Why are Asian people eating rice thin?

rice

It’s a common question. If carbs can make you fat, why were some populations (e.g. Japanese people) thin while eating a high carb diet?

Dr. Peter Attia has written a nice post on this: The Eating Academy: How do some cultures stay lean while still consuming high amounts of carbohydrates?

I basically agree with his ideas, although I think there are a few more answers to this question: 

The three big reasons

Here are the main reasons why I think populations could stay thin on high carb diets:

  1. Low to insignificant consumption of refined sugar (fructose). This may stop insulin resistance from developing.
  2. Traditionally they used to eat mainly unrefined starch (e.g. brown rice, root vegetables) that is slow to digest, due to high fiber content etc.
  3. Traditionally more physical activity then sedentary western population. Compare a Japanese rice farmer (in the field all day) to an American office worker with a car. If you burn more glucose (via physical activity) then less insulin is needed when you eat carbs.

If you avoid sugar (fructose) and refined high GI starch and stay physically active you can probably stay thin and healthy on a high percentage of carbs. Lots of populations have done so.

Addition:
Some people have rightly pointed out that Asian populations no longer eat brown unrefined rice, they now eat white rice. True. It’s also true that these populations are no longer thin and healthy – India and China now experience two of the worst type 2 diabetes epidemics in the world, even worse than in the US.1 This disease is connected to weight issues, particularly abdominal obesity.

Even using BMI (an imperfect measure, see below) the number of obese people in China have already surpassed the US. So what I’m discussing in this post is how these populations used to stay thin and healthy, because unfortunately they no longer are.

When did this problem (obesity + diabetes) start to accelerate in Asia? About at the same time as sugar and white rice was added to their diet.

Three more factors

There are three more minor factors that may have contributed to these populations staying thin, in past times:

  1. Poverty: These traditionally thin populations were on average fairly poor by todays standards, meaning perhaps they could not always afford all the food they would like to eat.
  2. Food reward/addiction. This may be controversial, but I think there is a point to all this food reward talk that’s been going on in the blogosphere. Our processed junk food and candy is carefully designed to artificially make it taste great and be addictive. It also contains a lot of sugar and starch. It’s like cigarettes: The nicotine makes people addicted, thus they smoke a lot and the smoke gives them cancer. Fast food and candy are also addictive, thus people eat more of it and the sugar/starch overdose makes them fat.
  3. Genetic makeup. Asians do not look like Caucasians or Africans. They have (on average) way less musculature, they have a thinner build. This means that comparisons between the weight of Americans / Europeans and Asians using BMI is misleading, it exaggerates the difference. Asians are often “skinny fat” or even get diabetes at BMI levels that are considered normal for Caucasians (e.g BMI 24).

What do you say?

What do you think about this common question and the possible explanations?

Advanced low-carb topics

Weight loss

Exercise

Diabetes

359 comments

Top comments

  1. Dear Laura
    I am a Professor of Biochemistry but we all have a lot to learn.

    1. The concept of tortuous metabolic pathway is not in the biochemical texts. Both fructose and glucose proceed through separate pathways of glycolysis but converge at the level of the triose-phosphtates so, at that point, they are essentially the same. The difference in metabolism has to do with the relative rates of the different enzymes and depends on a large number of factors. Ethanol does not proceed through this path except possibly under some unusual conditions. Ethanol is oxidized ultimately to acetyl-CoA and goes into the TCA cycle.

    2. Reading your comment, though, it hit me that this process is not called detoxification. In fact, the metabolism of alcohol through the dehydrogenates to acetyl-CoA is not called detoxification either. Detoxification of alcohol usually refers to the process at high alcohol ingestion where alcohol is less like a food than like a drug. In this case, it is not oxidized through the normal pathway but rather through the cytochrome P450 system which is completely different from normal metabolism and is considered detoxification but I don't think that fructose ever enters this system.

    3. On the specific point you raise though, glucose is the major source of protein glycosylation. This is because, although fructose exists to a greater degree in the open (free aldehyde) form, there is much less fructose in the blood. First, there is more glucose altogether but, remember, your body maintains blood glucose while it clears fructose. I challenged Lustig on this once and he did have an example where fructose was more important than glucose but this is rare.

