Many years ago I read The Okinawan Way by Bradley Wilcox, Craig Wilcox and Makoto Suzuki. The authors analysed the Okinawan diet and lifestyle in order to understand why so many lived to an extra-ordinary age, while maintaining excellent health.
The researchers found 10 key factors that contributed to the health and longevity of the Okinawans.
The 10 Factors
1. Okinawans have healthy arteries, low cholesterol, and low homocysteine levels.
Homocysteine levels are reduced by vitamins B6, B12 and folate. These are used by the body to turn homocysteine into a harmless protein. The Okinawan diet has high levels of these vitamins.
Okinawans also maintain a healthy blood pressure, and very low markers of inflammation
2. Okinawans have low body fat and are fit. Body mass index ranges from 18 -22
3. Okinawans have a low risk for hormone dependant cancers. The have 80% less breast and prostate cancer and half the ovarian and colon cancer rates of North Americans.
4. Okinawans have strong bones and about half the risk for hip fractures of North Americans.
5. Most Okinawans have remarkable mental clarity – even over the age of one hundred. This is related to the fact that they have clean arteries and good blood circulation to the brain. They also engage in lifelong learning to keep brain cells active.
6. Okinawan women have a natural menopause and don’t use hormone replacements. They have very few complications such as hip fractures, hot flushes and heart disease.
7. Youthful levels of sex hormones are found in elderly Okinawans. DHEA, oestrogen and testosterone levels are higher than Americans of a similar age.
8. Free radicals are found in low levels in the blood of Okinawans. Free radicals are highly reactive compounds that damage cells in the body are thought to be one of the main causes of ageing. Free radicals are increased with a high calorie and poor diet, smoking, and stress.
9. Long living Okinawans have excellent psycho-spiritual health. They have optimistic attitudes, are adaptable, have low stress levels, are self confidant, and have an easy going attitude to life. They also have strong social networks.
10. The Okinawans incorporate both Eastern and Western healing methods into their health care system. They frequently use natural and herbal tonics.
When diet was analysed it was found they had an exceptionally high level of nutrients, yet ate less calories -40% less calories than the North Americans and 20% less than the average Japanese. And even though they ate a very high carbohydrate diet, the predominant starch prior to 1949 was from a high nutrient sweet potato with a low glycemic index. This changed after the second world war when more wheat and rice was introduced into the diet.
After analysing the diet of the Okinawans the authors them went on to prescribe a high nutrient low GI diet using foods available in a Western society, which included whole grains.
Now here’s the thing – I just came across this paper by the same authors with a very interesting graph. Before 1949 the Okinawans ate NO Wheat and little rice.
Here it is:
Now what is interesting, is that I see this in a different light now. Especially the work of Lindeberg and his detailed work of the Kitavans – another race whose diet is also high in carbohydrates – from sweet potato. This group too have health devoid of Western disease.
Perhaps the Okinawans attained exceptional health, not solely because of their high nutrient diet, but because they like the Kitavans and other hunter gatherers ate no grains.
As the authors in this study note “However, dietary change since World War II has been largely deleterious, with younger Okinawans developing a higher risk of obesity and other chronic disease risk factors versus older Japanese.”
Further reading, reference: A detailed description of the high nutrient foods including herbs and spices in the traditional Okinawan diet “The Okinawan Diet: Health Implications of a Low-Calorie, Nutrient-Dense, Antioxidant-Rich Dietary Pattern Low in Glycemic Load” D. Craig Willcox, PhD, Bradley J. Willcox, MD, Hidemi Todoriki, PhD, Makoto Suzuki, MD, PhD
“The Okinawan Way, How to improve your health and longevity dramatically” Bradley Wilcox, Craig Wilcox and Makoto Suzuki
An excellent overview of the many factors that contribute to the long life and health of Okinawans: The Okinawan Centenarian Study – note – it’s not just the diet. Genetics and many facets of lifestyle play a part.
The Okinawan’s have a phrase, “hari hachi bu,” meaning eat only until you’re 80% full. We in the West clearly have trouble doing that!
My understanding is that traditional Okinawans are significantly more active than Western populations, e.g., lots of walking, even into advanced age.
Your wheat theory is interesting. Dan Buettner in his Blue Zones book looked at four longevity hot spots. He didn’t make any connection with wheat consumption, which doesn’t mean it’s not there. Food-wise, he focused on the relatively high plant and low meat consumption in the hot spots.
-Steve
I found this article interesting especially the fact that the authors tried to mimic a whole grain free diet using whole grains 🙂
I would like to point out though that the Okinawan diet is most likely totally devoid of folic acid and instead rich in folate, I think its important to differentiate between the two as they are not metabolised in the same way and may have different effects on the body. Unmetabolized folic acid is typically found in serum of individuals in countries that fortify grains and has been shown to decrease natural killer cell cyotoxicity which is potentially good news for tumors.
