Abstract
BACKGROUND/OBJECTIVES: Migrants are recognized as a vulnerable population for non-communicable diseases (NCDs) due to unique socio-cultural and environmental challenges associated with acculturation. Despite a growing migrant population, evidence on NCD risk among migrants in Japan is scarce. This study examined the prevalence, co-occurrence, and clustering of modifiable NCD risk factors among middle-aged foreign residents in Japan. METHODS: A cross-sectional web-based survey was conducted among foreign residents aged 30-60 years (n = 384). Eight risk factors were assessed: tobacco use (including cigarettes, e-cigarettes, and chewable tobacco), harmful alcohol consumption, inadequate fruit and vegetable intake, frequent consumption of ultra-processed foods, insufficient physical activity (PA), poor sleep, high stress levels, and high BMI. Latent class analysis (LCA) was used to identify risk clusters, and associations with demographic and socioeconomic characteristics were examined. RESULTS: The prevalence of risk behaviours was high, with 96% reporting inadequate fruit and vegetable intake, 55% poor sleep, and 50% insufficient PA. Risk factor co-occurrence was common: 32% reported three concurrent risks, 27.1% reported four, and 17.2% reported five or more. LCA identified two clusters. Cluster 1 (46.9% of participants) was characterized by tobacco and alcohol use, with inadequate diet and poor sleep. Cluster 2 (53.1% of participants) was defined by insufficient PA, inadequate diet, and poor sleep, but low tobacco and alcohol use. Cluster membership varied significantly by sex and employment. CONCLUSIONS: This study provides preliminary evidence of the high prevalence and clustering of modifiable NCD risk factors among middle-aged migrants in Japan. Findings highlight the need for comprehensive, multi-behavioral interventions tailored to migrant populations, while considering gender roles and occupational contexts.