In this narrative review, we summarized evidence from peer-reviewed articles, published before February 2024, that investigated lifestyle behaviors among children (≤12 years) and adolescents (13-18 years) representing different geographic descents. These behaviors included dietary patterns, screen time, physical activity, smoking, alcohol consumption, oral hygiene, unsafe sex, and sleep duration and quality. We documented the significant impacts of parental, school, and sociodemographic factors on the adoption of numerous lifestyle behaviors in this age category. Several health consequences could be attributed to unhealthy lifestyle behaviors during childhood and adolescence. For example, poor dietary habits can lead to a higher risk of obesity and cardiovascular disease. Physical inactivity contributes to the development of musculoskeletal and psychological disorders. Excessive screen time is associated with visual acuity problems, poor sleep, and psychological and behavioral problems. Tobacco use poses a significant risk for severe respiratory and cardiovascular diseases. Risky sexual behaviors are related to sexually transmitted infections and exposure to violence. Short sleep duration is associated with a lack of physical fitness and poor cognitive function. However, potential interventions, such as school-based health programs, community outreach initiatives, and national health policies and regulations, can improve lifestyle behaviors among children and adolescents.

Selenium, an essential mineral with antioxidant properties, can potentially prevent atherosclerosis and maintain cardiovascular health. However, the association between selenium and ischemic heart disease (IHD) remains unclear. This study aimed to determine the impact of selenium on global IHD incidence (IHDi) and mortality (IHDd) over a 28-year period from 1990 to 2018, using open data for global comparisons. IHDi and IHDd per 100,000 people were obtained from the Global Burden of Disease Study (GBD) 2019 database and estimated selenium intake from the Global Dietary Database. Covariates were obtained from the World Bank and GBD databases. The associations of selenium intake with IHDi and IHDd in the 28 years from 1990 onward were analyzed for 149 countries with populations >1 million, using a Bayesian generalized additive mixed model, controlling for covariates. A nonlinear relationship existed between selenium intake and IHDi and IHDd. The selenium intake levels with the lowest risk for IHDi and IHDd were 93.3 and 78.5 µg/d, respectively. The risk ratios (RRs) for IHDi were 2.30 (95% CI, 1.82-2.84) and 1.40 (95% CI, 1.13-1.73) for selenium intakes of 10.0 µg/d and 200.0 µg/d, respectively. For IHDd, the RRs were 3.40 (95% CI, 2.62-4.40) for intakes of 10.0 µg/d and 1.72 (95% CI, 1.31-2.20) for 200.0 µg/d. The risk was higher for selenium underintake than for overintake. This study revealed a nonlinear relationship between selenium intake and IHDi and IHDd, aiding in establishing a selenium target intake for the primary prevention of IHD and addressing public health problems.

Purpose: Cross-sectional analysis using open data has revealed an association between the traditional Japanese diet score (TJDS) and healthy life expectancy (HALE). This study aimed to clarify the association of the TJDS with the HALE and average life expectancy (LE) via a longitudinal analysis. Methods: Data regarding the food supply and total energy were extracted from the database of the Food and Agriculture Organization of the United Nations, and data regarding HALE and LE were obtained from the Global Burden of Disease Study 2019. The supply of items consumed frequently (rice, fish, soybeans, vegetables, and eggs) and less frequently (wheat, milk, and red meat) in the Japanese diet were scored (total: −8 to 8 points) and stratified into tertiles by country. The gross domestic product, aging rates, years of education, smoking rate, physical activity, and obesity rate were used as covariates. Longitudinal analyses were conducted for 143 countries, using the HALE and LE for each country from 2010 to 2019 as dependent variables and the 2010 TJDS as an independent variable. Results: The fixed effects (standard errors) were HALE 0.424 (0.102) and LE 0.521 (0.119), indicating significance (p < 0.001). Conclusion: The nine-year longitudinal analysis using international data suggests that the traditional Japanese diet based on rice may prolong the HALE and LE.

Background/Objectives: National food environments may be associated with cardiovascular risk, but how their association with country-level ischemic heart disease (IHD) mortality differs across diet-quality indices remains unclear. We compared six food supply-based dietary scores calculated using 2010 food data in relation to annual IHD mortality from 2010 to 2021. Methods: We conducted a longitudinal study of 148 countries with populations ≥ 1 million. Using 2010 FAOSTAT Food Balance Sheet data, we calculated the Dietary Approaches to Stop Hypertension (DASH) score, the Alternative Healthy Eating Index (AHEI), Mediterranean Diet Score (MDS), Traditional Japanese Diet Score (TJDS), Planetary Health Diet Index (PHDI), and Quantitative Index for Dietary Diversity (QUANTIDD). The outcome was age-standardized IHD mortality during 2010–2021. Associations between time-invariant baseline dietary scores and annual IHD mortality were assessed using multivariable-adjusted linear mixed-effects models. Effect sizes were expressed as mortality rate ratios (MRRs) per 1-standard deviation (SD) higher score; model fit was compared using Akaike information criterion (AIC) weights and marginal R², and effect estimates were compared pairwise. Results: Higher DASH and AHEI scores were associated with lower IHD mortality. MRRs per 1-SD higher score were 0.914 (95% confidence interval, 0.849–0.983) for DASH and 0.908 (95% confidence interval, 0.838–0.985) for AHEI. No significant associations were observed for MDS, TJDS, PHDI, or QUANTIDD. DASH had the highest AIC weight (0.434), followed by AHEI (0.341), with a slightly higher marginal R² for DASH. Pairwise comparisons showed no statistically significant differences in effect estimates between DASH and AHEI or between either of these scores and the other dietary scores. Conclusions: Higher baseline DASH and AHEI scores were associated with lower IHD mortality during 2010–2021, with similar effect estimates per 1-SD higher score and broadly comparable model fit. However, direct pairwise comparisons revealed no statistically significant differences in standardized effect sizes between these scores (DASH and AHEI) and the other dietary scores. These findings suggest that the relevance of dietary scores may depend on the outcome and analytic context rather than the superiority of a single index. Because this was an ecological study, these findings should not be interpreted as individual-level causal effects.

【目的】現在報告されている食事スコアと非感染性疾患との関連についてシステマティックレビューを行い，本研究ではそのうち地中海食スコアの特徴と有用性を明らかにすることを目的とした。【方法】成人を対象に食事スコアで非感染性疾患を評価し，英語・日本語でPubMedに発表された論文（2000年1月～2017年5月）から採択基準により抽出した。スコアごとに分類し，そのうち地中海食スコアの詳細をエビデンステーブルにまとめた。【結果】2,036件の抽出論文より，タイトル574件，アブストラクト902件，本文精読323件が削除され，最終採択論文は237件となった。食事スコアはHealthy Eating Index関連142件，地中海食スコア関連65件，Dietary Quality Index関連34件等に分類された。地中海食スコアはMediterranean Diet Score（MDS）17件，alternate Mediterranean Diet Score（aMed）23件，MedDietScore5件等であった。MDSとaMedは対象集団に依存する相対スコア，MedDietScoreは絶対値スコアであり，いずれも非感染性疾患との有意な関連が報告されていた。【結論】地中海食スコアは対象集団，目的等で使い分ける必要があることが示唆された。今後さらなるエビデンスの蓄積が必要だと確認された。