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Seaweeds contain minerals, vitamins, soluble dietary fibers, and flavonoids, which are regarded as preventive agents against lifestyle-related diseases. Seaweeds are consumed commonly in East Asian countries including Japan. Thus, intake of seaweeds might contribute to Japanese longevity via prevention of lifestyle-related diseases. Recently, two large Japanese cohort studies have reported the association of seaweed intake with reduced risk of cardiovascular diseases. On the other hand, seaweeds also contain iodine and heavy metals such as arsenic species, which are considered to have adverse effects on health. We here reviewed studies of the association between seaweed intake and mortality from or incidence of cancer and cardiovascular diseases, and their risk factors such as blood pressure or serum lipids. We also summarized the adverse effects of iodine and arsenic species in seaweeds. Although seaweeds have not been widely consumed in Western countries, dietary diversification and an increased proportion of immigrants from East Asia may increase seaweed consumption in those countries. Further epidemiological studies including observational and interventional studies are necessary to clarify the effects of seaweeds on disease and health.

This article focuses on selected large prospective cohort studies that examined the effect of alcohol consumption on the risks of hypertension and cardiovascular disease in Japanese men and women. Regardless of age and sex, alcohol consumption was positively associated with an increased risk of hypertension. There was a J-shaped association between alcohol consumption and the risks of stroke and cardiovascular disease in Japanese men, which was consistent with the findings of the studies conducted by Western countries. Few studies have been conducted to examine the effect of alcohol consumption on the risks of stroke and coronary heart disease in Asian women. We first showed that heavy alcohol consumption of ≥300 g ethanol/week was associated with increased risk of total stroke, hemorrhagic stroke, intraparenchymal hemorrhage, subarachnoid hemorrhage and ischemic stroke in women while light drinking was not associated with a reduced risk of stroke. Furthemore, heavy drinking (≥46.0 g ethanol/day) had an increased risk of mortality from coronary heart disease in women, whereas light drinking (0.1–22.9 g ethanol/day) had a reduced risk of mortality from total cardiovascular disease. The association between alcohol consumption and the risk of stroke was modified by social support and salt preference.

This retrospective longitudinal study examined the association between systolic blood pressure and hearing impairment among 13,187 Japanese individuals (men, 46.5%) aged 20-59 years. The systolic blood pressure of participants was categorized as <120, 120-129, 130-139, 140-149, 150-159, and ≥160 mmHg. Using pure-tone audiometry, hearing impairment at 1 and 4 kHz was defined as hearing thresholds in either ear >30 and >40 dB, respectively. We performed multivariable Cox proportional-hazards regression analysis to examine the association using two multiple-imputation methods (fully conditional specification and Markov chain Monte Carlo). There were 695 and 774 hearing-impairment cases at 1 and 4 kHz, respectively, during ~77,000 person-years of follow-up. Compared with the <120 mmHg group, the hazard ratios (95% confidence intervals) of hearing impairment for the 120-129, 130-139, 140-149, 150-159, and ≥160 mmHg groups after adjustment for age, sex, body mass index, high serum glucose, current smoking, and other potential confounders were 1.35 (1.12-1.63), 1.45 (1.13-1.86), 1.07 (0.73-1.58), 1.91 (1.18-3.07), and 1.81 (1.01-3.25), respectively, at 1 kHz using the first imputation method; 1.36 (1.13-1.63), 1.48 (1.17-1.86), 1.09 (0.76-1.58), 1.99 (1.29-3.06), and 1.92 (1.08-3.41), respectively, at 1 kHz using the second imputation method; 1.04 (0.86-1.24), 1.14 (0.91-1.43), 1.13 (0.83-1.54), 1.45 (0.96-2.19), and 1.35 (0.82-2.23), respectively, at 4 kHz using the first imputation method; and 1.03 (0.86-1.24), 1.17 (0.95-1.44), 1.15 (0.87-1.53), 1.54 (1.06-2.24), and 1.44 (0.88-2.35), respectively, at 4 kHz using the second imputation method. In conclusion, higher systolic blood pressure was associated with hearing impairment at 1 kHz. No clear association was observed at 4 kHz.

