- INSANE peer pressure. If you're skinny as a twig in the US, you're probably considered normal in Japan. If you're actually an obese person (again, in the US standard), people here wouldn't even look at you straight. This kind of environment put a huge pressure for one to stay in shape.
- INSANE obsession for health. I hear that Americans are obsessed with health, but oh boy, have they looked into Japan. Small clinics are everywhere and they're always filled with anxious patients because they have a benign stomach pain or something. Physical checkup is mandatory for most companies. I also read that the fear of COVID in Japan is the strongest in the world, despite a relatively low infection/death number here. People are always talking about their health, and so is the national media. If you watch the Japanese TV, you'll also feel sick, simply because there's so much fear! Maybe this is good for public health overall, but I bet there's a certain mental toll.
As an Italian person (also our life expectancy is really good on average) this hits home. An anecdotal example: I now live in Switzerland and my current doctor was shocked when I ask to get some blood analysis without being sick. He believed that I lied to my insurance company and hid some pre-existing condition.
In Italy, instead, it is pretty common that every couple of years you get a complete blood analysis just to see if everything is ok and whether you need to change something in your lifestyle.
Additionally, Sardinia (another "blue zone" with great life expectancy) also has a different diet compared to mainland Italy. Loads of seafood and relatively small amounts of livestock proteins.
Anecdotal data - as a Sardinia native, we do eat seafood, but to be honest around me at least that's at most a once a week practice. My grandpas, which lived to 96, 98 and 101, didn't eat much fish either. Lots of veggies though. One of my grandfathers died young due to a heart condition.
All of them were regularly checking their health and doing regular blood tests. I can confirm we don't see getting tested as being "obsessed with our health" but as a good (and for many, not very pleasurable) practice, part of the "preventing an illness is better than curing it" philosophy. Having cheap/free healthcare also helps.
Goes to show how important culture and religion can be in diet. Eating seafood instead of meat once a week, usually on Friday, is a widespread Christian practice called the Friday Fast. [1]
In Europe, I know a lot of people that still stick to this practice even without practicing Christianity.
Oh, there was some people following the Friday thing, but I've only heard about it during lent and not everyone is following it - it's quite going out of fashion esp with younger generations.
Younger people make up a smaller and smaller percentage of the total population every year though.
Ironically though, the young that do practice Friday fasting are much more likely, demographically, to have children. So I imagine the practice will continue for many centuries.
According to science it should be better than red meat. Additionally, a lot of seafood comes in smaller portions, is full of bones, shells and whatnot, whereas it’s relatively easy and cheap to get large quantities of fully edible red meat. It’s not that you couldn’t have a pound of peeled shrimps, but my own experience with seafood says it’s not very common.
So overall you’re most likely ending up eating less meat, and not just different meat.
Better how? What science? Do you have a citation? Most comparative diet studies are only observational with multiple confounding factors and no proper controls.
Fish can also have lots of mercury that meat lacks. It's probably best to eat a variety of different foods in order to avoid excess toxins and nutrient deficiencies.
There’s some interesting research suggesting that mercury poisoning is in fact just pulling out the availability of selenium for bio chemistry by forming metal ion complexes
I wouldn't say predominant, but certainly present! But we each represent a different set of connections, as I said, this kind of data is anecdotal ^^
I'd say i eat way more fish here in Japan than back in Sardinia.
When I was in Athens, a kilogram of fresh caught sardines ran about 2 euro for a kilo. Thats cheaper than canned!
On Crete, it was a bit more expensive at 4 euro per kilo but I never paid more than 4 euro for a pound of fish. thats cheap enough to make fresh caught fish a daily meal
Fellow Italian here: in Sardinia consumption of seafood is not particularly higher than the Italian average, certainly not higher than South Italy (i.e. from Rome downwards) especially Sicily or Naples area.
In Sardinia they eat a lot of blue fish (or oily fish), not surprisingly the European pilchard also called "sardine" of the genus "Sardine" has a very similar name to "Sardinia".
According to some recent study Aristotle himself named the fish after the population of Sardinia Island that were the first ones to trade it in ancient Mediterranean markets (looks like the most popular way to prepare it was in salt, as we still do nowadays).
But that's probably not why they are a "blue zone", an important difference is the kind of meat they eat: there is an abundance of sheep meat but much less beef red meat.
But that's probably no it either, Sardinians have genetic markups that protects them from entire classes of diseases, being a quite homogeneous population from the DNA point of view, they passed them on from a generation to the next.
As an Israeli, are blood tests not a normal thing done everywhere? I did not realize that...
My family doctor asks for a battery of lab tests about once a year (or whenever I get around to scheduling a check-up), including glucose and cholesterol and liver functions and so on. This has been going on since I was twenty something.
In Belgium, my general practitioner told me it used to be common practice to simple cross every box on the blood test selection sheet for a client's annual checkup.
Right now there is rightfully pushback against unnecessary testing. Over-medicalization by which people are subjected to treatment without suffering under symptoms is very much a problem. Also the socialized healthcare providers are not happy with this, as you can imagine.
Why conflate over/unnecessary treatment with availability and evaluation of markers? I guess if neither the patient nor the health care practitioner are uninterested in careful consideration of the data, then why bother I suppose. But then why bother at all with seat-belts, environmental laws, or dental visits if there's no value to prevention? We can just react after its too late, for everything.
There's a multitude of reasons, touched upon in a metastudy of inappropriate lab testing in medicine [1,2]:
> “But, unexpectedly, on a per-test basis, we actually found that the main problem was tests being over-ordered during a patient’s initial examination, rather than during repeat tests. This indicates to us that ordering the right test during the initial evaluation may lead to fewer errors and better patient care,” he said.
a. Tests are not accurate, a false positive causes alarm and follow-up examination where none was present.
b. On the inverse: negative tests provide a false sense of security and good-health. [2] discusses this as the prime motivator for patient blood test requests.
c. Economic cost to the insurer or ultimately patient/taxpayer, not of the tests themselves but of the downstream examinations.
As a general rule in medicine: Don't treat a patient without signs or symptoms. When a persons feels healthy, they usually are healthy.
I appreciate all those considerations but prevention of disease is all about identifying issues that may disrupt ones current feelings of and actual healthy state.
We cannot keep waiting for randomized experimental research to identify all the ways health may degrade over time. If we can regularly gather data en masse, we regularly over time can identify more predictors and risk factors for poor (and good) health, and evaluate efficacy of treatments received or effects from lack of treatment.
Again, why pay for seatbelts (and get tickets for not having them) in vehicles if I've have no history of accidents, or receive preventative dental care despite no serious current oral issues, etc.
Why do we have heat sensors in vehicles? The vehicles I've driven in life have never overheated.
Somehow we continue to excuse doctors who practice poorly by treating by markers alone rather than the whole picture (including the patients feelings and desires), or despite contraindications for the treatment being considered.
Somehow the only practical solution is to allow health degradation, and then rush to identify and treat and attempt reversal.
Some tests not only don’t benefit patients when done without reason, they actually harm them. medical interventions and procedures are often invasive and not without side effects, including pain, severe disability, and death. In many cases the studies you allude to us waiting for have arrived, and they show active harm for many cases where you’d think “why not add a test, what’s the harm”. Unfortunately medicine is still way too complex to reason about without the research to back it.
In my field of nutrition alone, there is tons more we could do to individualize and thus improve the targets for macro and micronutrients, as just one example. RDAs are only a rough starting point (when there is an RDA) as we understand more about individual genetics, food environment, etc. Why is all of medicine just invasive procedures and pharma? I'm not convinced that we somehow just need to sit and wait for some future time before we can jnvest and safely make use of markers over ones life to improve behaviors and health outcomes (for the benefit of an individual and others with similar medical characteristics).
Theres room to debate the degree and depth that we would utilize labs and other measures, but a complete non-starter mentality just leaves health outcomes to blind fate and promotes development of complex conditions much more difficult to unwind.
Not in my experience. I also lived in Sweden and UK. Blood tests are usually only a reactivate thing. You're sick you get blood tests. As prevention not as common I'm afraid.
The reason Sweden doesn't do regular health checks of the population is because there is no good scientific evidence that it has any effect. And that if a person feels healthy, they most likely are.
I think the similar reasoning is used in other countries.
> The reason Sweden doesn't do regular health checks of the population is because there is no good scientific evidence that it has any effect. And that if a person feels healthy, they most likely are.
I think this is naive: there are a number of reasons people in Sweden don't easily get health-checks, and among these are certainly cost-saving, where the healthcare representatives who you need to contact before speaking to a doctor or nurse act as gatekeepers to the system. This 'rationing' of resources can sometimes have dire consequences, as happened to a former colleague of mine, who was denied the in-person checks he needed and almost died as a consequence.
There's also an enormous amount of peer-pressure in Sweden to be skinny, fit and actively go to the gym several times each week. A fat person is an extreme rarity in Stockholm. Couple this with an ingrained cultural 'guilt-complex' instilled in everyone not to be a 'burden' on anyone else, and the health-service is suddenly transformed into an 'emergency-only' institution.
Naturally that may be seen as a positive - although for some people it may have bad outcomes. It certainly contrasts with my extended family in Spain, who have tests for every possible malady at all times. But otoh that seems to work pretty good too, as one of my uncles died last year at the age of 102.
The article says that you should check blood pressure and blood sugar every 5 years. And blood fats "some time". But that's very different from a regular check up.
I'm Irish and never heard of someone getting one unless they were checking for something specific. However, I do know that regular health checks are recommended once you hit 45 or so. Not sure if that includes blood tests.
