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ABSTRACT: BACKGROUND AND PURPOSE: Few prospective studies have examined the impact of both green tea and coffee consumption on strokes. We investigated the association of the combination of those consumption with stroke incidence in a general population. METHODS: We studied 82 369 Japanese (aged 45-74 years; without cardiovascular disease [CVD] or cancer in 1995 and 1998 for Cohort I and II, respectively) who received 13 years of mean follow-up through the end of 2007. Green tea and coffee consumption was assessed by self-administered food frequency questionnaire at baseline. RESULTS: In the 1 066 718 person-years of follow-up, we documented the incidence of strokes (n=3425) and coronary heart disease (n=910). Compared with seldom drinking green tea, the multivariable-adjusted hazard ratios (95% confidence intervals) of all strokes were 0.86 (0.78-0.95) and 0.80 (0.73-0.89) in green tea 2 to 3 and ≥4 cups/d, respectively. Higher green tea consumption was associated with inverse risks of CVD and strokes subtypes. Compared with seldom drinking coffee, the multivariable-adjusted hazard ratios (95% confidence intervals) of all strokes were 0.89 (0.80-0.99), 0.80 (0.72-0.90), and 0.81 (0.72-0.91) for coffee 3 to 6 times/week and 1 and ≥2 times/day, respectively. Coffee consumption was associated with an inverse risk of CVD and cerebral infarction. Higher green tea or coffee consumption reduced the risks of CVD and stroke subtypes (especially in intracerebral hemorrhage, P for interaction between green tea and coffee=0.04). None of the significant association was observed in coronary heart disease. CONCLUSIONS: Higher green tea and coffee consumption were inversely associated with risk of CVD and stroke in general population.
Stroke 03/2013; · 5.73 Impact Factor
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ABSTRACT: AimsAlthough dietary saturated fatty acids (SFA) are considered atherogenic, associations between SFAs intake and stroke and coronary heart disease are still debated. We sought to test the hypothesis that SFA intake is associated inversely with risk of stroke and its subtypes and positively with coronary heart disease among Japanese, whose average SFA intake is lower than that of Westerners.Methods and resultsThe Japan Public Health Center-based prospective Study involves two subcohorts: Cohort I, aged 45-64 in 1995 and followed-up through 2009, and Cohort II, aged 45-74 in 1998 and followed-up through 2007. A total of 38 084 men and 43 847 women were included in this report. Hazards ratios for incident total stroke, ischaemic stroke, intraparhenchymal haemorrhage, subarachnoid haemorrhage, myocardial infarction, and sudden cardiac death across quintiles of dietary SFAs were examined. We found inverse associations between SFA intake and total stroke [multivariable hazard ratio (95% confidence interval) for the highest vs. lowest quintiles = 0.77 (0.65-0.93), trend P = 0.002], intraparenchymal haemorrhage [0.61 (0.43-0.86), P for trend = 0.005], and ischaemic stroke [0.84 (0.67-1.06), trend P = 0.08], primarily for deep intraparenchymal haemorrhage [0.67 (0.45-0.99), P for trend = 0.04] and lacunar infarction [0.75 (0.53, 1.07), trend P = 0.02]. We also observed a positive association between SFAs intake and myocardial infarction [1.39 (0.93-2.08), trend P = 0.046] primarily among men. No associations were observed between SFAs intake and incidence of subarachnoid haemorrhage or sudden cardiac death.Conclusions
In this Japanese population, SFAs intake was inversely associated with deep intraparenchymal haemorrhage and lacunar infarction and positively associated with myocardial infarction.
European Heart Journal 02/2013; · 10.48 Impact Factor
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ABSTRACT: The Dietary Record by Cooked Dishes (DRcd) method, which enables simple assessment of food and nutrient intake, is unique because it uses a nutrient database of cooked dishes. Although this method has been validated among the rural Japanese populations for which the database was developed, the applicability of the DRcd for other populations is unclear. In this study, we have examined the applicability of DRcd among an urban population.
