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

PLoS One. 2017 Apr 26;12(4):e0174848. doi: 10.1371/journal.pone.0174848. eCollection 2017.


Objective: A 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.

Methods: Participants 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.

Results: 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. 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.

Conclusions: The prudent and Westernized dietary patterns were associated with a decreased risk of all-cause and cardiovascular disease mortality in Japanese adults.

MeSH terms

  • Aged
  • Cardiovascular Diseases / mortality*
  • Cause of Death
  • Diet*
  • Feeding Behavior
  • Female
  • Fruit
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Neoplasms / mortality*
  • Principal Component Analysis
  • Proportional Hazards Models
  • Prospective Studies
  • Public Health
  • Surveys and Questionnaires
  • Survival Rate
  • Vegetables

Grants and funding

This study was supported by National Cancer Centre Research and Development Fund (23-A-31[toku] and 26-A-2) (since 2011), a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010), Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus (15ek0210021h0002) from the Japan Agency for Medical Research and Development, JSPS KAKENHI Grant No 15H04779, and grants-in-aid for research from the National Centre for Global Health and Medicine (26A-201).