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Wellness

The Covid-19 Pandemic: An Update

Japan’s two largest “Covid-19 cases” waves were autumn 2022 and late 2022 to early 2023.

The same pattern applies to Japan’s daily new deaths.

For charts, please click here.

In summary, Japan’s relatively good 2020 and 2021 experience deteriorated during 2022 into 2023.

It is important therefore to update the data that appeared in our book: Wellness Topics: insights from Japan, section two, chapter one: “Why Japan has had relatively low Covid-19 deaths”.

G7 Countries plus South Korea. Covid-19-related Deaths per One Million Population

USA3,642
UK3,389
Italy3,261
France2,556
Germany2,182
Canada1,538
Japan595
S. Korea700

In terms of policy and people’s behaviors in Japan, a recent research study concluded that the intervention effects e.g. the requirements of the State of Emergencies (SOE) and quasi-SOEs, had positive effects on the adoption of preventive behaviors among individuals, including handwashing, working from home, avoiding traveling and social events.

However, the contribution of information effects, alerting people to the virus threat, was much larger than that of intervention effects, suggesting the importance of how and when information should be communicated to the public to prevent the spread of infection. (1, 2, 3, 4, 5)

We await studies examining the importance of the pre-pandemic health of the respective populations, e.g., with respect to the prevalence of obesity, diabetes, kidney disease, and so on.

References:

  1. Intervention and information effects at the individual level during the COVID-19 pandemic in Japan, by Mateus Silva Chang, Isamu Yamamoto, November 2023
  2. Japan’s voluntary lockdown, by Watanabe T, Yabu T., June 2021
  3. Japan’s voluntary lockdown: further evidence based on age-specific mobile location data, by Watanabe T, Yabu T., 2021
  4. Covid-19 Lockdown Cost/Benefits: A Critical Assessment of the Literature, by Allen DW, 2022
  5. The Immediate Effect of COVID-19 Policies on Social-Distancing Behavior in the United States, by Abouk R, Heydari B, 2021
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Wellness

Ayurveda and Scientific Support

It is not uncommon to encounter the health benefits of traditional remedies. Each of our blog posts and published books highlight the scientific support for wellness activities. So is there scientific support for herbal medicines, and more narrowly Ayurveda?

This is a complex subject, and readers are encouraged to read our background report, here. There is a considerable body of evidence, accumulated in India over the centuries. Whilst not to RCT standards, it is currently available only in Sanskrit, and is largely offline, i.e. not digitalized.

The reasons for a general dearth of RCT-based scientific research include:

  1. Ayurveda medicines have no patent protection, reducing the value of research findings.
  2. RCT studies are expensive.
  3. Ayurveda is more than a medicine, involving broader therapies, and it can become a way of life.

Testing a way of life is challenging.

However, the last twenty years have seen extensive research into the ingredients used in either classical, granthas products or proprietary Ayurvedic medicines (PAM), i.e. the Ayurvedic herbs.

In conclusion, there appears to be extensive evidence in India which will become progressively available in English and online over the coming years. In combination with more RCT-based studies, Ayurveda is expected to remain a topic of considerable interest.

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Wellness

Individual-level Workplace Wellness Programs: Limited Effects?

A study, (1) covering 233 organizations and 46,336 workers in the UK, investigated the impact of individual-limited well-being interventions, including resilience training, mindfulness, and well-being apps.

The principal finding of the study was that there is no difference between participants and non-participants across a range of well-being outcomes, subjective work environment measures, organizations, gender, ethnicity, income, and social groups.

By types of individual-level intervention, there was no difference found for the following programs: relaxation practices, time management, coaching, financial well-being programs, well-being apps, online coaching, sleep apps and sleep events. Resilience and stress management programs and mindfulness programs had negative estimates.

The only positive benefit estimate was found for “volunteering”.

The author concludes by recommending a bigger emphasis on organization-level change, in preference to individual-level interventions.

