Stroke mortality and proportional expenditure on selected food items in Japanese communities

Proportional food expenditure was calculated from the 1959 National Survey of Family Income and Expenditures and 843 municipalities were trichotomized according to the relative expenditure of various food items. Sex specific standardized mortality ratio (SMR) of stroke (1969-83) was calculated for each trichotomized food expenditure subgroup and compared. Results indicated that Western style diet such as expenditure of meat, milk and egg and bread had negative association with SMR. The expenditure of meat showed a negative association with SMR in all the three rice expenditure subgroups, but that of milk and egg in the low rice expenditure subgroup only. Consumption of constituents of the traditional Japanese diet, such as rice and other cereals, certain seasonings, salted and dried fish showed a positive association with SMR. Alcoholic beverages and cakes also showed a positive association. The secular trend of declining stroke mortality was parallel to the increase in the consumption of milk, meat, fish, eggs, soybeans, oil and fats and to the decrease in rice consumption. These findings were in accordance with the generally held view in Japan that moderate intake of animal protein was protective against stroke.