Healthiest Countries Review 2019

[Kelj]

The world's healthiest country in 2019, according to this annual report:
https://www-bloomberg-com.cdn.amppr...-as-world-s-healthiest-nation-while-u-s-slips
is Spain, followed by Italy in second place. The much vaunted Mediterranean diet clasping its hands over its head in victory once again, right? If so, it is hard to explain why Iceland comes in at number three of the world's healthiest countries. Perhaps, we are not surprised to find Japan in fourth place, but Switzerland is number five.
According to the article,
"Spain by 2040 is forecast to have the highest lifespan, at almost 86 years, followed by Japan, Singapore and Switzerland, according to the University of Washington’s Institute for Health Metrics and Evaluation."
The article certainly tries to explain the health of Spain and Italy (Italy was previously in the #1 spot) in this way:
"a “Mediterranean diet, supplemented with extra-virgin olive oil or nuts, had a lower rate of major cardiovascular events than those assigned to a reduced-fat diet,” according to a study led by the University of Navarra Medical School."
For an idea of the diet of number three, Iceland, check out this article:
Food in Iceland | An Introduction to Icelandic Cuisine
This is not a Mediterranean diet. It is a diet of fish, bread, cultured milk, lamb, and...my favorite point to turn all the reasoning on its head:
"From 1880, shortly after sugar-importation began, and up until 1950 sugar consumption in Iceland increased by over 710%!"
Not a surprise to find a sugar-loving country high on the list of healthiest countries, only for those on Ray Peat forum.
It seems clear from reading years of the healthiest countries report, the researchers have a hard time explaining why these countries are healthiest. These reports often speak of per capita healthcare expenditure as a reason. The higher the expenditure, supposedly, the higher the ranking. If this is so, how do you explain the United States? This article:
U.S. leads among countries that spend the most on public health care
Shows the U.S. far above the #2 spot, held by Luxembourg, in annual per capita healthcare expenditure. The U.S., #1 in spending, spends over 8 thousand dollars per person per year on healthcare, while Luxembourg spends five and a half thousand. What is the U.S. healthiest countries ranking?
It fell from #34 to #35.
I'm going to try to explain what is going on.
It is pretty clear that with such widely varying diets as are represented in the top five of the healthiest countries list, the particular foods in the diet are not the reason. We can go on and on about red wine, omega- 3's,
olive oil, meat vs vegetables, starches vs sugars all day long, but the top 3 being Spain, Italy, and Iceland make this ridiculous. Even just looking at the omega-3 question, which I know doesn't hold much weight, anyway, on the Ray Peat forum, you find this data:
How much fish do we consume? First global seafood consumption footprint published
"In terms of consumption footprint per capita, the Republic of Korea scored highest (78.5 kg per capita), followed by Norway (66.6 kg), Portugal (61.5 kg), Myanmar (59.9 kg), Malaysia (58.6 kg) and Japan (58 kg) – China comes in seventh at 48.3 kg per capita."
And, Fish Consumption Per Capita in Switzerland
"Fish consumption per capita reached 17.5 kg in 2013 in Switzerland, according to Faostat. This is 0.575 % more than in the previous year."
That is a widely varying consumption of fish in the countries which occupy #4 and #5 places in the healthiest countries.
Let's look at the interesting question of calorie consumption. It is considered by many to be a fact that the more you eat of calories the fatter you will be, and the fatter you are the less likely you are to be healthy. That would be the number one reason almost anyone would say that the U.S. is number 35 on the healthiest countries list. The U.S. does top the list on this site addressing calories:
List of countries by food energy intake - Wikipedia
USDA | OCE | U.S. Food Waste Challenge | FAQ's
But, what are we looking at?
According to the site:https://en.m.wikipedia.org/wiki/List_of_countries_by_food_energy_intake
"Food consumption refers to the amount of food available for human consumption as estimated by the FAO Food Balance Sheets. However the actual food consumption may be lower than the quantity shown as food availability depending on the magnitude of wastage and losses of food in the household, e.g. during storage, in preparation and cooking, as plate-waste or quantities fed to domestic animals and pets, thrown or given away.[2]"
So, this is a list of calories available to the consumer, not the actual calories consumed. Waste of food must be factored in. This article:
https://www.usda.gov/oce/foodwaste/faqs.htm
says,
"In the United States, food waste is estimated at between 30-40 percent of the food supply. This estimate, based on estimates from USDA’s Economic Research Serviceof 31 percent food loss at the retail and consumer levels"
So, when we factor in how many calories Americans are wasting, we get this:
"The U.S. Agriculture Department's Economic Research Service estimates that more than 30 percent of the U.S. food supply goes to waste — 133 billion pounds of it every year, equivalent to $161 billion.