Reference:

  1. Employee well-being outcomes from individual-level mental health interventions: Cross-sectional evidence from the United Kingdom, by William J. Fleming, January 2024
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Wellness

Miso: A Ubiquitous Fermented Food in Japan

A Miso Factory: Ishii Miso in Matsumoto, Nagano Prefecture

Scientific research supports the belief that fermented foods improve gut microbiome diversity and health. Fermented foods are common in the Japanese diet. Please see chapter 13 of our book: “Wellness Travel, Wellness-orientated adventureas in Japan: Good daily wellness behaviors whilst exploring Japan’s hinterlands“.

Koji—an amylolytic starter culture specific to Japan

Japan’s warm and humid climate is ideal for the bacteria and mold used for fermentation. For example, koji is an edible mold that lives in grains such as rice plants, barley, and soybeans. It was harvested in the wild, from the heads of rice plants for example, 800 years ago. In the fungi family, a sub microorganism of Aspergillus, Aspergillus oryzae.

Over the subsequent years, koji has been mass produced and refined. The fungal spores can be produced on cooked rice or other grains in a warm, moist environment: rice koji, barley koji, bean koji. There are an estimated 200-plus flavors and fragrances available in Japan based on Aspergillus oryzae.

The three most famous resulting seasoning products are:

  1. Miso: Rice, barley, or soybean grain malt for the koji (Aspergillus oryzae) and brine (sea salt and water) and soybeans.
  2. Shoyu (soy sauce): Wheat and Aspergillus oryzae, brine, and soybeans.
  3. Mirin (a cooking-sake): Rice koji (rice and Aspergillus oryzae), shochu spirits, and mochi rice.

Miso is, most commonly, a fermented rice-malt miso soybean paste used to make the ubiquitous in Japan miso soup. It is high in protein, vitamins, and minerals. Iis believed to have arrived in Japan during the Asuka period (seventh century), with the paste being spread on food. Miso soup is believed to have spread amongst the samurai class during the Kamakura period (late twelfth century to early fourteenth century).

At Ishii Miso, photo above, the miso ferments in wooden barrels for three years for a deeper taste. Mass-produced miso in plastic and metal containers can take as short as three months to manufacture.

Fun to eat, and good for one’s health!

Categories
Wellness

The Health and Wellness Benefits of Nature

Research is underway on the relationship between time spent in greenery, nature, and health.

For example, in Japan, shinrinyoku practices of walking amongst trees have been found to have scientifically supported positive benefits. (1)

More broadly, the research program divides into two techniques.

  1. Residential proximity – well advanced
  2. Direct exposure – underway

1) Residential proximity, for example the amount green spaces within one kilometer of one’s home. For more on the results of this approach, please follow this link.

Residential proximity research makes use of satellite data and big data techniques in general. However, what is not known is the frequency that people use the green space, or whether they regularly visit green space outside the residential proximity definition. For this, it is necessary to measure directly the time spent in natural environments.

2) Direct exposure, for example by direct monitoring or surveys. One study, (2) for example investigated the relationship between recreational nature contact in the last seven days and self-reported health and well-being measures. Weekly contact was measured in one-hour blocks. The study’s conclusion is interesting:

Compared to no nature contact last week, the likelihood of reporting good health or high well-being became significantly greater with contact ≥120 mins. Positive associations peaked between 200–300 mins per week with no further gain. The pattern was consistent across key groups including older adults and those with long-term health issues. It did not matter how 120 mins of contact a week was achieved (e.g. one long vs. several shorter visits/week).

In summary, two to four hours a week of recreational nature exposure, e.g., walking in large parks, woods, the countryside, is recommended.

Reference:

  1. J-Wellness 2020: the economics, career options, and investment opportunities, page 74, by Peter Eadon-Clarke and Yoriko Soma
  2. Spending at least 120 minutes a week in nature is associated with good health and wellbeing, by Mathew P. White, Ian Alcock, James Grellier, Benedict W. Wheeler, Terry Hartig, Sara L. Warber, Angie Bone, Michael H. Depledge & Lora E. Fleming, June 2019
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Wellness

Time-restricted Eating vs. Calorie Restriction

  1. Time-restricted eating, e.g., Eating from noon to 8 PM only
  2. Calorie restriction, e.g., a 25% reduction

Given the widespread problem of obesity, there is considerable interest in both techniques as a means to lose weight. Recently, time-restricted eating has gained popularity because of its seeming simplicity.

