Adiposity and risk of cardiovascular diseases in Japan: secular trend, individual level associations and causal pathway – implications for the prevention of cardiovascular diseases in societies with rapid economic development

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Abstract
In Japan, overweight/obesity in adults defined as a body mass index of 25 kg/m2 or over has roughly doubled among middle-aged men over the past few decades. In parallel with a population rightward shift in the degree of obesity, the proportion of hypertension attributed to overweight has increased. There is an indication that the incidence of ischemic stroke and coronary heart disease remains stable or has been increasing among men. These facts indicate that the relative importance of cardiovascular diseases (CVD) risk factors may have changed. Although it was confirmed at an individual level that the degree of obesity was positively associated with CVD incidence, there is a sizeable proportion of individuals who are at an increased CVD risk state without being overweight/obese in today’s Japan. Thus, further implementation and promotion of activities are needed to bring about meaningful changes in the obesity trend in communities that are harmonized with other domains of CVD prevention activities.