We're currently ranked 16th in the world for longevity, so I doubt regular blood checks is that important - at least, I remember reading previously that there's no evidence regular blood checks are actually useful unless you have an ongoing condition.
Irish too, and I get bloods done every year because I noticed my health insurance covers me for an annual checkup. First time I got them done revealed I had very high cholesterol
Yep we only care about hot chics and Germans. But seriously, was it the same doctor? Then it would indeed be kinda weird, but otherwise there is a wide range of types of doctors, those who love checkups and prescribing stuff and sending you to a specialist whenever you report the slightest problem, and those that just send you home again no matter what, tell you to get some rest, work less, eat healthier, and maybe come back in two weeks if it doesn't fix itself. And then everything in between.
As an Indian I'll say that annual health check-ups are now normal amongst the privileged class. In my opinion it is a good thing considering how unhealthy our environment and lifestyle is along with a lot of predisposed conditions.
I would consider a blood test every couple of years a default practice among GPs in Switzerland. Among other measures that fall under the "prevention is better than treatment" scheme such as free skin cancer screening or colon cancer screening from a certain age.
I find the described reaction of your doctor to be out of the ordinary, and with relation to the described accusation unacceptable.
Thanks. I ended up doing exactly what you said for other reasons (Covid). Now I have what is called telemedicine where I call some number where I describe my symptoms and I might get a prescription right away or some tests. I did it to minimize the interaction with people that have an higher chance of having covid due to their line of work.
Maybe it's egoist to do so, but if by doing check-ups I can improve the quality of my life when I'm older then I'm all in for that.
Moreover, some preventable conditions don't show symptoms. High cholesterol, for instance, doesn't show any symptoms until one of your blood vessels is clogged, but chances are that by then is too late and you might suffer a stroke/heart attack.
I don't know how much the average treatment for those costs, but I would say way less than few tens of blood/urine tests. Or even more "stealing" a good heart because you need a transplant due to a preventable condition.
By the way now I circumvent the Swiss reluctance to prevention by going to Italy and paying the analysis out of my pocket. It's still very cheap (~100 Euros every 18 month on average).
Here is a medical editorial which makes the same point and cites the relevant research. Routine annual check ups are probably a waste of resources in most cases.
For there to be benefit to an annual checkup, it would need to fall in the window wherein symptoms have not yet occurred, but the disease is already measurable, and also one that is searched for in those checkups.
I haven't visited a general practitioner in a decade, and when I last went it was indeed because of I noticed the symptoms of of an ear-infection that I indeed suffered.
I remember first reading about that as well. That's not to say we don't have preventative care in the Netherlands though, it's just more targeted. For example, women get regular screenings for breast cancer.
I don't know too much about breast cancer, but it was just an example. There's plenty more preventative care, they're just not grouped together in a single periodic check-up (which also doesn't check for "all" ailments - I don't think we even know of all of them :) ).
>I now live in Switzerland and my current doctor was shocked when I ask to get some blood analysis without being sick. He believed that I lied to my insurance company and hid some pre-existing condition.
this is the same kind of situation in Denmark, I've lived most of my life outside of Denmark, after I cam back in my early 40s I went to the Doctor and said innocently "well I guess I'm getting to that age now where I should have an annual checkup." There was no explaining the concept to him.
I'm also an American with good health insurance (PPO not HMO if that makes a difference). My GP is at Stanford, although she only seems to practice once a week or something (it can be hard to get an appointment).
I go to the doctor when something's bothering me, but that's about it. It's never been suggested that I go regularly. (I'm not quite 40 yet, so maybe that's the difference?)
My dentist on the other hand, sends me a postcard every 6mo.. :)
If you have fancy / private healthcare, you're also encouraged to have the FULL checkup. That is, running on a trend-mill while a doctor controls your heart rate, etc.
Many vegan friends also requested iron and B12 checkups with blood tests, and doctors had no issue with that.
>In Italy, instead, it is pretty common that every couple of years you get a complete blood analysis just to see if everything is ok and whether you need to change something in your lifestyle.
I agree. Other people here mentioned that sounds like a waste of money, but I honestly am not sure as I don't have good figures about how different treatments cost.
However, I believe that by doing so I can avoid preventable conditions later in my life and it's well worth it both for my quality of life and potentially for other people as I might not need that much medical assistance and leave it for those who need it.
Not the basic one as it is the same for everyone and prices are mandated by the government, but the premium packages do. For instance, you can add to your package that were you to spend nights at the hospital you'd like a private room. If you have an existing condition that makes it more likely that you'll end up spending nights at the hospital you need to pay more for said premium package.
Annual blood tests are standard for all patients with my current GP in the US. He is a younger doctor, so that might be a factor. I'm a bad patient in that I don't go every year.
Yup. We get told our cholesterol is high, our triglycerides are high, our blood pressure is high, we're pre-diabetic, we ignore it and come back the next year and get prescribed more pills.
I suppose that might be true of a lot of the western world. The good thing about regular blood tests is that, in theory, you can catch things early before you have symptoms and they become serious problems.
Every blood test I've had, has come back with good results. I have low blood pressure, and I don't take anything other than a few dietary vitamins daily. I'm fortunate in that I established good dietary habits back in my early twenties. It can be difficult to break old habits though, so we'll see how I fare now that I've crossed the age where things start going downhill.
Long-term resident of Japan here with no particular expertise or insights on longevity or health. Something that has struck me recently are the government-led educational efforts focused on nutrition for infants and children.
My daughter and one-year-old grandson live with me, and ever since he started eating solid food she has been feeding him exclusively homemade, vegetable-centric meals. When preparing the food, especially at first, she referred to guidelines for ri’nyū shoku (“weaning food”) in the Maternal and Child Health Handbook issued by the government for all babies [0, 1] as well as some cookbooks she bought. The emphasis of ri’nyū shoku guidance is on handmade, nonprocessed food; my daughter has yet to buy any commercial babyfood. She hasn't been able to have much interaction with other young parents (for obvious reasons), so I don't know how typical her approach to babyfood is. But my impression is that she is not unusual.
For older children, the government promotes something called shokuiku (food and nutrition education, [2]) that is incorporated into the school curriculum and is coordinated with the food that children actually eat at school. (Most schoolchildren eat school-supplied hot lunches.)
The specific guidelines for ri’nyū shoku and shokuiku seem to reflect both scientific research on nutrition and a nationalist nostalgia for traditional Japanese diet and eating customs.
That all sounds very wholesome, but based on what I've seen, reality is pretty different. That commercial baby food you mentioned seems to avoid salt entirely and make up for it with gobs of sugar. Snacks for kids like tamago boro are little puffs of sugar and starch.
I'll readily grant that the universal free school food is a huge improvement on the US swill, although this too has its share on unhealthy practices: mandating that everything served has to be eaten whether you're hungry or not or you like it or not (kids are regularly told that sukikirai, liking/hating foods, is not allowed), and the mandatory milk & milk bun for that sugar kick. At least whale meat has become too expensive to feature regularly anymore.
Well, I am far from a food snob but even for me, what you can often buy as baby food is bland and has some weird mix of ingredients (ie some are too oily, some have weird aftertaste). I am talking about french and swiss rather premium products, so not some supercheap crap for 3rd world countries done by likes of Nestle/Kraft.
When you cook it yourself even with very little salt and reasonable spices for a baby, the result is so much better. We can see how much our little one enjoys cooked stuff vs bought ones, so we stopped quickly with those. It takes some time, but covid is actually helping with this particular thing right now. Thank god our kindergarden has proper chef who actually cooks and not just reheats frozen stuff from cheap retailers.
Its a bit sad that even in 2021 we can't really manufacture en masse reasonably processed food that contains just the food ingredients and tastes at least reasonably.
Quite the opposite! Random strangers will stare, and friends and colleagues will make blunt comments in a way that would send them straight to HR in the US: you'll be told to your face you're fat, asked how much you weigh, get poked in the belly, asked if you've tried sumo wrestling, etc.
I've had a real example of this! I've never even been overweight but a Japanese friend, who was an exchange student, would poke me in the stomach and if there was the slightest pudge he would yell "Hamburger!"
It does seem like it's offensive in america to mention overweightedness at all, which seems like it enables overweight people to ignore it. Seems unhealthy as well, both physically and mentally.
I once incurred the wrath of many on a forum for simply saying that my best friend is quite fat.
100% of the those that were angry were from the U.S.A. and this was pointed out in the discussion by others that didn't seem to see the problem with stating such a simple thing about my best friend and most of those that were angry relented after chalking it up to a cultural difference.
But apparently it is deeply sensitive in the U.S.A. to remark upon a man's weight being too much.
The last time it happened to me was someone's remarking that I was putting on some weight, and I agreed, so I switched to a diet with more fibres and in mere weeks it was fixed. — it seems quite constructive to me.
Yeah I lived in cuba for a work project. I travelled to another city for a month, and when I came back the head of my host family said “you’ve gained weight”. Was probably five pounds or so.
Was motivational to stop that weight gain in its tracks! At that level pretty simple diet changes will turn it around.
In American culture being fat is seen as a moral failing. Calling people out who already know they are overweight is offensive. You aren’t telling them something they don’t know. Likely they have already tried to lose weight and failed.
What's wrong with calling people out for a moral failing? It's more polite to ignore and pretend it hasn't happened, but it's a bit insane too, isn't it?
I beg to differ. What is considered as normal in some cultures, can be considered offensive in other cultures. It's not because those people lack empathy.
