Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
1 Feb

The “Asian Paradox”: How Can Asians Eat So Much Rice and Not Gain Weight?

eatingriceHow the Primal community loves the concept of a dietary paradox. How we eagerly point to its various manifestations as supportive evidence for our way of eating, living, and moving. You know the French Paradox and how it confounds the experts. To mention all those smug surrender monkeys with their brie and their butter and their duck confit and their Gauloises and their seeming imperviousness to heart attacks is to make Dean Ornish binge on bran and pull out tuft after tuft of frizzy hair. And then there’s the lesser-known Israeli Paradox, which attempts to answer why Israelis have skyrocketing rates of heart disease despite a skyrocketing intake of “healthy” omega-6 fatty acids. In its wake, Walter Willet might be found weeping into a mug of safflower oil. There’s even an American Paradox – those who ate the most saturated fat had the least coronary heart disease – that had the minds of researchers thoroughly boggled.

All those paradoxes work out in “our favor.” Saturated fat gets off pretty much scot-free and omega-6 vegetable oils get raked over the coals (and, presumably, oxidized). And if people were honest about things, they would see these paradoxes not as paradoxes, but as reasons to reevaluate previously-held beliefs about health and diet.

But what about the Asian Paradox? How can Asian countries consume so much white rice and so many noodles and remain so thin? If carbs make you fat, how do they eat so many of them? This is a question I get from Mark’s Daily Apple readers all of the time, so it’s about time I gave a thorough response.

First of all, I want to confirm that Asia eats a lot of rice. It may be a “side dish” or not the main course, but there’s no dancing around the fact that a lot of rice gets eaten – the stats (PDF) are pretty clear on Asian rice consumption. I briefly covered the Asian Paradox in the rice post, but I think the subject deserves more than a brief paragraph. So, today, I’m going to explain why the Asian Paradox (like all “paradoxes,” really) isn’t actually a paradox, and why I consider it to happily coexist with all of the other Primal-friendly paradoxes. I’ll also explain why I think the Asian Paradox offers us Primals a chance to evaluate our own beliefs (because that’s the only honest thing to do).

They Move(d) Frequenty at a Slow Pace

Whenever I’m in a large city with a sizable Asian immigrant population, I notice a different approach to walking. For instance, Carrie and I were recently visiting San Francisco’s Golden Gate Park. We spent the day just walking around and getting sort of lost, and we both noticed the difference. Of all the multitudes of people walking, jogging, and otherwise being active, everyone but the older Asian folks seemed to be actively exercising. Exercising on purpose. Trying to “burn calories” or “improve VO2 max.” We noticed as a young mother with strollered child powerwalked down the path, wearing compression tights, a baseball cap, and the latest running shoes, while the elderly Chinese grandma she passed wore some keds and a knit sweater. Two seemingly identical joggers (one in Vibrams!) with Bluetooth earpieces jabbed at each other with business-speak opposite a pair of old friends strolling along and loudly speaking (in another language) of politics and times long past (again, it was another language) in well-worn suits and loafers. A group of cyclists could have passed for pros with all their gear and advertisements and special cycling shoes, while an older Asian gentleman wearing a collared shirt and slacks cruised by on a simple ten-speed. I got the distinct impression that walking or cycling or just getting around using your own limbs as the vehicles was simply a way to get from here to there for the older Asian folks. It wasn’t a special occasion. It was an everyday occurrence. It was normal. For everyone else, it was exercise. It was a big event that you had to get geared up and spend money for. Exercise is great, and walking with intent of getting healthier is great – I do it all the time. But my observations speak to a huge cultural difference between the way older Asian folks who immigrated over (and, presumably, the cultures back at home) and Americans treat moving frequently at a slow pace.

People living in Asian countries have historically been more active than people living in the States. It’s not that they’re all lifting weights and running sprints and joining gyms; it’s that their average daily activity levels are higher. And as everyone here probably already knows, the simple act of walking on a regular basis does wonders for one’s health. Daily walking is consistently associated with (among other health benefits) improved insulin sensitivity (better tolerance of carbohydrates like white rice), better moodlowered blood pressure and triglycerides, and greater longevity. America is a car country, and has been for about a hundred years. We don’t – and haven’t for over 50 years – have to walk to get around. Heck, oftentimes we can’t walk to get where we want to go even if we wanted to walk, since many of us live in a kind of suburban sprawl that requires the use of cars just to buy groceries or take the kids to school. The result is a country that takes fewer steps per day than the rest of the world. As Asians start buying more cars, relying more on vehicular transportation, and moving further away from labor-intensive work, I suspect you’ll see more carbohydrate intolerance, fat gain, and general ill health begin to emerge. It’s already happening, as you’ll see.

