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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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November 04, 2008

The World’s Healthiest Countries (and What We Can Learn From Them)

By Worker Bee
53 Comments

More than anything, the Primal Blueprint is a pragmatic approach to diet and lifestyle. It is not dogma; rather, it is based on empirical evidence suggesting that following the diet and many lifestyle behaviors of our early ancestors is the healthiest way to live. Though we keep abreast of the latest scientific news, how we feel when we eat, exercise, and live Primally is what motivates us to follow the Primal Blueprint. Results matter, and so we feel it might be useful to take a look at some of the healthiest countries in the world and understand what works for them.

We’ve drawn from several recent surveys of the healthiest countries. The Forbes survey, for example, focused almost entirely on healthcare, life expectancy, and air quality, which are certainly important issues – but how much can we really learn when the top ten countries all make the list for the same reasons? The Foreign Policy and Men’s Health lists offered different perspectives, tending to focus on nutrition and exercise. By looking at all three, I think you’ll get a fairly complete picture of what works, and what doesn’t work, to make these countries the healthiest.

Here are our top 10 countries (America not included) in no particular order:

Japan

With an average life expectancy of 86 for women and 79 for men, Japan has some of the longest-lived citizens in the world. And amazingly enough, much of Japan no longer features the bucolic, serene environments of the Kurosawa films that many assume still flourish. Japanese business culture has grown high stress and impacted, but the healthy diet – rich in seaweed and fish – has remained the same. Government-sponsored exercise programs contribute to the longevity, too.

What can we learn from Japan? Eat fish and exercise – so basically, just keep doing what we’ve been doing.

Australia

Men’s Fitness gave the Outback its top ranking. Their reasoning? The low rates of heart disease, stroke, and high blood pressure resulting from all the volleyball they play and steak they eat. Huh? A mainstream mag promoting red meat consumption? Amazing! What they fail to mention is that much of Australia’s cattle is range-fed, meaning most of their steak is raised the way nature intended.

Not that we needed to tell you, but intense bouts of exercise – like in beach volleyball – and grass-fed steaks are perfect for the Primal lifestyle.

Sweden

Sweden’s claim to good health is pretty undeniable: high cancer survival rates and excellent children’s healthcare. And their public healthcare is famously comprehensive, owing in part to the high government spending. But plenty of other countries have universal healthcare with less impressive results. Why is that? Sweden approaches healthcare from a holistic point of view, knowing that happier citizens are healthier citizens. From well-lit public places promoting evening walks to creating happier professional lives for its workers, Sweden understands the Primal idea that health isn’t just about medicine.

Greece

Sometimes, it’s not what you eat that’s important, but how you eat it. Greece puts heavy emphasis on the social aspect of dining. A meal is to be enjoyed, savored. And, in turn, the relaxation that accompanies a nice leisurely dinner aids in digestion. Now, though we doubt Primal man was much of a slow eater, not having to watch your surroundings for possible predators and being able to enjoy your food would have been a luxury even Grok would welcome. Don’t forget that eating is a social activity; eat Primally, but do so with friends and loved ones.

Italy

Shopping for the day’s groceries in Italy often means making several stops – at the butcher, the grocer, the baker. The Costcos and Ralph’s are few and far between, meaning that the focus is on fresh, unprocessed foods. Go to an American grocery store and you’ll be assaulted by cans, packages, and Styrofoam (as well as fresh vegetables and meats, provided you stick to the perimeter); but in Italy, you simply aren’t inundated with all the processed, pre-packaged food. And that means buying fresh, whole foods becomes an everyday part of life.

Iceland

Just like Sweden, Iceland places a heavy emphasis on healthcare, offering extensive pre- and post- birth healthcare for mother and child. The result? The world’s healthiest infants, with just two deaths before the age of five for every 1,000 births. Primal man knew the evolutionary imperative of providing for your offspring, and so does Iceland. Parents are also guaranteed three months of paid professional leave for every child, which undoubtedly makes for happy families.

Cuba

Longtime trade embargo notwithstanding, Cuba enjoys some of the best healthcare in the world. Cuban healthcare focuses on early detection and prevention. Medicine and medical equipment are often in short supply, making prevention a necessity. Cuba highlights the effectiveness of such a strategy. If Cuba can keep its citizens healthy despite the embargo and substandard equipment, what does that say about the American tradition of popping pills and chronic treatment? It sounds like maybe Primal, healthy living is the best healthcare around.

