Why do the Japanese live so long?

The low mortality rates from ischemic heart disease and cancer are thought to reflect the low prevalence of obesity in Japan; low intake of red meat, specifically saturated fatty acids; and high intakes of fish, specifically n-3 polyunsaturated fatty acids, plant foods such as soybeans, and nonsugar-sweetened beverages ...

nature.com - Why has Japan become the world's most long-lived country - Nature

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International comparison

Recent mortality-related statistics for the group of seven (G7) countries (Canada, France, Germany, Italy, Japan, United Kingdom (UK), and United States (US) in alphabetical order) from a World Health Organization (WHO) database are shown in Table 1 [1, 2]. Life expectancy and healthy life expectancy are both longest in Japan, in both men and women; longevity is particularly high in women. Age-standard mortality rate is also the lowest, at about two-thirds that of the US. By cause of death, the lowest mortalities from cancer (in particular, breast and prostate cancer) and ischemic heart disease are notable. In contrast, mortalities from cerebrovascular and infectious respiratory disease are relatively high.

Table 1 Mortality statistics in selected countries. Full size table

Since 1981, the leading cause of death in Japan has been cancer, which accounted for 27% of total deaths in 2018, followed by heart disease at 15% [3]. The recent longevity of Japanese is due to the low mortality rate of these diseases, which account for nearly half of total deaths.

Annual trends

Figure 1 shows changes in life expectancy in the G7 countries according to health statistics generated by the Organization for Economic Cooperation and Development (OECD) [4]. Whereas Japan had the shortest life expectancy in the early 1960s, Japanese men had the longest in the late 1960s and women in the mid-1970s. These rankings have been maintained despite increases in life expectancy in the other countries. Average life expectancy in Japan in 2016 was 81 in males and 87 in females, a record high. Women have enjoyed world-leading longevity since the 1980s. Fig. 1: Annual trends of life expectancy at birth (years) in selected countries. The figure was prepared by the author using datafrom “OECD Health Statistics 2019” (https://www.oecd.org/health/health-data.htm). Full size image Time-course trends in major causes of death according to the WHO Mortality Database [5] show that age-adjusted mortality rates for ischemic heart disease, cerebrovascular disease, and cancer are steadily decreasing in all countries, and that this has resulted in an increase in life expectancy worldwide (Figs. 2, 3). In Japan, mortality from ischemic heart disease and cancer was originally low, while that from cerebrovascular disease—which was extremely high—has steadily declined to a level comparable with that of Western countries. This pattern greatly contributed to Japan’s achieving the world’s highest life expectancy in the 1980s. Fig. 2: Annual trends in age-standardized circulatory diseases mortality rates per 100,000 world standard population in selected countries. The figure was prepared by the author using datafrom “WHO Mortality Database” (http://apps.who.int/healthinfo/statistics/mortality/whodpms/). Full size image Fig. 3: Annual trends in age-standardized cancer mortality rates per 100,000 world standard population in selected countries. The figure was prepared by the author using datafrom “WHO Mortality Database” (http://apps.who.int/healthinfo/statistics/mortality/whodpms/). Full size image

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Today, ischemic heart disease and cancer in women continue to decline, and remain at the lowest levels. In men, in contrast, cancer mortality was lowest but rose until the mid-1990s, and then began to decline. Lowest levels are now found in US and Canadian men, whose levels have been declining since the 1980s. Although the increase in life expectancy after World War II is in large part due to the dramatic decrease in infant mortality (30.7 per 1000 live births in 1960 vs 2.0 in 2016) in Japan, the steady increase after the war has been attributed to reduced mortality from major causes in adulthood. Looking at annual trends in age-adjusted mortality (1985 model Japanese population) by cause of death (Fig. 4), there was a marked decrease in infectious diseases such as pneumonia and tuberculosis after the war, followed by a decrease in cerebrovascular disease mortality that is characterized by a sharp decline from a peak in the mid-1960s. In addition, heart disease and women’s cancer have been on a gradual decline, while men’s cancer began to decline in the mid-1990s. Fig. 4: Annual trends in age-standardized mortality rate per 100,000 Japan 1985 model population for leading causes of death. The figure was prepared by the author using datafrom “Vital Statistics, Ministry of Health, Labour and Welfare” (https://www.e-stat.go.jp/). Full size image The decrease in cerebrovascular disease mortality can be largely explained by the decrease in that due to cerebral hemorrhage, which was dominant around 1950 (Supplementary Fig. 1). Cerebral infarction also increased after the war, but has been decreasing since the mid-1970s. As for cancer mortality (Supplementary Fig. 2), cancers of the stomach and uterus decreased consistently after the war, while liver cancer increased at this time but then declined from the mid-1990s. On the other hand, so-called Western-type cancers such as colon, lung, pancreas, prostate, ovary, and breast tended to increase after the war but have declined since the mid-1990s, except for breast cancer, which until recently continued to increase.

nature.com - Why has Japan become the world's most long-lived country - Nature

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