Background-Once-or twice-weekly consumption of fish (or a small amount of fish intake) reduces the risk of coronary heart disease and sudden cardiac death in Western countries. It is uncertain whether a high frequency or large amount of fish intake, as is the case in Japan, further reduces the risk. Methods and Results-To examine an association between high intake of fish and n3 polyunsaturated fatty acids and the risk of coronary heart disease, a total of 41 578 Japanese men and women aged 40 to 59 years who were free of prior diagnosis of cardiovascular disease and cancer and who completed a food frequency questionnaire were followed up from 1990 -1992 . Conclusions-Compared with a modest fish intake of once a week or Ϸ20 g/d, a higher intake was associated with substantially reduced risk of coronary heart disease, primarily nonfatal cardiac events, among middle-aged persons.

Evidence on the association between salt intake and gastric cancer is sparse, especially in prospective studies. We conducted a population-based prospective study in Japan, where the majority of men has been infected with Helicobacter pylori. A total of 18 684 men and 20 381 women aged 40 -59 years who reported their dietary habits and did not report any serious disease at baseline were followed from 1990 to 2001. A total of 486 cases, 358 men and 128 women, with histologically confirmed gastric cancer were documented among them. The quintile category of salt intake was dose-dependently associated with gastric cancer risk in men after adjusting for potential confounding factors (P for trend o0.001), while a trend was not clear in women (P for trend ¼ 0.48). Although stratification by study area, with varied salt intake and gastric cancer incidence, attenuated the observed clear associations with salt and salted foods, the frequency categories of highly salted foods such as salted fish roe and salted fish preserves were strongly associated with the risk in both sexes. Restriction of salt and salted food intake is a practical strategy to prevent gastric cancer in areas with high risk.

The objective of this study was to evaluate the validity and reproducibility of a self-administered food frequency questionnaire (FFQ) to estimate nutrient and food intake in the subjects of the Japan Public Health Center-based prospective Study on Cancer and Cardiovascular Diseases (JPHC Study Cohort II). The FFQ was originally developed to estimate intake in the JPHC Study Cohort I. A total of 392 subjects were recruited from the entire cohort participants in the 6 areas of Cohort II on a voluntary basis. The subjects completed the FFQ used for the 5-year follow-up survey twice at approximately a 1-year interval. Seven-day dietary records (DR) and blood samples were collected 4 times at 3-month intervals over a year. Daily nutrient and food intakes from FFQ and DR were estimated. The Spearman correlation coefficients for estimated intakes were calculated between FFQ and DR for validity, and between 2 identical FFQs for reproducibility. Correlation coefficients for the validity ranged from 0.09 to 0.82 among various nutrients and food groups. The correlation coefficients for most of the nutrients and food groups were improved to a level comparable to that of Cohort I by energy-adjustment. Correlation coefficients for reproducibility ranged from 0.42 to 0.82, similar to those of Cohort I.

In a population-based, prospective cohort study in Japan, frequent miso soup and isoflavone consumption was associated with a reduced risk of breast cancer.

We recently reported that circulating apolipoprotein AII (apoAII) isoforms apoAII-ATQ/AT (C-terminal truncations of the apoAII homo-dimer) decline significantly in pancreatic cancer and thus might serve as plasma biomarkers for the early detection of this disease. We report here the development of novel enzyme-linked immunosorbent assays (ELISAs) for measurement of apoAII-ATQ/AT and their clinical applicability for early detection of pancreatic cancer. Plasma and serum concentrations of apoAII-ATQ/AT were measured in three independent cohorts, which comprised healthy control subjects and patients with pancreatic cancer and gastroenterologic diseases (n = 1156). These cohorts included 151 cases of stage I/II pancreatic cancer. ApoAII-ATQ/AT not only distinguished the early stages of pancreatic cancer from healthy controls but also identified patients at high risk for pancreatic malignancy. AUC values of apoAII-ATQ/AT to detect early stage pancreatic cancer were higher than those of CA19–9 in all independent cohorts. ApoAII-ATQ/AT is a potential biomarker for screening patients for the early stage of pancreatic cancer and identifying patients at risk for pancreatic malignancy (161 words).

Valid food-frequency questionnaires (FFQ) need to be developed to assess isoflavone intake in investigations of its possible association with the lower incidence of breast and prostate cancer in Asian countries. We investigated the validity and reproducibility of isoflavone (daidzein and genistein) intakes from self-administered semiquantitative FFQ used in the JPHC Study (Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases). We also investigated the number of food items that would be sufficient to ensure validity and reproducibility. We collected FFQ, dietary records (DR), blood and urine samples from 215 subjects among JPHC Study participants, estimated isoflavone intakes from FFQ and DR, and measured serum isoflavone concentration and urine isoflavone excretion. For daidzein, mean intakes estimated from FFQ and DR, serum concentration and urine excretion were 18.3 mg/d, 14.5 mg/d, 119.9 nmol/L and 17.0 micromol/d and for genistein, 31.4 mg/d, 23.4 mg/d, 475.3 nmol/L and 14.2 micromol/d, respectively. Results were similar when analyzed by sex. Spearman correlation coefficients for daidzein of energy-adjusted intakes from FFQ with those from DR, serum concentration and creatinine-adjusted urinary excretion were 0.64, 0.31 and 0.43, respectively. Correlations between two FFQ estimates with a 1-y interval were 0.76. Results were similar for genistein. The shorter version of the FFQ with three items (natto, miso and tofu for miso soup) showed a similar correlation. The original FFQ and the shorter versions have sufficient validity and reproducibility to be used in epidemiologic studies.