A 12-month RCT study (1) of weight loss methods found that both techniques resulted in an average 5% reduction in body weight. The authors noted that time-restricted eating is both effective and feasible across a diverse population. In another RCT study, (2) both groups ate a low-calorie diet whilst one group also undertook time-restricted eating. The study conclusion: “Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction.”

The theory behind time-restricted eating is that after a period of hours without eating, the body switches from a ready supply of energy from food, to burning its fat resources. (3) This is a theory without research support currently. One study (4) found, following a 10-day fast, that, to quote the BBC article, (3) “the weight loss by a group of male subjects, during the early stages of the fast was predominately a loss of water, protein and other lean tissue rather than fat loss.”  

In addition, it is important during the time-restricted eating period to eat a balanced diet. If one goes from three meals to two meals, there is a risk of the diversity of food inputs declining.

In addition to a balanced diet, and when the body receives it, another factor to consider is the efficiency with which the body processes it. Please see our blog posts on the gut microbiome, e.g., “Diet, Gut Microbes, and Health”, of 30 June 2021

References:

  1. Time-Restricted Eating Without Calorie Counting for Weight Loss in a Racially Diverse Population: A Randomized Controlled Trial, by Shuhao Lin et al, July 2023
  2. Calorie Restriction with or without Time-Restricted Eating in Weight Loss, by Deying Liu et al, April, 2022
  3. https://www.bbcgoodfood.com/howto/guide/what-intermittent-fasting-diet
  4. Is muscle and protein loss relevant in long-term fasting in healthy men? A prospective trial on physiological adaptations, by Claire Laurens et al, October 2021

Categories
Wellness

A US$303 billion Wellness market

From the press release:

“Japan, the world’s 3rd largest wellness economy ($303 billion), has been added to the growing number of countries featured on the Global Wellness Institute’s “Geography of Wellness” site, providing the first-ever data on all of its wellness markets and an overview of its powerful wellness assets.

Japan, a country of mountains, forests, and natural hot springs, really defines wellness with its culture of healthy, unmodified food; its customs of Onsen bathing and forest bathing; its unique J-Beauty traditions; and its practices derived from Zen Buddhism, like martial arts, monastery stays, and meditative tea ceremonies.

The research was sponsored by Country Partners Conceptasia, a Tokyo-based company serving the spa, wellness and beauty industry, along with Fukui Wellness Collaboration, an organization focused on developing wellness tourism offerings in the Fukui Prefecture region.”

For more please follow the link: https://loom.ly/j8ux828

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Wellness

A Variety of Mushrooms

Please follow the link, here, for an introduction to the most popular mushrooms in Japan.

Mushrooms are an integral ingredient in the Japanese diet. Japan’s humid climate has resulted in approximately 5,000 varieties of mushrooms. Of these, about 100 are edible, and around 20 are eaten in large, commercial quantities.

Japanese farmers have been introducing techniques to break the link with nature. Mushrooms are normally harvested from nature in the autumn. 300 years ago, farmers introduced small logs with pre-prepared fungus spores. Today’s factory-controlled environments have enabled, with the one exception of matsutake mushrooms, fresh, cheap mushrooms available throughout the year.

The body’s gut microbiome is healthier with a diverse diet, and in Japan people consume a diverse range of vegetables, including a variety of mushrooms. In addition, different types of mushrooms have different potential health effects. For a discussion of the latter, with references, please follow the link in the first paragraph above.

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Wellness

The overlooked role of Japanese vegetables

Whilst it is difficult to generalize about national cuisines, it is safe to assert that the Japanese diet has a tilt towards, fresh and unprocessed seafood, vegetables, and fermented foods. The roles of seafood and fermented foods receive a lot of attention.

Japan’s mountainous and elongated topography (spanning latitudes 24 degrees to 55 degrees) lead to a diversity of micro-climates. In turn, these support a wide variety of vegetables.

