Japanese-style dietary patterns, mortality, and selected cancer outcomes in Japanese populations: a systematic review integrating meta-analysis, food-group loading visualization, and qualitative synthesis.

Authors

Tao Yu, Marina Yamagishi, Kota Okoshi, Shuhei Nomura, Naoko Yamamoto, Shoichiro Tsugane

Published in

Advances in nutrition (Bethesda, Md.). Pages 100756. Oct 15, 2026. Epub Oct 15, 2026.

Abstract

Japanese-style dietary patterns (DPs) are often regarded as healthy, but the food-group combinations needed to develop health-oriented Japanese-style DPs remain unclear. This systematic review synthesized associations between predefined (a priori) Japanese-style DPs and health outcomes in Japanese populations and used data-derived (a posteriori) DPs to examine outcome-specific heterogeneity in food-group composition and loadings. PubMed/MEDLINE and Web of Science Core Collection were searched for observational studies. Random-effects meta-analyses were conducted for comparable a priori Japanese-style DPs using adjusted hazard ratios (HRs) comparing the highest and lowest score categories. A posteriori DPs derived by principal component analysis or factor analysis were visualized using reported estimates, investigator-assigned pattern names, relative similarity to the Japanese Diet Index-9 (JDI-9) reference profile, and food-group loadings. Of 37 reports retained in the review, 12 longitudinal reports contributed to meta-analyses or food-group loading visualizations, and 25 were synthesized qualitatively. Across 3 independent studies contributing 5 analytic estimates per outcome, pooled HRs comparing the highest and lowest score categories suggested lower all-cause mortality (HR: 0.88; 95% CI: 0.83, 0.93; I² = 61.1%) and cardiovascular disease (CVD) mortality (HR: 0.82; 95% CI: 0.73, 0.93; I² = 71.6%), although heterogeneity was substantial; the pooled estimate for total cancer mortality was close to the null. Among 43 a posteriori DPs from 9 studies, 21 were classified as JDI-9-like; however, this relative classification alone did not consistently distinguish reported associations across outcomes; interpretation required examination of the reported component-level food-group loadings. These findings motivate a provisional three-layer framework distinguishing potentially favorable traditional components, high-sodium traditional components, and contemporary dietary components; the framework is hypothesis-generating and requires outcome-specific validation.

PMID:
42880456
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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