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Why it's easier to make healthy food choices in Japan


The U.S. and Japan are developed countries and comparable in many ways, but they're miles apart on the obesity spectrum. About 40% of Americans are obese. That's nearly 10 times higher than Japan's obesity rate. For our series Living Better, NPR's Yuki Noguchi explains why it's easier to make healthier choices in Japan.

YUKI NOGUCHI, BYLINE: I was born and raised in the American Midwest but love visiting my parents' homeland. A central part of that is the food - oh, my goodness, the food.

UNIDENTIFIED PERSON #1: (Non-English language spoken).

NOGUCHI: Eating is a raging national obsession here. Depachika are legendary department store food courts, each one a cornucopia of high-end hawking.

UNIDENTIFIED PERSON #2: (Non-English language spoken).

NOGUCHI: The traditional diet consists mostly of vegetables, seaweed and seafood, making it high in fiber, nutrition and good fats. Freshness is embedded in the culture of eating. It's visible in every dish. Fruits and vegetables aren't just wilted sides, but often the star. That's true even for Japan's versions of fast food, like the streetside ramen stall I duck into with my mother. Across the serving counter, we watch the chef draw broth from fish flakes. He ladles the soup onto noodles, a slice of roast pork, green onions, bamboo shoots and seaweed. The result is savory, nourishing and costs less than $5. People here relish food constantly, and yet obesity is not the public health threat it is in the U.S.

I asked Terry Huang, a health policy professor at the City University of New York, about this apparent contradiction. He says Asian countries generally place greater emphasis on health and longevity as compared to convenience, say, or instant gratification.

TERRY HUANG: It's very important because it influences much of how we design our communities, how we think about food, how we engage in lifestyle behaviors in general.

NOGUCHI: In other words, the fundamental construct of life in Japan makes it easier to live healthier. Huang calls this default design. He says it literally comes built-in - the fact that Japanese cities are heavily invested in public transport, for example.

HUANG: When cities are built more around public transportation it fosters higher levels of movement.

NOGUCHI: I certainly noticed that the week I spent shadowing my parents who live in central Tokyo.


UNIDENTIFIED PERSON #3: (Non-English language spoken).

NOGUCHI: I average over six miles a day here. That's 60% more than I walk in the U.S. Huang says default design bakes healthy habits into daily life. That's critical, he says, because otherwise, healthy behavior becomes less automatic and more dependent on individual effort.

HUANG: Anytime you add additional burden in planning for a healthy meal or going to exercise, that's going to translate into a lower likelihood of people actually engaging.

NOGUCHI: Even when it comes to food, Japan has a kind of default design that supports healthier eating.

HUANG: Culturally, when it comes to food, there is a stronger emphasis on quality and refinement in the preparation of each dish as opposed to quantity.

NOGUCHI: This even applies to convenience store food. Noodle salads, rice balls, bento boxes all come perfectly portioned and delicious. Sell-by dates on each package come timestamped to the minute because unsold wares get swapped out multiple times a day. This is not to say Japan's immune to industrialized and ultra-processed food trends driving up obesity rates worldwide. Excess weight is a growing concern here, too. Yet the population is remarkably resilient in the face of that global trend. Why? A key factor my mom and many experts point to is the Japanese school lunch. School lunches are free, scratch-made and balanced. But that isn't all, says Michiko Tomioka, a Japanese nutritionist based in New Jersey.

MICHIKO TOMIOKA: (Non-English language spoken).

NOGUCHI: She says starting in elementary school, lunchtime itself is treated like a class in nutrition. Kids serve each other food, are tasked with cleanup and are encouraged to eat everything they're given.

TOMIOKA: (Non-English language spoken).

NOGUCHI: Having a standardized lunchtime ritual establishes a common cultural understanding about what normal healthy eating looks like, she says. And that's how it also becomes a habit that endures.

Yuki Noguchi, NPR News, Tokyo.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.