Transcript: Why are people so Healthy in Japan?

When it comes to health, weight of course is not everything, but since there are so many health complications from being overweight or obese, it’s safe to say that Japan with an obesity rate of 35% is generally healthier than America with an obesity rate of 30%.

Japan isn’t perfect, it has found itself on the 2012 top 50 list for cancer rates, but it comes in near the bottom of the list at rank #48 while America is at rank #6. I’m contrasting Japan with America simply because these are the two countries I’ve lived in. Last time, I argued that convenient access to reasonably healthy food in Japan helps people stay thin.

But what else contributes to health? In my last video, a lot of comments pointed out that in Tokyo you end up walking everywhere, which is true and should help people stay lean. Also, walking while eating is generally frowned upon, so more walking means less snacking.

Public transportation is impressively convenient and reliable – if you’re traveling around Tokyo, your destination is almost always within a 20 minute walk from that area’s train, subway or bus station. However, this is just Tokyo. Such a population dense part of Japan with highly organized public transportation unsurprisingly has the lowest rate of car ownership in Japan. What’s interesting is that average body mass index doesn’t change too drastically prefecture to prefecture, and higher car ownership doesn’t particularly correlate to higher body mass index. That said, more walking surely helps people stay leaner and healthier, but it’s just one piece of a bigger puzzle.

Next, the portion sizes in Japan are definitely smaller. Here’s what some typical lunches look like. When I first came to live in Japan in 2010, I remember always being a little disappointed with the size of the meals. Of course bigger portions and even all you can eat places are available, but since food is more expensive here, I had to just get used to eating less food. In 2014, people spent on average about 135% of their income on food, which is more than twice what people in America spent.

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In 2013, 3682 calories were consumed per person per day in America, but it was only 2726 calories per day in Japan. So Japanese people typically spend more money for less calories. Although, cheap calories from the sugar in soda is probably a factor here as Americans consumed more than 5 times the amount of soda Japan did in 2011.

Next, the type of food being eaten over here is of course different. You may have noticed in the clips I just showed that everything comes with rice. The Japanese diet is by no means low carb, but while Japan and America eat about the same amount of the two grains, Wheat and Rice combined, Japan eats about half as much wheat as America. Cutting out wheat or gluten is usually suspected to be only a fad, but gluten, found in wheat and not rice, has been shown to have some unique properties. This 2012 Brazilian rodent study for example, found that putting just 45% wheat gluten in the diet increases body fat, inflammation, and insulin resistance.

Work by Dr Alessio Fasano and his team has shown that the gliadin protein of gluten, through the stimulation of a protein called Zonulin, opens up the spaces between the epithelial cells in your gut. This allows gliadin fragments to leak through the gut into the bloodstream, provoking an immune response and inflammation. However, since the reaction to gluten differs person to person and the science is relatively new and complex, it’s hard to say by what degree wheat is worse than rice or how much wheat is too much.

Next is the regular consumption of fermented foods in Japan. Élie Metchnikoff, winner of the 1908 Nobel Prize in Medicine, was the first to propose the theory that lactic acid bacteria are beneficial to human health. He suggested that “oral administration of cultures of fermentative bacteria would implant the beneficial bacteria in the intestinal tract.” As research on the gut microbiome develops, the health effects of certain gut microbes and bacteria are becoming clearer. A transplant of the microbes from one overweight woman to another woman caused the receiving woman to become obese, and it’s been found that transplanting microbes from a confident mouse to an anxious mouse will make that anxious mouse more confident. It’s estimated that there are 500 to 1000 species of bacteria just in your gut, and it’s important to take care of the right species of these bacteria.

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There’s even research showing that certain microbes produce certain neurotransmitters. And, fermented foods are supposed to support the microbes that we do want to have. Plenty of fermented foods have been part of the Japanese diet for a very long time. There’s Natto, soy sauce, miso, fermented fish and tsukemono which is pickled vegetables. Kimuchi, a fermented food traditionally from Korea, is also widely available in Japan.

Fermented foods like these are very easy to find at the supermarket, and it’s common to get a side of Japanese pickles with your meal.

The next point is balanced meat consumption. In 2017, total meat consumption in the US per capita was 984 kg where 514kg of meat per capita were consumed in Japan. American people per capita ate only 7 kilograms of seafood in 2015, while Japanese people ate 273 kilograms of fish and fish products in 2014. If the meat everyone was eating was antibiotic free grass fed meat, high meat consumption might not be a bad thing, but in any case we can agree that a higher fish intake is generally good for you.

And I don’t think it would surprise you to hear that it’s really easy to get fish wherever you are in Japan. But there’s another kind of balance that might be a factor – it’s the muscle meat to organ meat ratio. Organ meats have not usually been much of a component of the American diet. During World War 2, people were encouraged to eat organ meats as part of the food rationing effort. Articles like this one in this 1943 issue of Time Magazine sold organ meats as highly nutritious and explained how to cook them.

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