Diet Quality Affects the Association between Census-Based Neighborhood Deprivation and All-Cause Mortality in Japanese Men and Women: The Japan Public Health Center-Based Prospective Study

Nutrients. 2019 Sep 12;11(9):2194. doi: 10.3390/nu11092194.


Background: Individuals residing in more deprived areas with a lower diet quality might have a higher mortality risk. We aimed to examine the association between deprivation within an area and all-cause mortality risk according to diet quality.

Methods: We conducted a population-based prospective study on 27,994 men and 33,273 women aged 45-75 years. Neighborhood deprivation was assessed using the Japanese areal deprivation index (ADI). Dietary intakes were assessed using a validated 147-item food frequency questionnaire.

Results: Individuals residing in the most deprived area had the lowest dietary scores. During the 16.7-year follow-up, compared to individuals with a high quality diet residing in the least deprived area, individuals with a low quality diet had a higher risk of mortality according to increment of ADI (p trend = 0.03); the multivariate-adjusted hazard ratio (95% confidence interval) was 1.09 (0.999-1.19), 1.17 (1.08-1.27), and 1.19 (1.08-1.32) in those residing in the lowest through the highest third of ADI, respectively. However, individuals with a high quality diet had no significant association between ADI and mortality.

Conclusion: A well-balanced diet may prevent early death associated with neighborhood socioeconomic status among those residing in highly deprived areas.

Keywords: Japanese Food Guide Spinning Top; Japanese areal deprivation index; diet quality; early death; hazard ratios; mortality; neighborhood deprivation; neighborhood socioeconomic status; well-balanced diet.

MeSH terms

  • Aged
  • Censuses
  • Diet / mortality*
  • Diet Surveys
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Proportional Hazards Models
  • Prospective Studies
  • Psychosocial Deprivation
  • Residence Characteristics / statistics & numerical data*
  • Socioeconomic Factors