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. War/conflict and rice? I don’t get it but coming back to the rice topic I’d like to say that after talking to a friend who originates for Okinawa Japan and researching “authentic” foods (not all Asian recipes are authentic) over the past few years I have to say I agree with a lot of what you said in your post. They mash cooked rice into Mochi and fill it with sweet red bean paste, taro paste, or yam paste for a sweet. I don’t know about you but it’s hard to find a dessert or sweet here in the USA that doesn’t contain a large amount of highly processed ingredients. Even if they are made at home!
    I won’t say we eat exactly like Asians do but we love the food and I try to be as authentic as possible. Chicken feet, fish heads, tongue, intestines, and things of that nature do not sound appealing to myself or family. Fish with head on is not happening either but fresh fish is a favorite. I have a pantry that would make most Japanese, Koreans, and possibly Chinese proud. And yes we eat a lot of rice and I still lost 20# when we transitioned to this way of eating.
    As for walking it is easy over there since they have amenities near them. Most don’t walk 7 miles one way to the supermarket for food supplies like I would have to. Even the foods in the convenience stores can be healthier since most stock Bentos instead of salt laden TV dinners. Even the instant noodles over there have more healthy ingredients that those sold over here.
    My point is the USA is a “car” society and Asian is a walk, bike, public transportation society. We only find that when we live or visit large cities like New York, Boston, Dallas, etc. But when I was staying in Brooklyn there were corner markets that sold fresh produce along with chips, beer, cigarettes and all the other stuff. Walk a couple blocks and you had fresh ingredients for supper! Most of us don’t have that option and need to make walking part of our routine for the sake of increasing or maintaining our health.

    ManyVoices wrote on December 21st, 2013
  2. Having lived in Thailand for 8.5 years in the late 90’s to early noughties I could see an increase in wheat, dairy and procesed products into the ‘traditional’ Thai diet of rice, vegies, a little meat and fruit.

    Alit wrote on December 30th, 2013
  3. I start going paleo when I was 108 kg. first week I lost 7k. Other week 2-3 and it goes slower and slower in time. After like 6-7 months , I was 88 kg and not loosing anymore , or very slowly. Then , I go to Asia.

    I was in Southeast Asia for the last 8 months. Still going paleo but all new foods makes me curious so I was trying local foods , with rice or local deserts (not so much but , still). And like in 3-5 months I go down to 76 kg (also lost lots of muscle surprised me a lot)

    During Asia , I realized there’s always little bit of heat in my body. First I thought its because of the hot weather , but even in the cold days I felt it. And I noticed , I’m not healing quickly(bruises , cuts) I’m a really quick healer and my healing speed slowed maybe 10 times.

    And from lots of people , I heard(and observed) , it’s dirty in Asia , so there’s much more bacterias and stuff.

    Sooo , connecting all , I start to believe , by immune system is running sooo hard to get rid of all that new and so much bacteria , and that makes heat in my body. And because my immune system is always dealing with that , I’m not recovering quickly.
    So final conclusion , maybe rice gives extra boost to the immune system for dealing with all that.

    And it grows naturally there , and it’s so much in the diet(I believe the diets of nations are connected with geographical locations & lifestyles-not enough English , I hope I make the point-) , so maybe that’s natures way to keep us healthy?

    Just my theories without any scientific research or something :)

    Anıl Görür wrote on January 8th, 2014
  4. Excellent willing analytical vision meant for details
    and may foresee troubles before they occur.

    Estella wrote on January 10th, 2014
  5. With all the historical poverty, and political oppression wouldn’t the more obvious answer be relative caloric restriction (along with activity, veges and fish)?

    James wrote on January 12th, 2014
  6. There is no French Paradox, the French eat small portions of high quality food that is why they are thin. Their neighbors to the East in Germany, eat bigger portions and are fatter but still not as big as most Americans. The French consume about 1/5th the amount of refined sugar that the average American consumes. The French love to cook with butter, but fat satiates you faster.

    Soda is very expensive in France, a small cup of Coke in a restaurant in France will set you back 5 dollars. Also the proportion of French who own cars is less, a lot French walk daily.

    Americans who do exercise, exercise too much, and this actually makes you fat. Moderate exercise with moderate eating keeps your weight in the normal range.

    Europeans live less stressful lives as well, stress plays a role in weight gain and obesity, this is another reason why the French are on average thinner.

    I met a Frenchman who moved to the US and he gained about 25 pounds. The lifestyle in America is more stressful and the quality of food is lower, while the quantity is higher.

    Mario wrote on March 7th, 2014
  7. I lived in Asia for a while and culturally, people don’t eat alone, if they don’t have anyone to eat with them then they simply don’t eat. They can be starving but they still won’t go eat alone in a restaurant and even at home don’t like to eat alone, it is a sort of social stigma and social appearance is very high on the hierarchy compared to western culture where “self-actualization” is the highest. That’s why they are thin and perhaps one of the reasons why we are not. And if you try to get them to eat without white rice to go with every meal they won’t eat either. They don’t eat meals without white rice and/or noodle soup.