The research service worked out that the discarded food is equal to 1,249 calories per day for each and every American" from this site:
https://www.nbcnews.com/news/us-news/italy-sets-example-reducing-food-waste-u-s-tosses-161-n622561
which also says about #2, Italy:
"discards more than 17 percent of its food " and this site says regarding #1 Spain:
https://www.eu-fusions.org/index.php/country-reports/reports/300-spain
"In Spain, households waste 18% of their food".
So, 3,800 calories available to Americans is reduced to actual consumption of 2,551 calories on average.
Italy's 3,650 calories, reduced by 17% is 3,029.5 calories and Spain's 3,260 calories reduced by 18% is 2,673.2 calories on average. So, both Spain and Italy have an average calorie consumption above the calorie consumption of the U.S. As a recovered orthorexic, I know how important it has been to increase my own calorie consumption to improve my health and reduce my fat stores. I am absolutely convinced that biology dictates fat storage when calorie consumption is erratic. And that is how Americans consume calories...erratically. They do this because they have been convinced that fat stores are a result of too many calories and/or too much fat or sugar consumed. So, they are forever trying to reduce these. This is not how the body works. Let's look at this list of calorie availability, realizing that most countries do not have a 31% food waste habit like the U.S. and see how many likely average above the 3,000 calorie mark and are on the top 25 healthiest countries list:
Austria #7: 3,750 calories
Luxembourg #11: 3,680 calories
Italy #2: 3,650
Ireland #20: 3,590 calories
Portugal #22: 3,580 calories
Germany #23: 3,540 calories
Canada #16: 3,530 calories
France #12: 3,530 calories
Israel #10: 3,530 calories
Norway #9: 3,450 calories
Switzerland #5: 3,450 calories
United Kingdom #19: 3,450 calories
Denmark #25: 3,410 calories
Iceland #3: 3,260 calories
Netherlands #15: 3,000 calories
Spain #1: 3,260 calories
Australia #7: 3,220 calories
Finland #14: 3,220 calories
Cyprus #21: 3,190 calories
Sweden #6: 3,110 calories
S. Korea 17: 3,040 calories

That is a lot, for the top 25 countries. But, it doesn't entirely account for the health of a country. It may be a large factor, but take Japan, #4 of the world's healthiest countries. Average calorie availability is 2,800. Still higher than the ridiculous suggestion of 2,000 calories, which is so common, but way too low. What is going on here? Perhaps, a couple of points in this article are factors: https://www.livestrong.com/article/264082-a-typical-japanese-diet/
"The Japanese take pride in eating a diverse and nourishing diet"
"a meal without rice is not a meal at all."
A high calorie diet, following the body's desire for food is a way to ensure nutrients, but if the environment and culture allow for high nutrition in a varied diet, as in Japan, it can make up for a relative lower calorie intake. Both calories and nutrients are vital to good health. The Minnesota Starvation experiment gives us the lesson that if a person needs to recover from former starvation, taking vitamins and minerals as supplements without an abundance of calories will not bring about recovery. But, what if the damaging effects of starvation have not occurred because the person has consistently eaten a highly nutritious diet, though somewhat low in calories? The consistency could make up for the lower calorie content of the diet. Inconsistent food intake is what causes fat storage, and we know Japanese citizens are slim. This could also account for Spain's good health on an actual calorie intake of under 3,000 calories. A culture of consistent mealtimes of nutritious and varied foods could do it.
Higher calorie consumptions, however, can ensure good nutrition, and as long as eating is consistently everything one wants every day, no fat storage will occur.
These quotes from this article:
https://www.livestrong.com/article/404077-the-typical-diet-in-spain/
may be relevant to Spain's success.
"The Spanish diet consists of a lot of foods high in carbohydrates such as fruits, vegetables, fried potatoes, rice dishes, sweet rolls and hot sweet chocolate. Fish, eggs, pork sausage, cheese, herbs and spices are also common ingredients of the Spanish diet.".....high carb and varied.
"Most Spanish people who follow a traditional diet eat two additional meals a day, one around noon and another around 6 p.m. "...that's five meals.
And let's be real about olive oil. This:
https://www-oliveoiltimes-com.cdn.a...anish-eating-more-butter-less-olive-oil/23131
from 2011
"spanish-eating-more-butter-less-olive-oil"
did not hurt their 2019 ranking as the #1 healthiest country.

