A Diet From the World’s Longest-Lived Women: Okinawa, Japan

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IT TOOK ME TWO DAYS TO CONVINCE Gozei Shinzato to show me her arsenal of longevity supplements, but, in the end, she delivered.

Before me lay at least five compounds that could explain how the spry centenarian had eluded the diseases of aging to reach her 104th year with the flexibility of a yogi and the frenetic energy of a Chihuahua. She showed me one supercharged supplement with carotenoids, flavonoids, and saponins, and another that fights breast cancer by reducing blood estrogen. She pointed to a proven antimalarial agent that she uses to keep her stomach healthy, another that has been shown to help regulate metabolism, maintain low blood pressure, treat gallstones, and work as a prophylactic for hangovers. She reached down to pick up one that lowers blood sugar to help stave off diabetes. Three of them have proven antiaging properties.

While this may sound like the inventory of a well-stocked medicine cabinet, we were actually standing in Shinzato’s kitchen garden. The “supplements” on display were Okinawan sweet potatoes, soybeans, mugwort, turmeric, and goya (bitter melon). All of these grew in neat rows, just 15 steps outside of her house.

The day before, I’d traveled to her village in northern Okinawa with two longevity experts, gerontologist Craig Willcox, who along with his brother Bradley wrote the New York Times best seller The Okinawa Diet Plan, and Greg Plotnikoff, a U.S.-trained physician and authority on integrative medicine. Both of these men supremely understand how food can work as medicine—or as poison. We spent the day interviewing Shinzato about her diet, observing her lifestyle, and watching her prepare a traditional Okinawan meal. We watched her spring up and down from her tatami mat more than a dozen times. We learned that Shinzato’s life was one of comforting routine. She lived alone in a furniture-less, three-room house partitioned by rice-paper doors. Upon awaking, she wrapped her elfin 85-pound frame in a cobalt blue kimono. Then she made an offering at the ancestor shrine in her living room, lighting incense on a small altar cluttered with old photographs, a tortoiseshell comb, an urn, and other relics from her forebears.

Then, in the cool hours of the day, she worked in her garden. After lunch, she read comic books or watched a baseball game on television and napped. Neighbors stopped by every afternoon, and a couple of days a week her moai—four women who, together with Shinzato, had at a young age committed to one another for life—stopped by for mugwort tea and conversation. Whenever things had gotten rough in Shinzato’s life, when she’d run short of cash or when her husband had died 46 years ago, she’d counted on her moai and the Okinawan sense of social obligation—yuimaru—to support her. Her friends had relied on a lifetime of Shinzato’s support in return.

We watched her make jasmine tea, squatting in the corner and pouring hot water over tea leaves as the room filled with a delicate, floral aroma. At lunch, she mixed homemade miso into a saucepan of water. She spooned in fresh carrots, radishes, shiitake mushrooms, and tofu, and let it heat. Meanwhile, she moved up and down the kitchen wiping clean the counters, sink, and even the window. Then she pulled up a chair facing the stove to wait for her soup. The flame cast a feeble light on Shinzato’s creased but serene face. She spiced the soup with a sauce of marinated garlic and herbs—“longevity medicines,” Plotnikoff observed. Her movements were slow and careful with a patient, tortoise-like resolve; she seemed completely oblivious of us.

She poured her warmed soup into a bowl, gazed at it for a few long moments, and murmured, “Hara hachi bu.” This Confucian adage, intoned like a prayer before every meal, reminded her to stop eating when she was 80 percent full. She threw me a quick glance and then looked back at the steaming bowl, seemingly waiting for something. Then I realized: Perhaps she wanted to eat in private? I announced that we had to leave. “Thank you very much,” I said to her, bowing slightly. “May we come back and see your garden tomorrow?”

“If you must,” she quipped, fixing me with her mirthful, pinched smile. Or was that a wince?

