Category: Current Events

Surprise! you are now a part of the “Metabolic Syndrome Market”

Thomas Jefferson famously said, “The man who reads nothing at all is better educated than the man who reads nothing but newspapers.” As cliche as it’s become, the quote still rings very true to me as an avid newspaper and online news consumer.

Even today, it is very easy for those following the news to get caught up in the story of the day and completely miss the big picture. Part of the reason for this is that a news story is quite often the end result of months and months of researching, campaigning, planning, cost-benefit analyzing, focus grouping, intra-group wrangling, or any combination of the above. Therefore, when the average reader sees an announcement, whether it’s for a new hamburger at Wendy’s or the Barack Obama Speech About Race, we are forced to accept the basic premise and set of facts presented, and prevented by our own ignorance as outsiders, and the immediacy of reading information on the Internet, from seeing different parts of the story. The only possible response from the consumer is a sort of tit-for-tat reaction to the new information.

With that in mind, I want to talk about “Metabolic syndrome,” a set of symptoms, including overweight and high blood pressure, that puts one at risk of “lifestyle diseases” such as diabetes. In many cases it is indistinguishable from obesity (and in modern Japanese the terms are used somewhat interchangeably), but it is apparently useful as a medical definition.

The term became especially popular in Japan in 2007, as popular TV shows, infomercials, newspapers, and even the government played up the disease as a growing danger for Japanese people as they live increasingly sedentary lifestyles and consume ever-greater quantities of greasy Western snacks.

The English-language news media has noticed this phenomenon. The Japan Times, a local Japanese English-language newspaper aimed at the expat population, notes:

These days, not a single day goes by, it seems, without there being a fitness-club flier, a beverage ad or a new recipe that contains some mention of metabo, short for “metabolic syndrome.”

In contrast to the massive hype over the increasing problem of metabolic syndrome, the introduction of “specified medical examinations” at the beginning of this month has received much less fanfare. Under this system, all insured persons aged 40-74 will be required to undergo a yearly health check up, followed up by mandatory “guidance” if they are diagnosed with certain conditions. Metabolic syndrome is perhaps the most controversial, as people diagnosed with the condition may have to go through “active guidance” if they are particularly fat.

Coinciding with the introduction of this program is a series of article in the Nikkei Shimbun by a major corporate research group (I think Nomura) titled “the Emerging Metabolic Syndrome Market.” The series is ongoing, but some of its main points can be summed up as follows:

1) The specified examination system will result in thousands, if not millions, of people being officially diagnosed with “metabolic” syndrome.
2) The current medical establishment does not have the capacity to handle all these new “patients” so the mandatory follow-up care will be left in the hands of outsourcers.
3) The program, part of a Koizumi-era medical reform plan (also featuring increased premiums and patient contributions), is intended to make people healthier, which will reduce Japan’s total medical bill. However, actual cost savings will probably take at least 25 years to emerge, and in the short term the government will be dishing out massive largess to whoever can fill this current legally-mandated demand.

The Japan Development Bank has estimated that this metabolic syndrome market will grow to 280 billion yen, a “chance for medical institutions facing harsh business conditions [due to a drop in government payments in the national insurance scheme] to improve their revenue.” 45% of the 9.45 million targets of the system are expected to be judged as metabolic cases or in danger of becoming so, resulting in extra medical expenditures of 73-141 billion yen per year.

This specified exam system has been in the planning stages for years. In the meantime, the media has fanned popular worry over an obesity epidemic, couched in the convenient, one-word slogan “metabo.” And now doctors, or their counterparts in third-party examination centers, have the correct mindset and the legal authority to start diagnosing the problem and mandating treatment. The media, over the past two years or so, has featured the problem of metabolic syndrome in perhaps dozens of creative segments, ranging from features on anti-metabolic syndrome products, to informative explanations of the waist size/internal organ fat conditions for the diagnosis, to wackier efforts by Health Ministry officials to document their efforts to lose weight.