For detail on the tremendous diversity of vegetables in Japan, please follow the link here.

A diet rich in vegetables and fruits can lower blood pressure, reduce the risk of heart disease and stroke, prevent some types of cancer, lower risk of eye and digestive problems, and have a positive effect upon blood sugar, which can help keep appetite in check. (1)

When consuming vegetables, it is best to avoid using a blender.  A blender breaks down fibers to such a degree that the digestive system benefits, and the sense of a full stomach, is lost.

References:

  1. Harvard T.H. Chan, school of Public Health: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vegetables-and-fruits/
Categories
Wellness

Longevity: Behaviour dominates Genes

Manazuru Matsuri

Summary: This is a complex subject. Recent studies have shifted the balance of importance towards behavior. The contribution of genes to the variation in longevity is now believed to be less than 10%.

Studies look at longevity variations across relatives. However, in addition to common genes, there are likely to be common environmental, “sociocultural” factors. Attributing longevity variations between these factors is a challenging data and statistical activity. The study Estimates of the Heritability of Human Longevity Are Substantially Inflated due to Assortative Mating analyzed 54.43 million family trees from 406 million people’s birth and death records. The data came from Ancestry.com, spanning the nineteenth century and the first half of the twentieth century.

The study concluded that: the true heritability of human longevity for birth cohorts across the 1800s and early 1900s was well below 10%, and that it has been generally overestimated due to the effect of assortative mating.

Assortative mating is when people with similar genotypes mate with each other with greater frequency than expected by a random pattern. For example, deaf people tend to marry each other.

For a little more detail, and references, please see here.

Categories
Wellness

Nutritional Benefits of Eating Seaweed

Seaweed are algae that grow along rocky shorelines. Alternative names in English are sea vegetables or sea greens. In Japanese common names include wakame and nori.

Seaweed and leafy green vegetables have similar nutritional benefits.

Wakame is nutrient-dense, low in fat as well as an amazing source of omega-3s, which lowers the risk of heart disease, depression, and arthritis. Seaweed is rich in minerals and iodine, supports thyroid hormones and improves skin health. (1) Scientific research support is presented in the background paper available here.

Seaweed is normally classified into three groups by the leaf color: green, brown and red. Shallow waters receive a lot of sunlight, and the algae are green. Next is brown. Red algae are found in the depths. For examples of the different types of edible seaweed, please click here.

Some examples of seaweed in Japanese cuisine follow.

Nori is the “sushi seaweed”, and is particularly dense in protein, around 40% protein by weight.

Kombu is the seaweed in miso soup, being one of the main ingredients of dashi, used as the broth.

Wakame most commonly appears in Japanese salads.

Mekabu is the edible part of the wakame plant root. In Japan it is sold both fresh and dried.

Categories
Wellness

Educational Costs, impacting life choices

A 2021 survey (1) found that both public and private education costs had reached new highs. The cost of 15 years of private education was 3.2 times the cost of public education.

Study costs, 15 years from Kindergarten through High School¥ m
Public only5.7
Private kindergarten, Public thereafter6.2
Private kindergarten and High school, Public at other times7.8
Private only18.4

Source: Ministry of Education, Culture, sports, Science, and Technology

In addition to the difference in classroom tuition costs, other normal school related costs (excursions and field trips, extracurricular activities, textbooks and supplies, commuting costs) are higher at private schools. (2)

However, the relative cost is markedly highest at elementary schools.

 PublicPrivateMultiple
Kindergarten¥165,126¥308,9091.9x
Elementary¥352,566¥1,666,9494.7x
Junior high¥538,799¥1,436,3532.7x
High school¥512,971¥1,054,4442.1x

In the case of private elementary schools, the cost of supplementary study expenses is notably higher, approximately ¥663,000 a year versus ¥245,000 a year. (1) The probable additional service being provided is keeping the children at the school for three hours or so after the end of normal classes. This targets the “First-Grade Wall” (3) which relates to children advancing from kindergarten to elementary school at age 6.

