Food for thought: A traditional Okinawan diet may help prolong life

The view that, if there is a Garden of Eternal Life, it is likely located in Okinawa, may be a touch exaggerated but few places offer better models for the correlation between food, health and longevity than Japan’s southern islands.

“Being Okinawan, being different,” Donald Richie wrote, “makes for vitality.” Part of that vitality comes from elements found in its indigenous cuisine. Deriving from the Chinese notion that the same principals apply to both medical treatment and daily diet, Okinawans use the term “nuchi gusui” to define their traditional cuisine, “nuchi” denoting life, “gusui,” medicine.

The Okinawan diet stems in part from an inherent resourcefulness developed in periods of extreme poverty. During shortages, Okinawans resorted to famine foods such as cycad nuts and the pineapple-like fruit of the panadanus, or adan tree. Both required toxins to be carefully leached out before they could be consumed. The resilient sweet potato was brought to Okinawa after a tributary mission to China in 1605. The humble tuber, rich in flavonoids, fiber, lycopene, carotenoids and vitamin E, saved many Okinawans from malnutrition.

The legacy of frugality is evident in the handling of the humble pig, an object lesson in an economy of nonwastage. Swine were introduced to Okinawa from China in the 14th century. Okinawans, practicing a more indigenous animistic faith revolving around complex rituals conducted by priestesses known as noro and kaminchu, were little affected by the Buddhist prohibition on eating meat.

Rich in vitamin B and animal protein, pork contains less cholesterol than meat such as beef and chicken. Excess fat is removed during preparation, the meat boiled and simmered to tenderize it. In the past, what was not consumed immediately was salted, wrapped in straw and stored in ceramic jars and crocks, or hung from kitchen rafters. The fatty parts of the flesh were turned into lard and stored in oil vessels known as anda-chibu, while the crispier residues were roasted, combined with vegetables and used for miso soup or in a pork miso dish known as anda-insu. Mixed with starch and salt, the blood made a tasty seasoning.

The beast is still consumed in its entirety, from the ears, which are boiled, sliced and mixed with vinegar and soy sauce, or peanut butter, to form mimibichi, to the trotters, which are cooked in a slow, simmering soup. Less common but firmly on the Okinawan menu is chimu shinji (pork-liver soup). The intestines are not overlooked, finding their way into a soup featured on New Year’s Eve and wedding reception menus. A local saying holds that, “Every part of the animal is used — except the oink!”

The correlation between health and specific dishes is apparent in squid-ink soup, which is believed to lower blood pressure, promote fluid urination, clear toxins from the body and relieve fever. Squid and octopus are known to be rich in taurine, which lowers blood pressure and cholesterol. When Okinawans fry fish, their oil of choice is canola, which is said to be even healthier than olive oil. The plentiful consumption of fish explains why the elders have unusually strong bones.

Okinawa has the longest daylight hours in Japan, which may explain the concentrated richness of its vegetables and tropical fruit, the stronger fragrance and taste of its herbs. Okinawa’s best-known vegetable is goya (bitter melon), a knobbly green vegetable that is a member of the gourd family. Bitter melon acts as an antioxidant, partly because of its phytonutrient content — a compound that can help to reduce sugar levels in blood and forestall diabetes.

Rich in protein, tofu is a daily food among Okinawans, who value its isoflavone content, which helps to prevent prostate and breast cancer, bone loss and, in some instances, can relieve certain menopausal symptoms. The consumption of quality protein rejuvenates blood vessels and helps to reduce the incidence of stroke, hypertension and cognitive impairment.

For those who pay attention to health matters, the negative correlation between salt intake and life expectancy will know that Okinawa has the lowest salt intake in Japan, reflected in the far lower incidence of stomach cancer. But as Kiyoshi Okuhara, the leader of a food safety team at a refinery on Aguni Island, tells me, “good quality salt contains several types of minerals, like chromium, which promotes muscular contraction, and selenium, a powerful antioxidant. Salt can promote good health.”

