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A study by Zhou et al (2003) examined nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s in a comprehensive INTERMAP Study to draw comparisons between the chosen nations and to determine the growing problem with obesity-related illnesses. The purpose of the study is to “compare nutrient intakes among Chinese, Japanese, UK, and US INTERMAP samples, and assess possible relationships of dietary patterns to differential patterns of cardiovascular diseases between East Asian and Western countries” (Zhou et al 2003). In other words, the researchers wanted to find out how dietary habits and patterns related to obesity rates in the UK, Japan, US, and China. The study relates to the body of literature cited in the article directly by providing additional important information on the causes of obesity in the chosen 4 nations as well as the explanation as to why obesity rates continue to grow (Zhou et al 2003).
A study by Zhou et al (2003) explored INTERMAP samples of Chinese, Japanese, US and UK populations. China provided three samples, Japan provided four samples, UK provided two samples, and USA provided eight samples. The number of participants was 260 men and women aged 40–59 years per every sample to make a total of 4680 (Zhou et al 2003). The participants were selected haphazardly for each sample to make the study scientifically valid. The interventions or measurements used in the study involved thorough assessment of the existing food pyramids, food preferences and even specific products consumed by the 4 nations and put into a 76 nutrient database. The independent variables were the food preferences, different types of foods consumed, amounts of foods consumed, calorie intake, and frequency of use. The dependent variables involved the BMI rates (obesity/overweight) and the associated problems related to obesity found in the chosen 4 nations (UK, US, China and Japan). The study was conducted under the aegis of the INTERMAP Research Group that conducted research in these chosen destinations. The use of questionnaires, and interviews helped researchers collect the necessary data (Zhou et al 2003).
The important statistical findings by Zhou et al (2003) show that the average body mass index was higher in Western nations than in Eastern nations. The nutrient intake also differed substantially across samples. For instance western diet had more fat, more saturated fats, more trans fatty acids, high in sugars and lower in total carbohydrates and starches. It also means that western diet included more serum total cholesterol and higher rates of cardiovascular diseases, as well as greater mortality rates from cardiovascular diseases (Zhou et al 2003). Eastern diet was lower in protein, especially animal protein, as well as lower in calcium, selenium, phosphorus, and vitamin A. the Na/K ratio was higher in Asia/Eastern samples than in Western samples because of higher sodium and lower potassium intakes. This shows remarkable differences in vitamins, fibers, minerals and other important microelements that characterize eastern and western foods and diets and their relevance to not only obesity but also to cardiovascular and other diseases (Zhou et al 2003).

Obesity in Japan
The findings of the study suggested that the traditional Japanese or Asian diet is another important reason why the Japanese consumer fewer calories and therefore are less likely to be obese, unlike the Americans and Westerners in general. The traditional Japanese diet with the focus on fish, rice and vegetables keeps people thin and healthy in comparison to other nations, including the USA. The food pyramid in Japan is similar to the food pyramid in the Mediterranean diet habits (Zhou et al 2003). Both pyramids focus on grains, abundance is vegetables, fish and fruits. On the other hand, they greatly limit meats, animal fats and sweets. Furthermore, the Japanese, for instance, give a lot of attention to the aesthetics and how the food is served and presented, not only how it is cooked. The food does not only have to taste good, it has to have the right shape, texture, temperature, color, visual appeal and other characteristics. This certainly entails higher food prices and as a result, less consumption of foods. These findings compare with previous studies and corroborate the notion that western and eastern cultures, traditions and customs affect the food preferences and habits, which in turn result not only in different amounts of foods consumed, but also in different foods preferred. Eastern diets focus more on rice, fish and vegetables, while western diets focus more on animal protein, fats and sweets (Zhou et al 2003). Also western diets result in greater food consumption than eastern diets, thus stipulate higher calorie intake. The author’s suggestions for future research call for additional exploration of the importance of exercise that is also responsible for the high obesity rates as well as for the exploration of the role western mass media has in building western diets in the east and thus contributing to the growing obesity rates in the East (Zhou et al 2003).
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