II. Patterns of Health Risk
The Honolulu Heart Program studies began in 1965 with a cohort of 8006 Japanese American men and is still continuing. Much of what we know about the health and aging of Japanese Americans is based on the several hundred publications that have come out of the studies of these men, and now some women, as they age.
The cohort of Japanese men in the Honolulu Heart Program studies has a life expectancy that is longer than their counterparts in Japan, and Japan has the longest life expectancy of any country in the world. With a few exceptions noted below, the risk of most diseases that have been studied is lower among Japanese American elders than among other older Americans.
B. Cancer
Breast cancer in older Japanese American women is lower than in most other U.S. populations. Ovarian and prostate cancer is also low, although longer residence in North America has been correlated with an increase in risk for prostate cancer, which in turn has been noted to be associated with increased saturated fat intake. Likewise colon cancer seems to be increasing with the adaptation to Western diets. Japanese Americans have a rate of stomach cancer that is twice as high as most other populations in the U.S., which is thought to be related to eating nitrite-rich salty foods (e.g. cured meats).C. Diabetes
One disease that has a higher prevalence among Japanese Americans than their counterparts in either Japan or Caucasians in the U.S. is Type II Diabetes. In Seattle studies, 20% of Nisei men between 45 and 74 were found to have diabetes, half of which was not diagnosed, and 56% had abnormal glucose tolerance. Those rates are over twice as high as comparable samples of men in the U.S. population in general (Fujimoto et al., 1987). Those with diabetes were found to consume more fat and animal protein than their non-diabetic Nisei counterparts, although both groups consumed the same amount of calories.
A. Heart, Cardiovascular Disease, and Stroke
Japanese Americans have been found to have much lower risks of heart and cardiovascular diseases than their white American counterparts. With increasing adaptation to the western diet (high meat, less roughage), however, there appears to be an increase in coronary artery disease.
The Honolulu Heart Study cohort was found to have a lower risk for strokes than men in Japan. The incidence of strokes also declined during the first two decades since the inception of the studies. This decline was felt to be possibly related to a decline in blood pressure and smoking. However, there is a higher risk of hemorrhagic stroke among Japanese American men compared to Caucasian men. One theory is that this may be related to the lower fibrinogen levels found in a study by Iso et al. (1989).