Homocysteine is also converted to methionine by betaine (mostly found in wheat products) and choline (egg yolk and organ meats).
Good point – thanks!
That graph certainly is striking. To me the most interesting factor is the drop in sweet potatoes (and the associated drop in total % calories from the three sources graphed). What replaced sweet potatoes in the diet (certainly bread and rice increased, but not in such a way to account for nearly 60% of calories.)? I had a (very) quick glance at that paper as well- seems they think the incorporation of tofu in the diet is a good thing… I am suspicious…
I have pie chart which I’ll scan and add in soon which shows the complete breakdown of diet
In the meantime this presentation has lots of interesting material in it – the changes in diet in Okinawa and body weight in children / people etc
http://hsph.jp/JT2009/documents/Nutrition%20Transition%20in%20Post-War%20Okinawa%20Exploring%20the%20Link%20Between%20Diet,%20Obesity%20and%20Longevity.pdf
Reviewing the paper you linked, I’d say tying their decline in health to a transition to 10% of calories from wheat consumption is a rather big leap in conclusion, considering that a huge portion of their calorie intake, as someone above in the comments already pointed out, has been replaced by not-rice and not-wheat. If you review the data presented in the paper, and not just the graph you have posted in the article, it is clear that meat consumption (heavily-processed meat at that) has risen significantly, furthermore significantly increasing the proportion of calories now coming from fats. In fact, in the graphic titled “Nutrition transition: annual change of fat intake in Okinawa and Japan”, it seems that Okinawa overtook the rest of japan in % of calories coming from fat, which might explain why it went from being the healthiest and fittest, to the least healthy and fit, compared to the rest of japan.
Lastly, I will point out that Okinawa’s consumption of bread/wheat stays below 10% of dietary calories throughout the 60s and 70s as you show. I’m not sure what it was in the rest of Japan, it would be interesting to see whether at sub-10% Okinawans were eating more bread, proportionally, than the rest of Japan, and whether this would explain their pulling-away from Japan in obesity. In either case, with the data presented, animal foods, and a significant rise in fat consumption, seems to me far likelier an explanation.
One crucial piece of information is missing, however, and that is total calories consumed, Okinawa vs Japan overall. That’d need to be compared, as treating % of consumption as the end-all-be-all is erroneous. Quantity matters as well.
…
I may have found something useful.
http://ageconsearch.umn.edu/bitstream/134957/2/fris-1968-08-01-330.pdf
This appears to show that the total calories went from ~2000 to about 2300 post war for all of Japan (page 17). Proportionally, wheat, making up about 245 calories per day, is over 10% of that, for all of Japan. Thus it seems that the increase in wheat consumption may not explain the fattening trend, as the whole of Japan, proportionally, increased their wheat consumption MORE than Okinawa, while being beaten by Okinawa’s rise in weight.
I haven’t been able to find the total calorie intake change for Okinawa’s population before and after the war. This study http://www.okicent.org/docs/anyas_cr_diet_2007_1114_434s.pdf does show that in 49/50 the Okinawa diet was lower in calories compared to Japan’s. I wouldn’t be surprised if their proportional increase in weight also stems from them increasing their calorie consumption more post-war than the rest of Japan. As I mentioned above, japan increased overall about 15%. For Okinawa, having been at just under 1800 calories in 1949, a 15% increase would put them at 2070. Given their accelerated increase in the consumption of high calorie density foods like processed meats and fat, it wouldn’t be surprising if their weight gain comes from a super-15% increase in calorie intake in those years.
That might explain the weight gain, which can also lead to explaining the associated health issues they suffer. However, the quality of the calories also matters. So then the question is, is it the sub 10% wheat that is causing them diseases, or the more than 30% fat in their diet?
Thanks for your detailed comments. I wrote this some time back and at the time I wondered that the change from root vegetables to grains had an impact. Since then I’ve done a lot more research and reading on obesity increases worldwide and it is a lot more complex than one macronutrient or change. I would definitely need to revisit this post, however I do appreciate your input here. As you say – people are eating more calories – same goes for most other nations whose health is declining and weight is increasing. The facts to look at would be – where are these calories coming from, and why are we consuming more?
[…] Japanese: “Before 1949 the Okinawans ate NO Wheat and little rice” (Julianne Taylor, The Okinawan secret to health and longevity – no wheat?). Also, similar to the Mediterranean people (another population studied after the devastation of […]
[…] other Japanese: “Before 1949 the Okinawans ate NO Wheat and little rice” (Julianne Taylor, The Okinawan secret to health and longevity – no wheat?). Also, similar to the Mediterranean people (another population studied after the devastation of […]