JAPAN’S LIFESTYLE MEDICINE

By Ryhaan Shah

The Japanese have one of the world’s highest life expectancies, if not the highest. They have much fewer deaths due to heart disease and cancers, and this low mortality rate is attributable to a low rate of obesity.
The obesity rate for Japanese women is 3.7 per cent among women, and for men it’s 4.8 per cent. In Western countries, like Canada for instance, the obesity rate stands at some 25 per cent; that’s a quarter of the population. When you consider that obesity is a major risk factor for heart disease, diabetes and cancer, it becomes a vital health issue.
Japan’s longevity is a direct result of a number of variables that include a diet of mainly fish, vegetables and fermented foods, active lifestyles, strong community ties, cultural practices, and an effective health care system that is either free or affordable for most of the population.
The Japanese diet comprises very little red meat like beef and mutton and much less chicken than we consume. They eat fish, soy, vegetables, rice, and, well, seaweed, but I don’t think we are going to add that to our diet any time soon.
Their plant-based diet means it’s not calorie-dense, so there is less chance of gaining weight, and they do not use much dairy products like milk and cheese, or sugar, sweeteners, or even potatoes, which are all staples of our diet.
Because they eat less beef, mutton and chicken, they have a reduced intake of saturated fatty acids, which lowers their risk of heart disease, and their diet of more fish and seafood provides them with omega-3 fatty acids, which also works to lower their risk of heart disease.
In cooking, they add much less salt than we normally use, which is important for controlling blood pressure, and they cook with very little oil. Instead, they steam and simmer, which is water-based cooking. Their cultural practice is to eat until they are about 80 per cent full. This manages their calorie intake and is known as “hara hachi bu”.
Other cultural practices that aid their healthy lifestyle are daily movement like walking, gardening, and community activities, and they meditate for relaxation. They also practise ikigai, or “purpose”, which helps them find meaning in their daily life.
For older Japanese it is important that they enjoy life as they age. Their ikigai could mean caring for a pet animal each day, or, for someone else, it could just be meeting with a friend or finding solace in their faith. The idea is to give each day a purpose, a reason for being alive.
Their longevity is attributed to this blend of mindful eating, daily physical activity, strong community ties, and a calming focus on overall wellbeing.
In Okinawa there is no word for retirement, and, until recently, it was not even a concept. If you were a farmer, you continued to farm. The idea is to stay engaged with family and your community and to continue to enjoy activities that you always do.
A medical doctor and Confucian scholar named Ekiken Kaibara showed how illness can be prevented through lifestyle change. He wrote, “Don’t make your stomach full and reduce meat in your diet; walk after the meal and don’t sit at one place for a long time. Get up early and work hard; don’t be lazy.”
His recommendations were published in the first and most comprehensive lifestyle medicine book, “Yojokun”, which became a national best-seller. The year published? 1713. That’s right. Japan is ahead of the world by over 300 years in understanding the role lifestyle plays in our health.
Results from what is a “natural experiment” show that Japanese who have migrated to Western countries and have changed their diet and lifestyle now present with a higher risk of heart disease and cancer. As immigrants and their descendants assimilate into Western culture, their diets shift towards a higher consumption of red meat, saturated fats, dairy products, processed foods, sugar and salt.
In essence, adopting a Western diet appears to negate the protective health benefits associated with the traditional Japanese diet and negatively impacts their longevity.
We would not all want to suddenly change our diet drastically. But we would do well to consume less beef and mutton, add more vegetables and fruit to our diet, be aware of the quantities of such staples as whole milk and cheese that we use, and watch our intake of sugar, salt, and processed foods.
Incorporating the elements of lifestyle medicine, such as having good nutrition, regular exercise and maintaining good mental health, will help us to live a longer and healthier life.