The way the World Eats and Lives – The World’s Healthiest People
Now that you have some sense of what we’re doing wrong, I want to introduce you to the places where people are eating better and living longer, healthier lives. According to the CIA’s World Factbook, these are the places that have the highest life expectancies in the world, ranked in order:1
1. Macau (84.36 years)
2. Andorra (82.51 years)
3. Japan (82.12 years)
4. Singapore (81.98 years)
5. San Marino (81.97 years)
6. Hong Kong (81.86 years)
7. Australia (81.63 years)
8. Canada (81.23 years)
9. France (80.98 years)
10. Sweden (80.86 years)
11. Switzerland (80.85 years)
12. Guernsey (80.77 years)
13. Israel (80.73 years)
14. Iceland (80.67 years)
15. Anguille (80.65 years)
16. Cayman Islands (80.44 years)
17. Bermuda (80.43 years)
18. New Zealand (80.36 years)
19. Italy (80.20 years)
20. Gibraltar (80.19 years)
21. Monaco (80.09 years)
22. Lichtenstein (80.06 years)
23. Spain (80.05 years)
So where, you might be asking, does the United States fall on this list? The answer is pretty grim. Despite being the richest nation on the planet, the United States comes in only at number fifty, with an average life expectancy of 78.11 years—a ranking that seems to get worse with every passing year.
In 2006, Americans’ average life expectancy was 78.1 years, or 80.7 years for women and 75.4 for men, which isn’t all that bad in the grand scheme of things. But even in spite of the nation’s alarmingly high suicide rate, Japanese live 82.12 years on average (85.6 years for women and 78.7 years for men). In Andorra, a tiny mountainous country sandwiched between France and Spain, residents live even longer, an average of 82.51 years.
When you consider that the United States has the most money and the most advanced medical technology in the world, you might reasonably assume that Americans would also be the longest-lived people. So what do the Japanese and Andorrans know that we don’t? What exactly is the problem?
I can sum up the answer in one simple word: fat. Research indicates that dietary habits have a direct and profound impact on health, and as we’ve already discussed, Americans’ dietary habits are unhealthy in the extreme. More than any other factor, our expanding waistlines are to blame for our shorter life spans. That’s why overhauling our lifestyle, especially our diet, is the number one change we can make to improve our health over the long term. And to make these essential changes a reality, we need to borrow a few secrets from the countries that are getting it right.
COMBINE AND CONQUER: A SNEAK PREVIEW
What I call the combine-and-conquer strategy is an often overlooked key to healthy eating. Variety is the spice of life, and it might also be the secret to good health. The 5-Factor World Diet takes a global approach to eating precisely because there are great advantages to combining multiple healthy customs from several cultures into one diet. Honestly, why would you settle for eating one type of healthy cuisine when science and statistics have already proved that mixing healthy cuisines together is the key to losing even more fat, improving your health, and reducing your risk of disease? With this diet, you don’t have to.
Singapore—number four on the life expectancy list, with citizens living almost eighty-two years on average—is a perfect example of the power of finding the right mix of cuisines. This tiny island nation’s diet is a mixed bag in the best sense, influenced by many of its ethnically diverse neighbors: Malaysia, China, southern India, and Indonesia. There is even a distinct European stamp on Singaporean cuisine, since the British founded Singapore in the early nineteenth century. Individual elements of all these cultures are still evident in Singaporean dishes today.
You can see further proof of the benefits of the combine-and-conquer strategy in Andorran cuisine. The average Andorran lives more than six years longer than the average American. One reason for this strong statistic might be that instead of eating their own distinct cuisine, Andorrans eat a mix of different foods, combining the best elements of the much larger regions that border their small country, Catalonia (in Spain) and France.
By this definition, shouldn’t the United States have the healthiest food in the world? After all, few countries are home to as many different ethnic groups. That’s true, but unfortunately Americans have adopted the unhealthiest elements of these groups’ cuisines and blended them all together to make one big, unhealthy soup.
By contrast, Canada, my home country—which ranks number eight on the life expectancy list—is, like the United States, a nation of immigrants, but with one critical difference: Canada is a salad bowl, and America is a melting pot. In a salad bowl, everything is all mixed up together, but you can still recognize each ingredient and each influence. If you pluck one out, it retains its flavor, taste, and color. In Canada, which was settled simultaneously by the French and British, ethnic influences have coexisted for centuries. Cultures meet and share influences without losing what makes each of them unique.
In the United States, everything tends to melt into one homogeneous entity. The food court in an American mall is a classic example of this phenomenon. At one food court I visited, the Chinese, Cajun, and Japanese restaurants were all giving out samples of chicken tenders. I tasted all three, and I swear to you that I couldn’t tell the difference between them—not even a little bit. All three had been heavily Americanized, and they’d completely lost whatever had originally made them distinctive.
In the 5-Factor World Diet, we take a very different approach, searching the globe for the most delicious and the healthiest foods and cooking methods, then bringing them all together—but without losing what made these foods interesting in the first place. We cull the best of what the world has to offer and leave the rest behind.
Let me now explain how I ranked the world’s cuisines.
WHAT WENT INTO THE RANKINGS
After nearly a decade of traveling the world with celebrity clients, exploring the best foods the world has to offer, I had a pretty good idea of which places were healthy and which were less so. But my rankings are by no means a mere matter of opinion. In addition to drawing on my own observations and experiences, I arrived at my Top 10 list based on the two groups of statistics highlighted earlier: the WHO’s list of the fattest countries in the world and the World Factbook’s list of global life expectancy rates. There is, not surprisingly, very little overlap between these lists, since the residents of the longest-lived countries also in many cases happen to be the thinnest people in the world (with the exception of famine-ravaged countries).
