Speaking of Japan

[Guest guest]

Japan's New Public Health Problem Is Getting Big

Obesity Has Grown, Along With Appetite For Western Foods

By Akiko Yamamoto

Special to The Washington Post

Tuesday, June 19, 2007; Page A11

TOKYO -- When he arrives home late from work, Keizo Takemi says, he often

furtively opens the refrigerator and searches for something to quiet his

growling stomach. He is about to pounce when he hears his daughter's voice.

" Daaaaad, " she snaps, and he guiltily closes the fridge and slinks off to

bed chastened, his stomach grumbling in vain.

Takemi is 55 years old and Japan's vice minister for health, welfare and

labor, so he is not used to being told what he can and cannot eat, certainly

not by his daughter. But Takemi is no ordinary politician. In a bid to

foster awareness of a growing problem with obesity in Japan, he put himself

on a six-month diet and turned himself into a national guinea pig.

Keizo Takemi, vice minister for Japan's Health Ministry, gets measured after

his six-month public dieting campaign helped him lose 16.4 pounds and three

inches from his waist.

On a daily blog he lists what he eats, how much exercise he does, how much

his waistline fluctuates. There are even photos of his belly, the source of

his woes, before and after.

At a recent public weigh-in, Takemi said dieting in the spotlight hadn't

been easy. " The toughest thing was having to cut down on the things I really

want to eat, " said Takemi, who admits to loving meat and deserts. But the

hardship has paid off. Since December, Takemi has lost 16.4 pounds, and his

waist has shrunk three inches.

Outside Japan, the country is known for a high reliance on low-fat fish and

seaweed dishes. But meat and high-fat foods feature ever more prominently on

Japanese tables. While per capita calorie intake is stable, animal fat and

protein consumption has grown fourfold over the last 50 years.

As a result, obesity and other dietary complaints have become major public

health problems. At risk is one of Japan's proudest accomplishments, its

longtime position at the top of global longevity tables.

According to the Health Ministry, the rate of obesity in Japanese people

over age 20 is increasing in every age group except women ages 20 to 29 and

40 to 59. Men have gained most of the country's extra weight, but obesity in

children also has risen significantly, from 18.9 percent in 1988 to 24.3

percent in 2005, according to a survey.

In Tokyo, the local government has started offering lifestyle coaching for

obese children. At one children's center, counselors advise children on

eating habits, exercise and dieting safely. The weekly program has about 50

children on its waiting list.

In January, Manami Sugimachi, 12, started attending sessions at the National

Children's Castle, a kind of giant museum and activity center for young

people here. It pains her to have to check the calorie values of snacks

before deciding what to eat. But she has lost weight since joining the

program and has started to enjoy exercise. " I don't want to be sick as an

adult, " she said. " And I want to be able to wear the clothes I think are

cool. "

The Japanese government wants to combat obesity because it has started to

weigh down the national health system. According to government estimates,

about 10 trillion yen -- almost a third of national medical expenditures --

goes to the fight against lifestyle-related diseases enhanced by obesity.

Sixty-one percent of Japanese deaths are due to these ailments.

" We want to set up an environment where when you decide, 'I am going on a

diet,' you can, " said Hiroyuki Tanaka, director for nutritional education

promotion at the Health Ministry. " You can eat one MegaMac a week, " he said,

referring to a four-patty burger sold at Mc's in Japan. " But it is

important to choose what else you would eat that week. "

Many were once convinced that Japanese people lacked the fat genes found in

other groups. According to figures compiled in 2005 by the Paris-based

Organization for Economic ation and Development, only 3.2 percent of

Japanese people had a body mass index greater than 30, compared with 30.6

percent in the United States.

But experts say Japan is on the cusp of its own crisis. Katsuhiko Yano, a

senior investigator at the Pacific Health Research Institute in Hawaii, is

concerned. Since 1965, he has conducted dietary studies of Japanese people

in Japan and Japanese Americans in the United States. He found that Japanese

Americans, eating a Western diet higher in fat and animal protein, are at

higher risk of heart disease.

" Genes alone can't stop the steady move toward obesity, " Yano said.

The archetypal burger-eating man in the southern prefecture of Okinawa has

fast become a symbol of what is at stake in Japan.

For decades, the life expectancy of Okinawan men was among the world's

highest. But after American fast food arrived in the late 1940s, Spam and

taco-rice slowly supplanted the much healthier local diet. Every year, the

government in Tokyo publishes longevity statistics for Japan's 47

prefectures. After falling in the rankings from the top to fifth in 1990,

Okinawan men slumped to 26th in 2000.

Takemi, the vice health minister, sympathizes with how hard it can be to

turn away from steaks and cream puffs. Yet he hopes that his battle with his

weight can inspire other Japanese to wage their own. " Losing weight has made

a huge difference, " he said. " I feel lighter even when I am walking. And I

feel much less tired after work. "