Rain fell lightly the following day when we returned to her house. It was a chilly gray morning. Willcox, Plotnikoff, and I stood towering over Shinzato, who measures about four and a half feet tall in platform thongs. Across the road, past a few peasant homes and a small stream, was rioting jungle—viper habitat—that blanketed a mountainside. Shinzato’s garden glistened damply in luminescent shades of chartreuse and emerald. We asked Shinzato about her garden. What grows best? (Sweet potatoes.) Was there a longevity food? (No.) What do you use as fertilizer? (Fishmeal.) How many hours per day do you work in the garden? (Four.) What is your favorite part about gardening? (Solitude.) She endured our questions with polite serenity, rain dripping off of her wide, conical hat.

During a brief lull in our inquisition, she excused herself to dive back into her garden. Armed with a three-pronged hoe, Shinzato began attacking weeds. Working with a mechanical ferocity, she ripped at the red, rocky soil, working her way up and down the planted rows. Then, on a small rubber pad, she knelt down to pull small weeds by hand. We watched her for perhaps a half hour, taking pictures and making notes, until we got our fill. I walked over and tapped Shinzato on the shoulder and told her we were going. She looked up at me and tersely bid me farewell in Okinawan. I asked Willcox to translate.

“She said ‘good,’ ” Willcox responded. “Though I’m not sure if she means it was good to meet us or it is good to see us go …”

THE RISE AND FALL OF A GREAT LONGEVITY DIET

Okinawa is sort of a Japanese Hawaii—an exotic, laid-back group of islands with warm weather, palm trees, and sugar-sand beaches. For almost a thousand years, this Pacific archipelago has maintained a reputation for nurturing extreme longevity. Okinawans over the age of 65 enjoy the world’s highest life expectancy. The average life expectancy for men is 80, and for women it’s about 88. Men are expected to live to about 84, while women are expected to live to almost age 90. People here also have one of the highest centenarian ratios: About 6.5 in 10,000 live to age 100. They suffer only a fraction of diseases that kill Americans: a fifth the rate of cardiovascular disease, a fifth the rate of breast and prostate cancer, and less than half the rate of dementia seen among similarly aged Americans.

What was Shinzato eating that explained her 104 years of bounding exuberance? While she may not have seen this as a pertinent question, researchers have been seeking answers to it. Craig and Bradley Willcox’s work includes meticulous data collection and offers important insights. They began by noting the time span within which today’s Okinawan centenarians have lived. All Okinawans age 100 or more who are alive today were born between 1903 and 1914. During the first third of their lives, roughly before 1940, the vast majority of the calories they consumed—more than 60 percent—came from one food: the imo, or Okinawan sweet potato.

A purple or yellow variety related to our orange sweet potato, the imo came here from the Americas about 400 years ago and took well to Okinawan soils. That was lucky for pre–World War II Okinawans, who were otherwise calorie starved. This sweet potato—high in flavonoids, vitamin C, fiber, carotenoids, and slow-burning carbohydrates—is one of the healthiest foods on the planet.

In fact, the traditional Okinawan diet was about 80 percent carbohydrates, the Willcoxes found. Before 1940 Okinawans also consumed fish at least three times per week together with seven servings of vegetables and maybe one or two servings of grain per day. They also ate two servings of flavonoid-rich soy, usually in the form of tofu. They didn’t eat much fruit; they enjoyed a few eggs a week.

Dairy and meat represented only about 3 percent of their calories. Never influenced by Buddhism, 20th-century Okinawans observed no taboos against eating meat, but they still only ate it rarely. On special occasions, usually during the Lunar New Year, people butchered the family pig and feasted on pork—probably an important protein source at the time. A typical traditional meal of the time, wrote the Willcoxes in an article they authored for the Journal of the American College of Nutrition, began with Okinawan-style miso soup including seaweed, tofu, sweet potato, and green leafy vegetables. The main dish was champuru, stir-fried vegetables that might include goya, daikon (radish), Chinese okra, pumpkin, burdock root, or green papaya, sometimes accompanied by smaller servings of fish, meat, or noodles prepared with herbs, spices, and cooking oil. To drink, they served freshly brewed sanpin (jasmine) tea and perhaps a little locally brewed awamori (millet brandy).

