Akiko Nanri

Weight change and all-cause, cancer and cardiovascular disease mortality in Japanese men and women: the Japan Public Health Center-Based Prospective Study.

Background:It is unclear whether weight change during adulthood influences subsequent mortality in Asian populations, who have a relatively lean body mass.Objective:To assess the relation of weight change over 5 years to all-cause, cancer and cardiovascular disease mortality among Japanese men and women.Design:Subjects were 36u2009220 men and 44u2009091 women aged between 45 and 75 years without a history of serious disease at baseline. Weight change was calculated as the difference of body weight between two surveys with a 5-year interval.Results:During 699u2009963 person-years of follow-up, we identified 4232 deaths of all-cause, 1872 cancer deaths and 1021 cardiovascular deaths. The relation between weight change and all-cause mortality was reverse J-shaped. Multivariate hazard ratios (95% confidence interval) for weight loss of 5u2009kg or more versus weight change of less than 2.5u2009kg were 1.62 (1.45–1.81) in men and 1.76 (1.51–2.05) in women, whereas those for weight gain of 5u2009kg or more were 1.40 (1.22–1.59) in men and 1.25 (1.02–1.54) in women. These associations remained statistically significant even after the exclusion of deaths in the first 3 years of follow-up. The weight change–mortality association was pronounced in underweight persons or in nonsmoking men. The risk of cancer mortality increased in both men and women who lost weight by 5u2009kg or more. With regard to cardiovascular disease, mortality risk tended to increase with weight loss both in men and women, whereas its increase with weight gain was observed only in women.Conclusions:A large weight change, both loss and gain, was associated with an increased risk of mortality. Weight loss and gain may be predictors of early death in apparently healthy adult Japanese.

Magnesium intake and type II diabetes in Japanese men and women: the Japan Public Health Center-based Prospective Study.

This study examined the association between magnesium intake and type II diabetes risk among Japanese adults. Participants were 25u2009872 men and 33u2009919 women aged 45–75 years who had no history of diabetes. Magnesium intake was ascertained using a 147-item food frequency questionnaire. Odds ratio of self-reported physician-diagnosed type II diabetes over 5 years was estimated using logistic regression analysis. A total of 1114 new cases of type II diabetes were self-reported. Magnesium intake was not significantly associated with type II diabetes in either men or women. The multivariable-adjusted odds ratios (95% confidence intervals) of type II diabetes for the highest versus lowest quintile of magnesium intake were 0.86 (0.63–1.16) and 0.92 (0.66–1.28) for men and women, respectively. Although a small effect cannot be excluded in men, magnesium intake may not be appreciably associated with risk of type II diabetes for Japanese adults.

Dietary patterns and type 2 diabetes in Japanese men and women: the Japan Public Health Center-based Prospective Study

Background/objective:Dietary patterns in Western populations have been linked to type 2 diabetes, but the association of distinctive dietary patterns of Japanese population remains unclear. We prospectively investigated the association between dietary patterns and risk of developing type 2 diabetes among Japanese adults.Subjects/methods:Participants were 27u2009816 men and 36u2009889 women aged 45–74 years who participated in the second survey of the Japan Public Health Center-based prospective study and had no history of diabetes. Dietary patterns were derived by using principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Odds ratios of self-reported physician-diagnosed type 2 diabetes over 5 year were estimated using logistic regression analysis.Results:A total of 1194 new cases (692 men and 502 women) of type 2 diabetes were self-reported. We identified three dietary patterns: prudent, westernized and traditional Japanese patterns. Any dietary pattern was not significantly associated with type 2 diabetes risk after adjustment for covariates in both men and women. The multivariate-adjusted odds ratios (95% confidence interval) for type 2 diabetes for the highest versus lowest quartile of each dietary pattern score in men and women, respectively, were 0.93 (0.74–1.16) and 0.90 (0.69–1.16) for the prudent pattern, 1.15 (0.90–1.46) and 0.81 (0.61–1.08) for the westernized pattern, and 0.97 (0.74–1.27) and 0.87 (0.66–1.15) for the traditional pattern.Conclusions:Although a small protective effect of the prudent dietary pattern cannot be excluded, dietary patterns may not be appreciably associated with type 2 diabetes risk in Japanese.

Association of dietary and serum magnesium with glucose metabolism markers: The Furukawa Nutrition and Health Study

