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Volume 109, Issue 9, Pages 1540-1547 (September 2009)


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Continuing Education ArticleOnline ExtraDiet Based on the Japanese Food Guide Spinning Top and Subsequent Mortality among Men and Women in a General Japanese Population

Shino Oba, PhDCorresponding Author Informationemail address, Chisato Nagata, MD, Kozue Nakamura, MD, Kaori Fujii, Toshiaki Kawachi, Naoyoshi Takatsuka, MD, Hiroyuki Shimizu, MD

Accepted 6 March 2009.

Abstract 

Background

The Japanese Food Guide Spinning Top was developed by the Japanese Ministry of Health, Labor, and Welfare and the Ministry of Agriculture, Forestry, and Fishery to promote healthful diets.

Objective

Adherence to the Japanese Food Guide Spinning Top was evaluated in terms of future mortality in a prospective cohort study.

Design

A prospective cohort study among men and women in a general Japanese population.

Subjects/setting

The cohort consisted of 13,355 men and 15,724 women residing in Takayama, Japan, in 1992. At baseline, a food frequency questionnaire was administered, and adherence to the food guide was measured based on consuming the recommended number of servings of grains, vegetables, fish and meat, milk, and fruits, as well as total daily energy intake and energy from snacks and alcoholic beverages. Higher scores indicated better adherence to the recommendations on a scale of 0 to 70. Based on data obtained from the Office of the National Vital Statistics, deaths occurring among members of the cohort were prospectively noted from 1992 to 1999.

Statistical analyses performed

To assess the magnitude of association of adherence scores with subsequent mortality, a Cox proportional hazard model was applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

Among women, the adherence score was significantly associated with a lower risk of mortality from all causes (comparing highest and lowest quartiles of the score, HR 0.78, 95% CI 0.65 to 0.94, P for trend 0.01) in a multivariate analysis; noncardiovascular, noncancer causes (HR 0.69, 95% CI 0.50 to 0.96, P for trend 0.04) and cardiovascular disease (HR 0.76, 95% CI 0.56 to 1.04, P for trend0.05). No statistically significant association was observed between the adherence score and mortality among men.

Conclusions

The results suggest that diets based on the food guide have the benefit of reducing future mortality in women.

Corresponding Author InformationAddress correspondence to: Shino Oba, PhD, Department of Prevention for Lifestyle-Related Diseases, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu, Gifu 501-1194, Japan

 Meets Learning Need Codes 1060, 3000, 4000, and 4030. To take the Continuing Professional Education quiz for this article, log in to ADA's Online Business Center at www.eatright.org/obc, click the “Journal Article Quiz” button, click “Additional Journal CPE Articles,” and select this article's title from a list of available quizzes.

PII: S0002-8223(09)00767-6

doi:10.1016/j.jada.2009.06.367


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