The Asian Diet

• (a) observations and epidemiological studies of dietary patterns in Asia linking nutrition and chronic disease patterns;
  
  
• (b) results of current experimental research worldwide; and
  
  
• (c) epidemiological studies linking nutrition and chronic disease patterns in other regions of the world, especially the Mediterranean.

In some instances, healthy traditional dietary patterns are in decline in Asia (the proliferation of fast food hamburger restaurants in Japan and China are symptomatic). Increasing industrialization and urbanization have led to increasing wealth and a tendency to pursue diets higher in foods of animal origin. These trends are closely followed by increasing rates of cancer, heart diseases, and other diseases which chiefly affect Western populations. In other instances, Asian dietary trends have enhanced the health status of the region, as in the case of Japan where variety in the diet has increased over the last several decades, consumption of fresh fruits and vegetables has risen and the use of highly salted and pickled foods has declined. Often these positive and negative trends co-exist, making the task of establishing diet and health links more challenging.

This pyramid together with these accompanying notes should be considered preliminary and subject to revision. They are intended to stimulate further thinking and dialogue worldwide about what constitutes healthy diets, and how we can learn from the Asian experience.

An Abundance of Plant Foods

In traditional Asian diets, plant food contributes the core of the daily intake, whereas food from animals is more peripheral. Plant-based foods commonly consumed in Asia include rice and other grains, noodles, flatbreads, potatoes, fruits and vegetables (including sea vegetables), nuts, seeds, beans, various soy foods, other legumes, vegetable and nut oils, herbs and spices, and plant-based beverages including tea, wine and beer.

This diet, when consumed in sufficient amounts, provides all of the known essential micronutrients (i.e., vitamins and minerals), fiber and other plant food substances believed to promote health. Because these substances are numerous and complex, are found in differing proportions in food, and interact in ways that are incompletely understood, virtually all contemporary dietary guidelines around the world emphasize a large and varied intake of these foods.

Minimal processing and freshness of foods would be expected to maximize contents of dietary fiber, antioxidants, other micronutrients, and nonnutritive substances found in foods from plants.

Low Saturated and Total Fat

The healthy Asian diet is characteristically low in both saturated and total fat.

Future research is needed to clarify the impacts on health of the highly saturated fats and oils (e.g. coconut and palm oils and ghee) which are used in some Asian culinary traditions.

In comparing the Asian and Mediterranean diets, two notable cultural models for healthy eating, research suggests that both diets benefit from being low in saturated fat and high in plant-based foods. However, since the Mediterranean diet is not also low in total fat, future research needs to clarify what independent value, if any, the Asian diet may provide by being low in total fat as well (i.e., over and above the value of being low in saturated fat and plant-based).

Absence of Dairy Products, Except in India

Dairy products such as milk and cheese are generally absent in the diets of East and South Asia. The major exception to this is India, where moderate amounts of dairy foods are consumed in various forms including yogurt and simple cheese.

This general lack of dairy products in the diet may raise concerns in the United States and Europe where dairy foods are well regarded for their calcium and are thought by many to inhibit the development of osteoporosis. However, the plant-based, dairy-free diets of much of Asia are associated with low incidence of osteoporosis. In fact, it is in the diets of Western countries where calcium intake in the form of dairy products is the highest that osteoporosis is the highest.

Dairy foods should be considered optional in an Asian-style diet. If consumed, they should be generally low fat and used in low to moderate amounts.

Fish in Low to Moderate Amounts

Fish is generally consumed in low to moderate amounts in Asia, except in those areas where fish is not available or vegetarian traditions prevail. Current research suggests that weekly consumption of low to moderate amounts of fish would be compatible with excellent health, though such consumption should be considered optional in an Asian-style diet. It is imporant to note the wide variations in consumption of fish and seafood in traditional Asian diets between large land mass areas, such as the interior of China, Korea and India, and the seacoast and island areas, where fish is a daily staple.

Poultry and Eggs Used in Low Amounts; Red Meat Used Sparingly

Traditional Asian diets included food from land animals in limited amounts. Evidence increasingly supports a positive association between moderate to high consumption of meat -- especially red meats such as beef and pork -- and the incidence of chronic diseases such as coronary heart disease and some cancers. Meat contains no dietary fiber and virtually no antioxidant nutrients; its energy displaces that from plant foods that do contain these essential nutrients.

Generations of home cooks in Asia have developed healthy, highly palatable recipes and techniques to flavor large amounts of plant-based food -- noodles, rice, vegetables, fruit, legumes, nuts and seeds -- with very small amounts of meat and other food from animal sources. In much of Asia this flavor is supplied by as little as one ounce or less of meat per person per day.

In other parts of Asia, most notably India, cooks have created healthy, appealing vegetarian traditions that use no meat to flavor dishes, but rather utilize various spices to create flavor and excitement in their meals. Current experimental and epidemiological research continues to confirm the healthfulness of vegetarian diets that emphasize variety and are adequate in energy intake.

Tea, Wine, Beer and other Alcoholic Beverages Enjoyed in Moderation

Recent research on black and green tea, with their various antioxidants, suggests this Asian tradition may contribute to the low rates of certain chronic diseases in the region.

Japan and other Asian countries consume wine, beer and other alcoholic beverages on a moderate per capita basis. Experimental research as well as research on the Mediterranean diet suggest that this also may be a healthy Asian habit when practiced in moderation.

From a contemporary public health perspective, alcoholic beverages should be avoided whenever consumption would put an individual or others at risk, such as during pregnancy or before driving. Alcoholic beverages are considered optional in Asian-style diets, and individuals should make personal decisions about alcoholic beverage consumption based on many factors, including family history and other health and social considerations.

Physical Activity and Other Lifestyle Factors

Regular physical activity and other lifestyle factors -- such as the social support and pleasure that accompanies the sharing of food with family and friends -- may also contribute to the high adult life expectancy and low chronic disease rates found in many parts of Asia.

Definition of "Asia"

"Asia" represents an enormous land mass that contains a large variety of peoples, cultures and cuisines. The Healthy Traditional Asian Diet Pyramid was inspired by the cuisines of South and East Asia, including such countries as China, Japan, South Korea, India, Thailand, Vietnam, Cambodia, Indonesia, Malaysia, Philippines, and other related Pacific Rim areas.

Page and graphic from The OldWays Preservation and Exchange Trust.