Objective To examine whether eating until full or eating quickly or combinations of these eating behaviours are associated with being overweight. Design and participants Cross sectional survey. Setting Two communities in Japan. Results 571 (50.9%) men and 1265 (58.4%) women self reported eating until full, and 523 (45.6%) men and 785 (36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 (95% confidence interval 1.53 to 2.62) for men and 1.92 (1.53 to 2.40) for women and for eating quickly was 1.84 (1.42 to 2.38) for men and 2.09 (1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 (2.20 to 4.45) for men and 3.21 (2.41 to 4.29) for women. Conclusion Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

Background and Purpose-Few cohort studies have examined the association of carotid intima-media thickness (IMT) and plaque characteristics with the risk of stroke in apparently healthy persons. We examined the relationship of carotid IMT and the surface, morphology, and calcification of carotid plaques with the incidence of stroke among Japanese men. Methods-Carotid IMT and plaque were evaluated bilaterally with ultrasonography in 1289 men aged 60 to 74 years without a previous stroke or coronary heart disease. In this cohort, the subsequent incidence of stroke was investigated. Results-During the 4.5-year follow-up, 34 strokes occurred. The multivariate-adjusted relative risk (95% CI) for the highest versus lowest quartiles of maximum IMT of the common carotid artery (CCA; Ն1.07 versus Յ0.77 mm) was 3.0 (1.1 to 8.3) for stroke. The combination of CCA and internal carotid artery (ICA) wall thickness was a better predictor of the risk of stroke than was CCA wall thickness alone. Men with a plaque, defined as a focal wall thickness of Ն1.5 mm, in the ICA had a 3-fold higher risk of stroke than those without a plaque, and the plaque surface irregularity further increased the stroke risk. A significant excess risk of stroke was confined to men with an uncalcified plaque. Key Words: atherosclerosis Ⅲ carotid artery Ⅲ epidemiology Ⅲ risk factors Ⅲ stroke P rospective population-based studies in Europe and the United States have documented that carotid intima-media thickness (IMT) and plaque are positively associated with the subsequent incidence of stroke. 1-4 Furthermore, 2 prospective studies have investigated the association between echogenicity of plaques or carotid artery lesions and stroke risk in American populations; 1 study indicated that hypoechoic plaque was associated with increased risk of ischemic stroke, 5 and the other study implied that acoustic shadowing on carotid artery lesions is predictive of ischemic stroke. 6 In Asian countries, a previous follow-up study of Japanese patients with cardiovascular diseases or high-risk profiles showed a positive association between the severity of carotid plaque and the risk of ischemic stroke, 7 but no prospective study has been conducted in a general population. The aim of this prospective study was to systematically examine the incidence of stroke in relation to carotid IMT and the surface, morphology, and calcification of carotid plaque in community-dwelling Japanese elderly men. Conclusions-Increased Subjects and Methods Study PopulationSubjects comprised 1358 men aged 60 to 74 years who were all participants of the target ages in a cardiovascular risk survey between 1996 and 2000. Subjects lived in 1 urban and 2 rural communities in Japan (Minamitakayasu district in Yao City, an urban community in Osaka Prefecture, 278 miles west of Tokyo, with a total census of 23 552 in 2000; Ikawa town, a rural community in Akita Prefecture, 280 miles northeast of Tokyo, with a total census of 6116; and Noichi town, a rural community in Kochi Prefecture, 393 miles sout...

p Ͻ 0.001, †p Ͻ 0.05, ‡p Ͻ 0.01 (level compared with the immediately preceding period). 76Kitamura et al.

Background and Purpose-The role of serum fatty acids as a risk factor for stroke and stroke subtypes is largely unknown. Methods-A prospective nested case-control study of Japanese 40 to 85 years of age was conducted through the use of frozen serum samples from 7450 participants in cardiovascular risk surveys collected from 1984 to 1989 for 1 community and 1989 to 1992 for the other 2 communities. By the end of 1998, we identified 197 incident strokes whose subtypes were confirmed by imaging studies. Three controls per case were selected by matching for sex, age, community, year of serum storage, and fasting status. Results-Compared with controls, total (nϭ197), hemorrhagic (nϭ75), and ischemic (nϭ122) strokes had similar proportions of n3 polyunsaturated fatty acids, lower proportions of linoleic and arachidonic acids, and higher proportions of saturated and monosaturated acids, determined by gas chromatography. The multivariate odds ratios associated with a 1-SD increase in linoleic acid (5%) after adjustment for hypertension, diabetes, serum total cholesterol, and other cardiovascular risk factors were 0.72 [95% confidence interval (CI), 0.59 to 0.89] for total stroke, 0.66 (95% CI, 0.49 to 0.88) for ischemic stroke, 0.63 (95% CI, 0.46 to 0.88) for lacunar infarction, and 0.81 (95% CI, 0.59 to 1.12) for hemorrhagic stroke. The respective odds ratios for saturated fatty acids (4%) were 1.13 (95% CI, 1.05 to 1.65), 1.35 (95% CI, 1.01 to 1.79), 1.44 (95% CI, 1.03 to 2.01), and 1.21 (95% CI, 0.82 to 1.80). Further adjustment for other fatty acids attenuated these relations, but the relation between linoleic acid and risk of ischemic stroke remained statistically significant. Conclusions-A higher intake of linoleic acid may protect against ischemic stroke, possibly through potential mechanisms of decreased blood pressure, reduced platelet aggregation, and enhanced deformability of erythrocyte cells. (Stroke.

The metabolic syndrome is a major determinant of ischemic cardiovascular disease among middle-aged Japanese men and women, in particular among smokers.