Development of a Japanese Healthy Diet Index: The Fukushima Health Management Survey 2011

Abstract

A novel healthy diet index for dietary quality can be used to assess food intake. After the Great East Japan Earthquake in 2011, the Fukushima Health Management Survey collected dietary data using a short-form food frequency questionnaire (FFQ). The current study included eligible participants (n = 64,909) aged 16–84 years who answered the FFQ in 2011. The year- and sex-specific dietary patterns were determined via principal component analysis. Based on the typical Japanese individual, juice/dairy, and meat patterns, healthy diet index (HDI) scores were assigned for food items, resulting in Spearman’s correlation coefficients of 0.730, −0.227, and −0.257, respectively. The mean (standard deviation) of the HDI scores (range: 1–18) were 9.89 (2.68) in men and 9.96 (2.58) in women. Older individuals, women, nonsmokers, those in good health and with regular physical exercise, and those who did not transfer residences had a high HDI score. In the confirmatory analysis, the adjusted odds ratio (95% confidence interval) of the highest vs. the lowest quartiles of HDI scores was 0.87 (0.80, 0.94) for overweight, 0.89 (0.81, 0.97) for large waist circumference, and 0.73 (0.66, 0.80) for dyslipidemia. The HDI score obtained using the FFQ can be applied to evaluate dietary profiles.

A Narrative Review Exploring the Similarities between Cilento and the Already Defined “Blue Zones” in Terms of Environment, Nutrition, and Lifestyle: Can Cilento Be Considered an Undefined “Blue Zone”?

“…In agreement with Fara [ 128 ], who emphasized the relationship between sustainability and nutrition quality, it is important to consider healthy eating habits from different cultures; for example, Asian cuisines have an ancient tradition of maintaining health, and the Mediterranean diet has been recognized by UNESCO as an intangible cultural heritage of humanity. Last but not least, in order to assess the frequency with which the older population of Cilento consumes food and to evaluate its quality, a new Healthy Diet Index will be used, according to Ma et al [ 129 ].…”

Development of the Scores for Traditional and Modified Japanese Diets

“…The RSJDS was developed based on seven dietary components associated with the risk of mortality (intake of Japanese pickles, eggs, fish, meat, soup with noodles, use of low-salt soy sauce, and occasional drinking) [ 4 ]. The JDI [ 5 , 6 ], JHDI [ 7 ], and JFS [ 8 ] were established based on dietary patterns identified using factor analysis to characterize the traditional Japanese diet. The JDI scored seven positive (rice, miso soup, green and yellow vegetables, seaweeds, pickled vegetables, fish, and green tea) and two negative food items (beef and pork and coffee) [ 5 , 6 ].…”

“…The JDI scored seven positive (rice, miso soup, green and yellow vegetables, seaweeds, pickled vegetables, fish, and green tea) and two negative food items (beef and pork and coffee) [ 5 , 6 ]. The JHDI contains 10 positive-scored items (rice, boiled beans, tofu, fermented beans, miso soup, white vegetables, green vegetables, red/yellow vegetables, fruits, and fish) and 9 reverse-scored items (bread, soybean milk, vegetable juice, fruit juice, beef/pork, chicken, ham, milk, and yoghurt) [ 7 ]. The JFS consists of seven foods (beans and bean products, fresh fish, vegetables, Japanese pickles, fungi, seaweed, and fruits) [ 8 ].…”

“…Several dietary scoring systems [ 3 , 4 , 5 , 6 , 7 , 8 ] have been developed in Japan and their associations with health status have been investigated. Adherence to the Japanese Food Guide Spinning Top (JFGSP) [ 3 ] has been linked to a lower risk or prevalence of depression [ 9 ], metabolic risk factors [ 10 , 11 , 12 ], frailty [ 13 ], and mortality [ 14 , 15 ].…”

“…Several scores have been developed to measure adherence to the Japanese-style diet. The Japanese Diet Index (JDI) [ 5 , 6 ], Japanese Healthy Diet Index (JHDI) [ 7 ], Japanese Food Score (JFS) [ 8 ] and their higher scores have been associated with a lower risk of dementia (JDI) [ 6 ], functional disability [ 5 , 16 , 17 ] (JDI), mortality (JDI) [ 18 ], metabolic risk factors (JHDI) [ 7 ], and all-cause and CVD mortality (JFS) [ 8 ], respectively. Reduced-Salt Japanese Diet Score (RSJDS) has been linked to a low risk of all-cause mortality, CVD, and stroke [ 4 ].…”