نبذة مختصرة : BACKGROUND: From prior analyses on dietary data from the six-prefecture cohort in Japan, we found a possible protective effect of milk, meat and fish for cerebrovascular disease mortality from 1966 to 1981. However, this protective effect had not been examined for cancer and other causes of death. OBJECTIVES: The purpose of the present analysis is to further elucidate the associations between the joint intakes of dairy milk, meat and fish as main sources of animal protein and fat and the main causes of death in the subjects of the six-prefecture cohort study. METHODS: The subjects for this analysis were 225,019 men and women aged 40 to 69 at the baseline in December 1965, with neither prior disease history of cancer nor other diseases except for chronic stomach disease. There were 23,108 deaths for men and 16,785 deaths for women during the study period. To evaluate the joint intakes of dairy milk, meat and fish (DMF), data were re-categorized into binary data. For example, DMF (D,M,F) means the combination of dairy milk (1-3 times/week or more), meat (1-3 times/week or more) and fish (4 times/week or more). Thus DMF (d,m,f) was the reference group having dairy milk (less than 1 time/week), meat (less than 1 time/week) and fish (less than 4 times/week). Rate ratio (RR) adjusted for attained age, sex, prefecture, occupation, alcohol drinking, cigarette smoking and DMF was used for comparison. RESULTS: A weak joint effect on all cancer mortality was observed in DMF (D,M,F)(RR:1.09, 95%CI:1.00-1.17), although no statistically significant effect was found in cancer of the colon, rectum, breast, prostate, stomach, lung, oesophagus, gall bladder, liver, pancreas, cervix-uteri and urinary bladder. Neither all respiratory disease nor all external causes of death showed significant association between DMF and mortality. On the other hand, possible protective effects in DMF(D,M,F) were observed for the mortalities of all causes of death (RR=0.85, 95%CI: 0.81-0.88), all cerebrovascular diseases (RR=0.68, 95%CI: 0.62-0.73), all cardiovascular disease (RR=0.86, 95%CI: 0.78-0.95) and all other causes of death (RR=0.83, 95%CI: 0.73-0.89). CONCLUSION: The present analysis indicates that animal protein and fat was not strongly associated with cancer mortality. On the other hand, relatively high animal protein and fat intake, although much lower than that in the western countries, may have helped to reduce mortality from vascular disease in this cohort.
背景:われわれは､六府県コホートデータ(1966-1981)の解析から､牛乳､肉および魚の摂取が脳血管疾患の死亡に防御的な影響を及ぼすことを見つけた｡しかし､がんや他の疾患についても同様な影響があるのか未検討であった｡ 目的:本解析の目的は､六府県コホート研究対象者における動物性蛋白質･脂肪の主たる供給源としての牛乳､肉および魚の同時摂取と主要疾患の死亡率との関係をさらに明らかにすることである｡ 方法:解析対象は1965年12月のベースライン時に40歳～69歳までの男女225,019人であり､がんやその他疾患(慢性の胃疾患を除く)の既往歴があるものは解析対象から除外した｡研究期間中に観察された死亡数は男性23,108人､女性16,785人であった｡牛乳(Dairy milk)､肉(Meat)および魚(Fish)の同時摂取(DMFと呼称)の影響をみるために､データは二値データに再カテゴリ化した｡例えば､DMF(D,M,F)というのは,牛乳を週1～3回以上,肉を週1～3回以上､および魚を週4回以上摂取することを意味する｡すなわちDMF(d,m,f)は参照群であり､牛乳を週1回未満､肉を週1回未満､および魚を週4回未満の摂取とした｡死亡リスク(RR)は性､年齢､県､職業､飲酒､喫煙およびDMFを調整して比較に用いた｡ 結果:全がんに対してDMFは弱い影響がみられ､DMF(D,M,F)におけるRRは1.09､その95%信頼区間(95%CI)は1.0-1.17であった｡しかし結腸､直腸､乳房､前立腺､胃､肺､食道､胆嚢､肝､膵､子宮頸および膀胱では統計学的に有意な影響はみつからなかった｡またDMFは呼吸器系疾患や外因死とは関連がみられなかった｡一方､DMF(D,M,F)においては､全死因(RR=0.85,95%CI:0.81-0.95)､脳血管疾患(RR=0.68,95%CI:0.62-0.73)､心疾患(RR=0.86,95%CI:0.78-0.95)､その他の死因(RR=0.83,95%CI:0.73-0.89)となっており､これらの死因に対してDMFは防御的な影響を及ぼしたことが観察された｡ 結論: 今回の解析結果は,このコホートにおける動物性蛋白質･脂肪の摂取とがん死亡とは強く関連していなかったことを示している｡一方､欧米ほど量的に多くはない動物性蛋白質･脂肪の摂取は循環器系疾患の死亡を減らすことに役だっていたのであろう｡
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