Westernized food habits and concentrations of serum lipids in the Japanese

To investigate the association of westernized food habits and concentrations of serum lipids in the Japanese, we studied 1200 healthy Japanese living in Hiroshima prefecture and 1483 ethnic Japanese from Hiroshima prefecture living in the Hawaii Islands and Los Angeles. The nutritional assessments were made by the same dietitians. No major difference was observed in the total energy intake between the Japanese and the Japanese-Americans in both males and females. However, the intake of animal fat and simple carbohydrates (especially fructose) were markedly greater, and that of complex carbohydrates lower, in the Japanese-Americans compared with the Japanese. The mean serum cholesterol (CH), LDL-CH and serum triglyceride (TG) levels were significantly higher in the Japanese-Americans in both sexes. The mean HDL-CH concentration was similar between the two groups in males, but it was approximately 7 mg/dl higher in Japanese-American females. Using the 75 percentile values of CH and TG in the Japanese in Hiroshima, the frequency of WHO types IIa and IIb hyperlipidemia was about twice as high in the Japanese-Americans. These results suggest that westernized food habits in the Japanese include qualitative changes in animal fat, simple carbohydrate and complex carbohydrate diet rather than an increase in the total energy intake. These changes are associated with marked increases in the concentrations of serum CH and TG and increased prevalence of types IIa and IIb hyperlipidemia.     

Ethnic differences in post-menopausal plasma oestrogen levels: high oestrone levels in Japanese-American women despite low weight

Breast cancer incidence in Japanese-American women is approaching that of US Whites. We investigated whether this shift is paralleled by similar post-menopausal plasma hormone levels in the two ethnic groups. We also included African-American and Latina women to further our understanding of possible ethnic differences in oestrogen metabolism. We measured androstenedione (A), oestrone (E1) and oestradiol (E2) in 30 Japanese-American, 39 non-Latina White ('White'), 66 African-American and 58 Latina women. The (age-adjusted) geometric mean E1 levels were 34 pg ml(-1) in Japanese-Americans, 28 pg ml(-1) in Whites, 35 pg ml(-1) in African-Americans and 31 pg ml(-1) in Latinas. After adjustment for body mass index, Japanese-Americans had the highest mean E1 value of all groups and this was statistically significantly greater than the value for Whites (P(t-test) = 0.05). The geometric mean A concentrations were also highest in Japanese-Americans. There was little ethnic difference in E2 levels. In conclusion, post-menopausal plasma oestrogen levels in Japanese-American women are at least as high as those in Whites.     

Cultural barriers in oncology: Issues in obtaining medical informed consent from Japanese-American elders in Hawaii

In east-west cultural contexts medical decision-making by elderly Japanese-American oncology patients is made complex by cultural differences from mainstream service providers. Cultural, religious and practical factors thought to contribute to delays in obtaining informed consent for treatment in oncology from mentally competent Japanese-American elders in Hawai'i are identified in this study of health care professionals at Queen's Medical Center in Honolulu (n = 50). Circumstances under which Japanese-American elders sign informed consent documents without understanding them are also examined. Recommendations are offered by the participants and researchers for improvements to the informed consent process. Implications of the findings and recommendations are discussed for Health Care Practice with Japanese-American and other ethnic elderly patients in mainstream health care organizations.     

Alcohol-Related Problems Encountered by Japanese,Caucasians, and Japanese-Americans

Using population-based survey data, personal-problematic and socioproblematic factors were examined among Japanese in Japan, Japanese-Americans in Hawaii, and Japanese-Americans; Caucasians in California were analyzed as a control group. Caucasian males were more likely to exhibit drinking-related social problems, whereas Japanese males showed more personal-problematic symptoms. Japanese-American men, both in Hawaii and California, were least likely among the three ethnic groups to have personal-problematic symptoms and were more likely to have socioproblematic symptoms than Japanese men. These differences might be explained by differences in the perception of social problems.     