Subjects were selected from among patients who underwent cancer screening between 2004 and 2006 at the Research Center for Cancer Prevention and Screening, National Cancer Center, Japan. Subjects aged 40-69 years, who lived in Tokyo and the surrounding suburbs, were stratified into groups by sex and age. A total of 144 men and women agreed to participate in the study after random selection. Subjects were instructed to keep 4-day dietary records (4d-DR) of all consumed foods and beverages, including dish names, and all dishes were then coded using DRcd codes on the basis their names. The intake of 17 food groups and 40 nutrients was estimated using the dish-based nutrient composition table of the DRcd. Simultaneously, 4d-DR were used to calculate dietary intake independently, which served as a reference. We examined the applicability of the DRcd method using percentage difference and Pearson's correlation coefficients for intakes estimated using 4d-DR and the DRcd. Moreover, the results were compared to those of a previous study.
A total of 88% of the recorded dishes matched the dish codes of the DRcd database by name. Pearson's correlation coefficient scores of 0.6 or higher were observed for 12 and 10 food groups, and for 34 and 27 nutrients in men and women, respectively. Notably, the intake of majority of the nutrients tended to be underestimated, a difference that was more pronounced in men. In comparison with a previous study, the percentage differences and Pearson's correlation coefficient scores for intake tended to be lower in our study.
As the correlation coefficients (0.6) were high for a majority of food groups and nutrients estimated by DRcd, the DRcd method may be applicable for urban populations. However, regional intake data may be necessary for the estimation of absolute value for the intake of some nutrients.
[Nippon kōshū eisei zasshi] Japanese journal of public health 09/2012; 59(9):700-11.
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Motoki Iwasaki,
Gerson Shigeaki Hamada,
Ines Nobuko Nishimoto,
Mario Mourão Netto,
Juvenal Motola,
Fábio Martins Laginha,
Yoshio Kasuga,
Shiro Yokoyama,
Hiroshi Onuma,
Hideki Nishimura,
Ritsu Kusama,
Minatsu Kobayashi, Junko Ishihara,
Seiichiro Yamamoto,
Tomoyuki Hanaoka,
Shoichiro Tsugane
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ABSTRACT: Although epidemiologic studies have shown an inverse association between isoflavones and breast cancer risk, little evidence
for a dose–response relation is available. We conducted hospital-based case–control studies of patients aged 20–74years with
primary, incident, histologically confirmed invasive breast cancer, and matched controls from medical checkup examinees in
Nagano, Japan and from cancer-free patients in São Paulo, Brazil. A total of 850 pairs (390 Japanese, 81 Japanese Brazilians
and 379 non-Japanese Brazilians) completed validated food frequency questionnaires. The odds ratio of breast cancer according
to isoflavone intake was estimated using a conditional logistic regression model. We found a statistically significant inverse
association between isoflavone intake and the risk of breast cancer for Japanese Brazilians and non-Japanese Brazilians. For
Japanese, a non-significant inverse association was limited to postmenopausal women. In the three populations combined, breast
cancer risk linearly decreased from ‘no’ to ‘moderate’ isoflavone intake and thereafter leveled off. Compared to non-consumers,
adjusted odds ratios (95% confidence interval) for consumers in increasing quintile intake categories (median intake in each
category: 8.7, 23.1, 33.8, 45.7, and 71.3mg/day) were 0.69 (0.44–1.09), 0.54 (0.31–0.94), 0.45 (0.26–0.77), 0.34 (0.19–0.62),
and 0.43 (0.24–0.76), respectively. Overall, we found an inverse association between dietary isoflavone intake and risk of
breast cancer. Our finding suggests a risk-reducing rather than risk-enhancing effect of isoflavones on breast cancer within
the range achievable from dietary intake alone. In addition, women may benefit from risk reduction if they consume at least
moderate amounts of isoflavones.
Breast Cancer Research and Treatment 04/2012; 116(2):401-411. · 4.43 Impact Factor
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ABSTRACT: Analysis of dietary pattern is increasingly popular in nutritional epidemiology. However, few studies have examined the validity and reproducibility of dietary patterns. We assessed the reproducibility and validity of dietary patterns identified by a food frequency questionnaire (FFQ) used in the 5-year follow-up survey of the Japan Public Health Center-Based Prospective Study (JPHC Study).