Kindergarten3 yearsAge 3-5Optional
Elementary school6 yearsAge 6-11Compulsory
Junior high school3 yearsAge12-14Compulsory
High school3 yearsAge 15-17Optional

Public elementary schools send children home mid-afternoon. Parents are then responsible for their safety. Choices include one spouse changing from full-time to part-time work, everyday private lessons, or sports activities outside school, or finding regular after-school care.

The private school option is an expensive one.

Financial planning needs to start as early as possible.

References:

  1. Public and Private education Costs in Japan Soar to New Highs, Nippon.com, January 11, 2023
  2. Private School Costs triple Public Education Level Through High School, Nippon.com, October 4, 2018
  3. First-Grade Wall: Elementary School Places New Burdens on Working Parents, Nippon.com, January 4, 2023
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Wellness

Ikigai, but in Japan it is probably not work

The Japanese word Ikigai is known worldwide. It translates as the reason for living, one’s purpose in life. (1) Ikigai is associated with a longer life. (2) Please see our blog post of May 8, 2021.

Surveys (3, 4) of Japanese workers’ attitude to work indicate its relative lack of importance.

 JapanWorldwide
Importance of work in your life48%72%
My job gives me a sense of purpose38%57%

Source: Nippon.com (3)

72% of employees surveyed responded that they did not want to become a manager. (4) The reasons for this are shown below (multiple replies possible).

Reasons for not wanting a management position
No desire for advancement51%
Too many additional responsibilities50%
Increased workload43%
Not suited to management38%
Work is easier in current position25%
Would ruin my work-life balance24%
Salary would not increase proportionately23%
Satisfied with current situation9%
Don’t intend to stay with the company long-term8%
Wouldn’t be able to do the work I like7%

Source: Nippon.com (4)

This has implications for household finances. Previously office workers advanced with seniority, and the gradual increase in managerial responsibilities (being accountable for the performance of more people). Incomes grew steadily with time. This facilitated family formation and retirement savings. For the 70% of people that now wish to avoid advancement, incomes are less likely to grow.

It also suggests that many of Japan’s managers under the old system were performing management roles against their desire. This was probably associated with high stress.

References:

  1. Ikigai: The Japanese Secret to a Long and Happy Life, by Hector Garcia and Francesc Miralles, 2016.
  2. Relationship of having hobbies and a purpose in life with mortality, activities of daily living, and instrumental activities of daily living among community-dwelling elderly adults, by Kimiko Tomioka, Norio Kurumatani, and Hiroshi Hosoi, March 5, 2016
  3. Survey reveals Japanese Attitudes toward Work, Nippon.com, April 19, 2023
  4. Management positions Lose their Appeal to Japanese Employees, Nippon.com, February 22, 2023
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Wellness

Physical Contact: Welcomed intimate touch reduces anxiety

The Japanese say “skin-ship”: 「スキンシップ」.

The 2020-2022 global pandemic caused a sharp change in social behavior. This has facilitated analysis of physical contact’s impact on psychological wellbeing. One comprehensive study (1) found that in general deprivation of intimate touch (e.g., caressing, kissing, warm hugs) from close family was associated with increased feelings of anxiety and loneliness. However, the lack of friendly physical contact (e.g., social hugs, handshakes, shoulder taps) from friends or at work did not have a similar impact on psychological wellbeing.

Human skin has sensors called C-tactile fibers that detect the gentle stroking touch of 1 to 10 centimeters per second that people say is pleasant. Social touch causes the release of oxytocin, a social-bonding hormone, in the brain. Oxytocin is also believed to reduce anxiety and pain. (2)

There is an extensive research literature investigating the importance of touch:

Touch and different factors
FactorReferences
Social bonds3, 4, 5
Human psychology6, 7, 8, 9, 10
A person’s likability11, 12, 13
Generosity and compliance13, 14, 15
Infant stress16, 17
Infant touch deprivation18, 19, 20, 21
Infants and carers22, 23, 24
Close relationships25

For the references, please follow the link here.