While the term metabolic syndrome is not new and is not a Japanese invention, the intense media campaign has injected the word “metabo” as synonymous with obesity in the Japanese language, with the added twist of hipness (new, trendy words are always a topic of small talk in Japan) and the specificity that comes with “metabolic syndrome” being the name of an actual disease rather than a mere physical attribute.

Without this propaganda campaign and the re-definition of the word obesity, it is unlikely that a vibrant market for anti-metabolic syndrome products would develop as effectively. But taken together, public awareness of the issue is so high that a diagnosis of metabolic syndrome will make much more sense to people and may make them more receptive to attempts to influence their behavior in a healthier direction.

I see two ways to view this major awareness campaign to alert everyday Japanese to the dangers of obesity – either Japan’s medical establishment has come up with an ingenious method for preventive care that will ensure that the life expectancy for Japanese people extends well into the 90s, or government, industry, and the media are conspiring once again to manufacture demand to solve a non-existent problem.

True, it seems like there is a real obesity problem here and a comprehensive plan focused on preventive care (i.e., fighting unhealthy habits will help prevent more serious ailments such as diabetes and heart disease) is a great idea. On the other hand, a massive, mandatory treatment program might be overdoing it, especially if it is taxpayer funded. The system does sound like it might be effective in addressing a real problem, to the extent that it encourages healthy behavior, and could lead to better quality of life for a lot of people. And as with the intention of many Koizumi-era reforms, the creation of new markets through smart regulation may be just what Japan needs to enliven its economy and, through the health benefits, help keep its working population on the job for the extra years that will be required in an aging society.

But my more cynical side tells me that the medical industry may not have Japan’s best interests at heart. If in fact, the expenses are not justified (and hundreds of millions of dollars in extra health burden with no promised overall benefits for a generation seems a little fishy to me) then the government could merely be entrapping its people into a handout scheme for the medical and health product industries.

Only 3% of Japan’s population is considered obese by body mass index standards, compared to ten times that ratio in the US. The figure has risen significantly for Japan over the past few decades, no doubt a result of the often mentioned higher living standards and Westernized diets. But as any prolonged contact with Japanese people will tell you, the demand for health supplements, beauty products, spa treatments, exercise machines, and all manner of health-related products is enormous. I wouldn’t be surprised if the market scale rivaled the US.

However, metabolic syndrome is a substantial redefinition of obesity (not that that is necessarily a bad thing — it seems to correspond much more closely to health problems than BMI, at least from a comparison of Wikipedia articles). Even if people are not fat in the traditional sense, they are much more likely to have the required body measurements for metabolic syndrome. And sure enough, media fanfare over this syndrome dovetails nicely with the ever-growing numbers of products offered to help fight it. And as any quick look at the Japanese mass media will tell you, there is no shortage of such products (today on NHK I saw a full-on infomercial for boxer briefs that force men to take larger strides when they walk, which will help them burn more calories during the day).

From my own observation of the Japanese user-generated media (which consists of a few favored blogs, a 2ch news aggregator, and the diary posting of my mixi friends), the reaction to the metabolic syndrome hype has been quite shallow, with perhaps zero discussion of this upcoming mandatory treatment system (until now, since it came into effect). Indeed, according to a survey translated at What Japan Thinks, almost two thirds of people are unaware that the specified examination system even exists. That, I think, is understandable since the coverage of this issue has tended to be in the form of corporate press releases quoted verbatim, statistics from medical establishment publications on the growing problem.

Honestly, I am no medical expert, and I do not intend to attempt a comprehensive assessment of the relative benefits of mandatory health exams for the middle aged, or of the real dangers of metabolic syndrome. But personally, I have been disappointed in myself for not giving this issue much thought until I ran across that series of articles in the Nikkei. Like many people, probably 75% of the reading I do in a given day consists of news articles, the paper newspaper, and blog posts. They are all quite entertaining to read and keep me informed of what’s going on in the world on a day to day basis, but the net effect of reading superficial day to day coverage is that I end up being completely in the dark about what sort of plans are being hatched behind the scenes.

