The Asian Diet Pyramid

Background
The diets of Asia -- the phrase has, somehow, a nice, tidy sound, almost comforting in its suggestions of orderliness. Libraries and government agencies in Asia, we assume, just must have entire buildings full of books with page after page of neat, long rows of tables and charts telling who grew what, who ate what, and who died of what.

But this is not the reality.

The diet and health statistics of some Asian countries and peoples are indeed well and carefully recorded. But the data in others of this vastly diverse, often-tumultuous, and fast-changing half of the world are not readily accessible.

Fortunately, though, general patterns do emerge from available and reliable evidence. Agricultural production is catalogued with increasing sophistication, and agricultural exports and imports are thoroughly documented. Eating in Asia is often closely identified with religious practices or long-standing customs, and the recordation of these strictures is a source of excellent information. The public health agencies of governments of Asian nations, long-concerned with the diseases of malnutrition that accompany scarcity and poverty, are now having to deal with fast-rising rates of the chronic diseases of affluence that accompany a turn to western-type diets richer in saturated fats than the traditional Asian diets. The surveys and cataloguing of this crossover from diseases of famine to diseases of feasting offer rich data sources.

These data make clear that peoples who ate traditional Asian diets and were not malnourished had, in general, low rates of the chronic diseases that now plague western populations and are beginning to alarm public health officials in Asian countries.

The speakers, presenters and commentators at the 1995 International Conference on the Diets of Asia discussed the indicating data from Asian diet and health statistics in the context of releasing the traditional healthy Asian Diet Pyramid, jointly developed by Oldways and by senior scientists from Harvard School of Public Health, Cornell University and other institutions. This Asian Diet Pyramid is based on a generalized summary of the traditional healthy diets of Asian populations, in the light of current nutrition research.

It is analogous to the official healthy traditional Mediterranean Diet Pyramid that was released three years ago by Oldways and Harvard School of Public Health at an international conference in Cambridge, launching what The Washington Post called "Mediterranean Madness" among food writers, chefs, consumers, and the food industry. There is considerable anticipation that release of the official healthy traditional Asian Diet Pyramid will stimulate an "Asian Invasion" of American food pages, restaurant tables and family shopping lists by healthy, tasty Asian foods.

The Mediterranean Diet Pyramid, and the basic premises of the Asian Diet Pyramid, have received strong international support from leading nutrition scientists and medical specialists as useful alternatives to the 1992 U.S. Food Guide Pyramid. For example, the Food Guide Pyramid lumps some animal and plant foods together in a single group, while the Mediterranean and Asian Pyramids carefully distinguish between plant and animal foods. This central difference has drawn wide support to these traditional Mediterranean and Asian diet pyramids, because it clarifies nutrition guidance for consumers in a vital area.

As with any highly complex situation, there is the need to establish a level playing field of commonly-accepted data. One way to begin this process is to present data for review and comment. What follows is a beginning.

Rice provides 25 to 80 percent of the calories in the daily diet of 2.7 billion Asians, or half the world's population. Last year rice harvested around the globe amounted to 520 million metric tons, nearly all for human consumption (350 of those tons were harvested in China, India and Indonesia). The wheat crop was somewhat larger -- 560 million tons -- but 20 percent of that went to feed livestock; out of 529 million tons of corn, animals got 65 percent. In short, rice is the world's number one food crop.

As to starch in the rice kernel: the percentage of the starch component amylose in its make-up determines the cooking quality. If it's low, 10 to 18 percent, the rice will be soft and somewhat sticky, as preferred in Japan, Korea, Taiwan and China. If it's high, 25 to 30 percent, it'll be hard and fluffy, to the taste of India, Pakistan, and Sri Lanka. In between tends to be the preference of Southeast Asia -- Indonesia, Thailand, Malaysia -- and the U.S. and Europe. Laos likes it extra low, about 2 percent -- very sticky, glutinous, gluey, but every kernel distinct.
Since most rice is eaten in the countries where it's grown, the amount in world trade is small, only about 4 percent. The biggest exporter is Thailand, with 4.5 million tons a year, number two is the U.S. (2.2 million tons), and third is Vietnam (1.7 million tons).

