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How Japan solved its obesity crisis – and what the UK can learn from it

A member of staff from a clinic in Shibuya measures the waist of a man at the clinic in Tokyo
Weighty issue: Japanese 'metabo' law, introduced in 2008, requires every citizen between 40 and 74 to meet required waistline sizes each year - YOSHIKAZU TSUNO/AFP

At this time of year in Japan, familiar figures begin to appear outside the country’s branches of KFC. Life-sized Colonel Sanders statues dressed in red satin Santa Claus outfits have long been a fixture of the festive season, and a symbol of an unlikely Christmas ritual.

What started as a 1970s marketing ploy to persuade Japanese people that KFC was a Christmas staple in the western world is now entrenched as a unique cultural tradition. Every year around four million Japanese feast upon what is known as the “KFC Special Christmas Dinner”. During this frenzied period, Christmas accounts for reportedly around one-third of KFC’s annual sales in Japan.

Back in the UK, despite KFC currently advertising delights such as the Stuffing Stacker Burger (975 calories) and Stuffing Tower Burger (730 calories) most of us will instead prefer a traditional home-cooked Christmas dinner. The problem is the other 364 days of the year, when the Japanese resume one of the healthiest diets on Earth and the British return to the lifestyle and junk food habits that have plunged our nation into a spiralling obesity epidemic.

According to a new report published this week, Britain’s expanding waistline is now costing nearly £100 billion a year, damaging national productivity by up to nine times more than previously thought. The report, commissioned by the Tony Blair Institute, found that two-thirds of the population are now considered overweight or obese (a rise of around 11 per cent since 1993). Within 15 years, meanwhile, the cost of obesity is set to grow by a further £10 billion.

Our diet, warns Henry Dimbleby, the Government’s former food advisor and founder of restaurant chain Leon, is rapidly driving the country to ruin. As he points out, by 2035 treating Type 2 diabetes alone (just one of a number of health conditions related to obesity) will cost an estimated £16.9 billion – more than is currently spent on all cancer treatment within the NHS.

“As our diet-related conditions get worse, the NHS sucks up more money from the rest of the government,” he grimly forecasts. “We become both a sickly and impoverished nation.”

Despite Japan’s love of KFC at Christmas, the nation works hard the rest of the year to keep their weight down
Despite Japan’s love of KFC at Christmas, the nation works hard the rest of the year to keep their weight down - Alamy

Comparing ourselves to Japan, which, at just 4 per cent, has one of the lowest obesity rates of any country in the developed world, may seem a tall order. But Dimbleby and others argue that the country offers a salutary lesson in how we can come to grips with our own battle against the bulge.

Japan (alongside its East Asian neighbour South Korea) has successfully decoupled economic development from rising rates of obesity, proving that wealthy countries can keep their weight in check. But above all – and crucially with regard to the UK – that hasn’t always been the case in Japan. In fact, back in the 1960s, the country was deemed one of the least healthy in the G7, with the lowest life expectancy; its population growing fat on cheap US imports of food, which ramped up following the country’s defeat in the Second World War.

And yet, within a few decades, Japan achieved such a cultural shift in relation to food that it secured the coveted title of longest life expectancy in the world. Its successful transformation, the 53-year-old Dimbleby argues, demonstrates that obesity is an issue that can be fixed. Not by mass medication (the UK Government announced in June that it was rolling out a £40 million two-year pilot making anti-obesity drugs more widely available outside of hospital settings), but through addressing Britain’s increasingly toxic relationship with food. “People say the genie is out of the bottle and it’s all over,” he says. “But I think it is possible to change a culture.”

Starting with children is key, and here again the UK measures up unfavourably. When English children reach school age, according to the most recent NHS figures (2021/2022), around 10 per cent are already obese and 12 per cent overweight, rising to 23.4 per cent obese and 14.3 per cent overweight by the time they reach Year 6 (age 10 to 11). In Japan, 2019 statistics show that only 4 per cent of six- to 14-year-olds register as obese. In fact, according to the World Economic Forum, among the 41 countries in the EU and the OECD, Japan is the only country where fewer than one in five children is overweight.

By the time they reach secondary school, Japanese children are enrolled on an extracurricular club programme known as the “bukatsudō”. This scheme has been in place for decades and encourages children into physical activity seven days a week.

The US food writer Nancy Singleton Hachisu, who has been based in Japan since 1988 and published a series of Japanese cookbooks, placed all three of her now grown-up sons in the club programme. “They had to practise year-long before and after school and would get home at around 8pm,” she recalls.

