Lately I’ve been thinking a heretical thought:  What if what you eat and how much you go to the gym have nothing to do with whether you stay healthy?  

Take the Japanese, for instance. As a people, the Japanese fascinate medical scientists because they are such an apparent paradox: they have the lowest rate of heart disease in the world, despite the fact that smoking, one of the strongest risk factors, is virtually universal among Japanese men. 

 Lately I’ve been thinking a heretical thought:  What if what you eat and how much you go to the gym have nothing to do with whether you stay healthy?  

Take the Japanese, for instance. As a people, the Japanese fascinate medical scientists because they are such an apparent paradox: they have the lowest rate of heart disease in the world, despite the fact that smoking, one of the strongest risk factors, is virtually universal among Japanese men.

Japan’s longevity statistics confound all our expectations about what is required to live a long and healthy life. The country produces the world’s largest number of centenarians; currently a reported 40,000 people have reached their hundredth birthday, many of them smokers.

Transplanted results

Epidemiologists find transplanted societies particularly instructive, as they afford an opportunity to examine just how a particular community fares when confronted with profound social, cultural, or dietary upheaval. Len Symes and Ruell Stallones, two professors of epidemiology at the School of Public Health at Berkeley, decided to study just this issue by examining heart disease risk, plus dietary factors, and any social change in a pool of 12,000 men, divided among those who remained in Japan and two groups that had emigrated to Hawaii or northern California.

Stallones was interested in whether the Japanese had low rates of heart disease in their home country because of their low-fat diet, and whether the rate went up when they adopted a typical burger-and-fries American diet. But Syme was fascinated by the social factor: whether moving countries and cultures was so destabilizing that it caused heart disease.

The results confounded both their expectations. The rate of heart disease among Japanese men immigrating to California was five times greater than the rate among those who stayed in Japan, and the rate among those who immigrated to Hawaii was midway between the two.

This signalled that immigration didn’t automatically cause heart disease. Yet the results appeared to be completely independent of any of the usual supposed risk factors of heart disease, such as smoking, high blood pressure, diet, or cholesterol count; in fact the Japanese population studied contained the highest number of smokers and the lowest levels of heart disease.

Amazingly their results also appeared independent of any dietary changes. Whatever the Japanese ate – whether tofu and sushi or a Big Mac and fries – had no bearing on their propensity to heart disease.

The ties that heal

Although changes in the dietary habits made no difference in terms of heart disease, the kind of society the transplants created for themselves did. The most traditional group of Japanese Americans had a heart attack rate as low as their fellow Japanese back home, while those who had adopted the Western go-ahead lifestyle increased their heart-attack incidence by three to five times. These differences could not be accounted for by any of the usual risk factors, such as diet.

Those with social networks and social support were protected against heart disease regardless of whether they smoked or suffered from high blood pressure.

Social mobility – moving outside your own cluster and no longer belonging – made you ill.

Attacking the heart

The every-man-for-himself attitude fostered in the West, especially in American society, can prove deadly to us, particularly to our hearts. Numerous studies show that people who are– self-absorbed, cynical, and hostile to the world – are more likely to die from a heart attack.

The heart expert Dr Dean Ornish, for instance, has discovered an extraordinary statistic: all the usual risk factors for heart disease – smoking, obesity, a sedentary lifestyle, and a high-fat diet – account for only half of all heart disease.

Every so-called lifestyle risk factor laid at the door of cardiovascular illness by the medical community has less to do with someone having a heart attack than does simple isolation – from other people, from our own feelings and from a higher power.

In that sense, heart disease can be viewed chiefly as a disease of emotional alienation.

An enormous body of research reveals that the root of stress and ultimately illness is a sense of isolation, and most toxic of all appears to be our current tendency to pit ourselves against each other.

The need to move beyond the boundaries of ourselves as individuals and to bond with a group is so primordial and necessary to human beings that it remains the key determinant of whether we remain healthy or get ill, even whether we live or die.

It is more vital to us than any diet or exercise programme; it protects us against the worst toxins and the greatest adversity. The Bond we make with a group is the most fundamental need we have because it generates our most authentic state of being, and illustrates the most powerful need we have: the need to belong.