Impact of diet on the cardiovascular risk profile of Japanese immigrants living in Brazil: contributions of World Health Organization CARDIAC and MONALISA studies.

1. Japanese immigrants from Okinawa living in Brazil have a higher mortality from cardiovascular diseases and have their mean life expectancy shortened compared with their counterparts living in Japan. 2. A cross-sectional study comparing Okinawans living in Okinawa (OO) and Okinawan immigrants living in Brazil (OB) was designed to characterize the dietary factors that could interfere with the profile of cardiovascular risk factors and with this reduction on the life expectancy when Okinawans emigrate to Brazil. 3. In total, 234 OO and 160 OB (aged 45-59 years) were recruited to the present study to undergo medical and dietary history, blood pressure measurement, electrocardiograph (ECG), blood tests and 24 h food/urine collection. 4. In the present study, OO subjects presented with 37% less obesity and 50% less systemic hypertension than OB. The OB subjects used threefold more antihypertensive medication than OO. Meat intake was 34% higher in OB than OO, whereas fish intake was sevenfold higher in OO than OB. Serum potassium levels were 10% higher in OO than OB. Urinary taurine (an index of seafood intake) was 43% higher in OO than OB. Urinary isoflavones (an index of the intake of soy products) were significantly lower in OB than in OO. Of acid (20:5) and docosahexaenoic acid (22:6) were two- and threefold higher in OO than OB, respectively. 5. The rate of ischaemic ECG changes in OO subjects was only 50% of that of OB subjects. 6. There were no differences in the smoking rate between OO and OB subjects. 7. The results of the present study suggest that coronary risk factors and cardiovascular health are not only regulated by genetic factors, but that the impact of lifestyle (mainly diet) can be large enough to modulate the expression of genes.