Okinawa and the Secret to Graceful Aging

“My beloved Nana, walk straight,” I would say as I tried to gently straighten her bent back while we walked home on a calm summer evening from “yatakh”: an old tree trunk in the village center where the women sat nightly to exchange news. Her salt and pepper hair was tied up in a white cotton kerchief dotted with royal blue flowers, knotted at the top of her head above bright green eyes set in a tanned, leathery face earned from countless hours spent weeding the fields.  She wore a light gray, long-sleeved, cotton crew neck top; a tea-length, black cotton skirt; thigh-high black socks and black leather house slippers, a luxury from Tehran and one of her few prized possessions. Nana used a crude walking stick, scavenged from the side of the road, to support her weight and ease her pain as we made our way down the dirt road lined with dimly lit mud brick houses. She never resisted my efforts to correct her posture but, she immediately tilted toward one side in response to pain that she claimed was from a bad disc. “It is the old age my dear; it is the old age,” she whispered and went back to her original position.

I never saw my Grandma without agony. She would take an assortment of pills of different size, shape, and color. Before taking them, she would recite, “This is for blood pressure, this is for cholesterol and this for my heart.” I was afraid that Grandma might die unexpectedly because my Uncle would constantly warn her not to eat too much salt and bread. “You will have a stroke one day,” he would say as she laughed, eating a salt-saturated meat rolled in flat bread while winking at me.  She told me what she sincerely believed: “Beloved, enjoy your youth while you have it because old age is bitter and oppressive.” It was not only my Grandma who suffered from disfigured posture and several additional health issues, but the majority of her contemporaries shared the same fate. They all believed that when they turned sixty, they would fall apart and become dependent on their children.

It never occurred to me that old age would be anything but bitter. I started using all the proverbs about old age in our Assyrian culture: “It is a fruit of old age, Mother,” I said whenever I saw an old woman in pain. I was convinced that the monster of old age had inflicted my beloved Grandma and her neighbors with misery and pain. It never occurred to me that the real monster was their incorrect perspective regarding old age and their unhealthy lifestyle until I learned about Okinawans, people who age gracefully and enjoy long, full lives.

A closer look at Okinawan life uncovers the secrets behind their graceful aging. This old saying clearly communicates Okinawans’ incredibly positive perspective toward old age: “At 70 you are still a child, at 80 a young man or woman. And if at 90 someone from heaven invites you over, tell him, Oh, just go away, and come back when I am 100.”  They step into old age with great expectations, similar to a child eager to explore the unknown. These positive expectations pervade every aspect of their lives.

This small island’s secret to eternal youth has commanded the attention of numerous scientists from around the world, experts searching for a scientific reason for their successful aging. Kazuhiko Taira, a gerontologist and epidemiologist from the University of Ryukyus, for example, studied elders in Ogimi, a northern Okinawan village, questioning them about their daily activities and monitoring their vital signs. He concluded that Okinawans’ secret to graceful aging results from a combination of factors: strong community support, active lifestyle, healthy habits, specific diet and their positive perspective toward old age.

Taira concludes that community support plays a significant role in sustaining Okinawans’ emotional and psychological wellbeing. Like the rest of us, Okinawans do go through life seasons that are emotionally and psychologically challenging. For instance, the thought of an empty nest, that haunts many parents almost from the day that they bring their baby home from the hospital, has no place in the hearts and minds of Okinawans; not because they do not experience it  but because of the community support embedded in their culture. Taira explains it this way: when Ogimians send their children to a bigger city to obtain higher education or find jobs, neighbors fill the void and check on each other every day. Okinawans have a habit of opening their doors early in the morning to let the sun and the fresh air in, Taira observed. This traditional habit allows neighbors to check on each other first thing in the morning, without violating their privacy and personal space. If a door remains closed, neighbors make it their duty to find out why. This supportive attitude promotes psychological and emotional health and prevents suffering in isolation that potentially can lead to many diseases and subsequently shortens an individual’s life.