To clarify how low BMI and weight loss were associated with risk of chronic obstructive pulmonary disease (COPD) mortality, in a large prospective cohort of the general population across Japan, the Japan Collaborative Cohort Study, conducted between 1988 and 2009. A total of 45,837 male residents were observed for a median period of 19.1 years. Self-administered questionnaires, collecting information on BMI, weight loss since the age of 20, lifestyles, history of diseases, as well as records of COPD mortality, were analysed at 2019. During follow-up, 268 participants died from COPD. The multivariate-adjusted hazard ratio (95% confidence interval) of COPD mortality associated with a 1-SD increment of body mass index (BMI) was 0.48 (0.41–0.57), while for weight change from age of 20 (+ 2.0 kg) it was 0.63 (0.59–0.68). These associations were persistently observed after stratifications with smoking status, excluding those having airway symptoms in the baseline survey, and excluding early COPD deaths within 5, 10 and 15 years. Our study suggests that BMI and weight change since the age of 20 could be markers for COPD prognosis, indicated by risk of COPD mortality.

Background: Limited epidemiological evidence has suggested a positive relationship between night shift work and the risk of cancer. Herein, we investigated the prospective association between different forms of work schedule and the risk of numerous cancers and all-cause cancer among Japanese men and women.Methods: This cohort study included 45,390 working men and women aged 40–79 years and registered in the Japan Collaborative Cohort Study (JACC Study). The Cox proportional hazards models were used to calculate the hazard ratios (HRs) and their 95% confidence intervals (CIs) for incident cancer among those who reported engagement in night work and rotating shift work for their longest occupations compared with day work.Results: Within a median follow-up duration of 14.2 years, 2,283 (9.4%) men and 1,309 (4.5%) women developed cancer. Among men, rotating shift work was significantly associated with increased risk of esophageal cancer (HR 2.47; 95% CI, 1.42–4.31) and decreased risk of liver cancer (HR 0.54; 95% CI, 0.30–0.98). Also, rotating shift work tended to be associated with the increased risk of prostate cancer (HR 1.42; 95% CI, 0.95–2.12). Night work and rotating shift work were not related to the risk of all-cause cancer in either sex.Conclusion: Rotating shift work might contribute to the increased risk of esophageal cancer and prostate cancer and the decreased risk of liver cancer among Japanese men.

Background: The impact of weight change, physical activity, and sedentary behavior on endometrial cancer risk among the Asian population is uncertain. We investigated the association of those factors with endometrial cancer risk among Japanese women with a low body mass index level.Methods: We performed a large-scale nationwide cohort study consisting of 33,801 female participants aged 40–79 years. The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident endometrial cancer.Results: The mean body mass index of participants was 22.8 kg/m2. During a median follow-up of 14.8 years, 79 participants developed endometrial cancer. After adjustment for potential confounding factors, body mass index over 23.0 kg/m2 was linearly associated with the risk of endometrial cancer. The HR per 5 kg/m2 increase was 1.80 (95% CI, 1.28–2.54). Weight increment ≥+5 kg since age 20 was associated with an increased risk of endometrial cancer compared to a weight change of −5 to <+5 kg (multivariable HR 1.96; 95% CI, 1.12–3.40). Compared with females who were mainly sitting at the worksite, those who were mainly standing and moving were at lower risk; the multivariable HRs were 0.79 (95% CI, 0.39–1.59) and 0.46 (95% CI, 0.22–0.97), respectively (P for trend = 0.042). Hours of physical exercise, daily walking, and TV viewing were not associated with endometrial cancer risk.Conclusions: Overweight and weight gain were positively associated with the risk of endometrial cancer, while worksite physical activity was inversely associated with the risk.

Background: The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD) are unclear. Methods: A total of 72 014 subjects (29 668 men and 42 346 women) aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2-3 days, or once every 4 or more days) and laxative use (yes or no), and were followed-up until 2009. Results: During the subjects' 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women), 2024 from total stroke (1028 men and 996 women), 1127 from ischemic stroke (606 men and 521 women), and 828 from hemorrhagic stroke (388 men and 440 women). The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs]) of laxative users were as follows: 1.56 (95% CI, 1.21-2.03) for coronary heart disease and 1.37 (95% CI, 1.07-1.76) for ischemic stroke in men, and 1.27 (95% CI, 1.08-1.49) for total stroke, and 1.45 (95% CI, 1.17-1.79) for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed. Conclusions: Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke.

