As I alluded to in part 1 of this series [Sept. 9 issue], I've discovered it is extremely difficult to determine what foods are consumed in the longevity hotspots (aka, "blue zones") around the world, for a number of reasons: 1) There are no controlled studies focusing exclusively on diet, and most of those are observational.2) Much of the dietary information on these groups comes from Web sites and blogs associated with the health and nutrition industry. It became apparent that their tendency was to select data in support of the philosophy, books, diets or supplements they were selling. 3) Omissions of politically incorrect information make it harder to find. 4) Interviews of 90- and 100-year-olds from the same areas reveal individual food variations. 5) Different articles from different authors who travel to the same location find different conclusions, and their findings are often extrapolated by others to represent an entire longevity zone. 6) People who write about longevity zones don't limit their focus to foods.
What Do Healthy People Actually Eat?
My focus is on food because this is a nutrition column and I wanted to see what these people actually eat. And as a practicing DC, I am deluged with patients who are overwhelmed with questions on what they should and should not eat. Not a month goes by without a new diet with new claims made by either pushy people in the latest multilevel marketing scheme or know-it-all salesmen (who, by the way, do not know it all). The confusion is amplified by what people who work in gyms and health food stores say whenever a new study hits the news.
By the time this series is complete, you will understand that there is no single healthiest diet – something many of you probably suspected anyway, but may have lacked tip-of-the-tongue info to debate with someone who just memorized a spiel. As for readers who have embraced a single approach of macronutrient ingestion, my message to you is the following: Food is like footwear – one size does not fit all.
A Word About Longevity and Lifestyle
Lifestyle is every bit as important as diet; probably more important for some. In fact, the lifestyles of people who live long and healthy lives have more in common than the foods they eat, even though most of what is written implies their diets are similar. However, the diets of people from the five documented longevity hot spots – Ikaria, Greece; the Barbagia region of Sardinia; the Nicoyan peninsula of Costa Rica; Loma Linda, Calif. (the Seventh Day Adventists); and today's subject, Okinawa, Japan – vary widely.
The Okinawa Diet
The diet of the world champs of documented longevity is very healthy, but like every group we will study, contains some politically incorrect components. Okinawa is the biggest island in a chain of islands also known as Okinawa. It is home to 1.3 million people and is located 500 miles south of the southernmost main Japanese island, Kyushu. It has a semitropical climate with an average temperature of 72 degrees and 75 inches of evenly distributed rainfall throughout the year. It is the longevity capital of the world.
Thirty-four people out of every 100,000 live to be 100 years of age or older. Okinawans have a diet that is very high in carbs, soy and white rice, and low in protein and fat. But as I mentioned above, it is not that easy. What follows are passages that represent what I found after hours of research. They also represent what I did not find, which was that politically incorrect foods and data were ignored. In the case of Okinawans, this includes the fact that they eat less seafood than most Japanese and have 2-3 servings of white rice almost every day.
I suspect this "oversight" happened because of the fear of hearing something like this: "Since Okinawans eat a lot of white rice, and they live long healthy lives, white rice is healthy." Of course, the truth is that three servings of white rice is not unhealthy when accompanied by eight servings of fresh vegetables, a couple pieces of fruit, a little soy and some buckwheat noodles.
"Most traditional Okinawans eat mainly vegetarian diets. Their meals may include stir-fried vegetables, tofu, sweet potatoes, and Goya. Goya, often translated as 'bitter melon,' is a vegetable extremely popular as a symbol of Okinawan health food. ... While centenarian Okinawans occasionally eat some pork, it is traditionally reserved only for ceremonial celebrations and consumed in very small amounts. The Okinawan diet is rich with soy-based foods such as tofu and miso soup."1
"The average citizen consumes at least seven servings of vegetables daily, and an equal number of grains (in the form of noodles, bread, and rice - many of them whole grains). Add to this two to four servings of fruit, plus tofu and other forms of soy, green tea, seaweed, and fish rich in omega-3s (three times weekly). Sweet potatoes, bean sprouts, onions, and green peppers are prominent in the diet. Vegetables, grains, and fruits make up 72% of the diet by weight. Soy and seaweed provide another 14%. Meat, poultry, and eggs account for just 3% of the diet, fish about 11%. The emphasis is on dark green vegetables rich in calcium (Okinawans, like other Japanese, don't eat much dairy). Okinawans do drink alcohol, but women usually stick to one drink a day, while men average twice that. Moderation is the key."2
"Over a third of each meal consists of vegetables. The Okinawans eat 6 servings of vegetables and 1 serving of fruit a day. Sweet potato is a staple, and vegetables are often eaten with the peel. Other common vegetables eaten are radish, marrow, onions, carrots, cabbage and leafy greens. ... The Okinawans use seaweed as a flavoring and in stocks. Fish is eaten 2 or 3 times a week. ... Soya is a popular ingredient used by the Okinawans. ... Their diet includes 6 to 7 servings of whole grains every day, mainly in the form of rice and wheat udon noodles, or buckwheat noodles. Lean meat is kept to a minimum, and only eaten sparingly. Green tea is the main beverage, with at least 3 cups being drunk daily."3
"Okinawans eat fruit every day picked from their own trees including citrus fruits, pineapples, bananas, papayas, guavas, mangoes and passion fruit. (They) eat meat from locally-reared livestock mainly on special occasions. For example they will cook an entire pig and eat every part of it, including its face, boiled or stewed ... but they get their protein mainly from fresh fish and around 3 oz daily of melt-in-the-mouth tofu and traditionally-fermented soy products. (They) use salt sparingly, and when they do use salt it is mineral-rich local sea salt. (They) regularly use the powerful anti-inflammatory spice turmeric to flavor dishes. (They) replenish their cups from a large pot of green tea all day long and use mugwort and hibiscus to make herb tea."4
"A traditional Okinawan breakfast may consist of miso soup with spinach or eggs with rice; while a typical lunch would be papaya, tofu, and dark green leafy vegetables, and sweet green tea, with a bitter citrus fruit for a snack in the afternoons. ... The fruit staples are pineapples, papayas, mangoes, passion fruit, guavas, and citrus fruit. Vegetables normally eaten are Goya (bitter melon), hechima (squash), shikuwasa [a Clementine-sized citrus fruit with lemon-lime-orange taste], sweet potato, seaweed, garlic, onions, tomatoes, and plenty of green leafy salad leaves. Tofu, white and brown rice are also eaten. There is very little meat eaten with meals, however the meat staples are pork or soki (usually boneless stewed pork spare ribs), beef, and fish."5
- Blue Zone Regions - Health and Nutrition. "The Blue Zone in Okinawa."
- "Eat Like an Okinawan."
- "The Okinawa Diet: A Superb Anti-Aging Diet."
- "What Okinawans Eat."
- "Longevity and the Diet of Okinawa, Japan."
Note: All Web sites accessed on 10-12-11.
In part three of this series, we will take a look at what the Mediterranean populations eat; in part 4 we'll shift focus to the Americas.
Click here for previous articles by G. Douglas Andersen, DC, DACBSP, CCN.