Stamler, in his editorial in the May 10, 1993, issue of the Archives.1 correctly notes the high mean body mass index and the large proportion of obese Americans. He then goes on to point out that Americans should follow the lead of the Japanese and Chinese and adopt their diet. His evidence regarding the pattern in the United States in diet and obesity is clear. What is not clear from his editorial is that a similar rapid change in dietary, activity, and obesity patterns is occurring in China and Japan. We may wish to follow the traditional diet of pre-World War II China or Japan; however, the diet of modern China and Japan, particularly for middle-and upper-income Chinese and younger age cohorts of Japanese, is changing rapidly and causing great changes in obesity. In other words, we do not want to follow the lead of the Chinese and Japanese.