We investigated the relationship between time trends in dietary intakes and serum cholesterol levels in a Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town on Kyushu Island. Total subjects were 628 in 1958, 539 in 1977, 602 in 1982, 752 in 1989, 402 in 1999, and 329 in 2009, and all of the subjects were men aged 40 - 64 years. Eating patterns were evaluated by 24-hour dietary recall from 1958 through 1989, and by a food frequency questionnaire in 1999 and 2009. We also measured serum cholesterol levels in each health examination. The total energy intake decreased from 2,837 kcal in 1958 to 2,289 kcal in 2009. The carbohydrate intake in percentage of total energy intake decreased markedly, from 84% in 1958 to 58% in 2009, in contrast to large increases during this period in protein intake (from 11% to 16%) and fat intake (from 5% to 22%). In proportion to the dramatic change in protein and fat intake, serum cholesterol levels showed large increases (from 152.5 mg/dl to 207.7 mg/dl). Despite of such big dietary changes toward a westernized diet, incidence of coronary heart disease has not increased in our cohort for a couple of decades. However, careful surveillance is needed in the future because of the remarkably increasing intake of fats.
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