id>[\\\\d]+)\\/edit\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"POST\"],\"endpoints\":[{\"methods\":[\"POST\"],\"args\":{\"src\":{\"description\":\"URL to the edited image file.\",\"type\":\"string\",\"format\":\"uri\",\"required\":true},\"modifiers\":{\"description\":\"Array of image edits.\",\"type\":\"array\",\"minItems\":1,\"items\":{\"description\":\"Image edit.\",\"type\":\"object\",\"required\":[\"type\",\"args\"],\"oneOf\":[{\"title\":\"Rotation\",\"properties\":{\"type\":{\"description\":\"Rotation type.\",\"type\":\"string\",\"enum\":[\"rotate\"]},\"args\":{\"description\":\"Rotation arguments.\",\"type\":\"object\",\"required\":[\"angle\"],\"properties\":{\"angle\":{\"description\":\"Angle to rotate clockwise in degrees.\",\"type\":\"number\"}}}}},{\"title\":\"Crop\",\"properties\":{\"type\":{\"description\":\"Crop type.\",\"type\":\"string\",\"enum\":[\"crop\"]},\"args\":{\"description\":\"Crop arguments.\",\"type\":\"object\",\"required\":[\"left\",\"top\",\"width\",\"height\"],\"properties\":{\"left\":{\"description\":\"Horizontal position from the left to begin the crop as a percentage of the image width.\",\"type\":\"number\"},\"top\":{\"description\":\"Vertical position from the top to begin the crop as a percentage of the image height.\",\"type\":\"number\"},\"width\":{\"description\":\"Width of the crop as a percentage of the image width.\",\"type\":\"number\"},\"height\":{\"description\":\"Height of the crop as a percentage of the image height.\",\"type\":\"number\"}}}}}]},\"required\":false},\"rotation\":{\"description\":\"The amount to rotate the image clockwise in degrees. DEPRECATED: Use `modifiers` instead.\",\"type\":\"integer\",\"minimum\":0,\"exclusiveMinimum\":true,\"maximum\":360,\"exclusiveMaximum\":true,\"required\":false},\"x\":{\"description\":\"As a percentage of the image, the x position to start the crop from. DEPRECATED: Use `modifiers` instead.\",\"type\":\"number\",\"minimum\":0,\"maximum\":100,\"required\":false},\"y\":{\"description\":\"As a percentage of the image, the y position to start the crop from. DEPRECATED: Use `modifiers` instead.\",\"type\":\"number\",\"minimum\":0,\"maximum\":100,\"required\":false},\"width\":{\"description\":\"As a percentage of the image, the width to crop the image to. DEPRECATED: Use `modifiers` instead.\",\"type\":\"number\",\"minimum\":0,\"maximum\":100,\"required\":false},\"height\":{\"description\":\"As a percentage of the image, the height to crop the image to. DEPRECATED: Use `modifiers` instead.\",\"type\":\"number\",\"minimum\":0,\"maximum\":100,\"required\":false}}}]},\"\\/wp\\/v2\\/menu-items\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"GET\",\"POST\"],\"endpoints\":[{\"methods\":[\"GET\"],\"allow_batch\":{\"v1\":true},\"args\":{\"context\":{\"description\":\"Scope under which the request is made; determines fields present in response.\",\"type\":\"string\",\"enum\":[\"view\",\"embed\",\"edit\"],\"default\":\"view\",\"required\":false},\"page\":{\"description\":\"Current page of the collection.\",\"type\":\"integer\",\"default\":1,\"minimum\":1,\"required\":false},\"per_page\":{\"description\":\"Maximum number of items to be returned in result set.\",\"type\":\"integer\",\"default\":100,\"minimum\":1,\"maximum\":100,\"required\":false},\"search\":{\"description\":\"Limit results to those matching a string.\",\"type\":\"string\",\"required\":false},\"after\":{\"description\":\"Limit response to posts published after a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"modified_after\":{\"description\":\"Limit response to posts modified after a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"before\":{\"description\":\"Limit response to posts published before a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"modified_before\":{\"description\":\"Limit response to posts modified before a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"exclude\":{\"description\":\"Ensure result set excludes specific IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[],\"required\":false},\"include\":{\"description\":\"Limit result set to specific IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[],\"required\":false},\"offset\":{\"description\":\"Offset the result set by a specific number of items.\",\"type\":\"integer\",\"required\":false},\"order\":{\"description\":\"Order sort attribute ascending or descending.\",\"type\":\"string\",\"default\":\"asc\",\"enum\":[\"asc\",\"desc\"],\"required\":false},\"orderby\":{\"description\":\"Sort collection by object attribute.\",\"type\":\"string\",\"default\":\"menu_order\",\"enum\":[\"author\",\"date\",\"id\",\"include\",\"modified\",\"parent\",\"relevance\",\"slug\",\"include_slugs\",\"title\",\"menu_order\"],\"required\":false},\"search_columns\":{\"default\":[],\"description\":\"Array of column names to be searched.\",\"type\":\"array\",\"items\":{\"enum\":[\"post_title\",\"post_content\",\"post_excerpt\"],\"type\":\"string\"},\"required\":false},\"slug\":{\"description\":\"Limit result set to posts with one or more specific slugs.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"status\":{\"default\":\"publish\",\"description\":\"Limit result set to posts assigned one or more statuses.\",\"type\":\"array\",\"items\":{\"enum\":[\"publish\",\"future\",\"draft\",\"pending\",\"private\",\"trash\",\"auto-draft\",\"inherit\",\"request-pending\",\"request-confirmed\",\"request-failed\",\"request-completed\",\"flamingo-spam\",\"any\"],\"type\":\"string\"},\"required\":false},\"tax_relation\":{\"description\":\"Limit result set based on relationship between multiple taxonomies.\",\"type\":\"string\",\"enum\":[\"AND\",\"OR\"],\"required\":false},\"menus\":{\"description\":\"Limit result set to items with specific terms assigned in the menus taxonomy.\",\"type\":[\"object\",\"array\"],\"oneOf\":[{\"title\":\"Term ID List\",\"description\":\"Match terms with the listed IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"}},{\"title\":\"Term ID Taxonomy Query\",\"description\":\"Perform an advanced term query.\",\"type\":\"object\",\"properties\":{\"terms\":{\"description\":\"Term IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[]},\"operator\":{\"description\":\"Whether items must be assigned all or any of the specified terms.\",\"type\":\"string\",\"enum\":[\"AND\",\"OR\"],\"default\":\"OR\"}},\"additionalProperties\":false}],\"required\":false},\"menus_exclude\":{\"description\":\"Limit result set to items except those with specific terms assigned in the menus taxonomy.\",\"type\":[\"object\",\"array\"],\"oneOf\":[{\"title\":\"Term ID List\",\"description\":\"Match terms with the listed IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"}},{\"title\":\"Term ID Taxonomy Query\",\"description\":\"Perform an advanced term query.\",\"type\":\"object\",\"properties\":{\"terms\":{\"description\":\"Term IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[]}},\"additionalProperties\":false}],\"required\":false},\"menu_order\":{\"description\":\"Limit result set to posts with a specific menu_order value.\",\"type\":\"integer\",\"required\":false}}},{\"methods\":[\"POST\"],\"allow_batch\":{\"v1\":true},\"args\":{\"title\":{\"description\":\"The title for the object.\",\"type\":[\"string\",\"object\"],\"properties\":{\"raw\":{\"description\":\"Title for the object, as it exists in the database.\",\"type\":\"string\",\"context\":[\"edit\"]},\"rendered\":{\"description\":\"HTML title for the object, transformed for display.\",\"type\":\"string\",\"context\":[\"view\",\"edit\",\"embed\"],\"readonly\":true}},\"required\":false},\"type\":{\"default\":\"custom\",\"description\":\"The family of objects originally represented, such as \\\"post_type\\\" or \\\"taxonomy\\\".\",\"type\":\"string\",\"enum\":[\"taxonomy\",\"post_type\",\"post_type_archive\",\"custom\"],\"required\":false},\"status\":{\"default\":\"publish\",\"description\":\"A named status for the object.\",\"type\":\"string\",\"enum\":[\"publish\",\"future\",\"draft\",\"pending\",\"private\",\"flamingo-spam\"],\"required\":false},\"parent\":{\"default\":0,\"description\":\"The ID for the parent of the object.\",\"type\":\"integer\",\"minimum\":0,\"required\":false},\"attr_title\":{\"description\":\"Text for the title attribute of the link element for this menu item.\",\"type\":\"string\",\"required\":false},\"classes\":{\"description\":\"Class names for the link element of this menu item.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"description\":{\"description\":\"The description of this menu item.\",\"type\":\"string\",\"required\":false},\"menu_order\":{\"default\":1,\"description\":\"The DB ID of the nav_menu_item that is this item\'s menu parent, if any, otherwise 0.\",\"type\":\"integer\",\"minimum\":1,\"required\":false},\"object\":{\"description\":\"The type of object originally represented, such as \\\"category\\\", \\\"post\\\", or \\\"attachment\\\".