Finland

Thirty years ago, Finland had the highest death rate from heart disease among men – about 5 deaths per 1,000. Local governments began promoting healthy living, and today, fruit and vegetable intake has more than doubled. Smoking has dwindled, too. Nowadays, Finland men have a heart disease death rate about average for the region – 1 per 1,000 – and one of the lowest infant mortality rates. Just goes to show what a little focus on fresh whole foods and clean living can do.

Germany

All the usual culprits are here: nationalized healthcare, high tax rates, fresh, whole foods. So it’s no surprise that Germany ranks among the world’s healthiest countries. But Germany also has incredibly clean air, promoting a very active, outdoorsy culture that relishes walking and bike riding. Fresh, whole foods and clean air – what’s not to like?

France

Experts marvel at France’s low rates of heart disease in spite of the high fat content of its cuisine. Conventional wisdom says fat = bad! Of course, fat’s never turned us off, but it’s nice to see it being praised, rather than demonized. France also tends to eat longer, slower meals and use fresh, whole ingredients.

What activities, habits, or traditions of cultures around the world have caught your eye as being particularly health? Hit us up with a comment in the boards!

Further Reading:

A Sanitized World is a Healthier World?

Deconstructing Healthcare in America – A Modest Proposal

Healthy Tastes Great! – Japanese Cuisine

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45 Comments on "The World’s Healthiest Countries (and What We Can Learn From Them)"

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Holly
Holly
8 years 29 days ago

To vouch for Italy – I lived there for 8 months and with as many carbs (pasta, bread, pizza, etc) as I was eating every day I definitely should have gained a ton of weight – but I didn’t. I honestly attribute that to how fresh and unprocessed their foods were (even the pastas!). (As a side note, its a lot easier not eating pasta in the U.S. anymore, because, honestly, nothing can compare).

Andrew R
8 years 29 days ago

Very interesting article Mark! Thanks for the post. I can’t wait to visit these places.

All the Best,

Andrew R

Jim Jones
Jim Jones
8 years 29 days ago

Interesting how much emphasis is placed on rice in Japan yet they certainly don’t have an obesity issue. What am I missing?

Aaron
8 years 29 days ago
DR
8 years 29 days ago

Men’s Fitness may want to take a second look at Australia.

Like the U.S. and Canada and the U.K., etc…Australia has seen it’s obesity and type 2 Diabetes rate keep climbing year after year.

Here is an article from the Sydney Morning Herald – http://news.smh.com.au/national/kids-life-expectancy-may-drop-report-20081010-4y6p.html

Alex
Alex
8 years 29 days ago

A lesser known fact about Greece is that they place great emphasis on greens in their diet. Greens – often cooked with tomatoes, garlic, and onions – are usually a large part of meals. This was probably used as a “filler” in leaner times, but contributes to their healthy lifestyle. And the greens of the old days – and in many places present day – are wild. Also, at least on the islands, the produce and seafood are superfresh – most often picked the same day they are prepared and eaten.

Jan
Jan
3 years 9 months ago
Regarding Greece, Crete in particular has one of the lowest heart attack rates in the world if not the lowest. Just as I have given up wheat I find they eat huge quanities of bread and beans, with low to moderate consumption of meat and dairy. Maybe the huge quantities of olive oil and fresh home grown fruit and veg help. But maybe it means beans and bread and it is whole meal is not so bad. I only changed my diet about 6 weeks ago but in that time my cholesterol has gone up from 4 to 5.6. The… Read more »
Donna
Donna
8 years 29 days ago
I love this post and this is very interesting how other countries differ from America. My brother visited Germany and Italy and yes, this post is exactly how he described the people and their diet=”healthy” in these 2 countries. Italy has very thin people, he was there 2 weeks and saw no one ever eating junk food, and they walked alot, very happy, friendly people. YES, we certainly can learn from these top 10 countries that are the healthiest in diet and lifestyle. Eating Primal is so healthy, it’s the way to go! Thanks for this very awesome post, i… Read more »
Donna
Donna
8 years 29 days ago

Aaron,
I read the article you sent Jim. It makes me think “both” my grandma’s ate small amounts of rice often and both slim. But, they ate a very healthy diet, lots of fresh vegetables, fruits, meats. One of my grandma’s lived to be 93, my other is still alive at 96 years old.

