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Web-only Exclusives
November 30, 2000

From Our Correspondent: Hirohito and the War
A conversation with biographer Herbert Bix

From Our Correspondent: A Rough Road Ahead
Bad news for the Philippines - and some others

From Our Correspondent: Making Enemies
Indonesia needs friends. So why is it picking fights?

Asiaweek Time Asia Now Asiaweek story

THE ROAD TO FIT AND TRIM

By Tim Healy and Helen Wong / Hong Kong


Check-Up Reading Asia's Vital Signs

Challenges Hospitals face up to changing times

Crisis Medical facilities are barely coping in Indonesia

Checklist How hospitals stack up

Rights Patients push for a bigger say

Rural Warriors A humanitarian organization trains an army of doctors in China

The East The future of traditional Asian medicine

The West Americans are turning to alternative therapies

Therapy Sang Lan: The injured gymnast hopes to walk again

Celebrities The "inside" stories of people in the news

Advances Breakthroughs in medical technology

YOU'VE HEARD ABOUT THE Asian Economic Miracle - it might not have been so astonishing after all. But regional pride can now be boosted by a different paradigm backed by solid emperical evidence: The Asian Nutritional Health Model. It turns out that the traditional diets and lifestyles of many regional cultures are extremely good for you. But diet is just one factor that determines a person's overall health; fitness is at least as important. Also, the Asian diet is under threat, especially in economically advanced societies, from higher-fat choices with roots in the West.

First, the good news: A proven formula has been developed to promote a long, healthy life. Even better is that the prescription is rooted in the kinds of foods and active lifestyles that have traditionally characterized Asia. One of the biggest and most comprehensive medical studies ever conducted on diet and health shows, for instance, that the vegetables and grains embraced by many rural Chinese for centuries are precisely the ones that best suit humans. The long-term study, conducted jointly by Cornell University in the U.S., Oxford in England and the Beijing-based Chinese Academy of Preventative Medicine, set out to examine the eating habits and illnesses of 6,500 rural Chinese. It has been expanded to include more mainlanders and Chinese in Taiwan.

The study challenges conventional thinking with its finding that obesity is much more a function of the quality of one's diet than quantity. The conclusion is based on the discovery that, adjusted for height, Chinese consume 20% more calories than Americans do, but Americans are 25% fatter. On average, Chinese eat just one-third as much fat as Americans, one-tenth as much animal protein and three times as much fiber. Consequently, cholesterol levels among the Chinese are often one-half to one-third as high as those of Americans. The diet contributes to lower incidences of heart disease, diabetes and cancer. The finding has led to an Asian Food Pyramid (see chart ) to rival one developed in the West. The Asian model puts more emphasis on vegetables and less on meat than its rival, though the two are similar in many ways.

The China study found one especially surprising consequence of a mostly vegetarian lifestyle: a low incidence of osteoporosis or brittle bones. Osteoporosis can be a particular problem for Asian women, who in general have less bone mass than females in other races and are more vulnerable to loss. Conventional wisdom always had it that a diet high in calcium-rich dairy products was needed for strong bones. But the China study shows that a low intake of animal fat is more important. Researchers now believe that an animal-based diet actually draws calcium out of bones.

The cloud over all this good news is that the average Asian diet is becoming more Western - and less healthy. Not long ago at a medical symposium in Kuala Lumpur, researchers reported that in the two decades following the mid-1970s, Asians increased their fat intake from 10%-15% of total energy consumed to 25%-30%. Research shows that many more Hong Kong children have become obese in recent years and they now have cholesterol levels that are among the highest in the world. "These are frightening statistics," says Dr. Bill Andress, a preventive health specialist at the Hong Kong Adventist Hospital. "They indicate that future generations are setting themselves up for significant health problems."

"Food has become an indication of status," says Emily Yeung Wai-chun, chairperson of the Hong Kong Dietitians Association. "Asian parents use food to show their superiority, so they let their children choose whatever they want to eat, not necessarily what is right for them." The same cultural phenomenon is apparently being played out all over Asia. A study for the International Food Policy Research Institute by Jikun Huang and Howarth Bouis found that eating patterns are changing most dramatically in nations that have experienced the greatest economic gains. Over the last three decades in Japan and Taiwan, for example, consumption of the region's most important food, rice - a strong source of carbohydrates - has declined as much as 50%.

The region's long-term economic advancement has also had a generally negative impact on fitness, which represents the second main component of overall health. Too often, higher incomes encourage sedentary lifestyles - office workers chained to desks, workaholics sapped of energy once they leave the job, and driven executives who exercise only in fits and starts. The head of a Hong Kong property company voices a common complaint about the unending crush of work: "The only available time is on Saturdays, when I go and play golf. Sunday is a family day."

Of course, there are always the converted health fanatics who successfully reverse their evil ways. Malaysian David Morais, a 38-year-old lawyer in Kuala Lumpur, quit smoking and replaced the addiction with a fitness kick. Today, he is messianic about the transformation: "My whole perspective has changed. I can take challenges without thinking about them. It has opened up new vistas." Some executives pour the same energy they had devoted to work into fitness. Zainil Lee, a Shanghai-based corporate communications consultant, visits the gym four times a week: "I usually go in the evening after work and spend up to two hours working out. I arrange all my socializing around working out."

Such commitment is admirable, but it is also beyond the ability and reach of many. And yet, say fitness experts, people too often seem to believe that if they cannot go all out to achieve supreme fitness, they may as well not try at all. Nothing could be further from the truth, says Rob Devereux, a personal trainer for the Hong Kong-based Ray Wilson California Fitness Center. "Instead of looking for the body beautiful, we're trying to encourage people to look for strengthening the components of fitness that will enable them to lead active lives."

Advertising for the California and most other health clubs around the region, however, concentrates quite pointedly on shapely women and chiseled men. Fitness expert Pat VanGalen of Hong Kong's Matilda Hospital focuses, at least for the beginner, on incorporating activity into the daily routine rather than emphasizing strenuous exercise. "We're basically trying to get people to form habits they can sustain," says VanGalen. "If you want to lose weight, fine, work out 90 minutes a day and go on a crazy diet. But in another six months you'll be right back where you were." She urges clients to start small: get out of the taxi halfway to your destination. Walk to speak to a colleague rather using the phone or e-mail. Take the stairs instead of the elevator.

At the root of such an approach is the relatively recent - and still controversial - finding that it is generally better to be fat and active than skinny and inactive. "One of my goals," says VanGalen, "is to get people to enjoy physical activity so they do it for fun, not for health reasons. Maybe you want to go out hiking. Take the kids and go for a hike on the weekends. That might be a little more fun [than a treadmill]."

The primary message of nutritionists and fitness experts in the 1990s is at once encouraging and frightening. On one hand, be heartened by the fact that a longer, healthier life is within your grasp. Necessary dietary changes are no longer obscure or difficult to accomplish. Good fitness does not require that you abandon job and family. "What you do 80% of the time is what matters," says VanGalen. "People have a very unrealistic sense of what is good health. Do you have to be a vegetarian? Do you have to run a marathon? Absolutely not." Which brings us to the scary part. With a healthy lifestyle in such easy reach, there are fewer excuses to avoid it. Tennis anyone?

- With additional reporting by Santha Oorjitham/Kuala Lumpur


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