Doesn't the fact that Asian people live longer than Americans, and have less heart disease, prove a low fat, high carb diet... healthier than a low carb diet?

Well, that certainly seems to be the rather simplistic conclusion that a lot of people have jumped to, doesn't it? But there are a number of factors that don't seem to have been examined.

One of these is that while Japanese and Chinese people have lower rates of heart disease than we do, they have higher rates of some other diseases. For example, the Japanese have strokes at a very high rate, while the Chinese have more pancreatic and thyroid cancers than we do. Not sure I'd pick any of those afflictions over heart attack. On the other hand, I'd prefer to avoid them all!

Another is that while these folks have lower heart attack rates than Americans do at the present, they have a higher rate of heart attack than Americans did 100 years ago. What has increased in the American diet since then? Not so much egg and meat consumption, but consumption of sugar, highly processed cereals, hydrogenated vegetable oils, and processed foods in general.

But the big thing to question is whether macronutrient balance is the important difference. ("Macronutrient" refers to those nutrients which contribute energy -- calories -- to the diet; ie, fats, carbohydrates, and proteins (also alcohol.) "Micronutrients" refers to those nutrients which do not supply calories -- vitamins, minerals, and the like. So "macronutrient balance" refers to the ratio of fat/protein/carbohydrate.) Here's just a few other differences between the Asian diet and lifestyle and the American diet and lifestyle that I can think of:

First of all, they get the majority of their carbohydrates from vegetables, and from rice. Surely we are all clear now on the virtues of eating plenty of vegetables; this factor alone may well be tremendously powerful. As for rice, while it has a modest impact on blood sugar, it causes a paradoxically low insulin release. This means that Asian folks are getting most of their complex carbs from a low impact carbohydrate. In the meanwhile, most Americans are getting the majority of their carbs from stuff like white bread (or "wheat bread" that is mostly made from white flour; no improvement), highly processed cold cereals, potatoes, and sugar, all of which have a sky high impact on both blood sugar and insulin release. That's a big difference right there -- compared to the average American, Asian folks are eating an insulin controlling diet!

Both cultures eat less sugar than Americans do, and the communist Chinese eat very little indeed. Perhaps most importantly, their children eat far less sugar than American children do -- as I've mentioned before, American children now get an average of 50% of their calories from sugar, and a distressingly high part of the rest of their calories from white bread, white flour pasta, chips, cold cereal, and other similar garbage. This may well mean that Asian folks make it to maturity with a greater ability to metabolize carbohydrates safely.

Another very powerful factor that seems to be overlooked is that your average person in the People's Republic of China does not own a car -- they walk or bicycle virtually everywhere they want or need to go. A very high percentage of them do physical labor in the fields. It would be near-miraculous if all that exercise didn't make a difference in their health. Central heating is also not the commonplace that it is in much of the rest of the world; staying warm can use up a lot of extra calories. I am less certain about exercise rates in Japan, but I have certainly seen photos of Japanese urban rush hours, with the city streets clogged with bicycles.

Both Chinese and Japanese folks drink a great deal of green tea. Tea, especially green tea, contains the most powerful botanical antioxidant yet discovered. There is at least some evidence that a high intake of antioxidants will prevent heart disease, and the same antioxidants have been shown to have a protective effect against cancer.

Japanese people eat a great deal of sea food and of sea vegetables, both of which are very nutritious, and lacking in the American diet. Fish oils have, of course, been shown to exert a protective effect against heart disease. (That's why I take a salmon oil capsule every morning.) Both Chinese and Japanese people eat soy products, which despite the possible dangers mentioned in this newsletter in recent issues, do seem to exert some protective effect against heart disease. (On the other hand, I wonder about that pancreatic and thyroid cancer...)

Two more points worth mentioning which have nothing to do with heart attack rates, but everything to do with longevity rates: Both Japan and China have national health care, and neither country has widespread ownership of guns. I am not trying to make a political statement here; I am undecided on both issues myself. But there is no question that fewer people will die from lack of medical care, or postponing medical care, in a country with national health care, and that very few people, comparatively, are being shot to death at an early age in these countries. It doesn't take a whole lot of teenagers and young adults getting killed to pull down the national longevity statistics pretty dramatically.

Given these very powerful dietary and cultural differences, I find it very strange that the only explanation that most "experts" can find to point to is "Oh, they eat a low fat, high carb diet; go thou and do likewise."

There is no reason why your low carb diet cannot incorporate sea food and sea vegetables (if you don't want to eat seaweed -- it's not high on my list of faves -- kelp tablets are widely available), plenty of other vegetables, and green and/or black tea, and we know it restricts your sugar intake! If you've chosen a program which does allow a few carbs, certainly I would recommend brown rice (or, for that matter, Japanese buckwheat noodles) over white bread and other white flour products, cold cereal, or potatoes. And I've already urged my readers to go take a walk, play on the swings, ride a bike, go dancing, flip a Frisbee with the kids, etc.

Now, shall we talk about the French Paradox?