Jonas Colting
8 years 29 days ago
Right now in Sweden we´re having a heated debate about diet and obesity and the old “truths” about how over-weight people should limit fat and stick to fruits and whole wheat etc. The Swedish equivelance to the FDA is actually re-viewing their guidelines and may admit that they have actually been wrong all this time… A Swedish doctor has stirred a lot of feelings when she a few years ago started recommending her patients a strict LCHF-diet with great results on diabetes and overweight. She was initially criticized and even fired (I think)she is now a groundbreaker… And this is… Read more »
zbiggy
zbiggy
8 years 28 days ago
in my country (Eastern Europe, post soviet block) during my childchood (late 70s/early 80s) sweets were available in government rations only, I believe 1 or 2 chocolate bars per month. Cola was a luxury – cans were subjects of collections among the well off ones 🙂 And those days, in my primary school for 5 classes, ~ 150 kids of age 15 only one or two was overweight, while now when I take my 3 yo daughter to a playground and I look around – every second child has this problem and they don’t wait until their teens – it’s… Read more »
Dr Dan
8 years 28 days ago

Where is New Zealand!!!!!! Probably been a bit patriotic but we have free healthcare, clean air, huge outdoors lifestyle and grass fed beef and lamb. Our obesity is behind that of Australia too!!!!

Mark Sisson
8 years 28 days ago

Jim Jones, it often comes down to the amounts of rice in the diet. The Japanese eat a little in combination with protein and lots of green vegetables (and a fair amount of daily movement) is OK. When they go to fatten Sumo wrestlers in Japan, however, the major dietary component is rice – thousands of calories worth per day. Yes, they add some beer and some protein, too, but nothing puts on the fat like an abundance of rice.

Ryan
8 years 28 days ago

Seriously speaking, I thought some of france’s and italy’s longevity was attributed to their wine consumption!

I agree with Dr Dan – NZ has got to be up there.

I wonder what diabetes rates exist in asia where they typically eat a lot of rice/noodles/carbs (although they do eat lots of fish and veggies).

zbiggy
zbiggy
8 years 28 days ago

“eat a lot of rice/noodles/carbs” in Asia means about 2280 kcals per day. These included 360g carbs – according to a 1972 Japanese research mentioned in Gary Taubes’ GCBC.

At this level of energy intake, I guess it’s not so important high or low carb, it’s just called Calorie Restriction.

Sonagi
Sonagi
8 years 28 days ago
“The Japanese eat a little in combination with protein and lots of green vegetables (and a fair amount of daily movement) is OK. “ I wouldn’t call 2-3 cups a day “a little.” Every meal in Japan, Korea, and China includes a refined starch, either white rice or noodles. The rice is served in bowls about the size of one cup. They do eat animal protein and freshly prepared or pickled vegetables at every meal, including breakfast. Before I ever heard about LC, I discovered it on my own while losing weight in Korea. I had plateaued while trying to… Read more »
Son of Grok
Son of Grok
8 years 28 days ago
I think it is also interesting to note the decline of health in some of these countries as they become “westernized”. I remember reading an article somewhere on the McDonalds in Japan carrying a double big mac or something ike that. My in-laws are from Thailand and the Philippines and can both attest to how much “fatter” and unhealthier people have gotten since adopting a more “western” diet. And yes, some wahoos came in years ago and preached how bad the coconut is for you and so many southeast asians are cutting back on the coconut despite it working for… Read more »
Oscar
Oscar
8 years 28 days ago
I follow the LC diet and PB style but living in Asia and originally from a Mediterranean country sometimes I wonder how bad eating rice or pasta can be. Japan, Italy, Spain,…most great cooking countries have a strong dependency on pasta, rice and bread. The things in common between Med and Asia healthy styles are i) the absence of processed foods, ii) adoration for natural ingredients iii) enjoyment of eating as a social event and iv) some level of wine/alcohol consumption during meals. Mark,it is not obvious to me the relation between low carb (in the form of rice, bread… Read more »
Fitness Insights
8 years 28 days ago

Not sure I agree about Australia. We do like our steak, and we have been known to play volleyball, but I think the laidback lifestyle and the determination to sneak days off and dodge work any chance we get probably has the biggest part to do with why we aren’t keeling over left and right! 🙂

Jamie Atlas from Fitness Insights

Andrew(AJH)
8 years 28 days ago

Nice to see Australia so high on the list!