    That's some of the biochemistry that I do have although I admit that I could use more.
    RDF
    (i answered this in email so forgive possible duplication)

    Read more →
  2. Lustig can't be wrong because his is all over the place. He's as ubiquitous as Alec Baldwin so at some time he's said everything. "I am not against sugar" but it is a toxin. "I am not opposed to low-carb diets" but he would never use them because patients can't stay on them, never mind that the data show that they have better adherence than others. The problem with Lustig is that he has given up on scientific method and scientific rigor. His indictment of sugar is analogous to banning Hondas because the increase in traffic jams correlates with the increase in Hondas.

    From my perspective, he is making a parody of teaching biochemistry which is my job. A metabolic map is like any map. It tells you where you can go but it doesn't show you the traffic lights or the road construction. Also, what's missing from Lustig's compelling talks is data. The studies that support sugar as toxic are done at a total carbohydrate of 55 %. Under those conditions adding fructose is clearly worse than adding glucose, but is that what we want to know. Science is about the facts and understanding so, in some sense, there are no credentials but Lustig is simply not acting like a biochemist although he wants to take credit for being one. We could be wrong in our methods but he is definitely not a biochemist. The reason real biochemists don't like to jump in here is because we are reluctant to make sweeping statements. But we have some data and as far as we know, the effect of replacing fructose with glucose even under the conditions that he cites, is generally not as great as replacing any carbohydrate with any kind of fat.

    The bottom line from a therapeutic perspective is that the mass of data clearly shows that for diabetes and metabolic syndrome and obesity, dietary carbohydrate restriction is the best bet -- if it doesn't work, thou can try something else. If you want to take sugar out of the diet, even just sugared soda as a strategy for reducing total carbohydrate, that may be very effective for obesity. For diabetes, it may be better to reduce starch depending on the individual case and conditions. What's scary about Lustig is that he is on the American Heart Association panels, the group who have gone out of their way to attack low carb diets and to distort the scientific data.

    In term of the original thread on Asian diets, it is obvious that we don't know enough to make any clear statements although all the comments touch on relevant stuff. Overall, what we know is less than what we don't know but if you give up on scientific method, you've got nothing.

    Read more →
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All comments

  1. j
    it does not matter how much we eat coz we eat a lot! the reason why we asians are skinny is because we walk a lot, sweat a lot and move a lot. that is our exercise. if you are a westerner in asia wondering why you are not losing weight, maybe because you stay inside your air conditioning room all day.
  2. Rachel
    I'm Chinese I grew up thin then went obese in my 20s eating western diet then managed to slim down myself.

    I do not think rice is very refined carbs compared to packaged desserts(processed food) that you buy from the super market - and all this is western import food. It's when I ate the packaged desserts and drunk coca cola and similar sugary drinks bought from the supermarket etc. that made me fat.

  3. Brian
    Thank you for addressing this, but I do not believe we have the correct answers in the article.

    1) Low consumption of refined sugar. White rice is already pretty refined. When you eat it, it turns to glucose. It is true, though, that the consumption of fructose is likely lower.

    2) I'm a type 1 diabetic, so I know how foods affect my blood glucose. It's pretty much BS to assume that things like brown rice digest slowly when eaten alone. I follow a lot of diabetes forums, and the difference between a food that spikes your glucose in 10 minutes or 15 minutes is going to be negligible. Rice is very spiky - brown or white.

    3) More physical activity. THIS I will buy. Also from my type 1 experience. I make no insulin, so I always know how much insulin is in my body (because I'm injecting it). If I don't exercise, I need to inject 200-300% more insulin than if I'm exercising heavily. Also, exercise has an effect for up to 24 hours (or if you really do a lot, maybe 48 hours).