The participants were a subsample (244 men and 254 women) from the JPHC Study. Principal component analysis was used to identify dietary patterns from 28- or 14-day dietary records and 2 FFQs. To assess reproducibility and validity, we calculated Spearman correlation coefficients between dietary pattern scores derived from FFQs separated by a 1-year interval, and between dietary pattern scores derived from dietary records and those derived from a FFQ completed after the dietary records, respectively.
We identified 3 Japanese dietary patterns from the dietary records and 2 FFQs: prudent, westernized, and traditional. Regarding reproducibility, Spearman correlation coefficients between the 2 FFQs ranged from 0.55 for the westernized Japanese pattern in men and the prudent Japanese pattern in women to 0.77 for the traditional Japanese pattern in men. Regarding validity, the corresponding values between dietary records and the FFQ ranged from 0.32 for the westernized Japanese pattern in men to 0.63 for the traditional Japanese pattern in women.
Acceptable reproducibility and validity was shown by the 3 dietary patterns identified by principal component analysis based on the FFQ used in the 5-year follow-up survey of the JPHC Study.
Journal of Epidemiology 02/2012; 22(3):205-15. · 1.86 Impact Factor
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Ribeka Takachi, Junko Ishihara,
Motoki Iwasaki,
Satoko Hosoi,
Yuri Ishii,
Shizuka Sasazuki,
Norie Sawada,
Taiki Yamaji,
Taichi Shimazu,
Manami Inoue,
Shoichiro Tsugane
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ABSTRACT: The validity of estimates of dietary intake calculated using a food frequency questionnaire (FFQ) depends on the specific population. The 138-item FFQ used in the 5-year follow-up survey for the Japan Public Health Center-based Prospective Study was initially developed for and validated in rural residents. However, the validity of estimates based on this FFQ for urban residents, whose diet and lifestyle differ from those of rural residents, has not been clarified. We examined the validity of ranking individuals according to level of dietary consumption, as estimated by this FFQ, among an urban population in Japan.
Among 896 candidates randomly selected from examinees of cancer screening provided by the National Cancer Center, Japan, 144 participated in the study. In 2007-2008, at an average 2.7 years after cancer screening, participants were asked to respond to the questionnaire and to provide 4-day weighed diet records (4d-DRs) for use as the reference intake. Spearman correlation coefficients (CCs) between the FFQ and 4d-DR estimates were calculated, after correction for intraindividual variation of 4d-DRs.
The median (range) deattenuated CC for men and women was 0.57 (0.23 to 0.89) and 0.47 (0.08 to 0.94), respectively, across 45 nutrients and 0.51 (0.10 to 0.98) and 0.51 (-0.36 to 0.88) for 43 food groups.
Although the FFQ was developed for a rural population, it provided reasonably valid measures of consumption for many nutrients and food groups in middle-aged screenees living in urban areas in Japan.
Journal of Epidemiology 10/2011; 21(6):447-58. · 1.86 Impact Factor
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ABSTRACT: Despite the popular use of vitamin supplements and several prospective cohort studies investigating their effect on cancer incidence and cardiovascular disease (CVD), scientific data supporting their benefits remain controversial. Inconsistent results may be partly explained by the fact that use of supplements is an inconsistent behavior in individuals. We examined whether vitamin supplement use patterns affect cancer and CVD risk in a population-based cohort study in Japan.
A total of 28,903 men and 33,726 women in the Japan Public Health Center-based Prospective Study cohort, who answered questions about vitamin supplement use in the first survey from 1990-1994 and the second survey from 1995-1998, were categorized into four groups (never use, past use, recent use, and consistent use) and followed to the end of 2006 for cancer and 2005 for CVD. Sex-specific hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to describe the relative risks of cancer and CVD associated with vitamin supplement use.
During follow-up, 4501 cancer and 1858 CVD cases were identified. Multivariate adjusted analysis revealed no association of any pattern of vitamin supplement use with the risk of cancer and CVD in men. In women, consistent use was associated with lower risk of CVD (HR 0.60, 95% CI 0.41-0.89), whereas past (HR 1.17, 95% CI 1.02-1.33) and recent use (HR 1.24, 95% CI 1.01-1.52) were associated with higher risk of cancer.