What matters is who is doing the considering. Each friendship between people is its own "culture" in that sense; I don't generally do things that my friend would consider offensive, if they are actually my friend.
It's nothing to do with the wider culture or ethnic environment, or what third parties may or may not be offended by: I don't do things that I know would hurt my friends.
We could go into a whole debate about this. From my perspective, I don't think they're wrong, at the end of the day, I'm a foreigner in their country, and it's up to me to adjust my mindset. I don't think it's up to them to change their behavior because I find something offensive, that to them is not considered offensive.
You're describing a very superficial form of friendship. A true friend holds you accountable and tells you what you need to hear, even when it offends you.
> I don't generally do things that my friend would consider offensive, if they are actually my friend.
> I don't do things that I know would hurt my friends.
These two statements seem like they could be in conflict with each other. Suppose your friend has a methamphetamine addiction, but they consider it offensive for you to bring it up. Do you not bring it up ever because it's offensive to them?
An interesting thing I experience in making friends later in life is mapping expectations about 'what friends do' (I guess I pester and expect to be pestered about a lot of personal things, the closer the friendship the more personal the teasing should be) to expectation 'new' friends have about the relationship.
I thought about your human empathy v culture remark. It is true, empathy is a human trait, however, each culture and society have unique mores of their own. These idiosyncrasies will miss, or emphasize, various aspects of personality en masse, to some extent; evidently, there are different cultures. So maybe in this case, those belly pokers have been indoctrinated to be less empathetic towards what they see as overweight.
Even so, that's contextual. What may be thought of as hurtful in one culture could be considered merely honest in another. Ignoring the things could get lost in cultural translation is an unfortunate way to miss the forest for the trees.
A culture that promotes health and well-being sounds great to me. Here in the West any criticism of someone's health gets you sent to HR, or accused of hate speech (ok I'm exaggerating a little but I don't think we're far off from that). Perhaps after covid people will take their health more seriously?
Edit: by health I meant fitness, obviously many people have health issues that they cannot help.
> Perhaps after covid people will take their health more seriously?
I'm not hopeful of it. The problem is that it's just such good business to keep people in poor health. Consider all the products that can be sold to them:
- addictive junk food to exacerbate the cycle
- type 2 diabetes medication
- plus-size clothing
- plus-size identity media
- weight loss programs and medications
Now, I'm not saying that all of this is done intentionally. But what I am saying is that strong incentives exist to keep selling these products and keep demand for them high, unless society as a whole agrees that it's wrong to do so, (as it eventually did with tobacco) at least without warning.
It’s unlikely the problem will be solved until we can get some agreement on what is causing it. There isn’t consensus on this one. Why are people now overweight in many countries when they weren’t 50 years ago? What changed?
I'm not sure why people think it's their duty to fat-shame people into losing weight. I'm 6'2" and weighed 220 lbs when I was working out three hours a day 5 times a week. You'll notice that's considered 'overweight' and nearly obese.
I'm about 100 lbs. heavier now. I know I'm too heavy. And I need to work on it. Incidentally, a large part of my weight problem stems from an anxiety/PTSD problem. Sugary junk food makes me feel better when I'm not doing well mentally.
Yet somehow attempt to make me feel guilty is going to make me more healthy? It's more likely to cause me to have an eating disorder and further hurt my mental health.
I've had co-workers who binge drink regularly and smoke daily try to tell me my lifestyle is unhealthy. I do neither.
It's crazy how entitled people feel to be rude to overweight people.
Yes you are right - but something has to be done about Western health (I live in the UK, so the populations' health is a concern to me as we have a national health-service - the more people who are sick means fewer resources to go around). As you say, fat-shaming people is unhelpful - but on the flip-side we have "progressive"-types who claim images of skinny-people in the London underground are "offensive" [1].
I'm not saying that I agree with the idea that that ad is offensive. But the issue isn't that the person is skinny.
The issue that it's a very skinny model is pictured alongside the words "Are you beach body read?" This implies that the only people who have 'beach bodies' are those as skinny as that model.
The idea isn't 'OMG, skinny people are offensive'
The idea is 'The implication of this ad is that only people who look like that very skinny model are beach body ready. Meaning, only incredibly skinny people are welcome at the beach.'
"only people who have 'beach bodies' are those as skinny as that model."
But that's true isn't it? A beach body = someone who is skinny or has abs. This is how we humans view healthy people.
It's something to aspire to if that's your thing.
Personally when I see images of fit, well-toned men, it reminds me that I need to do more exercise. I don't agree that such images should be removed because not everyone can achieve those things.
In China, it's even more so. If you're an obese person and many will throw "wow you're fat" and "you should really lose some weight" right in your face.
Although it sounds terrible, most of the time they're more concerned about you rather than trying to hurt you intentionally. But it does make people feel more guilty about being fat or eating high-calorie foods.
It's really quite interesting that it's really quite easy to insults that come from genuine concern, and insults that come from a desire to insult with no actual concern, and oddly enough, the former is what is often more a cultural taboo than the latter.
Insults such as “Get mental help.” are rarely a form of genuine concern, and fly around far more than legitimate concerned advise that one might benefit from such therapy.
There's also the different family organization. My impression in Asia was that the elderly there spend a lot of time with their grandchildren, to the point where they cannot travel because they're on babysitting duty.
Many people feel younger after playing with kids. I wouldn't be surprised if it also affects you on a more chemical level, for example by triggering different methylation and thereby changing gene expressions.
From an external perspective being slim and healthy seems like to sensible things to be obsessed about.(Though your comment implies "too skinny" over "slim").
It seems better than "body positive" movements telling us that being overweight is "healthy" despite it being pretty common knowledge that it isn't. To me it's the equivalent of saying that smoking a few cigarettes a day is healthy.
> - INSANE obsession for health. I hear that Americans are obsessed with health, but oh boy, have they looked into Japan. Small clinics are everywhere and they're always filled with anxious patients because they have a benign stomach pain or something. Physical checkup is mandatory for most companies. I also read that the fear of COVID in Japan is the strongest in the world, despite a relatively low infection/death number here. People are always talking about their health, and so is the national media. If you watch the Japanese TV, you'll also feel sick, simply because there's so much fear! Maybe this is good for public health overall, but I bet there's a certain mental toll.
Ah, this explains how the rapey, but criminally attractive, bisyounen love interest in my favorite Japanese love fiction always rushes the protagonist to the infirmary in schools at the slightest cough, missing valuable lessons, and at the approval of the teacher, for merely walking their on one's own ambulance would be too much of a risk, if one have recently caughed.
From what I understand, in the U.S.A. and U.K. schools also have an infirmary and a licensed nurse that works there. — here in the Netherlands, no such thing existed, and a simple cough or headache was certainly not a reason to miss lessons.
The nurses in US schools (I've been out for 15 years, things may be different now) are mostly there if a kid gets a bloody nose, deals with a kid's allergic reaction, verify a sudden extreme temperature to dismiss the kid or generally stabilize before a paramedic arrives if it's serious. In high school, one kid cracked his head open on the gym floor from slipping while playing indoor soccer. Pretty much all she could do was slow the bleeding. Plus, school nurse isnt a cert nurse's first pick in jobs. Which I dont blame them. Who would want to deal with kids all day trying to fake sickness so they can skip class? A simple cough and low fever wouldn't get you out of class. You needed head lice, vomit 3 times within 1 hour, vomit blood, or a 101f fever to get out of class back in my day... or a cracked skull.
But "infirmary"... it's a $25 first aid kit (at best) and like 2 EpiPens. I carry a better medical kit in the trunk of my car just because I like being prepared.
Well, all of those things happened in my school too, including cracking my head open such that I had to go to a hospital's e.r. unit.
All of it was done by normal teachers that would otherwise teach history or geography and simply had taken a first aid course. I do not have a trained nurse at home either, and I can just as easily be hurt so to crack my head open there, dare I say more easily.
Not arguing with you. The whole school nurse thing is more for legality and insurance issues (I imagine). As a kid, I always thought the school nurse was borderline useless. The only thing I can see as being useful, a school nurse knowing how to perform a tracheotomy. Not something I expect a run of the mill teacher (or average person) can do. There's a relatively high peanut allergy rate in the USA amongst children due to our seriously flawed food knowledge and habits. Perhaps school nurses here do know how to do that well, amongst other "seconds matter" care before paramedics are needed. Though, I can't confirm or deny if they do.
> I also read that the fear of COVID in Japan is the strongest in the world, despite a relatively low infection/death number here
You mau want to reconsider your sources because having a promotional campaign to enhance travel during the midst of the pandemic has made lots of Japanese travel all over the place in crowds and stack in small restaurants. Does not match at all with a supposed fear of COVID.
> Maybe this is good for public health overall, but I bet there's a certain mental toll.
I'm trying to weigh this over the model in my country where even in private healthcare the doctors tend to downplay the severity of your ailments.
A friend of mine is currently suffering from multiple afflictions and this is his experience.
I've only ever got roped into unnecessary treatments (only affecting aesthetics really), so it was a surprise for me that even those who have all the incentive to look closely at your problems tend to leave it unless it something that can be done quickly.
The pressure is partially due to an understand of how public healthcare works.
If you're very obese, you're costing all other taxpayers a substantial amount of money. You're being careless with your health, and everyone collectively pays for it.
I have a hard time imagine that stress and fear over ones health is positive correlated to long life span. One possibility however is that less uncertainty in regard to health has a strong beneficial effect.
