An intriguing study has found that the real secret behind Japan's world-leading life expectancy lies not in eating small portions or a fish-heavy diet, but in a robust care system.
A joint research team from Sweden's Karolinska Institute and Japan's Kobe University recently published the results of a large-scale big data study in the international journal BMC Medicine, comparing survival patterns of approximately 1.18 million people aged 75 and older in both countries.
The researchers classified subjects into three groups: those receiving no formal care, those receiving care at home, and those residing in nursing facilities. They then tracked the survival periods and health conditions of each group.
Contrary to common belief, the analysis showed little difference between Japan and Sweden in the length of time people remained healthy without illness or care needs. For women aged 75, the average period of maintaining good health was 10.4 years in Japan and 9.9 years in Sweden — nearly identical. The gap for men was also negligible.
The decisive difference between life and death emerged in what could be called "life after illness." Looking at survival periods after entering a state requiring care, Japanese women survived an average of 5.1 additional years, while Swedish women lived only 3.8 years. This effectively proved that the overall lower mortality rate among Japan's elderly population is due to longer periods of living while receiving care services.
"Japan's overwhelming life expectancy is not simply because its elderly population 'stays healthy and illness-free,' but because the country has well-established medical and long-term care systems that maximize survival rates once people enter a state requiring care," the researchers said.
Meanwhile, longevity involves a complex interplay of factors beyond social care systems, including individual lifestyle habits and genetic factors. Eating less — known as "soshoku" (small eating) — is widely cited as a key method for slowing cellular aging by reducing metabolic burden.
In particular, Elizabeth Blackburn, a world-renowned authority on aging research, emphasizes telomeres — the structures at the ends of chromosomes often called the ticking time bombs of cellular aging. Telomeres shorten with each cell division, driving the aging process, and extreme stress is the primary culprit accelerating the rate at which telomeres erode. In other words, living longer requires not only social care infrastructure but also thorough personal stress management and a positive mindset.
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