Background and Objectives: To identify dietary practice patterns for Japanese adults and investigate the links between health behaviours and these patterns. Methods and Study Design: A random sample, stratified accord- ing to area, sex, and age, of 4570 adults aged 20-80 years completed a survey conducted in 2011 in a city, in Yamagata Prefecture, Northeast Japan. Results: Cluster analysis of 16 dietary practice items revealed four pat- terns labelled as: low fat, sugar, or salt; emphasis on nutrition; regular breakfast and staples; and meals not snacks. Findings from multiple linear regression analyses showed that those not engaged in habitual physical ex- ercise had lower scores on low fat, sugar, or salt (beta coefficient -0.22: 95% confidence intervals -0.30, -0.14); emphasis on nutrition (-0.17: -0.25, -0.09); meals not snacks; (-0.38: -0.46, -0.3) that other participants. Current smokers had lower scores than never smokers on low fat, sugar, or salt (-0.23: -0.32, -0.14); emphasis on nutri- tion (-0.28: -0.37, -0.19); regular breakfast and staples (-0.42: -0.51, -0.33) patterns. Compared with non- drinkers, those who had reduced their consumption of alcohol had higher scores on low fat, sugar, or salt (0.19: 0.09, 0.29) and emphasis on nutrition (0.17: 0.07, 0.27). These relationships were adjusted for other dietary prac- tice patterns, sociodemographic factors, body mass index, and the presence of major illness or pain. Conclusions: Findings support an integrated and targeted approach as part of public health policy by considering links between dietary practices and other health behaviours, such as habitual exercise and smoking behaviour that may facilitate changes in dietary practices.