Mark McManus
8 years 28 days ago

Nice to see Sweden up there (though I’m not Swedish).
I just think it’s great that their Government guidelines now accept the fact that a high fat, low carb diet is healthy.
Hopefully it’s the first country of many.
Mark from MuscleHack.com

Pat
Pat
8 years 28 days ago
Speaking about eating pasta in Italy as a sublime experience, I too, can agree. I used to think it was because I was so happily enjoying my vacation and the relaxed atmosphere of meals, but there is another difference. Last November, we visited the De Cecco factory in Abruzzo and learned that there are two countries which require a different formulation and have their own production lines…Japan and the USA. When all flour products in the US became “enriched,” the USDA also required that pasta imported by the US be made from enriched flour. We came home with a suitcase… Read more »
bobbi
8 years 28 days ago

Dear Mark,

I love your blog, I saw it on Mizfits post. I loved all the info you gave us! As a runner/cyclist and health freak, I love learning more and more about our bodies. Thanks so much I am adding you to my blogroll!!!

Bill
Bill
8 years 28 days ago

Mark,
what about the okanowans of japan whats there secret?

Bill

Donna
Donna
8 years 28 days ago

I’m a firm believer that people who don’t let themselves get stressed out over things add to longevity. Learning how to control stress as much as possible is a key to being healthier in addition to eating Primal and exercising!!!!

Son of Grok
Son of Grok
8 years 28 days ago

Donna,

Managing my stress came naturally through practicing the PB. I am thinking it is probably mostly hormonal, but suddenly I am just not as stressed out as I used to be.

Donna
Donna
8 years 28 days ago

Son of Grok,
That’s great! Oh yes, eating Primal does wanders. Eating bad food affects one’s mood just as eating healthy food does the same.
I’m so proud of you that you’re controlling stress, good for you Son of Grok!!!!

Terry
Terry
8 years 27 days ago
You don’t want to get sick in Cuba if you are an average Cuban. From Canada’s National Post, which assessed Cuba and its health system in a three-part series: “Even the most commonly available pharmaceutical items in the U.S., such as Aspirin and rubbing alcohol, are conspicuously absent [in Cuba]… Antibiotics… are in extremely short supply and available only on the black market. Aspirin can be purchased only at government-run dollar stores, which carry common medications at a huge markup in U.S. dollars. Cuban defector Dr. Leonel Cordova told the New York Times about his experience practicing in Cuba, “[E]ven… Read more »
Louise
Louise
8 years 27 days ago
As an Australian, I was quite suprised to see us so far up the list. I think the main reason we have good health and longevity is due to a better than average health care system, certainly not a better than average diet. We’re definitely following in the footsteps of America in terms of junk food and we work longer hours than ever before, leaving less time for exercise. One of the best things we have going for us is so many immigrants from countries such as Greece, Italy and Vietnam which gives us exposure to a wide range of… Read more »
Steve C
8 years 23 days ago

I was surprised to see Australia up there. We do love sport, but more as spectators than participants these days and even then it’s a love surpassed by a love of beer. I can count the number of lean middle-aged (50+) men I know on one hand.

Our obesity rate exceeds that of the US (60% overweight or obese) and diabetes is on the rise. One in three Australians will die of heart disease, another from cancer. Perhaps Men’s Health only spoke to the surviving third?

Donna
Donna
8 years 23 days ago
Just this morning i talked to my brother about this post. He said after visiting Germany “twice” that he believes in his opinion it’s just got to be the #1 healthiest place on earth to live and Germans love Americans. He told me “why” the air is incredibly clean. There’s NO oil refineries, no plants to cause pollution. Their forest is called “Black Forest” because their leaves do not die due to oxygen all year long. Their forest are dark green trees-cedar, evergreen,etc. Looking at the forest in Germany is so dark that’s how it got it’s name. And yes,… Read more »
Oriet
Oriet
1 year 24 days ago
I lived in Germany by the black forest, for about 14 years and I found that their diet hardly includes any creamy sauces! Salads don’t have any salad cream, they make it with vinegar and oil and all meals go with salads made like this, thus balancing the fat intake. Everything is freshly cooked and fruits are plenty, even the black forest famous cake is not very sweet, but very delicious. They have a saying ” Nach dem Essen sollst du schlafen oder 300 schritte laufen.” Which roughly translated means ” after a meal you should sleep or walk 300… Read more »
Tom Parker - Free Fitness Tips

Wow. I would never have had Australia down as one of the healthiest countries in the world. Interesting article.