Japanese children practicing mat exercise and horizontal bar
Schoolchildren are encouraged to participate in physical exercise seven days a week - T-kin

For three decades, Hachisu has also run an English school, which currently has eight children aged six to 12. School meals are far healthier than in the West, she says. In 1954, Japan introduced the School Lunch Law which ensured a healthy meal for all pupils every day. This was bolstered in 2005 by separate legislation, which similarly made food education an integral part of the school curriculum. “You see some podgy or frankly overweight kids, but not often,” Hachisu says.

The traditional Japanese diet of fresh fish, small amounts of meat, tofu and vegetables is undeniably naturally healthier than most Western food. But the celebrity chef Andrew Kojima, the author of No Sushi, who cooked Japanese food for the late Queen on a number of occasions, says there are also beneficial customs in Japanese dining which could be easily adopted on British tables.

He cites three vital philosophical concepts in Japanese cooking which are ingrained from a young age. The first, “Hara hachi bu”, means eating only until you are 80 per cent full. The second, “Ichiju sansai”, translates to a soup and three side dishes. And the third, “Go-syoku”, is the concept of always eating five colours (red, yellow, green, white and black). Ultimately, he says, this boils down to simply ensuring variety, delaying gratification and appreciating whatever you eat rather than piling it all on one plate and wolfing it down. “In Western cooking, we tend to joke that beige food is nice food, but if you eat all beige food, that is not a healthy diet,” the 45-year-old says.

Male chef holding a plate full of sushi at the kitchen
A traditional Japanese diet consists of fresh fish, small amounts of meat, tofu and vegetables – undeniably naturally healthier than most western food - Prasit photo/Moment RF

In Japan, there is little of the snacking and takeaway culture seen in Britain (this week the Waitrose Food and Drink report found almost one-third of the UK now sits down to eat only two meals a day, replacing the third with snacks). The quality of food available in institutional settings throughout Japan is also far healthier. In his book Ravenous, which explores ways to tackle the obesity crisis, Dimbleby recalls a 2019 stay in a Tokyo hospital after he suffered a nasty fall on the street. Breakfast was pickles, rice porridge and grilled fish. Lunch and dinner included a miso soup and steamed vegetables alongside grilled meat, fish, or an omelette.

He says such changes are possible in the UK without a dramatic increase in budgets. The charity Chefs in Schools, which Dimbleby co-founded in 2018, is aiming to improve menus in 5,000 schools in England over the next five years. He would also like to see an Ofsted-style inspection regime introduced for school dinners. “In schools and hospitals, there is no reason you couldn’t do it now if people who ran each of those institutions wanted to,” he says.

Adapting the Japanese “metabo” law is something he would also encourage in workplaces across the UK. The law, which was introduced in 2008, requires every Japanese citizen between 40 and 74 to meet required waistline sizes each year. Those who fail are offered counselling and incentivised to lose weight. Businesses can be fined if too many workers fall short.

A Japanese male office worker climbs stairs at Tamachi Station, Tokyo, that are marked with the calories being used by not taking the escalator
Step to it: businesses can be fined if too many workers fall short of Japan's weight guidelines - Damon Coulter/Alamy Stock Photo

In Britain, Dimbleby suggests this policy could be achieved under the guise of obliging companies to offer employees voluntary annual health checks. If nothing else, he argues, it would certainly provide a boost to Britain’s chronic lack of productivity. In Japan, annual sickness rates are, on average, 1.3 days per employee compared with 5.7 in the UK.

However, such changes require government intervention, and the current administration remains unwilling. The recommendations in the National Food Strategy, which Dimbleby led at the behest of Boris Johnson’s government, have been effectively ignored. Meanwhile anti-obesity measures, such as a ban on two-for-one junk food deals and introducing a 9pm watershed for advertising unhealthy food, have been delayed until 2025.

Campaigners are also calling for the sugar tax introduced for soft drinks in 2018 to be extended to other products. But Rishi Sunak, an evangelist of full-fat high-sugar Coca Cola, appears unmoved. Instead, Victoria Atkins, the new Health Secretary, has in recent days stressed the desire to appear “not nanny-stateish” and offer people “help and advice on how to be healthier”.

The problem is, due to the lack of government intervention and the power of corporations peddling us calorific food, we remain embroiled in a system where the chips are quite literally stacked against us. As our £100 billion junk-food bill demonstrates, Britain needs all the help it can get.

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