The Japanese press has asked some of the right questions, and for someone more engaged the information is out there. A Yomiuri Shimbun report from last year cites experts who wonder why the waist size requirements are slimmer than those of other countries (a detail that can have massive implications on how many are singled out for mandatory “guidance” and whether that will affect people who are actually healthy), but in the end the hype has drowned out skepticism and a “metabolic syndrome market” is already fast being built without the knowledge of the vast majority of people. Residents of Japan may be getting fleeced in the deal in terms of increased insurance costs and dubious products intended to solve a problem that for many won’t really exist.

Taiwan gets a little bit more modern

From The Taipei Times:

A ban on poultry slaughter in traditional markets will take effect on Tuesday as originally scheduled, National Science Council Chairman Chen Chien-jen (陳建仁) said yesterday. “Despite protests by poultry vendors who fear that the ban will affect their livelihood, the policy will go into effect on April 1, and all chicken, geese and ducks should then be slaughtered at licensed abattoirs,” Chen said. But as some complementary measures have yet to be completed, the government will postpone enforcement, originally scheduled for Oct. 1, for three to six months, he said. Chen, who concurrently serves as convener of a Cabinet bird flu epidemic prevention task force, said that preparatory work, such as setting up electric slaughter houses, disinfecting facilities at the abattoirs and launching a food safety publicity drive, is yet to be completed.

I may not exactly be in the habit of buying freshly slaughtered whole chickens at the market (or, for that matter, cooking) I am still mildly and inexplicably saddened at the fact that I will no longer have the opportunity should I once again live in Taiwan.

Who knew Bhutan could be so kinky?

While reading about Asia’s newest self-proclaimed democracy I did a double-take at the following factoid:

Bhutan’s first democratically elected prime minister will be Jigmi Thinlay, a charismatic politician who has portrayed the DPT as the party of ordinary Bhutanese. His rival, Sangay Ngedup, leader of the rival People’s Democratic Party (PDP), is the brother of the previous king’s four wives, all sisters.

(Note to readers: I know my last couple of posts have been frivolous. Many apologies. This stuff is just too amusing not to blog.)

Remembering the Railway of Death

About a week ago the New York Times had an article entitled “Seeking Recognition for a War’s Lost Laborers” on the lack of recognition for the Asian victims of Japanese forced labor in the construction of the famous “Railway of Death.” According to the article, the history of the 200,000-300,000 Asians who were employed, and often killed, in the construction of the railway, which was being constructed to link Bangkok and the Burmese (Myanmarese) capital of Rangoon (Yangon) to provide logistical support for Japan’s invasion of Southeast Asia, has been almost completely overshadowed by stories of the smaller number of Western POWs.

Between 200,000 and 300,000 Asian laborers — no one knows the exact number — were press-ganged by the Japanese and their surrogates to work on the rail line: Tamils, Chinese and Malays from colonial Malaya; Burmans and other ethnic groups from what is now Myanmar; and Javanese from what is now Indonesia.

“It is almost forgotten history,” said Sasidaran Sellappah, a retired plantation manager in Malaysia whose father was among 120 Tamil workers from a rubber estate forced to work on the railway. Only 47 survived.

[…]

By contrast, the travails of the 61,806 British, Australian, Dutch and American prisoners of war who worked on the railway, about 20 percent of whom died from starvation, disease and execution, have been recorded in at least a dozen memoirs, documented in the official histories of the governments involved and romanticized in the fictionalized “Bridge on the River Kwai,” the 1957 Hollywood classic inspired by a similarly named best-selling novel by Pierre Boulle.