BELLE
8 years 16 days ago
…this post really got my attention! how nice living in a healthy country! but in asia, especialy in third-world countries, mostly people eat noodles, rice and canned goods. So many of them have diabetes….it is because people have less income that they cant afford to have healthy foods for thier meal. whats important to them is that they can eat wether its a healthy food or not…its really sad to know that many asian children are malnourished..whew! please keep on posting about healthy lifestyle 2 encourage others to be healthy….not only for thier own good but also for our mother… Read more »
amy
amy
8 years 6 days ago

As an Australian vegetarian female who hasn’t played beach volleyball in 6 years, I think the reasoning behind putting us on the list is bogus, especially as we were labeled “fattest nation” this year.

Good to see you acknowledge us, though.

axel g
7 years 11 months ago

Hey Mark!

The good news is that many-a-nation send delegations abroad to study successful models. Hopefully it won’t take too long until the whole world will enjoy better health care…

Great design +_+

Chris
Chris
7 years 11 months ago
Volleyball – Australia? You must be kidding. The only time I’ve seen beach volleyball played is when the 2000 Olympics were held in Sydney. I’ve lived in Australia all of my life, and if you were to rate volleyball as one of our national sports, you’d be laughed out of the room. Football (soccer, Aussie Rules, Rugby League and Union), cricket and netball are probably our national sports – mostly watched by the majority, not played. Unfortunately we are following the USA lead of big portions and over-processed foods, but we do have the saving grace of a large number… Read more »
Massimo
Massimo
7 years 5 months ago
I am from Italy originally (Rome specifically), and went to Paris for the first time. I hadn’t been to Europe in 20 years, so this was almost like going again for the first time. When I got to Paris, I nearly fainted when I had my first croissant. There were things that I noticed that were not in the American food I have become accustomized to. Texture, decadence, flavor, and richness and also satisfaction. I noticed that I ate less because the food had SO much more flavor in it. Having a portion 1/2 the size was enough for me.… Read more »
suvetar
suvetar
6 years 4 months ago
No way is Germany one of the healthiest countries. Maybe the Bavarians, nobody else. Just about everyone I went to school with has health problems, they are minor problems atm but still, it’s making them very unhappy. Most Germans are depressed and unhappy, too, even though they might smile at you and say ” Good Day” when you pass them. When I went back recently everybody looked ill compared to Americans. Germans don’t get enough sun shine, they save every penny for vacations to sunny locations like Italy or Greece. Now with this said, Germans do have a slightly ‘healthier… Read more »
Drummalizer
Drummalizer
6 years 20 days ago

I like what I’m reading here about the Primal Lifestyle. I’ve found that knowing the basics of Ayurveda supersedes pretty much everything out there. It seemed complicated at first, but it’s actually really easy. You can learn more by reading the book Foods Heal.

chelsea
chelsea
5 years 9 months ago

wow i have to go visit some of these countries some time

Mo
5 years 9 months ago

you know what’s funny
many of the countrys have almost the same fast food as us…

but why are we the fastest, like, Japan has McDonalds’, yet why are we the fastest country?

God America! Loose some freaking weight!

Stephanie
Stephanie
5 years 1 month ago

Having been born in the USA and loving the food, it was a huge transition to move to Germany, but the food is far more healthy and I no longer crave junk food. And yes, they do exercise with vigor everyday and the kids are happier. From what I have seen, the kids don’t eat garbage during lunch at school. What a difference it makes. Good article

fre
fre
3 years 11 months ago

Hey, where’s Norway? If Sweden earns a spot Norway should be there too! I don’t want to start explaining lots and lots, but Norway are better in many ways.

http://angkorwatbuilding.info

To be able to calculate wholesome life expectancy, the study
factored in the impact nonfatal illnesses can have on quality of life.

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