The Okinawa Way

Every morning Seiryu Toguchi rises at 6, washes his face and exercises in the lush front yard of his home in Okinawa. He prepares a breakfast of rice and miso soup with spinach and egg. Then he tends his nearby farm, where he grows carrots, cabbage and other vegetables. At 5 p.m., he takes a hot bath and cooks homegrown radish with pork for supper. His wife died a few years ago and his children live in other cities, but he is self-sufficient. He reads newspapers and magazines, does his own laundry and sewing, and when he gets cravings for traditional brown-sugar doughnuts, he takes a bus to the nearest town to buy them. It's nothing out of the ordinary--until you consider that Toguchi is nearly 102 years old.

Lean and fit, Toguchi jokes that the key to his long life is a special drink he takes before bed: a mixture of garlic, honey, turmeric and aloe poured into awamori, the local distilled liquor. His sharp mind and high energy may be rare among the elderly in other parts of the world, but he is not so unusual in Okinawa, the southern group of islands located between Japan's main islands and Taiwan. Toguchi is one of about 600 centenarians out of a population of 1.3 million. Indeed, Okinawa has the highest proportion of centenarians in the world: 39.5 for every 100,000 people, compared with about 10 in 100,000 Americans.

What's their secret? In 2001, three specialists published a study of the locals' longevity in a book called "The Okinawa Program," which reached American best-seller lists. The authors--Okinawa International University gerontologist Makoto Suzuki, Bradley J. Willcox, a former geriatrics fellow at Harvard Medical School, and his twin brother, D. Craig Willcox, a medical anthropologist--found that elderly Okinawans had remarkably clean arteries and low cholesterol. Heart disease, breast cancer and prostate cancer were rare, which they attributed to the consumption of locally grown vegetables and huge quantities of tofu and seaweed, rigorous activity and a low-stress lifestyle. Suzuki and the Willcox brothers also determined that Okinawans have no genetic predisposition to longevity: when they grow up in other countries, they take on the same arterial disease risk as those in their new home. The authors claim that if Americans lived more like the Okinawans, "80 percent of the nation's coronary care units, one-third of the cancer wards, and a lot of the nursing homes would be shut down."

But increasingly, Okinawans are living more like Americans. That means less bean curd and walking, more burgers and stress. The islands' children aren't expected to live nearly as long as their grandparents. Heart disease, cerebral hemorrhage and lung cancer are all on the rise. Okinawan women now face a higher than average risk of uterine cancer, and mortality rates are climbing. No one is more concerned than Suzuki. "Most Okinawans like to think that they will live long simply because the islands have been known for it," he says. "They should learn the reasons for the famous longevity and act now to restore their health before it is too late."

Experts blame the islands' dramatic history for the current health crisis. Okinawa, formerly the Kingdom of the Ryukyus, had its own culture, foods and language until it was forcibly assimilated into Japan in the late 1800s. Still, the islands were so far from the central government that the people continued to depend on local salt, sugar, vegetables, fish, fruit and pork. Later, though, Okinawa became one of World War II's bloodiest battlefields. Even after the Allied occupation ended in 1952, the islands remained under U.S. control for 20 more years--long enough for residents to develop a taste for American food. Only recently did Okinawans begin to recognize how the changes in diet and lifestyle were endangering their health.

Now doctors and government officials are urging Okinawans to return to their roots. The prefectural government has launched "Healthy Okinawa 2010," aimed at strengthening health education. Next month Suzuki and his team will hold courses offering instruction in the classic Okinawan lifestyle, complete with morning walks, traditional dance lessons and cooking classes. On Jan. 1, the daily Ryukyu Shimpo began a series of articles on longevity. "We want to give a serious warning to our people," says Editor in Chief Takenori Miyara. "We will cover every area concerning our health situation, from history to culture, and from produce to what measures we should take."

One approach is to target the islands' schoolchildren. At Johoku Junior High School in Naha, the lunches often include local dishes: stir-fried papaya with carrots, rice with wakame (soft seaweed) and tonjiru (soup with pork and vegetables). Many kids said that they learned about Okinawa's longevity on TV. "I like Big Macs, but I would rather eat more Okinawan food to stay healthy and live long," says Masatsugu Uemura, 15. Yayoko Ishikawa, the principal of the junior high school, says that Okinawans believed for decades that their lifestyle was scorned by the rest of Japan. "It has taken such a long time to realize what we had was a treasure for longevity," Ishikawa says. "We should start teaching our children about traditional foods and how the people lived." After all, few people know how to age well better than Okinawa's old folks.