I think daily activity levels are probably the biggest determinant in tolerance to carbs. In American cities where walking is required or more convenient than driving, like New York, people are generally healthier, slimmer, and longer-lived. Things are changing, though. In 1989, 65% of Chinese performed heavy labor on a daily basis. By 2000, that proportion had dropped to 50% – still far more than in Western nations, but the downward trend is clear. You’ll notice on that same page that the proportion of overweight children also increased by the year 2000.

An Otherwise Unprocessed, Nutritious Diet

Traditional Asian food is highly nutritious. Go to a Vietnamese noodle house and the signature dish is pho, a big bowl of homemade beef marrow bone broth, tripe, tendons, brisket, and rice noodles. Go to a real Thai restaurant and get bone broth soup with cubes of pork blood, greens, rice noodles, and a duck egg. Go to a Chinese restaurant and get sauteed (alas, in soybean or corn oil these days) pork kidneys with Chinese broccoli and rice on the side. Go to a Japanese restaurant and get wild caught salmon eggs rolled with seaweed and rice, mackerel sashimi, and some fermented miso soup with kelp strips. Go to Korean barbecue and eat a dozen different kinds of kimchi, grilled short ribs, beef tongue, and liver all wrapped in lettuce, with rice on the side. In all these foods, rice is present, but so are real bone broth, fresh meat, fermented cabbage, offal, and vegetables. The presence of rice does not invalidate or negate the presence of every other nutrient.

Of course, that’s restaurant food. If you want to get an idea of how Asian folks cook at home, go to their supermarkets and note what people are buying. It’s not as fancy or flavorful, but it’s just as nutritious. Stand by the register and you’ll see twenty kinds of whole fish; live oysters, mussels, clams, crabs, snails, and sea urchins; a pig’s entire digestive tract; buckets of chicken feet; bags full of strange leafy green things and exotic vegetables like bitter melon; all sorts of herbs, roots, and teas; fermented, pickled foods; a dozen different kinds of root vegetable; and yes, rice. If you want to isolate the rice from that list of nutrient-dense offerings and say “What about that?” be my guest, but not me. I’ll be admiring the handsome beef foot oozing collagen and marrow and imagining all the wonderful dishes it could make (while I mentally compare the contents of shopping carts in Asian markets to the contents of shopping carts in standard American grocery stores… guess who wins).

Before recently, Asians ate less refined sugar and used animal fats for cooking. Sugar intake is rising now, of course, and cooking oils made from corn and soybean have largely replaced lard and tallow, but rice in the context of a low-sugar, no-HFCS (remember, the oft-cited 55/45 fructose/glucose breakdown for HFCS is highly misleading and actually quite often incorrect), low-vegetable oil, nose-to-tail nutrient-dense diet is (or was) acceptable. You can’t reduce a food down to its constituent parts and focus on, say, the bit of fructose in a blueberry and then condemn the entire berry because of it. Similarly, you can’t reduce a diet down to a single constituent food and condemn – or praise – it based on that single food. You have to look at the entire picture, and the Asian diet is largely a nutritious one.

More Rice, Less Wheat

Thanks to regular monsoons, 90% of the world’s rice production is located in Asia. It’s been cultivated in the region for close to 10,000 years, so the region’s occupants tend to eat a fair amount of the stuff.

Luckily for them, rice, especially white rice (the favored type across most of Asia; as a Thai friend of mine who grew up there and came to Hollywood in the 60s told me, “rice bran was for the chickens”), is a mostly non-toxic source of glucose. On the grain spectrum, where wheat and other gluten grains reside at one end, rice relaxes at the opposite end. It’s not “good,” but it’s also not “bad.” It just is. It’s pretty much neutral. Whether you can handle (or need) the glucose load is another thing, but you can rest assured that white rice will be generally free of gut irritants, phytic acid, and deleterious lectins. If you’re eating wheat, on the other hand, you have gluten, wheat germ agglutinin, and a host of other antinutrients with which to contend. And, as Ned Kock’s masterful (and under-appreciated) series of stats posts on the China study data suggests, rice intake is associated with a reduction in cardiovascular disease while wheat flour intake is associated with an increase in cardiovascular disease. The upper level of rice intake did correlate with a slight increase in CHD, however, but not a major one.

All else being equal, people will be healthier on a rice-heavy junk food diet than on a wheat-heavy junk food diet.

Is Asia Even All That Healthier Anymore?

