The Okinawa Diet Plan: Get Leaner, Live Longer, and Never Feel Hungry Paperback - 2005

Okinawa: lean people, long, healthy lives

N'kashin tchu nu kutuba ya, amari fusuko neran.
The wisdom of the ancients is still true and applicable.


Far off in the East China Sea, between the main islands of Japan and Taiwan, is an archipelago of 161 beautiful, lush green islands known as Okinawa. The beaches are a dazzling powdery white; the waters are crystal turquoise, and the pristine subtropical rain forests house a huge variety of exotic flora and fauna. But while Okinawa has all the makings of a tropical paradise, it is in fact something even more special-Okinawa is more like a "real-life Shangri-la."1 Why?

Because the islands are home to the longest-lived population in the world.2 It's a place where the aging process seems to have slowed and age-related diseases common in the West are kept to a minimum (see figure 1.1). Great-grandfathers practice martial arts. Energetic great-grandmothers garden and perform traditional dance. And some centenarians of both sexes even run businesses and lead socially fulfilling and wonderfully independent lives. You can see them daily as you stroll the streets. Here, a lean, wiry woman who appears to be sixty walks with a container of freshly made Okinawan tofu perched on her head-she's ninety-nine years old. There, a slender, tanned "seventy-something" woman sells traditional bright red, yellow, and blue Okinawan kimonos in the thriving marketplace-she's actually 101. And there, a spry woman pushing an overloaded wheelbarrow collects bottles for her recycling company-she's 102 years old. And over there, a fit-looking, older man with a floppy straw hat threshes sugarcane. He is 103 years old. This is life as usual in Okinawa.


I hope to live to 120...To tell the truth, I really only feel like eighty.
--Ushi Okushima, 100 years old


Okinawa, in fact, has the highest concentration of centenarians worldwide, some of them 110 years old and older, including the world's oldest living citizen, Kamato Hongo, still going at age 116.3 These so-called supercentenarians now account for more than 15 percent of the world's documented living supercentenarians-despite Okinawa's paltry 0.0002 percent contribution to the world's population.4 When you consider that the United States counts only about 10 centenarians per 100,000 people, while Okinawa has 40 per 100,000, you begin to see the significance of these numbers.5


My brother and I first began investigating this amazing phenomenon a decade ago when we joined Dr. Makoto Suzuki as part of the research team for the landmark Okinawa Centenarian Study, which had been established in 1976 to uncover the secrets of the elders' successful aging. But we had been fascinated by reports of unusually hale and hearty Okinawan elders all through our university days. It was in 1994, in fact, upon meeting one of these elders, Mr. Toku Oyakawa, while doing a research project as medical and graduate students at the University of Toronto that we initially felt compelled to go to Okinawa.

We had been studying the impact of body fat on hormone-associated cancers, and because the Japanese had among the lowest risks of breast, prostate, and colon cancers in the world, we had wanted to include as many Japanese (and Japanese-Canadians) in our study as possible.6 Mr. Oyakawa, who had been raised in Okinawa and had immigrated to Canada more than half a century earlier, graciously agreed to an interview. At the time, he was 105 years old and likely the oldest man in Canada.

When we arrived at his home in the Ontario countryside, Mr. Oyakawa was just coming back from fishing-one of his regular favorite pastimes. As he walked over to greet us, fresh catch in hand, we were flabbergasted. This 105-year-old man was lean and vital. He had twinkly eyes and tan, supple skin, and he moved with a grace and ease that any seventy-year-old would envy. After talking with him for only a few minutes, it was obvious that his mind was as youthful as his body.

As Mr. Oyakawa recounted stories of his unusually long life and told us about Okinawa, we were more fascinated than ever. One fact that especially caught our attention was that Mr. Oyakawa and his ninety-two-year-old wife (who was also in incredible shape) had maintained a near-traditional Okinawan diet during all their years in Canada. Dietary habits were an important part of our study, and if indeed there was an entire population of people who had the same eating patterns as Mr. Oyakawa and were as fit, slim, and healthy as he was, we absolutely needed to find out more. With the help of a research grant from the Medical Research Council of Canada, we were soon on our way to the East China Sea.