To our knowledge, this is the first prospective cohort study to examine simultaneously the associations between vitamin supplement use patterns and risk of cancer and CVD. This prospective cohort study demonstrated that vitamin supplement use has little effect on the risk of cancer or CVD in men. In women, however, consistent vitamin supplement use might reduce the risk of CVD. Elevated risk of cancer associated with past and recent use of vitamin supplements in women may be partly explained by preexisting diseases or unhealthy background, but we could not totally control for this in our study.
BMC Public Health 01/2011; 11:540. · 2.00 Impact Factor
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ABSTRACT: Heterocyclic amine (HCA) concentrations were measured in meat and fish samples cooked by pan-frying, grilling and churrasco (Brazilian barbecue) to various levels of doneness in accordance with the cooking methods most commonly used in Brazil. HCAs were extracted by the Blue-rayon absorption method and measured by liquid chromatography-mass spectrometry. 2-Amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), and 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (4,8-DiMeIQx) were sharply increased in very well-done meats and fish. HCA levels varied somewhat across cooking methods: levels of PhIP (ng/g) in very well-done, non-marinated samples were particularly high for churrasco (31.8 in the exterior of the sample), compared to lower levels for grilled (16.3), and pan-fried beef (0.58). On comparison across foods, chicken contained higher HCA levels than other non-marinated samples. For example, PhIP levels (ng/g) in very well-done pan-fried foods were 34.6 for chicken with the skin, 0.58 for beef, 7.25 for pork, 2.28 for sardines, and 7.37 for salmon cooked with the skin. HCA levels were lower in marinated meats and fish than in non-marinated samples, except for pan-fried salmon. This study provides valuable information which will allow the estimation of dietary HCA exposure using an epidemiologic questionnaire and the investigation of the association of HCA intake with cancer risk in Brazil.
Journal of Food Composition and Analysis 02/2010; 23(1):61-69. · 2.08 Impact Factor
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ABSTRACT: Although dietary risk factors may differ between localized and advanced prostate cancer, data on associations between the consumption of fruits and vegetables and risk of localized and advanced cancers are limited. We examined associations between fruit and vegetable consumption and risk of prostate cancer in a Japanese population. During 1995-1998, a validated food frequency questionnaire was administered to 43,475 men aged 45-74 yr. During 321,061 person-years of follow-up until the end of 2004, 339 cases of prostate cancer were identified. Consumption of fruits or total vegetables was not associated with a decreased risk of total prostate cancer, with corresponding multivariate hazard ratios of the highest vs. lowest quartiles of 1.09 (95% CI = 0.77-1.53; trend P = 0.39) for fruits and 1.33 (95% CI = 0.93-1.91; trend P = 0.52) for total vegetables. Also, no association was observed for intake of either fruits or vegetables (total or any subtype) with localized or advanced prostate cancer. This prospective cohort study suggests that consumption of fruits or vegetables may not be associated with the risk of either localized or advanced prostate cancer in Japanese men. However, the possibility of confounding by detection bias on the risk of localized cancer could not be totally ruled out.
Nutrition and Cancer 01/2010; 62(1):30-9. · 2.78 Impact Factor
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Motoki Iwasaki,
Gerson Shigeaki Hamada,
Ines Nobuko Nishimoto,
Mario Mourão Netto,
Juvenal Motola,
Fábio Martins Laginha,
Yoshio Kasuga,
Shiro Yokoyama,
Hiroshi Onuma,
Hideki Nishimura,
Ritsu Kusama,
Minatsu Kobayashi, Junko Ishihara,
Seiichiro Yamamoto,
Tomoyuki Hanaoka,
Shoichiro Tsugane
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ABSTRACT: We tested the hypothesis that polymorphisms in cytochrome P450c17alpha (CYP17), aromatase (CYP19), 17beta-hydroxysteroid dehydrogenase type I (17beta-HSD1) and sex hormone-binding globulin (SHBG) genes may modify the association between isoflavone intake and breast cancer risk. We conducted hospital-based, case-control studies in Nagano, Japan and Sao Paulo, Brazil. A total of 846 pairs (388 Japanese, 79 Japanese Brazilians, and 379 non-Japanese Brazilians) completed validated food frequency questionnaires. Four single nucleotide polymorphisms (SNPs) in CYP17 (rs743572), CYP19 (rs10046), 17beta-HSD1 (rs605059), and SHBG (rs6259) genes were genotyped. We found no association between the 4 SNPs and breast cancer risk. In combination analyses of isoflavone intake and SNPs, an inverse association between intake and risk was limited to women with at least one A allele of the rs605059 polymorphism for all 3 populations, albeit without statistical significance. For the rs6259 polymorphism, the inverse association was limited to postmenopausal Japanese with the GG genotype (odds ratio [OR] for highest vs. lowest tertile = 0.50, 95% confidence interval [CI] = 0.29-0.87; P for trend < 0.01), and to non-Japanese Brazilians with at least one A allele (OR for consumers vs. nonconsumer = 0.21, 95% CI = 0.06-0.77). We found no remarkable difference for the rs743572 and rs10046 polymorphisms. Our findings suggest that polymorphisms in the 17beta-HSD1 and SHBG genes may modify the association between isoflavone intake and breast cancer risk.