Healthy, long-lived Asia isn’t so healthy and long-lived. Both China and India are facing diabetes epidemics. In Taiwan, KoreaVietnam, and Thailand, diabetes is also increasing. The perfect storm – of sedentary living, processed junk food full of carbs and bad fats, and poor sleep – that has ravaged America and other industrialized nations for almost a century and led to a host of debilitating illnesses is beginning to descend upon Asia. Cooking oils have displaced traditional animal fats and sugar intake is rising. People walk less and eat more wheat.

Even the low BMIs of Asian countries are misleading. At equal BMIs, Asians generally have more body fat than other groups (PDF). So, on average, the American or the Pacific Islander with a BMI of 25 has less body fat than the Chinese guy with a BMI of 25. It’s not clear whether these higher body fat levels (at lower BMIs) correspond to increased risks for certain diseases, but it does suggest that BMI is an unreliable barometer for a country’s leanness on a particular diet. You can be skinny-fat with a low BMI – and it appears that significant numbers of Asians with low BMIs fit that profile.

So, like every other one before it, the Asian Paradox topples: there is actually no paradox. Asian countries remain lean (if they’re actually lean, that is) on a rice-heavy diet by virtue of lots of low-level aerobic activity to promote insulin sensitivity, lots of nutrient-dense food to go with that rice, and because rice is the least offensive grain.

Any questions? Fire away!

You want comments? We got comments:

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  1. Thank you first of all for thoroughly addressing this topic. It is one I have always wondered about, and up until now have only found small references to it. As an American who lived in Japan until recently, I can attest to overall health through a naturally active lifestyle: walking and bicycles are the most common form of transportation (to and from train stations, of course), and the outdoors is central to living…many homes don’t even have indoor hallways but rather outdoor corridors. They don’t shield themselves from nature, but rather integrate themselves with it. I would also purport that the decrease in health levels as you mentioned at the end is not in fact due to rice consumption but rather due to the increase in fast food restaurant chains and processed food. After all, rice has been consumed in large quantities for centuries, but health has only declined recently, corresponding to an influx in American food influences.
    And, finally, as a family that still cooks Japanese food at home, I am happy to hear that I won’t always have to pass on the rice with our vegetable curry or stir fried veggies.

    Tracey @ Control the Chaos wrote on February 1st, 2012
    • I agree with you.
      I love my rice, my walks, love nature, and love simple cooking too.
      I experienced the abuse of eating too much fast foods in the past and suffered with unhealthy physical condition. Then changed back to my old ways of eathing more natural plus rice of course. Now, I am back to healthy again, lost the extra weight I gained thru six years of bad eating.
      Now, I designed my house sorroundings as if I lived in a farm where I used to live….this means, no fast or junk foods, processed or canned foods store in pantry or fridge.
      I snack on fruits, steamed yams, roots, seeds, and coconuts! My real view of true fast foods are FRUITs…just peel and eat it.
      Thank you for reading.

      Talusan wrote on July 10th, 2012
      • Talusan, you are amazing! Thank you for sharing your past and your present!

        Ella McJ wrote on September 8th, 2012
  2. I was just flipping through a UK dept of health booklet on diabetes looking at risk factors. Being 45 and over for European people but 25 and over for Asian people was mentioned.

    They also mentioned that eating too much sugar is a myth it is overweight that’s the problem…sooo I don’t know if I can trust ‘em.

    Living in NZ we have plenty of Asian people, and I’m surprised at how often I see lovely thin young Asian girls sitting down with only a steak and green salad or even sipping on a bottle of cream.

    Marielize wrote on February 1st, 2012
  3. I’ve read somewhere in a medical book that Asians have genetically larger Pancreas than any other race on this planet.

    Arty wrote on February 1st, 2012
    • Yes, and Inuits have larger livers as a result of their long time traditional diets. And, I don’t mean unhealthy, enlarged livers just more robust livers.

      rarebird wrote on February 1st, 2012
  4. I think this speaks to the whole idea of “refuting” a dietary hypothesis by pointing to a population that appears to contradict it.

    I don’t think anyone on this board would say that the Standard American Diet is a healthy one, but the fact is that there are a significant number of people who apparently thrive on it. That doesn’t mean there’s a “SAD Paradox”, it just means that there can be significant differences among individuals, and groups of individuals, that allow them more dietary leeway than the rest of us.

    Sam Knox wrote on February 1st, 2012
    • I am totally on board with “individual differences” – always have been. Doing non-normative research isn’t always (ever?) easy but it is valuable.

      Yes, and some people smoke cigarettes into their 90’s with relative impunity, too. Doesn’t mean that cigarettes are heathy – but there we are.

      My husband’s grandmother recently passed away at the age of 102. She regularly smoked cigarettes her entire adult life. She ate SAD, plus Southern fried foods. She never “exercised”. And, she lived in a heavily polluted environment.

