Marks Daily Apple
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1 Feb

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

How 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:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Take a look at rice farmers in China. They are not fat at all.

    Rice farming is very hard work.

    Peter wrote on February 16th, 2012
  2. Rice doesn’t make you fat, excessive calories does. Plain and simple. I don’t know a lot about the science behind carbohydrates in regards to fat storage and to be quite frank, I don’t care. I think the negative reputation of carbohydrates has been hugely blown out of proportion. I’m saying this from personal experience. I grew up in a very traditional Asian family and white rice was eaten 2-3 times a day. If i had to estimate how many grams of carbs I get in a day from rice alone, I’d say around 150. I don’t remember a day that has gone by that I did not eat at least a serving of rice. As far as physical activity goes, playing basketball on weekend was as strenuous as it got for me. Am I overweight? Not even close. None of my siblings are either.

    Russel Lee wrote on February 20th, 2012
  3. The “Asian Paradox” refers to the low rates of cardiovascular disease and cancer in Asian countries despite high rates of smoking. Your definition is different than what I was searching for. Maybe you could call yours the “Asian Obesity Rice Paradox”?

    Rex wrote on February 29th, 2012
  4. The Asian paradox is interesting, and some parts are historically even more fascinating. Beyond Buddhist vegetarianis,, Certain Taoists, many of them mountain recluses,poets, sages and herbalists followed a variety of diets. the small book Immortal Sisters, by Thomas Cleary, is about the female practitioners of this lifestyle. I doubt they ate meat, although they may have eaten grubs or something if starving, but they did eat a LOT of mushrooms,tubers and leafy greens, and AVOIDED ALL GRAINS, claiming that it extended life and helped clear the mind for meditation and spiritual exercises.

    These are the same folks who invented Chinese physical therapies and the martial arts to defend against invading bad guys, so there must have been good reason for it all.)

    Elsie Harrington wrote on March 3rd, 2012
  5. Yet another proof that Asians are not immune to the effects of rice:

    http://ca.news.yahoo.com/white-rice-seen-type-2-diabetes-says-study-233837784.html

    White rice linked to type 2 diabetes.

    Pete wrote on March 15th, 2012
  6. Cool coffee graphic…unfortunately, though, caffeine can cause magnesium deficiency, and it reduces appetite! I’m trying to restore my appetite and replacing coffee with chicory in the morning has helped! Though I suppose the effect varies from person to person, some don’t get affected that way by coffee.

    Milla wrote on April 2nd, 2012
  7. I live in Japan for 17 years, I think Mark is right, they move a lot. I would walk to the train station then from the station to work. My wife rode her bike to work every day. When we went out to drink or eat usually we rode out bikes. I think that Japanese get a lot more natural exercise.

    Also the sugar use is a lot lower. Most people I know drink ice tea with no sugar instead of soft drinks.

    My family did eat lots of rice but a lot of other very healthy food. At home we did not fry a lot or eat processed food much. This is changing in Japan. There are fast food shops everywhere and more and more people are eating bread and processed food. The obesity rate in Japan is going up but not near as fast as the US.

    I think that the traditional lifestyle in Japan naturally included two of the primal key elements, move a lot and very low sugar.

    Since moving back to the US and driving everywhere and eating out I gained 20 pounds. Hopefully getting back to a more primal way of life will help with that.

    Davew wrote on April 4th, 2012
  8. in 2001, I went to the Cape Verde Islands for 45 days..staple diet? Rice. Little meat but lots of rice. I came back 20 pounds lighter. I noticed how much rice everyone ate at every sitting, but how slim everyone was. Of course, they walked everywhere as well. Long roads, steep hills. Long slow walks. Every time I run into articles in favor of what I term “third world diets,” I definitely give kudos:)

    sonia wrote on April 12th, 2012
  9. Do you think it’s possible that the way Asians prepare the rice white before cooking it has anything to do with it? I lived in Okinawa, Japan for 3 years and while there, learned the proper way to prepare rice. The Japanese people soak their rice for at least an hour in a non-metallic bowl and wash the grains by rubbing them between their fingers until the rice turns pearly white. It is then drained and all the excess starch is rinsed away. It is only then is the rice suitable for cooking.

    Leah wrote on May 7th, 2012
  10. Huh? You went to a park and saw Asians jogging and concluded that this is the reason why they are not obese despite high carb diet? Really? That’s it?