    Bryan wrote on March 26th, 2014
  8. I’m Korean, and I have eaten (mostly) white rice up until I started the Primal Blueprint, and I have no problems eating it. While I do reserve rice as the occasional treat, as long as I portion control, I feel fine. That said, the food I eat is sort of a hybrid between Primal and traditional Korean. Traditional Korean food (and the rest of Asia for that matter) is indeed very nutritious and healthy. However, you have to keep in mind that the healthiest foods can be contaminated with bad stuff like gums, sugar, wheat, soy lecithin, etc. I was horrified to learn that the fermented bean paste I use had wheat, processed soy, and other unhealthy additives, sweeteners, colorings, and preservatives. So I’ve had no choice but to cut some of Korean food from my diet which is sad, but necessary. There aren’t farms where I live where they make traditional Korean food. (Pepper paste and bean paste are extremely hard to make, and much time, effort, and space is required; not to mention good ingredients.) It’s sad that very healthy and nutritious diets all over the world are slowly decreasing and being replaced by the SAD diet. :(

    Raine wrote on April 25th, 2014
  9. Yes!!! Historically and globally shows us that asian loves their rice, and before we speculate on to much theories we must take into account that ‘Thought is the product of behaviours, and results is the outcome of the reoccurring behaviours” So let’s just simply ask that question “What were they thinking?!!”

    Henry wrote on April 27th, 2014
  10. You took away the wrong impression of Asian culture in SF, Mark. Why is that not a surprise? Oh, I know. Because it fits your logic. You mentioned “older” Asians taking their time, riding a bike, walking slow. I would think most older folks, Asian or not, would do the same. Golden Gate Park? Seriously? You didn’t even hit Chinatown or Japantown? Don’t you think you’d have a better understanding of Asian culture if you went to, I don’t know, the Asian areas of the city??? Next trip, try going there. You’ll see the hustle and bustle. The knocking you out of their way as they hurriedly try to pass you (on foot!). Ah, but that’s just an aside. What about the fact that Asians are different. Caucasians are different. African Americans…We have different ways of processing food because we are different. The intestines are even different sizes. Aisans’ intestines are shorter than Caucasian. We get different diseases. We are ethnically different. You don’t think things like that make a difference? Finally, just another point to prove that grains have no bearing on fat, skinny, god forbid tolerance, etc.–JUNK FOOD, restaurants, creamer in coffee, all of it. And I mean anything your mom, your grandmom or you didn’t make in. the. kitchen. When will folks finally realize that it ruined their insides and they may be stuck with your diet now.

    Rayca wrote on September 18th, 2014
  11. Great Article
    Thank you for the information

    Bali Tour wrote on November 13th, 2014
  12. I am wondering: Would Asians perhaps be even healthier than they actually are when ditching the rice or replacing it by sweet patatoes?

    Heaven wrote on December 17th, 2014
  13. The French do not have the same level of obesity as Americans is because of the variety and portion sizes. All you can eat buffets are very rare in France. I visited the country several times and noticed that they eat a variety of food in small portions at a meal, meals have several different courses. A good number of them cannot afford cars so they either ride bikes or take public transportation which involves walking. Finding healthy food in a French supermarket is actually quite easy despite me not speaking one word of the language.
    That being said the French are getting bigger themselves, they are not rake thin as most would believe but on average are 4 BMI points smaller than the average American.
    Israelis having a high rate of heart disease? Well could it have to due with tense political situation over there? I would be serious money that could be an issue, life in Israel is not a picnic, imagine living in a place where at any moment you could be in a life and death situation. America has violence of course, but not like Israel, which constantly faces attacks.
    Asian diets seem to be healthy to a degree and Western lifestyles are very toxic to Asian people.

    Jake Goldman wrote on December 24th, 2014
  14. Interesting theory. However, i notice that most asians of all ages in america are thin, despite eating provably the same junk food other americans eat. I am asian and i eat more junk food than healthy food, and most of it isnt of asian cuisine. I am mostly sedentary like most other americans, yet i am not overweight. I think an experiment should be done feeding people of different races the same junk food and force them to sit at their computers all their waking days for a month, and then compare everyone’s weight gain at the end. My guess is the asians will still be thin. The reason is its just a metabolism issue.

    Sadame wrote on May 11th, 2015
  15. I thought the Asian paradox is all about miraculous vit K2! Mark talked about natto already. Asians traditionally eat fermented foods and specifically soybeans. So they may not even know that they eat vit K2. The rest of the (conscious) world has to do with supplements of K2 MK7.