      She was wiry, active, and didn’t start to need any extra care from family until shortly before her death. She lived independently until then. She DID develop emphysema but not until her 90’s. She DID develop arthritis in her hands about the same time. Neither issues slowed her down much.

      Go figure.

      rarebird wrote on February 1st, 2012
  5. The cooking oils most used in China today are rape seed oil and peanut oil (for more affluent kitchens). Rape seed oil is the precursor to canola oil, developed by Canadian scientists to lessen the plant toxins in rape seed oil. Hard to know when they started this switch over to vegetable oils. Rape seed oil was used in the West as a machine oil in the 19th century and was considered unfit for human consumption until they figured out a way to purify it. Prior to that people used lard. The switch was probably made for economic reasons rather than a public health initiative as in the West.

    Ann wrote on February 1st, 2012
  6. Of all the cereal grains that I gave up for the sake of PB, rice is the only one I still eat periodically; I eat sushi once a week and if I go out for Asian food will have a little bit with my meal. In my case it is the only cereal grain that doesn’t cause significant gut issues.

    Mary wrote on February 1st, 2012
  7. I just came back from Thailand. Training twice a day, I decided to put oatmeal, rice, and noodles back in my diet, (also took coffee out). After 4 weeks I had belly fat creeping over my waistband. I eliminated the grains, added the coffee back, and in 2 weeks, the fat was gone! BTW, you will see plenty of “chubby” folks in Asia!

    Bill Berry wrote on February 1st, 2012
    • Think – Happy Buddha…..

      rarebird wrote on February 1st, 2012
      • Buddha’s teaching is awesome!

        Talusan wrote on July 10th, 2012
  8. I completely agree with this article. I also agree with Keoni Galt’s comment – although I am still exploring the issue about rice bran being an anti-nutrient and white rice being a better form. There are other options – like American bred and raised light brown basmati.

    As always, the bottom line is how our own bodies responds – and as Keoni Galt and others here point out that response can change over time and changing bodies/circumstances. I, too, am following the practice of glucose monitoring. I believe – at this point – that I am benefitting from eliminating oats and the little bit of rice that I ate pre-primal – had already eliminated ALL gluten foods months before on general principles.

    When I have normalized my body composition and health in general, I may add back a few foods like rice – but always accompanied by glucose monitoring and the trusty old tape measure for measuring the waist. Evidently, waist circumference is now considered a stand alone risk factor for cardiovascular disease.

    rarebird wrote on February 1st, 2012
  9. I’ve noticed that the Asian diet barely contains any dairy or dairy products. So two of the most common food intolerances are generally avoided – wheat and dairy.

    Lisa wrote on February 1st, 2012
  10. Thank you for dispelling the myth that Asians eat endless bowls of rice.
    My mother is Korean and she was always curbing our rice intake, let alone the Western carbs. We never had sugar, fruit juices, cereals, ice cream, cookies, etc.
    Your article made me hungry for Korean food again!

    lisa wrote on February 1st, 2012
  11. I loved to hear Mark’s comments on the way the older folks in GG park were “exercising”. I have never been into exercising for the sake of it, though I walk my dogs every day and walk or ride my bike to do errands. When I switched to 80% paleo diet I lost 22 pounds in about 6 months w/o changing my exercise.

    In January my husband and I switched to 100% paleo and started doing some light work outs, I’ve lost another 5 pounds. I wasn’t doing it to loose weight, I wanted to gain strength and support my husband who is trying to loose weight. But the benifits of the paleo diet, go beyond weight loss, I sleep better than I ever have and have so much more energy. I feel stronger than I did 10 years ago and at 51 that is saying something.

    Patty wrote on February 1st, 2012
    • Yes, me too! I bought a new bike last year – and got an old school, minimalist “cruiser” type. My 90 yo neighbor and I go for leisurely spins around the neighborhood. Life is good :-).

      rarebird wrote on February 1st, 2012
  12. Except that obesity is but one expression of poor glucose control and insulin resistance, which Asians have plenty of. People stuck on just “obesity” is missing the big picture.

    js290 wrote on February 1st, 2012
    • True. I am not obese and not diabetic. I am overweight and my triglycerides are elevating. According to current ADA guidelines, and my doctor, I have healthy glucose levels. BUT, according to my own body and my research, confirmed via glucose monitoring at home, I am developing dysglycemia. I am heading potential health crisis off at the pass and getting my body normalized now.

      rarebird wrote on February 1st, 2012
  13. when was rice cultivated in Asia? i think it’s < 10k years?