Nutrition and Cancer 01/2010; 62(4):466-75. · 2.78 Impact Factor
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Ribeka Takachi,
Manami Inoue,
Taichi Shimazu,
Shizuka Sasazuki, Junko Ishihara,
Norie Sawada,
Taiki Yamaji,
Motoki Iwasaki,
Hiroyasu Iso,
Yoshitaka Tsubono,
Shoichiro Tsugane
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ABSTRACT: Although the influence of salt, per se, on the risk of cancer or cardiovascular disease (CVD) might differ from that of salt-preserved foods, few studies have simultaneously examined the effects of sodium and salted foods on the risk of either cancer or CVD.
We simultaneously examined associations between sodium and salted food consumption and the risk of cancer and CVD.
During 1995-1998, a validated food-frequency questionnaire was administered to 77,500 men and women aged 45-74 y. During up to 598,763 person-years of follow-up until the end of 2004, 4476 cases of cancer and 2066 cases of CVD were identified.
Higher consumption of sodium was associated with a higher risk of CVD but not with the risk of total cancer: multivariate hazard ratios for the highest compared with lowest quintiles of intake were 1.19 (95% CI: 1.01, 1.40; P for trend: 0.06) for CVD and 1.04 (95% CI: 0.93, 1.16; P for trend: 0.63) for total cancer. Higher consumption of salted fish roe was associated with higher risk of total cancer, and higher consumption of cooking and table salt was associated with higher risk of CVD. Similar results were seen for the risk of gastric or colorectal cancer and stroke.
Sodium intake as a whole salt equivalent may not increase the risk of cancer but may increase that of CVD. In contrast, salted food intake may increase the risk of cancer. Our findings support the notion that sodium and salted foods have differential influences on the development of cancer and CVD.
American Journal of Clinical Nutrition 12/2009; 91(2):456-64. · 6.67 Impact Factor
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ABSTRACT: To develop of a quantitative food frequency questionnaire (QFFQ) to assess intake of specific foods, nutrients and heterocyclic aromatic amines (HAAs) in a case-control study of colorectal adenoma.
A cross-sectional survey conducted in a hospital in Sao Paulo, Brazil. A trained dietitian collected 24-h recalls from 60 Japanese Brazilian outpatients (29 men and 31 women; mean age 58 years and 57 years, respectively).
Fruit, vegetable and legume intake was high, with mean daily servings consumed in men and women of 8.2 and 6.9, respectively. The QFFQ contains 161 food items presented in 15 food groupings, with particular emphasis paid to the HAA content of meat, fish and chicken items.
We have developed a QFFQ appropriate for Japanese Brazilians that will allow us to estimate HAA intake and will be used to examine our hypotheses related to foods, nutrients and HAAs, and diet-gene interactions in colorectal neoplasia in this population.
International Journal of Food Sciences and Nutrition 05/2009; 60 Suppl 7:128-39. · 1.15 Impact Factor
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ABSTRACT: Several studies have determined that dietary intake of B vitamins may be associated with breast cancer risk as a result of interactions between 5,10-methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) in the one-carbon metabolism pathway. However, the association between B vitamin intake and breast cancer risk in Brazilian women in particular has not yet been investigated.
A case-control study was conducted in São Paulo, Brazil, with 458 age-matched pairs of Brazilian women. Energy-adjusted intakes of folate, vitamin B6, and vitamin B12 were derived from a validated Food Frequency Questionnaire (FFQ). Genotyping was completed for MTHFR A1298C and C677T, and MTR A2756G polymorphisms. A logistical regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs).
