independent study final draft

Running head: UNDERSTANDING CULTURAL INFLUENCES ON HEALTH 1

Understanding Cultural Influences on Health:

A Cross-Cultural Analysis between the United States and Japan

Brandy La Roux

University of Montana

UNDERSTANDING CULTURAL INFLUENCES ON HEALTH 2

Acknowledgments

I would like to take the time to acknowledge the people who have helped me along this

journey. A special thanks for Udo Fluck, Ph.D., Director, Global Gateway at the University of

Montana for guiding me through the writing process and giving necessary feedback for the

literature review. Also, I would like to thank Julie Edwards, Associate professor/Librarian from

the University of Montana, for her help with finding research and reviewing the drafts.

This process has granted me insights into the areas of culture, food, and the psyche that

influences the countries of U.S. and Japan. My interests first sparked when I met a friend from

Japan and I began to learn more about her culture through food and her thoughts towards

American dishes in comparison to her own. Given my interest in culture and psychology, I plan

to take this information with me in the future for when I travel abroad. Holding an understanding

how mental and physical health are impacted by cultural eating patterns, I will be able to further

understand the cultural connection that people have to what they eat, how they think, and their

identity.


Table of Contents

Acknowledgements 2

Table of Contents 3

Introduction 4-5

Cultural Influences on Diet: U.S. and Japan 5-7

Physical Health Top Four Nutrition Related Diseases (Chronic Diseases) 7-8 U.S and Japan’s Chronic Health Issues 8-9

U.S and Japan’s Marketing and Consumption Patterns 9-12

U.S. & Japan’s Labeling Practices 12-14

Dietary Research Projects and Social Movements The “Blue Zones” 14-15 Slow Food Movement 15-18

Reinventing the Wheel: A Spin on Healthy 18-19

Conclusion and Recommendations 19-22

Beyond this Scope 22-23

References 23-28


Introduction

Food is at the center of all our lives and is a necessary component to life itself. While

what is considered edible may vary from culture to culture, food choices typically represent a

culture’s identity (Rappoport, 2003). Analyzing food choices within a specific culture exposes

the underlying values, thoughts, and traditions that impact an individual’s actions. The United

States and Japan are two distinct cultures that have historically different food identities, however,

over the last two hundred years they have begun to influence one another through world trade

(Ohnuki-Tierney, 1997). Both countries are considered to be developed and industrialized, which

are categorized as having the highest socioeconomic standing worldwide (Boundless.com, 2015).

People within these countries usually have a higher standard of living comparatively to

developing countries (Boundless.com, 2015). This hierarchy will be used as a way to distinguish

between developed (industrialized) and developing nations.

Through the examination of a culture’s popular food choices, a greater understanding can

be made on how these cultural norms impact an individual’s health (Witkowski, 2007). The fast

food industry is highly associated with Western culture and has become increasingly abundant in

foreign countries along with other processed foods (Witkowski, 2007). The globalization of

markets, specifically the food industry, have created a shift in the composition of traditional

meals worldwide (Logan, 2014). Along with dietary changes that include more processed foods,

the world has seen a similar increase in nutrition related diseases; possibly a result from

westernized food industries operating during the twentieth century (Logan, 2014). The World

Health Organization (WHO) has statistical information that outlines the top four nutrition related

diseases, also known as chronic diseases. These four diseases, from most to least prevalent are:

cardiovascular, various cancers, diabetes (Type I and II), and chronic lung disease (The World

Health Organization, 2015). Given that these diseases are related to dietary health, it has become

increasingly important to understand how food choices, cultural influences, and the created

psychological framework play a role on one’s physical wellbeing.

This literature review will take a closer look at all of these dimensions as they relate

specifically to the U.S. and Japan; individualistic vs. collectivist nations. Furthermore, this

literature review will encompass: cultural influences on diet, physical health, dietary education

projects and social movements, marketing and consumption patterns, and cultural adaptations to


Western food. With the focus specifically on food choices and health, there are many factors of

influence that could not be elaborated on in greater detail. Suggested areas to consider for future

study are: the role of physical activity, social connections, social economic standing, religion,

food security and acquisition, supplements, use of caffeine, alcohol, tobacco, inheritable genetic

diseases, and pharmaceuticals.

Cultural Influences on Diet: U.S. and Japan

Stemming from America’s growth in the 1940’s there was a desire for other countries to

become industrialized; resulting in American culture being highly associated with success

(Rappoport, 2003). Among the many changes to the United States, the transformation of food

became the one of the most salient changes alongside infrastructure (Rappoport, 2003). The

environment began to change and with it the production of food needed to match the modern

lifestyle that valued a faster pace of living. Convenience was a natural complement to this

change and the influx of processed food and their varieties paved the way for an environment

that exuded abundance (Fukkoshi, Akamatsu, & Shimpo, 2015). With this new convenience,

snacking throughout the day became more popular, leading to an increase in one’s average daily

food consumption (Fukkoshi, et al., 2015).

The quickened pace of life inevitably influenced the family dynamic, specifically, the

amount of time available to meet and prepare a home cooked meal (Carroll, 2013). By the mid

1970’s, mothers working outside of the home had reached one out of three and today two-thirds

of all households have parent(s) who work (Schlosser, 2002). This is important to note because

traditionally women held the role for meal preparation (Schlosser, 2002). While this cultural shift

out of the home was necessary to provided women with more options, it is no wonder that the

time dedicated to family meals decreased while the preference for easy-to-make processed foods

increased over the following decades (Schlosser, 2002).

