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A century ago in Japan, rice was the dominant food at every meal, but meats, breads and milk products now dominate. The health implications of such changes are two-sided. On the one side, a steady increase in heart attacks and strokes is alarming. Japanese men who grew up consuming a “Western” diet are more likely to suffer from diabetes than are men who grew up on a traditional Japanese diet, and diabetes is a risk factor for heart disease. On the other side, deaths in Japan have declined as modern sanitation and immunizations have brought infectious diseases under control, and the new diet provides much more protein than a traditional rice-based diet. Extra protein during the growing years has enabledthe younger generation to grow taller and stronger than any generation before them. In general, Japan still enjoys a higher life expectancy and lower overall rate of heart disease than many other nations, but new choices present new risks.

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