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Eat Like an Okinawan

A few years ago scientists were studying Cretans for clues to their longevity. The conclusion: high consumption of olive oil, fruits, grains, and vegetables, plus lots of hard physical work, was what kept heart disease rates low on Crete and in other parts of Greece. Now another island, Okinawa, is in the news, thanks to a best-selling book called The Okinawa Program, by researchers Bradley and Craig Willcox and Makoto Suzuki.

Okinawa is one of the Ryukyu islands south of Japan; in 1945 it was the site of one of World War II's bloodiest battles as U.S. forces pushed toward the Japanese mainland. Though the island was returned to Japan in the early 1970s, the U.S. still maintains large military bases there.

Since 1976 the Japanese Ministry of Health has been studying older Okinawans (who live in traditional cultures presumably unaffected by the American presence), hoping to unlock the secrets of their amazing good health. What's most interesting about them is that they have the longest disability-free life expectancy in the world. Okinawa boasts the highest percentage of centenarians anywhere. Heart disease rates are low: 80% fewer heart attacks than Americans, and Okinawans who have heart attacks are more likely to survive. Breast and prostate cancer are so rare as to be unheard of among the older population. Obesity is equally rare. Smoking, the reader is led to conclude, is also rare among older Okinawans, though the book cites no statistics.

Five-a-day is only a start

The Okinawan diet might well amaze Americans. The average citizen consumes at least seven servings of vegetables daily, and an equal number of grains (in the form of noodles, bread, and rice—many of them whole grains). Add to this two to four servings of fruit, plus tofu and other forms of soy, green tea, seaweed, and fish rich in omega-3s (three times weekly). Sweet potatoes, bean sprouts, onions, and green peppers are prominent in the diet. Vegetables, grains, and fruits make up 72% of the diet by weight. Soy and seaweed provide another 14%. Meat, poultry, and eggs account for just 3% of the diet, fish about 11%. The emphasis is on dark green vegetables rich in calcium (Okinawans, like other Japanese, don't eat much dairy). Okinawans do drink alcohol, but women usually stick to one drink a day, while men average twice that. Moderation is the key.

In short, the average Okinawan's diet is far richer in complex carbohydrates and plant-based foods, and lower in fat, than the average American's. (It's completely different from low-carbohydrate plans like the Atkins and Zone diets.)

Sweet potatoes, not couch potatoes

These people are far from sedentary. Most practice martial arts and traditional Okinawan dance. They garden, they walk. Even at age 100, they look lean and healthy. (For photographs and other information, visit the program's website.) Furthermore, they live comfortably and share the same spiritual and religious values, and the status of women is high. The health-care system is good and covers everybody.

The book includes a number of recipes designed to help Americans ease into Okinawan eating habits. It's not so easy, of course, to change to an Okinawan life-style and consume, say, 20 servings of vegetables, fruits, and grains daily. But this book can point you in the right direction. Actually, the recipes, with such titles as Mediterranean Minestrone, Paradise Burgers (tofu), and Immortal Paté (more tofu), sound like what you might find in a high-end vegetarian or East-West fusion restaurant. As adapted for Americans, the Okinawan diet is not strange at all.

You've heard it before: The recommendations emerging from the book will sound familiar to readers of this newsletter: a plant-based diet of fruits, vegetables, and grains (with an emphasis on whole grains), plus fish, small amounts of meat and poultry, moderate alcohol intake (if any), no smoking, and lots of exercise. We do recommend nonfat dairy products, and so does this book, whatever the Okinawans may do. And soy, as we've said, can be one element of a healthy diet.

You don't need to move to the Pacific rim to eat—and exercise—like an Okinawan. A good place to start is the anti-hypertension diet known as DASH (see Wellness Letter, May 1999).