Community support is also evident in the way the younger generation helps promote elder Okinawans’ independence by buying whatever they are capable of selling such as woven goods, vegetables grown in their gardens, and fish. For instance, an older lady who once was capable of going to the wholesaler to buy fresh fish and sell it in her store is able to continue her business when, a younger lady goes to market and buys the fish for her. Other community members complete the circle of support by buying the older lady’s fish, regardless of the fact that the fish might not be as fresh as another store’s or that she might forget to wash her hands before handling it. All these simple but premeditated efforts of support give Okinawan elders an encouraging message: they are productive and important members of their community, encouraging them to want to live longer.

Along with their positive perspective and strong community support, Okinawans maintain an active lifestyle. They begin the day with exercise thus conditioning their body for later activities. According to Badri, they walk several kilometers a day, practice some type of martial arts, ride bikes, dance, and do gardening. All these activities take place outdoors, providing opportunities to interact with one another and benefit from nature thus, reducing stress and strengthening community bonds. The combination of daily activities and the manner in which they occur not only promotes physical health, but sustains Okinawans’ mental health as well.

Okinawans maintain active lives, yet they are far from being workaholics. It seems that they have fair contracts with their bodies. This harmonious relationship is evident in a story of Ushi, a 103 year old Okinawan woman, who cites an afternoon nap among her daily activities. A study of 788 Okinawans, aged 60-93 years old, confirmed an association between afternoon naps and sleep health that is essential to overall health. By taking a short afternoon nap, Okinawans avoid exhaustion and give their bodies a chance to restore their energy.

In addition to the afternoon naps, Okinawans possess yet another healthy habit that is equally important and that contributes to their graceful aging: humor. Humor is interwoven in Okinawans’ daily lives. They deliberately keep that energetic, carefree little child inside throughout their lifetimes. For example, as Taira observed, the villagers do not hesitate to stop on each other’s doorstep to crack a joke on the way to and from their daily tasks. They also interweave jokes into their daily conversation with family members and strangers alike, making it pleasant and entertaining. For instance, when Ushi was asked about her new habit of wearing perfume, she joked that she had a new boyfriend. Or, when Toguchi, an old man in Ogimi, was asked about his secret to long life he answered playfully: a special drink he takes every night before bed that consists of garlic, turmeric, honey and, of course, local liquor. Okinawans effectively apply the therapeutic power of laughter in their lives.

Some health experts emphasize laughter as a powerful medicine that promotes physical, mental and social health and boosts the immune system. Laughter prevents heart attacks and other cardiovascular problems by improving blood vessel function and increasing blood flow. Laughter also promotes mental health by triggering the release of endorphins. These natural feel-good chemicals enhance resilience, improve mood, relieve stress, and ease anxiety and fear. According to these experts, laughter benefits the individual and the larger society by protecting and strengthening relationship against the destructive power of resentment, disagreement, and hurt. Okinawans treasure and welcome humor in their lives; in turn, humor showers them with joy and a good health that paves their way to smooth aging.

Another key factor to Okinawans’ graceful aging is their diet. Okinawans have discovered the direct relationship between a healthy diet and good eating habits and a long, quality life. This awareness is evident in elders’ daily advice, their food choice, and their eating habits. In other words, Okinawans do not eat only to survive; they eat to thrive. Therefore, their excellent health status is neither an accident, nor a pure product of genetic disposition.

Okinawans grow up under the guiding advice of their elders who model and encourage graceful aging. For example, a healthy and proud 101- year-old mother advises her 70-year-daughter to follow her footsteps if she too desires to live long: she must eat lots of vegetables and fish and she should avoid over indulging. Okinawans’ diet consists mostly of homegrown vegetables, seafood accompanied by rice, noodles and pork. According to a health article, 72% of Okinawans’ diet consists of grains, fruit and vegetables. People in other regions of the world might share similar diets, but their diet differs from Okinawans’ in some simple yet significant ways. For instance, in his study, Taira noticed a small twist in Okinawans’ diet that distinguished them from other nations including their Japanese counterparts: a balanced diet of fat and protein and low on salt. As he observed, Okinawans use lard to cook and had a greasier diet, compared to Japanese, yet were much healthier and lived longer. This did not surprise Taira because, “Fat is the mortar to protein’s brick when it comes to building and maintaining the outer membrane of every cell in the body” therefore, it should not be dreaded and eliminated from daily diet. The second differing factor in Okinawans’ diet compared to their Japanese neighbors, who hold the highest average of life expectancy in the world, was less salt consumption. Taira emphasized high consumption of salt if combined by low levels of calcium, potassium, and magnesium can raise the blood pressure dangerously and lead to fatal stroke, mainly in genetically susceptible people. These findings show the importance of food choice and proportion.

