Thursday, May 15, 2008

Diet and Mortality Patterns in Japan

(Circulation. 2007;116:II_789.)
© 2007 American Heart Association, Inc.

Population-Based Risks for CHD and Mortality
Abstract 3485: A Japanese Diet and 19-Year Mortality: NIPPON DATA80.
Yasuyuki Nakamura1; Hirotsugu Ueshima2; Takehito Hayakawa3; Yoshikuni Kita4; Robert D Abbott5; Akira Okayama6

1 Kyoto Womens Univ, Kyoto, Japan
2 Tomonori Okamura, Takashi Kadowaki, Shiga Univ of Med Science, Otsu, Japan
3 Fukushima Med Univ, Fukushima, Japan
4 Shiga Univ of Med Science, Otsu, Japan
5 Shiga Univ of Med Science &Univ of Virginia Sch of Medicine, Kyoto, Japan
6 National Cardiovascular Cntr, Suita, Japan


Although dietary patterns are associated with death from several causes, few studies have examined the association between Japanese diet and mortality outcomes.


We analyzed the relationship between a healthy Japanese diet and all-cause and cause-specific mortality using the database from NIPPON DATA80. At baseline in 1980, data on history, physical examinations, and blood biochemical measurements were collected on study participants aged 30 years and over from randomly selected areas in Japan. A nutritional survey was conducted using food-frequency methods. We defined a measure of a healthy Japanese diet based on 7 components. They included egg intake ≤ 2 eggs/week, fish intake ≥ once in 2 days, meat intake ≤ 2 times/week, tsukemono (preserved roots or leaves of seasonal vegetables) intake ≥ once per day, infrequent intake of soup with noodles, use of low salt soy sauce, and occasional drinking. If a dietary component was part of a typical daily diet, it was scored as one and zero otherwise. Thus, the total Japanese diet score ranged from 0 to 7, with 0 being least healthy and 7 being most healthy. Participants were divided into approximate tertiles of dietary scores (0 –2, 3 and 4 –7 scores). After excluding participants with co-morbidities, we followed 9,086 participants (44% men) for 19 years.


There were 1823 all-cause and 654 cardiovascular deaths during the follow-up. With the dietary score group 0 –2 serving as a reference, the Cox multivariate adjusted hazard ratios for groups with score 3 and scores 4 –7 for all-cause mortality were 0.92 (95% confidence intervals: 0.83–1.04) and 0.78 (0.70 – 0.88) (trend P < 0.0001). For cardiovascular mortality they were 0.91 (0.75–1.10) and 0.80 (0.66 – 0.97) (trend P = 0.022).


Adherence to a healthy Japanese diet was associated with an approximate 20% lower rate of all-cause and cardiovascular mortality. While Japanese are exceptionally long-lived, placing greater emphasis on the intake of foods that are low in salt could increase longevity in Japan further.

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