Okinawa has been a big part of our lives ever since-and it's even more magical for us now than it was in the beginning. Amid the physical beauty of the islands, we've discovered a rich, wondrous culture with fascinating shamanistic traditions and inspiring holistic beliefs. It's a land where good health is viewed as a natural right, women play the dominant role in religion, the elderly are honored and revered, and ancient healing herbs and tonics are smoothly integrated with Western medicines. And the people are truly exceptional.

The men and women we've met, interviewed, and befriended over the years-many of whom we introduced to you in our last book, The Okinawa Program-are remarkable individuals in their eighties, nineties, and beyond, who in many ways are much like Mr. Oyakawa. Their minds are lucid, their bodies are slim, their movements are fluid, and their zest for life is infectious. And, of course, their health is superb for their years. Not only do these long-lived people have among the lowest rates of the West's leading killers-cancer, heart disease, and stroke-but they also have the world's longest disability-free life expectancy.7 While Americans have about seven years of disability at the end of their lives, Okinawans have only 2.6 years of disability-even though they live longer than Americans. This means that Okinawans are not just living longer but living longer in good health-and that's really the secret to successful aging. I think we'd all agree that longevity tends to lose its appeal if it means years of infirmity and dependency.


Other Shangri-la Contenders


Of course, we've heard stories of such Shangri-la populations before. Long-lived people supposedly lived in abundance in Pakistan's Hunza Valley, in the mountainous village of Vilcabamba in Ecuador, and in the Caucasus region of the former Soviet Union, where yogurt was supposed to be the magic elixir. (The TV commercial featuring an ancient Soviet Georgian crone sweetly coaxing her octogenarian son to eat his yogurt is a classic.) Unfortunately, none of those longevity claims held up to scientific scrutiny.8 On close examination, it turned out that age exaggeration was rampant and that birth certificates-the sine qua non of credibility in studies of long-lived people-were few and far between.

Okinawa, however, is a different story. Every town, city, and village has an official family register system (koseki) that has been recording all births, marriages, and deaths since 1879. Pertinent data, including birth certificates, are highly reliable. There's no doubt that Okinawan centenarians have beaten the odds to ascend the peak of the world's longevity scale. The question is, How did they do it.


The Okinawa Centenarian Study


That question continues to be addressed and answered by the Okinawa Centenarian Study. The study, now entering its twenty-eighth year, is the world's longest-running population-based study of centenarians and has spawned more than two hundred scientific papers.9 Over the years, we've interviewed and examined more than seven hundred Okinawan centenarians and hundreds of "youngsters" in their seventies, eighties, and nineties, looking for any and all commonalities in their diets, exercise habits, genetics, psychospiritual practices, and social structures that could possibly explain their long-term vitality and exceptionally healthy longevity. And we've found many of them.

We shared a good number of these discoveries with you in The Okinawa Program as we explored the elders' life-affirming worldviews, supportive social structures, and inspiring psychospiritual practices, examined their restorative eating and exercise habits, and developed a holistic health program geared toward healthy longevity.10 Now we have more to share with you. Since the highly successful publication of that book, our ongoing study has continued to reveal even more secrets of the Okinawans' healthy lifestyle. Our latest findings are not only among the most outstanding-they could make a huge difference in your life.


Discovery: Okinawan Elders are lean for life

We've always been impressed by how slim and fit the Okinawan elders are, but recently we discovered something even more impressive. The Okinawans are not just lean; they are lean for life. Okinawan elders constitute one of the only known adequately nourished large-scale populations that have not gained significant weight with age.11,12 While most of us struggle daily to keep off the pounds, the Okinawan elders have done it naturally all their lives, without dieting and without giving it a second thought. In fact, many of the healthy, slim centenarians we've interviewed over the years are not even familiar with the concept of dieting.

