Global Association between Traditional Japanese Diet Score and All-Cause, Cardiovascular Disease, and Total Cancer Mortality: A Cross-Sectional and Longitudinal Ecological Study

Abstract

Objective

Studies conducted on Japanese people have suggested that a traditional Japanese diet contributes to good health, longevity, and protection against several non-communicable diseases. However, it is unknown whether traditional Japanese dietary patterns are associated with all-cause mortality, cardiovascular disease, and cancer mortality globally. The purpose of this cross-sectional and longitudinal ecological study is to clarify the global association between the traditional Japanese diet score (TJDS) and all-cause, cardiovascular disease, and total cancer mortality.

Methods

Data on food supply and all-cause mortality, cardiovascular disease mortality, total cancer mortality, and covariables by country were obtained from a relevant internationally available database. TJDS by country was calculated from eight food groups and the total score ranged from −8 to 8, with higher scores indicating greater adherence to a traditional Japanese diet. We evaluated the cross-sectional and 10-year longitudinal association between TJDS and all-cause, cardiovascular disease, and total cancer mortality using 2009 as the baseline in 142 countries with populations of more than one million. A cross-sectional analysis and a longitudinal analysis were performed using three general linear models or three linear mixed models with different covariables.

Results

In cross-sectional models controlled for fully-adjusted covariables, TJDS was negatively associated with all-cause mortality (β ± standard error; −43.819 ± 11.741, p < 0.001), cardiovascular disease mortality (−22.395 ± 4.638, p < 0.001), and total cancer mortality (−3.893 ± 1.048, p < 0.001). In 10-year longitudinal models controlled for fully-adjusted covariables, TJDS was significantly negatively associated with all-cause mortality (−31.563 ± 7.695, p < 0.001), cardiovascular disease mortality (−16.249 ± 4.054, p < 0.001), and total cancer mortality (−3.499 ± 0.867, p < 0.001).

Conclusions

This cross-sectional and longitudinal ecological study suggests that the traditional Japanese diet is associated with lower all-cause mortality, cardiovascular disease mortality, and total cancer mortality, worldwide.

Keywords:

• dietary pattern
• Japanese diet
• all-cause mortality
• cardiovascular disease
• total cancer

Acknowledgments

Our analysis relies on secondary analysis of internationally published data sources as indicated in the Methods.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data described in the manuscript are available from the organizations listed in the Methods.

Additional information

Funding

This study was supported in part by JSPS KAKENHI Grant Number 22K02194. The sponsor was not involved in study design, data collection, analysis, interpretation, report writing, or report submission, and there are no restrictions on publication.