One reason given for this inequality of historical memory are that virtually none of the Asian victims were from Thailand, giving the local government little incentive to commemorate them. Another is that, unlike the American and British POWs who wrote memoirs and gave countless interviews to journalists and historians, virtually none of the Asian laborers were literate, and they lacked ready access to mass media.

At this point, I would like to present some photos I took at a very peculiar museum that Adam, his (now) wife Shoko, and I visited when we were in Kanchanaburi, the location of the famous Bridge on the River Kwai.

The Jeath War Museum (JEATH is an acronym for Japan, English, American and THai) is a rather eccentric museum based on the collection of a wealthy Japanese history buff, who apparently purchased a building a number of years ago, stocked it haphazardly with local WW2 memorabilia of both great and small interest, and has not had arranged to have it cleaned since.

First, some photos from outside the museum itself.

This is a picture of the famous Bridge which I quite like.

Here are Adam and Shoko posing with the bridge behind them. I do not know the sleeping man, but I have to assume that he is a war criminal of some kind.

This is a silly little train which lets  tourists ride across the bridge and 1 or 2km into the jungle on the other side, and then ride backwards to the other side.

I blurrily snapped this memorial obelisk in the jungle across the river, from aforementioned silly train. It says something along the lines of “the remains of the Chinese army ascend into heaven.”

This plaque is location near the bridge. I did not, however, see one for the British POWs, although I certainly could have just missed it.

And now we reach the museum portion of our tour. I do not seem to have any photographs of the entrance area, but the first thing you see upon approaching the entrance to the museum proper are these statues of historical figures, with biography written on the wall behind them. I will transcribe the highly amusing text another time.

Here is Tojo.

Adam and Shoko again, with their good friends Josef Stalin and General Douglas MacArthur.

The lovable Albert Einstein gets a wall as well.

Inside the museum we are confronted with more dramatic statues, such as this tableau of POWs constructing the railway.

Here is one in a cage. Note the real straw.

Eerie closeup of another caged POW statue’s face.

Adam and his new friend, the WW2-era Japanese soldier driving an old car.

The driver.

Another old car. I do not recognize the make, but it is covered in dust that may weigh as much as the steel.

US Army signal core teletypewriter

Recreation of Japanese army tent

Read the text carefully. Do you know when the CD was invented?

A message from Japan to the Thai people. It’s a bit hard to read, so if anyone wants I can transcribe it.

A British anti-Japan political cartoon

Overall, the museum is a complete shambles. While it has a huge array of cool stuff, it is strewn about almost at random, covered in dust, and sometimes behind other stuff. Not to mention placed in crowded and un-lit cases with poor labeling. Despite the numerous flaws, it is certainly worth a visit if you are in the area, but I can’t say that it will do much to provide any sort of historical narrative, and certainly does not even try to meet the standard hoped for by the Times article I began this post with.

Green solidarity? Emphasize the white

One of my best friends in college was a Taiwanese guy firmly in the “green” (pro-independence) camp. We had many conversations about the symbolism of green in the independence movements of both Ireland and Taiwan. We were also both into vexillology, the study of flags, and we often compared the evolution of Irish flags to the evolution of flags in Taiwan.

Fast forward a few years. Today was the St Patrick’s Day parade down Omotesando in Tokyo. Much to my curiosity, there were a couple of elderly Taiwan independence protesters out with their green Taiwan independence flags, which made for an interesting comparison with the Irish tricolors hung from flagpoles farther down the avenue. It was also an interesting contrast with the typical crowd of subculture groupies and bemused foreigners that hang out by the entrance to Yoyogi Park.

Green nationalist solidarity

Despite being color-coordinated for the occasion, they seemed rather lonely at their posts. Apparently getting Taiwan admitted to the UN is not high on the political priority list of most Tokyo residents.