This was a startling discovery as well as a watershed in gerontology research. To get accurate data on a population's long-term weight gain and eating habits, researchers have to carefully follow a group of people over a long period and check them at regular intervals. That's why these kinds of studies are expensive and rarely undertaken. But the ancestors must have been smiling on us with the Okinawans. Like the fortunate existence of birth certificates that verified their ages, we found records that gave us impressive data on the Okinawans' health and dietary statistics over the years.

Our search first took us back to early Japanese government dietary surveys, which we meticulously studied and compared with the dietary surveys of elder Okinawans we ourselves had compiled over twenty-eight years in our Okinawa Centenarian Study. Then we flew to Washington, D.C., and pored over thousands of documents from the National Archives for health and nutrition data on the Okinawans. (Because Okinawa was an American territory from 1945 to 1972, the National Archives are a storehouse of useful historical data.) All our weeks in the paper trenches paid off. We discovered stacks of records listing the actual kinds of foods Okinawans ate, its caloric content, and the heights and weights of the people surveyed.

This was an awesome find. Joining this treasure trove with other data we had collected from old anthropological records and the modern data we've been collecting since the 1970s, we were able to piece together fascinating statistics that all led to the same conclusion: Unlike the rest of us, Okinawans who followed their traditional diet simply did not gain weight as they aged.11,12 No matter how we ran the numbers, that conclusion was inescapable. While the Harvard Alumni Study,13 one of the best ongoing, long-term exercise- and weight-related gerontology studies, revealed that American men gain an average of twenty-two pounds between the ages of twenty and sixty and the Cooper Clinic studies showed that American women average a twelve-pound gain,13 our statistics showed that Okinawans actually lost about five pounds during those years, consistent with the fact that older people require fewer calories as they age (see figure 1.2).

This discovery promises enormous potential benefits for all of us fighting the battle of the bulge. Once we establish exactly how Okinawan elders stay lean all their lives, we can do it too-and greatly reduce our risk for weight- and age-related diseases such as coronary heart disease, stroke, diabetes, and cancer. We'll have a potential solution to America's epidemic obesity problem, and we'll be able to get off the psychologically debilitating dieting treadmill that has us running from one trendy weight-loss plan to another, only to end up right back where we started-or even heavier. Eating the Okinawa way could be the answer to our prayers.


From the Hardcover edition.

“The Okinawa Diet Plan is a significant contribution to the science of healthy weight loss and longevity. This book can help you reduce the risk of many weight-related diseases by achieving and maintaining the healthiest weight for you.” —Andrew Weil, M.D., author of 8 Weeks to Optimum Health

“Spectacular. This is the best advice on all aspects of lifestyle in one book that can be found anywhere. It is not only well-researched and well-written, but the amount of ground covered is immense.” —Thomas Wolever, M.D., Ph.D., Professor, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, coauthor of The Glucose Revolution

Bradley J. Willcox, M.D., M.SC., is an internationally recognized expert on healthy aging, a U.S. National Institute on Aging-funded scientist, and a principal investigator in geriatrics for the Pacific Health Research Institute. He is also Co-Principal Investigator of the Okinawan Centenarian Study and Assistant Professor of Geriatric Medicine at the University of Hawaii.

D. Craig Willcox, PH.D., M.H.SC., is a noted medical anthropologist and gerontologist. He is an internationally recognized expert in nutritional anthropology, aging, and health. He is Assistant Professor at Okinawa Prefectural University-College of Nursing and Co-Principal Investigator of the Okinawa Centenarian Study.

Makoto Suzuki, M.D., PH.D., is a cardiologist and geriatrician and an internationally recognized expert on aging and health. He is Professor Emeritus at the University of the Ryukyus in Okinawa and Professor of Human Welfare and Director of the Okinawa Gerontology Research Center at Okinawa International University. He is the founder, Director, and Principal Investigator of the Okinawa Centenarian Study.