    When i visited family in Taiwan, i noticed there were a lot of _elderly_ in the parks, early in morning, exercising (Tai-chi, sword, or dance, walking) or socializing.

    i stayed in a small residence hotel that offered continental breakfast, it was made every morning.

    it was not gourmet food, tasted very homey. there was always white rice (in various form), egg, meat, some sauteed veg, salad, fruit, bread, small desserts, milk, soy milk (plain, & very _beany_), coffee, toast.

    so for a month, i had THREE FULL HEARTY MEALS almost everyday. & my bowl movement was so regular. (oh, there was plenty of squatting toilets too, LOL)

    people like to sit down to eat there. even for busy working people, lunch break was a big thing. they don't like grabbing a "quick bite" for lunch.

    btw, my grandma cooked w/ lard; (white) rice porridge cooked in broth + egg + salt is what she'd feed us after a diarrhea. in our family a meal has to have rice, meat, veg. fruit is served @ the end as dessert.

    but i'm sure most switched to "heart healthy" seed oil there now.

    despite having hearty meals everyday (probably cooked in inferior fats), i never once had sugar cravings, i also lost a little weight.

    this was before i switched my diet.
    but it was my first revelation that why they appear to eat more heartily & weigh less.

    sadly things are changing in Asia too.

    regards,

    PHK wrote on February 1st, 2012
  14. I eat white rice regularly – so shoot me! I probably eat a small amount once or twice a week. I started doing this a couple of months ago on the direction of my naturopath (who is primal). He felt my diet was too low-carb and had caused a big stall on my weight-loss journey. Low & behold, when I started adding in more healthy carbs (like white rice, sweet potatoes, white/yellow potatoes and other starchy veggies), I started losing weight again after many many months of not losing a thing. White rice is the only grain I eat, and I do eat it in small amounts.

    Alice wrote on February 1st, 2012
    • I hear you right, I love rice along with vegestable cooked in coconut milk plus water/garlic/onions/ginger/tomato/sea salt and put some fish meats. Love to sip hot broth. I love this kind of food to eat following a very physical, sweating, and long hard work in the farm or garden. Men, love this food!

      Thank you for reading.

      Talusan wrote on July 10th, 2012
  15. Makes good sense. Now I’ll have good response for the “what about Asians and rice?” question. :-)

    Susan Alexander wrote on February 1st, 2012
  16. Good post Mark, I love me some basmati white rice myself. As mentioned, it is neutral, but can be made nutritious if you add some coconut milk or beef tallow to it. I personally think rice is also great with seaweed in it. And if everything else in the diet is wonderfully nutritious than have some neutral starch that makes the diet a whole lot more enjoyable isn’t going to hurt. This is pretty much the Perfect Health Diet’s claim to fame (don’t get me wrong though, I love that entire book), and I completely agree with them.

    Jeff wrote on February 1st, 2012
  17. So an excess of 150 grams of carbohydrates per day doesn’t necessarily mean insidious weight gain ( and you don’t even have to be a marathon runner or even a runner for this to be true).

    Alex wrote on February 1st, 2012
  18. The reality is that rice is not as evil as some primal/paleo practitioners like to think.

    I want to reiterate the note about nutrition density. Asian meals are generally very nutritious and varied. Growing up, our dinners always consisted of 2-3 different dishes. Soups, stews, grilled meats, stir fried, steamed, etc. The “restaurant” experience was everyday life. Vegetables were always part of the dish itself, instead of something off to the side. One didn’t make a conscious effort to eat vegetables–they were just there. Asian cultures also feature a lot of stews and soups with nutritious hearty broths. Soups as a meal doesn’t really exist in the American diet.

    And we really don’t eat that much rice. Sure, more than the typical American, but we’re not gorging ourselves. A small amount of rice goes a long way in filling you up. Serving sizes for meals are much smaller than American portions.

    Asians also typically don’t chronically snack like Americans tend to do. There are three meals and that’s it. A snack is a true treat.

    jinushaun wrote on February 1st, 2012
    • I’ve heard paleo/primal people more refer to rice with a “why bother?” than decry it as evil, but I get your point.

      I’m in the “why bother?” most of the time. It’s just not all that interesting a food.

      Nick W. wrote on February 2nd, 2012
  19. History of rice:

    Considered the oldest cultivated grain in the world – dating back to 2500 BC – meaning that its been around about 4,600 years. Origin in China.

    http://www.duke.edu/web/soc142/team3/Group%20Rice/History.htm

    http://www-plb.ucdavis.edu/labs/rost/Rice/introduction/intro.html

    http://www.cambridge.org/us/books/kiple/rice.htm

    rarebird wrote on February 1st, 2012
  20. We eat rice, never stopped. It’s cheap and a great filler. Me and my kids get smaller portions of rice but my insulin sensitive husband gets as much as he wants(he has a very active job). I love rice!