Fast food began to make its mark as a signature American staple in the 1950’s, post-

World War II, and has become very popular in our culture due to its allure of: easy meals,

comparable price for less effort, and accentuated taste (Rappoport, 2003). Compared to “…a

generation ago, three-quarters of the money used to buy food in the United States was spent to

prepare meals at home. Today about half of the money used to buy food is spent at restaurants –

mainly at fast food restaurants” (Schlosser, 2002, p. 4). Fast forward to the twenty-first century


and the act of gathering around the family table has significantly decreasing as eating out has

becoming the new family ritual (Carroll, 2013). Along with the changes to family mealtimes,

there has also been an increase in individuals eating alone, on the go, and gathering around the

TV instead of the table (Rappoport, 2003). This suggests that as society changes so does the way

in which people eat; perhaps altering our health (Carroll, 2013).

Beyond America’s “…quick-lunch restaurants [rests] the foundation for perhaps

America’s most famous and controversial cultural export: fast food” (Carroll, 2013, p. 131). In

Eric Schlosser’s 2002 book “Fast Food Nation,” he highlights that the fast food industries within

the United States are becoming very competitive for consumer growth and look to expand into

the global food market (Schlosser, 2002). The presence of fast food overseas has increased since

the 1980’s and is highly associated with the Western identity of modern power and independence

(Cambridge, 2009). This transition has pinned traditional eating styles (usually at home) against

modern living in industrial nations such as Japan (Cambridge, 2009). Younger generations

gravitate towards these food places because of what they symbolize and as a means to

accommodate Japan’s industrial lifestyle (Rappoport, 2003).

Traditionally, Japan’s diet is based upon the philosophy that the “no cooking is the best

kind of cooking”, which is expressed through their globally known sushi dishes (Carroll, 2013, p.

302). Alongside this philosophy is the value of mindfulness as part of the eating experience;

which holds great importance, especially, when teaching children to reflect these cultural values

(Keiko, Chihiro, Chunyan, Nobuko, & Cindy, 2014). The act of being mindful according to the

Japanese is to “…engage all parts of us: our body, our heart, and our mind; in choosing,

preparing, and eating food” (Keiko et al., 2014, p. 56). This is reflects the great pride that the

Japanese have in food that is of high quality, purity, and simplicity of flavors (Hays, 2013).

The impact of how one thinks about food plays a significant role in eating behaviors

within a culture. For instance, the American influence in the nineteenth century allowed for the

introduction of meat that was adopted by Japan because of their views toward America as a more

‘civilized’ nation compared to China and Korea at that time (Cambridge, 2009). The United

States influences had a positive impact on the traditional Japanese diet; as prior to the 1960’s it

was lacking meat protein, fats, and oils necessary to balance out the nutritional composition of

their local diet (Cambridge, 2009). Currently, fast food restaurants in Japan, such as McDonalds,


are viewed as a symbol of the Western identity (Rappoport, 2003). This industry has gained

popularity with the younger generations who seek to acquire a Western connection through

eating this type of food (Rappoport, 2003).

Physical Health

Top Four Nutrition Related Diseases (Chronic Diseases)

Living healthy into old age is usually a goal for many people. However, being able to live

a healthy life usually entails not being limited by physical or mental ailments. The elderly

population in developed nations is growing worldwide, but living longer does not always mean

living a “healthy long life” (Alliance of Aging Research, 2006). Organizations like the World

Health Organization and the Center for Disease Control are highlighting chronic diseases as a

pressing issue that is affecting both developed and developing countries alike (Logan, et al.,

2014). Since 2010, “the concept of global health has gained support. This is important…because

diseases cross national boundaries with ease now” (Powell, 2010, p. 1). The rates of chronic

diseases occurring in developing countries account for close to eighty-two percent of premature

deaths (before 70 years old), with the total deaths of all chronic diseases equaling thirty-eight

million worldwide (World Health Organization, 2015). While this issue regarding developing

countries is of great concern; the focus of this review will continue to be on developed nations

and chronic diseases.

The top four chronic disease that appear worldwide are: cardiovascular disease, cancers,

respiratory diseases, and diabetes; which account for over eighty percent of deaths (World Health

Origination, 2015). Chronic disease usually occur later in life, heavily weighted towards the

elderly population (Alliance of Ageing Research, 2006). Given that chronic disease develops

across the lifespan, it is important to keep in mind that these disease can be reduced with

preventative measures (World Health Organization, 2003). Changes in diet and lifestyle are low

cost measures that more than ninety percent of people can implement to defend against disease

(Ornish, 2006). The future generations will face challenges as the rates of cancer, heart disease,

lung disease, and diabetes are predicted to account for seven out of ten deaths worldwide;

mimicking conditions currently in the United States (U.S. Department of State, 2015). Diseases

“…such as cardiovascular diseases (CVD), cancers, diabetes, and chronic obstructive pulmonary

disease (COPD) are linked by common lifestyle determinants such as diet…” (Yusuf, Reddy,


Ounpuu, & Anand, 2001, p. 2747). Although there are many factors of influence besides one’s

diet, an unbalanced diet may hinder an individual’s health in the long term.