Three foods in the Okinawan diet of those days—turmeric, sweet potato, and seaweed—provided an additional benefit we understand better today: They mimic caloric restriction, a digestive survival mode that has longevity benefits. As food is digested, mitochondria in our cells convert calories into energy. A by-product of this process are free radicals, oxidizing agents that deteriorate the body from the inside out just as oxidation forms rust on iron and ultimately destroys it. Free radicals can stiffen the arteries, shrink the brain, and wrinkle the skin. In caloric restriction mode, our cells protect themselves by producing less energy but also throwing off fewer free radicals and thus slowing the aging process. One way to turn on caloric restriction is to eat about 40 percent fewer calories than the average American consumes (about 2,500 for a man and 1,800 for a woman.) But recent research from the Willcoxes has shown that regular consumption of turmeric, sweet potato, and seaweed can provide some of the benefits of caloric restriction, tripping genetic triggers that minimize production of free radicals without causing hunger.

Typical Daily Diet of Okinawans, 1949 (Percentage of daily intake in grams)
Typical Daily Diet of Okinawans, 1989 (Percentage of daily intake in grams)

Through the post-war decades, Okinawans ate more greens and more yellow, orange, and red vegetables than other Japanese. They also ate more meat—primarily pork—but they ate less fish, less salt, and much less added sugar.

FAST-FOOD INVASION

As healthful as they were, some of these Okinawan food traditions foundered mid-century. Following the war, the United States established an army base in the middle of Okinawa. Western influences—and economic prosperity—crept into traditional life and food habits changed. According to detailed Japanese government surveys, sweet potatoes dropped from 60 percent to fewer than 5 percent of Okinawans’ daily calories between 1949 and 1960. Meanwhile, they doubled their rice consumption, and bread, virtually unknown before, also crept in. Milk consumption increased; meat, eggs, and poultry consumption increased more than sevenfold. Not coincidentally, cancers of the lung, breast, and colon almost doubled.

The meat in their diet gave me pause. When I first struck off on my Blue Zones research in 2000, I was absolutely convinced that I’d find that a vegan diet yielded the greatest health and life expectancy. So when I discovered that older Okinawans not only ate pork but loved it, I thought their example must be an outlier—that they were living long despite pork. Pork is high in saturated fat, which, when consumed in excess, often leads to heart disease. But again, we learn a few lessons. Okinawans stewed the pork for days, cooking out and skimming off the fat. What they ate, in the end, was the high-protein collagen.

One dietary expert I met in Okinawa, Kazuhilo Taira, believed that it was this pork protein that actually explained their longevity. His theory was that we all suffer small tears in the blood vessels that bring blood to our brains. Severe tears result in strokes, but minor tears, while still doing damage, often go unnoticed. Pork protein actually acted like a caulking of sorts, for the pig protein is very similar to human protein. And it was this protein that Okinawans love.

“Oh yes, I like meat, but not always,” Shinzato had told me. “When I was a girl, I ate it only during New Year festivals. I’m not in the habit of eating it every day.”

But today fast-food restaurants serving quick-cooked burgers and other meat sandwiches abound in Okinawa. The island boasts the largest A&W Root Beer stand in the world. In 2005 Okinawans, who live on an island only 70 miles long and 7 miles wide, consumed tons of Spam, a processed meat product introduced by American GIs after World War II. Between 1949 and 1972 Okinawans’ daily intake increased by 400 calories. They were consuming more than 200 calories per day more than they needed—like Americans. And health statistics show the effect of those changes. By 2000 Okinawa ranked 26th among Japan’s 47 prefectures for life expectancy of men at birth, while older Okinawans, whose diets had solidified before that time period, are the world’s longest-lived people.

Some traditions do not die—and apparently some food traditions keep Okinawans living long and healthy lives, even with the onslaught of the modern fast-food culture.

TOP LONGEVITY FOODS FROM OKINAWA

Okinawans have long told their children to eat something from the land and from the sea every day. I’ve found that these time-honored adages survive for a reason, as do other food traditions that help contribute to a long, healthy life.