    Katie wrote on February 1st, 2012
  21. I also lived in Korea for a wint season, (DoD civilian) I loved being among the locals and eating as they do. I wish I had known what I know now about food and would never bought a rice cooker. I remember washing the rice etc, I bought from the local markets then as well most of my food. I also bought from the PX but I had a great landlady who showed me many great recipes etc. I practically lived off of kimchi and rice and occasionally bulgolgi etc. I hoped I would lose some weight then (I was 20 then) and never lost a pound. Everyone said it was because it was winter, I don’t deal with cold, all the myths. Now I understand I had a low tolerance for the carb load I was ingesting even as I ate about the same the locals who were seemingly slimmer than me. Even then fast food was becoming more common in such places as Soeul, but not yet in the smaller towns where I was. I never even missed the dairy. All the meat still was grassfed local meat even on the base.

    Tamara wrote on February 1st, 2012
  22. I’ve just come back from living in China (Yunan Province) for 2 years. I went primal one year ago, following my wife who is a big MDA fan. My observations from eating with Chinese friends and family are as follows:
    1) In cities, rice is seen as a filler at the end of the meal and served in small amounts (if at all). In the very poor rural areas, rice forms a much larger part of the meal, with vegetables – less-so meat.
    2) Eating with chopsticks from small bowls (even when brought up to the mouth) means that people fill up faster without putting away large portion sizes as we do in the West.
    3) It is virtually impossible to buy meat without bones in the local wet markets. They also eat every part of the animal. A skinless, boneless chicken breast is considered the worse cut of chicken in China.
    4) Although the older and poorer people still use lard to cook, in the cities, industrialised oils are pervasive.
    5) Every time I visited Shanghai or Beijing and popped into a Macdonalds to use the bathroom (believe me you do go out of your way to find these!), I would be astounded at the number of fat teenage Chinese in there – grotesque!
    6) Chinese historically ate very little dairy. I don’t know if there is a link, but rates of breast cancer in China (1 in 10,000) are quite a bit lower than the 1in 10 in the West…except for those Chinese who emigrate to the West and eat/drink dairy and have the same ratio. Makes you think though!

    marcopolo wrote on February 1st, 2012
  23. I just had an anthropometric lab last week where we calculated our “frame size”. Almost everyone in the class is of European descent and almost everyone classified as a “medium” frame size. I have to wonder if Asians, in general, calculate as “small” frame size.

    Emily Mekeel wrote on February 1st, 2012
  24. Like you Mark, I too dabble in the art of ‘park observation’ (not in a creepy way:) but the people at my park are far less interesting (and far less…Asian)haha
    Good points in regard to the the balance between rice and the other nutrient-rich foods Asians eat.I think we health and well being enthusiasts can be guilty of throwing the baby out with the bath water at times rather than looking at the whole picture,so well done.

    Isaac wrote on February 1st, 2012
  25. Spent a fair amount of time working in Asia and Japan. There is a lot rice served, but eaten in small servings. Rice seemed to be used mostly as a bed to serve all the good bits on. I would always eat all the rice and ask for more, which seemed weird as I would be only one doing that. In China, it seemed that all parts (head to tail) of the pig, cow, chicken, or duck was used. One rarely saw a actual steak or pork chop. Peking duck is just that, a whole roasted duck, head and feet included. More lit bits of this and that. Lots of “other” meats included snake, frog (paddy chicken), eel, snails, etc. Most of these were brought to the table live, on ordering, so you could verify that indeed they were fresh. Different regions have different specialties. Since going primal, have been jonesing for the pork fatback served in Taiwan. Imagine a 2″ piece of fat, with a thin layer of meat. Not sure how it was actually cooked, but the fat would melt in your mouth. This was served on top of a small bowl of rice, to soak up the juice and nibble on.
    As far as exercise, Mark is totally spot on. In Bejing, at the Temple of Heaven, you see folks walking backwards slowly, usually over the uneven bricks that accented the main promenade, maybe a mile long. Parks and public spaces had stretches of walk ways with large pebbles sunk in the concrete. People would walk over these barefoot, free reflexology. Lots of cheap bikes everywhere and used for hauling pretty big loads also. Once saw a old man, maybe in his 70’s with a 3 wheeler and a full load of coal brick in the back (bed was about the size of a small pick up) A lot of bikes getting pushed out by mopeds though, all across Asia. Lots of manual labor in the large construction projects. You would see like 5 guys carrying a large bundle of 20′ pieces of re-bar. Tractors and back hoes were used, but there were armies of guys with picks and shovels too. There were so many small things that you would observe. They are making a lot more sense to me now.

