En español | The first thing I bought when I moved back to Pennsylvania after eight years in Hong Kong was a bag of my favorite potato chips. The second thing I purchased, fearing all the weight I could gain, was a scale.
I'd returned to my hometown of Lancaster this past September in large part to be near my parents. They're both now in their mid-70s and have suffered a number of health issues over the past few years: rheumatism, neuropathy, hip replacements, cataracts, a back surgery here, a neck surgery there, not to mention gallbladder surgery and one rather painful broken tooth.
I want to be nearby to help them out when they need it. They've done a lot for me, and I think it's time for me to return the favor.
But now that I'm back, I'm not just concerned about their well-being, I'm concerned about my own, too. Life expectancy in the U.S. peaked in 2014. Today, on average, Americans live roughly as long as they did in 2013 — and that's before you account for the pandemic's disastrous effects on older adults. For the planet's wealthiest country, our longevity stats are troubling.
Fortunately, I can draw on my years in Hong Kong as I plan for the future. The territory, which is a special administrative region of China, boasts the longest life expectancy of any country or territory on Earth. Women live 87.6 years on average, while men last 81.9 — about six years longer than their U.S. counterparts.
So ... why do Hongkongers live so long? And what lessons can we borrow from them to live longer, healthier lives?
A diet that's all about balance (and pleasure)
Dietitians point to the healthfulness of the Hong Kong diet, with its emphasis on stir fries that provide a great balance of high-fiber carbohydrates, brightly colored vegetables and healthy proteins like fish, tofu, or chicken.
But what may be just as important to longevity is how meals are shared family style, with food being a major focus of every day. As Mary Purdy, a Seattle-based registered dietitian notes, “Taking pleasure in eating is critical, and bringing a sense of enjoyment to a meal often leads to less overeating.”
Hongkongers also tend to eat what's in season, eschewing the processed food (see: potato chips) Americans are often fond of. Their obsession with balance in all things means that overeating (shellfish is the big temptation) is usually swiftly followed by a countermeasure. If you've eaten something deep-fried, for instance (what they call a “dry hot” food), you're likely to follow it with something “cooling” like ginseng tea to put the brakes on the unhealthy stuff.
While these terms have special significance culturally, they also represent something helpful in terms of their approach to healthy eating: being attuned, dish by dish, to what you're putting in your body and adjusting, plate to plate, to maintain your health. “We're into maintenance,” my wife, Wendy, says, and that means a tighter focus on diet.
Another way Hongkongers avoid the obesity behind so many of Americans’ life-shortening illnesses? Never “supersizing” anything. While McDonald's is still one of Hong Kong's most popular restaurants, the portions there are smaller than in the U.S. A medium-sized soda at a Hong Kong Golden Arches, for instance, is about 5 ounces smaller than a U.S. medium. Want a free refill? You're out of luck.
Walking, and more walking
At first glance it doesn't make sense that Hongkongers would live so long. People work crazy long hours, lead stressful lives in an overpopulated city, live in tiny, cramped flats, and breathe polluted air that envelops its skyscrapers in a brownish-yellow haze.
But as it turns out, living in congested quarters may be a big advantage because it forces people to get out and walk.
In 2017, Stanford University published a study called the Activity Inequality Project. It analyzed mobile phone data from 111 countries and discovered that Hongkongers topped the list in walking. The average Hongkonger takes 6,880 steps per day, roughly 2,100 more than the average American. (Not coincidentally, I'm averaging 2,272 fewer steps per day since returning home in the fall.) They also found more walking correlated with lower obesity rates.
Staying cooped up in a tiny flat isn't much fun, so people go outside — to stroll the ubiquitous shopping malls, walk the numerous hiking trails, eat dim sum with friends, and buy fresh produce at the local market. Few people drive, so most rely on the city's world-class transportation system, which further increases how much people walk.
According to a 2017 study by the American Cancer Society, walking just six hours a week lowers the risk of dying from cardiovascular disease, respiratory disease and cancer. The more one moves, the longer one lives.
Lots of family under one roof
Okay, so food isn't everything in Hong Kong. Family is extremely important, too. It's still quite common for at least two adult generations to live under one roof. The ancient Confucian virtue of respect for one's parents, the elderly and ancestors means children not only respect their parents but often support them financially in retirement.
Admittedly, this financial burden can cause great stress, particularly for adult children who have kids of their own, but it also fosters a culture in which society collectively cares for the aged.
Living in densely populated apartment blocks and crowded flats may also help extend elderly Hongkongers’ lives. There's just less room for loneliness and social isolation, which public health experts say can be as damaging to health as smoking 15 cigarettes a day.
What's more, the city is designed to encourage the social bonds that fend off life-trimming ills like depression, high blood pressure or dementia. Public spaces inviting older adults to gather dot the city, as do apartment building courtyards, gleaming shopping malls, and overflowing dim sum restaurants. And when elders return home, it's doubtful their flats are empty.
Do kids like helping their aging parents? Sure, some do. Others find it to be a tremendous burden. But as my wife says, “Children accept that it's their duty.” And that duty includes ensuring that their parents keep active.
Holding on to the lessons learned
When it comes to health, America will never be like Hong Kong — a mostly homogenous, tiny archipelago anchored in the South China Sea, with 7.5 million people living on a total landmass that's less than one and a half times the size of New York City. Its environment, history, laws and cultures are of course vastly different from ours.
But we can apply some of their healthy habits. For me that means being there to help my parents. It also means forcing myself to walk more. Just last week, after I calculated how many steps I've fallen short, I started parking farther away from the grocery store so I can get in more steps.
My wife and I continue to stir-fry our veggies and eat small portions. Swapping sugary sodas for warm tea hasn't been easy, but over the years I've learned to enjoy a cup of jasmine tea. I'm trying to hold on to the art of balance in all things — career, marriage and frequent doctors’ appointments for my parents included.
And, I'm happy to report, I haven't had a bag of potato chips in weeks.