\",\"type\":\"string\",\"required\":false},\"object_id\":{\"default\":0,\"description\":\"The database ID of the original object this menu item represents, for example the ID for posts or the term_id for categories.\",\"type\":\"integer\",\"minimum\":0,\"required\":false},\"target\":{\"description\":\"The target attribute of the link element for this menu item.\",\"type\":\"string\",\"enum\":[\"_blank\",\"\"],\"required\":false},\"url\":{\"description\":\"The URL to which this menu item points.\",\"type\":\"string\",\"format\":\"uri\",\"required\":false},\"xfn\":{\"description\":\"The XFN relationship expressed in the link of this menu item.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"menus\":{\"description\":\"The terms assigned to the object in the nav_menu taxonomy.\",\"type\":\"integer\",\"required\":false},\"meta\":{\"description\":\"Meta fields.\",\"type\":\"object\",\"properties\":[],\"required\":false}}}],\"_links\":{\"self\":[{\"href\":\"https:\\/\\/geriatrics.jp\\/wp-json\\/wp\\/v2\\/menu-items\"}]}},\"\\/wp\\/v2\\/menu-items\\/(?P<id>[\\\\d]+)\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"GET\",\"POST\",\"PUT\",\"PATCH\",\"DELETE\"],\"endpoints\":[{\"methods\":[\"GET\"],\"allow_batch\":{\"v1\":true},\"args\":{\"id\":{\"description\":\"Unique identifier for the post.\",\"type\":\"integer\",\"required\":false},\"context\":{\"description\":\"Scope under which the request is made; determines fields present in response.\",\"type\":\"string\",\"enum\":[\"view\",\"embed\",\"edit\"],\"default\":\"view\",\"required\":false}}},{\"methods\":[\"POST\",\"PUT\",\"PATCH\"],\"allow_batch\":{\"v1\":true},\"args\":{\"id\":{\"description\":\"Unique identifier for the post.\",\"type\":\"integer\",\"required\":false},\"title\":{\"description\":\"The title for the object.\",\"type\":[\"string\",\"object\"],\"properties\":{\"raw\":{\"description\":\"Title for the object, as it exists in the database.\",\"type\":\"string\",\"context\":[\"edit\"]},\"rendered\":{\"description\":\"HTML title for the object, transformed for display.\",\"type\":\"string\",\"context\":[\"view\",\"edit\",\"embed\"],\"readonly\":true}},\"required\":false},\"type\":{\"description\":\"The family of objects originally represented, such as \\\"post_type\\\" or \\\"taxonomy\\\".\",\"type\":\"string\",\"enum\":[\"taxonomy\",\"post_type\",\"post_type_archive\",\"custom\"],\"required\":false},\"status\":{\"description\":\"A named status for the object.\",\"type\":\"string\",\"enum\":[\"publish\",\"future\",\"draft\",\"pending\",\"private\",\"flamingo-spam\"],\"required\":false},\"parent\":{\"description\":\"The ID for the parent of the object.\",\"type\":\"integer\",\"minimum\":0,\"required\":false},\"attr_title\":{\"description\":\"Text for the title attribute of the link element for this menu item.\",\"type\":\"string\",\"required\":false},\"classes\":{\"description\":\"Class names for the link element of this menu item.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"description\":{\"description\":\"The description of this menu item.\",\"type\":\"string\",\"required\":false},\"menu_order\":{\"description\":\"The DB ID of the nav_menu_item that is this item\'s menu parent, if any, otherwise 0.\",\"type\":\"integer\",\"minimum\":1,\"required\":false},\"object\":{\"description\":\"The type of object originally represented, such as \\\"category\\\", \\\"post\\\", or \\\"attachment\\\".\",\"type\":\"string\",\"required\":false},\"object_id\":{\"description\":\"The database ID of the original object this menu item represents, for example the ID for posts or the term_id for categories.\",\"type\":\"integer\",\"minimum\":0,\"required\":false},\"target\":{\"description\":\"The target attribute of the link element for this menu item.\",\"type\":\"string\",\"enum\":[\"_blank\",\"\"],\"required\":false},\"url\":{\"description\":\"The URL to which this menu item points.\",\"type\":\"string\",\"format\":\"uri\",\"required\":false},\"xfn\":{\"description\":\"The XFN relationship expressed in the link of this menu item.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"menus\":{\"description\":\"The terms assigned to the object in the nav_menu taxonomy.\",\"type\":\"integer\",\"required\":false},\"meta\":{\"description\":\"Meta fields.\",\"type\":\"object\",\"properties\":[],\"required\":false}}},{\"methods\":[\"DELETE\"],\"allow_batch\":{\"v1\":true},\"args\":{\"id\":{\"description\":\"Unique identifier for the post.\",\"type\":\"integer\",\"required\":false},\"force\":{\"type\":\"boolean\",\"default\":false,\"description\":\"Whether to bypass Trash and force deletion.\",\"required\":false}}}]},\"\\/wp\\/v2\\/menu-items\\/(?P<id>[\\\\d]+)\\/autosaves\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"GET\",\"POST\"],\"endpoints\":[{\"methods\":[\"GET\"],\"args\":{\"parent\":{\"description\":\"The ID for the parent of the autosave.\",\"type\":\"integer\",\"required\":false},\"context\":{\"description\":\"Scope under which the request is made; determines fields present in response.\",\"type\":\"string\",\"enum\":[\"view\",\"embed\",\"edit\"],\"default\":\"view\",\"required\":false}}},{\"methods\":[\"POST\"],\"args\":{\"parent\":{\"description\":\"The ID for the parent of the object.\",\"type\":\"integer\",\"minimum\":0,\"required\":false},\"title\":{\"description\":\"The title for the object.\",\"type\":[\"string\",\"object\"],\"properties\":{\"raw\":{\"description\":\"Title for the object, as it exists in the database.\",\"type\":\"string\",\"context\":[\"edit\"]},\"rendered\":{\"description\":\"HTML title for the object, transformed for display.\",\"type\":\"string\",\"context\":[\"view\",\"edit\",\"embed\"],\"readonly\":true}},\"required\":false},\"type\":{\"description\":\"The family of objects originally represented, such as \\\"post_type\\\" or \\\"taxonomy\\\".\",\"type\":\"string\",\"enum\":[\"taxonomy\",\"post_type\",\"post_type_archive\",\"custom\"],\"required\":false},\"status\":{\"description\":\"A named status for the object.\",\"type\":\"string\",\"enum\":[\"publish\",\"future\",\"draft\",\"pending\",\"private\",\"flamingo-spam\"],\"required\":false},\"attr_title\":{\"description\":\"Text for the title attribute of the link element for this menu item.\",\"type\":\"string\",\"required\":false},\"classes\":{\"description\":\"Class names for the link element of this menu item.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"description\":{\"description\":\"The description of this menu item.\",\"type\":\"string\",\"required\":false},\"menu_order\":{\"description\":\"The DB ID of the nav_menu_item that is this item\'s menu parent, if any, otherwise 0.\",\"type\":\"integer\",\"minimum\":1,\"required\":false},\"object\":{\"description\":\"The type of object originally represented, such as \\\"category\\\", \\\"post\\\", or \\\"attachment\\\".\",\"type\":\"string\",\"required\":false},\"object_id\":{\"description\":\"The database ID of the original object this menu item represents, for example the ID for posts or the term_id for categories.\",\"type\":\"integer\",\"minimum\":0,\"required\":false},\"target\":{\"description\":\"The target attribute of the link element for this menu item.\",\"type\":\"string\",\"enum\":[\"_blank\",\"\"],\"required\":false},\"url\":{\"description\":\"The URL to which this menu item points.\",\"type\":\"string\",\"format\":\"uri\",\"required\":false},\"xfn\":{\"description\":\"The XFN relationship expressed in the link of this menu item.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"menus\":{\"description\":\"The terms assigned to the object in the nav_menu taxonomy.\",\"type\":\"integer\",\"required\":false},\"meta\":{\"description\":\"Meta fields.\",\"type\":\"object\",\"properties\":[],\"required\":false}}}]},\"\\/wp\\/v2\\/menu-items\\/(?P<parent>[\\\\d]+)\\/autosaves\\/(?P<id>[\\\\d]+)\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"GET\"],\"endpoints\":[{\"methods\":[\"GET\"],\"args\":{\"parent\":{\"description\":\"The ID for the parent of the autosave.\",\"type\":\"integer\",\"required\":false},\"id\":{\"description\":\"The ID for the autosave.\",\"type\":\"integer\",\"required\":false},\"context\":{\"description\":\"Scope under which the request is made; determines fields present in response.\",\"type\":\"string\",\"enum\":[\"view\",\"embed\",\"edit\"],\"default\":\"view\",\"required\":false}}}]},\"\\/wp\\/v2\\/blocks\":{\"namespace\":\"wp\\/v2\",\"methods\":[\"GET\",\"POST\"],\"endpoints\":[{\"methods\":[\"GET\"],\"allow_batch\":{\"v1\":true},\"args\":{\"context\":{\"description\":\"Scope under which the request is made; determines fields present in response.\",\"type\":\"string\",\"enum\":[\"view\",\"embed\",\"edit\"],\"default\":\"view\",\"required\":false},\"page\":{\"description\":\"Current page of the collection.