True Blue Zones: Okinawa

In my last blog, we began a discussion of blue zones—regions with a lot of centenarians—as popularized by Dan Buettner in his book The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest. As we saw in his chapter on the Sardinian blue zone, he leaves out considerable information that contradicts his premise, namely that the longevity diet is one that contains a lot of vegetables and only small amounts of meat—that’s lean meat, not “processed meats that are filled with fat.”

In his next chapter, Buettner turns his attention to the mixed peoples of Okinawa, an island situated equidistant from Hong Kong and Tokyo. The average lifespan for women in Okinawa is 84 (compared to 79 in American), and the island boasts a disproportionately large number of centenarians. Okinawans have low levels of chronic illness–osteoporosis, cancer, diabetes, atherosclerosis and stroke–compared to America, China and Japan, which allows them to continue to work, even in advanced years. In spite of Okinawa’s horrific role in World War II as the site of one of the bloodiest battles of the Pacific, Okinawa is a breezy, pleasant place, neither crowded nor polluted, with a strong sense of family and community and where the local people still grow a large portion of their vegetables in family gardens.

Buettner subtitles his chapter on blue zones in Okinawa “Sunshine, Spirituality, and Sweet Potatoes,” but what he reveals in the very first paragraph is the fact that SPAM-and-vegetable stir-fry is the favorite dish of Okinawans. (Fact Alert: SPAM is a processed meat that is full of fat.)

Okinawa SPAM omusubiFrom a USDA Foreign Agricultural Report we learn: “Annual average consumption of luncheon meat per person in the prefecture [of Okinawa] is about 14 cans (340 g per can)/year. It is even more impressive when you learn that Okinawa, with only 1.1 percent of the total Japanese population, is responsible for over 90 percent of the total luncheon meat consumption in Japan. The local menu using luncheon meat ranges widely from stir-fried vegetables to rice balls. ‘SPAM omusubi’ (see photo) is particularly popular.” The Okinawans also eat more hamburger than people in Japan.

Back to Buettner: In his visit to Sardinia, he asked “questions from the National Institute on Aging—nonleading questions, carefully crafted to tease out the lifestyle by eliciting a narrative. Instead of asking a man what he ate when he was a child, the question would inquire, ‘Can you think about things you do every day or have done most days of your life?’” As we learned from his discussion of the Sardinian diet, such a technique is not very useful for finding out the important details of a traditional diet.

Buettner uses a different approach for the centenarians of Okinawa, “a survey developed by the National Institute on Aging to systematically interview . . .  Okinawans in search of common lifestyle characteristics. And I’d connect with scientists to find out how those characteristics connected to longevity.”


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The scientist he teams up with is Dr. Greg Plotnikoff. Dr. Plotnikoff has a decidedly vegetarian bent, having written a paper entitled “Nutritional assessment in vegetarians and vegans: questions clinicians should ask,” published in Minnesota Medicine. On his website he recommends a ghastly-sounding smoothie made of coconut milk, protein powder (from whey, rice, pea or hemp), sunflower lecithin, medium chain tryglyceride oil and liquid fish oil.

As Plotinoff says to Buettner: “People don’t realize how bad sugar and meat are for them over time.”  Okinawans eat mostly fresh vegetables he says, fewer salty pickles and less canned meat (hello—SPAM is canned meat).  They have good vitamin D status, he says, because they get plenty of sun.


Buettner does admit that in Okinawa, people eat most every part of the pig (an excellent source of vitamin D, by the way)—unlike the Japanese who get more protein from fish.  But he insists that the Okinawans eat pork only for festivals. (Another embarrassing fact: SPAM is made from pork.) His conclusion about the Okinawan diet (presumably based on what he found from using the National Institute of Aging survey, although he doesn’t say): “Older Okinawans have eaten a plant-based diet most of their lives. Their meals of stir-fried vegetables, sweet potatoes, and tofu are high in nutrients and low in calories. Goya [bitter melon], with its antioxidants and compounds that lower blood sugar is of particular interest. While centenarian Okinawans do eat some pork, it is traditionally reserved only for infrequent ceremonial occasions and taken only in small amounts.”

