Fauzi Muhammad, Kartiko-Sari Indri, Poudyal Hemant
Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan.
Asian Nutrition and Food Culture Research Center, Jumonji University, Saitama 352-8510, Japan.
J Clin Med. 2022 Apr 22;11(9):2350. doi: 10.3390/jcm11092350.
Health Japan 21 is Japan's premier health promotion policy encompassing preventive community health measures for lifestyle-related diseases. In this repeated cross-sectional survey, we report 24-year trends of type 2 diabetes mellitus (T2DM), obesity, hypertension, and their association with dietary intakes to evaluate Health Japan 21's impact and identify gaps for future policy implementation. We analyzed data from 217,519 and 232,821 adults participating in the physical examination and dietary intake assessment, respectively, of the National Health and Nutrition Survey 1995-2019. Average HbA1c and BMI have significantly increased along with the prevalence of T2DM and overweight/obesity among males. Despite a significant decrease in daily salt intake, the decline in the combined prevalence of Grades 1-3 hypertension was non-significant. Seafood and meat intakes showed strong opposing trends during the study period, indicating a dietary shift in the Japanese population. Neither salt nor vegetable/fruit intake reached the target set by Health Japan 21. Metabolic disease trend differences between males and females highlight the need for a gender-specific health promotion policy. Future Health Japan 21 implementation must also consider locally emerging dietary trends.
“健康日本21”是日本首要的健康促进政策，涵盖针对生活方式相关疾病的社区预防保健措施。在这项重复横断面调查中，我们报告了2型糖尿病（T2DM）、肥胖症、高血压的24年趋势，以及它们与饮食摄入的关联，以评估“健康日本21”的影响，并找出未来政策实施中的差距。我们分别分析了1995 - 2019年国民健康与营养调查中参与体检和饮食摄入评估的217,519名和232,821名成年人的数据。男性的平均糖化血红蛋白（HbA1c）和体重指数（BMI）随着T2DM患病率以及超重/肥胖率显著上升。尽管每日盐摄入量显著下降，但1 - 3级高血压合并患病率的下降并不显著。在研究期间，海鲜和肉类摄入量呈现出强烈的相反趋势，表明日本人群的饮食结构发生了变化。盐摄入量和蔬菜/水果摄入量均未达到“健康日本21”设定的目标。男性和女性之间代谢疾病趋势的差异凸显了制定针对性别健康促进政策的必要性。未来实施“健康日本21”还必须考虑当地新出现的饮食趋势。
