Isn’t it fascinating how many people in modern-day society rely so heavily on those things related to health they inherently “know” to be true? Think about it: saturated fat will clog your arteries, we must use Purel to stay germ-free, to get your fiber eat lots of healthy whole grains, having high cholesterol levels leads to heart disease unless you take a statin drug…I could go on and on. Very few people ever stop to challenge these common axioms to verify whether they are true or not. People just believe them.
Ever since I first started blogging about low-carb diets in 2005, perhaps the most common example of this I have heard is, “Asian people eat rice and they are thin and healthy.” The connotation has been that carbohydrates cannot possibly be the culprit in obesity, diabetes, heart disease and other chronic health problems since people in those countries eat lots of carbs with very little impact on their health. However, as we discussed in Episode 90 of the “Low-Carb Conversations” podcast, there was a recent headline my co-host Dietitian Cassie and I discussed with our guest friends entitled “China ‘Catastrophe’ Hits 114 Million as Diabetes Spreads.” A new survey conducted there offered up a stark reality check for those who think those high-carb foods haven’t caught up to them. When we discussed this on the podcast, the general consensus was that the heavy influence of Western food culture has now made these traditional foods like white rice more damaging than they used to be before.
However, a brand new listener to “Low-Carb Conversations” over the past month named Andrea Clark e-mailed me to offer up her own first-hand experience living in an Asian country for 10 months as a Rotary exchange student. Andrea is 19 years old and had the great opportunity to live in Taiwan to experience the day-to-day life there. And that included participating in and observing their food culture. She noted that while she agrees the Western food influence certainly plays a part in the rising rates of diabetes and other health issues, it’s not the whole story. So I invited Andrea to write a special guest blog post for you today to enlighten us all about this important topic of discussion.
Interestingly, Andrea is pursuing a degree in nutrition at a college in Texas right now with an ultimate goal of becoming a registered dietitian in the future. Ironically, it was while she was an exchange student in Taiwan last year and into the early part of 2013 that she “accidentally discovered Gary Taubes” while visiting a Taiwanese library. She saw a copy of Why We Get Fat: And What to Do About It, read it from cover to cover, and was introduced to the healthy low-carb lifestyle for the first time in her life. This propelled her to continue researching other resources and look into this idea behind why Asians can eat so many carbohydrates like white rice seemingly without any health consequences. When I asked Andrea about sharing her thoughts and insights with my blog readers, this young lady was thrilled to hear what you guys think about what she has to share. So please feel free to chime in with your comments at the end of the post.
“Obesity and Diabetes: Made In Taiwan?” by Andrea Clark
As a Rotary youth exchange student ambassador, our goal is to learn our foreign country’s ways inside and out. We’re given several host families and basically become a part of those families. So we eat, say and do what our families do, just as if I was their actual daughter. It’s all about cultural adaption. Therefore I did just that–eat what they did.
As I adopted the Taiwan style of eating, there was no doubt some junk was growing in my trunk. Despite exercising and watching my calories, the pounds were piling on no matter what I tried. It was disheartening since most my fellow Taiwanese classmates were skinny as can be and the skinny-Andrea that came to Taiwan now was becoming the plump-Andrea right before their very eyes. I remained a chubby bunny until the glorious discovery of low-carb through Gary Taubes. I adapted the low-carb wisdom into my lifestyle as best as I could and saw results even with small changes. Still being an exchange ambassador, I couldn’t flat out refuse all their traditional foods (as that would be offensive and null the entire purpose of my exchange) so I picked the healthiest one I could out of the bunch.