His factory produces handmade steamed and sun-dried salt that has become an international brand.

Elderly Okinawans enjoy far lower risks of arteriosclerosis than other Japanese, the lower level of heart and blood-related diseases often linked to water and soil quality.

Both are rich in alkaline, magnesium, potassium and calcium. Unlike mainland Japan, whose acidic water is soft, Okinawa’s underground and tap water is hard, a characteristic believed to have a softening effect on blood vessels. Local fragrant teas such as sanpin-cha and yanbaru-cha, which are similar to jasmine tea and are often drunk by the elderly, are made from this water. Calcium properties in the soil also differ; Okinawan soil contains a higher lime content derived from its coral reefs.

It’s not only what the elders eat, but what they choose not to consume that determines good health. Older Okinawans practice a healthy abstinence that is embodied in the expression “hara hachi-bu,” which means “eat until you are 80 percent full.”

Being circumspect about the amount of food you eat is clearly not a virtue of younger Okinawans, who have embraced the sugar and salt-rich American fast food diet with glee. In an island with the largest consumption of junk food in Japan, the rates of obesity, heart-related diseases and premature death among those under 50 are the highest in the country. Lung cancer and cerebral hemorrhage are also on the rise.

The benefits derived from the combination of a vital, unique culture, warm climate and the special features of its cuisine are well documented. The authors of the best-selling book, “The Okinawa Program,” gerontologists Bradley Willcox and Makoto Suzuki, and medical anthropologist Craig Willcox, based their study of the link between diet and longevity on 25 years of research. Nowhere is that connection more evident than in the village of Ogimi, in the far north of mainland Okinawa.

This village of some 3,500 people boasts around 100 residents over the age of 90. Those of advanced age tend to be physically active, many taking part in village events, volunteer activities and senior citizen’s clubs. Many continue working or tending their kitchen gardens until the end of their lives. Interestingly, there is no word in the Okinawan language for “retirement.”

Adhering to a diet that is high in nutrition and antioxidants, but low in calories, Ogimi’s elders appear to suffer a far lower incidence of lifestyle diseases such as myocardial infarction and stroke. Some ascribe Ogimi’s disproportionate longevity figures to the quality of its shikuwasa (shequasar). Rich in vitamin C, it has a notably higher concentration of citric acid, carotene and mineral content than other citrus fruit. Another important element in the fruit is nobiletin, which is said to aid in the prevention of cancer. Added to food, it can act as a preservative.

For the past 26 years, Emiko Kinjo has been running what appears to be the only restaurant in the village, the organic eatery Emi-no-Mise.

Using the generic term, dento-ryori (traditional cuisine), Kinjo has created a menu featuring medicinal herbs based on ancient Chinese methods of food preparation, in which great heed is paid to the principle of yin and yang, the balancing of opposing yet complimentary forces in nature. The set I sampled, a dish called choju-zen (longevity dish), had distinct smells, texture, stickiness and astringency.

Kinjo was eager to point out that there are two interpretations of Okinawan food, both of which she tries to combine in her menu: ujini-mun, or food with nutritional value, and kusui-mun, or food with medicinal benefits.

The expression, “ishoku dogen,” means that you can obviate visits to the doctor by eating healthy, fresh food. Happily converted to the spirit of edible health after lunch at Emi-no-Mise, we leave with a departing nuchi gusui naibitan, an expression of gratitude that means, “This food has been medicine for my life.”

It is interesting that the authors of “The Okinawan Program” conclude that the islanders have no particular genetic predisposition to longevity. Okinawan migrants to places such as Brazil and Hawaii have developed identical arterial and other health problems to those found in their new home. Conversely, it means the benefits of the diet are accessible to all of us.

As I leave the village, a stone monument placed along Route 58 catches my eye. Its message, tinged with a touch of forgivable bravura, reads: “At 80, we remain children.”

If death visits us at 90, we should say, “Wait until we are 100, then we might consider it.”

