Understanding How Culture Shapes Health and Diet in the US and Japan

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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