Yukio Yamori, a pathologist who headed a World Health Organization study of the links between diet and longevity for 15 years in 25 regions around the world, points out other dietary factors that promote health and lead to Okinawan longevity: the consumption of tofu and soybean products, seafood and seaweed. This study revealed that soybean products rich in isoflavonoids, estrogen-like compounds, help in calcium absorption, therefore, prevent osteoporosis. Soybeans might be the underlying factor in reducing the rate of breast and prostate cancer, Yamori adds. Okinawans gratefully consume whatever the sea abundantly offers, from seafood to seaweed, another dietary element that contributes to their health. Yamori states that seafood and seaweed, rich in protein and omega-3 fatty acids, keep arteries unblocked and ultimately lessen the risk of heart disease. Smart food choice has enabled Okinawans to avoid or postpone major health issues and diseases that cut other seniors’ lives short and negatively impact their quality of life. Pork, a meat that numerous health experts advise people to avoid, supplements Okinawans’ protein needs. It may be that the manner in which Okinawans prepare their pork, and the proportion they consume, does not jeopardize their health. According to Taira, Okinawans simmer pork for several hours and constantly skim off the fat. Then, they add chunks of this meat to noodles or the mixture of rice and vegetables. This way, they avoid over-consumption of fat while providing their body with another source of protein.

In addition to a calculated diet, eating habits also play a role in sustaining good health. Seniors frequently remind the younger generation to avoid overindulging by keeping one fifth of their stomach empty. To achieve this goal, Okinawans have adapted specific eating habits and arranged their plates accordingly. According to Badri, Okinawans eat several times a day but off of small plates. A healthy diet accompanied by good eating habits, therefore, is another key factor that promotes successful longevity in Okinawa.

Scientists examined Okinawans’ genetic make-up to determine whether they had a   genetic disposition to longevity. A study of independent and active Okinawan centenarians revealed the genetic disposition to longevity; nonetheless, the environmental factors still held greater significance. For example, Okinawan immigrants who reside in Brazil live 17 years less than Okinawans that live in Okinawa. While genetic disposition plays a part in Okinawan longevity, the environmental factors impose a greater impact.

I wish I could rewind time to share Okinawans’ secret to graceful aging with Grandma and her neighbors who, although they lived into their late eighties, did not age gracefully. Grandma passed away in 2006 as a result of a stroke at the age of 85, having had open-heart surgery several years before. It is hard to predict if sharing Okinawans’ secret could convince them to change their perspective toward old age and not dread it. They, of course, desired to enjoy their old age and live a disease-free life but just did not know if that was a possibility. Perhaps this new information about Okinawans’ diet and its incredible health benefits would motivate them to make some changes: to reduce salt and increase vegetables, seafood, tofu and soybean products in their diet and to eat meat and rice in moderation. This new information also might encourage them to continue what they were already doing right: community support, active lifestyle, a colorful diet of homegrown vegetables and fruit, afternoon naps, humor and laughter. Okinawans’ successful aging model leaves no place for individuals to blame old age for destroying later life’s quality, or to over-exaggerate the role of good genes in longevity.

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babrudi picSharlete Babrudi is pursuing a doctorate in psychology; she aims to help troubled teens overcome childhood adversity and realize their value. She spends her spare time scouring Colorado for antique treasures, surfing Craigslist for free furniture that her husband is endlessly refinishing, and cooking delicious Persian meals for her friends. She speaks four languages fluently and lives in Colorado Springs with her husband and two lively boys.

Photo By: Forks Over Knives