U.S and Japan’s Chronic Health Issues

The Western lifestyle associated with socioeconomic development has influenced people

to adopt a more sedentary work environment and a high fat diet (Iso, 2008). Considering the

chronic diseases that are present in the United States and Japan it is notable to mention their

similarities and their differences. First and foremost, both countries have approximately one third

of their countries chronic diseases attributed to cardiovascular disease alone (World Health

Organization: Facing the Facts, 2015). Both countries have a nearly equal rate of cardiovascular

disease; with the U.S. having thirty-eight percent and Japan having thirty-one percent (World

Health Organization: Facing the Facts, 2015). The United States and Japan are also alike in the

fact that both countries have cardiovascular disease and cancer as their top two chronic diseases,

followed by similar rates for chronic respiratory disease. Beyond incidence rates, the number of

men being overweight in both countries is predicted to increase over the next ten years, along

with American women (World Health Organization: Facing the Facts, 2015). Surprisingly, the

number of overweight Japanese women is expected to decrease in the next decade (World Health

Organization: Facing the Facts, 2015). The reasons for this decline is unknown.

Conversely, both countries do not have the same incidence rates for diabetes or chronic

kidney disease (Imai, Matsuo, Makin, Watanabe, Akizawa, Nitta, Iimuro, Ohashi, & Hishida,

2008). This discrepancy may be due to cultural differences in dietary habits. The United States

has three times more people with diabetes than Japan, with diabetes accounting for three percent

of the population compared to Japan’s one percent (World Health Organization: Facing the

Facts, 2015). Roughly, “… 75% of Americans do not eat enough fruit, more than half do not eat

enough vegetables, and 64% consume too much saturated fat... low fruit and vegetable

consumption and high saturated fat intake are associated with coronary heart disease, some

cancers, and diabetes.” (Macera, 2010, Pg. 7). While one to three percent of the population with

diabetes seems rather small, comparatively, “Diabetes is also known to facilitate the onset or

development of strokes and cardiovascular diseases…” which is alarming, considering that

cardiovascular disease is at the top of the list for both countries (Health Japan 21, 2008, p. 5).

Although the U.S. has more occurrences of diabetes, Japan has a staggeringly high rate of


Chronic Kidney Disease (CKD) with incidences much higher than any other Asian country and

the U.S. (Imai et al, 2008). Studies suggest this may be due to the amount of salt that individuals

consume compared to other nations (He & MacGregor, 2008). Even though Japan has a

significant amount of kidney disease, Japan differs from the U.S. and most of the world when it

comes to average life expectancy; approximately, eighty-four years old (the highest worldwide)

(Buettner, 2015).

With further examination of this topic, it is clear to see that the U.S. and Japan both have

chronic health issues related to dietary behaviors. Considering nationwide dietary changes as a

means of prevention along with early diagnosis and treatment may be an important first step in

decreasing the number of debilitating chronic diseases. Prevention of chronic diseases is

especially important considering that more people are living longer, not only in high-income

countries, but all over the world due to medical advances (Buettner, 2015). Besides eating certain

foods, what are other underlying factors that can influence a person’s health? Could the appeal of

processed foods be due to both modern culture and inherited traits?

U.S and Japan’s Marketing and Consumption Patterns

Looking first from an evolutionary perspective, it is important to examine the food

behaviors that lead some people to prefer certain foods that can negatively affect their health.

Ancestral diets consisted of more low-calorie foods and natural sugars. Recently, in the last

century, the industrialization of urban cities and the food industry has introduced numerous

varieties of processed foods that contain higher amounts of sodium, fat, and sugar than any other

century prior. “Never before in the world’s history of individual evolution were so many

temptations put before him in the field of appetite and sensuous appeal as today” (Logan &

Jacka, 2014, p. 7). Globally, the average daily caloric intake has seen an increase of

approximately five-hundred calories over the last fifty years in developed countries (National

Geographic, 2011). Today the average daily caloric intake for Japan is two-thousand seven-

hundred and fifty-four calories (2,754 cal), while the U.S. averages three-thousand eight-hundred

and twenty-five calories (3,825 cal) (Hays, 2013). Both countries have seen a shift in average

daily calories in the last fifty years with Americans having an increase of nine-hundred calories,

while Japan has a minimal increase of one-hundred and thirty calories during this same time

period (National Geographic, 2011).


“…experimental research suggest that it is the highly palatable combination of

sugar, fat and sodium that plays a key role in the attractiveness of such foods.

From an evolutionary perspective, the pleasure associated with energy-dense

food consumption in the ancestral environment could motivate intake as a

means of offsetting the scarcity of foods. Moreover, contemporary economic

factors magnify the allure of inexpensive, widely available, energy-dense and

nutrient-poor foods” (Logan & Jacka, 2014, p. 4).

Beyond taste appeal lies a psychological component to food. Anthropological research

reveals that our ancestors ate meat from animals that they believed to be powerful in the belief

that they themselves would take on these qualities (Rappoport, 2003). Today the same can be

seen with eating behaviors, but on a more social scale. Advertisements have a great influence on

how the food is perceived by the public through famous people or groups who associate with that

food identity (Rappoport, 2003). “Social psychology studies have demonstrated that people will

make fairly consistent judgments of other based on their grocery shopping lists. Equally

important is that people come to judge themselves through their eating habits” (Rappoport, 2003,

p. 52). Those seeking to connect with a certain lifestyle may eat the same foods or go to the same

stores to achieve this identity.

