【The secret of longevity】Why do people live longer in Japan?
Why are Japanese people living so long?
How long do people live to in Japan?
According to the World Health Organization (WHO), Japanese women have a life expectancy of 87 – the highest in the world, while male life expectancy is in the top ten internationally, ahead of the US and UK. Why is this?
Japan has the highest “healthy life expectancy” in the world, with Japanese boys and girls expected to live to 73 without any major illness of disability.
Nagano, Japan, has the longest life expectancy in the world, thanks to the region’s healthy lifestyle. At 66, a man has already come out of retirement once and expects to work well into his later years.
“It’s part of the lifestyle here. You work in an office and then you retire to the farm. It’s just the next stage in life,” he says. As it turns out, it’s a very long life.
A healthy diet, regular physical activity, extended work years and aggressive government intervention have helped the Nagano region produce the longest life expectancy in Japan, which in turn is the longest in the world.
That marks a remarkable turnaround for an area that, as recently as the early 1980s, had the highest rate of strokes in Japan.
・Location: Japanese Alps
・Population: 2.15 million
・No. 1 in: Life expectancy, employment rate for those 65+ and vegetable consumption per capita
Women in Nagano prefecture can expect to live an average of 87.2 years, while men can look forward to living 80.9 years, according to the latest data from Japan’s Ministry of Health, Labor and Welfare.
The lifestyle in Nagano, home of the 1998 Winter Olympics, has also produced some of the lowest per capita medical costs in Japan.
“Nagano is unique in many ways, but there are lessons you can apply anywhere. Improve your diet, stay active, continue to work as you get older. The key is not just to live longer, but to stay healthy longer.”
Why do people live longer in Japan?
The reason is…
Is it the Japanese Diet?
A 2016 study in the British Medical Journal (BMJ) found that Japanese adults who followed government advice regarding food intake had lower rates of mortality than those who didn’t.
Some aspects of the Japanese diet (like a preference for highly refined rice and bread as staples) could be responsible for increasing rates of diabetes, through a low dietary fibre intake and a high glycemic index.
The traditional Japanese diet is also under threat as more western food chains and dietary habits become popular. This has led to a rise in obesity in Japan, and as a result, increasing cases of hypertension (high blood pressure) and other adverse health outcomes, such as breast cancers.
Despite this obesity rates in Japan are still very low, with around 3.8% of men classed as obese and 3.4% of women, compared to 24..4% of men in the UK and 25.1% of women.
Is it the healthcare system?
Since 1961 Japan has had universal healthcare, with equal and universal access to healthcare for all, through a health insurance scheme (paid for by government, employers and individuals). As such, Japan performs well when looking at the social determinants of health.
In Japan regular check-ups are also the norm. Mass screening is provided for everyone at school and work or in the community by local government authorities. This may help people become more health conscious.
However, the financial and social underpinnings of health provision are threatened by economic decline and widening inequalities. In conjunction with rising costs and an ageing population this raises the question as to whether healthcare can remain universal forever.
Japan provides its universal healthcare for around 10% of its GDP (Gross Domestic Product). That’s slightly more than the UK’s 9% but quite a bit less than the USA’s 17%. Does this mean that Japanese people are using less healthcare than their US counterparts because they are healthier, or is their healthcare system more cost effective?
Do Japanese people exercise more?
Some studies suggest not. For example, Japan was one of four countries where less than a third of their population was in the high physical activity category.
However, some observers argue that everyday life in Japan involves more commuting by public transport than by car, meaning more daily exercise than, for instance, in the US.
Do Japanese people have better genes?
There is some evidence that Japanese people have good genes which are aiding their longevity. Studies have suggested two genes in particular, DNA 5178 and the ND2-237Met genotype help the Japanese live longer, by protecting them against some adult onset diseases.
However, this isn’t seen across the whole population. Some families in Okinawa for instance, have inherited more good genes than others. And even here other factors, including personality (especially conscientiousness, openness and being extroverted) also seem to be important.
Are there any downsides to the Japanese way of life?
Since the 1970s there have been discussions of “Karoshi” – death by overworking. Since 1987, the Japanese Ministry for Labour has been publishing figures on “Karoshi”, as companies were encouraged to limit working hours. The biological aspects behind these deaths are linked to heart disease, high blood pressure and strokes.
Not only is there death due to overworking, but suicide rates in Japan, especially for young men, are also very high and are linked to overworking – known as “karojisatu”. The highest risk of suicide is seen by those in managerial and administrative jobs, where stress levels are high, as well as in those with low social support, lack of control over work and heavy workloads.
So what lessons can you learn from Japan?
A healthy diet can help you live longer, wherever you live. So follow government healthy eating guidelines.
Universal healthcare, with equal access to all helps too.
We shouldn’t underestimate the value of social cohesion – the sense of belonging to organisations and communities. We need to consider how to achieve this both as individuals and as a society.
Avoid the factors that risk reducing longevity in Japan, like fast food and overwork.
Keys to a long life
Japan is one of the most rapidly aging societies in the world. A quarter of the population is age 65 or older. In Tokyo alone, some 3.1 million residents will be 65 or older by 2025, according to the health ministry.
Keeping those people healthy and productive is key to controlling costs for Japan’s national health care system and helping offset a declining birth rate. At first glance, Nagano would seem an unlikely setting for a long and healthy life.
Tucked high in the Japanese Alps, the area experiences long and harsh winters. Arable land is limited. Surrounded by mountains, Nagano is one of the few regions of Japan without immediate access to the fresh fish and seafood that makes up much of the national diet.
Even as Japan’s economy boomed and longevity rates climbed through the postwar era, life expectancy in Nagano lagged. Men in particular suffered from high rates of stroke, heart attack and cerebral aneurysm.
Housewives in Nagano for generations preserved all manner of homegrown produce to make up for the lack of fresh vegetables during long snowy winters.
And while every village had a secret recipe for the dish, called tsukemono, all included one ingredient: copious amounts of salt.
One survey found that Nagano residents on average were consuming 15.1 grams of salt per day — that’s nearly three times the daily maximum in U. S. dietary guidelines.
“In wintertime, people would sit around and talk and eat tsukemono all day.”
“The turning point was 1981, when Nagano became number one in strokes. We decided, ‘OK, we have to do something about this.’ ”