14 Secrets from Countries with the Lowest Heart Attack Rates
Japan, Korea, and France have the lowest rates of heart disease in the world. Learn their heart-healthy habits to tack on years to your life.
They eat smaller portions
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Overeating is less of a problem in Japanese culture due to the nature of their workday. Having to rise early to commute to work and return late means meals on the run and in smaller portions. According to Theodore Takata, MD, a clinical cardiac electrophysiologist at Texas Health Fort Worth, “The Japanese have portion control ingrained in their culture. Following a particularly good meal, the Japanese use the phrase ‘Hara Hachi Bu.’ This phrase simply means 80 percent, as in 80 percent full. At 100 percent, a person is said to feel uncomfortable and stuffed.”
They eat fermented foods
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No Korean meal is complete without a side dish (or two) of kimchi. The fermented food craze has been widely praised by nutrition experts: According to Ornish Lifestyle Medicine, “Fermented foods reduce inflammation, improve immunity, digestion and gut health, support weight loss by enhancing metabolism, improve mental health, and even reduce the risk of heart disease.” Make sure you avoid these 13 foods cardiologists never eat.
They choose green tea over coffee
Green tea is loaded with antioxidants, which can lower blood pressure and cholesterol. And while most Americans reach for the coffee machine on instinct, Japanese people opt for tea bags. Claire Koga, MD, a family physician and board member of Keiro, a non-profit health group, points out: “Japanese consume large amounts of tea, particularly green tea. Several studies have shown that antioxidants, specifically flavonoids found in green and black teas, may protect the heart in part by improving endothelial function—and this can reduce the risk of clogged arteries.”
They eat a lot of fish
It’s no secret that fish is insanely good for you. But integrating them into your daily diet the way the Japanese and Koreans do helps boost lifespan. The secret lies not in fish’s protein and vitamin D (added bonuses), but the omega-3 fatty acids. “The number one explanation [of great heart health] is the greater consumption of fatty fish rich in omega-3 fatty acids such as EPA and DHA. This can be measured by the AA/EPA ratio in the blood, which is seven times lower than Americans,” says Barry Sears, MD, author of the Zone Diet book series and president of the Inflammation Research Foundation.
They don’t spend too much time sitting down
TV is much less present in both French and Japanese culture, which contributes significantly to their low death rate. The stats back this up: In a Canadian Fitness survey, those who stood most of the day had a 33 percent lower mortality than those who sat. According to Dr. Takata, “Using hours of television watched per week as a surrogate for sitting—people can remember how much television watched in a week more easily than how much time they sat—one study demonstrated that every single hour of television watched after the age of 25 years reduces the viewer’s life expectancy by 21.8 minutes.”
They drink alcohol moderately
People who want to live longer may want to avoid bars. In his book, The Blue Zones Solution, Dan Buettner shares the healthy habits of several enclaves of long-lived populations. Most notably, these people drink alcohol moderately but regularly. He writes, “Moderate drinkers outlive non-drinkers. The trick is to drink one to two glasses per day… with friends and/or with food. And no, you can’t save up all weekend and have 14 drinks on Saturday.”
They choose red wine
Take a stroll down Champs-Élysées, and you’ll easily be able to spot Parisians at a café sipping wine—almost any time of day. Yet, the French population is much healthier in comparison to other health-obsessed nations riddled with heart disease. This strange phenomenon, dubbed the French Paradox, has baffled researchers for a long time. The exact reason for the country’s low rate of heart troubles is unclear, but researchers believe that their red wine intake contributes significantly to a heart-smart diet. Pair your glass of vino with the best foods to eat to avoid clogged arteries.
They walk everywhere
The world’s longest-lived people aren’t focused on pumping iron, running marathons, or joining gyms. Instead, they live in environments that encourage and support activity. In France, Japan, and Korea, driving (especially in major cities) is less common. Instead, people frequently walk, bike, or take public transportation. “Moving naturally refers to remaining active during the course of daily activities,” notes Dr. Takata. “Unlike in the States, most travels in these countries require walking several blocks to the train station, transfers at large train stations, and more walking once the destination is reached.”
They eat less red meat
Bacon and hamburgers are American, period. But cutting red and cured meat from your diet just may lower your risk of heart disease. According to Dr. Koga, Japanese people tend to eat less meat than people in Western nations. They tend to get their proteins from lean meats, which contributes to a lower cholesterol and a decreased risk of coronary heart disease. (Check out what else happens to your body when you stop eating red meat.)
They keep an eye on their weight
According to OCED data, South Korea and Japan have the lowest obesity rates in the world (with only about 4 percent of the adult population being obese). As the American Heart Association points out, overweight people are 32 percent more likely to develop cardiovascular disease in their lifetime compared to people at normal weight. If you want to take a cue from these winning cultures, take the time to savor your meal. Studies have indicated that eating fast may lead to eating more, which in turn leads to greater obesity rates.
They take time to relieve stress
Zen is an important concept in both Korean and Japanese philosophy, which encourages stress reduction through meditation. According to Buettner, “Stress leads to chronic inflammation, [which is] associated with every major age-related disease. What the world’s longest-lived people have that we don’t are routines to shed that stress. Okinawans take a few moments each day to remember their ancestors, Adventists pray, Ikarians take a nap, and Sardinians do happy hour.”
They smoke less
We all have different lifestyles, but a bad heart may be a sign that you’re smoking too much. Many people point to Japan’s steadily declining rate of smoking as an explanation for their rising life expectancy. According to Dr. Koga, “Smoking rates, especially among men, have declined substantially in Japan since the 1960s when the vast majority of men smoked. When one quits smoking, that person’s risk of heart disease decreases greatly compared to that of a smoker.”
They have lots of preventive care
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Doctor visits are still key to preventing future heart problems, Dr. Koga says. “Preventive care is frequently practiced in Japan, and Japanese health care providers are more likely to catch problems early on when they can be more easily treated and/or managed. Annual comprehensive physical exams are quite common as well. The government and employers often encourage their employees to adopt healthier behaviors based on the results of these annual exams.” (Check out the heart health tips that cardiologists always follow.)
They maintain tight social networks
Want to lengthen your lifespan? This one may be the easiest of them all: Keep your friends. Buettner notes, “The world’s longest-lived people chose—or were born into—social circles that supported healthy behaviors. Okinawans created ‘moais’–groups of five friends that committed to each other for life. Research from the Framingham Studies shows that smoking, obesity, happiness, and even loneliness are contagious. So the social networks of long-lived people have favorably shaped their health behaviors.” Don’t forget to check out these 30 ways to reduce your risk of heart disease.