    Lazar wrote on June 10th, 2012
  11. …and this makes me feel really good about all the rice I’ve been eating. Goodbye, wheat bread!

    Thomas Frank wrote on June 11th, 2012
  12. Let’s not forget that in general, Asians eat small amounts compared to the Standard American Diet, even if they may eat rice and/or noodles a lot. Couple that with walking a lot and voila, thin people!

    Edward Brown wrote on June 15th, 2012
  13. Good article, I am slender and I was gainning weight when I left rice and was eating whole wheat bread, whole wheat cookies, etc. However, recently I changed, I stopped every consumption of bread, except casabi (no gluten) and I eat my white rice everyday (I excersise several days a week with Jillian Michaels videos)and I can say, I am not gainning weight and I am loosing it easier.

    Rebeca wrote on June 27th, 2012
  14. You can’t eat too much carbs, you just pee themn out. The problem arises when you eat too much fat.

    I eat loads of rice and I’m not fat or asian lol. I just cut the fat out.

    Read the china study it’s great.

    Charlie wrote on August 11th, 2012
  15. I am asian 5’2 size 0/2 and I eat a lot of rice 2mugs of rice/meal (breakfast, lunch and dinner) thats about 6-8 mugs of rice/day which normal for us asians. Rice is the main dish, everything else is just a sider!
    but we also eat a lot of fruits as opposed to chocolates or ice cream or puddings. We prefer water or fruit juice as opposed to coca cola or coffee. we are not a “bread” or “potato” lovers. Sandwich is not something we prefer to eat. Not too many asians eat sandwiches. In Asia, specially southeast, everything is served with rice. We cannot live without rice.

    The only fat asians you see are the ones you see at mcdonalds, KFC, starbucks etc…

    So stop eating junk =)

    Lisa wrote on August 15th, 2012
  16. My wife is Japanese, and I have visited her family several times (Kagoshima- Southern part of Japan), as well as made several trips there while in the Navy. The Japanese DO eat rice with complete ferocity. An interesting note, however, is that traditional Japanese wisdom shared with me by my Japanese mother in-law is that a reduction in the amount of daily rice intake is how a Japanese person used to lose weight. They figured the correlation of high rice intake to bigger guts a long time ago.

    Now-a-days, this wisdom is lost in the fight to reduce sugar intake (found in abundance within the beverage machines located on every corner in the whole country). My mother in-law did leave me with one piece of marvelous advice, this after visiting her mother who is 102 yrs old. The advice was to eat what you want, the healthy stuff first, and be sure to include at least 30 (yes thirty) different whole foods into your diet every day. I found out this was significantly harder than it sounded. By whole foods, she was referring to veggies, fruits, and meats.

    AUCARK wrote on August 16th, 2012
  17. I eat primal + white rice for every meal, and in my rice I always mix 1 tsp of butter for flavour. An interesting thing happens however if I don’t put the butter in, I become ravenous within a few hours and have an almost uncontrollable desire to eat sweets. I started to remove the butter in an attempt to lower my fat intake, but I don’t that now.

    By eating this way, I have watched a very slow but progressive loss of weight. I estimate about 200g of weight loss per week. If I add a bit of rye bread the loss is much slower but it does go (3 thin slices per day, and this particular bread is 100% organic, stone ground etc … you could call it primal bread)

    An interesting thing happened when I added instead, normal white bread however. My weight loss stalled, and after a week I began to gain the weight again.

    I’m back to primal + rice and I feel awesome again, and I’m back to slowly losing the weight.

    Roxie

    Roxie wrote on September 11th, 2012
  18. Thank you a bunch for sharing this with all people you really recognise what you’re speaking approximately! Bookmarked. Please also talk over with my site =). We will have a link change contract among us

    dating chinese men wrote on September 13th, 2012
  19. Simple!!! Excess calories make u fat. Carbs, protein, or fats. Doesn’t matter! Excess calories are the only thing that matter. In the Philippines I know people who only eat fast food but stay thing because they have low total calorie intakes. Calories are KING!!

    Chris wrote on September 14th, 2012
  20. Brown rice is pricier because they grow bugs faster, just like white flour stores for longer.

    I am Thai. People don’t really eat that much rice (or food for that fact), especially ones that live in the city. There’s still the negative cultural connotation of gluttony flying around. The ones outside of the city that do labor works do eat a lot.