A prospective study of alcohol,diet, and other lifestyle factors in relation to obstructive uropathy

The association of alcohol, diet, and other lifestyle factors with obstructive uropathy was investigated in a cohort of 6581 Japanese-American men, examined and interviewed from 1971 to 1975 in Hawaii. By studying this migrant population with its heterogeneous exposures, it increases the probabilities of identifying potential risk factors of this prostate disorder. After 17 years of follow-up, 846 incident cases of surgically treated obstructive uropathy were diagnosed with benign prostatic hyperplasia. Total alcohol intake was inversely associated with obstructive uropathy (P < 0.0001). The relative risk was 0.64(95% confidence interval: 0.52–0.78) for men drinking at least 25 ounces of alcohol per month compared with nondrinkers. Among the 4 sources of alcohol, a significant inverse association was present for beer, wine, and sake, but not for spirits. Buddhist (vs. other) religion, rural (vs. urban) birthplace, and the presence of prostate symptoms were each associated with increased risk of obstructive uropathy, but no association was found with education, number of marriages, or cigarette smoking. Increased beef intake was weakly related to an increased risk (P = 0.047), while no association was found with the consumption of 32 other food items in the study. © 1993 Wiley-Liss. Inc.     

Comparison of Characteristics and Survival of Colorectal Cancer Between Japanese-Americans in Hawaii and Native Japanese in Japan

Purpose This study was designed to investigate whether characteristics, prognostic risk factors, and survival of colorectal cancer of Japanese-Americans in Hawaii are different from those of native Japanese in Japan. Methods Aretrospective review of patients with colorectal cancer surgically resected in single institutions in Hawaii and Japan from 1996 to 2002. Results A total of 410 Japanese-American patients (218 males; median age, 73 years) and621 native Japanese patients (382 males; median age, 65 years) were included. There were significant differences in age (P < 0.001), age distribution (P < 0.001), gender (P= 0.008), preoperative carcinoembryonic antigen (P < 0.001), and anatomic site distribution (P < 0.001). The tumor characteristics of Japanese-American patients wereclose to the general American population compared with the Surveillance, Epidemiology, and End Results data. There were no differences in tumor size, histologic grade, each of T, N, M status and TNM stage between the two groups. The overall five-year survival rates (Japanese-Americans, 75.5 percent; native Japanese, 76.2 percent; P = 0.55) and survival rates in each of four stratified stages were similar. Risk factors associated with survival were not different, except for carcinoembryonic antigen (P = 0.036). Conclusions In patients with colorectal cancer in Japanese-Americans in Hawaii, some of tumor characteristics have changed from those of native Japanese inJapan. However, there are no remarkable differences in prognostic factors and survival between the two groups. The present study suggests that certain changes of colorectal cancer characteristics that were seen in Japanese-American may occur in native Japanese in Japan in the near future, although the survivaloutcome of colorectal cancer may remain the same. Read at the Clinical Congress of the American Collage of Surgeons, San Francisco, California, October 16 to 20, 2005.     

Greater hand-grip strength predicts a lower risk of developing type 2 diabetes over 10 years in leaner Japanese Americans

Aims

Much is known about body composition and type 2 diabetes risk but less about body function such as strength. We assessed whether hand-grip strength predicted incident diabetes.

Methods

We followed 394 nondiabetic Japanese-American subjects (mean age 51.9) for the development of diabetes. We fit a logistic regression model to examine the association between hand-grip strength at baseline and type 2 diabetes risk over 10 years, adjusted for age, sex, and family history.

Results

A statistically significant (p = 0.008) and negative (coefficient −0.208) association was observed between hand-grip strength and diabetes risk that diminished at higher BMI levels. Adjusted ORs for a 10-pound hand-grip strength increase with BMI set at the 25th, 50th or 75th percentiles were 0.68, 0.79, and 0.98, respectively.

Conclusions

Among leaner individuals, greater hand-grip strength was associated with lower risk of type 2 diabetes, suggesting it may be a useful marker of risk in this population.