Neither dietary intake of folate, vitamin B6, or vitamin B12 nor MTHFR polymorphisms were independently associated with breast cancer risk. Analysis stratified by menopausal status showed a significant association between placement in the highest tertile of folate intake and risk of breast cancer in premenopausal women (OR = 2.17, 95% CI: 1.23-3.83; P trend = 0.010). The MTR 2756GG genotype was associated with a higher risk of breast cancer than the 2756AA genotype (OR = 1.99, 95% CI = 1.01-3.92; P trend = 0.801), and statistically significant interactions with regard to risk were observed between the MTHFR A1298C polymorphism and folate (P = 0.024) or vitamin B6 (P = 0.043), and between the MTHFR C677T polymorphism and folate (P = 0.043) or vitamin B12 (P = 0.022).
MTHFR polymorphisms and dietary intake of folate, vitamin B6, and vitamin B12 had no overall association with breast cancer risk. However, increased risk was observed in total women with the MTR 2756GG genotype and in premenopausal women with high folate intake. These findings, as well as significant interactions between MTHFR polymorphisms and B vitamins, warrant further investigation.
BMC Cancer 05/2009; 9:122. · 3.01 Impact Factor
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Motoki Iwasaki,
Gerson Shigeaki Hamada,
Inês Nobuko Nishimoto,
Mario Mourão Netto,
Juvenal Motola,
Fábio Martins Laginha,
Yoshio Kasuga,
Shiro Yokoyama,
Hiroshi Onuma,
Hideki Nishimura,
Ritsu Kusama,
Minatsu Kobayashi, Junko Ishihara,
Seiichiro Yamamoto,
Tomoyuki Hanaoka,
Shoichiro Tsugane
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ABSTRACT: Epidemiologic studies have shown an inverse association between isoflavones and breast cancer risk. Because isoflavones bind estrogen receptors, we hypothesized that polymorphisms in the estrogen receptor genes might modify the association between isoflavone intake and breast cancer risk. We conducted hospital-based case-control studies of patients aged 20-74 years with primary, incident, histologically confirmed invasive breast cancer, and matched controls from among medical checkup examinees in Nagano, Japan, and from cancer-free patients in São Paulo, Brazil. A total of 846 pairs (388 Japanese, 79 Japanese Brazilians and 379 non-Japanese Brazilians) completed validated food frequency questionnaires, and provided blood samples. Five single nucleotide polymorphisms in the estrogen receptor alpha (rs9340799, rs1913474, and rs2234693) and beta (rs4986938 and rs1256049) genes were genotyped. We found no consistent association between the five single nucleotide polymorphisms and breast cancer risk among the three populations. In analyses of combinations of isoflavone intake and single nucleotide polymorphisms, an inverse association between intake and risk was limited to women with the GG genotype of the rs4986938 polymorphism for postmenopausal Japanese (odds ratio for highest versus lowest tertile = 0.47; P for trend = 0.01), Japanese Brazilians (odds ratio for highest versus lowest median = 0.31) and non-Japanese Brazilians (odds ratio for consumers versus non-consumers = 0.37) (P for interaction = 0.11, 0.08, and 0.21, respectively). We found no remarkable difference for the other four polymorphisms. Our findings suggest that polymorphisms in the estrogen receptor beta gene may modify the association between isoflavone intake and breast cancer risk.
