From My Library: The Okinawa Program (2001)

Dear Readers,

  Fascinating book, enjoy with a cup of green tea!

Fascinating book, enjoy with a cup of green tea!

This is my second time reading through this fascinating book, and I wanted to share it with y'all! (I originally reviewed it for my Best Books of 2014.)  

The authors (an internal medicine doctor from the Mayo Clinic, a medical anthropologist, and a geriatrician) team up to bring us the results of a fascinating 25-year study they did on some of the world's longest-lived people, the inhabitants of the islands of Okinawa.  In 1996, the World Heath Organization reported that Okinawans enjoyed an average life expectancy of 81.2 years, the longest in the world at the time.  Furthermore, they were pretty well buffered from many of the debilitating diseases we suffer from here in the West: for example, Okinawan death rates in 1996 (per 100,000 people) from coronary heart disease was 18--contrasted with 100 deaths in the United States for the same year.  Okinawans experienced many fewer deaths from cancer as well, when compared with those here in the States.  Generally, these people finally died of "old age" rather than the usual suspects that we lose our loved ones to here in the west (heart disease, cancer, Alzheimer's, etc.). 

The authors suggest a very wide range of reasons for this legendary health span and longevity (Okinawa boasted, in 2001, over 400 centenarians living among their population of 1.3 million people.  These 100+ year-old citizens were generally living independently, and were healthy and active). I will refer to these centenarians as "Okinawan elders" in my summary below.  Among the reasons for their longevity are the following, which the authors go into great detail in the book (citing an impressive array of medical literature in the footnotes as they go):


  • The Okinawans' longevity is not just due to "good genes": theoretically, we could all enjoy this kind of health span, since our genes only constitute about one-third of our tendency to suffer from various diseases (heart disease, cancer, etc.), while our diet and lifestyle account for the other two-thirds.
  • The traditional Okinawan diet is plant-based, high-fiber, low-calorie, and high in flavonoids (the fantastic little plant chemicals found in fruit, veggies, and green/black tea, for example...these guys are thought to help reduce our risk of nasty things like breast, ovarian and prostate cancers).  Instead of wheat, they eat a lot of rice and sweet potatoes (the ones called “Japanese sweet potatoes” with dark-purple skin and white flesh, not the super-sweet yams with orange flesh you see at Thanksgiving).  Dairy is not a component of their diet; they do eat eggs (not more than one per day).  They drink a lot of flavonoid-rich tea (such as green, black, jasmine, and oolong tea). 
  • Traditional Okinawans do not consume much meat (when they do, it’s pork), although omega-3-rich saltwater fish (such as salmon, herring, mackerel, and sardines) are part of their diet. The authors recommend the "3/4 Rule:" fill three-fourths of your plate with plants, and one-fourth with animal products.
  • Sugar, processed foods, and alcohol are not really their thing (they do drink sake now and then). Their diet, like that of mainland Japan's, was far too high in sodium intake for many years (from all the high-sodium soy sauce and miso), and they had some of the highest rates of stomach cancer in the world until low-sodium soy sauce was introduced.  


  • The Okinawan elders in this study had lower BMIs (Body Mass Index) than comparable Americans of their age, and were both fit and flexible.  This was thanks in part to their practice of "soft" martial arts like Tai Chi throughout their lives.  They also walk for exercise, and are avid gardeners.  
  • Okinawans describe their cultural outlook on life with the word taygay, which generally means "easygoing" or "laid-back."  They do not rush: meetings and conferences in Okinawa start on "Okinawa time" (which is rather late, by western standards).  They do not fast-track through life the way we tend to here in the United States, multitasking and always feeling like there's too much to do (and too little time to do it).  
  • Okinawan elders have typically spent their entire life on the islands, sometimes even living in the same house their entire lives as well.  They maintain what the authors refer to as "Healing Webs" of family and friends throughout their lives, and routinely gather for religious ceremonies, family celebrations, and so on.  As you can imagine, if your entire group of family and friends isn't moving every few years in pursuit of educational or job opportunities, you'd have lots of friends, too!  Okinawans are similar to the French in this regard (although in France this may be changing, sadly), who also tend to stick fairly close to their geographic and cultural roots throughout their lives...this definitely has its upsides, in terms of making and maintaining lifelong friendships.
  • They have a deep, meaningful, and life-long connection with the Divine.  The Okinawan elders studied prayed daily to the gods and to their ancestors (whom they consider their protectors) for health and guidance, and they were often the leaders at various religious festivals. They are treated with great reverence and respect in their communities: in fact, it's considered good luck to touch an elder, in the hopes that their good health will come to you as well in your old age!

While I have great respect for the compelling and authoritative research the authors present in this book, I felt that the recipes and dietary recommendations (starting in Chapter 12) were somewhat lacking.  Maybe this is because the book came out in the midst of the low-fat, low-carb diet craze of the early 2000's.  Whatever the case, please take their dietary recommendations with a grain of salt (good advice for any new diet you read about, and there are a dizzying number of them out there these days.  Always check with your doctor before starting any new diet, too!).  Their recipes recommend cooking with things like egg substitutes, fat-free cheeses, tofu-lite, margarine, canola oil, etc., all things that aren't particularly good for you (and certainly don't taste great either).

Their fascinating commentary on the traditional lifestyle on the Okinawan islands was pretty cool, though, as are their summaries and stories of what makes these elders "tick" well into and past 100 years of age (while still enjoying good health: no nursing home for these elders, thank very much).  That's something to aspire to!  The way I figure, any good dietary or lifestyle habits we can take away from the lessons of the Okinawan elders is a good investment in our health span.

Yours Truly,