> Small clinics are everywhere and they're always filled with anxious patients because they have a benign stomach pain or something
What are you talking about ? They are filled woth old people most of the time because of the large elderly population in Japan. Most salary men are too busy with their jobs to even take a break from office work which is why the OTC market is so large in Japan to treat various ailments without seeing doctors.
As an Italian I wouldn't call it peer pressure, but attention to ones health.
I have a mild condition of high blood pressure, it runs in my family, when my doctor visited me the first thing he said was "you're a bit overweight, let's lose 4-5 kg, it usually helps and if it doesn't we'll work on the drug dosage" (my current intake is a "kids' dose") and it actually worked, I went from a minimum of ~85 to 70 just by losing some weight.
Some body shapes, like being to skinny or too fat, are linked to "not being well".
> but I bet there's a certain mental toll.
We talk about three things in Italy: food, health and weather (and soccer if you are into it, I am not).
There's no real mental toll to it, we just talk about it, but there is no real pressure around it (except those who spread fear for personal or political gain, but that's not different from Trump saying that Mexicans bring 'tremendous infectious disease' to the US).
What's different, I think, it's that we grow up with the notion that "good health begins at the table" meaning that eating well is the most important thing to stay healthy, we keep doing it and teach it to our children.
This is not correct. Before covid only people who felt like thay might have a cold or similar wore face masks, to reduce risk of infecting others.
(This is my understanding after living there for one year and then travelling for a month every other year for ~20 years. I’m not native though so there may be some nuance to mask wearing I’m missing)
IIRC, I've also read that they consider it helpful for allergy season. Japan supposedly has one of the worst allergy seasons in the world due to misguided industrial policy around timber.
TL,DR; After WWII Japan heavily incentivized reforestation to provide cheap domestic timber for industrial and defense purposes, but only with two types of trees, Japanese cedar and Japanese cypress. It turns out that even with this explicit industrial policy, it's cheaper to import timber, so trees weren't being cut down as fast as expected and the forestry industry had a declining workforce that couldn't maintain the forests. The resulting bi-cultural conifer forests grew so thickly that no sunlight reached the forest floor and these forests became devoid of biodiversity. And now all of these trees release a lot of pollen.
In Japan this isn’t really a problem, since the forests are clearly able to breed if they are growing denser, and the streets are mostly not wide enough to have trees except maybe on major roads.
That’s just false. In many places in Asia it’s considered a must to wear a mask when you’re sick, but nobody in Japan is wearing it 24/7. Not sure where you got this information from.
In the United States, supercentenarian status is predicted by the absence of vital registration. The state-specific introduction of birth certificates is associated with a 69-82% fall in the number of supercentenarian records. In Italy, which has more uniform vital registration, remarkable longevity is instead predicted by low per capita incomes and a short life expectancy. Finally, the designated ‘blue zones’ of Sardinia, Okinawa, and Ikaria corresponded to regions with low incomes, low literacy, high crime rate and short life expectancy relative to their national average. As such, relative poverty and short lifespan constitute unexpected predictors of centenarian and supercentenarian status, and support a primary role of fraud and error in generating remarkable human age records.
"This article is a preprint and has not been certified by peer review"
also the first comment there (http://disq.us/p/25lpyed)
which I take the liberty to reproduce here:
Greetings,
With all due respect, the allegations in the article, namely, that supercentenarians are concentrated into regions with no birth certificates and short lifespans is false. By the study of the Gerontology Research Group, International Database on Longevity and Max Planck Institute for Demographic Research among others, we know that supercentenarians are extremely rare, yet an existent and validated population. The Gerontology Research Group takes the global view on the subject, using stable and defined validation criteria outlined by Dr. Poulain of Belgium in the Supercentenarians monograph (2010). I invite all of you who would like to learn more about the GRG data and its characteristics.
Measurement error. How many people forget this detail and build whole lives around faulty studies like the Blue Zones.
The Blue Zones is also selective in other ways. Utah has similar life expectancy to Loma Linda seventh day adventist. This was left out in the Blue Zones "study" since it did not fit the data.
I would sincerely like to get a breakdown of all the factors that contribute to the Japanese living to such an old age, rather than the usual "this one weird trick" bullshit that Economist and others try to swindle on the Western readership. It's quite frankly annoying, although I've lost the last ounce of respect I've had for the Economist years ago so I'm the idiot for expecting them to be any better.
I've gone through pop diet literature like How Not To Die, Blue Zone, and others, but it's mostly just people trying to push an agenda in one way or another. I just want the facts, in somewhat of plain as English as possible but I don't mind some technical fluff if it will help clarify things. I tend to find in a lot of this sort of literature that the technical fluff is useless to majority of the readership and yet takes up 80%+ of the content, as the authors try to use as many half-baked analogies and metaphors as they can to explain technical concepts that nobody cares about. At the same time, something more substantial than "Eat food, not too much, mostly plants" would be welcome. You know, how does exercise play a part in it. How does ancestry that has also lived to an old age play a part in it. Is it kind of a big deal, or nice to have? How many consecutive generations of people living to 100 does it take before it happens at a regular basis. These sorts of things. Holistic analysis that compares more than just "Wim Hof has slightly more brown fat than most people and that's the reason why he is superhuman" level of nonsense.
The latest bit seems to be from longevity research where cold showers and fasting are in vogue again, for the Nth time. Oh, but our company is the only one that provides this one unique test that checks your age biomarkers. We didn't just name drop the company in there for the sake of baiting you into it or anything.
I think the short answer is quite simply nobody really knows.
Your best bet IMO is to ignore genetics (can't change it), pick a "Blue Zone", and emulate what you can- within reason. This is something we still haven't solved, so the next best thing is to try to follow a proven playbook. You could call it cargo cult'ing, but until we crack the code it's the best we've got.
Then you can sprinkle in rock-solid conventional knowledge, for example we're pretty much dead-certain that exercise is good for you and time in nature improves your well-being.
Your criticism about cherry-picking is relevant if you are trying to distill the secret ingredients of longevity. However, I'm saying just forget about all that. Pick a healthful region of your choosing with proven long-term success, and emulate it as possible/reasonable. The end.
Follow this advice and you'll increase your chances of growing older increases quite a lot, and you'll stay healthier in your older years as well.
There is only so far these things can take us though. A lot of (but still too little) research is being done on slowing down or maybe even reversing aging, which could increase our lifespan to 150 (or maybe even longer). Not only would we live longer, but we would stay healthier for longer as well.
If you're interested, make sure to check out the longevity subreddit[0], some longevity discords[1][2]. Also make sure to read Lifespan by Dr. David Sinclair[3] and/or Ageless by Dr.Andrew Steele[4]
Some other things to keep an eye on:
- Blood pressure
- Resting heart rate
- Brush teeth twice a day
- Reduce meat
- Don't smoke
- Reduce alcohol
- Avoid stress
- Your mental health
Modern lifestyle makes you chase technohopium based ideas. Often they'll sell you complex solutions for a non existent problem.
Modern life is never calling for bad ideas loudly, but tons of incentives that make you go the wrong way slowly.
Bad job -> stress -> comforting with premade meals too tasty due to sugar and additives. No more walking because you want to leverage your car. You delay sleep to work later (bad work practices) to have leisure.
When I did simpler but physically demanding jobs, I ate simpler, went to bed early because I was simply cooked but it didn't feel like stress, but good fatigue (the kind you have after long swim session).
Modern jobs also turn you against each other way too often. I firmly believe there's a huge amount of benefits of doing simple chores in team, rather than ruminating in your cubicle delaying answers in mails..
You two are talking different things, you originally said "modern lifestyle advice", but now you're saying "modern lifestyle", which are very different things, the "advice" agrees with you, that's what the guy was asking about it.
Let's not play on words. Consumerism sell you promises of better life which turned out to be false most often. It might only be an implicit advice but anyway.
Seems like you have some divergent ideas here. On the one hand, you ask about practical, actionable stuff; on the other hand, you ask "How many consecutive generations of people living to 100 does it take before it happens at a regular basis.". The answer to the latter question is not something you can really use for anything.
I sometimes wonder if the right thing for westerners wouldn't just be a big sequence of photos of mid-tier Japanese restaurant food -- like what's served at train stations -- with all the components broken down, along with a description of how a person fits those things together every day to have complete story for food. After going there a few times, I was surprised by how much healthier I ate, and figured out how to reproduce some of the effect back in the United States.
One category of difference with Japanese diet is things that are somewhat healthier at baseline. That is the way Japanese junk food is. A mochi is pounded rice, sugar and beans; and many sweets are actually filled with bean paste. A common kind of savory Japanese snack is grilled seaweed.
Another category of difference is eating the same thing but just in slightly different proportions. It's quite common in the USA that you go somewhere and get a meal and it's literally a piece of meat and a potato. Even at a good restaurant; but especially at less expensive restaurants. This isn't about Japanese food versus other kinds of foods. If you got a German restaurant in Japan (they are somewhat more popular in Japan than in the USA) and you get a plate it will be like three different kinds of sausages (in small sizes) and one or two salads and one or two vegetable items.
This is not due to some kind of technical balancing or something like that; Japanese consumers just demand somewhat more varied food with more vegetables.
There isn't a recipe or some weights or formulas. I just went there for 1-2 weeks at a time 5-6 times and tried a bunch of food and got used to it, came back and then wondered about what I could do differently. Everything that has changed in my diet as a result is entirely a matter of small adjustments -- adding vegetables at certain times of day or something like that -- but I did lose weight and have enjoyed other benefits like no acid reflux, no food coma, &c.