\",\"type\":\"integer\",\"default\":1,\"minimum\":1,\"required\":false},\"per_page\":{\"description\":\"Maximum number of items to be returned in result set.\",\"type\":\"integer\",\"default\":10,\"minimum\":1,\"maximum\":100,\"required\":false},\"search\":{\"description\":\"Limit results to those matching a string.\",\"type\":\"string\",\"required\":false},\"after\":{\"description\":\"Limit response to posts published after a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"modified_after\":{\"description\":\"Limit response to posts modified after a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"before\":{\"description\":\"Limit response to posts published before a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"modified_before\":{\"description\":\"Limit response to posts modified before a given ISO8601 compliant date.\",\"type\":\"string\",\"format\":\"date-time\",\"required\":false},\"exclude\":{\"description\":\"Ensure result set excludes specific IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[],\"required\":false},\"include\":{\"description\":\"Limit result set to specific IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[],\"required\":false},\"offset\":{\"description\":\"Offset the result set by a specific number of items.\",\"type\":\"integer\",\"required\":false},\"order\":{\"description\":\"Order sort attribute ascending or descending.\",\"type\":\"string\",\"default\":\"desc\",\"enum\":[\"asc\",\"desc\"],\"required\":false},\"orderby\":{\"description\":\"Sort collection by post attribute.\",\"type\":\"string\",\"default\":\"date\",\"enum\":[\"author\",\"date\",\"id\",\"include\",\"modified\",\"parent\",\"relevance\",\"slug\",\"include_slugs\",\"title\"],\"required\":false},\"search_columns\":{\"default\":[],\"description\":\"Array of column names to be searched.\",\"type\":\"array\",\"items\":{\"enum\":[\"post_title\",\"post_content\",\"post_excerpt\"],\"type\":\"string\"},\"required\":false},\"slug\":{\"description\":\"Limit result set to posts with one or more specific slugs.\",\"type\":\"array\",\"items\":{\"type\":\"string\"},\"required\":false},\"status\":{\"default\":\"publish\",\"description\":\"Limit result set to posts assigned one or more statuses.\",\"type\":\"array\",\"items\":{\"enum\":[\"publish\",\"future\",\"draft\",\"pending\",\"private\",\"trash\",\"auto-draft\",\"inherit\",\"request-pending\",\"request-confirmed\",\"request-failed\",\"request-completed\",\"flamingo-spam\",\"any\"],\"type\":\"string\"},\"required\":false},\"tax_relation\":{\"description\":\"Limit result set based on relationship between multiple taxonomies.\",\"type\":\"string\",\"enum\":[\"AND\",\"OR\"],\"required\":false},\"wp_pattern_category\":{\"description\":\"Limit result set to items with specific terms assigned in the wp_pattern_category taxonomy.\",\"type\":[\"object\",\"array\"],\"oneOf\":[{\"title\":\"Term ID List\",\"description\":\"Match terms with the listed IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"}},{\"title\":\"Term ID Taxonomy Query\",\"description\":\"Perform an advanced term query.\",\"type\":\"object\",\"properties\":{\"terms\":{\"description\":\"Term IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[]},\"operator\":{\"description\":\"Whether items must be assigned all or any of the specified terms.\",\"type\":\"string\",\"enum\":[\"AND\",\"OR\"],\"default\":\"OR\"}},\"additionalProperties\":false}],\"required\":false},\"wp_pattern_category_exclude\":{\"description\":\"Limit result set to items except those with specific terms assigned in the wp_pattern_category taxonomy.\",\"type\":[\"object\",\"array\"],\"oneOf\":[{\"title\":\"Term ID List\",\"description\":\"Match terms with the listed IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"}},{\"title\":\"Term ID Taxonomy Query\",\"description\":\"Perform an advanced term query.\",\"type\":\"object\",\"properties\":{\"terms\":{\"description\":\"Term IDs.\",\"type\":\"array\",\"items\":{\"type\":\"integer\"},\"default\":[]}},\"additionalProperties\":false}],\"required\":false}}},{\"methods\":[\"POST\"],\"allow_batch\":{\"v1\":true},\"args\":{\"date\":{\"description\":\"The date the post was published, in the site\'s timezone.\",\"type\":[\"string\",\"null\"],\"format\":\"date-time\",\"required\":false},\"date_gmt\":{\"description\":\"The date the post was published, as GMT.\",\"type\":[\"string\",\"null\"],\"format\":\"date-time\",\"required\":false},\"slug\":{\"description\":\"An alphanumeric identifier for the post unique to its type.\",\"type\":\"string\",\"required\":false},\"status\":{\"description\":\"A named status for the post.\",\"type\":\"string\",\"enum\":[\"publish\",\"future\",\"draft\",\"pending\",\"private\",\"flamingo-spam\"],\"required\":false},\"password\":{\"description\":\"A password to protect access to the content and excerpt.\",\"type\":\"string\",\"required\":false},\"title\":{\"description\":\"The title for the post.\",\"type\":\"object\",\"properties\":{\"raw\":{\"description\":\"Title for the post, as it exists in the database.\",\"type\":\"string\",\"context\":[\"view\",\"edit\"]}},\"required\":false},\"content\":{\"description\":\"The content for the post.\",\"type\":\"object\",\"properties\":{\"raw\":{\"description\":\"Content for the post, as it exists in the database.\",\"type\":\"string\",\"context\":[\"view\",\"edit\"]},\"block_version\":{\"description\":\"Version of the content block format used by the post.\",\"type\":\"integer\",\"context\":[\"edit\"],\"readonly\":true},\"protected\":{\"description\":\"Whether the content is protected with a password.\",\"type\":\"boolean\",\"context\":[\"view\",\"edit\",\"embed\"],\"readonly\":true}},\"required\":false},\"excerpt\":{\"description\":\"The excerpt for the post.\",\"type\":\"object\",\"properties\":{\"raw\":{\"description\":\"Excerpt for the post, as it exists in the 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src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/logo.png\" alt=\"老年栄養ドットコム\" title=\"老年栄養ドットコム\"/></a>\n<div id=\"header-right\">\n<div id=\"menu-box\">\n<div class=\"openbtn4\"><span></span><span></span><span></span></div>\n<menu class=\"dnone\">\n<ul>\n<li><a href=\"https://geriatrics.jp/\">ホーム</a></li>\n<li><a href=\"https://geriatrics.jp/main-contents\">メインコンテンツ</a></li>\n<li><a href=\"https://geriatrics.jp/news\">お知らせ一覧</a></li>\n<li><a href=\"https://geriatrics.jp/main-contents/press-release/\">プレスリリース</a></li>\n<li><a href=\"https://geriatrics.jp/contact\">申請・お問合せ</a></li>\n</ul>\n</menu>\n<!-- end div#menu-box --></div>\n<div id=\"search\">\n\r\n<form role=\"search\" method=\"get\" class=\"search-form\" action=\"https://geriatrics.jp/\">\r\n    <label class=\"screen-reader-text\" for=\"s\">検索:</label>\r\n    <input type=\"search\" id=\"s\" class=\"search-field\" placeholder=\"検索キーワード...\" value=\"\" name=\"s\" />\r\n\r\n    <input type=\"hidden\" name=\"cat\" value=\"-1\" />\r\n    <button type=\"submit\" class=\"search-submit\">\r\n        <span class=\"screen-reader-text\">検索</span>\r\n    </button>\r\n</form>\r\n<!-- end div#search --></div>\n<!-- end div#header-right --></div>\n</header>\n\n<nav class=\"breadcrumb\">\n    <ul>\n        <li><a href=\"https://geriatrics.jp/\">ホーム</a></li><li>メインコンテンツ</li>    </ul>\n\n    <!-- RSSフィードボタン - 条件付きで表示 -->\n            <div class=\"rss-feed-button\">\n            <a href=\"https://geriatrics.jp/feed/\">\n                <img src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/rss.png\" alt=\"RSSフィード\"/>\n            </a>\n        </div>\n    </nav>\n\r\n<main class=\"subpage\">\r\n    <div id=\"main-con\">\r\n        <h1>メインコンテンツ</h1>\r\n\r\n        <div id=\"main-con-area\">\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/diagnosis-of-low-nutrition/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-06-1.webp\" alt=\"低栄養診断\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/diagnosis-of-low-nutrition/\">低栄養診断</a></h2>\r\n                        <p>高齢者の低栄養状態を的確に把握し、予防と早期介入へとつなぐため、エビデンスに基づく評価手法を幅広く解説・情報提供します。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/diagnosis-of-low-nutrition/\">低栄養診断を見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/nutrition-support/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-27-1.webp\" alt=\"栄養サポート\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/nutrition-support/\">栄養サポート</a></h2>\r\n                        <p>多職種が連携し、一人ひとりの状態に合わせた栄養サポートを総合的かつ柔軟に実践できるポイント、エビデンスなど。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/nutrition-support/\">栄養サポートを見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/exercise-nutrition-oral/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-15-1.webp\" alt=\"運動・栄養・口腔\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/exercise-nutrition-oral/\">運動・栄養・口腔</a></h2>\r\n                        <p>栄養問題の要因や改善の焦点に、身体活動や栄養摂取、口腔問題が絡んでいることがあり、栄養問題解決に重要な視点です。