 

[sunraiser]

You have to look at human freedom in these countries as well.

Spain, Iceland and Switzerland all benefit from strong workers rights regulation and a mixed economy, curbing the worst of the free market. They all provide left wing freedoms to their workforce and have more social cohesion and far less inequality and poverty than the UK or US.

Japan definitely has a high quality of life, but they do seem to trend towards over work culture - definitely harder to explain around lifestyle. There's an ethos in Japan in which those at the top of businesses take the brunt when a company is struggling, and you see similar throughout Japanese culture. This kind of attitude can really help curb poverty and stark inequality which both drag down life expectancy in a country.

 

[yerrag]

I notice that many of these countries value tasting the flavor from fresh produce and livestock, rather than going with flavorings that mask the low-quality of processed foods. So the food they eat would be more fresh, and likely more nutritious. Either it comes from a dynamic agricultural sector not dominated by factory farms or agribusiness conglomerates, or from having access to pasture lands for livestock to grow on, or access to the bounty of wild fish from the seas.

Singapore may not have farmlands, but it's still a culture that values fresh foods, but in recent years it has come down the rankings probably because it could traded convenience for freshness as a result of its increasing wealth and rise up the ranks among countries.

 

[lexis]

On the issue of economic inequality,first question to be raised is if humans need to consume a huge assortment of foods. For instance,the favourite curry of every middle class Indian requires a plethora of indigestible vegetables,lot of tomatoes,onions,few dozen unnecessary spices. None of this contribute to good health.But it must be eaten for ego.

If they were asked to eat rice with a little sauce,they may die of an heart attack

How in the world can India produce enough tomatoes and onions if everyone were to eat this sort of curry?

This is a clue about the inequality in India.To satisfy the ego of the middle class,lower class must be deprived.

 

[bromuda]

I thought suicide was quite prevalent in Iceland in proportion to their small population (round 300k).

 

[Kelj]

You have to look at human freedom in these countries as well.

Spain, Iceland and Switzerland all benefit from strong workers rights regulation and a mixed economy, curbing the worst of the free market. They all provide left wing freedoms to their workforce and have more social cohesion and far less inequality and poverty than the UK or US.

Japan definitely has a high quality of life, but they do seem to trend towards over work culture - definitely harder to explain around lifestyle. There's an ethos in Japan in which those at the top of businesses take the brunt when a company is struggling, and you see similar throughout Japanese culture. This kind of attitude can really help curb poverty and stark inequality which both drag down life expectancy in a country.

I agree that worker's rights, freedom and social cohesion are all factors that support good health. Physical well-being and emotional strength cannot be divided and they cut both ways.

World Happiness Index 2019

This is the annual world happiness index. The strongly socially supportive and economically secure Scandinavian countries are usually at the top of this list, so close in their scores that a point or two will bump one or the other into the #1 spot from one year to the next. This year's #1 is Finland, followed by #2 Denmark, #3 Norway, #4 Iceland, and #5 Netherlands. Of course, we see Iceland, which occupies the #3 spot from the healthiest countries report. If social factors were the overriding reason for good health, I would expect to see these happiest countries be higher up on the healthiest list. We do see, though, Norway is #9 on the healthiest list, Finland #14, Netherlands #15 and Denmark #25. It is certainly a factor when we see these countries on the top 25 of the healthiest list.
I think Scandinavia has been following in the footsteps of the U.S. and making some bold assumptions which have not done any good for Americans. One example from:
All the diet advice you need, in one chart from Sweden - Vox
"In truth, the experts at the Swedish food agency write, 'most people know perfectly well what they should eat. It's no secret that vegetables are good for you and sugar isn't.'"