Of course, Iife was hard during World War II.  “We had famines, times when people starved to death,” says one of Buettner’s informants.  “Even when times were good, all we ate was imo (sweet potato) for breakfast, lunch, and dinner.”  But they also ate fish and pork from the family pig, and it’s obvious that this starvation diet was a temporary phenomenon and not a reason to eat a diet based on sweet potatoes.

Let’s look at what other surveys have found about the diets of long-lived Okinawans.  In 1992 scientists at the Department of Community Health, Tokyo Metropolitan Institute of Gerontology, Japan published a paper which examined the relationship of nutritional status to further life expectancy and health status in the Japanese elderly. It was based on three epidemiological studies. In the first, nutrient intakes in ninety-four Japanese centenarians investigated between 1972 and 1973 showed a higher proportion of animal protein to total proteins than in contemporary average Japanese. The second demonstrated that high intakes of milk(!) and fats and oils had favorable effects on ten-year survivorship in 422 urban residents aged sixty-nine to seventy-one. The survivors revealed a longitudinal increase in intakes of animal foods such as eggs, milk, fish and meat over the ten years. In the third study, nutrient intakes were compared between a sample from Okinawa Prefecture where life expectancies at birth and sixty-five were the longest in Japan, and a sample from Akita Prefecture where the life expectancies were much shorter. It found that the proportion of energy from proteins and fats were significantly higher in the former than in the latter.

According to the paper, “The food intake pattern in Okinawa has been different from that in other regions of Japan.  The people there have never been influenced  by Buddhism. Hence, there has been no taboo regarding eating habits. Eating meat was not stigmatized, and consumption of pork and goat was historically high. . . The intake of meat was higher in Okinawa… On the other hand, the intake of fish was lower… Intake of NaCl was lower… Deep colored vegetables were taken more in Okinawa… These characteristics of dietary status are thought to be among the crucial factors which convey longevity and good health to the elderly in Okinawa Prefecture. . . Unexpectedly, we did not find any vegetarians among the centenarians.”

From another source, Animal Foods, Seafoods, Fat and Okinawa Cuisine (the link has disappeared from the Internet), we learn that “Traditional foods of Okinawa are extremely varied, remarkably nutrient-dense as are all traditional foods and strictly moderated with the philosophy of hara hachi bu [eat until you are 80 percent full]. While the diet of Okinawa is, indeed, plant-based it is most certainly not “low fat” as has been posited by some writer-researchers about the native foods of Okinawa. Indeed, all those stirfries of bittermelon and fresh vegetables found in Okinawan bowls are fried in lard and seasoned with sesame oil. I remember fondly that a slab of salt pork graced every bowl of udon I slurped up while living on the island. Pig fat is not, as you can imagine, a low-fat food yet the Okinawans are fond of it. Much of the fat consumed is pastured as pigs are commonly raised at home in the gardens of Okinawan homes. Pork and lard, like avocado and olive oil, are a remarkably good source of monounsaturated fatty acid and, if that pig roots around on sunny days, it is also a remarkably source of vitamin D.

“The diet of Okinawa also includes considerably more animal products and meat – usually in the form of pork – than that of the mainland Japanese or even the Chinese. Goat and chicken play a lesser, but still important, role in Okinawan cuisine. Okinawans average about 100 grams or one modest portion of meat per person per day. Animal foods are important on Okinawa and, like all food, play a role in the population’s general health, well-being and longevity. Fish plays an important role in the cooking of Okinawa as well. Seafoods eaten are various and numerous – with Okinawans averaging about 200 grams of fish per day.” Buettner implied that the Okinawans did not eat much fish, but in fact, they eat quite a lot, just not so much as the Japanese.