Do all Japanese actually eat that healthy? I can believe it of some of them, but there’s little fruit and many salarymen seem to live on a diet of fried chicken, hard liquor and cigarettes.
What's an alternative to the Economist? I can't find a better publication short of an academic journal or literature. Someone recommended Foreign Affairs but I've yet to buy one.
I tried searching for one a few months ago when my Economist subscription was expiring. Unfortunately, not even a single one comes close.
The Atlantic is often advertised as the other high-quality publication. The target audience, however, is overwhelmingly the US. Economist makes me feel like other countries exist, and there is enough going on outside the US.
On the ideological front, I fell into this trap of finding a periodical with little bias towards the political left or the political right. While Economist touts itself to be centre, it would be naive to take them at face value as they clearly are centre-left. The silver lining is that they are far better than others who make absolutely no efforts to quell their suppress their ideological biases (e.g. New York Times).
I call this a trap because I've since realized that it is virtually impossible to expect a "truly" unbiased publication. As long as I feel that I am not falling into an echo chamber, I am fine with biases. Politically charged articles generally have more than one perspectives.
One would be hard-pressed to find a single publication as diverse as the Economist. I think this is primarily a historical artifact - they just have had a significant first-mover advantage (I think) and have accumulated a solid bunch of human capital. I'm slowly inclining towards subscribing to more niche publications instead.
Financial Times is a reasonable contender, though far more costlier.
The Economist is quite simply the best news magazine in existence. Imperfect but the least bad. Foreign Affairs is entirely an entirely different publication made of collections of topical essays on foreign policy
It's not a competitor to the Economist, but for general scientific topics including some health information Scientific American would be a step up in depth and coverage, while not being as dense as real journals or Science, Nature, etc.
If something is truly genetically linked then dieting for you might as well be lipstick on a pig if you don't have the right heritage. There are a couple other places in Asia with similar levels of longevity. Hong Kong, Singapore, and South Korea come to mind. Maybe look into what similarities they share with Japan. For Europe there are the usual Mediterranean countries, including Israel. (For European demographics, remember to adjust for large numbers because population size vary wildly.)
Isn't Okinawa a good place to start? You get two interesting comparisons: Okinawans vs other Japanese during the last century, and Okinawans then vs now. It reduces the number (or at least the scale) of differences so that you can better pinpoint the factors, right?
Interestingly enough, Okinawa has the highest life expectancy in Japan. They also really got the short end of the stick during WW2 though (a third of the civilian population died during the US invasion), so this may be a statistical/survival of the fittest type quirk too, plus the historically the local diet there was fairly different to the rest of the Japan (lots of pork, less seafood, sweet potato/taro instead of rice, chillies, bitter melon, etc).
That's because lots of US troops are stationed in Okinawa and with them came lots of fast food chains. Young(er) people in Okinawa eat lots of junk food, and they have shorter life expenctancy than their parents.
The blue zone studies and conclusions seem, to me, to be the opposite of “one weird trick” and run in the face of pop diet literature.
At some point, a holistic lifestyle offering statistically higher quality of health outcomes could risk sounding like an agenda, I suppose, but perhaps only if something about that lifestyle makes one feel guilty.
As you go into particular questions, you might find the material around blue zones goes more into those than most. Along with temperance and mostly plants, commonalities included natural exercise and positive disposition, for example.
Or perhaps, is our disdain of the simple holistic findings a result of our convenience culture? Are we actually just unhappy there is not one weird trick, preferably in a tablet form, that wouldn’t inconvenience our own “modern” ways?
Disclosure: My mother’s side had many siblings making it to 100, some were part of the California blue zone, while others lived in Scandinavia, farming and fishing by the sea. The realization these lives are differently healthy is hardly pop: there’s a body of health knowledge behind that tracing back to late 1800s, Kellogg (the family behind the cereal whose home page now says “one of the original plant-based wellbeing companies”), and the like.
> I would sincerely like to get a breakdown of all the factors that contribute to the Japanese living to such an old age, rather than the usual "this one weird trick" bullshit that Economist and others try to swindle on the Western readership.
Why is it that the term “western" is so often at some point introduce with some implication some culturally cohesive unit called “the west” exists any time Japan in particular is mentioned somewhere?
I find that very often when this happens, and when attributes of this supposed “western” culture are listed, it seems to mostly mean “The Anglo-Saxon world”, not so much “the west”.
The last time it happened on H.N. where someone complained about a sensationalist “western" article about Japan, it was pointed out that it was posted in a Japanese newspaper, and a translation from an original Japanese article, however sensationalist it might be.
Other than that, yes, there is probably not a single simple rule that governs it but a myriad of factors that contribute with many no doubt also working in the opposite direction, such as Japan's famously stressful workplace life and the high suicide rate of office workers.
Like you I've had the same experience, then I started using an app recently called chronometer [1], you type in what you eat and it tells you how much of the RDI of vitamins you get. There were a lot I was missing out on I found, also, at the same time I was trying to move to a Mediterranean diet.
A diet of a lot more plants like the Mediterranean diet meant I met all my RDI's, whereas a normal meat and 3 veg, cereal for breakfast western diet didn't - things like vitamin E and so on were a lot easier to get with the Mediterranean diet, though for things like Zinc I had to start eating nuts and so on - something I'd never done much.
It surprised me that the things that seem to stop cancer (according to some studies) were exactly the same things that are more prevalent in the Mediterranean diet, it became a bit of a no brainer. Give it a go (I'm just a happy customer - its free any way with a paid tier)
The Mindspan Diet, by Preston Estep has a lot to say about the Japanese diet. I think he makes many convincing arguments. Some key take-aways: Iron is very bad for longevity, refined carbs that aren't sugar and that have relatively low glycemic indexes (long grained rice and many pastas) are actually quite good (rice/pasta), meat bad but seafood ok, don't over do the saturated fat in general, drink moderate alcohol if at all.
I got a lot from How Not to Diet. I also got a lot from the Mindspan diet. I think the truth is out there, but as you have already put it, it's pretty bloody hard to get anything definitive. It's hard because it takes decades to prove anything and it's hard because food is big business and entrenched food production pipelines protect themselves against disruption the best they can (looking at you, sugar industry).
Seafood specifically can't be judged as some ideal one 200 years ago prior to oceans pollution. If you want to pick up seafood which is not heavily contaminated by heavy metals, various regional spills, factory drains, near deltas of biggest rivers in Asia/Africa etc. you will find out you just play russian roulette with your food. Mercury poisoning with ie tuna can be achieved relatively quickly depending on the brand. Pregnant women should probably avoid things like salmon & tuna completely, the benefits are far outweighted by the crap. Farmed sea fish are properly bad food.
Freshwater fish can be better but they are almost 100% farmed, and good luck trusting some farmer with what he feeds them, since infections in overpopulated ponds are very frequent. Fish meat reflects what its being fed, so crappy food makes previously healthy fish into more bacon one.
Also meat is not an uniform substance, cheap beef is most probably less healthy than lean bio free range turkey. Also depends on the cuts, pork has very lean and very fatty tissues in the same animal. And so on.
I'd say for the food the quantity, timing, being active every day for longer stretch, calm peaceful life and obviously not much poisons/addictions makes up more than rest. We have centenarians in the west too. At least that's the best effort, if one has crappy genes with high probability of cancer or heart attack before 50, there are sadly some limits these days. But one can and should still maximize their own potential.
I'm mostly a vegetarian except that I do take molecularly distilled fish oil. Very simple way to get some of the health benefits of seafood consumption but take no risk.
However, I actually feel mercury isn't nearly the bugaboo that vegan proponents often make it out to be. High ocean mercury levels have been a thing for over 100 years. Yet a great many studies have found seafood to be beneficial to longevity and overall health.
All of your points sound like vegan talking points, but to each their own.
I'm assuming one underestimated facet is the nonviolent culture. Many injuries due to violence in the U.S. go unreported, leading to chronic health problems which can further cause mental health problems.
It takes 100 years to get one data-point. For us to track a person's habit throughout their life that eventually ends up living to 100 years is not an easy or quick task.
And even if you had the best tracking in place, isolating cause and effect given how so many variables are involved is no easy task either.
So instead we have to rely on small experiments, low sample size studies, and studies where variables are hard to isolate.
But there's a lot that's known that's pretty clear, exercice is good, cardio or strength or flexibility, they all seem good. We don't know how much of it is needed, but more doesn't seem to hurt.
Having lower body fat, eating at a slight deficit, that's pretty clear as well.
Cutting out bad nutrients, chemicals, processed foods, etc. That's not totally proven, but at least it helps with weight control, and it definitely doesn't seem to be beneficial, so at best it's neutral at worst harmful.
Pollution of all kinds has negative effects. That's pretty well established. Nothing much you can do about it since about everywhere and everything is polluted it seems nowadays.
Having low stress and good nights of sleep, that seems pretty well established as well.
Genetics, ya genetics for sure. But can't do anything about it so no reason to worry about it.
Now eating good foods also help. There's ton of micro-nutrients with small studies that show benefits. So just make sure you eat plenty of all kind of good micro-nutrients. You'll get the most out of vegetables, legumes, fruits, herbs, seeds, nuts, and all that. Fatty fish are good, and other fish and seafood have some good micro-nutrients as well. Except the larger the fish, the more pollutant it contains, so don't exaggerate either on fish.
Meats are uncertain. At least keep them on the lower side, especially red meat since there might be links with some form of cancers. That said, if you do eat meat, make sure it's grass fed and all, cause meet from grass fed animals have way more good micro-nutrients in them.