This study examined the association between cigarette and heated tobacco product (HTP) use before and during pregnancy and after six months postpartum and premature breastfeeding cessation (within 6 months postpartum). An internet-based cross-sectional survey was conducted from July to August 2021 in Japan, and the data of 4,005 women who gave birth between January 2019 and February 2021 were analyzed. The Poisson regression model with robust error variance showed that pre-pregnancy cigarette-only (adjusted prevalence ratio [aPR], 1.34; 95% confidence interval, [CI] 1.06 – 1.70) and combination users (i.e., cigarettes and HTPs) (aPR, 1.34; 95% CI, 1.02 – 1.77) and quitters during pregnancy (aPR, 1.37; 95% CI, 1.15 – 1.64) were more likely to cease breastfeeding prematurely than non-users. HTP-only users before (aPR, 1.32; 95% CI, 0.99 – 1.76) and during pregnancy (aPR, 1.08; 95% CI, 0.61 – 1.92) had no association with premature breastfeeding cessation. The multinomial logistic regression model showed that premature breastfeeding cessation was associated with cigarette-only (adjusted relative risk ratios [aRRR], 2.17; 95% CI, 1.22 – 3.85) and combination-use (aRRR, 2.62; 95% CI, 1.17 – 5.87) after 6 months postpartum. Women with cigarette or combination-use histories, despite quitting during pregnancy, tended to terminate breastfeeding prematurely, but this was not the case for HTP-only users.

Background: Alcohol consumption is a potential risk factor for gastric cancer. However, findings from cohort studies that examined the relationship between alcohol consumption and gastric cancer risk among Japanese population are not conclusive. Methods: A total of 54,682 Japanese men and women participating in the Japan Collaborative Cohort study completed a questionnaire, including alcohol consumption information. The Cox proportional hazard model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results: After a median 13.4-year follow-up, we documented 801 men and 466 women incident cases of gastric cancer. Alcohol consumption was associated with increased risk of gastric cancer among men (HRs in ex-drinkers and current alcohol consumption of <23 g, 23–<46 g, 46–<69 g, and ≥69 g/d categories versus never drinkers were 1.82; 95% CI, 1.38–2.42, 1.41; 95% CI, 1.10–1.80, 1.47; 95% CI, 1.17–1.85, 1.88; 95% CI, 1.48–2.38, and 1.85; 95% CI, 1.35–2.53, respectively, and that for 10 g increment of alcohol consumption after excluding ex-drinkers was 1.07; 95% CI, 1.04–1.10). The association in men was observed for cardia and non-cardia gastric cancer (HRs in the highest alcohol consumption category versus never drinkers were 9.96; 95% CI, 2.22–44.67 for cardia cancer and 2.40; 95% CI, 1.64–3.52 for non-cardia cancer). However, no such trend was observed in women. Conclusions: Alcohol consumption is associated with increased risk of gastric cancer among Japanese men, regardless of anatomical subsite of the cancer.

Background/objectivesThe longitudinal association between skipping breakfast in parents and their children, and the subsequent risk of childhood overweight/obesity is unknown, especially in children under 10 years of age. We therefore aimed to prospectively assess the association between parents who skip their breakfast and the risk of children skipping their breakfast, as well as the risk of childhood overweight/obesity in children who skip their breakfast, using a10.5-year follow-up data on nationality representative samples.MethodsA total of 43, 663 children aged 1.5 years in 2002 were followed until 12 years of age. An overweight body mass index (BMI), including obesity, was defined as a BMI greater than or equal to 25 kg/m2, according to the International Obesity Task Force cut-off points for children. Associations between parents, when children were 1.5 years of age, and children (2.5–12 years of age) skipping breakfast, as well as childhood overweight/obesity were calculated using logistic regression models.ResultsOf the 42 663 children included, 12 and 32% of their mothers and fathers usually skipped breakfast when the child was 1.5 years of age, respectively. Children whose mothers or fathers skipped breakfast were more likely to skip breakfast, than those whose parents ate breakfast for all ages: the range of multivariable odds ratios (ORs) was 1.90 (95% confidence interval (CI) 1.56-2.31) to 2.98 (95% CI 2.28-3.90) among mothers and 1.42 (95% CI 1.33-1.51) to 2.43 (95% CI 1.90-3.11) among fathers. When both parents skipped breakfast, the strongest association was observed. Compared to children who did not skip breakfast, children who skipped breakfast had 18–116% increased risk of overweight/obesity; the multivariable ORs were 1.18 (95% CI 1.05-1.32) and 2.16 (95% CI 1.55-2.99), respectively.ConclusionsThere was a significant association between skipping breakfast in parents and children. Children who skipped breakfast had significantly increased risk of childhood overweight/obesity.