Women’s And Men’s Health Issues In Japan

Maintaining good health is major focus in Japan.

By RonBailey

Each year the National Institute of Health and Nutrition in Japan conducts a very thorough survey of the nutritional status of the Japanese population, with the results published in an annual report (in Japanese). The published information is an excellent source of current and historical information on basic vitamin and mineral consumption, trends in food and nutrient intake, blood cholesterol and blood pressure status and other useful nutrition and health-related data. Data from the most recent survey (1997) published last year included the following highlights:

* Energy (calorie) consumption on a daily basis was right on target at just over 2000 calories per day for the average participant (both male and female) in the survey, with the predictable age-related differences compared to the targets for each age group. This result is considered a strong positive given the increased availability and consumption of relatively high fat Western-style foods in Japan.
* Calcium consumption was again lower than the 600 mg per data Recommended Daily Allowance (RDA) target, at an average of 579 mg per day. Calcium is the only vitamin or mineral that is deficient in the average Japanese diet for both men and women, with lowest consumption among 20-39 year-old men (87% of the RDA) and 15-19 year-old women (71% of the RDA). Although calcium consumption has been gradually increasing over the years, the deficiency across most adult age groups and for both men and women is of serious concern in Japan.
* Iron consumption for young women continued to be lower than the 12 mg RDA in the 30-39 year-old age group in particular (84% of the RDA), but of no concern among adult males.
* Calories from fat has been increasing slowly as a percent of the total calorie intake and is now at 26.6%, but the upward trend has essentially stopped, based on data from the last three annual surveys. While this is encouraging, the sub-group of 7-14 year-olds (males and females) consumed just over 31% of their calories from fats and oils. This is consistent with the concern in Japan that young people of both sexes are getting less exercise and consuming too many high fat foods, which may prove to have negative health consequences in the future.
* High blood pressure is of concern for older people (60 and above) of both sexes, with around 30% of the survey participants in these age groups having a blood pressure reading that is considered unacceptably high in Japan. For men, the highest incidence was in the 60-69 year-old age group, while for women it was primarily after age 70.
* Blood cholesterol levels continue to be of concern for both sexes, although more so for women over 50 years of age. Over 53% of women had a total blood cholesterol reading of greater than 200 mg/dl, with the biggest increase beginning after age 50. For men, over 46% had similar readings, with the increase coming after age 40. In terms of health risks, however, it is worth noting that there is some evidence (JAMA, 7/12/95) that a 200 mg/dl total blood cholesterol level in a Japanese person does not result in the same risk of dying from heart disease as in the U.S., for reasons that are not yet clear.

Lifestyle Issues—Women and Men

Perhaps the most important statistics at least broadly indicative of the overall health status of women and men in Japan relate to life expectancy. While both sexes currently have the longest life expectancy in the world, the 1998 Ministry of Health and Welfare data showing women with a life expectancy of just over 84 years and men at just over 77 years suggests significant health differences between the sexes. The nearly seven-year age gap is in fact expanding and has been for several years.

It has been suggested that there are many lifestyle differences that might help to explain the differences in life expectancy. Cancer is the leading cause of death in Japan and has been since 1981. Lung cancer deaths in particular are much more common among men than women, consistent with the relative incidence of cigarette smoking between the two groups. Alcoholic beverage consumption is also higher among men and this is predictably reflected in the statistics for deaths from cirrhosis of the liver. Other leading causes of death in Japan, including cardiac failure and cerebrovascular failure, are commonly considered to be at least somewhat related to lifestyle choices, including overwork. It has been estimated that if these three major causes of death in Japan could be eradicated, the average life expectancy would increase by another eight to nine years for both sexes.

On a somewhat less threatening level, statistics on stress collected by the Ministry of Health and Welfare in Japan indicate that for 20-40 year-olds the father’s work is clearly the most common source of stress, whereas for women in that age group it is child care and the children’s education. It is common for women to stop working outside the home after marriage, or at least by the time the first child arrives, and this means those women have the luxury of not participating in the daily commute and long work hours that are part of a normal hectic urban lifestyle. Later on in life the stress related to senior citizen caregiving, which is commonly done at home by an older female caregiver, is the most common source of stress for those age groups.

FOSHU Health Targets

The category of FOSHU foods in Ja­pan is formally endorsed by the Japanese Ministry of Health and Welfare and the products are actually approved by that government health agency. It is therefore appropriate to assume that the health conditions for which on-label claims can be made for FOSHU products are considered significant from a health maintenance point of view in Japan. These claim areas include:

* Gastrointestinal health via probiotic bacteria, prebiotic oligosaccharides and
fiber sources such as psyllium seed husk and wheat bran
* Bone health via calcium sources such as calcium citrate malate
* Cholesterol reduction via soy protein, chitosan, sodium alginate and beta- sitosterol
* Anemia elimination via iron sources such as heme iron
* Blood pressure reduction via various peptides and a Chinese herbal extract
* Blood triglyceride control via diacylglycerol
* Dental caries prevention via palatinose and maltitol

Most of the FOSHU foods are not positioned specifically to men or women but more generally to the health condition. Japanese consumers are well aware of the special calcium and iron needs of young women, however, and it can be expected that those products are primarily consumed by that group. In addition, Japanese women are generally much more interested in trying new products (not just foods) of all types, and much of the marketing is skewed to women for that reason as well.

In terms of new products, a review of the Functional Food and Health Food section of the December, 1999 JapanScan Food Industry Bulletin published in the U.K. by JapanScan Ltd. is also instructive in terms of learning which health conditions are believed by non-drug, non-FOSHU food marketers to be important in Japan at the present time. New product introductions featured in that issue of JapanScan included the following ingredients and health targets:

* Oolong tea extract for dental plaque and dental caries
* Blueberry anthocyanin for eye comfort
* Cranberry juice for urinary infection
* Fructooligosaccharide for bifidogenic intestinal health
* Vitamin D for calcium absorption
* Konjak fiber as a low (zero) calorie diet aid
* Fruit pectin for cholesterol control
* Red wine for its polyphenol antioxidant content
* Collagen beauty drink for healthy skin maintenance

The marketers of most of these new product examples would expect the products to be primarily consumed by women, at least initially, even if the product label does not specify a primary user. The health conditions mentioned are not restricted to men or women, but the most receptive audience is likely to be female. As an example, the average young Japanese female is clearly not fat, and not even overweight by any normal standards, yet the primary users of diet and weight loss products in Japan are young women since it is generally considered that “thinner is better.”

Expectations for the Future

It can be expected that women in Japan will continue to lead the way in consuming foods to maintain and improve their health and that marketers will tend to position their products to women for that reason. The men who are interested in personal health will follow the lead of the women, although often not very quickly and not with the same level of enthusiasm. As a result, it is expected that the life ex­pectancy gap between women and men will continue to increase, even though there are hopeful signs such as a decreased incidence of smoking among men in Japan, which will help to reduce the rate of increase. It can also be expected that an improved diet (more calcium, more iron, reduced salt and pickled foods, controlled fat consumption) will help to reduce the incidence of serious diseases and require less drug intervention. This future applies to both women and men equally, as long as both groups are willing to make the diet and lifestyle choices appropriate for improved health. Clearly this conclusion is not limited to Japan, even though the Japanese priorities for health maintenance, and their response to those priorities, will continue to be unique.

NW

Ron Bailey is president of California Functional Foods and has been an independent consultant for the past 15 years, focusing primarily on the transfer of food technology between the U.S. and Japan. He can be reached at 165 Almond Street, Ashland, OR 97520; 541-488-3184; Fax: 541-488-3274; E-mail: bailey@mind.net.