Also seems you want to keep your brain active as well, continue to learn new things, helps prevent dementia and other brain degenerative issues.
Apparently good company, having people to laugh and socialize with is good as well, but unsure how much, again it clearly doesn't hurt and might be good.
That's it, but, the sad part of all this, all those things just help a little bit, mostly with quality of life and not that much with longetivity. What has helped the most with longetivity has been modern medicine and surgeries, which is pretty much the single reason why people live longer now then before.
Edit: Oh and it also seems that there are other things that can affect you a lot, like which bacteria and viruses you've been exposed too thorought your life at different stages. Exposure to these can be good or bad depending.
I also forgot good amount of fibers can prevent diverticulitis and other possible digestive issues. Proper levels of vitamins (best if obtained from foods), including D (which is best obtained from the sun). Good hydration (helps some of your organs function). And amortize sugar intake, so you don't spike your blood sugars.
read deep nutrition, i can summarize sinple.
eat all kinda meat, organ, muscle all of it, egg and milk also good.
plants have evolved to protect themselves using chemicals so they're bad.
seed oils are the root of all evil and illness.
good nutrition of ancestors means better looks for next generation.
Eating “chemicals” designed to defend against nonhuman species isn’t going to be bad for you. That includes capsaicin and caffeine which are if anything healthy. There’s also the xenohormesis effect, if you believe in that, where small amounts of poison are good for your defenses.
Could be, but it sounded more like a naturalistic fallacy. Though lately people opposed to plants are upset about phytoestrogens turning them into women, which they don’t do, as far as I know.
Seed oils being bad may be correct, but I haven’t looked up specifically what’s supposedly bad about them.
If you are going to pick a small arbitrary region of the country to compare, then I’m sure you could pick an arbitrary region of Japan to compare to New Jersey favorably.
This is a very fair point but at the same time it there are one-million asians in New Jersey (mostly non-Japanese) and the link states that the pattern is true for lots of big states such as NJ, MA, NY, PA,etc. I agree there are probably cities in Japan or certain areas that have extra high life expectancy too but I think this cuts against the diet argument a bit.
On a recent Tyler Cowen podcast he stated that Japanese Americans have the longest life expectancy and speculated it was a combination of genetics + wealth. I think it is a good counter to the diet argument the piece puts forward. I was unable to find a link to the study he referred to though - so I linked to the one above. Hopefully my recall of Cowen's point is correct.
Probably a bad idea to compare a large data set (people in entire county) with comparatively vastly smaller sample set (Asian-American living in New Jersey).
Does this control for wealth? Wealthier individuals have longer lifespans. If the average New Jersey Asian American is wealthier than the average Japanese, that could explain the discrepancy.
This is a good point - though they definitely aren't a majority. Lots of different people of different backgrounds but your point stands they may not be comparable to Japanese
As a non-expert, the thing that bugs me about the notion that varied diets are ideal is that hunter gatherers often didn't have varied diets. Quite the opposite. Also, having a diet that isn't varied is a way to naturally regulate hunger/ghrelin.
I know we don't want to commit the naturalistic fallacy or anything like it, but it does give me pause given how little we know about the microbiome. Presumably, in human evolutionary history, we coevolved with a microbiome that relied on a very homogeneous diet. What is the impact of suddenly having a diet with 50+ food types instead of 5? We already know that this sorta screws up our hunger regulation mechanism, but could there be other deleterious effects?
I easily accept that a whole foods diet is ideal, however.
I am by no means an expert (not a great start to a comment I realise), but from what I've read about it (e.g. in Sapiens by Harari) hunter gathers typically did have a diverse diet. In fact it's hard to imagine they wouldn't. For a start, different foods obviously have different availibility with the seasons. And, as the name suggests, there was typically a hunter/gatherer split (along gender lines) and hunting has this very bimodal distribution of getting a big kill that lasts for days or getting nothing at all, so the balance between the two is very variable. As for the content of both what is gathered and what is hunted, that varies a lot due to both natural variation (a natural forest isn't just filled with a single type of tree) and desire for variation. The desire for variation presumably evolved from both the nutritional benefit of having a varied diet and the fragility of relying on a single food source - if you don't learn how to hunt more than one type of animal then you'll end up starving if their numbers dwindle (e.g. because you hunted them too much).
> coevolved with a microbiome that relied on a very homogeneous diet
Did he go through specific examples? The Hadza only eat five foods and have a diet that's significantly less varied that modern society. I'll see if I can find counter-examples.
However I will say, even though the Hadza only eat five foods, they eat everything in the animal including the organs, which definitely adds variation.
It's always surprised that the longevity in Japan is often attributed to diet. From my travels there my impression is of a diet that largely consists of rice and various meats and a high consumption of alcohol and cigarettes. Although there definitely seems to be far less sugar in everything.
Culturally it seems that fitness in general is encouraged, combined with a very different attitude toward being overweight (I had several locals comment that I was a bit fat [my BMI is ~26])
A normal home meal is fairly balanced, if you were eating out a lot that isn't a great representation of a normal diet. Also portion sizes are much smaller than the west.
I think you are right about fitness, in general there is a lot of riding and walking in daily life. Unlike in a lot of the west, where you can go from sitting at home to sitting in your car to sitting at your desk without more than 100m of walking.
I will admit that it's amazing the smoking is rarely mentioned. It's everywhere oh my god, I got head spins from one cafe. Your clothes smell like cigarettes half the time. I think it's getting better, lots of places choose to ban smoking inside now. But it's still pervasive.
It's more than restaurants choosing to limit it, a straight up ban has gone into effect for the last 9 months now [1] - hence it's much better than before. Not sure how or if it's legal, but some divey spots have managed to get exemptions or are just risking it though - a friend of mine who runs a cafe says that the cafe is classed as some kind of social club so it's not subject to the same ban, but that sounds pretty shakey lol.
In the USA, it's called fat-shaming. In Asian countries, you may feel a little bit shamed if you're overweight. You'll even get less food around the table if you're fat. Societal pressures could be both a curse and a blessing.
Fat shaming is brutal in Asian countries. If one is fat, they will be bullied or they will need to be bully. I know a Pakistani American obese woman who went to Pakistan for a wedding. Every kid in the neighborhood was calling "moti" auntie which is equalant of fatty.
I work with a lot of Indians and they will randomly point out that you have gained weight.
> Culturally it seems that fitness in general is encouraged, combined with a very different attitude toward being overweight (I had several locals comment that I was a bit fat [my BMI is ~26])
This, perhaps, is the key to their longevity.
The French have a similar attitude as well (based on my time in France).
The single biggest difference between Japanese and American diet is the amount of food. Just going for US servings to Japanese servings is enough to shed quite a bit of weight, although you are likely to go hungry if you are used to American sizes.
Otherwise the Japanese diet is indeed carb heavy (rice, soba and udon), but I don't think there's anything wrong with that.
> The single biggest difference between Japanese and American diet is the amount of food
What about sugar? There's a big difference there, too. Americans put sugar in everything, even things you'd think wouldn't need it, like salad dressing and pizza dough.
Sugar (sucrose) is made up of glucose & fructose, and I don't think fructose is healthy for us. And its metabolic pathway makes us fat [0] via _de novo lipogenesis_.
There's a ton of sugar in Japanese food. Usually it's added either directly as sugar (sucrose) or as mirin (sweet sake), although food from the south of Japan might be sweeter than in the north.
I personally never add sugar to anything I cook unless it's a desert, but I can only cook French food.
I think the difference is the amount though - the cheesecake I had at the Cheesecake Factory after getting used to Japanese cheesecakes was shockingly sweet.
Re diet: putting aside that alcohol-per-capita consumption here in Japan is less than the OECD average [1], and also how the article is actually about how the introduction of meat into the Japanese diet has caused a decrease in strokes (i.e. this is probably off-topic); it is true that if you are eating out cheaply, you'll likely find lots of rice and meat stuff like gyuudon (beef on rice), katsudon (breaded meat on rice) and what not.
But a normal Japanese meal generally has a pretty good mix of stuff - some fermented side dishes (tsukemono), some veggies, miso soup, some rice or noodles, some fish, maybe some meat. Perhaps my wife is an outlier, but every meal she's cooked for our household has had at least 3 dishes of different categories as a part of it, and my impression from seeing other households and just looking at a typical bento box, is that that's a pretty normal expectation for any healthy meal. Someone else pointed me to this Youtube video on the topic on a different thread, and I'd say it's pretty accurate [2].
When I go to drinking bars, izakayas, with Japanese people they usually tend to do the same and order a variety of small dishes too - it's not common to just get fried chicken (karaage), but rather people almost always also throw in salty drinking foods (otsumami), which usually include seafood, pickles and vegetables (shiokara, takowasa, various tsukemono and so on). Even then, if someone orders sweets or something, they tend to be a lot less unhealthy than American counterparts (use of less calorific ingredients like adzuki beans or black sesame, compared to a cheesecake or something; and if you did order that cheesecake, it'll be 1/4 the size of what you got at the Cheesecake Factory, and be a whole lot less sweet and rich, as you've pointed out).
It's not straightforward to get a really authentic food experience if you're coming as a tourist who doesn't know locals nor the local food scene well. My first impression was also that it's a ton of rice and meat, but after living here it turns out that that is the case... if you think that Japanese food is all sushi and ramen, and are being sold food to satisfy a standard American tourist, who thinks that anything pickled is gross, anything served cold besides ice cream is disgusting, and that a meal that doesn't include a giant hunk of meat, isn't a meal at all. Get past that, and you'll find that most Japanese people don't eat like that at all.