The benefits of physical contact are not limited to humans; nor are they new.

To quote Ishmail Abdus-Saboor of Columbia University: “All mammals that have been studied have C-tactile fibers, suggesting that these sensory cells, and the ability to detect social touch, are evolutionarily conserved and essential.” (2)

Scientists have also studied the benefits for children and adults of stuffed animals. “For children, stuffed animals can provide comfort and security at bedtime, opportunities to develop and practice reading skills, and relief from pain in post-surgical settings.” (26) For adults, “across two studies, we found that socially excluded individuals who touched a teddy bear acted more prosocially as compared to socially excluded individuals who just viewed the teddy bear from a distance.” (27)

Categories
Wellness

Japanese Pickles

In Japan, pickles, known as tsukemono, are as ubiquitous as photos of Mount Fuji!

Fermented vegetables are a useful component in a balanced diet.

Japanese Pickles
Japanese nameDescription
AsazukeLightly picked vegetables
TakuanPickled daikon
KimchiSalted and fermented cabbage and radish
NukazukeRice-bran fermented vegetables
HakusaizukePickled Chinese cabbage
ShiozukeSalt-pickled vegetables
UmeboshiSalt-pickled plums
NozawanazukePickled turnip leaves
ShibazukePickled eggplant and cucumber
FukujinzukeSoy-sauce-pickled vegetables
RakkyoSweet pickled Chinese onions
TakanazukePickled mustard leaf
SenmaizukePickled bulbous Kyoto turnip
AmazuzukeSweet-vinegar-pickled vegetables
Note: Japanese pickles ranked by popularity. Please see the article: “Asazuke” Tops Ranking of Japan’s Favorite Pickles, Nippon.com, 9 March 2023

Source: Nippon.com (note above), Conceptasia, March 2023

Pickles are a source of enzymes and probiotic microorganisms, because of the fermentation process. It is increasingly understood that the diversity of the gut microbiome is critical for the body’s efficient processing of food. A damaged gut microbiome is associated with weight gain and other problems. A fermented food-rich diet has been found to increase microbe diversity.

A second benefit of tsukemono comes from the essential vitamins, minerals, e.g., potassium, polyphenols and dietary fiber found in vegetables. Polyphenols have antibacterial and antioxidative effects.

For a little more, please click here.

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Wellness

Seasonal Affective Disorders

Known as SAD, seasonal affective disorder is a category of clinical depression that follows a seasonal pattern. Prevalence is usually highest during the winter months. Symptoms include a depressed mood, a sense of worthlessness, lethargy, irritability, and a desire to sleep more than usual. SAD sufferers are about 10% of all those diagnosed with clinical depression. SAD is three times more common in women than men. Scientists do not know why.

The cause of SAD is not fully understood. However, the best predictor is the relative lack of exposure to sunlight during Autumn and Winter. This leads to a variety of questions and hypotheses.

  1. The body uses morning light to coordinate the body’s internal clock, the circadian rhythm. This could lead to melatonin, the hormone that makes you sleep, being disrupted.
  2. Another hormone, serotonin, affects one’s mood, appetite, and sleep. It is believed that a lack of sunlight may lead to reduced serotonin production. Lower serotonin levels have been associated with depression.

Recommended treatments are diverse, reflecting the above uncertainties:

  1. Lifestyle measures: Maximizing natural sunlight, reducing stress, exercise, diet, e.g. (1)
  2. Light treatment: A light box is used to stimulate sunlight exposure.
  3. Talk therapy, e.g., Cognitive Behavior Therapy.
  4. Anti-depressant medicine.

In Japan, there is something called gogatsubyo, “May Sickness”, with similar symptoms to SAD. (2) Why the incidence rate of patients increases after the early May national holidays is not clear.

Whilst the causes are not understood completely, the condition needs to be treated seriously.

References:

  1. https://www.wellspa360.com/wellness/health/news/22657843/3-spa-snacks-that-will-help-clients-sleep
  2. https://japantoday.com/category/features/lifestyle/seasonal-turmoil-%27gogatsubyo%27-and-relationships