The urban environment has created a fast paced lifestyle with numerous fast food

establishments to match it, especially among poorer areas (Rappoport, 2003). According to

Rappoport (2003) the environmental landscape and social factors influence the meaning of what

food is, the range of foods that are available, and the types of experiences that determine one’s

attitudes towards food in general. This perspective has been shown to begin within the family

home environment and widen as people get older; today children are less likely to eat the same

foods that their parents did when they were growing (Rappoport, 2003). Consumer studies have

revealed that increasingly more American people are viewing shopping and cooking as a low-

priority activity (Rappoport, 2003). “The result is a continuing trend away from traditional

home-cooked meals shared by families. Indeed, one of the few predictions that marketing

experts, scholars, and culture critics of cuisine seem to agree on is that the home-cooked family

meal will continue to decline in favor of several new alternatives” (Rappoport, 2003, p. 186).

The popularity of processed foods in urban areas has been linked to the concept that


when people are living with either high stress or non-stimulating routines, people are more

willing to seek out foods that are stimulating, easy to find, and cheaper (Rappoport, 2003).

Colorful foods are perceived as being tastier and this is why the American flavor industry makes

over a billion dollars in revenue each year and why changing from procced foods to un-process

foods seem less appealing (Schlosser, 2002). Perhaps, living in urban areas increases the

cognitive demand that a person has, resulting in less will power when making decision later in

the day; especially regarding food choices. “A great deal of mental effort is required to make

conscious decisions and then implement them in the form of behaviors. Most of our responses to

our environment can be understood as automatic behaviors” (Cohen & Farley, 2008, p. 3). It

takes more mental effort to resist eating food that is present, than it does to continue eating

(Cohen & Farley, 2008). The issues of obesity is more likely due to automatic eating behaviors

and portion sizes rather than people simply being unconcerned about their weight; which is

usually a misconception (Cohen & Farley, 2008).

Navigating the landscape of various foods, packaging / labeling, and advertisements can

be a confusing experience. Research has shown that people want variety and often have sporadic

eating patterns (Rappoport, 2003). “Taste allied with convenience is clearly pitted against health,

but both are prospering. Both have large consumer support, and despite the contradiction, they

often overlap one another” (Rappoport, 2003, p.191). Conceivably, the underlying reason for this

may be a result of marketing and strategically placed branding. In areas where there are many

fast-food establishments, the amount of fruit and vegetable consumption dramatically decreases

(Logan & Jacka, 2014). There are similar findings that connect the amount of screen-based

media exposure to decline in healthy dietary habits (Logan & Jacka, 2014).

Branding to children through television advertisements has been shown to significantly

alter a child’s perception of food and ultimately taste itself (Robinson, Borzekowski, Matheson,

& Kraemer, 2007). Through the success of fast-food marketing such as Ronald McDonald’s play

areas and commercials, child centered product design has influenced what parents buy for their

children (Robinson, Borzekowski, Matheson, & Kraemer, 2007). There is also research that

strongly suggests that food preferences emerge during prenatal development and shortly after

birth; giving rise to the importance of establishing healthy habits early on (Rappoport, 2003). All

things considered, it is important to note that most of the framing of the research cited in this

section was conducted through an American lens regarding behaviorism. With both countries


having similar modern environments and fast-food influences, it stands to reason that this

research overlaps to some degree with the Japanese population.

Considering the differences in calorie consumption in the U.S. and Japan, the way food is

packaged may be directly associated with the amount of food that is eaten. “More for less” seems

to be the running theme for American advertisements; case in point, it is very difficult to buy one

serving of anything. On the other hand, “smaller portions are the hallmark of Japanese eating

habits…children are taught to feel satisfied without feeling stuffed,” this is where the saying “eat

eighty percent full” comes from (Hays, 2013). The Japanese also value freshness, quality, and

simplicity of their food; willing to pay a higher prices for quality over quantity (Hays, 2013).

Portion sizes play a significant role in the amount of food that a person consumes along with the

presentation of food itself. The Japanese often share bowls, have smaller plates, and do not allow

their food to touch the outer rim of the plate; thus cutting down on consumption (Hays, 2013).

For Americans, platting is much different and usually involves a combination of foods

converging on one plate or with containers overflowing, as evident during holiday celebrations

(Wansink & Van Ittersum, 2007). The size of the plate impacts the perception of serving size and

ultimately the amount of food that is consumed (Wansink & Van Ittersum, 2007).

Marketing, food presentation, and culture significantly impact the types and the amount

of foods that people eat. Our inherited traits that seek out calorie-dense foods are no longer as

helpful as they once were due to the modern lifestyle in developed countries. Health care

professions seek to decrease the number of chronic diseases by advising people to reduce portion

sizes, limit processed foods, and reduce the exposure to advertising (Cohen & Farley, 2008).

