Marks Daily Apple
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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:

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. Glucose doesn’t automagically get stored as fat? Really? DUH! It is more likely to get shuttled away so it does not damage you system when you eat *too much* for your liver and muscles to store and that means triglycerides. How are you not getting his?

    Marnee wrote on February 1st, 2012
  2. In my case this isn’t true. Two years ago I changed my diet to low carb high fat without changing my caloric intake. I’ve always worked out and didn’t change my workouts a bit. I dropped 30 pounds in a year.

    One thing no one’s mentioned is that since Asian’s caloric totals have historically been low, although the percentage of carbohydrates in their diet may be high, they’re probably still not going much higher than 150g per day on their traditional diets. So they’re overall carb consumpion is still low (just high relative to protein and fat).

    Skateman wrote on February 1st, 2012
  3. Good comment. Its nice when people stop looking at macro nutrients and start looking at individual foods.

    Evan wrote on February 1st, 2012
  4. Hmm. Interesting. When I went primal I started eating more. My kid says I eat like a pig. Lost 35 lbs in 4 months. 5 years ago…

    DB wrote on February 1st, 2012
  5. I tracked my calories on an excel spreadsheet before (for about a month, but I eat roughly the same thing every day) and after. Couldn’t understand why no matter how hard I worked out, I couldn’t lose weight. I started around 2,800 calories a day (6 foot 1 weighed 205), and am still at about 2,800 calories a day (still 6 foot 1 but now 175) – just replaced carbs with fat. Lost some strength in the gym at first, but doing 5X5 now and got it all back. Can see my ab muscles for the first time in my life.

    I’m of Scottish and Polish descent. I figure my ancestors (Celts) have been eating grains (in any significance) for less than 2,000 years.

    Skateman wrote on February 1st, 2012
  6. You know, you’re really being rude. This is a primal/paleo website, so obviously the people who frequent it aren’t going to be pro-grain and carbohydrate. If you can’t respect that, then quit messing in their lives and being a jerk.

    Carson wrote on July 24th, 2013
  7. Yep. From the wikipedia:

    Human evolution

    Carbohydrates are an energy rich food source. Amylase is thought to have played a key role in human evolution in allowing humans an alternative to fruit and protein. A duplication of the pancreatic amylase gene developed independently in humans and rodents, further suggesting its importance. The salivary amylase levels found in the human lineage are six to eight times higher in humans than in chimpanzees, which are mostly fruit eaters and ingest little starch relative to humans.

    rarebird wrote on February 1st, 2012
  8. I forgot the quotes:

    “Human evolution”

    “Carbohydrates are an energy rich food source. Amylase is thought to have played a key role in human evolution in allowing humans an alternative to fruit and protein. A duplication of the pancreatic amylase gene developed independently in humans and rodents, further suggesting its importance. The salivary amylase levels found in the human lineage are six to eight times higher in humans than in chimpanzees, which are mostly fruit eaters and ingest little starch relative to humans.”

    rarebird wrote on February 1st, 2012
  9. I think that what constitutes “too much” of anything varies per the individual – and is not static. At this point in my life (age 59), I eat NO grains, NO legumes, very few starchy tubers/roots, and get my carbs from a little raw honey, a little fruit, and a little more vegetables. That’s what my body needs right now – but didn’t need that for most of my life and may not need that again once I normalize my body composition and make a few other lifestyle changes.

    rarebird wrote on February 1st, 2012
  10. Some people are not able to store fat on a very low carb diets, particularly people new to low carb diets. The fat is converted to ketones and excreted. In this case you will eat a lot but still lose fat.

    Unfortunately this honey moon period does not last forever.

    Another thing is that a good healthy diet will increase energy consumption if the body is not too broken.

    anand srivastava wrote on February 1st, 2012

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