Toshiko Ikebe

Trends in fatal coronary heart disease among people aged 25-74 years in Oita City, Japan, from 1987-1998

Serum cholesterol has been increasing in recent years in Japan. There is concern that risk of coronary heart disease (CHD) may be increasing too, but there is little information on validated fatal CHD trends in the Japanese population. We identified 1,056 deaths from heart disease and other deaths possibly hiding CHD from death certificates of residents aged 25-74 years in Oita City, Japan in 1987-1988, 1992-1993, and 1997-1998 (mean population, 273,000 in 1997-1998). We validated 994 of them by medical record review and physician interviews, classifying them into definite fatal acute myocardial infarction (AMI) and possible fatal AMI or CHD death based on Monitoring Trends and Determinants in Cardiovascular Disease projects criteria. Sudden death was defined to estimate the number of CHD sudden deaths. In men, age-adjusted mortality rates due to validated fatal CHD remained quite stable over 10 years (25.3 per 100,000 [95% CI, 15.0-35.5] in 1987-1988 to 24.2 per 100,000 [95% CI, 16.1-32.3] in 1997-1998). When 50% or all sudden deaths were included as fatal CHD, the rates for men tended to decline. This was due to decreasing out-of-hospital deaths in connection with a declining CHD death rate among men aged 65-74 years, whereas in-hospital CHD deaths were level. In women, the rate of validated fatal CHD was highest in 1992-1993, but the 1997-1998 rate was similar to the 1987-1988 rate. We did not find that fatal CHD rates increased in Oita men and women from 1987-1998. Rather, out-of-hospital fatal CHD tended to decline in Oita men.

Food Intake and Food Consumption Patterns of Hospital Workers in the Dominican Republic

Coronary heart disease (CHD) is the leading cause of death according to official mortality statistics in the Dominican Republic. The purpose of this study was to assess food intake and food consumption patterns of Dominicans and to discuss CHD risks related to nutrient intake. The subjects were 22 men and 81 women voluntarily recruited among 230 hospital workers in Santo Domingo. The mean nutrient intake and food consumption were estimated from a single 24-hour recall method administered by trained persons who elicited each subject’s previous day’s intake from midnight to midnight. The mean energy intake was 2030 kcal. The mean intake of total protein, total fat and carbohydrates were 66.3g, 89.1 g and 248g, respectively. Percentage of energy from total fat was 39.5%, which was higher than WHO recommendations. But, the percentage of animal fat per total fat was 46.8%. Especially, the value in the low income group was 31.7%. Moreover, we analyzed the food consumption structure in order to understand the Dominican dietary pattern, and three factors were found to explain the characteristics on the basis of factor analysis.The low percentage of animal fat was due to the diets rich in vegetable oil. Our results suggested that it was difficult to assume that CHD risks increased as a result of the Dominican dietary pattern. This was consistent with our previous findings that the average serum cholesterol level of Dominicans was generally low.