    We get more diabetes and lifestyle related diseases because we move less, foods became easier to get, and the exercise sciences/exercise professionals are not as prevalent (haven’t caught up) with all the junks in the diet. Maybe the higher fat in the body also correlates with the fact that we do more endurance work in general.

    And it’s true that an average Asian grocery cart is way better than an average non-Asian. My cultural background makes me think sandwiches, mac & cheese and boxed stuff are depressing. I would much rather have a steamed fish and rice any day. lol.

    Natcha Maithai wrote on September 18th, 2012
  21. Honestly, I’d contend that they actually don’t eat all that much more grain than we do in the US. As near as I can tell (according to my data, though I’d like to do a little more research before saying this conclusively or citing sources), people in the US consume 300g or so of grains per day on average. Compare that to China’s 250g or so of rice (admittedly, this doesn’t include other grains, but rice is to China as wheat is to the US, so I doubt it would rise over 300g).

    CocoaNutCakery wrote on October 14th, 2012
  22. i have seen and lived in developed asian countries and still dont see obesity.
    Even with cars asians are more active.

    djeu wrote on November 12th, 2012
  23. How about embryo rice?

    Do you have any figure abt enmbryo rice ?
    Asian starting to eat embryo rice.

    Erice wrote on November 13th, 2012
  24. racists…

    Steve French wrote on November 14th, 2012
  25. I was just wondering if all that rice is eaten with alot of oils, meat veggies, it has been shown that adding fat, veggies (fiber) and meat lowers the gi of the rice, which translates it into a low carb food,simply because it is not low carb in the stomach but low carb in the blood stream trickles in a little at a time avoiding glycation, depletion of nutrients in handling it, and oh yea forgot, they get more unprotected sun exposure, vitd and other fat soluable vitamins have been show to reduce the need for body fat, body fat is a storage not just caloires but cholesterol and vitamins and calcium that you need when you run short so much, it is a protection from times you don’t eat enough cholesterol sulfer, fat soluable vita/min and get enough unprotected sun exposure. I have been following a low carb (75 percent plant based) I just love my milk to much to not drink at least a glass a day, and a little meat, and of course I can’t avoid using egges in my low carb meals/desserts I make. eggs have choline, vita a, sulfer, cholesterol, omega 3, so I won’t stop eating them, my caloiric load seems to flutate daily as some days I am more hungry then others, and yes I am losing weight, can’t believe it but I am. I do not set a caloire maximum, just a caloiric minimum. following now for two months, and my energy is going up, I have a spring in my step, my ankles don’t hurt anymore when I walk/jog, or on my feet for long periods, my clothes are looser and cravings for junky foods gone, I don’t limite fruits, or veggies or even beans, I just make sure to fill up alot on coconut oil or real butter and some meat in my meals too, that way the amount of carb is controlled not rushing into my blood stream.

    roberta wrote on December 4th, 2012
  26. I don’t believe that anyone has mentioned the disparity in intestine length between Japanese and Europeans. Here is a quote from an interesting essay about the topic. He mentions that intestinal length is variable, and that people with meat-based diets tend to have shorter, stiffer intestines than people with plant-based diets:

    “Consulting a German anatomy textbook, Dr. Scheube learned that intestines in Europeans were typically between 800 and 900 centimeters long. To test his ‘surmise,’ he gathered measurements on the intestines of 26 Japanese corpses aged between 17 and 60 from a Japanese hospital. Of the combined data set, he wrote, ‘The 26 cases give a length of intestine of 953.7 cm. The maximum was 1203, the minimum 667; only 3 times the intestine was below 800…Accordingly, even the absolute length of the intestine is greater in the Japanese than in the European.’

    The difference was even more pronounced when Dr. Scheube accounted for the fact that Europeans were, on average, 11 centimeters taller than Japanese people. Relative to body length, he found that Japanese intestines were 20 percent longer. He cautioned, however, that 26 intestines were not a lot to go on.”

    http://www.biguglyreview.com/body/nonfiction_andy_raskin.html

    Anna wrote on January 16th, 2013
  27. i’m Asian, yes we’re skinny hahaha suck on it!

    asiaperson wrote on January 27th, 2013
  28. hurrah , we have finally established the reason rice is and has been dominating food in numerous Asian countries. Thank you *nods in appreciation*

    asiaperson wrote on January 27th, 2013

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