Cancer Science 03/2009; 100(5):927-33. · 3.33 Impact Factor
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Motoki Iwasaki,
Gerson Shigeaki Hamada,
Inês Nobuko Nishimoto,
Mario Mourão Netto,
Juvenal Motola Jr,
Fábio Martins Laginha,
Yoshio Kasuga,
Shiro Yokoyama,
Hiroshi Onuma,
Hideki Nishimura,
Ritsu Kusama,
Minatsu Kobayashi, Junko Ishihara,
Seiichiro Yamamoto,
Tomoyuki Hanaoka,
Shoichiro Tsugane
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ABSTRACT: Epidemiologic studies have shown an inverse association between isoflavones and breast cancer risk. Because isoflavones bind estrogen receptors, we hypothesized that polymorphisms in the estrogen receptor genes might modify the association between isoflavone intake and breast cancer risk. We conducted hospital-based case-control studies of patients aged 20–74 years with primary, incident, histologically confirmed invasive breast cancer, and matched controls from among medical checkup examinees in Nagano, Japan, and from cancer-free patients in São Paulo, Brazil. A total of 846 pairs (388 Japanese, 79 Japanese Brazilians and 379 non-Japanese Brazilians) completed validated food frequency questionnaires, and provided blood samples. Five single nucleotide polymorphisms in the estrogen receptor alpha (rs9340799, rs1913474, and rs2234693) and beta (rs4986938 and rs1256049) genes were genotyped. We found no consistent association between the five single nucleotide polymorphisms and breast cancer risk among the three populations. In analyses of combinations of isoflavone intake and single nucleotide polymorphisms, an inverse association between intake and risk was limited to women with the GG genotype of the rs4986938 polymorphism for postmenopausal Japanese (odds ratio for highest versus lowest tertile = 0.47; P for trend = 0.01), Japanese Brazilians (odds ratio for highest versus lowest median = 0.31) and non-Japanese Brazilians (odds ratio for consumers versus non-consumers = 0.37) (P for interaction = 0.11, 0.08, and 0.21, respectively). We found no remarkable difference for the other four polymorphisms. Our findings suggest that polymorphisms in the estrogen receptor beta gene may modify the association between isoflavone intake and breast cancer risk. (Cancer Sci 2009; 100: 927–933)
Cancer Science 02/2009; 100(5):927 - 933. · 3.33 Impact Factor
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ABSTRACT: The objective of this study was to validate a food frequency questionnaire (FFQ) used to estimate energy and selected nutrient intake in a Brazilian population with various ethnic backgrounds. Validity of intake estimated using the FFQ was tested among 55 Brazilian women, namely 26 Caucasians, 15 of Japanese descent, and 14 others. The FFQ was originally developed for use in a case-control study of breast cancer conducted in Sao Paulo. Dietary records (DRs) recorded in two seasons were used as references. Intake of energy and 24 nutrients were calculated using the USDA and Japanese food composition tables. Validity and reproducibility were evaluated using Spearman's correlation coefficients. Results showed that intake of chicken/poultry, eggs and legumes were overestimated by the FFQ compared to the DR, whereas that of pork and fat was underestimated. Further, intake of folate, fiber and isoflavones was overestimated by the FFQ whereas that of energy, fat, carbohydrate alpha-carotene and lycopene was underestimated. Energy-adjusted correlation coefficients between nutrient intakes estimated with the FFQ and DR were high for isoflavones (0.76), calcium (0.50), and vitamin C (0.49). In contrast, validity varied from moderately high to low for energy and other nutrients. In conclusion, validity of the FFQ for estimation of the intake of selected nutrients among Brazilian women with varied ethnic background was moderately high.
Asia Pacific Journal of Clinical Nutrition 02/2009; 18(1):76-80. · 1.13 Impact Factor
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ABSTRACT: Calcium and vitamin D have a potential protective effect against colorectal cancer.
We investigated the association of dietary intake of calcium and vitamin D with the risk of colorectal cancer in a large prospective cohort study of middle-aged Japanese men and women.
A total of 74 639 subjects (35 194 men and 39 445 women) who participated in the Japan Public Health Center-based Prospective Study were followed from 1995-1999 to the end of 2004, during which time 761 cases of colorectal cancer (464 men, 297 women) were newly identified. Dietary intake of nutrients was calculated with the use of a 138-item self-administered food-frequency questionnaire.
After adjusting for potential confounding factors, the multivariate hazard ratio in the highest quintile of dietary calcium intake compared with the lowest was 0.71 (95% CI: 0.52, 0.98) among men. The association appeared to decrease considerably among subjects in the second quintile without a clear further dose-response relation (P for trend: 0.09). No association was seen among women. No statistically significant association with dietary vitamin D intake was seen in either men or women, although men in the highest dietary intake group of both nutrients had a lower risk than did men in the lowest group.
These findings indicate a potential decrease in the risk of colorectal cancer with higher dietary intake of calcium among middle-aged Japanese men, who have a relatively low dietary intake of calcium. Although vitamin D and colorectal cancer risk were not associated, potential effect modification between calcium and vitamin D on the risk of colorectal cancer was indicated.