So yeah, I think diet probably does make a significant difference, as you can tell plainly by how few obese people there are in Japan; and recently the government finally seems to be doing things to reduce tobacco consumption (you can't smoke in most bars and restaurants in Tokyo anymore, when you can it's generally e-cigarettes only, fueling a huge shift to IQOS/other brands e-cigs which have as of 2019 taken over around 16% of the tobacco market [3]; anecdotally it feels like a lot more than that as of 2021 living here).
Re culture: Agreed, here in Japan (and in other parts of Asia too) it's pretty normal for friends to tell you things like, "wow, you got fatter since we last met!" to someone who's much less than 26 on the BMI index. It's not really considered insulting like it is in the West. That said, female Japanese models tend to be insanely skinny, creating an unrealistic concept of beauty - but that's hardly unique to Japan.
> anything served cold besides ice cream is disgusting,
In the west there are salads. They're cold. In Japan salads are rare and usually nothing but iceberg lettuce and cherry tomatoes.
> who thinks that anything pickled is gross,
The pickled isle of a western super market has more pickled things than the corresponding Japanese super market. They're just different kinds of pickled things.
> normal Japanese meal generally has a pretty good mix of stuff
And similar in the west isn't it? The normal family dinner is 1 meat dish (beef/chicken/pork/fish), 1 starch dish (bread/potatoes/rice), 1-2 veggie dishes (salad, green beens, peas, carrots, etc...)
Japanese "in general" find many western things disgusting. Most Japanese find savory beans gross. As popular as cheese as become in Japan there's still a large percentage of Japanese that have never eaten any or eat it rarely. This is especially true outside big cities where the culture is less influenced by the west.
Japanese often can't eat anything other than Japanese food. There are plenty of tours of other countries where you can sign up to have all your meals prepared for you while abroad and all of it will be Japanese food.
Many Asian cultures (including Japan), for many people if you haven't eating a bowl of rice you haven't eaten.
Agreed that it goes both ways - just making the point that tourists tend to have a pretty warped idea of what the food traditions in the countries they go to are. My point of reference is how annoying it is when you try to go to an oden spot or something and your friend complains that they’re not eating wagyu steaks (which you’ve eaten every week for the last month for each friend visiting Japan pre-corona times), and therefore this meal is unhealthy because it lacks a huge amount of protein. I think a lot of people’s impressions of foreign food are a result of their own pickiness.
Specific to the American culinary tradition though I find it pretty wild that for most people I know back home, healthy = salad, there seems to be very little mainstream options besides that. Like you said, it is possible to be healthy; but the default American family meal these days is a far cry from that, even compared to a typical convenience store food eating lazy Japanese person.
But- is that what the elders (who will be the subject of current longevity studies) are eating? The elders who, I will note, were born in Imperial Japan and not Westernized Japan.
Yep, article (title) is hard to believe. The affordable food is rice, noodles and fried things like chicken and some fishes. Every other thing (meat, vegetables, fruits) is really expensive. It’s often not worth the hassle to cook lunch meal in comparison to the cost of raw ingredients in the supermarket. To add insult to the injury Japanese cooking involves a lot of steps, tools and preparation so cooking something tasty is like a full time job. Making foreign dishes is usually even more expensive, and usually hard to even get the ingredients in the first place.
> To add insult to the injury Japanese cooking involves a lot of steps, tools and preparation so cooking something tasty is like a full time job.
I have to disagree here. A large number of Japanese recipe are highly homecook-able especially for Japanese people living in Japan, who probably already have the right tools/ingredients. It all depends on what you usually shelf at home.
In fact, even as I live in US, I find it easier and quicker to cook Japanese food rather than Chinese or western food. When I'm tired or in a hurry, Japanese recipe is my go to choice.
> A large number of Japanese recipe are highly homecook-able especially for Japanese people living in Japan, who probably already have the right tools/ingredients. It all depends on what you usually shelf at home.
Agreed. I'm not making kaiseki every night, nor any night for that matter here in Tokyo.
Typically I'll have the rice cooker set to have rice ready at 17:00 when I finish work for the day. I'll usually have some dashi on hand that I made over the weekend, but otherwise it's a 5-minute job with instant stuff that's not powdered, or 20 or so if I feel like making it from scratch. Mix in white/red miso and any other extras, and soup's done. A quick stir-fry with some meat, bean sprouts, and a packet of seasoning takes me all of another 5 minutes, and that's dinner.
If it's noodles, I'll usually have some fried vegetables from the supermarket in the fridge, and that takes 5 minutes to heat up in the toaster oven. Udon can be boiled and done in that time. Slice up a green onion, mix in a raw egg, add soy sauce and some roe, and that's another quick dinner.
When I feel like doing something more major, making nabe on the weekends really isn't that much harder. Prepping ingredients takes maybe half an hour, and then it's just letting it simmer for another hour. Plus, leftovers from the last a long time.
Curry's also something else that takes an hour tops from start to finish.
Pan-fried chicken thigh with Nanban sauce (soy sauce + vinegar + sugar + mirin + sake). If I have tomatoes and lettuce lying around, I'll cut a few slices and make it into a chicken sandwich.
This takes me about 17 minutes, 20 minutes tops, basically as long as it needs to cook and rest the meat.
I'm interested what dishes you're specifically talking about here? Japanese cooking is not complicated, just different.
Me and a lot of my friends here can all meal prep <500yen per meal and that ranges from Japanese food to Indian/Italian/Mexican. You just need to make smart adjustments and substitutions.
Agreed, it's pretty dead simple and cheap to make some miso soup, some kind of stir fried veggie dish, sear a piece of fish and throw in some tsukemono from the market - which is exactly the kind of easy, healthy meal me and my wife eat at home all the time. Perhaps I got the crash course for eating cheap in Japan on easy mode by having a Japanese wife who already knows how to do it, but there's plenty of simple recipes to follow on Cookpad if you can read some Japanese.
Also are you going to an expensive supermarket? If you can buy vegetables and fruits from a green grocer (yaoya, 八百屋) or from a cheaper supermarket like Gyomu or Big-A or something, it's much cheaper than buying it from a higher-end grocery like Seijo Ishii or Kinokuniya - like several times cheaper sometimes. I didn't know that when I first came to Japan but point is, it's worth it to do your due diligence and find the cheap groceries just like you would in your home country, Americans have complained about Whole Foods being overpriced since the dawn of time.
> it's pretty dead simple and cheap to make some miso soup, some kind of stir fried veggie dish, sear a piece of fish and throw in some tsukemono from the market
Sure if you are going for the lowest of low effort you can make something edible, but that doesn’t mean it’s tasty nor something one would like to eat everyday. The miso soup meme is funny once a week but let’s be honest and not pretend it has good nutritional value. The pork soup is a way better upgrade but it already requires two times more ingredients and more step and doing a steak and fries. One time a friend cooked a ratatouille plus some meat aside for three persons and it’s cost us 2000 yen each... (ok I could have lowered the price by 500 but not more given how expensive vegetables are)
In fact your message hints at the root of the problem when mentioning your wife: the Japanese cuisine is based on the model of the housewife who had a full day to go shopping for various ingredients, do many processing steps, use various sauces and let things soak in it to prepare the 3-4 side dish of a Japanese meal for a family. This kind of organization is impossible for a working people living alone.
If I dont make breakfast for my boyfriend he'll make 一汁三菜 for breakfast or miso with a tsukemono and TKG. None of these things take an abundant amount of time to buy or prep for. We both work full-time jobs. Again, this sounds like a lack of knowledge about meal prep rather than a actual time issue.
Huh? Not only is my wife a working engineer, but I do this same kind of meal all the time on my own as a full time working person, and it takes about 5 minutes of bumping around the supermarket and yaoya that are across the street from each other conveniently located next to my station. It really is not hard to put together a nice meal of a hot pot or whatever. Miso soup isn’t literally just miso and water, you can put whatever you want in it, including boiling vegetables, tofu, fish, soy milk, whatever - crazy simple, I some variation almost every day and it’s neither boring nor a meme.
Meta point, you sound very bitter and defensive about this. How about give some of the suggestions people have made a shot? Like I mentioned, can you read some Japanese? Cookpad has tons of simple recipes.
Gyomu for chickpeas, tahini, real peanut butter and all my frozen vegetables, and then Hanamasa for the bulk meats.. my freezer is basically overflowing 24/7 but its so cheap it feels like daylight robbery haha
> I'm interested what dishes you're specifically talking about here? Japanese cooking is not complicated, just different.
That isn't necessarily true, Japanese cuisine (along with Italian which are my two cuisines I cooked professionally) actually relies more on elaboration and skill of seemingly humble ingredients: more than just about any other cuisine in my experience. It's a great equalizer to have something seen as exotic as truffle shaved on a soufflé be outshined by a long way by a Chawanmushi with a proper dashi, seasonal (cheap) vegetables, herbs and seafood.
Sure you can make staples like maze gohan, tamago gohan, takikomi gohan or ocha zuke with whatever you have on hand and rift where needed to keep it from being boring but each and everyone of those dishes that is carefully created and balanced makes it so much more satisfying and I find that to be the trick to Japanese cuisine as it makes you re-evaluate your perceptions/positions, and thus the execution of what is really important in a recipe as a result: I dislike eating in the morning, like really hate it, but I really loved having onsen tamago over slightly seasoned uruchimai rice and some handmade zukemono and miso (with proper dashi) for breakfast. The extra I could just eat as onigiri with toasted nori later in the day with a miso shiro and it was that good and never something I never get tired of despite being prone to 'palate fatigue.'