The wisdom of herbs

As the urban shredding at the edges of Naha and Yonabaru recedes, fields of sugar cane, vinyl greenhouses, private orchards and kitchen gardens appear. The world seems a little fresher, a touch more natural and renewed for it.

It’s an effortless 30-minute motorcycle ride from Naha to Sashiki on the Chinen Coast, but it’s a little difficult negotiating the lanes looking for the address I have scribbled in my notebook.

When I stop a local farmer in his truck, however, he immediately recognizes the name Paul Lorimer. Hailing from New Zealand, Lorimer, with several exhibitions to his name and a supportive client base, is a well-known potter, but it is his long, empirically tested interest in herbs that has brought me to his door.

At first glance, Lorimer’s plot of land resembles nothing so much as a wilderness — an unkempt allotment, overrun with a riot of invasive plant life. A closer inspection reveals an emerging order in patches of greenery too delineated in their positioning to be weeds.

Lorimer talks me through the pharmacopeia of his garden, identifying chomeiso (long-life plant); Okinawan sansho pepper; the spinach-like handama (two-colored gynura), which, being high in iron, reduces anemia; Ryukyu yomogi (Okinawan mugwort); fuchiba (felon herb); and nigana, effective for settling the stomach and intestinal disorders, as well as for countering heart disease, boosting blood supply and controlling body temperature.

There is also botanbofu (Japanese peucedanum), which addresses high blood pressure, alleviates rheumatism, acts as an anti-sclerotic agent and can work as a cough medicine. Lorimer directs my attention to a sprig of gekitsu (orange jasmine or cosmetic bark tree), noting its usefulness as an instant cure for diarrhea. It soon becomes clear that we are not walking through a theoretical terrain, but a tried and tested one, as Lorimer points out a herb known as seronbenkei (air plant), which he has crushed, removed the juices, made into a poultice and used to great effect on his son’s bruised arm after complaints he couldn’t sleep.

Lorimer uses herbs in two ways. First, he uses herbs as cures for specific ailments and as preventative medicine. Since living in Okinawa, he has never felt the need, or desire, to resort to Western medicine.

The second usage of herbs, connected to the maintenance of good health and the enhancing of culinary flavors, is for everyday consumption in the dishes he prepares. Lorimer also makes his own herbal brews — turmeric tea and mixtures of hibiscus flowers, mint, lemon grass, guava leaves and getto seeds — and even mixes his own potions for treating minor ailments such as colds. He makes habu oil, derived from the venomous snake of the same name, as a balm for grazes, cuts and burns.

Today, Lorimer has made three dishes for me to sample: taro stalks with sumiso (a vinegar-miso mix); a similar plate with the addition of tofu; and slices of sashimi supplemented with handama, chopped chomeiso and wasabi. Cognizant that much of the wisdom associated with the knowledge of herbs and their use is vanishing with the passing of the elderly, Lorimer has translated a book by Masako Ota titled “Okinawa Yakuso Hyakuka” (“An Okinawan Natural Medicine Dictionary”).

Lorimer’s early lessons in plants and herbs came some 35 years ago, when he was employed to cut the undergrowth in the hills of Ishigaki Island.

“My co-workers,” Lorimer explains, “were mostly older men who taught me which trees and seedlings to leave and which to cut out. I also observed several of them collecting different plants to take home.”

These were natural medicines, and his co-workers pointed out what they were used for. This led to Lorimer’s interest in the subject and to questioning elderly Okinawan people about the way they used medicinal plants.

The Japanese call Okinawa “the healing islands” — a forgivable exaggeration — but Lorimer’s experience appears to endorse the concept of nuchi gusui: the healing power of food.

Indeed, it’s an experience that chimes with the words of Tokashiki Tsuka, a physician to the king of the Ryukyus. In his 1832 “Textbook of Herbal Medicine,” the good doctor wrote that “if we nourish the spirit through proper food and drink, illness will cure itself.”

The first installment of a two-part series on lifestyle issues that affect the elderly. The second installment of the series will appear on Sunday, Dec. 20, and will focus on senior citizens in the workforce.