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/exercise-nutrition-oral/\">運動・栄養・口腔を見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/cga-frail/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-08-1.webp\" alt=\"フレイル\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/cga-frail/\">フレイル</a></h2>\r\n                        <p>老化だけでなく、社会的な問題、生活習慣など多くの側面でフレイルをみる必要性があります。フレイル関連情報を提供。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/cga-frail/\">フレイルを見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/muscle-health-sarcopenia/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1.webp\" alt=\"マッスルヘルス・サルコペニア\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/muscle-health-sarcopenia/\">マッスルヘルス・サルコペニア</a></h2>\r\n                        <p>高齢者の筋肉量減少や筋力低下はサルコペニアとして知られています。筋の健康つまり、マッスルヘルスが健康長寿に超重要です。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/muscle-health-sarcopenia/\">マッスルヘルス・サルコペニアを見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/cga/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-10-1.webp\" alt=\"CGA・5Ms\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/cga/\">CGA・5Ms</a></h2>\r\n                        <p>包括的高齢者評価（CGA）と5Msの視点を活用し、高齢者に必要な多面的ケアを提供する高齢者診療の主軸について情報提供します。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/cga/\">CGA・5Msを見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/feed-swallowing/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-02-1-scaled.webp\" alt=\"摂食嚥下\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/feed-swallowing/\">摂食嚥下</a></h2>\r\n                        <p>食べる喜びを支える摂食嚥下問題への対応は高齢者ケアに不可欠です。評価・ケア・訓練などについて学習するお手伝いをいたします。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/feed-swallowing/\">摂食嚥下を見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/ingenuity-and-recipes/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-05-1.webp\" alt=\"食事工夫・レシピ集\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/ingenuity-and-recipes/\">食事工夫・レシピ集</a></h2>\r\n                        <p>高齢者の嗜好や嚥下機能に配慮したレシピや調理の工夫を多数紹介。美味しさと栄養を両立させるヒントが満載です。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/ingenuity-and-recipes/\">食事工夫・レシピ集を見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/press-release/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-20-1.webp\" alt=\"プレスリリースの場\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/press-release/\">プレスリリースの場</a></h2>\r\n                        <p>老年栄養の最新研究成果や取り組みを広く知らせるプレスリリースを集約。医療者と一般の方、報道機関の方に向けた情報発信拠点です。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/press-release/\">プレスリリースの場を見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/guideline-and-statement/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-18-1.webp\" alt=\"ガイドライン・声明\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/guideline-and-statement/\">ガイドライン・声明</a></h2>\r\n                        <p>学会や機関が発表する老年栄養に関係するガイドラインや声明をわかりやすくまとめ、現場で役立つエッセンスを提供します。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/guideline-and-statement/\">ガイドライン・声明を見る</a></span></p>\r\n                    </div>\r\n                                <div class=\"main-con-box fit-image\">\r\n                        <a href=\"https://geriatrics.jp/main-contents/papers/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-16-1.webp\" alt=\"論文紹介\"/>\r\n                        </a>\r\n                        <h2><a href=\"https://geriatrics.jp/main-contents/papers/\">論文紹介</a></h2>\r\n                        <p>国内外の最新エビデンスを厳選して解説。実践現場で即活用できる知見を提供し、高齢者ケアの質向上をサポートします。</p>\r\n                        <p class=\"pright\"><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/papers/\">論文紹介を見る</a></span></p>\r\n                    </div>\r\n                    </div>\r\n    </div>\r\n</main>\r\n\r\n\r\n<footer>\r\n<a href=\"https://geriatrics.jp/\"><img src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/logo-footer.png\" alt=\"老年栄養ドットコム\" title=\"老年栄養ドットコム\"/></a>\r\n<address>\r\n<a href=\"https://geriatrics.jp/maeda-lab\">Maeda Labの紹介</a><a href=\"https://geriatrics.jp/contact\">申請・お問合せ</a>\r\n</address>\r\n</footer>\r\n\r\n<div id=\"page-top\">\r\n<p><a id=\"move-page-top\">▲</a></p>\r\n</div>\r\n<!-- end div#con --></div>\r\n\r\n\n<!-- Sign in with Google button added by Site Kit -->\n<script src=\"https://accounts.google.com/gsi/client\"></script>\n<script>\n(()=>{async function handleCredentialResponse(response){try{const res=await 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20,\r\n        centeredSlides: true,\r\n        autoplay: {\r\n            delay: 5000,\r\n            disableOnInteraction: false,\r\n        },\r\n        speed: 1000,\r\n        breakpoints: {\r\n            640: {\r\n                slidesPerView: 1.25,\r\n            },\r\n            960: {\r\n                slidesPerView: 1.5,\r\n            },\r\n        },\r\n    });\r\n});\r\n</script>\r\n\r\n<main>\r\n\r\n<div id=\"info\">\r\n        <h1>栄養問題 @ 高齢者</h1>\r\n    <div class=\"info-content\"><p>高齢者に特有の低栄養、フレイル、サルコペニア、嚥下障害や食欲不振、誤嚥性肺炎、骨粗しょう症、転倒など、幅広い栄養課題を多角的に取り上げます。ポリファーマシーの影響や肥満なども含め、日々の暮らしを支えるために役立つ知識を発信します。人生終盤の栄養や食事介助まで、一人ひとりに寄り添う情報をお届けするサイトです。栄養という側面から健康長寿・豊かな人生を支えたい。LIVE LONG and PROSPER！</p></div>\r\n<!-- end div#info --></div>\r\n\r\n<div id=\"topics\">\r\n<div id=\"topics-title\">\r\n    <h1>TOPICS</h1>\r\n    <p>おすすめ記事</p>\r\n<!-- end div#topics-title --></div>\r\n<div id=\"topics-area\">\r\n        <div class=\"topics-box fit-image\">\r\n        <a href=\"https://geriatrics.jp/nutrition-support/test-01/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/topics-default.webp\" alt=\"\"/>\r\n                    </a>\r\n        <h1><a href=\"https://geriatrics.jp/nutrition-support/test-01/\">テスト用 &#8211; 体系化された栄養ケアとはのコピー</a></h1>\r\n        <p class=\"p-time\">2025.3.26</p>\r\n    <!-- end div.topics-box --></div>\r\n        <div class=\"topics-box fit-image\">\r\n        <a href=\"https://geriatrics.jp/nutrition-support/%e4%bd%93%e7%b3%bb%e5%8c%96%e3%81%95%e3%82%8c%e3%81%9f%e6%a0%84%e9%a4%8a%e3%82%b1%e3%82%a2%e3%81%a8%e3%81%af/\">\r\n                            <img width=\"300\" height=\"229\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス-300x229.png\" class=\"attachment-medium size-medium wp-post-image\" alt=\"\" decoding=\"async\" fetchpriority=\"high\" srcset=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス-300x229.png 300w, https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス-768x585.png 768w, https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス.png 896w\" sizes=\"(max-width: 300px) 100vw, 300px\" />                    </a>\r\n        <h1><a href=\"https://geriatrics.jp/nutrition-support/%e4%bd%93%e7%b3%bb%e5%8c%96%e3%81%95%e3%82%8c%e3%81%9f%e6%a0%84%e9%a4%8a%e3%82%b1%e3%82%a2%e3%81%a8%e3%81%af/\">体系化された栄養ケアとは</a></h1>\r\n        <p class=\"p-time\">2025.3.24</p>\r\n    <!-- end div.topics-box --></div>\r\n        <div class=\"topics-box fit-image\">\r\n        <a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">\r\n                            <img width=\"300\" height=\"200\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s-300x200.jpg\" class=\"attachment-medium size-medium wp-post-image\" alt=\"\" decoding=\"async\" srcset=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s-300x200.jpg 300w, https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s.jpg 640w\" sizes=\"(max-width: 300px) 100vw, 300px\" />                    </a>\r\n        <h1><a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の世界基準-GLIM基準-</a></h1>\r\n        <p class=\"p-time\">2025.3.24</p>\r\n    <!-- end div.topics-box --></div>\r\n    <!-- end div#topics-area --></div>\r\n<!-- end div#topics --></div>\r\n\r\n<div id=\"whatsnew\">\r\n<div id=\"whatsnew-title\">\r\n    <h1>What\'s new</h1>\r\n    <p>おしらせ</p>\r\n<!-- end div#whatsnew-title --></div>\r\n<div id=\"whatsnew-area\">\r\n    <ul>\r\n        <li>2025.3.14<br />\r\n        <h2><a href=\"https://geriatrics.jp/news/news-2025-03-11-02/\">お知らせ（現在準備中）</a></h2>\r\n    </li>\r\n        </ul>\r\n    <p><span>\r\n        <a href=\"https://geriatrics.jp/category/news/\">おしらせ一覧</a>    </span></p>\r\n<!-- end div#whatsnew-area --></div>\r\n<!-- end div#whatsnew --></div>\r\n\r\n<div id=\"top-list\">\r\n    <div class=\"top-list\">\r\n    <h1><a href=\"https://geriatrics.jp/main-contents/diagnosis-of-low-nutrition/\">低栄養診断</a></h1>\r\n    <div class=\"top-list-area\">\r\n        <!-- end div.top-list-area --></div>\r\n    <div class=\"top-list-area2\">\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/2307246_s-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/%e4%bd%8e%e6%a0%84%e9%a4%8a%e3%81%ae%e4%b8%96%e7%95%8c%e5%9f%ba%e6%ba%96-glim%e5%9f%ba%e6%ba%96/\">低栄養の世界基準-GLIM基準-</a></h2>\r\n            <p class=\"p-time\">2025.3.24</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/sample-diagnosis-of-low-nutrition-01/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-04-1-150x150.webp\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/diagnosis-of-low-nutrition/sample-diagnosis-of-low-nutrition-01/\">サンプル &#8211; 低栄養診断1</a></h2>\r\n            <p class=\"p-time\">2025.2.14</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <!