title: Dietary pattern and mortality in Japanese elderly patients with type 2 diabetes mellitus: does a vegetable- and fish-rich diet improve mortality? An explanatory study.
abstract: OBJECTIVE
  To assess the effect of dietary patterns on all deaths and diabetes-related deaths in the Japanese Elderly Diabetes Intervention Trial (J-EDIT).
  
  
  METHODS
  We investigated relationships between that of overall mortality and dietary pattern, and diabetes-related deaths and dietary pattern as observed among 912 registered cases of the J-EDIT study, which is a prospective follow-up study of elderly Japanese type 2 diabetic patients.
  
  
  RESULTS
  Factor analysis with the factor number 3 led to deriving three dietary patterns (healthy type, snack type and greasy type). The relationship between these patterns and overall mortality or diabetes-related death was investigated. Although not statistically significant, there was a lower tendency of overall mortality and diabetes-related deaths for the healthy type dietary pattern. When the tendencies of overall mortality were analyzed for "young-old," who are younger than 75 years-of age, and "old-old" of over 75 years-of-age, the mortality rate for the greasy type and healthy type dietary patterns were nearly the same and higher than the snack type dietary pattern in young-old. In contrast, in old-old, a higher mortality rate was reported for the greasy type dietary pattern and a lower mortality rate was reported for the healthy type dietary pattern. The hazard ratio by Cox regression analysis for greasy type to healthy type in old-old was 3.03 (P = 0.04, CI 1.07-8.57). Furthermore, in old-old, as vegetable consumption increased, the lower the tendency foroverall mortality, and the more fish that was consumed, the overall mortality significantly decreased (P = 0.020) in the tertile.
  
  
  CONCLUSIONS
  The greasy type dietary pattern with an increased amount of sugar, fat and meat led to poor life prognosis for elderly Japanese type 2 diabetic patients. The healthy type dietary pattern rich in vegetable and fish, which is similar to the Mediterranean diet and Dietary Approach to Stop Hypertension diet, was suggested to improve life prognosis.
authors.affiliation: Department of Biostatistics, School of Public Health, the University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iimuro
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Katsuya
authors.initials: K
authors.lastname: Iijima
authors.forename: Hideki
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D000818:Animals; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D004032:Diet; D005260:Female; D005399:Fishes; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D014675:Vegetables