Morbidity and mortality statistics, including incidences of fat-related cancers (FRCs), and dietary intake and sources of fats and oils were compared for Japanese, Mediterranean and American people. Incidences of FRCs, except for steeply increasing colon cancer, have remained low in Japan. Similarly, Mediterranean people enjoy relatively low risks of FRCs compared with American people. The low risks of FRCs in Japanese may be explained by limited intake of fats and oils as a whole, and a low ratio of n-6 polyunsaturated fatty acids (PUFAs) versus n- 3 PUFAs through consumption of the latter from marine foods. They also frequently consume vegetables and fruit, and dietary fiber. Mediterranean people moderately consume fats and oils from a large amount of olive oil, containing not only oleic acid but also polyphenols (including flavonoids), á-tocopherol and carotenoids (including â-carotene), which are antioxidants and anti-carcinogenic as in red wine, vegetables (including herbs) and fruit. The diet also features medium intake of fish and shellfish along with cereals/pasta/bread. From the standpoint of intake of total fat, the low risks of FRCs in Japanese seem "plausible," while the low risks in Mediterranean people may be termed "paradoxical." In summary, limited consumption of fats and oils, moderate intakes of marine foods, and vegetables and fruit, in line with a modest intake of energy may be advocated for promoting health, prolonging life and prevention of lifestyle-related diseases including FRCs.
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