[Discussion] Low Rate Of Heart Disease In Japan Compared To US And Other Developed Countries

[jzeno]

Heart disease is the number one killer in the USA. Japan has one of the lowest rates of heart disease among developed countries. Also, when Japanese immigrate to the USA, their risk for heart disease goes up.

Has this been discussed before by Ray Peat or this forum?

Table: Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations

Source: Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations

"Since the 1970s, mortality from coronary heart disease as well as stroke has declined substantially in Japan, probably due to a major decline in blood pressure levels and for men a more recent decline in smoking, in spite of an increase in body mass index and total cholesterol levels. However, the decline in mortality was smaller and plateaued in middle-aged men aged 30-49 in the metropolitan cities of Tokyo and Osaka. The incidence of coronary heart disease has increased among middle-aged men residing in the suburbs of Osaka. As for the associations between lifestyle and cardiovascular disease, higher sodium, lower calcium and lower animal protein content in the diet and for men higher alcohol consumption may account for the higher prevalence of hypertension and higher risk of stroke for Japanese than for western populations. On the other hand, lower saturated fat (meat) and higher n3 polyunsaturated fat (fish) in the Japanese diet may contribute to the lower prevalence of hypercholesterolemia and lower risk of coronary heart disease among Japanese. Japan is unique among developed countries in that coronary heart disease mortality has been low and has continued to decline, while stroke mortality has declined substantially. However, a recent trend for coronary heart disease incidence to increase among urban men is a cause for concern as a potential source of future problems for public health and clinical practice in Japan."

Source: https://www.jstage.jst.go.jp/article/jat/18/2/18_6866/_pdf/-char/en

I find it interesting that they cite higher Omega 3s and lower saturated fat in their diet for lower risk of heart disease, but this seems to fly in the face of everything Peat has stated through his research of the research that's out there.

Which is it? Can't argue with the fact that Japanese eat less saturated fat and more omega 3s (I would presume that is accurate, but it could be wrong or misrepresented), but the connection of this and lower heart disease seems suspicious.

Haidut posted this relevant post the other day: A High-carb Diet May Explain Why Okinawans Live So Long

What are your thoughts?

 

[jzeno]

I think this observation is interesting: "The traditional Okinawan diet as described above was widely practiced on the islands until about the 1960s. Since then, dietary practices have been shifting towards Western and Japanese patterns, with fat intake rising from about 6% to 27% of total caloric intake and the sweet potato being supplanted with rice and bread.[9] This shifting trend has also coincided with a decrease in longevity, where Okinawans now have a lower life expectancy than the Japanese average.[10]"

Source: Okinawa diet - Wikipedia

I presume increased fat intake is including all fats--PUFAs and some saturated, but mostly PUFAs in the form of vegetable oils (they are relatively much less expensive and available in almost any part of the world compared to saturated fats--especially true in an island country like Japan that has limited space)

This news article seems to suggest something similar, that unhealthy carbohydrates are the cause: Fatty foods don’t cause heart disease, bread and pasta do

I'm thinking like conventional commercial pasta and bread which is raised through yeast, not sourdough, etc. This seems to make some sense.

Somewhat related, this article poses the theory that perhaps it's the yeast and not wheat or bread that is causing food allergy reactions: Could it be yeast rather than wheat that is the cause of so many cases of apparent food intolerance?

I think that last idea is kind of interesting.

Perhaps yeast is a bigger problem, but pasta is also a problem. Not sure, but I could see both being true but one is more dangerous than the other.

I'm becoming more convinced that yeast is a bigger issue than previously thought.

 

[fradon]

Heart disease is the number one killer in the USA. Japan has one of the lowest rates of heart disease among developed countries. Also, when Japanese immigrate to the USA, their risk for heart disease goes up.

Has this been discussed before by Ray Peat or this forum?

Table: Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations

Source: Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations

"Since the 1970s, mortality from coronary heart disease as well as stroke has declined substantially in Japan, probably due to a major decline in blood pressure levels and for men a more recent decline in smoking, in spite of an increase in body mass index and total cholesterol levels. However, the decline in mortality was smaller and plateaued in middle-aged men aged 30-49 in the metropolitan cities of Tokyo and Osaka. The incidence of coronary heart disease has increased among middle-aged men residing in the suburbs of Osaka. As for the associations between lifestyle and cardiovascular disease, higher sodium, lower calcium and lower animal protein content in the diet and for men higher alcohol consumption may account for the higher prevalence of hypertension and higher risk of stroke for Japanese than for western populations. On the other hand, lower saturated fat (meat) and higher n3 polyunsaturated fat (fish) in the Japanese diet may contribute to the lower prevalence of hypercholesterolemia and lower risk of coronary heart disease among Japanese. Japan is unique among developed countries in that coronary heart disease mortality has been low and has continued to decline, while stroke mortality has declined substantially. However, a recent trend for coronary heart disease incidence to increase among urban men is a cause for concern as a potential source of future problems for public health and clinical practice in Japan."