Life expectancy is, of course, measured by many different statistics. In a few rare cases, a population’s longevity can be attributed to having access to socialized medicine or top-notch prenatal and natal care, to lower incidences of war, or to a lower crime rate, as is the case in Iceland.
The eradication of infectious diseases in the industrialized world also has added quite a few years to the average citizen’s life, which is why we focus on countries with a standard of living similar to that of the United States. The country with the shortest life span, Swaziland—whose citizens live an average of 39.4 years—is, like many of its neighbors in sub-Saharan Africa, plagued by diseases such as AIDS, poor health care, famine, lack of clean drinking water, and civil conflicts.
But again, you might be wondering why the United States, which has none of these problems, lags so far behind other countries in life expectancy and other critical measures of health. The answer is complex. For one thing, almost 47 million Americans (that’s roughly the population of South Africa) have no health insurance, which means they receive little preventive care for health issues in their early stages.2 Diabetes, heart disease, and many other problems are often neglected until far too late. The United States also has a surprisingly high infant mortality rate, with an estimated 6.8 deaths for every 1,000 live births.3 This figure is even higher among minority populations such as Hispanics and African Americans.
When choosing the world’s healthiest countries, I also looked at other statistics, including the percentage of both overweight and obese adults, how many calories the average citizen consumes on a daily basis, and the proportion of meat to vegetables in people’s diet. When the data was available, I looked at how much people exercise every day and in what context. I took into account some more subjective, less easily quantifiable criteria, such as what ingredients people use, what cooking techniques are the most popular, and what, if any, impact those considerations may have on a population’s health.
I want to emphasize that there are many different factors that go into the health of a nation. Although oversimplification is tempting, I made a point of taking into account what I call “confounding factors,” all of which made my reading of these statistics more nuanced. So that the comparisons would be meaningful, I stuck with industrialized countries with a standard of living and an availability of resources (including food, technology, and health care) roughly comparable to those of the United States. I excluded countries that face problems such as famine and widespread disease, as in many countries in Africa, which have low obesity rates but also low life expectancies.
Genetics also plays a role that can be hard to quantify in assessing the health of any large group of people. Certain ethnic populations, for example, are more predisposed to certain health issues than others: Hispanic women are more likely to deliver preterm babies, African Americans are more vulnerable to type 2 diabetes, and people of Mediterranean descent are predisposed to thalassemia. Still other groups are more prone to certain types of cancer. I took all of these factors into account when making my list.
Of course, you can’t judge the health of a nation just on the basis of how its inhabitants eat. You must also examine how they live—and move. With that in mind, I looked at people’s physical activities in various aspects of day-to-day life and how those activities influence overall health. What occupations are most common? Do people engage in manual labor, or do they spend most of their workdays sitting in front of a computer? How widespread is technology, particularly television and other forms of stationary entertainment? How much does the average citizen walk every day? How do most people get to work—on foot, by bicycle or public transportation, or in a car—and does their mode of transportation have an impact on their health? I will be asking these questions and many others as we travel from country to country in search of better health.
The Big Picture
In the end, after crisscrossing the globe in search of the healthiest diets and lifestyles, I narrowed my focus to ten countries in Asia and Europe. Many of these countries’ diets might be familiar to you, and that’s a good thing: you may already have a grasp of the basic principles and ingredients that are key to enduring health. But be careful. Remember my trip to the food court: in many cases, we “Americanize”—that is, make more unhealthy—cuisines that, in their native form, could be doing us a lot of good. In this post series, I’ll teach you how to combine the healthiest elements of the Top 10 cuisines into a tasty, varied, and nourishing way of eating and thinking about food.
And now, what you’ve all been waiting for, my Top 10 list of the healthiest nations on the planet:
THE TOP 10 COUNTRIES
8. South Korea
In the country-by-country assessment in part 2, you’ll find a sample of these countries’ daily menus and explanations of their cuisines through the lens of five simple categories.
What They Eat
This is a broad overview of the country’s diet: what types of food the people eat and why. I touch on climate, agriculture, and other factors that influence diet.
What’s in It
Here I examine the ingredients that make the nation’s diet unique and of interest to us, including the most popular beverages. Some of these ingredients might be familiar to you already; some of them might sound as if they came from Mars. I hope that all of these ingredients will have made their way into your grocery cart.
How They Prepare It
This section offers a broad look at the most common cooking methods in the country. Why do the French braise and the Chinese stir-fry? Why is baking virtually unknown to Korean chefs? I also touch on the most frequently used cooking base in each country: is it butter, olive oil, canola oil, or, as in the United States, corn oil?
How They Eat It
Here I explore the ceremonial and cultural aspects of eating. After all, it’s not just what we eat but how we eat it that affects our health. This category is broad, encompassing everything from dining ceremonies to a nation’s philosophical approach to food.
Occasionally under this heading, I address Americans’ widespread misconceptions about certain “foreign” dishes and cuisines. Do the Chinese really begin every meal with greasy fried egg rolls? Do the Italians live off massive servings of pasta drowning in cream sauce? Sometimes it’s important to examine the differences between what we think other cultures eat and what they actually consume.
How They Burn It
In this section, I take a look at how people burn calories. You might be surprised by how simple some of their exercise secrets are. I cover everything from formal group exercise to practical getting-to-work routines.
So let’s get going. We’ve got a lot of territory to cover in our culinary trip around the world.
1. CIA, The 2007 World Factbook.
2. U.S. Census Bureau, “Income Climbs, Poverty Stabilizes, Uninsured Rate Increases” (press release, August 29, 2006).
3. “Infant Mortality Rates Are Rising in U.S., While Rates in Other Countries Are Improving,” ABC News, November 1, 2005.