U.S. & Japan’s Labeling Practices

A country’s style of communication directly influences the presentation of food packages

and their labels. The U.S. and Japan are two countries where labels differ in the way they are

presented to the public. According to Hall’s intercultural communication styles, a country can be

either high or low in context (Nishimura, Nevgi, & Tella, 2007). The U.S is considered to be a

low-context society, where Japan is recognized as being an extremely high-context society

(Nishimura, Nevgi, & Tella, 2007). In countries in which their language is considered to be

“low-context,” details, descriptions, and gestures are abundant as a way to inform the consumer

of exactly what the product is (Nishimura, Nevgi, & Tella, 2007). In Japan, the language and


form of communication is based on embedded meaning that is established within the network of

the culture and thus the way a word is presented or spoken will imply the meaning (Nishimura,

Nevgi, & Tella, 2007). For example, a disposable coffee cup from a low-context society would

have details regarding the temperature and many descriptions of its contents, while a disposable

coffee cup from a high-context society would have minimal labels due to culture’s implied

understanding of its contents.

Looking broadly at how packed foods are displayed, there is one notable difference

between these two countries. The United States uses a “mandatory” labeling systems, regardless

of the contents in the package; an example being a bottle of water (Label Bank, 2016). Nutrition

labels can be found on every item that is sold individually in the United States (Label Bank,

2016). Conversely, Japan’s regulations are more relaxed in nature and fall under the category of

“necessary” which means that nutrition labels are only necessary when there food contains:

sodium, carbohydrates, fat, protein, and energy (calories) (Label Bank, 2016). The food products

originating from these two countries are different, but international trade from these countries

have led to new regulations being implemented due to consumer concern regarding imports.

A reoccurring issue in the United States, involves the deception of the consumer’s trust

regarding nutritional content in processed food products (Nestle, 2014). One tactic by

manufactures is to “green-wash” the nutritional label so that consumer is misguided in believe

that they are making a healthier choices (Nestle, 2014). Green-washing is essentially taking the

same product that originally had a white, black, or red front of package label and replacing it

with a green one (Nestle, 2014). This action has led to an increase of sales for products due to the

color green being associated with it being a healthier option, regardless if the calorie content is

the same, what constitutes a “healthy’ calorie amount is subjective to the processed food

manufacturer (Nestle, 2014). Although, front of label packaging is not on every product in the

U.S., this type of product labeling may increase in the coming years as a way to help consumers

quickly gage the calorie content. In a country that is low-context, it is imperative that the public

become more aware of these inconsistencies within the food industry (Nestle, 2014). The

abundant amount of funding from food manufacturers has inhibited consumer initiatives,

however, in recent years the public has been more successful through smaller initiatives joining

together (Nestle, 2014).


Finally, the inconsistent found with the United States have been met with concern by the

Japanese government regarding labeling practice. The issue lies in Japan’s consumers have

concern over the origin of food and as a response to misleading labels (Business Insights:

Essentials, 2016). Japan imports many U.S. food products and the new regulation under Japan

Agricultural Standard (JAS) will mandate that processed foods must have: ingredients, net

contents, best-before date, storage instructions, name of the manufacturer and distributer

(Business Insights: Essentials, 2016). The labeling requirements presented by Japan is one

example of the growing concern regarding food quality and nutrition content.

Dietary Research Projects and Social Movements

Blue Zones

Currently, several cultures around the world are making healthy food choices that have a

positive impact on their health. These decisions, regarding their interaction with food, have led to

communities where individuals live well into their nineties and beyond. Underlying this success,

is a common theme stemming from a connection between the individual and food; through act of

mindfulness (Buettner, 2015). Where do such examples of longevity and vitality exist? What is

the key to their success? To further explore this question, it is important to examine the work of

Dan Buettner and his team of experts. Buettner’s work explores areas all over the world where

people are living lives exceeding a hundred years (centenarians); areas known as the Blue Zones

(Buettner, 2015).

In his book, “The Blue Zones Solution,” he outlines the diets and lifestyles of

centenarians, providing insights into their success. According to Buettner, “No one thing

explains longevity in the Blue Zones, It’s really an interconnected web of factors…Food is at the

center of that ecosystem, and food may be the best starting point for anyone seeking to emulate

the health, longevity, and well-being found in the world’s Blue Zones” (Buettner, 2015, p.31).

Through research based studies, Buettner and his team found similar habits among the people

living in the five Blue Zone regions. Buettner (2015) states, there are nine aspects referred to as

the “power nine” that are present in daily living. These include: move naturally, purpose (in life),

downshift (stress), 80 percent rule (eating portions), plant slant (plant based diet), wine at five,

right tribe (social circles), community, and loved ones first.


“The Blue Zones Solution” describes how each Blue Zone region adapts their “power

nine” habits to fit their local environment and their cultural values. Although the food readily

available to eat may be different from region to region, an important aspect of living a long

healthy life is to focus on how food fits into your life, “not just the nutritional value of

ingredients but also where food is grown, how it’s prepared, what rituals surround it, when it’s

consumed, and with whom” (Buettner, 2015, p.32). The people living in Okinawa, Japan and

Loma Linda, California are located in two very distant places with unique cultures, but both

communities embrace a food-focused mindset which has allowed the people of these

communities to maintain a healthy active lifestyle into their nineties and beyond (Buettner,

2015).

Taking into consideration both Okinawa and Loma Linda are prominent Blue Zone

communities, it is anticipated that they share many similarities alongside some differences.