Oh, really? Is it perfectly obvious? The body will turn your own muscle into glucose if your diet is devoid of it. It is that vital to well-being. So, what's obvious?
And this,
"While American guideline makers are reluctant to urge the public to eat less of anything (lest they offend powerful industry lobby groups), the Swedes are clear about what people really need to cut back on: red and processed meat, salt, and sugar."
That's patently ridiculous. Americans are forever being told to eat this or that and cut back on the other thing. And what's more. Americans do it, which is what has gotten them into trouble. And if Swedes are clear about cutting back on meat, salt and sugar, they will suffer the way Americans are suffering. Could this Americanesque diet advice be why we don't see Scandinavia, especially Sweden, higher on the healthiest countries list in spite of their social and economic advantages?
Let's consider the above quote on cutting back on "processed meats" , which Swedish people are so clear on. Do we recognize these processed meats?
Prosciutto
Salami
Capocollo
Bresaola
Mortadella
Pancetta
Soppressata
All cured pork or beef from Italy, not to mention bologna and many others. How did a country living so dangerously as to manufacture and eat all the most famous processed meats in the world come to be #2 on the healthiest countries list?
Then there's chorizo and Serrano ham, famous for their inclusion in the Spanish tapas, from the #1 healthiest country.
Every country has traditionally chosen from the foods available in their climate, and so long as the people have plenty of it and the food is not too narrow in options, the diet is robust and the people are healthy. The more a culture tries to impose restrictions on the populace, the less healthy they become. Calorie restriction is particularly onerous, whether it comes about through eating less and/or exercising more.

 

[Kelj]

I thought suicide was quite prevalent in Iceland in proportion to their small population (round 300k).

That's an interesting question. It must not be enough to offset the other contributing factors.
http://worldpopulationreview.com/countries/suicide-rate-by-country/
This chart shows Switzerland having more suicides per 100,000 than Iceland. The article from Bloomburg does cite drug addiction and suicide as a reason for the U.S. dropping one spot.

 

[Blossom]

Shows the U.S. far above the #2 spot, held by Luxembourg, in annual per capita healthcare expenditure. The U.S., #1 in spending, spends over 8 thousand dollars per person per year on healthcare,

I think that’s actually disease care. There’s very little spent on keeping citizens healthy as far as I can tell.

 

[opson123]

I just fail to understand how Finland ranks at the top on the happiness ranking. Every single trip to the grocery store and all I see is miserable and sick looking people. Also fat people, lots of fat people. This is the majority, a few beautiful and shiny flowers here and there being the minority.

The index doesn't measure people's happiness, but something else?

 

[Kelj]

I think that’s actually disease care. There’s very little spent on keeping citizens healthy as far as I can tell.

Yes, I always want to provocatively put "health"care.

 

[Collden]

Spain and Italy have the highest unemployment rates in western Europe. Reminds me of how people in the US actually became healthier during the great depression. Perhaps being out of a job isn't so bad?

 

[Kelj]

Yes. Why aren't these countries the happiest?
The lowest suicide rates in the world are concentrated in the Caribbean Islands of the Bahamas, Jamaica, Grenada, Barbados, and Antigua and Barbuda. Suicide is almost unheard of in each of these countries, with Barbados and Antigua And Barbuda reporting 0.8 and 0.5 suicides per 100k, respectively.
http://worldpopulationreview.com/countries/suicide-rate-by-country/

 

[Kelj]

Spain and Italy have the highest unemployment rates in western Europe. Reminds me of how people in the US actually became healthier during the great depression. Perhaps being out of a job isn't so bad?

SAGE Journals: Your gateway to world-class research journals
True. This article makes this point about poor, mid-Victorian Brits living in isolated places:
"The aim of this study was to examine the impact of regional diets on the health of the poor in mid-Victorian Britain......there was an overall improvement in life expectancy during the latter part of the 19th century......Dietary surveys showed that the poor labouring population in isolated rural areas of England, in the mainland and islands of Scotland and in the west of Ireland enjoyed the most nutritious diets. These regions also showed the lowest mortality rates in Britain........also fewer deaths from pulmonary tuberculosis, which is typically associated with better nutrition"
It explains their food supply was secure because of payment made in food, instead of a cash economy.

 

[bromuda]

Yes lifestyle and community is very important. The culture in southern Europe compared to Scandinavia is quite massive. More focus on family in southern Europe and I get a sense that there's less distance between strangers. Plus I think Sweden has one of the highest amount of single households in the world.

 

[lampofred]

I agree that worker's rights, freedom and social cohesion are all factors that support good health. Physical well-being and emotional strength cannot be divided and they cut both ways.

