Ramen lovers may want to consider possible stroke risk

Ramen fans will find this difficult to swallow: The more ramen restaurants per capita in an area, the higher the death rate from stroke.

This was the conclusion drawn in a recent Japanese study, published in Britain's Nutrition Journal, although it stopped short of directly pinning the blame on ramen intake.

"We acknowledge that we have not identified a direct relationship between ramen consumption and stroke mortality rates," said the team of researchers from Jichi Medical University in Tochigi, about two hours north of Tokyo.

"However, the prevalence of a specific type of restaurant is controlled by local demand and therefore provides some indication of regional food preferences."

Stroke occurs when a blood vessel to the brain is blocked or ruptures, and was the top cause of death in Japan from the 1950s to the 1980s. The number of annual stroke fatalities has markedly fallen since, but it is the fourth top cause of death after cancer, heart disease and pneumonia.

"Ramen, a popular food in Japan, is high in carbohydrates and salt and thus may increase the risk of stroke mortality," the study said.

The researchers compared the number of ramen, fast-food, French or Italian, and udon or soba restaurants per capita in each prefecture, against the mortality rate from stroke and from myocardial infarction, or heart attacks.

The team managed to find a significant correlation only between the number of ramen restaurants per capita and the stroke mortality rate, across gender and age range.

No strong link was found for the other types of restaurants, nor for heart attacks. This led the researchers to speculate that fast food, which is "high in unhealthy fats, salt and sugar and contributes to obesity", might be regularly consumed only by a limited number.

The results showed three at-risk regions in Japan: the areas bordering the Sea of Japan (or East Sea) in north-east Tohoku; the northern Kanto region; and the southern Kyushu region.

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In contrast, the Kinki region (including Kyoto and Osaka) and the southern Kanto region (including Tokyo and Yokohama) have comparatively low stroke mortality rates, the researchers noted.

These areas are more cosmopolitan, which the researchers said could lead their residents to be more health-conscious. "Healthier" ramen options, such as low-salt or no-carbohydrate noodles, are increasingly common in these areas.

Dr Tomonori Okamura of the Keio University School of Medicine told The Sunday Times: "Although welcome from a public health perspective, the choice of such options is likely to be concentrated on those with high socioeconomic status, and is likely to be only in cities with many such people."

Meanwhile, the Jichi Medical University research team also said it was unable to draw a direct link to ramen intake due to several limitations. For one, it was not possible to measure the frequency of ramen consumption, nor consider different types of ramen. "Ramen is delicious and indispensable for Japanese food culture," said Dr Okamura, even as he urged moderation.

He noted the Japanese culture of ending a night of heavy boozing with a bowl of ramen, which will cause excessive calorie intake in the middle of the night.

He also advised ramen eaters not to finish the broth, which typically contains a lot of salt, and to pair their meal with more potassium-rich food like vegetables and fruit, which can counter the risk of high blood pressure from the excessive salt intake.

This article was first published in The Straits Times. Permission required for reproduction.