Nutrient patterns and mortality: Results from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study

Background : The consumption of a healthy diet may play an important role in the prevention of noncommunicablediseases (NCDs). Although the associationsbetween nutrient patterns and cardiometabolic risk factors or NCDs have been examined, the associationsbetween nutrient patterns and mortality remain unknown. The present study examined the relationships between nutrient patterns and all-cause and cause-specific mortalities in a large Japanese population. Methods : A prospective cohort analysis was performed on the data of 72,939 subjects aged 35–69 years in the Japan Multi-Institutional Collaborative Cohort Study. A factor analysis was applied to the energy-adjusted intakes of 21 nutrients, and 4 nutrient patterns were extracted: Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol patterns); Factor 2 (unsaturated fatty acidand vitamin E patterns); Factor 3 (saturated fatty acid, calcium, vitamin B2 and low carbohydrate patterns); and Factor 4 (sodium, protein and vitamin D patterns). A Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of nutrient patterns after adjustments for potential confounders. Results : During a mean follow-up of 11.7 years, 3488 deaths were identified. A higher factor1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol) score was associated with lower all-cause (HR 0.81, 95% CI 0.73–0.90), CVD (HR 0.65, 95% CI 0.49–0.85) and cerebrovascular disease (HR 0.60, 95% CI 0.38–0.96) mortalities. The second lowest quartile group of the factor 2 (unsaturated fatty acid and vitamin E) score was associated with lower all-cause (HR 0.86, 95% CI 0.79–0.94) and cancer (HR 0.85, 95% CI 0.76–0.95) mortalities. On the other hand, a higher Factor 2 score was associated with greater cerebrovascular disease mortality (HR 1.57, 95% CI 1.03–2.40). Conclusions : The results of the present study suggest that increased adherence to nutrient patternsrich in folate, carotene, fiber, vitamin C, potassium, iron, and retinol or moderate adherence to unsaturated fatty acids and vitamin E are associated with a decreased risk of mortality in Japanese adults.