Given that both communities are located in different regions of the planet and most likely abide

by different cultural practices, obvious differences will exist. Other than Okinawans consuming

pork, fish, and alcohol on occasion, both regions have very similar dietary breakdowns. The

foundation of both diets consist of mostly plant-based meals that are derived from vegetables,

soy, and non-refined grains, with both cultures discouraging the use of salt, sugar, and refined

foods (Buettner, 2015).

Slow Food Movement

The creation of the Slow Food Movement began in Italy during the 1980’s, with its roots

stemming from a protest against the development of a McDonalds site “at the Spanish steps in

Rome.” (The CQ Researcher, 2007). The founder, Carlo Petrini began the activist group in 1989,

as a way to keep the regional traditions of slow living alive (Schepers, 2002). The slow food

movement is an international organization that seeks to bring awareness to communities about

where food comes from, how it is grown, and how individual food choices effect the rest of the

world (Winston, 2010). The Slow Food Movement is unique in that it promotes both agricultural

farmers around the world and education through community activism. The mission can be

expressed through its vision of “…a world which all people can access and enjoy food that is

good for them, good for those who grow it and good for the planet.” (Slow Food Foundation for

Biodiversity, 2015). This global outreach program emphasizes eating and living ‘slow’ by means


of supporting local gardens and eating more fresh produce, such as fruits and vegetables. The

organization has a motto: “good, clean, and fair quality…for a better future” (Slow Food

Foundation for Biodiversity, 2015). This motto reflects the three main goals of the organization

which are to provide education about taste, defend the right to material pleasure (of food) at

friendly gatherings, and the ark of taste (Pietrykowski, 2004).

Education surrounding taste involves programs that teach both children and adults about

agro-industrial heritage, while respecting cuisine native to that region (Pietrykowski, 2004). The

Slow Food Movement also has deep roots in the concept of “Pleasures of the table,” denoting the

importance of gathering for meals with friends and family around a table (Pietrykowski, 2004, p.

311). Enjoying the material bounty of seasonal foods is viewed as being a key element in how

the culture continues to exist (Pietrykowski, 2004). In other words, how a culture interacts with

preparing and eating food is the embodiment of that cultures identity.

The third element of the movement involves eco-agriculture and craft production.

Through the “Ark of Taste” conference, established in Italy in 1996, members work together to

categorize various food products and keep documentation of what foods are threatened by

extinction (Pietrykowski, 2004).This conference intends to preserve and increase knowledge

about agricultural biodiversity. Additional conferences have been established since the

organization first began and in essence attempts to recreate a more mindful approach to eating

behaviors; similar to the blue zone regions.

Today the slow food movement has grown to over a one-hundred and fifty countries

including the United States and Japan (Slow Food Foundation for Biodiversity, 2015). In the U.S

alone there are forty-seven states comprising of 200 organizational chapters, consisting of

approximately sixteen-thousand members (Slow Food Foundation for Biodiversity, 2015). With

the growth of the Slow Food Movement in the U.S., the shift has been focused around informing

the public through engaging conversations centered on food. While sixteen-thousand people is

minor in comparison to the population of the U.S., the Slow Food Movement gained national

attention in 2011 during one of President Obama’s meetings (Webster, 2012). Joshua Viertel is

the president of the Slow Food U.S.A, he submitted a question to be answered by President

Obama during his online interview in 2011. Mr. Viertel presented the question as to why

processed cereal such as Fruit Loops are cheaper for American families to buy than real fruit


(Webster, 2012). Public attention began to grow as people on the YouTube forum began

discussing this topic and votes grew rapidly, enough to catch the attention of the President

himself. His submission was then aired during the “Your Interview with the President 2011”

hosted by YouTube (Webster, 2012).

The Slow Food U.S.A movement has been creating an impact in communities around the

nation and farmers markets have increased sixty-three percent between the years of 1994 and

2000 (Schepers, 2002). Farmers markets provide an environment where produce is widely

available to everyone, including adults who are more susceptible to developing chronic diseases

(The World Health Organization, 2003). Other noticeable impacts by this movement include the

introduction of school gardens and “many initiatives, including Garden-to-Table projects to

teach children where food comes from and how it [is] produced” (Slow Food Foundation for

Biodiversity, 2015). This is especially important when considering that there may be an

association between the risk of developing cancer later on in life and a high calorie diet during

childhood (The World Health Organization, 2003). Between the increase of farmers markets and

school education programs, there are more conversations about food and this in turn may impact

many more to gather around the table; perhaps changing the food culture of the U.S. in coming

decades.

Far across the globe, the country of Japan has been undergoing rapid changes to their

cultural identity. Now one of the most industrialized countries in the world, the traditional

background that once defined Japan’s identity are now reaching a cross roads between their

historical practices and their modern life (Oguro, 2005). “The country today imports almost 60%

of its food and the local ingredients for many traditional recipes can no longer be found.”