    4) Poverty: Yes, quite likely! Eating fewer calories overall (regardless of the macro composition) seems to be the consistent way to prevent type 2 diabetes. Also, we see studies of life extension on a calorie restricted diet. Poverty can be a double edge sword: often the cheaper foods are less healthy (think hydrogenated oils). But if you're eating inexpensive rice and veggies and not eating a surplus of calories, you can be healthy... This follows along with some recent theories of Type 2 diabetes NOT being caused by defective insulin/insulin receptors... and instead being caused by a general surplus of energy in the body.

    5) Addictive food... this goes along with overeating theory.

    6) Genetic makeup. Genetic Makeup is actually a factor, as we see populations that have not historically been exposed to high nutrient density having a much higher susceptibility to Type 2 diabetes and it's associated health risks. If anything, I would expect these thin people to be much more prone to type 2 if they adopted a nutrient dense "western diet" - more susceptible than westerners who have been exposed to surplus calories for a longer period of time.

  4. deborah conner
    I think Jason Fung's work with fasting also gives some insight here. Simply, short intervals between meals, snacking, keeps a steady flow of insulin in the blood, whereas periods of fasting -- not eating between meals or from after dinner until breakfast -- allow recovery. Factor this into the model. When in the West are we not glomming or imbibing?
  5. Leslie in San Francisco
    I did not read all of the comments but I personally know that many Chinese and other Asian Americans subscribe to the rule of only eating until you are 80% full. They do not stuff themselves. Nor do they eat fast food and refined sugar desserts aplenty as I regrettably do.
  6. Martie
    I spent one month in Vietnam eating with a local family. We ate heaps of bone broth with bits of meat and the family enjoyed heaps of nourishment from eating all the gelatin and other fibres around the bones.. We ate piles of green leafy vegtables often using these to wrap titbits such as prawns. We ate no deserts or glutin, no dairy and a little fruit after the meal. Then heaps of green tea with each meal. bones, herbs, protein fat and greens with total lack of processed food.

    In 4 weeks my artthritis improved so much I could walk up the stairs on to the aeroplane without effort! I had not done that for almost 3 years before my holiday. Now I am trying to eat similarly and each time I deviate, the inflammation in my joints returns.

  7. Fran
    No sugar is used
  8. Joan Geohegan, BSN, CDE, T1D 51 years
    Visceral vs abd fat.
  9. Helen
    Up until 50 years ago, every culture in the world ate a lot of starch, including bread, potatoes and rice, but very little SUGAR. Now almost every processed food contains sugar, and it is a huge per centage of calories all over the world, including Asia. I struggled with low calorie diets for years, then did keto for a decade, but was not able to maintain my weight until I totally ditched sugar. Now I bake my own sourdough bread and eat reasonable portions of potatoes and rice, and have completely conquered my sweet cravings, and have maintained my weight within 1.5 pounds for a year without counting calories, carbs, or anything else. The reason Asians never used to gain weight or have diabetes is they ate miniscule amounts of sugar. Now they eat tons, and are as fat and diabetic as everyone else in the world. Lustig is right!
  10. Judith
    My daughter was recently in Japan and asked me the same question when she returned. Obviously the answer is complicated. But I find after years of researching nutrition and asking "why" that the introdfuction of highly processed foods in any Country starts them spiraling downward to the same metabolic problems and diseases we have here in the USA.
  11. Wayne A
    Asians eat HULLED white rice. The hulls have lectin which is 'poisonous' to our systems. Same thing with beans.
  12. S K
    Two things:

    1. Not all of us have diabetes from being overweight. There are two types. Type I diabetics have pancreases that make no insulin.

    2. In this article, it states "India and China now experience two of the worst type 2 diabetes epidemics in the world, even worse than in the US." This is sensational data as each of those countries have a population of nearly 4 times that of the US. Proportionately, the 49-52% of the US population has diabetes or pre-diabetes while that same number is about 47% in China (The JAMA Network Journals, 2017). Claiming the number rather than percentage is just a gimmick to draw readers in to believing you. Not cool!

    References
    The JAMA Network Journals. (2017, June 27). High prevalence of diabetes, prediabetes in China. ScienceDaily. Retrieved August 23, 2018 from http://www.sciencedaily.com/releases/2017/06/170627134326.htm

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