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There are a lot of possible explanations for why Japan has weathered the COVID-19 pandemic better than the United States. It’s possible that the Japanese are more used to wearing masks, that the government used contact tracing more effectively to contain outbreaks, and that handshakes aren’t a widespread cultural practice. But according to Dariush Mozaffarian, a cardiologist, and the dean of the Tufts Friedman School of Nutrition Science and Policy, one of the main reasons Japan is coping with the coronavirus more successfully than the United States is for a different reason entirely: their obesity rate.

America has one of the highest rates of obesity in the developed world, and Japan has one of the lowest. And it’s this gap that’s making America’s response to COVID-19 much more difficult. Mozaffarian explains why that is, and the ways we can deal with it.

Three Takeaways

• According to a recent study of COVID-19 hospitalizations in New York City, obesity is a major problem. Obesity was more important in determining hospitalization than high blood pressure, diabetes, cancer, kidney disease. In fact, after age, it was the biggest factor leading to hospitalizations.
• Since obesity drives COVID-19 hospitalizations, America is uniquely vulnerable. “About half of all American adults have diabetes or pre-diabetes,” Mozaffarian says, “and 3 in 4 American adults are overweight or obese. So very few of us are actually healthy, and COVID-19 is basically like pouring gasoline on a smouldering fire.”
• But according to Mozaffarian, there’s a surprising amount we can do now: “People think that if you’re obese, it takes years and years to deal with that and get healthy,” he says. “But many well-controlled trials have shown that if you’re overweight or obese and have poor metabolic health, and you just change what you eat… within four to six weeks, [there are] dramatic improvements in many metabolic parameters.”

More Reading

• Here’s some more data on obesity increasing coronavirus risk, from The New York Times.
• Mozaffarian explains how your diet can also help “flatten the curve” in this CNN opinion piece. 
• An interview we conducted with Mozaffarian last year, where we talk even more about the obesity epidemic.