-- end div.top-list-area2 --></div>\r\n    <p><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/diagnosis-of-low-nutrition/\">低栄養診断をもっと見る</a></span></p>\r\n    <!-- end div.top-list --></div>\r\n        <div class=\"top-list\">\r\n    <h1><a href=\"https://geriatrics.jp/main-contents/nutrition-support/\">栄養サポート</a></h1>\r\n    <div class=\"top-list-area\">\r\n        <!-- end div.top-list-area --></div>\r\n    <div class=\"top-list-area2\">\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/nutrition-support/test-01/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/pict-sample4.webp\" alt=\"\"/>\r\n                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/nutrition-support/test-01/\">テスト用 &#8211; 体系化された栄養ケアとはのコピー</a></h2>\r\n            <p class=\"p-time\">2025.3.26</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/nutrition-support/%e4%bd%93%e7%b3%bb%e5%8c%96%e3%81%95%e3%82%8c%e3%81%9f%e6%a0%84%e9%a4%8a%e3%82%b1%e3%82%a2%e3%81%a8%e3%81%af/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/栄養ケアプロセス-150x150.png\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/nutrition-support/%e4%bd%93%e7%b3%bb%e5%8c%96%e3%81%95%e3%82%8c%e3%81%9f%e6%a0%84%e9%a4%8a%e3%82%b1%e3%82%a2%e3%81%a8%e3%81%af/\">体系化された栄養ケアとは</a></h2>\r\n            <p class=\"p-time\">2025.3.24</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <div class=\"top-list-box2 bno\">\r\n        <a href=\"https://geriatrics.jp/nutrition-support/sample-nutrition-support-03/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-21-150x150.webp\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/nutrition-support/sample-nutrition-support-03/\">サンプル &#8211; 栄養サポート3</a></h2>\r\n            <p class=\"p-time\">2025.3.15</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <!-- end div.top-list-area2 --></div>\r\n    <p><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/nutrition-support/\">栄養サポートをもっと見る</a></span></p>\r\n    <!-- end div.top-list --></div>\r\n        <div class=\"top-list\">\r\n    <h1><a href=\"https://geriatrics.jp/main-contents/exercise-nutrition-oral/\">運動・栄養・口腔</a></h1>\r\n    <div class=\"top-list-area\">\r\n        <!-- end div.top-list-area --></div>\r\n    <div class=\"top-list-area2\">\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/exercise-nutrition-oral/sample-exercise-nutrition-oral-03/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-07-1-150x150.webp\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/exercise-nutrition-oral/sample-exercise-nutrition-oral-03/\">サンプル &#8211; 運動・栄養・口腔3</a></h2>\r\n            <p class=\"p-time\">2025.3.15</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/exercise-nutrition-oral/sample-exercise-nutrition-oral-02/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-15-1-150x150.webp\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/exercise-nutrition-oral/sample-exercise-nutrition-oral-02/\">サンプル &#8211; 運動・栄養・口腔2</a></h2>\r\n            <p class=\"p-time\">2025.3.15</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <div class=\"top-list-box2 bno\">\r\n        <a href=\"https://geriatrics.jp/exercise-nutrition-oral/sample-exercise-nutrition-oral-01/\">\r\n                            <img width=\"150\" height=\"150\" src=\"https://geriatrics.jp/wp-content/uploads/2025/03/fig-13-150x150.webp\" class=\"attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" decoding=\"async\" />                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/exercise-nutrition-oral/sample-exercise-nutrition-oral-01/\">サンプル &#8211; 運動・栄養・口腔1</a></h2>\r\n            <p class=\"p-time\">2025.3.15</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <!-- end div.top-list-area2 --></div>\r\n    <p><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/exercise-nutrition-oral/\">運動・栄養・口腔をもっと見る</a></span></p>\r\n    <!-- end div.top-list --></div>\r\n        <div class=\"top-list\">\r\n    <h1><a href=\"https://geriatrics.jp/main-contents/press-release/\">プレスリリースの場</a></h1>\r\n    <div class=\"top-list-area\">\r\n        <!-- end div.top-list-area --></div>\r\n    <div class=\"top-list-area2\">\r\n        <div class=\"top-list-box2\">\r\n        <a href=\"https://geriatrics.jp/press-release/%e3%83%86%e3%82%b9%e3%83%88%ef%bc%88%e3%83%97%e3%83%ac%e3%82%b9%e3%83%aa%e3%83%aa%e3%83%bc%e3%82%b9%e3%81%ae%e5%a0%b4%ef%bc%89/\">\r\n                            <img src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/pict-sample4.webp\" alt=\"\"/>\r\n                    </a>\r\n        <div class=\"top-list-text\">\r\n            <h2><a href=\"https://geriatrics.jp/press-release/%e3%83%86%e3%82%b9%e3%83%88%ef%bc%88%e3%83%97%e3%83%ac%e3%82%b9%e3%83%aa%e3%83%aa%e3%83%bc%e3%82%b9%e3%81%ae%e5%a0%b4%ef%bc%89/\">テスト（プレスリリースの場）</a></h2>\r\n            <p class=\"p-time\">2025.3.24</p>\r\n        <!-- end div.top-list-text --></div>\r\n    <!-- end div.top-listbox2 --></div>\r\n        <!-- end div.top-list-area2 --></div>\r\n    <p><span class=\"top-list-link\"><a href=\"https://geriatrics.jp/main-contents/press-release/\">プレスリリースの場をもっと見る</a></span></p>\r\n    <!-- end div.top-list --></div>\r\n    <!-- end div#top-list --></div>\r\n\r\n<div id=\"funded\">\r\n    <p>Funded by</p>\r\n    <div class=\"funded-area\">\r\n        <a href=\"https://geriatrics.jp/\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/アセット-6.png\" alt=\"老年栄養ドットコム\"/></a>\r\n        <a href=\"https://geriatrics.jp/\"><img src=\"https://geriatrics.jp/wp-content/uploads/2025/03/ご支援募集中.png\" alt=\"ご支援募集中\"/></a>\r\n        </div>\r\n<!-- end div#funded --></div>\r\n\r\n</main>\r\n\r\n\r\n<footer>\r\n<a href=\"https://geriatrics.jp/\"><img src=\"https://geriatrics.jp/wp-content/themes/geriatricsjp/assets/image/logo-footer.png\" alt=\"老年栄養ドットコム\" title=\"老年栄養ドットコム\"/></a>\r\n<address>\r\n<a href=\"https://geriatrics.jp/maeda-lab\">Maeda Labの紹介</a><a href=\"https://geriatrics.jp/contact\">申請・お問合せ</a>\r\n</address>\r\n</footer>\r\n\r\n<div id=\"page-top\">\r\n<p><a id=\"move-page-top\">▲</a></p>\r\n</div>\r\n<!-- end div#con --></div>\r\n\r\n\n<!-- Sign in with Google button added by Site Kit -->\n<script 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updates','https://geriatrics.jp/wp-admin/update-core.php','unactioned','',NULL,NULL),(202,30,'dismiss','Dismiss','#','actioned','',NULL,NULL),(203,31,'woopay-beta-merchantrecruitment-update-WCPay-04MAY23','Update WooCommerce Payments','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(204,31,'woopay-beta-merchantrecruitment-update-activate-04MAY23','Activate WooPay','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','actioned','',NULL,NULL),(205,32,'woopay-beta-existingmerchants-noaction-documentation-27APR23','Documentation','https://woocommerce.com/document/woopay-merchant-documentation/?utm_source=inbox_note&utm_medium=product&utm_campaign=woopay-beta-existingmerchants-noaction-documentation-27APR23','actioned','',NULL,NULL),(206,33,'woopay-beta-existingmerchants-update-WCPay-27APR23','Update WooCommerce Payments','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','actioned','',NULL,NULL),(207,34,'woopay-beta-merchantrecruitment-short-activate-04MAY23','Activate WooPay','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','actioned','',NULL,NULL),(208,34,'woopay-beta-merchantrecruitment-short-activate-learnmore-04MAY23','Learn More','https://woocommerce.com/woopay-businesses/?utm_source=inbox_note&utm_medium=product&utm_campaign=woopay-beta-merchantrecruitment-short-activate-learnmore-04MAY23','actioned','',NULL,NULL),(209,35,'woopay-beta-merchantrecruitment-short-update-WCPay-04MAY23','Update WooCommerce Payments','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(210,35,'woopay-beta-merchantrecruitment-short-update-activate-04MAY23','Activate WooPay','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','actioned','',NULL,NULL),(211,36,'woopay-beta-merchantrecruitment-short-activate-06MAY23-TESTA','Activate WooPay Test A','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','unactioned','',NULL,NULL),(212,36,'woopay-beta-merchantrecruitment-short-activate-learnmore-06MAY23-TESTA','Learn More','https://woocommerce.com/woopay-businesses/?utm_source=inbox_note&utm_medium=product&utm_campaign=woopay-beta-merchantrecruitment-short-activate-learnmore-06MAY23-TESTA','unactioned','',NULL,NULL),(213,37,'woopay-beta-merchantrecruitment-short-activate-06MAY23-TESTB','Activate WooPay Test 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More','https://woocommerce.com/woopay-businesses/?utm_source=inbox_note&utm_medium=product&utm_campaign=woopay-beta-merchantrecruitment-short-activate-learnmore-06MAY23-TESTC','unactioned','',NULL,NULL),(217,39,'woopay-beta-merchantrecruitment-short-activate-06MAY23-TESTD','Activate