    Meegeek wrote on February 1st, 2012
  26. anyone who thinks there is a paradox needs their head read. This article is not one of your best Mark, playing to simple observation studies. Some of the highest rates of diabetes in the world and fastest growing are asian countries. Having spent the last 9 months in asia i can safely say, there is no paradox.

    Dan wrote on February 1st, 2012
    • Agreed. This post is pretty terrible, in that it is mainly observational and anecdotal in nature. I see people in the park so….

      I’ve lived in Asia. While rice is present at meals, it isn’t typically eaten in large quantities, not by western standards. This could be a long post but i don’t have the time.

      Anyways, the question is would Asians be healthier if they didn’t eat rice?

      pete smith wrote on February 1st, 2012
  27. Hey I’m Asian and I don’t eat a lot of rice. Just kidding.

    My family actually eats a lot of brown of rice which is better I guess, but in general, the majority of Asian dishes are rice or noodle centric.

    But they also use a lot veggies and lean meats as well.

    Keith wrote on February 1st, 2012
  28. Portion Size & Slow Exercise:
    Ive just returned from Thailand – and every time im there, im always reminded by how small their portions are.
    Im tall/skinny, but can easily down 2 or 3 mains at a ‘local’ thai eatery.
    When i travel to the US, i struggle thru a single main course at a local restaurant.

    And due to the sheer number of people, everyone walks/trains/buses to work/school etc…

    Glen wrote on February 1st, 2012
  29. Its only a paradox if you buy the silly notion that carb consumption leads to “insidious weight gain”. You’re a genius yo.

    In wrote on February 1st, 2012
  30. Monsanto and McDonalds will snuff out this paradox soon enough. Asians can get just as fat on SAD as anyone. My fat nephews and nieces (Thai) can attest to that.

    Ron D wrote on February 1st, 2012
  31. As an Asian, I’m quite proud of this informative article. My parents said when they were young & poor, they survived with only rice & kimchi. They were still very active, working the entire day out in the rice field, etc. But like you mention, our diet and lifestyle are changing rapidly, so as the percentage of overweight people. Very unfortunate, indeed.

    Stephanie wrote on February 1st, 2012
  32. Are you still against white rice in reasonably small quantities as a source of glucose calories? I know root vegetables like sweet potatoes are more nutritious, but white rice isn’t inherently bad.

    Josh Frey wrote on February 1st, 2012
    • I believe Mark said it was okay, since it doesn’t contain the same inflammatory compounds as other grains.

      Reiko wrote on February 1st, 2012
      • Where did you see/hear that from Mark?

        In the 21 day transformation book rice is listed in the purge the pantry section with the other grains:

        “Cereal, corn, pasta, rice and wheat:….”pg 91

        And in the PB book he says “Grains – wheat, rice, corn, bread, cereal, pasta, etc. “Worst mistake in the history of the human race.””pg 2

        rarebird wrote on February 1st, 2012
        • That “worst mistake” is a quote from an anthropologist that has implications beyond dietary. Mark has written on article on this site talking about how white rice is not so bad. Like, if you’re going to go for a grain, might as well be that.

          Nick W. wrote on February 2nd, 2012
        • Yes, Nick W. I saw the reference in the book to Jared Diamond – with regard to that statement. Diamond is an evolutionary biologist not an anthropologist. And, while Diamond’s argument IS much broader than diet, in Mark’s book the entire context in which he made that quote was regarding diet.

          What I am saying is that Mark’s books place rice solidly in the same category as other grains – with specific reference to dietary issues in general. The discussions I am referring to in his books are not made with regard to specific issues like gluten intolerance but to more general issues like insulin resistance.

          That said, I will search the blog to see else he may have said here about rice.

          rarebird wrote on February 2nd, 2012
    • What’s the point of eating something that doesn’t give you much nutrients when you can fill that space with some nutrient dense stuff like meat or veg.

      White rice are mostly polished and that removes even more nutrients.

      I can eat meat/veg by itself but no way i can down rice by itself without any side dish.

      Ong wrote on February 1st, 2012
  33. The thing that struck me most about this article was his discussion of the American car culture. As an EMT, I see the effects of our sedentary ways on a daily basis especially among the 40 to 60 age group.

    Surprisingly, the over 60 crowd seems to be doing things the way they’ve always done them; long walks or bike rides with the intent to accomplish some errands and they are all the more healthy for it. The 40 to 60 year olds hop in the car to pick up something from the store only a few blocks away and spend most of their time in front of the TV or computer only to lament that they get out of breath just walking up a flight of stairs.