Now, I bet you might be wondering what exactly does this Taiwan style of eating look like? I’ll speak specifically for the prominent city of Taipei, which is where I lived those 10 months but it probably epitomizes the Taiwanese cuisine in general. Yes, there is a MAJOR carb overload throughout the entire day. Here’s what a typical day can look like:
Breakfast: Bread pastry or a sugary beverage Lunch: Bowl of noodles Dinner: Hamburger with French fries Snacks: Convenience store candy, bubble tea and sugary junk
As you can see, nothing in that full day’s worth of meals seems nutritious at all. Undoubtedly this is a terrible way to eat, but my personal observation is that Taiwan is all about convenience. Did you know that the country of Taiwan has the highest concentration of convenience stores in the world! It’s almost ridiculous how many 7-11′s, Hi-Life, FamilyLife and other stores that seem to take root in every block. And what kind of food do they supply in such establishments?
*cue the Darth Vader theme music*
Carbs, carbs, carbs, carbs-carbs-carbs, carbs-carbs-caaaarbs!
There are rice, noodles, rice balls, rice rolls, sugary beverages of all sorts, candy bars, sugary dried fruit and more. All types of foods that are obviously bad for you dominate the store shelves. But it’s the quickness and convenience that makes them so compelling and easy to sell to the Taiwanese people. Taipei is an extremely busy city and that means these convenient sources of food are more popular than ever before.
Surely there must be SOMETHING good at these convenience stores, right? And there are! After sniffing through the carb-filled selections that dominate the shelves of these stores, there are generally 3 foods that I found to be the only choices for healthy eating:
Fruit: Mostly fruit comes in pre-cut containers and can vary from watermelon, papaya, pineapple, etc. Salad: A very small selection, basically lettuce leaves with a few additional vegetables and sauce packets Tea eggs: These are eggs boiled in a tea infused liquid, giving it extra flavor. You peel off the shell and enjoy a hot yummy egg.
Sadly, these three things are perhaps the healthiest convenience foods available which significantly limited my healthy food options while I was living there. Sometimes I encountered a problem with getting a salad because they weren’t restocking quickly enough and would run out. Nevertheless, whenever I ate a salad for lunch, my Taiwanese classmates would very frequently ask me why I was eating that and not the rice or noodles that they were eating. That epitomizes their food thought process perfectly. You better believe I was singled out and mocked for not eating their cultural foods that make me so chubby and not a single one of these people ever ate a salad. In fact, I can truly say I never EVER saw one Taiwanese person eat a salad during my year-long stay. They all seem to stick with their carb-loaded foods.
It is extremely common for the retired grandmother to live with her child’s family. Since she doesn’t have to work anymore, she’ll do household chores and cooking. Without the busy work schedule of the average Taiwanese employee, the grandmother figure in the household has the time to shop at a local farmer’s market for fresh ingredients so she can prepare the meal for the family. This is a very time-consuming process that can take up most of her day. Therefore, the working mothers and fathers who don’t have that kind of time in the hustle-and-bustle of living their lives tend to stick to those unhealthy convenience foods I mentioned before. But it’s the grandmother’s cooking that takes a nutritional turn for the better.
One of my host families while I lived in Taiwan had such a grandmother who prepared fresh home-cooked meals everyday. These are the times I got to dive into delicious fish, meat and non-starchy vegetable dishes that were amazing. Granted, white rice was a staple of the meal too with other carb-filled foods now and then. But generally speaking, these were the healthiest meals I was exposed to. Why? Because the host grandmother cooked more traditional Taiwanese foods free from the influence of Western culture. Heck, even the dessert was usually some fruit, making it a much healthier alternative than a typical American-styled sugar-bomb of a triple-chocolate slice of cake with ice cream on top!
The average Taiwanese does not have the time to cook and lacks even an ounce of cooking skills. Why bother when you can run to a nearby convenience store or fast food place and grab a cheap bite? It’s important to know how inexpensive these kind of quick eats are just like they are in America. Therefore people gravitate to the carb-loaded convenience foods because it’s much less hassle as a meal option for them.
But what about that long-standing bafflement of Asians always eating white rice and yet remaining so darn twig-like skinny! How do they do it?! Even when they eat hamburgers and cakes they seem to remain so unbelievably thin and healthy. Well, here’s my theory on the matter: Indeed, Asians have generally kept up a thin, healthy appearance even when consuming heaps of rice, noodles and other grain-based, high-carb foods. I think that mostly comes from their genetic heritage. They probably are just programmed with the ability to eating like that and still remain skinny.
