The 3 rules of the Okinawa diet for longevity

Highlights:

• Okinawans who eat their traditional diet enjoy a significantly longer and healthier lifespan than the rest of the world
• The Okinawa diet combines calorie restriction, high antioxidant intake, and low consumption of fat and sugar 
• Such an approach creates a way of eating which promotes healthy longevity

Introduction

Okinawa is an island south of Japan that belongs to a very exclusive “club” called the Blue Zones. People who reside in Blue Zones live exceptionally long and healthy lives compared to the rest of the world. There are many variables that influence the lifespans enjoyed by Okinawans including genetics, environment, and lifestyle. Diet seems to be one of the stronger influences and it is quite well-studied. There are several aspects of the Okinawa diet that make it particularly interesting when looking at longevity. Understanding these will help you lead your clients towards adopting them.

What does a traditional Okinawa diet look like?

The main source of calories in the traditional Okinawa diet is the sweet potato, not rice like in the rest of Japan. Okinawans also enjoy a variety of whole grains and legumes, which makes their diet very carbohydrate-rich. Studies show that they get 85% of their calories from carbohydrates and only 6% from fat and 9% from protein (1). Here is a more detailed split of what they eat:

• Vegetables (60%): sweet potatoes, seaweed, kelp, bamboo shoots, daikon radish, bitter melon, cabbage, carrots, green papaya, pumpkin, Chinese okra
• Grains (33%): millet, wheat, rice
• Soy foods (5%): tofu, miso, natto, edamame
• Meat and seafood (2%): white fish, seafood, pork
• Other (1%): eggs, tea, spices, broth

Okinawa was historically a relatively isolated region, which means its inhabitants did not have access to a wide variety of foods. For that reason, anyone trying to mimic the traditional Okinawa diet would have to mostly avoid beef, poultry, dairy, legumes (except for soy), most fruit and nuts and seeds, and certainly all ultra-processed food prevalent in modern western diets.

Benefits connected with the Okinawa diet

The most well-known benefit of the traditional Okinawa diet is its connection to longevity. Okinawans over the age of 65 enjoy the world’s highest life expectancy. Men are expected to live to about 84 and women are expected to live to 90. Okinawa is also home to more people over the age of 100 years than any other place in the world (2).

This amazing longevity also comes with a reduced risk of chronic diseases. Okinawans have a much lower rate of coronary heart disease compared to the rest of Japan and the US (3). They also suffer only a fraction of some types of cancer, dementia, and other chronic diseases. Research shows that a high percentage of Okinawa’s inhabitants over 90 years old still lead independent lives (4). Okinawans do not just live long, they enjoy what we can call healthy longevity.

These are some amazing benefits that most of us would like to replicate in our clients. Thankfully, there are several key aspects of the traditional Okinawa diet that can be connected to health and longevity not just because of the incredible lifespan of Okinawans but also through different lines of research. Here is a closer look at the three most important ones.

#1 Calorie restriction

There is a phrase in Japan that goes “Hara hachi bun me” which roughly translates to “Eat until you are eight parts full.” People in Okinawa say it before meals as a reminder to stop eating before they are full. This practice helps them restrict energy intake. The average daily intake of an Okinawan is only about 1900 calories which is around 11% fewer than the normal recommended consumption for a healthy adult.

Calorie restriction has been shown to be very effective at extending lifespan in a variety of model organisms (5). There is also a clinical trial showing that calorie restriction in humans over the period of 2 years produces benefits for health and longevity (6).

#2 High antioxidant intake

Okinawans typically eat at least 7 different fruits and vegetables every day and more than 200 different foods and spices overall. This variety is built into their diet. For example, one of their very popular dishes called Chanpuru could be translated as “to mix together” and comprises of bitter melon, tofu, egg, bean sprouts, carrots, cabbage, and onions. This is often served with a side of sweet potato and miso soup made with seaweed and daikon radish. Okinawans also often enjoy a portion of fruit after or between meals with some freshly brewed jasmine tea. This abundance of whole or minimally processed plant foods ensures a high intake of antioxidants. Research suggests that antioxidant-rich foods may help slow the aging process by protecting cells from free radical damage and reducing inflammation (7).

#3 Low sugar and fat intake

The high amount of added sugar and fat in western pattern diets is arguably one of the biggest issues. It tends to increase overall calorie intake which is a risk factor for obesity and a host of related problems. The traditional Okinawa diet includes almost no such foods due to their historical scarcity on the island.

