Dietary behaviours and related lifestyles according to the presence or absence of skipping breakfast in Japanese adults: the JPHC-NEXT study.

OBJECTIVE: To assess dietary behaviours and related lifestyles according to the presence or absence of skipping breakfast. DESIGN: We analysed the cross-sectional data from a baseline survey of a large-scale population-based cohort study in Japan conducted in 2011-2016. Participants provided information on dietary behaviours and lifestyles through a self-administered questionnaire. Skipping breakfast was defined as not eating breakfast at least once a week and was classified according to the frequency of skipping breakfast as 1-2, 3-4 or ≥5 times/week. SETTING: Sixteen municipalities in seven prefectural areas across Japan under the Japan Public Health Centre-based prospective study for the Next Generation. PARTICIPANTS: 112 785 residents (51 952 males and 60 833 females) aged 40-74 years. RESULTS: After adjustment for age, socio-demographic status, drinking status and smoking status, individuals who skipped breakfast at least once a week, compared with those who ate breakfast every day, were more likely to have adverse dietary behaviours such as frequent eating out (multivariable OR = 2·08, 95 % CI (1·96, 2·21) in males and 2·15, 95 % CI (1·99, 2·33) in females), frequent eating instant foods (1·89, 95 % CI (1·77, 2·01) in males and 1·72, 95 % CI (1·56, 1·89) in females). They had late bedtime (1·85, 95 % CI (1·75, 1·95) in males and 1·98, 95 % CI (1·86, 2·11) in females) and living alone (2·37, 95 % CI (2·17, 2·58) in males and 2·02, 95 % CI (1·83, 2·21) in females), using the logistic regression model. CONCLUSIONS: Both adult males and females who skipped breakfast were likely to eat out, to have a dietary habit of eating instant foods and have lifestyles such as late bedtime and living alone than those who ate breakfast.

Association between dietary intake of n-3 polyunsaturated fatty acids and risk of colorectal cancer in the Japanese population: The Japan Collaborative Cohort Study.

BACKGROUND: Epidemiological studies of the dietary intake of specific n-3 polyunsaturated fatty acids (PUFA) and anatomical subsite-specific colorectal cancer (CRC) are limited. We examined the prospective associations of total n-3 PUFA, marine-derived n-3 PUFA [combined eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA)], and alpha-linolenic acid (ALA) as plant-derived n-3 PUFA with the risk of CRC by subsite in the Japan Collaborative Cohort Study. METHODS: The participants completed a self-administered food frequency questionnaire and had no prior history of CRC. Cox proportional hazards model was used to determine the associations between n-3 PUFAs intake and CRC risk overall and by anatomical subsite. RESULTS: During the median 13.8-year follow-up period, 699 of the 42,536 participants aged 40-79 years developed incident CRC. An inverse association was found between dietary ALA intake and the risk of distal colon cancer; the multivariable hazard ratios and 95% confidence intervals for the highest quartiles (Q4) were 0.41 (0.21-0.81; p trend = 0.01) compared with the lowest quartiles (Q1). Marine n-3 PUFA intake was not associated with CRC risk in the overall or anatomical subsite-specific analyses. CONCLUSION: Our findings suggest that higher ALA intake may be beneficial for lowering the risk of distal colon cancer.

Dietary intake of beans and risk of disabling dementia: The Circulatory Risk in Communities Study (CIRCS).

OBJECTIVE: To examine whether bean intake (including soybeans) among Japanese adults is associated with risk of disabling dementia severe enough to require care under the national insurance system. METHODS: This cohort study involved 3739 individuals aged 40 to 64 years. The participants were categorized into five groups based on their dietary bean intake estimated by a 24h dietary recall. Hazard ratios and 95% confidence intervals of disabling dementia were estimated using Cox proportional hazard models adjusted for potential confounding factors (smoking, drinking, and intakes of energy and fish). RESULTS: During the 59,681 person-year follow-up, 670 cases of disabling dementia were observed. A weak inverse association between bean intake and risk of disabling dementia was found; the multivariable hazard ratios (95% CIs) were 0.79 (0.62-1.00), 0.80 (0.63-1.01), 0.84 (0.67-1.06), and 0.78 (0.62-0.99) for the four groups with higher bean intake, respectively, compared with the lowest group (P for trend = 0.21). A significant inverse association was observed for dementia without a history of stroke; for the four groups with higher bean intake the multivariable hazard ratios were 0.81 (0.61-1.08), 0.70 (0.52-0.95), 0.71 (0.52-0.95), and 0.69 (0.51-0.92), respectively, (P for trend = 0.03). No such association was observed for dementia with history of stroke. The group with increased natto intake were inversely associated with risk of disabling dementia (P for trend = 0.003), but tofu intake was not (P for trend = 0.19). CONCLUSIONS: Bean intake was inversely associated with risk of disabling dementia in those without a history of stroke.

Weight Change and Mortality from Cardiovascular Diseases: The Japan Collaborative Cohort Study.

