Why is the occurrence of diabetes so low in Japan when white rice is staple?

Replied by Misha Yurchenko (ユルチェンコ ミーシャ)

Japan-based entrepreneur, author and avocado-eater

Rice isn’t bad on its own. You could eat rice and fish and veggies all day and you’d be fine — that’s what we do in Japan. Besides, Japanese people often put rice vinegar (in sushi) with their rice, which reduces the initial blood sugar spike.

That said, the rate of diabetes is increasing in Japan. I’m not going to single it down to one factor, because there are so many individual, biological variables. But like most of the world, diabetes rates have been rising since the introduction of the Western diet. Coupled with Japan’s stressful work environment, this is a recipe for disaster.

This does not mean people are going to be visibly obese. As you know, you can be a skinny diabetic or have metabolic syndrome but not tip the scale.

Eating large amounts of carbs causes insulin resistance which can lead to diabetes. Added sugar is often the culprit. Over 80% of foods in American grocery stores have added sugar to them. These products have made their way to Japan.

I was eating kaiten sushi (carousel sushi) the other day and noticed the soy sauce had added sugar. Why? Why is this necessary?

Rice isn’t bad on its own. You could eat rice and fish and veggies all day and you’d be fine — that’s what we do in Japan. Besides, Japanese people often put rice vinegar (in sushi) with their rice, which reduces the initial blood sugar spike.

That said, the rate of diabetes is increasing in Japan. I’m not going to single it down to one factor, because there are so many individual, biological variables. But like most of the world, diabetes rates have been rising since the introduction of the Western diet. Coupled with Japan’s stressful work environment, this is a recipe for disaster.

This does not mean people are going to be visibly obese. As you know, you can be a skinny diabetic or have metabolic syndrome but not tip the scale.

Eating large amounts of carbs causes insulin resistance which can lead to diabetes. Added sugar is often the culprit. Over 80% of foods in American grocery stores have added sugar to them. These products have made their way to Japan.

I was eating kaiten sushi (carousel sushi) the other day and noticed the soy sauce had added sugar. Why? Why is this necessary?

Charles Boyce (ボイス, チャールズ)

Aug 30, 2017 · 20 upvotes including Misha Yurchenko (ユルチェンコ ミーシャ)

This is incorrect. Japan is 5th worldwide in the number of Type II Diabetes cases, and the best estimate is there are about 3 million untreated cases as well.

There is plenty of sugar and carbs in the Japanese diet, and until a few generations ago, one bowl of rice, not to mention people eating multiple large bowls of rice was not common.

One ‘traditional’ small dorayaki has 50–60 grams of carbs, 40 to 50 grams more than the daily limit on a low-carb diet.

Dependind on the serving, there are 50–100 grams of carbs in one bowl of rice, which is soon turned directly into glucose. This is the same as eating raw sugar by the tablespoon.

The poster said that ‘fat, sugar and carbs causes insulin resistance,’ which is also incorrect. Fat, without carbs and sugar, does not cause insulin resistance. If eaten with a low-carb diet, fat is burned by the body, resulting in better cholesterol numbers and weight loss. Low fat milk has more carbs than heavy cream. Cheese has generally one gram or less of carbs per large serving. Conventional wisdom has been wrong.

Japan has many root vegetables, fish, and other dishes which, without rice, are very healthy. But add too many carbs to any diet and the incidence of diabetes will increase.

Read the original Atkin’s research or any of the other recent studies on dieting. Carbs, not fat, are the major culprit.

Replied by Misha Yurchenko (ユルチェンコ ミーシャ)

Charles, thanks for the comment. I mostly agree with what you’ve said and have slightly changed my post to reflect your points (specifically about insulin resistance).

Japanese people have been eating rice for the past 1000 years, so it doesn’t make sense to say that simply more carbs are causing this sudden increase in diabetes over the past couple of decades.

From everything I’ve researched, sugar+carbs, not only carbs, have been the culprit that have spiked the diabetes and metabolic syndrome epidemic globally. Because the diagnosed cases have continued to increase, as you pointed out, I’ve found no other variable that’s changed in the human diet the past 100 years except for sugar.

I realize there is some ongoing debate in the scientific community and I find it an endlessly interesting topic to follow!

Kevin Speck

I’ve lived in Japan for the last 14 years, and agree with both Misha Yurchenko (ユルチェンコ ミーシャ) and Charles Boyce. The traditional Japanese diet that has a lot of vegetables along with moderate quantities of rice is OK (the vegetables slow down the rate at which the carbohydrates of the rice is transferred into glucose, and therefore even out blood glucose (blood sugar) spikes). However, my wife is Japanese, and we`re both medically trained, and we only eat brown rice (玄米), because it is a lower GI food than white rice (and healthier). We also eat Sweet potato as despite its name it is one of the lower Gi foods. However, Misha Yurchenko (ユルチェンコ ミーシャ)`s view about more sugar being added to the diet, more western food being eaten, and typically patterns of unhealthy lifestyle (excessive alcohol intake, excessive work hours, lack of sleep time, life stress, high rates of passive smoking as non-smoking policies are rare in eating places, etc), also contribute a lot to Japanese health problems. The traditional diet of fish, a lot of vegetables, and moderate quantities of rice is not bad at all and it is no coincidence that older Japanese on those diets are some of the longest lived in the world. On the other side of the argument, I went on ketogenic diet last year that was very low carbs, so I understand the low-carb approach. However, at my work place, no one has time for decent home cooking, so most of my Japanese workmates only eat convenience store prepared meals, and of course beer is a big part of after work events along with Izakaya type foods in a smokey environment. So, the rise in dabeties among Japanese is part of a larger problem. Moderate intakes of unrefined carbohydrates, along with fish and vegetables are fine by themselves. Of course the key word is moderate, if someone is skimping on cooking properly and just eating three bowls of white rice, then that is bad.