Taiwan independence movement

For whatever reason, green is an underused national flag color once you go east of the Indian subcontinent and the extensive Islamic influence in that half of Asia. Macau has a nice green flag (as does Tokyo), but the nations of East and Southeast Asia have generally adopted red, white and blue in varying proportions, with yellow stars sprinkled here and there.

The consensus among books I’ve read and people I’ve spoken to is that green became associated with Ireland (and its native Catholics) simply because Ireland is a very green country–they don’t call it the “Emerald Isle” for nothing. (Although green is prominent in the flags of other Catholic countries–Italy, Portugal, Mexico and Brazil for instance–it doesn’t have religious significance in the stories behind any of these flags.)

Wikipedia’s explanation for the Taiwanese independence movement’s use of green is that the Democratic Progressive Party adopted green because environmentalism was a major part of its agenda, and the color eventually became associated with everything else the DPP advocated.

In both cases, it seems that green took on another meaning: it drew a sharp contrast to powerful adversaries who flew red and blue flags, namely the British in Ireland and the communists and Kuomintang in China and Taiwan. Then you have the United States, where the Green Party is the most popular (if you can call it that) alternative to the “red” and “blue” parties.

I’m not sure if there is really a point to these parallels, besides that people will find ways to divide themselves by color even when they’re all the same color to begin with. The Irish flag acknowledges this in its own way–it stands for peace (the white mid-section) between two opposing sides (the green Catholics and orange Protestants). Ireland eventually got this peace after a few decades of faking it. Who knows where Taiwan is headed–all I know is that I will support a green flag in Asia, because this part of the world is crying out for vexillological diversity.

Jenkins book finally available in English

For those of you who have been waiting for it, the story of the famous Vietnam war era deserter to North Korea, Charles Jenkins, is finally out in English. Normally I would explicitly avoid promoting something I was notified about through spam from the publisher, but I think I can safely say that a clear majority of people who would be reading this blog want to read Jenkins’ story.

I’m sure it’s on Amazon etc. but here’s the official book web page at the University of California Press site.

I can’t wait to read this book. I just hope there’s a special edition, in which Jenkins’ impenetrable southern drawl is transcribed phonetically, like an Irvine Welsh novel.

The “Rosebud” moment

Now that Fidel Castro is finally resigning, just think of all the decades of trouble that could have avoided if President Roosevelt had just sent him that ten dollars he wanted back in 1940.

President of the United States.
If you like, give me a ten dollar bill green american, in the letter, because never I have not seen a ten dollar bill green american and I would like to have one of them.

My address is:
Sr. Fidel Castro
Colegio de Bolover
Santiago de Cuba
Oriente, Cuba

I don’t know very English but I know very much Spanish and I suppose you don’t know very Spanish but you know very English because you are American but I am not American.

Thank you very much, Good by. Your friend, Fidel Castro

If you want iron to make your ships I will show you the bigest mines of iron of the land. They are in Mayori, Oriente Cuba.

The actual letter is preserved in the US National Archives.

Fishing with poison

Upon seeing the photo Joe posted of a sign prohibiting kinds of fishing that no one should ever engage in, I was somewhat skeptical at the prospect that anyone might actually try and catch fish using poison. Well, I was wrong. The NYT today has a rather distressing account of Jamaicans catching shrimp in just this manner.

And in the Blue Mountains and John Crow Mountains here, people go fishing by dumping poison in the Rio Grande.

Any toxin will do. Some favor the pesticide used to keep insects off the coffee plants. Others use the potent solution used to rid cows of ticks. When subjected to the poison, the shrimp — large and small — float right to the top. So do the fish. Catching them is as easy as scooping them up before the river washes them and the poison away.

“You have to put all morals and conscience aside, and then you throw a toxic pesticide in the river,” said Kimberly John of the Nature Conservancy, which is leading an effort to stop what it considers the principal threat to the ecosystem. “It’s a very cold, hard reality to put poison in the river, and whatever jumps out, you catch.”

If I read many more articles like this, I may have to start reconsidering eating food at all.