東京のオフィス街と不健康な都市Central Tokyo and the Unhealthy City

I have been spending the past few days based in the office district of central Tokyo, and with each passing year my impression that this is an unhealthy city grows stronger. Unhealthy is a word with many layers, but put simply I mean that nothing has changed in roughly the past ten years. The role Tokyo once played as Japan's great metropolis was to transform itself faster than any other city in the world. To put it in extreme terms, the city you saw a year ago and the city you saw today were entirely different places. That was Tokyo's greatest attraction through the 1990s.

This quality was unlike that of global cities such as New York or London, and it was inseparable from Tokyo's history of being periodically reset. Even looking only at the last hundred years or so, the Great Kanto Earthquake of September 1923 and the firebombing of Tokyo in March 1945 both reduced the city to nothing. Each time, the city that had turned to ash was rebuilt within decades. Destruction and regeneration, over and over.

This quality of periodic forced reset is something that global cities like New York and London do not possess. Each time Tokyo was reset it was reborn as an entirely different city. But since the last reset, the 1945 firebombing, more than eighty years have passed without another. Like the Japanese population itself, now deep into a super-aged society, the city feels as though it has simply grown old. Everything has slowed down. The image is of a city that no longer knows where it is wandering in relation to the rest of the world.

If we compare it to the human body, food that is consumed but not properly metabolized remains as waste inside the system, and its accumulation eventually becomes a source of dysfunction. When the body reaches an impasse there are various optimal approaches, fasting, detoxification, and others, but a city likewise must undergo adjustments to reactivate its metabolism. Tokyo's metabolism has fallen into dysfunction, and the unhealthy quality visible from that dysfunction is now reflected wholesale in the people who inhabit the city. What I sense intuitively when I say Tokyo is unhealthy comes down to the fact that there is no happiness on the faces of the people in the streets. It looks as though nothing but strained, abrasive human relationships have proliferated to form a single enormous structure.

The world-class speed of change that Tokyo once possessed is now a story from the past. The metabolic character the city maintained through the 1990s has completely stagnated, and the residual debts of the past have become waste that impairs metabolism at every level. The result is an inflammation so widespread that it is no longer possible to locate the source of the city's dysfunction. This chronic urban inflammation has pushed the city's infrastructure to its limits in every direction, and the tension that generates is transmitted to the people. Human relationships grow more degraded with each passing year. That is the Tokyo of the present. What astonishes me most is that the people have not changed since I was living here ten years ago. One might describe it as people who cannot grow, circulating through the city as its waste.

There is no single cause, but let me look at it through the lens of health. New shops and restaurants continue to open, but because the Tokyo Metropolitan Government does not impose the kind of regulations on food-service establishments that other advanced cities do, the sheer number of restaurants has reached a world-leading excess. Convenience stores, drugstores, izakaya, ramen shops, fast-food chains, Starbucks and other elements that enable a frictionless but unhealthy daily life are woven into the city at every turn, in numbers that seem abnormal even as you walk the streets. Tourists still line up from midday outside the famous ramen shops of Harajuku. That too is unchanged from ten years ago. I do not eat ramen at all. As we move past the middle of the 2020s I consider it a mark of absent discernment to pay 2,000 yen for a dish whose flavor is engineered from gluten, low-grade oil, and excessive additives.

First and foremost, Tokyo is Japan's great metropolis and yet it is flooded with nothing but unhealthy dining options. I ran into four Malay Muslim women in the entrance hall of the apartment building where I am staying with a friend. They had come through Airbnb. They told me there were no suitable options for their dietary needs in central Tokyo and that the overwhelming majority of restaurants would not accommodate individual requests, so they had rented a room with a kitchen and were cooking all their own meals. These frustrations are not limited to foreigners. I share them. I do not consume gluten, casein, or sugar as a matter of course, and I scrutinize the quality of oils, additives, pesticides, and types of salt across many dimensions. For someone like me, Tokyo's restaurants are strikingly unhelpful and offer almost no viable choices. Japan as a whole lacks transparency around food. The ingredients flowing into Tokyo from across the country cannot be trusted when there is no transparency. You have no way of knowing what went into the dish you ordered or what is being added as seasoning behind the closed doors of the kitchen. This lack of openness is an unkindness to the customer, and it inevitably becomes the soil in which human relationships deteriorate.

The current state of affairs, with convenience stores wedged into every gap between vast numbers of unhelpful restaurants, looks to me like a symbol of Tokyo as the most backward city among the advanced nations. Tokyo is not proposing a future. And so the people walking its streets have not changed in ten years either. If anything, the deterioration in their health over those ten years is becoming starkly visible. In one's younger years the body can absorb a certain degree of dietary disorder without consequence, but maintain that lifestyle for a decade and the rule of our era guarantees you will be beset by problems of unidentifiable origin. That is how degraded the food environment surrounding us has become worldwide. In a city like Tokyo you have no choice but to protect yourself, and the more people who make that decision the more restaurant standards are naturally driven upward. But what is happening in Tokyo right now is the opposite. People appear to be continuing the dietary rules of thirty years ago without alteration.

