IJE Advance Access first published online on February 22, 2007
This version published online on April 11, 2007
International Journal of Epidemiology, doi:10.1093/ije/dym005
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Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study
1 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
2 Department of Health Science, Shiga University of Medical Science, Shiga, Japan.
3 Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan.
4 Division of Epidemiology, Miyagi Cancer Center Research Institute, Natori, Japan.
5 Division of Health Policy, Tohoku University School of Public Policy, Sendai, Japan.
* Corresponding author. Division of Epidemiology Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan. E-mail: tshimazu-thk{at}umin.ac.jp
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Abstract |
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Background Although ecological observations suggest that the Japanese diet may reduce the risk of cardiovascular disease (CVD), the impact of a Japanese dietary pattern upon mortality due to CVD is unclear.
Methods We prospectively assessed the association between dietary patterns among the Japanese and CVD mortality. Dietary information was collected from 40 547 Japanese men and women aged 40–79 years without a history of diabetes, stroke, myocardial infarction or cancer at the baseline in 1994.
Results During 7 years of follow-up, 801 participants died of CVD. Factor analysis (principal component) based on a validated food frequency questionnaire identified three dietary patterns: (i) a Japanese dietary pattern highly correlated with soybean products, fish, seaweeds, vegetables, fruits and green tea, (ii) an ‘animal food’ dietary pattern and (iii) a high-dairy, high-fruit-and-vegetable, low-alcohol (DFA) dietary pattern. The Japanese dietary pattern was related to high sodium intake and high prevalence of hypertension. After adjustment for potential confounders, the Japanese dietary pattern score was associated with a lower risk of CVD mortality (hazard ratio of the highest quartile vs the lowest, 0.73; 95% confidence interval: 0.59–0.90; P for trend = 0.003). The ‘animal food’ dietary pattern was associated with an increased risk of CVD, but the DFA dietary pattern was not.
Conclusion The Japanese dietary pattern was associated with a decreased risk of CVD mortality, despite its relation to sodium intake and hypertension.
Keywords Diet, factor analysis, statistical, cardiovascular diseases, mortality, prospective studies, Japan
Accepted 4 January 2007
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