Source: https://www.jstage.jst.go.jp/article/jat/18/2/18_6866/_pdf/-char/en

I find it interesting that they cite higher Omega 3s and lower saturated fat in their diet for lower risk of heart disease, but this seems to fly in the face of everything Peat has stated through his research of the research that's out there.

Which is it? Can't argue with the fact that Japanese eat less saturated fat and more omega 3s (I would presume that is accurate, but it could be wrong or misrepresented), but the connection of this and lower heart disease seems suspicious.

Haidut posted this relevant post the other day: A High-carb Diet May Explain Why Okinawans Live So Long

What are your thoughts?

iron fortification. japanese eat rice. rice in japan is not fortified but rice in america is. high iron increase CVD. one thing i have noticed is quaker oats has stopped fortifying its oatmeal...which is a good thing. since one packet of instant oats had like30-40% of daily iron. I used to eat six packets a day. and this was not even good iron it was reduced iron(metal shavings) which turn toxic in the stomach.

 

[tankasnowgod]

Heart disease is the number one killer in the USA. Japan has one of the lowest rates of heart disease among developed countries. Also, when Japanese immigrate to the USA, their risk for heart disease goes up.

Has this been discussed before by Ray Peat or this forum?

I don't know if it's been discussed here, but it's been known for a while that the Japanese have less heart disease than the US, and the immigration rate is usually brought up, and pretty much the only thing that shows is that it's not a genetic factor, but largely environmental.

I find it interesting that they cite higher Omega 3s and lower saturated fat in their diet for lower risk of heart disease, but this seems to fly in the face of everything Peat has stated through his research of the research that's out there.

Which is it? Can't argue with the fact that Japanese eat less saturated fat and more omega 3s (I would presume that is accurate, but it could be wrong or misrepresented), but the connection of this and lower heart disease seems suspicious.

Why do you find it interesting that Omega 3s and lower Saturated Fat are cited? That's been the "official" narrative that's been pushed for a while, and the World Health Organization is absolutely going to go along with it. In fact, they may be the ones pushing it in the first place.

As for the fact that those two cherry picked factors are associated..... so what? It in no way means they are causal. There are many differences between Japan and the US, and not just dietary. Japan is a much smaller country, has a much smaller population, and is very different culturally than the US.

Yeah, the Omega 3 consumption and Saturated Fat consumption are different. So is Iodine consumption..... much higher (at least on average) in Japan. Natto consumption is WAAAAAY higher in Japan, and Natto is the richest source of Vitamin K2 that can be found in food. Iron fortification also doesn't exist in Japan, so that could be a huge factor.

How does the rate of alcohol consumption differ between the two countries? And by type? Beer, wine, spirits? Smoking? Type of tobacco smoked? How's the economy? How's the racial makeup? How's the family structure? Stress levels? All sorts of other factors to be examined.

And how about the this image......



Japanese people very, very often wear surgical masks in public and at work. American's rarely do. Maybe it's the fact that Japanese people shield themselves better from germs and colds, and also raise their body's carbon dioxide levels?

 

[lampofred]

I've read somewhere that the Japanese have the highest natural progesterone levels.

 

[haidut]

Yes, we just posted a thread on this topic a few days ago.
A High-carb Diet May Explain Why Okinawans Live So Long

So, low fat, low protein, high carb diet may be one explanation of the longevity and good health of a subset of the Japanese population.

 

[sunraiser]

High omega 3 intake is consistent with longevity in northern Europe, too.

They also have high gamma tocopherol intake in Japan via soy.

I think natto is maybe only helpful when white rice is the main carb source - it seems in wheat/grain/potato eating countries there's less cultural trend in ferments beyond beer and wine. My guess is that fibre sources of grain starch and mixed veg provide adequate food for a healthy microbiome.

Iodine content is also interesting - it's possibly needed because of the soy and goitrogen prevalence. I always need more goitrogenic veg after supplementing kelp.

Northern Europeans thrive on much lower iodine content so I'm unsure if all the iodine is used in Japan rather than being compensatory.

On a personal level I do better with some omega 3 intake .. Regularish salmon and mackerel. My grandad lived to 93 eating fatty fish regularly, and most northern European ancestry relied on it, too.

Japan also has a a different kind of social infrastructure - they're not playing the gdp game the way US are - it tends to lead to mass lower wellbeing.