BACKGROUND & AIMSnMagnesium may play an important role in cardio-metabolic abnormalities, including type 2 diabetes, but epidemiological evidence linking magnesium status to glucose metabolism is limited among Asians. We cross-sectionally examined the association of dietary and serum magnesium with markers of glucose metabolism among Japanese subjects.nnnMETHODSnSubjects were 1796 workers, aged 18-78 years, who participated in a health survey. Dietary magnesium intake was assessed with a validated brief diet history questionnaire. Serum magnesium concentrations were measured using an enzymatic method. Multivariable linear regression models were used to estimate means of fasting insulin, fasting plasma glucose, homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), and glycated hemoglobin (HbA1c), with adjustments made for potential confounding variables.nnnRESULTSnDietary magnesium was inversely associated with HOMA-IR (Ptrendxa0=xa00.01). Multivariable-adjusted means (95% confidence intervals) of HOMA-IR for the lowest to highest quartiles of dietary magnesium were 0.94 (0.89-0.99), 0.92 (0.88-0.97), 0.88 (0.83-0.92), and 0.86 (0.81-0.90). Serum magnesium concentrations were also inversely associated with HOMA-IR (Ptrendxa0=xa00.04) and HbA1c (Ptrend <0.01). Multivariable-adjusted means (95% confidence intervals) for the lowest to highest quartiles of serum magnesium were 0.94 (0.90-0.98), 0.87 (0.83-0.91), 0.90 (0.85-0.95), and 0.86 (0.81-0.92) for HOMA-IR and 5.41 (5.36-5.45), 5.33 (5.28-5.37), 5.30 (5.25-5.36), and 5.28 (5.22-5.35) for HbA1c. Excluding subjects with diabetes did not materially change the association between dietary magnesium and HOMA-IR (Ptrend <0.01), while it attenuated the association of serum magnesium with HOMA-IR (Ptrendxa0=xa00.27) and HbA1c (Ptrendxa0=xa00.15).nnnCONCLUSIONSnThe present findings suggest that lower dietary magnesium, but not serum magnesium, is associated with IR in apparently healthy adults.

Development and validation of risk models to predict the 7-year risk of type 2 diabetes: The Japan Epidemiology Collaboration on Occupational Health Study

We previously developed a 3‐year diabetes risk score in the working population. The objective of the present study was to develop and validate flexible risk models that can predict the risk of diabetes for any arbitrary time‐point during 7 years.

Menstrual and reproductive factors and type 2 diabetes risk: The Japan Public Health Center-based Prospective Study

Menstrual and reproductive factors, including age at menarche, parity and breast‐feeding, have been linked to type 2 diabetes risk. We prospectively investigated the association between these factors and type 2 diabetes risk in a large Japanese cohort.

Dietary patterns and prostate cancer risk in Japanese: the Japan Public Health Center-based Prospective Study (JPHC Study)

PurposeThe development of prostate cancer may be impacted by environmental factors, including diet. The aim of this study was to evaluate the association between dietary patterns and risk of prostate cancer in a large prospective cohort study among Japanese men.MethodsA total of 43,469 men who participated in the Japan Public Health Center-based Prospective Study were followed from 1995 to 1998 to the end of 2012, during which 1,156 cases of prostate cancer were newly identified. Dietary intake was assessed using a validated food frequency questionnaire in the 5-year follow-up survey.ResultsThree major dietary patterns were derived using exploratory factors analysis: prudent, westernized, and traditional dietary patterns. The westernized dietary pattern was associated with a higher risk of total prostate cancer (HR: 1.22; 95% CI 1.00–1.49; p trendu2009=u20090.021), localized cancer (HR: 1.24; 95% CI 0.97–1.57; p trendu2009=u20090.045), and advanced cancer (HR: 1.23; 95% CI 0.82–1.84; p trendu2009=u20090.233). The prudent dietary pattern was associated with a lower risk of total and localized prostate cancer, with respective multivariable HRs for the highest and lowest quintiles of 0.71 (95% CI 0.50–1.02; p trendu2009=u20090.037) and 0.63 (95% CI 0.38–1.03; p trendu2009=u20090.048) among subjects detected by subjective symptoms. No association was found between the traditional dietary pattern and prostate cancer risk among our subjects.ConclusionOur results suggest that a western-style diet may lead to a higher risk of prostate cancer in the total population, whereas the prudent diet contributes to a lower risk among subjects detected by subjective symptoms.

Rice and Type 2 Diabetes

A recent meta-analysis of four articles observed that rice intake was associated with type 2 diabetes risk. In particular, among Asian populations who consume more rice, the increased risk of type 2 diabetes associated with rice intake was stronger than those among Western populations. Although rice is rich in carbohydrates, the association between carbohydrate intake and type 2 diabetes is controversial. Because the amount of rice intake and the amount or sources of carbohydrate intake differ between Asian and Western populations, the association of these intakes with type 2 diabetes risk might differ. However, there are few studies which have examined the association between them among Asian populations. Not only quantity but also quality of the carbohydrate (GI and GL) may play a role in development of type 2 diabetes or glucose intolerance.

Magnesium and Diabetes Prevention

In Japan, the respective prevalence of probable and possible diabetes increased respectively from 6.9 to 8.9 and from 6.8 to 13.2 million cases between 1997 and 2007 [1]. Probable diabetes cases are characterized by either high levels of glycated hemoglobin (≥ 6.1 %) or by receiving medication for type 2 diabetes. Possible diabetes cases are characterized by glycated hemoglobin levels ranging from 5.6 % to 6.1 % [1]. Within populations of Japanese men and women aged over 50 years, the prevalence of probable and possible diabetes has been reported to be as high as 30–40 % [1]. Although the prevalence of obesity (an important risk factor of type 2 diabetes) is lower in Japanese than in Western populations [2], the prevalence of type 2 diabetes is not dramatically lower [3]. While these epidemic proportions of type 2 diabetes among Japanese have mainly been attributed to genetic differences between Asian and Caucasian populations [4], some limited evidence also suggests the influence of environmental factors, such as diet. For example, magnesium is involved in glucose homeostasis and insulin action [5], and its protective effect against type 2 diabetes has been demonstrated by several prospective studies, including one involving a Japanese population.