And all of that is because the elaboration and prep that went into making things that use affordable ingredients but require a great deal of attention to detail--for example a bitter salty dashi, or worst yet that hondashi powder, is repulsive and indicative of improper heat monitoring and regulation with the katsubushi/niboshi. A hastently made zukemono is very disappointing when eating teishoku as you want the sourness and saltiness and crunch to refresh your palate as you go back and forth between dishes. Not having that ruins the meal entirely.
> From my travels there my impression is of a diet that largely consists of rice and various meats and a high consumption of alcohol and cigarettes. Although there definitely seems to be far less sugar in everything.
That really depends on what you eat, donburis are typically their version of fast food, which as you said consists of some basic elements: rice, protein, veg etc... But just consider that the basic tare has extraordinary amounts of sugar, albeit fermented for long periods of time if done correctly. This is critical, so much of their foods are fermented and pickled and I think having a healthy gut biome is far more important to overall physical and mental health that I think is entirely overlooked in so much of Western Medicine. Kombucha is only a recent phenomena in the West, but how long has something like miso shiro been the accompanied soup of choice in set meals (Teishoku). Yakult has been a thing there since the 30s I think, which is also incredibly sweet!
But sugar is present in a lot of things, the tri-fecta of Japanese flavour is building off of shoyu-mirin-sake (mirin being a sweet sake) but dashi and sugar can often be quite as prevalent as bases.
One of my favorite donburis, gyudon, can be overly sugary for my tastes when others make it and I prefer a more savoury feel to accompany the beef, so I use like 5x the amount of onions (ideally Maui ones) and slow sweat/saute to bring out the natural sugars in the onions to mask my rather overly savoury tare: I use quite a lot of kombu and katsubushi/niboshi in my dashis as I like the brinier taste when I cook as I do in my miso soup. You feel more satiated eating smaller portions this way, too and is a hack/trick to reduce over consumption as you tap into the innate metabolic/feedback satiation mechanisms if you're healthy.
But think about it, Teishoku is a very healthy balanced meal and coupled with their active daily lives in and our of cities you get pretty good averages on healthy people. Japan has many Sociological issues (some outright toxic) that I won't go into depth into that impact their image as the 'pinnacle of health' but those are solid baselines.
The issue you raise is well taken, especially for me whose repertoire is Japanese and has an obsession with topics related to food/diet in relation to health and disease.
And it is definitely a multi-variable equation, but I think diet--especially in contrast to the American one so many of us grew up on--and an active lifestyle (car ownership is super expensive and has lots of complications that promote limited ownership as well as logistical issues in big urban cities) really explains most of the observations.
I'd like to nerd out about ichiju-issai, and the history and significance of Kaiseki and trace the origins of the composition and structure of meals in relation to Seasons, but you get what I'm trying to say.
> Culturally it seems that fitness in general is encouraged, combined with a very different attitude toward being overweight (I had several locals comment that I was a bit fat [my BMI is ~26])
In a World where anything even remotely suggesting people's health is being obviously compromised due to excessive consumption (of all things but specifically food in this case) is considered fat shaming, I find it rather refreshing and it's something I too have adopted. It's not trying to be mean, its just a reminder that things related to diet seem to be out of synch and could explain a wide array of maladies and symptoms, which are often brought up as topics of conversation.
Here's another way of looking at this. After WWII and other events the amount of salt in the Japanese diet had gone down. This reduced all kinds of problems associated with high salt diets. Many things (soy sauce, pickles, dried meat) were staples in Japan since they did not have non salted ways of preserving food (ie: refrigerators).
In other words, Japanese may be living longer because the DNA of living harder got passed down (hard labor, high salt diet, low calories and only two meals a day/when available). However, Japanese seem, at least to me, to be getting different diseases. In Japan there is plenty of talk about diabetes, arthritis, alzheimer's, etc. in media and in social circles. To me it seems while the Japanese may be more heart attack/stroke resistant they are getting more Western diet related diseases. Having lived in Japan for almost a decade my view of the Japanese diet is highly biased from what I have seen but I think the stereotype of all Japanese being healthy needs to be based on seeing regular Japanese people eat day in and day out.
I thought I'd chime in with something that seems to be overlooked. Japanese have the 80% diet rule. Eat until you are 80% full. Hara hachi bun me. Calorie restriction has been shown to increase lifespan in several different species,
When my wife was working in NYC, she gained weight considerably, with her normal eating portion. After she went home back to Japan, and still had her normal eating portion, she lost her weight.
At the same time, every time I visited Japan for 2 weeks I usually splurge daily, above my normal portion, and I did not gain weight at all. I might've even lose some occasionally.
> 1) Japan is not built around cars. There are more trains. You get to walk more.
This is false. About half of the population lives outside big cities, where you'll need a car to survive. I don't see people's shape changes in the rural areas.
> 2) Food portions are smaller, making it harder to overeat.
I think you got this backward. Food portions are smaller in Japan because people's stomach is smaller. Junk foods are cheap, so it's still easy to overeat.
ahh, you beat me to it! Yes, good point about the smaller stomachs.
Wikipedia says that "Studies show that there is a correlation between small stature and a longer life expectancy. Individuals of small stature are also more likely to have lower blood pressure and are less likely to acquire cancer." https://en.wikipedia.org/wiki/Human_height
That's true for Tokyo and some big cities, but not true in the rest of Japan, which is very much built around cars with crumbling public transport.
As for food - lots of fried stuff in Kyushu everywhere you go. I'm thinking it must be the metabolism rather than the diet. However, yes, food portions are small by default. You have to ask "omori" to get the bigger one, and there are even bigger sizes offered sometimes!
" Japan is not built around cars. There are more trains. You get to walk more."
I hear this a lot, but what does this really amount to? I live in a city without a car, and all my walking on my daily commute (during non-covid times) burns 125 calories or so. That's nothing. Eating two oreo cookies is more calories than that.
Moreover, consider that America is no more car centric than it was in 1970 or 1980, but people are much larger now than then.
I don't think any of this matters. Its clear if you spend a lot of time in the company of Japanese people they actually prioritise their health and most always opt for sensible choices and restrict themselves when necessary.
Hmm. When I look at the graphs, I see nothing spectacular here, except for one. In all cases, they pretty much mirror every other country, which over time shows gradual declines.
That is, except for Cerebrovascular.
I have to wonder, what of WWII?
1) Almost every single Japanese city of any size was firebombed, and the cities being mostly wooden, most of those cities burned extensively.
In fact, the number of deaths from firebombing dwarfed the two nuclear bombs dropped. Now imagine all of that smoke, burning varnish + paint + wood for days or weeks on end.
You may think that burning wood is not an issue, but people have died from burning pressure treated wood, as an example, due to the chemicals in it. I don't know what sort of treatments 1940s Japan had in its mostly wooden cities of the time, including buildings 100+ years old, but you can be sure they had something. Pressure treating has been around since the early 1800s, but even staining/coating wood with chemicals to kill pests (insects), is almost a certainty.
How does this affect a person's body? There is a lot of talk about diet, and diet is important, but what about creosote, a common preservation agent used on wood at the time? There are all sorts of potential side effects, and as we known from some other conditions, it can take a long time to manifest.
Or, perhaps, damage is done... but does not exhibit itself until old age. Meaning, "near the end", the thing which gets you is "what has been most weakened."
2) Of course, there were the bombs. There were birth defects, raised cancer rates, on and on.
3) People with 'bad outcomes' in those graphs peaking up to the 1970s, would have been 20 to 30 years old or so in the 40s.
I guess what I'm saying here is, 20-30 year olds during WWII would show as a peak in graphs during the 70s, potentially.
Why do the graphs start right when those who experienced WWII as adults, would be perhaps dying due to the effects of those conditions?
Subtitle: Japan’s rate of strokes fell during a period when it began eating a bit of meat
Article is paywalled, but the subtitle appears to make a correlation between the consumption of meat in Japan and the decline in the rate of strokes. At face value, this seems dubious.
Not killing off the bacteria in soil that produce B12 would also help reduce B12 deficiency, a condition that is also common among meat eaters in the US.
In Europe, I can usually get an appetizer and a main course and be kinda full, but not stuffed. In the US, the appetizer along would usually get me full.
This is a common misconception - very few people in the west are actually doing hard labor consistently for such a long time that they would burn enough calories to balance crappy diet full of bad calories like raw sugar in sodas.
I mean how many do daily effort on the level of running 1-2 marathons to burn all those calories? If you look around you will see plenty of older manual workers being overweight in the US, and not only there.
- INSANE peer pressure. If you're skinny as a twig in the US, you're probably considered normal in Japan. If you're actually an obese person (again, in the US standard), people here wouldn't even look at you straight. This kind of environment put a huge pressure for one to stay in shape.
- INSANE obsession for health. I hear that Americans are obsessed with health, but oh boy, have they looked into Japan. Small clinics are everywhere and they're always filled with anxious patients because they have a benign stomach pain or something. Physical checkup is mandatory for most companies. I also read that the fear of COVID in Japan is the strongest in the world, despite a relatively low infection/death number here. People are always talking about their health, and so is the national media. If you watch the Japanese TV, you'll also feel sick, simply because there's so much fear! Maybe this is good for public health overall, but I bet there's a certain mental toll.