WooPay Test D','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','unactioned','',NULL,NULL),(218,39,'woopay-beta-merchantrecruitment-short-activate-learnmore-06MAY23-TESTD','Learn More','https://woocommerce.com/woopay-businesses/?utm_source=inbox_note&utm_medium=product&utm_campaign=woopay-beta-merchantrecruitment-short-activate-learnmore-06MAY23-TESTD','unactioned','',NULL,NULL),(219,40,'woopay-beta-merchantrecruitment-short-activate-button-09MAY23','Activate WooPay','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','unactioned','',NULL,NULL),(220,40,'woopay-beta-merchantrecruitment-short-activate-learnmore-button2-09MAY23','Learn More','https://woocommerce.com/woopay-businesses/?utm_source=inbox_note&utm_medium=product&utm_campaign=woopay-beta-merchantrecruitment-short-activate-learnmore-button2-09MAY23','unactioned','',NULL,NULL),(221,41,'woopay-beta-merchantrecruitment-short-update-WCPay-09MAY23','Update WooCommerce Payments','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(222,41,'woopay-beta-merchantrecruitment-short-update-activate-09MAY23','Activate WooPay','https://geriatrics.jp/wp-admin/admin.php?page=wc-settings&tab=checkout&section=woocommerce_payments&method=platform_checkout','unactioned','',NULL,NULL),(223,42,'woocommerce-WCSubscriptions-June-2023-updated-needed-Plugin-Settings','See available updates','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(224,42,'woocommerce-WCSubscriptions-June-2023-updated-needed-dismiss','Dismiss','#','actioned','',NULL,NULL),(225,43,'woocommerce-WCReturnsWarranty-June-2023-updated-needed','See available updates','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(226,43,'woocommerce-WCReturnsWarranty-June-2023-updated-needed','Dismiss','#','actioned','',NULL,NULL),(227,44,'woocommerce-WCOPC-June-2023-updated-needed','See available updates','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','actioned','',NULL,NULL),(228,44,'woocommerce-WCOPC-June-2023-updated-needed','Dismiss','https://geriatrics.jp/wp-admin/#','actioned','',NULL,NULL),(229,45,'woocommerce-WCGC-July-2023-update-needed','See available updates','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(230,45,'woocommerce-WCGC-July-2023-update-needed','Dismiss','#','actioned','',NULL,NULL),(231,46,'learn-more','Learn more','https://woocommerce.com/document/fedex/?utm_medium=product&utm_source=inbox_note&utm_campaign=learn-more#july-2023-api-outage','unactioned','',NULL,NULL),(232,47,'plugin-list','See available updates','https://geriatrics.jp/wp-admin/plugins.php?plugin_status=all','unactioned','',NULL,NULL),(233,47,'dismiss','Dismiss','https://geriatrics.jp/wp-admin/admin.php?page=wc-admin','actioned','',NULL,NULL),(234,48,'woocommerce-WCStripe-Aug-2023-update-needed','See available updates','https://geriatrics.jp/wp-admin/update-core.php?','unactioned','',NULL,NULL),(235,48,'dismiss','Dismiss','#','actioned','',NULL,NULL),(236,49,'dismiss','Dismiss','#','actioned','',NULL,NULL),(237,50,'dismiss','Dismiss','#','actioned','',NULL,NULL),(238,51,'avalara_q3-2023_noAvaTax','Automate my 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INSERT INTO `wp_wc_admin_notes` VALUES (1,'wc-refund-returns-page','info','en_US','返金および返品ポリシーページをセットアップしておくと、ストアの信頼性が向上します。','下書きの返金および返品ポリシーページのサンプルを作成してあります。 内容を確認し、自分のストアに合わせて更新してください。','{}','unactioned','woocommerce-core','2024-11-05 23:40:39',NULL,0,'plain','',0,0,'info'),(2,'wayflyer_bnpl_q4_2021','marketing','en_US','Grow your business with funding through Wayflyer','Fast, flexible financing to boost cash flow and help your business grow – one fee, no interest rates, penalties, equity, or personal guarantees. Based on your store’s performance, Wayflyer provides funding and analytical insights to invest in your business.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(3,'wc_shipping_mobile_app_usps_q4_2021','marketing','en_US','Print and manage your shipping labels with WooCommerce Shipping and the WooCommerce Mobile App','Save time by printing, purchasing, refunding, and tracking shipping labels generated by <a href=\"https://woocommerce.com/woocommerce-shipping/\">WooCommerce Shipping</a> – all directly from your mobile device!','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(4,'your-first-product','info','en_US','Your first product','That’s huge! You’re well on your way to building a successful online store — now it’s time to think about how you’ll fulfill your orders.<br /><br />Read our shipping guide to learn best practices and options for putting together your shipping strategy. And for WooCommerce stores in the United States, you can print discounted shipping labels via USPS with <a href=\"https://href.li/?https://woocommerce.com/shipping\" target=\"_blank\">WooCommerce Shipping</a>.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(5,'wc-admin-optimizing-the-checkout-flow','info','en_US','Optimizing the checkout flow','It’s crucial to get your store’s checkout as smooth as possible to avoid losing sales. Let’s take a look at how you can optimize the checkout experience for your shoppers.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(6,'wc-payments-qualitative-feedback','info','en_US','WooPayments setup - let us know what you think','Congrats on enabling WooPayments for your store. Please share your feedback in this 2 minute survey to help us improve the setup process.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(7,'share-your-feedback-on-paypal','info','en_US','Share your feedback on PayPal','Share your feedback in this 2 minute survey about how we can make the process of accepting payments more useful for your store.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(8,'google_listings_and_ads_install','marketing','en_US','Drive traffic and sales with Google','Reach online shoppers to drive traffic and sales for your store by showcasing products across Google, for free or with ads.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(9,'wc-subscriptions-security-update-3-0-15','info','en_US','WooCommerce Subscriptions security update!','We recently released an important security update to WooCommerce Subscriptions. To ensure your site’s data is protected, please upgrade <strong>WooCommerce Subscriptions to version 3.0.15</strong> or later.<br /><br />Click the button below to view and update to the latest Subscriptions version, or log in to <a href=\"https://woocommerce.com/my-dashboard\">WooCommerce.com Dashboard</a> and navigate to your <strong>Downloads</strong> page.<br /><br />We recommend always using the latest version of WooCommerce Subscriptions, and other software running on your site, to ensure maximum security.<br /><br />If you have any questions we are here to help — just <a href=\"https://woocommerce.com/my-account/create-a-ticket/\">open a ticket</a>.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(10,'woocommerce-core-update-5-4-0','info','en_US','Update to WooCommerce 5.4.1 now','WooCommerce 5.4.1 addresses a checkout issue discovered in WooCommerce 5.4. We recommend upgrading to WooCommerce 5.4.1 as soon as possible.','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(11,'wcpay-promo-2020-11','marketing','en_US','wcpay-promo-2020-11','wcpay-promo-2020-11','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(12,'wcpay-promo-2020-12','marketing','en_US','wcpay-promo-2020-12','wcpay-promo-2020-12','{}','pending','woocommerce.com','2024-11-05 23:40:41',NULL,0,'plain','',0,0,'info'),(13,'ppxo-pps-upgrade-paypal-payments-1','info','en_US','Get the latest PayPal extension for WooCommerce','Heads up! There’s a new PayPal on the block!<br /><br />Now is a great time to upgrade to our latest <a href=\"https://woocommerce.com/products/woocommerce-paypal-payments/\" target=\"_blank\">PayPal extension</a> to continue to receive support and updates with PayPal.<br /><br />Get access to a full suite of PayPal payment methods, extensive currency and country coverage, and pay later options with the all-new PayPal extension for WooCommerce.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(14,'ppxo-pps-upgrade-paypal-payments-2','info','en_US','Upgrade your PayPal experience!','Get access to a full suite of PayPal payment methods, extensive currency and country coverage, offer subscription and recurring payments, and the new PayPal pay later options.<br /><br />Start using our <a href=\"https://woocommerce.com/products/woocommerce-paypal-payments/\" target=\"_blank\">latest PayPal today</a> to continue to receive support and updates.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(15,'woocommerce-core-sqli-july-2021-need-to-update','update','en_US','Action required: Critical vulnerabilities in WooCommerce','In response to a critical vulnerability identified on July 13, 2021, we are working with the WordPress Plugins Team to deploy software updates to stores running WooCommerce (versions 3.3 to 5.5) and the WooCommerce Blocks feature plugin (versions 2.5 to 5.5).