We can also see an interesting contrast between the older and younger generations in Okinawa. Younger Okinawans are exposed to western foods high in added sugar and fats and the prospects of amazing health and lifespan are starting to fade. Okinawa experienced an infusion of these foods after World War II, and with that their body mass index and energy intake gradually increased while energy expenditure decreased. This resulted in a loss of caloric restriction and a rise in cardiovascular diseases (8).

How to mimic the traditional Okinawa diet?

The traditional Okinawa diet is quite restrictive. It limits the intake of fat, protein, and calories and removes several entire food groups. Most of your clients are unlikely to be able to stick with this level of restriction long term. You can still help them to try and mimic those three most important aspects of the diet – calorie restriction, high antioxidant intake, low sugar and fat consumption. Here are several recommendations you can offer to your clients.

• Eat slow. Eating faster typically results in taking in more calories. When you slow down you will notice much sooner that you are no longer hungry.
• Avoid mindless snacking. It is easy to overeat when food is constantly at arm’s reach. Decide how much of a snack you will have before you sit down with it in front of your PC or TV.
• To increase the intake of antioxidants, regularly include coffee and green teas, add more spices to your meals, and buy one or two types of vegetables you don’t usually eat with each shop.
• Focus on home food preparation to have control over how much sugar and fat is added. Do not keep sweetened beverages and ultra-processed snacks at home, in your car, or at the office. Stock up on healthier whole food snacks instead.

Conclusions

The traditional Okinawa diet offers a lot of health and longevity benefits. There are several aspects of this diet such as calorie restriction and a focus on a high intake of varied plant foods that make it stand out. You can use the Okinawa diet as an inspiration to help your clients find a way to implement some of these beneficial habits.

References

1) Donald Craig Willcox, Giovanni Scapagnini, Bradley J Willcox. Healthy aging diets other than the Mediterranean: a focus on the Okinawan diet. Mech Ageing Dev. Mar-Apr 2014;136-137:148-62. doi: 10.1016/j.mad.2014.01.002. Epub 2014 Jan 21.

2) D Craig Willcox, Bradley J Willcox, Wen-Chi Hsueh, Makoto Suzuki. Genetic determinants of exceptional human longevity: insights from the Okinawa Centenarian Study. Age (Dordr). 2006 Dec;28(4):313-32. doi: 10.1007/s11357-006-9020-x. Epub 2006 Dec 8.

3) D Craig Willcox, Bradley J Willcox, Hidemi Todoriki, Makoto Suzuki. The Okinawan diet: health implications of a low-calorie, nutrient-dense, antioxidant-rich dietary pattern low in glycemic load. J Am Coll Nutr. 2009 Aug;28 Suppl:500S-516S. doi: 10.1080/07315724.2009.10718117.

4) D Craig Willcox 1, Bradley J Willcox, Sanae Shimajiri, Sayuri Kurechi, Makoto Suzuki. Aging gracefully: a retrospective analysis of functional status in Okinawan centenarians. Am J Geriatr Psychiatry. 2007 Mar;15(3):252-6. doi: 10.1097/JGP.0b013e31803190cc.

5) Priya Balasubramanian, Porsha R Howell, Rozalyn M Anderson. Aging and Caloric Restriction Research: A Biological Perspective With Translational Potential. EBioMedicine. 2017 Jul;21:37-44. doi: 10.1016/j.ebiom.2017.06.015. Epub 2017 Jun 19.

6) William E Kraus et al. 2 years of calorie restriction and cardiometabolic risk (CALERIE): exploratory outcomes of a multicentre, phase 2, randomised controlled trial. Lancet Diabetes Endocrinol. 2019 Sep;7(9):673-683. doi: 10.1016/S2213-8587(19)30151-2. Epub 2019 Jul 11.

7) Kedar N Prasad, Meixia Wu, Stephen C Bondy. Telomere shortening during aging: Attenuation by antioxidants and anti-inflammatory agents. Mech Ageing Dev. 2017 Jun;164:61-66. doi: 10.1016/j.mad.2017.04.004. Epub 2017 Apr 18.

8) Natalia S. Gavrilova, Leonid A. Gavrilov. Comments on Dietary Restriction, Okinawa Diet and Longevity. Gerontology. 2012 Apr; 58(3): 221–223. Published online 2011 Aug 31. doi: 10.1159/000329894

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