Yet compared to thirty years ago Japan's demographic landscape has been transformed. Japan and Italy are both confronting the problems unique to aging societies and have entered full decline. Even in the midst of this, the fact that dietary habits, the foundation of health, have not changed at all and are in fact worsening makes food seem like one of the clearest indicators of a city's future. And given the negligence of Tokyo's regulatory framework, which permits the unlimited opening of food-service establishments, it becomes self-evident that health can only be realized through individual will. Put differently, I believe the people who will matter most after the next time Tokyo is reduced to ash are those who are forming a health consciousness within this world's largest city of rampant unhealthiness and choosing to protect themselves. Whether the trigger is a direct-hit earthquake beneath the capital or a missile from North Korea is unknown, and no one can say when it will happen. But the movement to build Tokyo's future after the next destruction has already quietly begun.

My purpose in visiting Tokyo this time was to experience that movement at the earliest possible stage. What I came for is a genomic test released at the end of last month by a certain clinic, one that employs the world's first methodology for ultra-high-depth whole-genome sequencing. This test identifies over 20,000 SNP variants at remarkably deep sequencing depth. From that foundation it systematically covers the full set of protein-coding genes, various RNA genes, mitochondrial genes, and thorough metabolic analysis, integrating whole-genome sequencing across multiple next-generation sequencers with an informatics platform and proprietary algorithms for variant systematization. It is, in the most literal sense, the finest genetic test currently in existence on this planet. This is not a generic genetic analysis. It encompasses an enormous range of interpretation, from the foods and supplements that are right for you, to your ancestral roots, optimal career, ideal human relationships, where you should live, the right headache medication, oncology drug matching, spirituality and how to deepen it, discovery of your life's purpose, which Shinto shrines are aligned with your constitution, Ayurgenomics as a fusion of India's classical Ayurvedic medicine with cutting-edge genomics, and readings through the lens of China's Yin-Yang Five Elements theory. The output is a full-color book of approximately two hundred pages, a complete guide created for one person alone. There is nothing else like it.

It is precisely the intersection of Eastern and Western medicine, and it carries the spirit of Japan's once-celebrated craftsmanship and the obsessive depth of the Japanese temperament. The fact that a development like this has emerged in the unhealthy center of present-day Tokyo is a sign. It may prove to be the opening chapter of an enormous story that leads through Tokyo's next cycle of destruction and regeneration to the regeneration of Japan itself. It may be difficult to believe now, but the Japan that emerges after the next time Tokyo is reduced to ash holds the potential to sweep the world again in a different sense. Not through economics or industry as before, but through a contribution to the world that only the Japanese can make, one that will likely appear as a great current organized around the keyword of health. That vision of health will draw on the wisdom embedded in traditional Japanese food, its ingredients and fermentation techniques, while proposing something closer to the world of Ghost in the Shell, a theme of intersection and fusion between a distinctly Japanese sensibility and the most advanced technology available.

For that possibility to become visible to everyone, at least another forty to fifty years will be needed. Until then Japan will decline to its very limits. But as I have said before, ending is not a bad thing. What must end must be allowed to end. The small shoots emerging now are seedlings that will be nurtured over the next half-century. They are the first clearing in which a new forest will grow. At present these shoots are appearing inside advanced clinics where the intersection of traditional medicine and cutting-edge technology, quantum medicine aimed at deepening spirituality, sound meditation, genetic testing, psychedelic medicine, and many other themes are all circulating in the same space.

In former eras the salons run by cultural figures served as the foundations for building the next world. Today that role has shifted to a handful of advanced clinics, where physicians with vision are leading the formation of the next cultural current. Detect the signs of abnormality and trouble in your current state through blood data. Identify where the problem is occurring through a metabolic map. Determine the root cause and the genetic variants associated with related traits through comprehensive analysis. What could once be done only as isolated points can now be connected, point to point, until the optimal answer comes into view. As a result, the attitude of processing problems through conventional binary methodology is buffered. A true neutrality emerges, one that is neither aggressive affirmation nor denial. Within that neutrality a new method is born, one that faces a single individual. Through this, a future in which true health, different for every person, is realized has already begun.

By understanding the greatest question of the twenty-first century, what health means for you, as early as possible, the mission you are meant to fulfill becomes clear on that foundation. You come to understand how to build the environment in which to carry out that mission. The result is the possibility of living in thorough alignment with your own genes. A better life can be defined on an entirely different plane from the abstracted self-help of the past.

The problems that belong to the one and only you in this world can only be solved by you.