Japan has the highest life expectancy in the world, an average about 84.1 years, compared to 78.6 years for the US. That difference is used to suggest that the Japanese diet must be far healthier than the American. We should all drink green tea and eat such: rice with seaweed and raw or smoked fish. Let me begin by saying that correlation does not imply causation, and go further to say that, to the extent that correlation suggests causation, the Japanese diet seems worse. It seems to me that the quantity of food (and some other things) are responsible for Americans have a shorter life-span than Japanese, the quality our diet does not appear to be the problem. That is, Americans eat too much, but what we eat is actually healthier than what the Japanese eat.
Top 15 causes of death in Japan and the US in order of Japanese relevance.
Let’s look at top 15 causes of deaths in Japan and the US in order of significance for Japan (2016). The top cause of disease death is the same for Japan and the US: it’s heart disease. Per-capita, 14.5% of Japanese people die of this, and 20.9% of Americans. I suspect the reason that we have more heart disease is that we are more overweight, but the difference is not by that much currently. The Japanese are getting fatter. Similarly, we exceed the Japanese in lung cancer deaths (not by that much) a hold-over of smoking, and by liver disease (not by that much either), a holdover of drinking, I suspect.
Japan exceeds the US in Stroke death (emotional pressure?) and suicide (emotional pressure?) and influenza deaths (climate-related?). The emotional pressure is not something we’d want to emulate. The Japanese work long hours, and face enormous social pressure to look prosperous, even when they are not. There is a male-female imbalance in Japan that is a likely part of the emotional pressure. There is a similar imbalance in China, and a worse one in Qatar. I would expect to see social problems in both in the near future. So far, the Japanese deal with this by alcoholism, something that shows up as liver cancer and cirrhosis. I expect the same in China and Qatar, but have little direct data.
Returning to diet, Japan has more far more stomach cancer deaths than the US; it’s a margin of nine to one. It’s the number 5 killer in Japan, taking 5.08% of Japanese, but only 0.57% of Americans. I suspect the difference is the Japanese love of smoked and raw fish. Other diet-related diseases tell the same story. Japan has double our rate of Colon-rectal cancers, and higher rates of kidney disease, pancreatic cancer, and liver cancer. The conclusion that I draw is that green tea and sushi are not as healthy as you might think. The Japanese would do well to switch the Trump staples of burgers, pizza, fries, and diet coke.
The three horsemen of the US death-toll: Automobiles, firearms, and poisoning (drugs). 2008 data.
At this point you can ask why our lives are so much shorter than the Japanese, on average. The difference in smoking and weight-related diseases are significant but explain only part of the story. There is also guns. About 0.7% of Americans are killed by guns, compared to 0.07% of Japanese. Still, guns give Americans a not-unjustified sense of safety from worse crime. Then there is traffic death, 1.5% in the US vs 0.5% in Japan. But the biggest single reason that Americans live shorter lives is drugs. Drugs kill about 1.5% of Americans, but mostly the young and middle ages. They show up in US death statistics mostly as over-dose and unintentional poisoning (overdose deaths), but also contribute to many other problems like dementia in the old. Drugs and poisoning do not shown on the chart above, because the rate of both is insignificant in Japan, but it is the single main cause of US death in middle age Americans.
The king of the killer drugs are the opioids, a problem that was bad in the 60s, the days of Mother’s Little helper, but that have gotten dramatically worse in the last 20 years as the chart above shows. Often it is a doctor who gets us hooked on the opioids. The doctor may think it’s a favor to us to keep us from pain, but it’s also a favor to him since the drug companies give kickbacks. Often people manage to become un-hooked, but then some doctor comes by and re-hooks us up. Unlike LSD or cocaine, opioid drugs strike women and men equally. It is the single major reason we live 5 1/2 years shorter than the Japanese, with a life-span that is shrinking.
Drug overuse seems like the most serious health problem Americans face, and we seem intent on ignoring it. The other major causes of death are declining, but drug-death numbers keep rising. By 2007, more people died of drugs than guns, and nearly as many as from automobile accidents. It’s passed automobile accidents since then. A first suggestion here: do not elect any politician who has taken significant money from the drug companies. A second suggestion: avoid the Japanese diet.
Robert Buxbaum, April 28, 2019.
1. What drugs contribute to dementia in the old?
2. “do not elect any politician who has taken significant money from the drug companies” This is nutty. Only a small number of drug companies produce opioids.
3. There is no substitute for opioids for certain types of chronic severe pain. Attitudes like yours are causing doctors to choose between alleviating excruciating pain in their patients and going to jail, due to catch-all restrictions on the amount that can be prescribed.
4. Rather few doctors who prescribe opioids get kickbacks. I agree that this practice should end. But as long that the practice exists and is legal, I see no problem with a doctor accepting kickbacks if all his opioid prescriptions are medically justified. Any doctor who writes such prescriptions without medical justification is a rogue doctor and is part of the problem, whether or not he is getting kickbacks.
5. A minority of opioid deaths is caused by prescribed opioids; deaths due to diverted and illicit opioids constitute the majority.
6. The opiate of the masses is now opioids.
At some point, I’d like to write about Alzheimer’s / dementia, and probably I will. The demographic data, I find, is quite remarkable. It’s something I briefly allude to in this essay. The growth rate, too, is remarkable. My best thought of a cause is drugs, but I don’t know more than that at the present time. It’s a research project, and if you’d like to look into it, that would be welcome.
Well, in my limited experience—one parent died of multiple health problems including dementia, and one grandparent died of multiple health problems including Alzheimer’s—I’d say increased longevity leads to increased risk of developing some form of dementia.
Neither had a problem with illicit drugs, but both took prescription drugs. I assume you’re talking about prescription drugs here?