To identify dietary patterns in the current Japanese diet and evaluate the associations between these patterns and Na and K intakes.

Dietary patterns were extracted by factor analysis from the intakes of food groups assessed with a validated self-administrated diet history questionnaire. Na and K intakes and urinary Na:K were assessed by repeated 24 h urine collection.

Healthy Japanese adults aged 20–69 years (353 men and 349 women).

Twenty study areas in twenty-three prefectures in Japan.

Four dietary patterns were identified in each sex. After adjustment for several confounding factors, the ‘Fish and vegetable’ pattern was associated with higher urinary Na excretion, but the association was not significant (P=0·37 in men and P=0·06 in women). This pattern was also associated with higher K excretion in both sexes. The ‘Noodle’ pattern tended to be associated with higher urinary Na excretion (P=0·17 in men and P=0·04 in women) and higher Na:K (P=0·02 in men). The ‘Meat, vegetable and oil’ (in men)/‘Meat and oil’ (in women) and ‘Bread and confectioneries’ patterns were not associated with urinary Na excretion (in men) or were negatively associated (in women).

Contrary to the case in Western countries, the ‘Fish and vegetable’ and ‘Noodle’ patterns contributed to higher Na intake in Japan. Target foods for salt reduction should be set based on careful consideration of the relationships between dietary patterns and Na and K intakes in the target population.