Dietary patterns and cardiovascular disease mortality in Japan: A prospective cohort study

Taichi Shimazu, Shinichi Kuriyama, Atsushi Hozawa, Kaori Ohmori, Yuki Sato, Naoki Nakaya, Yoshikazu Nishino, Yoshitaka Tsubono, Ichiro Tsuji

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278 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)600-609
Number of pages10
JournalInternational Journal of Epidemiology
Issue number3
Publication statusPublished - 2007 Jun


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