World Happiness Index 2019

This is the annual world happiness index. The strongly socially supportive and economically secure Scandinavian countries are usually at the top of this list, so close in their scores that a point or two will bump one or the other into the #1 spot from one year to the next. This year's #1 is Finland, followed by #2 Denmark, #3 Norway, #4 Iceland, and #5 Netherlands. Of course, we see Iceland, which occupies the #3 spot from the healthiest countries report. If social factors were the overriding reason for good health, I would expect to see these happiest countries be higher up on the healthiest list. We do see, though, Norway is #9 on the healthiest list, Finland #14, Netherlands #15 and Denmark #25. It is certainly a factor when we see these countries on the top 25 of the healthiest list.
I think Scandinavia has been following in the footsteps of the U.S. and making some bold assumptions which have not done any good for Americans. One example from:
All the diet advice you need, in one chart from Sweden - Vox
"In truth, the experts at the Swedish food agency write, 'most people know perfectly well what they should eat. It's no secret that vegetables are good for you and sugar isn't.'"

Oh, really? Is it perfectly obvious? The body will turn your own muscle into glucose if your diet is devoid of it. It is that vital to well-being. So, what's obvious?
And this,
"While American guideline makers are reluctant to urge the public to eat less of anything (lest they offend powerful industry lobby groups), the Swedes are clear about what people really need to cut back on: red and processed meat, salt, and sugar."
That's patently ridiculous. Americans are forever being told to eat this or that and cut back on the other thing. And what's more. Americans do it, which is what has gotten them into trouble. And if Swedes are clear about cutting back on meat, salt and sugar, they will suffer the way Americans are suffering. Could this Americanesque diet advice be why we don't see Scandinavia, especially Sweden, higher on the healthiest countries list in spite of their social and economic advantages?
Let's consider the above quote on cutting back on "processed meats" , which Swedish people are so clear on. Do we recognize these processed meats?
Prosciutto
Salami
Capocollo
Bresaola
Mortadella
Pancetta
Soppressata
All cured pork or beef from Italy, not to mention bologna and many others. How did a country living so dangerously as to manufacture and eat all the most famous processed meats in the world come to be #2 on the healthiest countries list?
Then there's chorizo and Serrano ham, famous for their inclusion in the Spanish tapas, from the #1 healthiest country.
Every country has traditionally chosen from the foods available in their climate, and so long as the people have plenty of it and the food is not too narrow in options, the diet is robust and the people are healthy. The more a culture tries to impose restrictions on the populace, the less healthy they become. Calorie restriction is particularly onerous, whether it comes about through eating less and/or exercising more.

Interesting that Finland is #1. It has the highest rates of Alzheimer's and Parkinson's and many neurological issues. So something doesn't add up.

 

[LiveWire]

Well Icelanders sure like their shark fin soups. And they harvest the fins very sustainably, by cutting them off and letting the shark swim on. So to speak.

 

[yerrag]

Well Icelanders sure like their shark fin soups. And they harvest the fins very sustainably, by cutting them off and letting the shark swim on. So to speak.

And the Iceland sharks? They repay in kindness, cutting off limbs and letting Icelanders swim on to shore sustainably lol.

 

[pepsi]

Interesting, Greeks also consume a Mediterranean diet but rank at #26. Theres something more going on.

 

[sunraiser]

Yes. Why aren't these countries the happiest?
The lowest suicide rates in the world are concentrated in the Caribbean Islands of the Bahamas, Jamaica, Grenada, Barbados, and Antigua and Barbuda. Suicide is almost unheard of in each of these countries, with Barbados and Antigua And Barbuda reporting 0.8 and 0.5 suicides per 100k, respectively.
http://worldpopulationreview.com/countries/suicide-rate-by-country/

Suicide rates are almost always lower in sunny countries.

It partly explains the higher suicide rate in countries that are largely happy with quality of life yet very far north. Additionally, when you have a high functioning society it's even more alienating to be depressed and feel left behind so it might result in more dire consequences.

 

[sunraiser]

Interesting, Greeks also consume a Mediterranean diet but rank at #26. Theres something more going on.

The Greek economy has been absolutely condemned by sanctions fron the European commission. They've been condemned to poverty for the next half century to make sure the French and German banks get their money immediately from old greek government debt.

They're not a great example at the moment.