High intake of sweet foods such as cakes, cookies, chocolate and ice cream has been reported to be associated with depressive symptoms. However, prospective studies are scarce and no study has been conducted in Asian populations. We prospectively investigated the association between confectionery intake and depressive symptoms in a Japanese working population. Participants were 911 workers (812 men and 99 women; aged 19–68 years) without depressive symptoms at baseline who completed a 3-year follow-up survey. Dietary intake was assessed using a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Multiple logistic regression was used to estimate the OR of depressive symptoms according to tertile of confectionery intake with adjustment for covariates. At the time of the 3-year follow-up survey, 153 (16·8 %) workers were newly identified as having depressive symptoms (CES-D score ≥ 16). Confectionery intake was significantly associated with increased odds of developing depressive symptoms. The multivariable-adjusted OR of depressive symptoms for the highest v. lowest tertile of confectionery intake was 1·72 (95 % CI 1·03, 2·86) after adjustment for covariates including dietary factors such as folate, vitamin B6, vitamin B12, n-3 PUFA, Mg, Zn and soft drink (Pfor trend = 0·012). Our results suggest that confectionery intake is associated with a higher risk of depressive symptoms in a Japanese working population predominantly comprised of men.

Evidence that diet is associated with breast cancer risk is inconsistent. Most of the studies have focused on risks associated with specific foods and nutrients, rather than overall diet. In this study, we aimed to evaluate the association between dietary patterns and breast cancer risk in Japanese women. A total of 49 552 Japanese women were followed-up from 1995 to 1998 (5-year follow-up survey) until the end of 2012 for an average of 14·6 years. During 725 534 person-years of follow-up, 718 cases of breast cancer were identified. We identified three dietary patterns (prudent, westernised and traditional Japanese). The westernised dietary pattern was associated with a 32 % increase in breast cancer risk (hazard ratios (HR) 1·32; 95 % CI 1·03, 1·70; Ptrend=0·04). In particular, subjects with extreme intake of the westernised diet (quintile (Q) Q5_5th) had an 83 % increase in risk of breast cancer in contrast to those in the lowest Q1 (HR 1·83; 95 % CI 1·25, 2·68; Ptrend=0·01). In analyses stratified by menopausal status, postmenopausal subjects in the highest quintile of the westernised dietary pattern had a 29 % increased risk of breast cancer (HR 1·29; 95 % CI 0·99, 1·76; Ptrend=0·04). With regard to hormone receptor status, the westernised dietary pattern was associated with an increased risk of oestrogen receptor-positive/progesterone receptor-positivetumours (HR 2·49; 95 % CI 1·40, 4·43; Ptrend<0·01). The other dietary patterns were not associated with the risk of breast cancer in Japanese women. A westernised dietary pattern is associated with an increased risk of breast cancer in Japanese women.

Limited and inconsistent associations between cholesterol and egg consumption and type 2 diabetes risk have been observed in Western countries. In the present study, the association of dietary cholesterol and egg intakes with type 2 diabetes risk was examined prospectively. The study subjects comprised 27 248 men and 36 218 women aged 45–75 years who participated in the second survey of the Japan Public Health Center-based Prospective Study and had no histories of type 2 diabetes or other serious diseases. Dietary cholesterol and egg intakes were estimated using a validated 147-item FFQ. The OR of self-reported, physician-diagnosed type 2 diabetes over 5 years were estimated using multiple logistic regression. A total of 1165 newly diagnosed cases of type 2 diabetes were self-reported. Although dietary cholesterol intake was not associated with type 2 diabetes risk in men, it was found to be associated with a 23 % lower odds of type 2 diabetes risk in women in the highest quartile of intake, albeit not statistically significant, compared with those in the lowest quartile (Ptrend= 0·08). Such risk reduction was somewhat greater among postmenopausal women; the multivariable-adjusted OR for the highest quartile of cholesterol intake compared with the lowest quartile was 0·68 (95 % CI 0·49, 0·94; Ptrend= 0·04). No association between egg intake and type 2 diabetes risk was found in either men or women. In conclusion, higher intake of cholesterol or eggs may not be associated with an increased risk of type 2 diabetes in Japanese populations. The observed association between decreased type 2 diabetes risk and higher dietary cholesterol intake in postmenopausal women warrants further investigation.

The relationship between different types of meat intake and the risk of type 2 diabetes remains unclear. We prospectively examined the association between total meat, total red meat, unprocessed red meat, processed meat and poultry intake and the incidence of type 2 diabetes. Subjects were 27 425 men and 36 424 women aged 45–75 years who participated in the second survey of the Japan Public Health Center-based Prospective Study, and had no history of type 2 diabetes, cancer, stroke, IHD, chronic liver disease or kidney disease. Meat intake was estimated using a validated 147-item FFQ. OR of self-reported, physician-diagnosed type 2 diabetes over 5 years were estimated using a multiple logistic regression. A total of 1178 newly diagnosed cases of type 2 diabetes were self-reported. Intakes of total meat and total red meat were associated with the increased risk of type 2 diabetes in men but not in women. The multivariate-adjusted OR for the highest quartile compared with the lowest quartile of total meat and total red meat intake were 1·36 (95 % CI 1·07, 1·73; P for trend = 0·006) and 1·48 (95 % CI 1·15, 1·90; P for trend = 0·003) for men, respectively, and 0·82 (95 % CI 0·62, 1·09; P for trend = 0·14) and 0·77 (95 % CI 0·57, 1·02; P for trend = 0·08) for women, respectively. Intakes of processed red meat and poultry were not associated with the increased risk of diabetes in either men or women. In conclusion, elevated intake of red meat is associated with the increased risk of type 2 diabetes in Japanese men but not in women.

Vegetable and fruit intake has been associated with a reduced risk of cancer and CVD, but its relationship to the risk of type 2 diabetes remains unclear. We prospectively examined the association between vegetable and fruit intake and the incidence of type 2 diabetes. Subjects were 21 269 men and 27 168 women aged 45–75 years who participated in the second survey of the Japan Public Health Center-based Prospective Study and had no history of type 2 diabetes or other serious diseases. Intake of vegetables and fruit was estimated using a validated 147-item FFQ. The OR of self-reported, physician-diagnosed type 2 diabetes over 5 years was estimated using multiple logistic regression. A total of 896 newly diagnosed cases of type 2 diabetes were self-reported. Intake of vegetables and fruit combined or fruit only was not associated with a lower risk of type 2 diabetes. However, there was an approximately 20 %, albeit not statistically significant, risk reduction associated with vegetables (men only), green leafy vegetables (men and women) and cruciferous vegetables (men only). Such risk reduction was somewhat greater among obese or smoking men than non-obese or non-smoking men. In conclusion, although a small beneficial effect of vegetables, especially green leafy and cruciferous vegetables, cannot be excluded, vegetable and fruit intake may not be appreciably associated with the risk of type 2 diabetes for Japanese adults.