<br /><br />Our investigation into this vulnerability is ongoing, but <strong>we wanted to let you know now about the importance of updating immediately</strong>.<br /><br />For more information on which actions you should take, as well as answers to FAQs, please urgently review our blog post detailing this issue.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(16,'woocommerce-blocks-sqli-july-2021-need-to-update','update','en_US','Action required: Critical vulnerabilities in WooCommerce Blocks','In response to a critical vulnerability identified on July 13, 2021, we are working with the WordPress Plugins Team to deploy software updates to stores running WooCommerce (versions 3.3 to 5.5) and the WooCommerce Blocks feature plugin (versions 2.5 to 5.5).<br /><br />Our investigation into this vulnerability is ongoing, but <strong>we wanted to let you know now about the importance of updating immediately</strong>.<br /><br />For more information on which actions you should take, as well as answers to FAQs, please urgently review our blog post detailing this issue.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(17,'woocommerce-core-sqli-july-2021-store-patched','update','en_US','Solved: Critical vulnerabilities patched in WooCommerce','In response to a critical vulnerability identified on July 13, 2021, we worked with the WordPress Plugins Team to deploy software updates to stores running WooCommerce (versions 3.3 to 5.5) and the WooCommerce Blocks feature plugin (versions 2.5 to 5.5).<br /><br /><strong>Your store has been updated to the latest secure version(s)</strong>. For more information and answers to FAQs, please review our blog post detailing this issue.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(18,'woocommerce-blocks-sqli-july-2021-store-patched','update','en_US','Solved: Critical vulnerabilities patched in WooCommerce Blocks','In response to a critical vulnerability identified on July 13, 2021, we worked with the WordPress Plugins Team to deploy software updates to stores running WooCommerce (versions 3.3 to 5.5) and the WooCommerce Blocks feature plugin (versions 2.5 to 5.5).<br /><br /><strong>Your store has been updated to the latest secure version(s)</strong>. For more information and answers to FAQs, please review our blog post detailing this issue.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(19,'habit-moment-survey','marketing','en_US','We’re all ears! Share your experience so far with WooCommerce','We’d love your input to shape the future of WooCommerce together. Feel free to share any feedback, ideas or suggestions that you have.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(20,'woocommerce-core-paypal-march-2022-updated','update','en_US','Security auto-update of WooCommerce','<strong>Your store has been updated to the latest secure version of WooCommerce</strong>. We worked with WordPress to deploy PayPal Standard security updates for stores running WooCommerce (version 3.5 to 6.3). It’s recommended to disable PayPal Standard, and use <a href=\"https://woocommerce.com/products/woocommerce-paypal-payments/\" target=\"_blank\">PayPal Payments</a> to accept PayPal.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(21,'woocommerce-core-paypal-march-2022-updated-nopp','update','en_US','Security auto-update of WooCommerce','<strong>Your store has been updated to the latest secure version of WooCommerce</strong>. We worked with WordPress to deploy security updates related to PayPal Standard payment gateway for stores running WooCommerce (version 3.5 to 6.3).','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(22,'pinterest_03_2022_update','marketing','en_US','Your Pinterest for WooCommerce plugin is out of date!','Update to the latest version of Pinterest for WooCommerce to continue using this plugin and keep your store connected with Pinterest. To update, visit <strong>Plugins &gt; Installed Plugins</strong>, and click on “update now” under Pinterest for WooCommerce.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(23,'store_setup_survey_survey_q2_2022','survey','en_US','How is your store setup going?','Our goal is to make sure you have all the right tools to start setting up your store in the smoothest way possible.\r\nWe’d love to know if we hit our mark and how we can improve. To collect your thoughts, we made a 2-minute survey.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(24,'needs-update-eway-payment-gateway-rin-2022-12-20','update','en_US','Security vulnerability patched in WooCommerce Eway Gateway','In response to a potential vulnerability identified in WooCommerce Eway Gateway versions 3.1.0 to 3.5.0, we’ve worked to deploy security fixes and have released an updated version.\r\nNo external exploits have been detected, but we recommend you update to your latest supported version 3.1.26, 3.2.3, 3.3.1, 3.4.6, or 3.5.1','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(25,'updated-eway-payment-gateway-rin-2022-12-20','update','en_US','WooCommerce Eway Gateway has been automatically updated','Your store is now running the latest secure version of WooCommerce Eway Gateway. We worked with the WordPress Plugins team to deploy a software update to stores running WooCommerce Eway Gateway (versions 3.1.0 to 3.5.0) in response to a security vulnerability that was discovered.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(26,'ecomm-wc-navigation-survey-2023','info','en_US','Navigating WooCommerce on WordPress.com','We are improving the WooCommerce navigation on WordPress.com and would love your help to make it better! Please share your experience with us in this 2-minute survey.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(27,'woopay-beta-merchantrecruitment-04MAY23','info','en_US','Increase conversions with WooPay — our fastest checkout yet','WooPay, a new express checkout feature built into WooCommerce Payments, is now available —and we’re inviting you to be one of the first to try it. \r\n<br><br>\r\nBoost conversions by offering your customers a simple, secure way to pay with a single click.\r\n<br><br>\r\nGet started in seconds.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(28,'woocommerce-wcpay-march-2023-update-needed','update','en_US','Action required: Security update for WooCommerce Payments','<strong>Your store requires a security update for WooCommerce Payments</strong>. Please update to the latest version of WooCommerce Payments immediately to address a potential vulnerability discovered on March 22. For more information on how to update, visit this WooCommerce Developer Blog Post.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(29,'tap_to_pay_iphone_q2_2023_no_wcpay','marketing','en_US','Accept in-person contactless payments on your iPhone','Tap to Pay on iPhone and WooCommerce Payments is quick, secure, and simple to set up — no extra terminals or card readers are needed. Accept contactless debit and credit cards, Apple Pay, and other NFC digital wallets in person.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(30,'woocommerce-WCPreOrders-april-2023-update-needed','update','en_US','Action required: Security update of WooCommerce Pre-Orders extension','<strong>Your store requires a security update for the WooCommerce Pre-Orders extension</strong>. Please update the WooCommerce Pre-Orders extension immediately to address a potential vulnerability discovered on April 11.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(31,'woopay-beta-merchantrecruitment-update-04MAY23','info','en_US','Increase conversions with WooPay — our fastest checkout yet','WooPay, a new express checkout feature built into WooCommerce Payments, is now available — and you’re invited to try it. \r\n<br /><br />\r\nBoost conversions by offering your customers a simple, secure way to pay with a single click.\r\n<br /><br />\r\nUpdate WooCommerce Payments to get started.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(32,'woopay-beta-existingmerchants-noaction-27APR23','info','en_US','WooPay is back!','Thanks for previously trying WooPay, the express checkout feature built into WooCommerce Payments. We’re excited to announce that WooPay availability has resumed. No action is required on your part.\r\n<br /><br />\r\nYou can now continue boosting conversions by offering your customers a simple, secure way to pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(33,'woopay-beta-existingmerchants-update-27APR23','info','en_US','WooPay is back!','Thanks for previously trying WooPay, the express checkout feature built into WooCommerce Payments. We’re excited to announce that WooPay availability has resumed.