Yeah, food could make a big difference, especially for the poor. But the not-so-poor can make different food choices, potentially.
The culture of walking is harder to keep up without the kind of transportation options you have in Japan, but again, that is something one could choose.
So…if these explain the difference, and you can choose it, how is it not partly the fault of (many, though not all) of the people for not making these choices? (Note — even if it is their fault it doesn’t mean you should be mean to them…generally any excuse for being mean to people is a bad one.)