The Okinawan diet became a subject of interest with the publication of a 1996 article in Health Magazine by gerontologist Kazuhiko Taira, who described the Okinawan diet as “very healthy-and very, very greasy.” The whole pig is eaten-everything from “tails to nails.” Local menus offer boiled pigs feet, entrail soup and shredded ears. Pork is cooked in a mixture of soy sauce, ginger, kelp and small amounts of sugar, then sliced and chopped up for stir fry dishes. Okinawans eat about 100 grams of meat per day–compared to 70 in Japan and just over 20 in China–and at least an equal amount of fish, for a total of about 200 grams per day, compared to 280 grams per person per day of meat and fish in America. Lard–not vegetable oil–is used in cooking.

According to Taira, Okinawans also eat plenty of fibrous root crops such as taro and sweet potatoes. They consume rice and noodles, but not as the main component of the diet. They eat a variety of vegetables such as carrots, white radish, cabbage and greens, both fresh and pickled. Bland tofu is part of the diet, consumed in traditional ways, but on the whole Okinawan cuisine is spicy. Pork dishes are flavored with a mixture of ginger and brown sugar, with chili oil and with “the wicked bite of bitter melon.”

Damage control soon followed in the form of the Okinawa Centenarian Study. The study confirmed the longevity and good health of Okinawans and focused on genetic and family factors. However, in the press, the study was described as follows: Okinawa, a chain of islands in southern Japan, has the highest concentration of centenarians. Uniformly these old folks have a vegetable-based, low-calorie, low-fat diet and exercise daily. They eat on average seven servings of vegetables and seven servings of grain per day, several servings of soy products, fish rich in omega-3 fatty acids, and little dairy or red meat.

Bradley Willcox, D. Craig Willcox and Makoto Suzuki repeat this description in their best-selling books The Okinawa Program and The Okinawa Diet Plan.  The factors that confer longevity, they insist, include a politically correct low-calorie, plant-based, high complex-carbohydrate diet, exercise and “attention to spirituality and friendships.” The high content of monounsaturated fatty acids from lard in the Okinawan diet gets translated into a recommendation for politically correct canola oil.

The recipes in the Okinawa diet books feature a great deal of tofu, leading vegan author John Robbins, author of Diet for a New AmericaMay All Be Fed and The Food Revolutionto claim that the reason the Okinawans enjoy such longevity is because they eat two servings of soy foods per day, with soy constituting 12 percent of their calories.   Numerous other vegan spokespeople soon repeated these figures like gospel in their articles, blogs, YouTubes and Facebook postings.

As pointed out by Kaayla Daniel:  “The amount of soy that Okinawans eat is not at all clear in these books. The authors say that the Okinawans eat ‘60 to 120 grams per day of soy protein,’ which means, according to the books’ context, soy foods eaten as a whole food protein source. But the authors also include a table that lists total legume consumption (including soy) in the amounts of about 75 grams per day for the years 1949 and 1993. On yet another page, we learn that people eat an average of three ounces of soy products per day, mostly tofu and miso. And then we read that the Okinawans eat two servings of soy, but each serving is only one ounce.  As for soy making up 12 percent of the Okinawan diet, Robbins pulled that figure from a pie chart in which the 12 percent piece represents flavonoid-rich foods, not soy alone. Will the correct figures please stand up?”

What’s clear is that the real Okinawan longevity diet is an embarrassment to modern diet gurus. The diet was and is greasy and good, with the largest proportion of calories coming from pork and pork fat, and many additional calories from fish; those who reach old age eat more animal protein and fat than those who don’t. Maybe that’s what gives the Okinawans the attitudes that Buettner so admires, “an affable smugness” that makes it easy to “enjoy today’s simple pleasures.”

The Weston A. Price Foundation is your source for accurate information on traditional diets.  Your membership supports the work we do.

Author: Sally Fallon Morell

Sally Fallon Morell is best known as the author of Nourishing Traditions®: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats. This well-researched, though-provoking guide to traditional foods contains a startling message: animal fats and cholesterol are not villains but vital factors in the diet, necessary for normal growth, proper function of the brain and nervous system, protection from disease and optimum energy levels.

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