Dietary patterns and all-cause, cancer, and cardiovascular disease mortality in Japanese men and women: The Japan public health center-based prospective study.

Akiko Nanri,Shizuka Sasazuki,Hiroyasu Iso,Taichi Shimazu,Mitsuhiko Noda,Shoichiro Tsugane,Tetsuya Mizoue,Junko Ishihara,Norie Sawada,Ribeka Takachi,Hajo Zeeb

doi:10.1371/journal.pone.0174848

Abstract

ObjectiveA meta-analysis showed an inverse association of a prudent/healthy dietary pattern with all-cause mortality and no association of a western/unhealthy dietary pattern. However, the association of distinctive dietary patterns of Japanese population with mortality remains unclear. We prospectively investigated the association between dietary patterns and all-cause, cancer, and cardiovascular disease mortality among Japanese adults.MethodsParticipants were 36,737 men and 44,983 women aged 45–74 years who participated in the second survey of the Japan Public Health Center-based Prospective Study (1995–1998) and who had no history of serious disease. Dietary patterns were derived from principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Hazard ratios of death from the second survey to December 2012 were estimated using cox proportional hazard regression analysis.ResultsA prudent dietary pattern, which was characterized by high intake of vegetables, fruit, soy products, potatoes, seaweed, mushrooms, and fish, was significantly associated with decreased risk of all-cause and cardiovascular disease mortality. The multivariable-adjusted hazard ratios (95% confidence intervals) of all-cause and cardiovascular disease mortality for the highest versus lowest quartile of the prudent dietary pattern score were 0.82 (0.77 to 0.86) and 0.72 (0.64 to 0.79), respectively (P for trend <0.001 in both). A Westernized dietary pattern, characterized by high intake of meat, processed meat, bread, and dairy products, was also inversely associated with risk of all-cause, cancer, and cardiovascular disease mortality. A traditional Japanese dietary pattern was not associated with these risks.ConclusionsThe prudent and Westernized dietary patterns were associated with a decreased risk of all-cause and cardiovascular disease mortality in Japanese adults.

Highlights

Japanese life expectancy began to increase rapidly in the 1950s and has become among the highest in the world [1]
A prudent dietary pattern, which was characterized by high intake of vegetables, fruit, soy products, potatoes, seaweed, mushrooms, and fish, was significantly associated with decreased risk of all-cause and cardiovascular disease mortality
A traditional Japanese dietary pattern was not associated with these risks

Summary

Introduction

Japanese life expectancy began to increase rapidly in the 1950s and has become among the highest in the world [1]. Socioeconomic status, cultural background, and the Japanese diet might have contributed to Japanese population health [1]. Japanese food has a balanced nutritional profile, and the diet of the Japanese population has changed with economic development. Consumption of total fat (especially animal fat), animal protein, and calcium has increased with accompanying increases in consumption of meat and poultry and milk and dairy products [2]. The increase in the intake of these foods and nutrients after war achieved a peak in the 1970s [2]. The modern Japanese diet, which is somewhat westernized while maintaining aspects of the traditional diet, including regular consumption of fish and soy products, may have a beneficial effect on health

Methods

Results

Conclusion