(Oguro, 2005). Traditional meals like Dashi (soup stock) were prepared by means of steaming or

boiling the soup’s contents, preparing the dried bonito, rather than using means of fast heating

microwaves or high heat and oil (Logan, 2014). Not only are the traditional meals disappearing,

but the people of Japan are at risk of losing traditionally exclusive recipes that could only be

found regionally due to Japan’s unique geography (Sardo, 2010). The biodiversity may be

compromised when imports increase and farmers are not able to compete at the market (Sardo,

2010). In efforts to retract western influence, Slow Food Japan was created in 2004 along with

the first world meeting of all the food communities, the Terra Madre convention included about

five-thousand delegates from 130 countries (Slow Food Foundation for Biodiversity, 2015). The


necessity to regain a sense of human connection to food is best summarized in Oguro’s

statement: “There has been such acceleration and change affecting so many of the foods we eat,

that these factors are invisible and beyond our reach. Wanting to slow down to a speed that

allows the eye to see and the hand to touch and feel — a speed adjusted to human nature — is

what the Slow Food Movement desires” (Oguro, 2005). Through this organization there are

many resources that help to create awareness for the public, giving people more food for thought

on the concept of living slower, and in a way reuniting their ancestral past with present day life.

Reinventing the Wheel: A Spin on Healthy

With the ever changing landscape there is also a change in the way people reinvent what

has previously existed. This is also true within the area of food, namely fast-food, where modern

convenience is pinned against healthier alternatives. Can modern consumers support unprocessed

foods and transition into a more healthy diet in today’s world?

It seems as though this is possible with new food chains offering healthier options while

providing speedy service. The country of Japan, along with others, have incorporated

Westernized fast-food chains as part of its food industry with adaptations, most notably, in their

very popular vending machines (Healthy Choices Healthy Futures, 2014). The sprawling cities of

Japan have many of the working class citizens on a tight schedule, especially during lunch hours

and dinner. Convenience is the epitome of modern living and Japanese vending machines do not

fall short in what they offer; everything from hot soups to live seafood. The value of freshness

with modern conveniences are reflected in these popular vending machines that offer alternatives

to Westernized food-chains and sit-down restaurants.

Both the U.S. and Japan are combining the convenience of a vending machines with the

health conscious foods found in a grocery stores. Utilizing an easy to read stop-light system,

people of all ages are able to quickly recognize healthier food options (Healthy Choices Healthy

Futures, 2014). The new vending machine stop-light system in Japan is gaining momentum and

is becoming an integrated part of schools and the work environment (Healthy Choices Healthy

Futures, 2014). The categories go from: green, amber, and red; with fifty percent being green,

thirty percent amber, and twenty percent red (Healthy Choices Healthy Futures, 2014). The

location within the vending machine also impacts the likelihood that green items (located at the

top) are more easily seen and chosen vs. red items located at the bottom (Healthy Choices


Healthy Futures, 2014). This strategic placement takes advantage of the impulsive nature that

surrounds quick snacks. The United States has also been influencing the eating behaviors of its

citizens by integrating the stop-light system and creating an easy to remember slogan: “go”,

“slow”, “whoa” (Mealey, 2010). Theses descriptive words encourage consumers to take healthier

actions when considering their diet. The U.S. has also seen a dramatic increase of health items in

fast-food chains and new emerging quick-stop establishments to meet the growing consumer

demand for healthy options (Minkin & Renaud, 2009).

Conclusion and Recommendations

Considering the changes that have occurred over the last fifty years worldwide, the

attempt to keep up with the new modern lifestyle has ultimately changed humans and their

connection to food. While convenience is a necessity in the twenty-first century, the global

community must now build upon the research to generate healthier alternatives to combat

chronic diseases. Can industrialized nations like the United States and Japan find a balance

between a food quality and the need for convenience?

The environment is key in understanding the way a person lives, thinks, and behaves.

Two major environmental influencers are culture and local environment. Living in a sprawling

city is vastly different than rural areas, each with differences on what is available for food

options. The technological advancements found in most parts of the world have paved the way

for the variety, amount, and types of foods that are available to most people. Prior to the

industrialized era of food production, food was usually eaten seasonally, and was limited by

location. Developed nations like the United States and Japan are able to regularly trade food

products and it is common to find international foods in local grocery stores. The global

exchange has brought opportunities to try foods that would otherwise not be experienced, as the

seasons do not impact what foods are available as it once did. The invention of the can and mass

production of food products have allowed many people to access food and preserve foods

beyond a week; assuming that they can buy food. Granted, there are still populations that are

food insecure, even in first world countries like America. But with the modern food processing,

people have the option of obtaining canned goods and packaged grains through donations.

For most, having abundance at every turn seems to go against the limited will-power

people have and accentuates the natural allure of eating energy-dense foods. The growing


concern surrounding chronic diseases is focused on lifestyle changes that an individual can do to

reduce the risk of developing these diseases. However, taking a closer look at the industrial

landscape, eating less processed and low-calorie foods is a challenge that most do not have the

time to take. The hustle and bustle of modern life creates little time when choosing or preparing

foods. Quick judgments about what to eat along with marketing and behavior patterns have

shown greater preference towards convenient foods. The issue does not lie solely with the

individual, but also within the local environment that they find themselves. Tremendous amounts

of advertisement dollars are spent each years in hopes of engaging new customers with a food

brand and creating brand loyalty with previous customers. Studies have shown that branding can

start at a young age through television media and packaging. Children are extremely

impressionable and show the same tendencies as adults to connect with an ideal through

characters or figures they can relate to. For adults it may be a certain group or lifestyle that

attracts them to the food product. Case in point, the common example of Ramen as being

distinctly a college student’s diet.

Although advertisements play a significant role in what people are open to eating, the

school lunch environment is also of great concern, especially in America. The school lunch has

transitioned into a fast-food source that also appeals to the youth’s concept of taste. Pizzas,

sodas, and vending machines make up the environment in which children explore food options.