We examined the validity and reproducibility of a 44-item food frequency questionnaire used in a baseline survey of the Japan Public Health Center-Based Prospective Study Cohort I conducted in February 1990. Subjects were 94 men and 107 women selected on a voluntary basis among respondents to the baseline survey. Four or five years after the baseline survey, they provided four 7-day diet records during a 1-year period, and then responded to the same questionnaire a second time. The median (range) for energy-adjusted correlation coefficients between 30 nutrients measured by the questionnaire and the diet records was 0.36 (0.06-0.81) for men and 0.37 (0.11-0.52) for women. The median correlation (range) for 17 food groups was 0.30 (0.08-0.75) for men and 0.28 (0.08-0.46) for women. The median correlation (range) for energy-adjusted correlation coefficients between the two questionnaires was 0.24 (0.04-0.69) for men and 0.50 (0.27-0.60) for women for the nutrients, and 0.34 (0.15-0.63) for men and 0.48 (0.18-0.55) for women for the food groups, respectively. The results indicate that this brief food frequency questionnaire provides reasonably valid and reproducible measures of consumption for many nutrients and food groups, and is useful for examining the association between diet and health in the Japanese population. J Epidemioi2003;13(Suppl):S125-S133.Key words: food frequency questionnaire, validity, reproducibility, dietary record, prospective study. Center Districts (Ninohe, Yokote, Saku, Katsushika-kita, and Ishikawa) were asked to complete a self-administered questionnaire including a 44-item food frequency section, which is referred to as the baseline food frequency questionnaire 1 (BFFQ1)9. Completed questionnaires were collected from 50,245 subjects, with a response rate of 82%. SubjectsThe subjects of this validation study were a subsample of the participants in the prospective study in four districts, omitting one area in Tokyo (Katsushika-kita). We selected 122 men and 125 women on a voluntary basis. Table 1 summarizes the sequence of data collection. In three districts of mainland Japan (Ninohe, Yokote and Saku), we obtained 7-day diet records four times in different seasons in 1994, five years after the baseline survey, and administered the same questionnaire (BFFQ2) again in February, 1995. In one district of Okinawa Island, we collected 7-day diet records in the winter and summer of 1995, and the second questionnaire was administered in February 1996. We collected the diet records only twice in this sub-tropical area because the seasonal variations in diet were small. We also collected fasting blood and 24-hour stored urine samples twice, in February and

The association between vegetables and fruit consumption and gastric cancer risk was investigated in a population-based prospective study in 4 public health center areas in Japan. Dietary and other exposure data were obtained in 1990 from a cohort of 19,304 men and 20,689 women with a self-administered questionnaire. After 10 years of follow-up, a total of 404 cases of gastric cancer were documented among them. After adjustment for age, gender, areas and other potential confounding factors and after exclusion of the cases diagnosed in first and second follow-up years, the relative risk associated with intake 1 or more days per week compared to less than 1 day per week was 0. Although gastric cancer mortality has been declining during the last few decades, it remains the second most common cancer worldwide. 1 High consumption of vegetables and fruit has been hypothesized to have protective effects against gastric cancer. Although in many previous case-control studies a high consumption of vegetables and fruit has been associated with a reduced risk of gastric cancer, 2-4 the evidence from 11 prospective cohort studies has not been consistent. [5][6][7][8][9][10][11][12][13][14][15] Trends of gastric cancer incidence reportedly differ depending on the subsites and histologic types. The incidence of cardia cancer has recently increased, while the rate of distal cancer has been stable for intestinal type or decreasing for diffuse type. 16 -19 On the other hand, recent studies have indicated that infection by Helicobacter pylori (H. pylori), an established risk factor for gastric cancer, is associated with an increased risk for noncardia cancer 20 but not for cardia cancer. 21 These findings indicate that discrepancies in incidence trends between the two subsites (noncardia and cardia) and 2 histologic types (intestinal and diffuse) may be linked with not only H. pylori infection but also dietary habits or nutrient factors including the consumption of vegetable and fruits. However, only a few case-control studies of fruits, vegetables and gastric cancer have analyzed the data according to subsites and histology, [22][23][24][25] and no prospective study has been conducted.To further examine the association between the consumption of vegetables and fruit and the risk of gastric cancer, we conducted a population-based prospective study in four public health center areas as part of the Japan Public Health Center-based prospective study on cancer and cardiovascular disease (JPHC Study). Furthermore, we examined the association between the risk of different gastric cancer subsites and histologic types and vegetables and fruit consumption. MATERIAL AND METHODS Study cohortJPHC Study Cohort I is a prospective cohort study that began in January 1990. The study design has been described previously. 26 Briefly, the cohort included 27,063 men and 27,435 women, aged 40 -59 years at baseline who registered their addresses in 4 public health center (PHC) areas: Ninohe PHC area of Iwate Prefecture, Yokote PHC area of Akita, Saku P...