September 7, 2010

"Japan may be one of the most diabetic countries right now"

I'm reposting a comment to a post at Steve Sailer's on diet and evolution, specifically whether or not East Asians process carbs better than Europeans -- they are thinner than we are, so maybe they're better genetically adapted to a diet that a hunter-gatherer would find high-carb. I don't believe so, and the reason is that we have to look at the full spectrum of diseases that cluster into Metabolic Syndrome, not just obesity. No links are provided for the quotes below, as you can find them in the first page of googling "japan diabetes," which will give you more sources anyway.

Obesity is only one symptom within the larger cluster disease called Metabolic Syndrome or Syndrome X. It also includes type II diabetes, insulin resistance, heart disease, high blood pressure, hypertension, etc.

If East Asians deal well with carbs, then they should have low rates of these symptoms. They do tend to be thinner, but that is only because they don't eat loads of food to begin with.

More glucose causes more insulin causes more storage of fat -- but how much fat gets stored depends on how much chow you're eating. If they don't eat many large meals like we do, their higher glucose and insulin levels won't have as much fat to store.

So we need to check whether East Asians or other groups have high / rising rates of diabetes, insulin resistance, hyperglycemia, etc. Those are tell-tale signs of not dealing well with carbs, as they respond directly to how much glucose you're taking in, whereas obesity also requires a high level of food intake to show up.

The other symptoms of Metabolic Syndrome are runaway in East Asia, South Asia, the Gulf states, etc. See this post. Here's just one summary of the Japanese from 2005:

In fact, the prevalence of diabetes, particularly type 2 diabetes, is increasing explosively in Japan, as well as those in the other Asian and African countries. Japan may be one of the most diabetic countries right now. [...] insulin resistance enhanced by change of lifestyle ...

And another from 2002:

Among Japanese men, these changes have been associated with a steadily increasing body mass index (BMI), a well-known risk factor for the development of insulin resistance, impaired glucose tolerance, and diabetes. Genetic characteristics common to many Japanese may also contribute to their higher prevalence of diabetes. The Japanese have a higher prevalence of polymorphisms for at least three genes that code for proteins thought to play key roles in lipid and glucose metabolism: the beta 3-adrenergic receptor, the peroxisome proliferator-activated receptor γ, and calpain-10. The interaction between changes in lifestyle and the ‘thrifty’ genotype characteristic of many Japanese people may play a significant role in the increasing prevalence of diabetes and associated cardiovascular risk in this population.

Again, just Japan, but it's true for all other thin but carb-scarfing countries. They all point to their inability to thrive on a high-carb diet, but you'd only detect that by looking at diabetes, insulin resistance, glucose metabolism, etc., rather than just obesity.


  1. So what makes you think that it has anything to do with carbs? Do the Japanese really eat many more carbs than before? Could it not be another factor?

  2. I think it has to do with carbs because that's the mechanism connecting glucose, insulin, and fat storage.

    There's probably a subtler story about rising levels of sugars and starches compared to eating seaweed and nuts, but carbs are the main story because of the mechanism.

  3. What about exercise? The other normal reason for insulin resistance to rise is a lack of physical fitness. Could Japan be dealing with an overly sedentary society these days?

  4. agnostic, re: this no sugar, high fat hunter-gatherer diet you're always touting, do you eat only grass-fed animal products? Can you succeed on this diet eating all kinds of grain-fed products? Isn't that just like eating grains, except for the insulin part (which I guess is the main part, but then proponents of this diet are always talking about how it's better against inflammation and stuff)? Also, any thoughts on whether you should cut out artificial sweeteners?


  5. Probably the main reason I don't buy into the low carb fad - despite wanting to, it makes such good sense and taps into the timeless human desire to have finally found "the" solution that will give us health - is having lived in Asia for so long. These people don't just "tend to be thinner" - they are THIN! Super-thin! And they eat tons of carbs and sugar. Every meal - and I mean EVERY - is rice based, and sugars and just carbs in general are huge there. So what am I gonna believe, a theory or my lying eyes?

    I love though how you softpeddle the facts on this issue - THE major claim made on behalf of low-carb is that it causes fatness, and that is the reason why we are fat in America. This is claim #1, the central plank and pillar of low carbers - When faced with the reality of super-thin, carb-devouring Asians, suddenly this issue - the major claim of low -carbers - gets shoved to the side and all sorts of periphals come to the fore. Yes, they are thing but diabetic.

    Ok, maybe that's true - but then stop saying Americans are fat because of high-carb, start admitting entire parts of the world are high-carb and very thin anyways, and start questioning your claims and reappraising them! But no, Asians are high carb and thin? Well, Americans are still fat because of high carb. They just are. It's a good theory, and I'm sticking to it.

  6. East Asians are getting fatter, read the post.

    You can't put two ideas together -- that glucose drives up insulin which drives up fat storage, and that this requires a lot of food / fat intake in order to store lots of fat -- so there's no point in responding.

    Enjoy being thin and wracked by diabetes, heart disease, and the rest.

  7. You're privelaging theory over experience - maybe in theory, the human body works as you say. I admit it makes superb sense - in practice, as the reality of Asia shows, it is easy, and common, to eat an extremely high carb diet and be thin. That's reality. No matter how much good sense the glucose/insulin theory makes, no matter how many times it is backed up in critical trials, as long as the reality of the world shows that it is common and easy to be high-carb and thin, we must question the theory. Why not simply admit that we don't know? We just don't really know? We have a nice theory, but it is belied by too many realities - let us admit that we as yet don't know the true causes. The hardest thing seems to be to simply admit that we don't know a thing. We simply have to have dogmas and theories. I guess that's why Socrates was such a world-historical figure with his claim that he simply didn't know what others claim they don. That really is a revolutionary attitude.

    If you now are admitting that high-carb is perfectly and easily compatible with thinness, but is bad because of diabetes and heart disease, great, that's a claim that needs to be dealt with on its own terms. Glad the high-carb obesity thing though is no longer such a dogma.

  8. You still can't put the two ideas together. Glucose drives insulin drives fat storage. Eating a lot, including fat, provides the fat to be stored.

    Thus there is no contradiction of the high-carb leading to obesity theory. It's a necessary condition, and almost always sufficient, except where people don't eat that much at all. So it is compatible with people eating carbs and not being obese -- but compatibility is not the question, but how often that happens. Almost never.

    Again just give it a little time and Asians will be as obese as Americans, since the explosion in obesity is already underway.

    It's not a theory. The mechanisms are well understood. And it's not a rationalistic human design -- it's the outcome of natural selection that a high-carb diet screws us up.

    Obesity is not a single disease -- part of Metabolic Syndrome. That's why you cannot separate it from diabetes, heart disease, insulin resistance, hyperglycemia, etc.

  9. Gary Taubes gives his answer to the Asian question here:

    Go to 5:15 in and listen for a couple of minutes. In short, he thinks that refined carbohydrates -- sugar, fructose -- may be necessary to trigger obesity. Asians, while high-carbers, were historically on a very low sugar diet. Now they are not and obesity is growing.

    However, Taubes continues to point out, treating obesity is another question entirely. Once you've done the damage to your system, more drastic measures may be necessary -- i.e., cutting out all the carbs.


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