\r\n<br /><br />\r\n\r\nUpdate to the latest WooCommerce Payments version to continue boosting conversions by offering your customers a simple, secure way to pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(34,'woopay-beta-merchantrecruitment-short-04MAY23','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, a new express checkout feature for WooCommerce Payments. \r\n<br><br>\r\nBoost conversions by letting customers pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(35,'woopay-beta-merchantrecruitment-short-update-04MAY23','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, our new express checkout feature. <br>Boost conversions by letting customers pay with a single click. <br><br>Update to the latest version of WooCommerce Payments to get started.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(36,'woopay-beta-merchantrecruitment-short-06MAY23-TESTA','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, a new express checkout feature for WooCommerce Payments. \r\n<br><br>\r\nBoost conversions by letting customers pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(37,'woopay-beta-merchantrecruitment-short-06MAY23-TESTB','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, a new express checkout feature for WooCommerce Payments. \r\n<br><br>\r\nBoost conversions by letting customers pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(38,'woopay-beta-merchantrecruitment-short-06MAY23-TESTC','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, a new express checkout feature for WooCommerce Payments. \r\n<br><br>\r\nBoost conversions by letting customers pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(39,'woopay-beta-merchantrecruitment-short-06MAY23-TESTD','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, a new express checkout feature for WooCommerce Payments. \r\n<br><br>\r\nBoost conversions by letting customers pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(40,'woopay-beta-merchantrecruitment-short-09MAY23','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, a new express checkout feature for WooCommerce Payments. \r\n<br><br>\r\nBoost conversions by letting customers pay with a single click.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(41,'woopay-beta-merchantrecruitment-short-update-09MAY23','info','en_US','Increase conversions with WooPay — our fastest checkout yet','Be one of the first to try WooPay, our new express checkout feature. <br>Boost conversions by letting customers pay with a single click. <br><br>Update to the latest version of WooCommerce Payments to get started.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(42,'woocommerce-WCSubscriptions-June-2023-updated-needed','marketing','en_US','Action required: Security update of WooCommerce Subscriptions','<strong>Your store requires a security update for the WooCommerce Subscriptions plugin</strong>. Please update the WooCommerce Subscriptions plugin immediately to address a potential vulnerability.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(43,'woocommerce-WCReturnsWarranty-June-2023-updated-needed','update','en_US','Action required: Security update of WooCommerce Returns and Warranty Requests extension','<strong>Your store requires a security update for the Returns and Warranty Requests extension</strong>.  Please update to the latest version of the WooCommerce Returns and Warranty Requests extension immediately to address a potential vulnerability discovered on May 31.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(44,'woocommerce-WCOPC-June-2023-updated-needed','update','en_US','Action required: Security update of WooCommerce One Page Checkout','<strong>Your shop requires a security update to address a vulnerability in the WooCommerce One Page Checkout extension</strong>. The fix for this vulnerability was released for this extension on June 13th. Please update immediately.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(45,'woocommerce-WCGC-July-2023-update-needed','update','en_US','Action required: Security update of WooCommerce GoCardless Extension','<strong>Your shop requires a security update to address a vulnerability in the WooCommerce GoCardless extension</strong>. The fix for this vulnerability was released on July 4th. Please update immediately.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(46,'woocommerce-shipping-fedex-api-outage-2023-07-16','warning','en_US','Scheduled FedEx API outage — July 2023','On July 16 there will be a full outage of the FedEx API from 04:00 to 08:00 AM UTC. Due to planned maintenance by FedEx, you\'ll be unable to provide FedEx shipping rates during this time. Follow the link below for more information and recommendations on how to minimize impact.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(47,'wcship-2023-07-hazmat-update-needed','update','en_US','Action required: USPS HAZMAT compliance update for WooCommerce Shipping & Tax extension','<strong>Your store requires an update for the WooCommerce Shipping extension</strong>. Please update to the latest version of the WooCommerce Shipping &amp; Tax extension immediately to ensure compliance with new USPS HAZMAT rules currently in effect.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(48,'woocommerce-WCStripe-Aug-2023-update-needed','update','en_US','Action required: Security update for WooCommerce Stripe plugin','<strong>Your shop requires an important security update for the  WooCommerce Stripe plugin</strong>. The fix for this vulnerability was released on July 31. Please update immediately.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(49,'woocommerce-WCStripe-Aug-2023-security-updated','update','en_US','Security update of WooCommerce Stripe plugin','<strong>Your store has been updated to the latest secure version of the WooCommerce Stripe plugin</strong>. This update was released on July 31.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(50,'woocommerce-WooPayments-Aug-2023-security-updated','update','en_US','Security update of WooPayments (WooCommerce Payments) plugin','<strong>Your store has been updated to the more secure version of WooPayments (WooCommerce Payments)</strong>. This update was released on July 31.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(51,'avalara_q3-2023_noAvaTax','marketing','en_US','Automatically calculate VAT in real time','Take the effort out of determining tax rates and sell confidently across borders with automated tax management from Avalara AvaTax— including built-in VAT calculation when you sell into or across the EU and UK. Save time and stay compliant when you let Avalara do the heavy lifting.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(52,'woocommerce-usermeta-Sept2023-productvendors','update','en_US','Your store requires a security update','<strong>Your shop needs an update to address a vulnerability in WooCommerce.</strong> The fix was released on Sept 15. Please update WooCommerce to the latest version immediately. <a href=\"https://developer.woocommerce.com/2023/09/16/woocommerce-vulnerability-reintroduced-from-7-0-1/\" />Read our developer update</a> for more information.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(53,'woocommerce-STRIPE-Oct-2023-update-needed','update','en_US','Action required: Security update for WooCommerce Stripe Gateway','<strong>Your shop requires a security update to address a vulnerability in the WooCommerce Stripe Gateway</strong>. The fix for this vulnerability was released on October 17. Please update immediately.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(54,'amazon-mcf-reviews-2023-12-07','marketing','en_US','Enjoying Amazon MCF for WooCommerce?','We\'re Never Settle, the developers behind Amazon MCF for WooCommerce, and would be deeply honored to have your review. Reviews help immensely as other users can learn how MCF can solve their needs too! Not happy or need help? Please reach out for support and we’d love to make things right!','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(55,'remove_estimated_deposits_2024','marketing','en_US','Estimated deposits are going away','To provide more accurate deposit information and support the expansion of instant deposits, estimated deposit details will no longer be available in WooPayments. We recommend upgrading to the latest version of WooPayments for more detailed balance status information.','{}','pending','woocommerce.com','2024-11-05 23:40:42',NULL,0,'plain','',0,0,'info'),(56,'wc-admin-customizing-product-catalog','info','en_US','How to customize your product catalog','You want your product catalog and images to look great and align with your brand. This guide will give you all the tips you need to get your products looking great in your store.','{}','unactioned','woocommerce-admin','2024-11-05 23:42:22',NULL,0,'plain','',0,0,'info');
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