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Epidemiology

A longitudinal association between the traditional Japanese diet score and incidence and mortality of breast cancer—an ecological study

European Journal of Clinical Nutrition volume 75, pages 929–936 (2021)Cite this article

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Abstract

Background

The traditional Japanese diet is considered one of the important factors of health and longevity in Japanese people. Breast cancer is the most common cancer among women in the world. However, the association between the traditional Japanese diet and breast cancer is unclear. The purpose of this study was to investigate the longitudinal association between the traditional Japanese diet score (TJDS) with the incidence and mortality of breast cancer in an ecological study.

Methods

Food supply and breast cancer incidence and mortality by country were obtained from an international database. TJDS by country was calculated from nine food groups and the total score ranged from −9 to 9, with higher scores indicating greater adherence to a traditional Japanese diet. Longitudinal associations of interaction between TJDS and fiscal year on breast cancer incidence and mortality were investigated in 139 countries with populations of 1 million or greater. The longitudinal analysis was evaluated using four linear mixed-effect models with different adjustment covariables.

Results

Many countries with high scores on TJDS had lower distributions of breast cancer incidence and mortality in 1990–2017. Longitudinal analysis using a linear mixed-effect model controlled for socio-economic and lifestyle covariables showed that the interaction between TJDS and fiscal year was significantly associated with incidence of breast cancer (−0.453 ± 0.138, p < 0.01) and mortality of breast cancer (−0.455 ± 0.135, p < 0.001).

Conclusions

This longitudinal analysis suggested that a traditional Japanese diet has been associated with lower breast cancer incidence and mortality worldwide in recent years.

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Fig. 1: Relationship between TJDS and breast cancer in 2017.
Fig. 2: Trend in breast cancer over time about countries.

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Acknowledgements

We would like to thank Forte Science Communications (Tokyo, Japan) for carefully English proofreading the manuscript.

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Authors and Affiliations

  1. Department of Life and Environmental Science, Tsu City College, Tsu, Mie, Japan

    Chisato Abe

  2. Department of Food Science and Nutrition, Doshisha Women’s College of Liberal Arts, Kyoto, Japan

    Tomoko Imai

  3. Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan

    Ayako Sezaki, Masayo Sanada & Hiroshi Shimokata

  4. Department of Nursing, Nagoya University of Arts and Sciences, Nagoya, Aichi, Japan

    Keiko Miyamoto

  5. Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan

    Fumiya Kawase

  6. Department of Food and Nutritional Environment, Kinjo Gakuin University, Nagoya, Aichi, Japan

    Yoshiro Shirai

  7. Department of Nutrition, Hamamatsu University Hospital, Shizuoka, Japan

    Ayaka Inden

  8. Department of Nutrition, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, Japan

    Takumi Kato

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  1. Chisato Abe
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by CA, TI, and HS. The first draft of the manuscript was written by CA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Chisato Abe.

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Abe, C., Imai, T., Sezaki, A. et al. A longitudinal association between the traditional Japanese diet score and incidence and mortality of breast cancer—an ecological study. Eur J Clin Nutr 75, 929–936 (2021). https://doi.org/10.1038/s41430-020-00847-5

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