  • BITTER MELONS: The bitter melon is not a fruit as its name implies—it’s a long, knobby gourd that looks something like a warty cucumber. Eaten green, it tastes quite bitter. Known as goya in Okinawa, bitter melon is often served with other vegetables in a stir-fried dish called goya champuru, the national dish and cornerstone of the Okinawan diet. Recent studies found bitter melon an “effective anti-diabetic” as powerful as pharmaceuticals in helping to regulate blood sugar. Like the sweet potato, turmeric, and seaweed common to the Okinawan diet, goya contains chemicals that may slow the production of corrosive free radicals. Bitter melon is more and more often available in American gourmet produce markets. There is nothing quite like it as a substitute in our everyday cuisine.
  • TOFU: Tofu is to Okinawans what bread is to the French and potatoes are to Eastern Europeans: a daily habit. Okinawans eat about eight times more tofu than Americans do today. Made by curdling soy milk to coagulate the bean’s protein, the product is then pressed into a block and sliced like a piece of cake. Along with other soy products, tofu is renowned for helping to protect the heart. Studies show that people who eat soy products in place of meat have lower cholesterol and triglyceride levels, which reduce their risk of heart disease.
  • SWEET POTATOES: Okinawan imo is a supercharged purple sweet potato, a cousin of the yellow-orange sweet varieties. Despite its sweet, satisfying taste, the supercharged purple imo does not spike blood sugar as much as a regular white potato. The leaves are eaten as greens in miso soup; the potato itself has been a staple since the 17th century. Like other sweet potatoes, it contains antioxidants called sporamin, which possess a variety of potent antiaging properties. But the purple version is higher in antioxidants than its cousins.
  • GARLIC: Sometimes eaten pickled on Okinawa, garlic is one of nature’s most powerful natural medicines. A recent review of thousands of scientific studies concluded that “intake of garlic by humans may either prevent or decrease the incidence of major chronic diseases associated with old age” and named atherosclerosis, stroke, cancer, immune disorders, cerebral aging, arthritis, and cataract formation among those diseases.
  • TURMERIC: Ginger’s golden cousin, turmeric, figures prominently in the Okinawan diet as both a spice and a tea. A powerful anticancer, antioxidant, and anti-inflammatory agent, turmeric contains several compounds now under study for their antiaging properties, especially the ability to mimic caloric restriction in the body. Its compound curcumin has been shown in both clinical and population studies to slow the progression of dementia—which may explain why Okinawans suffer lower rates of Alzheimer’s disease than Americans do. The Okinawan practice of adding black pepper to turmeric increases the bioavailability of curcumin 1,000 times.
  • BROWN RICE: In Okinawa, where centenarians eat rice every day, both brown and white rice are enjoyed. Nutritionally, brown rice is superior. The milling done to produce white rice strips away dietary fiber and nutrients, including most of the B vitamins and all of the essential fatty acids found in rice. Okinawan brown rice, tastier than the brown rice we know, is soaked in water to germinate until it just begins to sprout, unlocking enzymes that break down sugar and protein and giving the rice a sweet flavor and softer texture.
  • GREEN TEA: Okinawans drink a special kind of green tea they call shan-pien, which translates to “tea with a bit of a scent,” created by adding jasmine flowers and often a little turmeric. Green tea contains unique substances that studies suggest may protect against a host of age-related problems, including various forms of heart disease and cancer, stroke, osteoporosis, diabetes, and mental decline.
  • SHIITAKE MUSHROOMS: These smoky-flavored fungi, which grow naturally on dead bark in forests, help flavor Okinawans’s customary miso soup and stir-fries. They contain more than 100 different compounds with immune-protecting properties. Purchased dried, they can be reconstituted by soaking or by cooking in a liquid like a soup or sauce, and most of their nutritional value remains.
  • SEAWEEDS (KOMBU AND WAKAME): Seaweeds in general provide a filling, low-calorie, nutrient-rich boost to the diet. Kombu and wakame are the most common seaweeds eaten in Okinawa, enhancing many soups and stews. Rich in carotenoids, folate, magnesium, iron, calcium, and iodine, they also possess at least six compounds found only in sea plants that seem to serve as effective antioxidants at the cellular level. Wakame, an edible seaweed harvested for centuries in Japan and Korea, is now available dried in the United States. Kombu, a type of kelp, is also a centuries-old Asian mainstay now sold dried and packaged in the United States.

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