Rice consumption in the U.S. is rising. While the annual per capita rate is nowhere near those is Asia, it has come up from 14 pounds to 22 in the past decade. That an increasing proportion of the U.S. population is of Asian and Latin American background may have something to do with this. Also, rice has begun to be seen as part of a healthy diet, with gourmet possibilities. (For comparison, the average Burmese eats about 415 pounds of rice per year, the average Thai 329, and the average Chinese, including the wheat-eating northern Chinese, 243 pounds.) -- National Geographic Society, May 1994

Over time, traditional regional diets have emerged in India, and these have been based primarily on local agricultural practices, climate, and religious beliefs. Despite many centuries of cultural invasions, traditional diets remained unchanged, although some newer dietary habits were added. Diets were usually carefully prescribed in many parts of India to suit occupation, health and physiological status, and the amount of physical activity. Times for eating were prescribed, overeating was prohibited, and vegetarian diets were recommended. Until recently, locally grown agricultural products have dominated diets in India, thus creating distinct rice-based, wheat-based, and millet-based diets.

During the last three decades, increases in urbanization, and the availability of cafeteria or hotel-based meals in the cities and towns explain the dramatic changes in the long-standing cultural dietary habits. Tea, coffee, soft drinks, and snacks are now also consumed widely among both the middle-income and the poorer segments of the population. Smoking and alcohol consumption have increased in many population groups. Physical exercise has decreased among the urban populations, contributing to obesity.

Major differences are now emerging between the health patterns of urban and rural areas in the developing world. Statistics used for the disease patterns of the developing world markedly underestimate the current impact of cardiovascular disease and cancers in urban communities in Africa, Asia, the eastern Mediterranean region, and Latin America. Large increases in the urban population are expected, especially in developing countries, and, with these, a deterioration in many aspects of the nutritional quality of food is likely. This suggests that there is an urgent need to rethink national agricultural and food policies for urban as well as rural communities, before governments in developing countries are overwhelmed by the demands for diagnosis and management of diseases that can now be linked to current and projected dietary changes. -- Diet, Nutrition and the Prevention of Chronic Disease, World Health Organization, 1990

The dietary pattern of the Chinese population has changed (over the last twenty years). People's diets have become more westernized, especially in larger and medium sized cities.

The disease pattern in China is shifting towards that in affluent societies; the diseases of poverty are decreasing and the diseases of affluence are observed to be increasing. Based on the estimation of the Ministry of Public Health, cancer, cerebrovascular disease, and ischemic heart disease are now the three leading causes of death.

A recognition of trends toward the westernization of the diet in some city populations has led to the formulation of policies to encourage maintenance of the traditional Chinese dietary pattern in which plant food constitutes the main body of the diet with moderate amount of animal food, and an increase in the variety of food.

China is making a big effort to promote a more healthy diet at the national level. The program, approved by the State Council in February, 1993, aims to regulate food production and supply at the national level, maintain the basic pattern of the Chinese diet and absorb useful information provided by other countries. -- X.S. Chen and K.Y. Ge, Nutrition Transition in China, In Proceedings, XV International Congress of Nutrition

The foods of Asia -- exciting, aromatic, mysterious, captivating.

Why?

Because they were designed that way.

Over many centuries, they became as much a part of the culture and traditions of Asians as did pagodas and mysticism.

The eight flavors that Chinese cooks must balance; the five flavors blended in Thai cooking; the deft use of aromatics in Indian cooking; the balance of cooked, uncooked, and barely cooked foods in Japanese cuisine; the nuoc mam fish sauce in Vietnam; and the stunning adaptations of all of these in Hong Kong.

Crispy-skinned Peking duck ... exquisitely seasoned shrimp, fish and shellfish in Hong Kong ... the gorgeous sushi and sashimi of Kyoto and Tokyo ... parades of trolleys filled with dim sum ... soothing, aromatic sobu noodles steeping in a broth of lemongrass with a kick of spicy pepper ... symbolic and extravagant "food as art" in formal Chinese banquets ... a magnificent Indonesian Rijsttafel ... steaming Mongolia hotpots ... the dizzying variety of flavors and shapes of bread from the wheat-growing regions of India's north ... delicate pad thai noodles ... rices -- steamed, curried, fried, boiled ... Vietnamese spring rolls, with fresh vegetables, shrimp, chicken and cilantro wrapped in crisp rice paper.

Nutrition science is now discovering the reasons why these traditional cuisines are healthier than "modern" food.

K. Dun Gifford
Oldways Preservation & Exchange Trust