The inherited traits of our ancestor’s leaves taste buds yearning for calorie-dense food items,

however in environment with so much abundance and dense food choices, famine is not likely.

This mixture of ancestral influences, advertisements, and environment make for an unhealthy

force when it comes to maintaining a nutritional diet. The research conducted by Rappoport

(2003) have shown the connection between family eating patterns and prenatal influences on

food preferences. This shows that the family home environment is an important place to establish

healthy diets and its effects are inter-generational.

What the child eats will influence what they eat as an adult and eventually their children.

The available time to eat home-cooked meals has decreased and with it the power of influence.

Even if the types of food prepared in the home consist of high fruit and vegetable content, what

awaits outside the home is mostly the opposite; choosing lower-calorie options has proven to be

a difficult task. Given the amount of global research on chronic health issues and dietary

influences, it is imperative that communities become educated about the impacts of food on


health. Schools should look to fund programs that teach children about nutrition, clear space for

a school garden, omit vending machines that have high-calories items, and change the food

options for school lunch as a way to indirectly influence healthy behaviors.

The body is geared towards the high-calorie fatty rich foods and as many people who

make diet goals would know, this tendency can be more like an enemy when it comes to the food

choices that are presented to us. As the New Year comes around, many people all over the world

tend to think about New Year’s resolutions; most consider losing weight. The focus in America

to lose weight has created a huge paradox for the public. Everywhere the American media

broadcasts “new” ways to shed the pounds, “tricks of the trade”, and “long-forgotten remedies”

that are the quick fix. The modern lifestyle has shaped a mindset where “quick” is preferred, if

not, a better way to approach life. Listen to any advertisement and it is inevitable that the product

will be explained as solving a problem quicker, faster, or make life easier. This cultural mindset

has lead people into a revolving door every year. The beginning of the year boasts shedding

excess weight, while the end of the year celebrations offer people the ability to relax and enjoy

the frivolous bounty of food. This roller-coaster can affect the way people view what they eat,

why they eat it, and how they view others or themselves. Accompanying this paradox is the

concept that “…people can become depressed when they violate their diets, but they are most

likely to violate their diets when they feel depressed” (Rappoport, 2003, p. 52). Obesity is often

highlighted as a culprit linked to chronic diseases. Thus, it is important to note that the issues

with fast-food products, in general, are their lack of balanced nutritional content. Even people

who are considered within a normal body mass index (BMI) can also show signs of malnutrition

in the same regards as those who are considered over or under the recommended BMI (Centers

for Disease Control, 2015).

Taking a closer look, there are many smaller changes that a person can implement into

their daily lives to make a change in their health. The world is becoming increasingly connected

and chronic diseases continue to be an issues across many nations. “Fast food is the one form of

American culture that foreign consumers literally consume. By eating like Americans, people all

over the world are beginning to look more like Americans, at least in one respect” (Schlosser.

2001, p. 240). With this in mind, it may be necessary to look at the world’s Blue Zones and learn

from the world’s longest living people. Both the United States and Japan share regions where

people are able to live active lives well beyond the general population. The area of Okinawa,


Japan is a shining example of a place where people are directly connected to what they eat and

how they eat; reflected through their acts of mindfulness.

One simple approach, such as being aware of one’s consumption patterns, may help to

alter the automatic eating behaviors present in today’s society. Avoiding eating in front of the

television will decrease mindless eating and lessen the exposure to food advertisements. When

purchasing processed foods, take the time to flip it over and analyze the label for nutrition

content; especially servings per container. Additionally, making the effort to include home-

cooked meals and pre-made lunches as part of the regular routine will cut down on impulsive

purchases at work or school. Exchanging bigger plates for smaller plates at home or buying

smaller packages of food can dramatically reduce the amount of calories in each meal. By

gradually incorporating more fruits and raw vegetables into the shopping list, people can begin to

transition into a healthier diet. The goal is not to omit all processed foods from the diet, but

rather to gain awareness on how much is consumed. Other ways to make the transition include:

taking advantage of local food education programs, sign up for a cooking class, make home-

cooked meals a family activity, plant a home garden (if possible) or plant some spices, and

having fruit for desert. Another avenue that is often overlooked is the amount of consumer

buying power that exists, people can influence the food industry simply by where they spend

their money. Showing support for local growers, stores with quality foods, and healthy food

chains can dramatically change the food environment.

Each and every small change adds up over time and the time taken today will impact

one’s health in later years. “Through the act of self-awareness, people can begin to change their

attachment to food by altering the meaning they have with food. For example, if a person ties

food primarily to “satisfaction of [their] desires, there can be no end to the conflict between …

the holy trinity of [their] desires for pleasure, health, and convenience…a problem rooted in the

meanings we attach to eating” (Rappoport, 2003, p. 212) Healthy and longevity are priceless

when compared to the small everyday changes in building a nutritious diet.

Beyond this Scope

Given the nature of this literature review, the information presented is merely a glimpse

into the complexity surrounding cultural influences on chronic health issues. Future areas of

study should include more research on Japan and how their culture perceives the food industry


and its changes; specifically how fast-food may change their family dynamic. Other areas to

consider for future study include: the impacts of a global industrialized environment on human

health, psychology of food and food culture for countries besides the United States, and


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