    Tamara wrote on July 24th, 2015
  16. I think you left off the most important factor of all.

    They all use chop sticks! We just scoop and stuff!

    Omar Haikal wrote on August 13th, 2015
  17. I am Asian. we eat rice everyday. and no, it’s not a side dish. it is our main dish, we compliment it with veges, fish, chicken, meat etc

    green girl wrote on August 19th, 2015
  18. The most interesting paradox is how a site like this one that puts out so much misinformation has so many followers…

    Yes, finally at the end of the article the author mentioned a true fact, the whole world, including Asia, is getting heavier and sicker.

    Rice is not the least offensive grain, white rice is processed and is not what primarily led to long-lived populations of Asia. The longest living population in Asia is in Okinawa which consumed large daily amounts of their calories from Okinawa Sweet Potatoes (Yams), very little rice and animal protein.

    It has been my personal observation for the last fifteen years that as Asian populations increase in personal wealth they become heavier and sicker while they increase their consumption of white rice, sugar, meat and oils.

    Richard wrote on August 28th, 2015
  19. The Israeli paradox can be explained by the whackish amount of stress the average person deals with everyday. There’s a ton of pressure put on people to exceed in work and academics. My Israeli friends also deal with a lot of stress from family as well. My mom’s Asian and has diabetes, as do my grandparents. They eat junk like it’s no one’s busines though.:/

    Elvan wrote on October 25th, 2015
  20. I am Caucasian. They are Asian. A different race! That’s the closest we have to a different species. Negro species gets sickle cell anemia. Why don’t Caucasians or Asians get it? Because they are a different race! Asians have different sized intestines than Caucasians. A whole different digestion going on then. Quit looking for voodoo answers for all things diet. Get over it. Americans do all thing in a big, loud, obnoxious way. We suffer the penalties of that kind of culture.

    Rayca wrote on December 11th, 2015
  21. 1. Rice has little nutritional value;
    2. Asians – and most people – do not eat like Americans. They don’t eat vast quantities of rice or any other food; and
    3. If you want to get fat, eat like an American

    JohnC wrote on January 12th, 2016
  22. Many years ago I lived in South Korea and dropped about 20 lbs there effortlessly in a year on a Korean diet, which consisted of a very huge bowl of rice at almost every meal. The rest of the meal was small portions of vegetables and meat or fish. For breakfast I got a fried egg. I also walked a lot. I didn’t run or exercise in any other way. However, I was younger then. I went to Japan a year ago and loved the food, so I ended up gaining 5 lbs in 3 weeks. Must be a change in my metabolism in my older years. 😉

    EXE60 wrote on January 20th, 2016
  23. Old post but wanted to give my $.05 – This is something I’ve contemplated for years and still haven’t found THE answer. I know the oldest noodle discovered was in China and made from millet. Still I think it was only 4,000yo. I suspect wild rice is ‘paleo’. It requires less processing to eat than any other grain (some might say quinoa). It would be something you could pick up along the lake trail and eat with your speared fish rather easily. Not sure cooking techniques used (I’m not a gastronomical archaeologist).
    As I’ve seen mentioned on other sites, arsenic could be a problem with ‘crude’ rice consumption (and has been proposed as a cause for more white vs brown rice consumption in Asia). I’ve wondered if steaming in a leaf wouldn’t reduce arsenic but leave B vitamins in rice.
    Anyone who knows the answers to any of my speculations please post.

    jon compton wrote on February 12th, 2016
  24. BECAUSE THEY EAT BROWN RICE!!!! AND HERE IS a statement in google!!

    Brown rice is also good for diabetics due to its high fibre content. Here are 6 reasons why brown rice is better for you. Also, try this healthy brown rice methi pulao. It is essential to understand that white rice does have its own set of benefits and eating it or not depends on one’s body.

    John Pierre wrote on February 21st, 2016
  25. I’m from Asia. Rice is a staple which keeps us full and is a good complement to other meat and veggie dishes.

    The number of overweight people here has increased over the years, however, due to increased consumption of junk food and less active lifestyles.

    Those of us who maintain our weight successfully simply lead more active lifestyles and move more out of habit. We’re thus able to burn off all the calories we consume. It’s the art of balancing our levels of activity with what we eat. And yes, we prefer fresh food to processed junk.

    Aquarius Moon wrote on March 1st, 2016
  26. In the Philippines, we eat a lot of rice on our plate. I mean I eat a whole regular plate of rice but was skinny in the Philippines. But here in America I eat less and control eating rice and am already over weight after staying in the USA for 6 years. My thinking is that because it is too hot in the Philippines which is mostly 90-95 degrees farenheit almost the year round. It is too hot rather than cold that makes my burning faster when I am there. Filipinos loose weight by visiting the Philippines even just for a month and then regain weight when returning to USA.

    rez wrote on March 4th, 2016

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