Coronary artery disease, the type that causes heart attacks and is generally known as heart disease, is the leading killer in the U.S., and men have much higher rates of it than women. Things are different elsewhere, so this article will tell you why Japanese men have far less heart disease than Americans.
Virtually every man is taught to fear heart disease, with good reason, and wants to do everything to prevent it.
Heart disease rates are much higher in the U.S. and the UK than many other places, such as Japan. Dr. Malcolm Kendrick posted the following stats, taken from the article “Cardiovascular Disease and Risk Factors in Asia”.1
|% WHO SMOKE||35.4%||23%||17.2%|
|AVERAGE BP (SYSTOLIC)||130.5mmHg||131.2mmHg||123.3mmHg|
|% OF POPULATION WITH DIABETES||7.2%||7.8%||12.6%|
|RATE OF CHD/100,000/year||45.8||143.7||150.7|
Dr. Kendrick wished to make a point about cholesterol, namely that it cannot be a risk factor. The point I wish to make is: can we learn from the Japanese experience and keep our heart disease risk low?
Japanese men smoke cigarettes at twice the rate of American men, have higher cholesterol and higher blood pressure, yet they have about 30% the rate of heart disease as in the U.S.
Note that their rate of diabetes is about 60% that of the U.S.; that’s important.
Here are some candidates for the lower male Japanese heart disease rate, along with what I believe are the best answers.
Maybe the Japanese have some kind of genetic protection against heart disease.
Unfortunately for that thesis, Japanese men who move to the U.S. have much higher rates of heart disease than Japanese men in Japan.2
The incidence rate was lowest in Japan where it was half that observed in Hawaii. The youngest men in the sample in Japan were at particularly low risk. The incidence among Japanese men in California was nearly 50 percent greater than that of Japanese in Hawaii. A striking increase in the incidence of myocardial infarction appears to have occurred in the Japanese who migrated to the United States; this increase is more pronounced in California than in Hawaii.
No, Japanese genes do not offer protection.
The Japanese eat a lot more fish than Americans, and this is important, since omega-3 fatty acids, the type in which fish is abundant, are protective against heart disease.3
A study done in 2005 found that the more fish the Japanese ate, the higher was their consumption of omega-3 fats, and the lower was their rate of heart disease.4
The following chart shows the decline in heart disease risk with increasing omega-3 consumption.
At the highest quintile (fifth) of consumption, risk was ~70% less than the lowest quintile of consumption — and keep in mind that the risk in Japan is already low. The study also notes that the lowest quintile of fish consumption in Japan was equal to the third quintile in Western countries, meaning that for us Westerners, increasing our fish and/or omega-3 consumption could lower our heart disease risk greatly.
Sugar consumption is linked to heart disease, probably through its effects on insulin resistance. People who consume 2 or more sugar-sweetened drinks (SSBs) daily had a 35% greater risk of heart attack.5
In the U.S., the average person consumes 126 grams of sugar daily. That’s about 25 teaspoons.
The corresponding figure for Japan is 57 grams, or about 11 teaspoons. Less than half the amount as the U.S.
Trans fats are the artificial fats created in the making of vegetable oil and margarine. They are strongly implicated in coronary heart disease. Risk in highest quintile of consumption vs lowest is 50% higher.6
Processed food of all kinds, but especially baked goods, are loaded with trans fat. Margarine is basically about 100% trans fat and should never be used. Vegetable oils — throw them out. Use coconut oil, olive oil, lard, and butter instead.
Vitamin D deficiency is associated with heart disease, with a 62% higher rate in those who are deficient.7
Fish are high in vitamin D, and as we saw above, the Japanese eat a lot of fish.
Excessive iron is strongly associated with many diseases. As a rough and ready measure of iron status, we find that Japanese women are more than twice as likely to be anemic as American women.8
That tells us that both iron intake and iron levels are lower in Japan than in the U.S., and could be a big factor behind lower heart disease rates.
The U.S. obesity rate is 33%; in Japan, it’s 5%. As obesity is linked to heart disease, enough said.
Men in Japan, despite smoking much more than American men, and despite higher cholesterol and blood pressure, have a rate of heart disease 70% lower than American men.
Among the reasons for this are high consumption of fish and omega-3 fats, more vitamin D, and less consumption of sugar, trans fats, and iron.
To lower your risk of heart attack: