Japan's reputation for healthiness can be attributed to a combination of factors including a healthy diet, active lifestyle, preventative healthcare practices, low stress levels, traditional medicine practices, clean air, social connections, low smoking rates, access to healthcare, and cultural values. The traditional Japanese diet is rich in vegetables, fish and tofu which are all low in saturated fat and high in nutrients. Additionally, portion sizes in Japan tend to be smaller than those in Western countries. Japan has a strong emphasis on preventative healthcare with regular check-ups and screenings being commonplace. Social connections are important for overall health and wellbeing and Japan has a strong culture of community and social support. Smoking rates have declined significantly due to government initiatives aimed at reducing tobacco use. Japan has a universal healthcare system that provides access to medical care for all citizens.