title: Quality of diet and mortality among Japanese men and women: Japan Public Health Center based prospective study.
abstract: OBJECTIVE
  To examine the association between adherence to the Japanese Food Guide Spinning Top and total and cause specific mortality.
  
  
  METHODS
  Large scale population based prospective cohort study in Japan with follow-up for a median of 15 years.
  
  
  METHODS
  11 public health centre areas across Japan.
  
  
  METHODS
  36,624 men and 42,970 women aged 45-75 who had no history of cancer, stroke, ischaemic heart disease, or chronic liver disease.
  
  
  METHODS
  Deaths and causes of death identified with the residential registry and death certificates.
  
  
  RESULTS
  Higher scores on the food guide (better adherence) were associated with lower total mortality; the multivariable adjusted hazard ratios (95% confidence interval) of total mortality for the lowest through highest scores were 1.00, 0.92 (0.87 to 0.97), 0.88 (0.83 to 0.93), and 0.85 (0.79 to 0.91) (P<0.001 for trend) and the multivariable adjusted hazard ratio associated with a 10 point increase in food guide scores was 0.93 (0.91 to 0.95; P<0.001 for trend). This score was inversely associated with mortality from cardiovascular disease (hazard ratio associated with a 10 point increase 0.93, 0.89 to 0.98; P=0.005 for trend) and particularly from cerebrovascular disease (0.89, 0.82 to 0.95; P=0.002 for trend). There was some evidence, though not significant, of an inverse association for cancer mortality (0.96, 0.93 to 1.00; P=0.053 for trend).
  
  
  CONCLUSIONS
  Closer adherence to Japanese dietary guidelines was associated with a lower risk of total mortality and mortality from cardiovascular disease, particularly from cerebrovascular disease, in Japanese adults.
authors.affiliation: Department of Epidemiology and Prevention, Centre for Clinical Sciences, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan, 162-8655 kkurotani@ri.ncgm.go.jp.
authors.forename: Kayo
authors.initials: K
authors.lastname: Kurotani
authors.affiliation: Department of Epidemiology and Prevention, Centre for Clinical Sciences, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan, 162-8655.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Department of Epidemiology and Prevention, Centre for Clinical Sciences, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan, 162-8655.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kashino
authors.affiliation: Department of Public Health, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, Japan, 162-8666.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Goto
authors.affiliation: Department of Epidemiology and Prevention, Centre for Clinical Sciences, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan, 162-8655.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: Department of Diabetes Research, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan, 162-8655 Department of Endocrinology and Diabetes, Saitama Medical University, 38 Moro-hongo, Moroyama, Iruma-gun, Saitama, Japan, 350-0495.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
authors.affiliation: Epidemiology and Prevention Group, Research Centre for Cancer Prevention and Screening, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan, 104-0045.
authors.forename: Shizuka
authors.initials: S
authors.lastname: Sasazuki
authors.affiliation: Epidemiology and Prevention Group, Research Centre for Cancer Prevention and Screening, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan, 104-0045.
authors.forename: Norie
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Epidemiology and Prevention Group, Research Centre for Cancer Prevention and Screening, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan, 104-0045.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000368:Aged; D004032:Diet / Q000706:statistics & numerical data*; D004034:Diet Surveys; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D018673:Nutrition Policy; D016016:Proportional Hazards Models; D011446:Prospective Studies