Why the traditional Okinawan diet is the recipe for a long life

The Mediterranean diet gets loads of attention for being one of the healthiest approaches to eating on the planet—and it’s well deserved. But there's another super-healthy diet that's often overlooked: The traditional Okinawan diet, which is loaded with plant-based foods and is anti-inflammatory and rich in antioxidants and phytochemicals, which are health-promoting compounds in plants. In fact, the traditional Okinawan diet is associated with greater longevity compared with eating habits in other parts of the world. 

Okinawa is one of the famous Blue Zones, the geographic regions around the world that have the highest concentrations of people who live to age 100 or older. While there isn’t nearly as much research on the benefits of the Okinawan diet as there is for the Mediterranean diet, the dietary principles behind it are sound and mounting research is revealing how this diet can contribute to good health. For example, when people followed an Okinawan-based diet for 12 weeks, they not only lost weight but their blood sugar, insulin, and cholesterol levels, also decreased and they experienced positive changes in their gut microbiota, according to a study in 2023 issue of the journal Nutrients.  

What makes the traditional Okinawan diet so beneficial for human health? There are many factors. 

“It’s low in calorie density and high in nutrient density and fiber,” says Craig Willcox, a professor of gerontology at Okinawa International University and head of research and codirector of the Okinawa Research Center for Longevity Science. “It’s rich in phytonutrients, including lots of antioxidants. It’s low in glycemic load, and it’s anti-inflammatory.” This is significant, Willcox adds, because “chronic low-grade inflammation at the cellular level drives the aging process and age-related diseases such as heart disease, stroke, diabetes, and cancer.” 

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The diet is also beneficial for immune function. Research has found that people who regularly eat Okinawan vegetables and fruits have higher levels of antibodies—including IgA, IgG, and IgM—that help protect the body from viral and bacterial infections. What’s more, there’s growing recognition that foods in the Okinawan diet may contribute to long-term brain health, helping to reduce the risk of developing age-related cognitive impairment.  

“If you’re interested in healthy aging, it’s the perfect diet,” Willcox says. “A lot of these foods turn on FOXO3, the longevity gene, which slows telomere shortening and reduces inflammation.” (Telomeres are the protective caps at the ends of your chromosomes, which prevent the genetic material inside from unraveling; as a result, they help determine how fast your cells age.)

The diet’s origins and essential foods 

Located in the southernmost islands of Japan, Okinawa has been home to one of the longest living populations in the world. This is believed to be linked to the traditional diet and overall lifestyle, says Asako Miyashita, a dietitian in New York City who grew up in Japan. “They spend lots of time outdoors, and eat small amounts of each food throughout the day, everything in moderation.”

Compared to the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) plan, the traditional Okinawan diet is the lowest in fat (especially saturated fats) and the highest in carbohydrates. In fact, the proportions of macronutrients in the Okinawan diet skew heavily toward good-quality carbohydrates (like sweet potatoes, other root vegetables, and leafy greens)—with 85 percent carbohydrates to 9 percent protein and 6 percent from fats, including omega-3 fatty acids.

In the traditional Okinawan diet, the staple carbohydrate is the antioxidant-rich sweet potato (not just the orange variety but purple and white ones, too), rather than rice as it is in the Japanese diet. “The sweet potato is a high-quality carb so it doesn’t whack out your blood sugar levels,” Willcox says.

Other core foods include large amounts of soy foods (including soybeans, tofu, and miso soup), leafy greens (including spinach, mustard greens, mizuna, and cabbage), legumes, root vegetables (such as carrots, taro, pumpkin, squash, and daikon radish), mushrooms, various seaweeds, fish, fruits (like bitter melon, grapes, bananas, and green papaya), with smaller amounts of meat (particularly pork). Favorite beverages include tea (especially jasmine) and sake. Commonly used seasonings include turmeric, ginger, bonito flakes, soy sauce, and garlic. 

In fact, one study found that tofu and various types of seaweed were the most frequently consumed foods among residents of the village of Ogimi, at the north end of Okinawa. Seaweed contains lots of minerals, which helps maintain a good electrolyte balance in the body and protects neurological and brain function, says Miyashita. 

“It’s a remarkably healthy diet because it adheres to the fundamental theme of healthy eating—it’s real food, mostly plants in a sensible, balanced assembly,” says David Katz, a preventive medicine specialist, past president of the American College of Lifestyle Medicine, and co-author of How to Eat: All Your Food and Diet Questions Answered. “Optimal nutrition keeps everything working well so that you keep working well. By putting good fuel in the tank, you’re optimizing the engine and you’re essentially detoxing every day.” 

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Another noteworthy aspect of the traditional Okinawan diet is the concept of food as medicine, says Willcox, coauthor of The Okinawa Program: How the World’s Longest-Lived People Achieve Everlasting Health—and How You Can Too. In the traditional Okinawan diet, plants, including herbs and spices, are often used for therapeutic purposes. 

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For example, jasmine tea is known to adjust the autonomic nervous system in ways that have a relaxing effect, notes Miyashita. And research has shown that regularly drinking antioxidant-rich Ishimaki tea (made from extracts of Ooitabi leaves, a plant native to Okinawa) for three months can reduce blood pressure and improve lipid abnormalities. 

Among the things that are noticeably absent from the traditional Okinawan diet: Processed foods, refined sugars, and lots of red meat. And “there’s not a lot of dairy because they didn’t have animals to produce it,” says Keith Ayoob, a dietitian in New York City and an associate professor emeritus of pediatrics at the Albert Einstein College of Medicine.  

“What it has in common with the Mediterranean diet is [the Okinawan diet] wasn’t designed to treat a chronic health condition,” says Ayoob. “It was just part of their culture and it evolved.” 

Bringing your mind to the table

Part of the traditional diet’s magic stems from the Okinawan attitude toward eating.

The Okinawans embrace a concept called hara hachi bu, a practice that encourages people to stop eating when they feel 80 percent full. “It’s a really good recommendation,” says Ayoob, “because you might feel 80 percent full now but in 15 or 20 minutes, you might feel 100 percent full.” That’s because it takes that long for your brain to register satiety. 

Besides preventing overeating, this practice allows for a natural form of mild calorie restriction that helps with weight management, healthy digestion, and metabolic health. And because the primarily plant-based diet is low in calories, high in nutrients, and high in volume, Willcox says, it contributes to satiety and weight control.  

Traditionally, “Okinawans have been lean, which is healthy,” Katz says. 

In recent decades, the traditional way of eating in Okinawa has given way to a more Westernized approach. This trend may have started when the American military brought Spam—the pink, canned pork product—to Okinawa during World War II and it was quickly adopted into favorite local dishes like champuru (a stir-fried dish). Since then, white rice and eggs have become more commonly used in Okinawa, and fast-food joints have proliferated on the island. Not surprisingly, obesity, and hypertension rates, have been climbing in Okinawa in recent years. 

If the people of Okinawa and elsewhere can return to the traditional Okinawan diet, it would do their health a world of good, experts say. It’s good for the planet, too. “These days, any discussion of diet and health needs to address sustainability and planetary health,” Katz says. “People have lived on the Okinawan diet for generations. It’s sustainable.”