AIM: The aim of this study was to assess the association between weight change and mortality due to cardiovascular diseases (CVDs) in a Japanese population. METHODS: We used the data of a population-based prospective cohort study that was conducted from 1988 to 1990 in 45 areas throughout Japan. Among a total of 69,681 men and women aged 40-79 with no history of CVD or cancer at baseline, the association between weight change from 20 years of age to baseline and CVD-related mortality was evaluated. RESULTS: During a median follow-up period of 19.1 years, we observed 4,274 deaths from total CVD. After adjusting for age, sex, and other potential confounding factors, compared with participants with a weight change of ＜2.5 kg (stable weight), participants with a greater weight change (either loss or gain) had an increased risk of mortality from total CVD (U-shaped association). The hazard ratios for the total CVD risk in participants with a weight loss and a weight gain of ≥ 12.5 kg were 1.50 (95% confidence interval [CI], 1.30-1.72) and 1.21 (95% CI, 1.07-1.36), respectively. The associations between weight change and risk of mortality from ischemic heart disease or stroke showed similar trends. The risk of intracerebral hemorrhage was associated with weight loss only. Weight change was not associated with mortality from subarachnoid hemorrhage. CONCLUSIONS: Weight loss or gain could be a risk factor for mortality from total or ischemic CVD, while weight loss could be a risk factor for intracerebral hemorrhage.

Association between free sugars intake and nutrient dilution among Japanese adults: the 2016 National Health and Nutrition Survey, Japan.

PURPOSE: The association between free sugars and nutrient intake is unclear in Japanese adults with relatively low free sugars intake. This cross-sectional study aimed to elucidate this relationship using data from the 2016 National Health and Nutrition Survey, Japan, and according to the current World Health Organization (WHO) guidelines for the prevention of nutrient dilution [< 5% or < 10% of energy (%E)]. METHODS: Dietary intake of Japanese adults (aged ≥ 20 years; n = 16,652) was assessed using a 1-day weighed dietary record. Mean intakes for selected nutrients and food groups were compared among categories of free sugars intake (i.e., < 2.5%E, 2.5 to < 5%E, 5 to < 10%E, and ≥ 10%E) by adjusting for sex, age, weight status, smoking status, habitual drinking, and occupation. RESULTS: Free sugars intake was inversely associated with the intake of 16 of 24 micronutrients investigated. Compared to its lower categories of free sugars intake, significant reductions in intake were identified for almost all micronutrients at ≥ 10%E, whereas ten micronutrients were reduced at 5 to < 10%E. The intake of dietary fibre, sodium, potassium, calcium, and iron was lower at < 2.5%E than at 2.5 to < 5%E and/or 5 to < 10%E. Free sugars intake was also positively associated with sugars and jams, confectionaries, fruit and vegetable juices, and soft drinks and inversely with pulses and nuts and vegetables. CONCLUSIONS: This study identified nutrient dilution among Japanese adults with higher free sugars intake and confirmed the significance of the WHO guidelines for preventing nutrient dilution in Japanese.

The Association of Having a Late Dinner or Bedtime Snack and Skipping Breakfast with Overweight in Japanese Women.

Background: We aimed to assess the association of habitually eating in the late evening and skipping breakfast with the prevalence of overweight/obesity. Methods: A total of 19,687 Japanese women, aged 40-74 years, were asked about their height, weight, and habitual eating behaviors such as having a late dinner and a bedtime snack and skipping breakfast, using a self-administered questionnaire. We defined overweight/obesity as body mass index greater than or equal to 25 kg/m2. Results: Among the participants, 11% regularly had a late dinner, 22% had bedtime snacks, and 8% skipped breakfast. After adjusting for age, exercise, smoking, sleep duration, and employment, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of skipping breakfast were 2.47 (2.18-2.81) for having a late dinner and 1.71 (1.53-1.91) for having a bedtime snack. These eating behaviors were associated with an increased risk of overweight/obesity: the multivariable-adjusted ORs (95% CIs) of obesity/overweight were 1.43 (1.27-1.62) for having a late dinner, 1.47 (1.34-1.62) for having a bedtime snack, and 1.23 (1.06-1.42) for skipping breakfast. Conclusions: Japanese women who consumed late dinners or bedtime snacks were more likely to skip breakfast. Having a late dinner or bedtime snack was associated with a higher probability of overweight/obesity.

Highly frequent and enhanced injection site reaction induced by peripheral venous injection of fosaprepitant in anthracycline-treated patients.

BACKGROUND: Fosaprepitant-associated injection site reaction (ISR) has been reported in patients treated with cisplatin, an irritant drug. We conducted this retrospective study to clarify the incidence and symptoms of fosaprepitant-associated ISR in patients treated with anthracycline. PATIENTS AND METHODS: Fifty six patients receiving 159 injections administering doxorubicin/cyclophosphamide (AC), fluorouracil/epirubicin/cyclophosphamide (FEC), or rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone (R-)CHOP regimen through a peripheral vein at ambulatory treatment centers reviewed for this study from patients' medical records. Incidence of ISR was compared between 24 patients with fosaprepitant injection (fosaprepitant group) and 32 patients without fosaprepitant (control group). Frequency and symptoms of ISR per injection were also compared between 61 injections with fosaprepitant and 98 injections without fosaprepitant. RESULTS: Both the ISR incidence rate per patient and per injection were significantly higher in the fosaprepitant group than in the control group (67% vs. 16%; P=0.0002, 34% vs. 8.2%; P<0.0001, respectively). By multivariate analysis, fosaprepitant injection was found to be a significant independent variable correlated with ISR risk. Symptoms observed in 61 injections of fosaprepitant were pain (n=14, 23%), erythema (n=10, 16%), swelling (n=6, 10%), and delayed drip infusion (n=6, 10%). After the observation period, no ISR occurred when the administration route was changed to central venous injection or oral aprepitant was administered despite the continuation of chemotherapy. CONCLUSION: ISR occurred more frequently and severely when fosaprepitant was injected through the peripheral vein in patients treated with anthracyclines compared to those without fosaprepitant.