American Journal of Clinical Nutrition 01/2009; 88(6):1576-83. · 6.67 Impact Factor
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ABSTRACT: The objective of the present study was to evaluate the validity of a FFQ in the estimation of dietary amino acid intake. Amino acid intake was calculated using a composition database developed based on the Standard Tables of Food Composition for amino acids in Japan. Subjects were subsampled from two populations of the Japan Public Health Center-based Prospective Study who volunteered to participate in the validation study of the FFQ. The first group was from the population the FFQ was developed for (internal population; n 215) and the second was a separate population to confirm external validity (external population; n 350). The validity of the FFQ was evaluated using 28 d weighed dietary records (DR) as a reference method. Spearman's rank correlation coefficients (CC) between amino acid intake from the FFQ and DR were calculated. The dietary intake of amino acids was slightly underestimated by the FFQ. Deattenuated CC of energy-adjusted amino acid intake according to the FFQ and corresponding amino acid intake according to the DR ranged from 0.15 to 0.52. The median CC for twenty amino acids were 0.33 for men and 0.25 for women in the internal population, and 0.40 for men and 0.30 for women in the external population. In conclusion, the validity of the FFQ in estimating amino acid intake was low to moderate.
The British journal of nutrition 11/2008; 101(9):1393-9. · 3.45 Impact Factor
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ABSTRACT: Although it has been hypothesized that a high intake of dietary calcium may reduce the risk of cardiovascular disease (CVD), no prospective studies have been conducted to examine the specific association between calcium intake and incidence of stroke or coronary heart disease among Japanese with a low average calcium intake.
To investigate the association between calcium intake and risk of CVD, a total of 41 526 Japanese men and women age 40 to 59 years without a history of CVD or cancer and who had completed a food consumption frequency questionnaire were enrolled in this study. The subjects were followed up from 1990 to 1992 to 2003, and after 533 692 person-years of follow-up, 1321 incident cases of stroke (664 ischemic, 425 intraparenchymal hemorrhage, and 217 subarachnoid hemorrhage) and 322 of coronary heart disease were documented.
Total calcium intake showed an inverse association with the risk of total stroke; the multivariable hazard ratio and 95% CIs for the highest versus the lowest quintile were 0.70 (95% CI, 0.56 to 0.88; P for trend=0.02). Dairy calcium intake was inversely associated with risks of total and ischemic stroke with respective multivariable hazard ratios (95% CIs) of 0.69 (0.56 to 0.85; P for trend=0.007) and 0.69 (0.52 to 0.93; P for trend=0.05). Dietary calcium intake was not significantly associated with risk of coronary heart disease.
Dietary calcium intake, especially calcium from dairy products, was found to be associated with a reduced incidence of stroke among middle-aged Japanese.
Stroke 09/2008; 39(9):2449-56. · 5.73 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the effect of low Ca intake on the 10-year incidence of vertebral fractures in cohorts I and II of the Japan Public Health Centre-based Prospective Study. The baseline studies were conducted in 1990-1994, with the follow-up studies conducted after 10 years. We analysed 33,970 subjects aged 40-59 years in cohort I and 41,664 subjects aged 40-69 years in cohort II. At baseline, the intake of Ca was assessed as a predictor, using validated FFQ. A meta-analysis was performed to estimate a summary relative risk (RR) for the two cohort studies. The 10-year cumulative incidences of self-reported vertebral fractures were 0.38% for cohort I and 0.56% for cohort II. In women, lower Ca intake was associated with a higher incidence of vertebral fractures (P for trend=0.001), with the lowest quartile of Ca intake having a significantly higher incidence (0.89/1000 persons per year or RR 2.10 (95% CI 1.25, 3.55)) than that (0.42/1000 persons per year) of the highest. In addition, the RR calculated using energy-adjusted Ca intake (by the residual method) as an outcome was 1.92 (95% CI 1.28, 2.88). However, no such association was observed in men. An increase of Ca intake should be considered as a preventive strategy for vertebral fractures in peri- and post-menopausal women with a low Ca intake.
The British journal of nutrition 07/2008; 101(2):285-94. · 3.45 Impact Factor