But in recent years, we’re starting to see that stereotype no longer apply because of the rise in the rates of diabetes in China like you discussed on “Low-Carb Conversations.” During my time as an exchange student in Taiwan, there were indeed some very teenie-weenie slim-looking people walking down the streets. But to my surprise, I also saw many others who would be considered obese. Note how I said obese and not just “overweight.” The problem I saw exceeded just the level of a few extra pounds. I remember thinking to myself when I first saw this, “This is so weird.” It made me start investigating this issue further and what I found was shocking–Taiwan is the most obese country in Asia!
We’re still left begging the question how obesity rates increased so much in recent years. Articles analyzing this Taiwanese obesity epidemic blame the lack of exercise, but I thoroughly disagree! When I traveled to my school in Taiwan, I didn’t just cruise in a car. Nope, I walked to the bus stop, took both the bus and the subway (all the while doing a surfing balancing act), walked 15 minutes to my school, engaged in physical activity during my P.E. class, martial arts club and sports activities during the lunchtime break. And did I mention they have stairs everywhere in Taiwan? For example, when we had a student assembly, the entire student population had to walk nine flights of stairs together. Even apartment complexes required the task of inclined steps since most of them don’t have elevators (which is quite the task when facing five flights of stairs and carrying two 50-pound suitcases). Though the gym life isn’t popular, a good number of occupants can be seen in school gyms, school tracks, or at public parks. And remember, this is Asia, so there’s definitely a large number of Tai Chi followers and other such movement activities. It’s for these reasons and more that I don’t think for a second that exercise is the problem. As we low-carbers know, the real secret is in the foods they eat.
I think I have pinpointed the reasons why, at least in Taiwan, we’re seeing obesity rate increase. My theory blames sugar as the ultimate culprit leading to doom and destruction in the wake of an incredibly addictive path to health decline! As we know, eating too much sugar results in a higher insulin level which cascades into numerous chronic diseases and conditions. By neglecting to rein in such a high sugar intake, it starts messing with their bodies on both the outside and inside. Outwardly we see it as weight gain but inwardly I think it is actually messing with their DNA to make them less carbohydrate tolerant than their ancestors. Several studies have pointed out that unhealthy eating habits can affect genetic traits passed on from parent to child, such as an increased risk of diabetes. Following this logic, I don’t see why the same mechanism wouldn’t apply to the Asian population as well. If a trait relating to higher insulin levels passes down from generation to generation, getting progressively worse and worse in each subsequent generation, then this provides a theoretical explanation of the increasing obesity and diabetes rates we are now seeing today.