    And, in retrospect, I am disappointed in just how sedentary I’ve become. My day is filled with short spurts of intense activity followed by long intervals of sitting in the ambulance eating junk.

    Rand wrote on February 1st, 2012
  34. I’m from Sweden, but have spent 6 of the last 8 years living in Vietnam. Part of that time I’ve spent teaching English to children and adults. Based on my observations of middle-class childrearing here, I predict an urban obesity epidemic within the next 10 years. Being fat, or at least chubby, is still considered healthy here, signaling that you come from a rich family. Consequently, parents have no qualms about buying their kids little mini-bags of potato chips, accompanied by mini-packs of sweetened milk with various flavors. Of 30 or so yoghurt brands, 2 are unsweetened, and all are sold in mini-containers. Everything is optimized for parents to be able to give their kids a quick sugarfix wherever they demand it. In many of my classes I’ve had obese children (often with probable blood sugar-related behavioral issues) with literally rotting teeth. Again, these are not poor children, but children whose parents either have never learned to say no, or who are unaware of the damage they are doing to their kids. While working as the class teacher for a group of Korean 6-year-olds at an international kindergarten, I had to implore parents in the weekly newsletter not to let their kids bring soft drinks, candy and chips into the classroom, and it wasn’t rare for an over-“caring” mother to drop in with a bag full of insanely sweetened birds nest drinks for the whole class. This is still such a new phenomenon (Vietnam’s middle class having grown enormously in the last 10 years) that only the kids who are genetically predisposed to early insulin resistance (presumably) are currently obese. But as this generation grows older, unless their dietary habits change, there will likely be many who succumb to obesity later in life. Another problems is that massive advertising of brands like Chin-Su, sauces and condiments packed with more additives (especially MSG), colorants and preservatives than I’ve seen in any product, have made them the stock of homes and restaurants. The nearest supermarket now carries ONE brand of unadulterated fish sauce. I could go on and on…

    Henrik wrote on February 1st, 2012
    • Bit of a correction: For Vietnamese boys/men chubbiness is considered good. For girls, slim is the ideal. (actually a healthy slim, it is very common for Vietnamese girls to encourage friends to eat more to gain some weight if they look too skinny).

      Henrik wrote on February 1st, 2012
  35. I have been awaiting this article for a long, long time! Thanks Mark!!

    Félix wrote on February 1st, 2012
  36. I’m Chinese and growing up, I was always told not to eat much of the rice. Most of our home cooked meals consisted of 2 meats 1 vegetable dish and a soup which usually has more meat and vegetables. If we ate more than a small bowl of rice, we would be called “rice trash cans”!

    Sandra wrote on February 1st, 2012
  37. Asians acknowledge that rice and wheat products are fillers, and pretty much never order them when having a family feast. Instead, we order whole animals, like fish, crab, and duck. The exceptions are:
    – For Lunar New Year’s, we eat fried egg rolls because they look like gold bars. They signify wealth.
    – For birthdays (or new year’s), we eat noodles because they signify long life.
    We still order animals and vegetables, though. They make up the majority of the meal.

    Also, when people get sick, they are to eat Xi Fan (rice porridge) for energy. As they get well, they can add dried shredded pork, pickled cucumbers, and raw peanuts to the porridge. This technique works really well for me, because I can’t stomach fatty foods when I’m sick. Inert, carb-rich foods like white rice is perfect.

    Reiko wrote on February 1st, 2012
    • I miss my dried pork, and pickled Japanese cucumers… damn!

      Jason Sandeman wrote on February 1st, 2012
    • Hello Reiko! I am curious as to why you are talking about Chinese food, when your name leads me to believe you are Japanese. Are coming from a Japanese or a Chinese perspective?

      Eric wrote on May 2nd, 2012
  38. Great post! This has actually answer a lot of questions I had about rice intake in Asian countries.

    Michelle wrote on February 1st, 2012
  39. I am from Singapore and can assure u that obesity rates in the country is definitely rising.
    One of the saving point for us is that our cars are expensive and this forces most people to use public transport and where walking is essential to get you from point to point.

    Regardless, there is plenty of food cheaply available in Singapore hawker centers that is flour-centric and lots of cheap vegetable oils.
    1 meal cost about US$2-4 in the hawker centers and mostly nutrient deficient.

    Ong wrote on February 1st, 2012
  40. my hypothesis is that they are not just thin, they’re rake thin, and they are short. They are collectively suffering from generations of malnourishment. And that malnourishment comes from eating too much rice. It’s the epigenetics.

    wozza wrote on February 1st, 2012

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