I can’t say Taiwanese people have been eating more sugar in recent years and that’s the obvious reason for their obesity problem. We still need more evidence to demonstrate whether or not this is true. Although I’m only a student right now and not a certified scientist (yet!), I can give real-life examples of some suspicious foods that I think might be contributing. Consider these common sweet treats that have become as much a part of their food culture as white rice:
Desserts: Traditional Asian desserts (the kind those grandmothers prepared for their families) aren’t a daily occurrence but more of a rare treat. As I stated before, it was basically just fruit. In modern times, though, thanks to Western influence there are more bakeries stuffed with cheap cakes, pastries, candies and more high-carb junk food. Convenience stores are packed with sugary snacks people eat for dessert. Snickers? They got it. Twix? They got it. Oreo cookies with Blueberry Ice Cream flavored cream in the middle? Strange as it sounds, they got it too. These desserts/snacks are more prevalent in modern Taiwan than ever before which is a stark difference to their humble, infrequent fruit indulgences. Pastries: Snacks and entire meals would sometimes be nothing more than a plateful of sweet baked goods. Bakeries are so popular there nowadays and the place to go to for pastries. Hardly anyone bakes at home anymore because of constraints on time, so it’s all up to those bakeries to fill in the gaps to fulfill the desires of the consumer. You can see these sugary treats on full display within the cozy establishment and it is quite obvious to anyone paying attention that these foods have a special place in the hearts of the Taiwanese consumer. We can thank (or blame!) Western influence for all the pastries, and especially the abundance of sweet versions. You can’t find a single cupcake, pastry or other such sugary dessert in the traditional Asian cuisine. Bubble Milk Tea: This is what I think is the biggest culprit in Taiwan adding more sugar to their diet than anything else. Bubble milk tea is a crucial part of their culture there. Notice how I said “culture” and not “food culture.” Taiwanese culture basically is just the different food it has, meaning food is a BIG deal. If you are unfamiliar with bubble milk tea, it’s a sweet drink with chewable tapioca balls added. Shops that carry these beverages are found on nearly every street corner requiring very little effort for those who desire to consume a cup virtually any time of the day. You can select what percentage of sugar you want in your bubble milk tea from 0%, which is sugar-free and bitter (and no Taiwanese I knew ever ordered it), to upwards of 100% sugar. Most people ordered 100% or 50%.
A 50% sweetness level to me is a MAJOR SUGAR OVERLOAD! I couldn’t believe it when I saw what was happening. I tried this stuff for myself and it tasted like liquidized sugar. Talk about baffling. Then I thought, if that was 50%, what the heck does the 100% taste like? No, I never bought a 100% because the 50% scared me half to death. Other exchange students can confirm the ultra sweetness being too much for them and these are people from around the world. Stunningly, this sugary bubble milk tea concoction is very common in Taiwan. I would bet bubble milk tea is way worse than the sugary soda that is so prevalent in the United States. Thinking about how much of this stuff the Taiwanese people are drinking definitely explains my theory of modern increases in sugar consumption resulting in higher insulin levels which then get passed down through their genes.
I already mentioned how I adapted to their lifestyle while I was living there and became too pudgy to be comfortable in the clothes I brought with me from America. This was a recurring problem I saw with my fellow exchange students. Nearly all of us gained weight when we arrived and this included people who came from various parts of Europe, North America, South America and beyond. Even with all of these different types of people from varying cultures and backgrounds, it seemed all were negatively affected in their weight and health in less than a year living in Taiwan. It appears their eating lifestyle seems to affect foreigners more than the Taiwanese people.
Perhaps Asians have tougher genes. Maybe these macho genes heavily fight to keep insulin levels down despite their high-carb intake. That could explain why they ate white rice for so long yet remained slim. But with the Western influence and the modern sugar overload catastrophe, it could be too much for their systems to resist anymore. Too much opposition results in high insulin levels leading to all those diseases humanity loathes, including diabetes and obesity. This effect might seep into their DNA and then get passed on to their children. Continue with a domino effect and there will definitely be some serious national health problems there in the years to come. Some people blame the lack of exercise while others hold the rice consumption in suspicion. For me, I think it’s sugar affecting our insulin levels to a point where all the beloved traditional grain-based carbs (like rice, noodles, dumplings, etc.) that they were once bulletproof to are making their dangerous marks thanks to sugar weakening them internally.
This theory of mine seemed to make sense all throughout my low-carb enlightened stay in the country of Taiwan last year as I observed my surroundings. I hope it gives you a slightly better insight on the inner workings of the way Taiwan operates and perhaps other Asian countries. In your opinion, do you think this theory could be the reason to the mystery of the changing Asian eating habits and slimness in recent years? Would you agree or disagree on anything I have shared in this guest blog post? Also, if you have any questions on what Taiwanese eat or their lifestyle, I can provide more detailed info if requested. I just hope this little theory of mine gives back to the low-carb community in some way.
So what do you think? Thoughts? Comments? Let Andrea Clark hear what YOU have to say about what she’s written here today. I think this young lady will have a lot to say about nutrition in the years to come.