The old people's village on the island of immortals

The old people's village on the island of immortals
OKINAWA
PREAMBLE
Islands of health. What can we learn about healthy ageing from those who have themselves
grown oldest? Svenska Dagbladet's journalist Henrik Ennart – author of the book Åldrandets
gåta ('The Mystery of Ageing') – visited Okinawa with photographer Malin Hoelstad. This
Japanese island is classed as a 'blue zone', where people reach exceptionally high ages.
Sumiko Taira darts about, weeding her peanut patch. She is in a hurry, as the weekend is on
its way. "That's when my great-grandchildren come from town to get their vegetables", she
says, her face slightly stern.
As usual, Sumiko Taira has risen at six o'clock, had a light breakfast and cycled to the village
school, where she works as a school crossing supervisor. She's spent the rest of the day
pedalling around to her 15 vegetable plots scattered along the hillside. It's only when I
mention that Swedes stop working at 65 that she comes to a standstill, arms akimbo. A
surprised smile spreads across her face. "Ha, ha! 65!" she laughs, throwing her head back.
"They're still children. If you don't do anything, you'll lose your wits fast enough."
Sumiko Taira should know what she is talking about. She is 95 years old and the oldest of
five siblings who are all alive and over 85.
Almost anywhere else, this bundle of energy would be considered a remarkable force of
nature. But here in the village of Ogimi on Okinawa's north coast, she is just one of many.
For a thousand years Okinawa has been known among Chinese seafarers as the land of
immortals, and it is still home to many of the world's oldest people. The Japanese have the
world's highest life expectancy – 83.91 years – and the people of this island are the oldest of
them all.
Above all, it is the women who grow old. 86.88 years of life expectancy at birth is the highest
figure in the world, and the island's women also stay healthy longer. This has made Okinawa
an official UN region for longevity, and nowhere in this region are people as long-lived as in
the village of Ogimi, where we are now. At the latest census, 156 of the 3 386 villagers were
over 90, and 13 of them had turned 100. Thanks to these figures, Ogimi has become known as
'the old people's village'.
It was Makoto Suzuki who first described the phenomenon scientifically. In 1975, the then
young researcher from Tokyo heard about a famous centenarian who lived in the countryside.
He decided to go there, but only had a name.
"I stopped a woman who looked like 70 and asked for directions. She replied, 'Here I am!' I
couldn't believe it, she looked so young. Later, I found documents confirming her age",
Makoto Suzuki tells us around a table in his office in Okinawa's Ginowan City.
Methodically, Makoto Suzuki started to visit the island's old people, and today he has over
900 files carefully sorted on his bookshelves. "Every file represents a person who lived to
over 100", he says, pointing at the shelves. What has been collected in Makoto Suzuki's files
is nothing less than the world's first and longest study of people who have reached over 100
years of age. Without the Okinawa centenarian study, mankind would know much less about
how our lifestyle affects ageing.
Nowhere else is this link as clear as on Okinawa.
For the fortunate generations born in the late 1800s and early 1900s, who benefited both from
the island's traditional lifestyle and from new, modern hygiene and health reforms, life
expectancy started to rocket upward. But people did not just grow old - they were healthy too.
With an average BMI of 20.4 among the middle-aged, virtually nobody on the island was
overweight in the early 1960s. Heart attacks, diabetes and the cancers that are common today
were almost unknown.
When Makoto Suzuki started his work, he found 40 people on the island who were over 100
years old, and almost all of them were extremely healthy as well. Since then, the number of
old people has continued to increase on Okinawa, as in the rest of the world. At the time of
our visit, there are 920 people over 100 out of a population of 1.4 million.
In addition, a remarkably large proportion of all those who have reached 110 years of age
have lived on Okinawa, in total some 20 men and women. The oldest person right now is 113
years old. But the picture is being clouded. "There are more centenarians, but their health has
worsened", says Makoto Suzuki, shaking his head. The reason for this, he thinks, is the
second US invasion.
In 1945, Okinawa was the scene of some of the Second World War's bloodiest battles. It was
here, in the group of islands 1500 km south of the Japanese 'mainland', that the United States
first attacked the country's territory. The battles were terrible, with heavy losses on both sides.
After the war, Okinawa became a US military hub in the Pacific region. 50 000 American
soldiers, civilian employees and family members on the island's bases have left their mark.
Nowhere else in Japan are there so many fast food restaurants.
In spring 2012 it was reported that Okinawan men between 20 and 69 are now the fattest in
Japan. Almost half of them have a BMI over 25, so more people suffer from diabetes, cancer,
stroke and heart disease.
The consumption of quick-release carbs and sugar has increased dramatically and at the same
time the percentage of energy in food that comes from fat has risen from slightly over 10
percent in the 1960s to today's 30 percent, reflecting a higher consumption of meat and dairy
products and industrially processed fat. At the same time, the consumption of konbu, a
seaweed used in traditional cuisine, has plummeted by two thirds.
People over 80 still eat the traditional food, while the younger generations have been
Americanized. The impact is striking. Middle-age people under 65 now account for one in
every five deaths on Okinawa, and the worst affected are men. While the women are still the
oldest in Japan, in five years the men have dropped from 4th to 35th place among the
country's 47 prefectures.
One way to measure the incidence of exceptionally old age is to calculate the proportion of
centenarians. Okinawa has topped that list since 1973 and has 66 centenarians per 100 000
inhabitants today.
The drastic fall in the standard of health separates the age groups like a knife cut. Since the
island's population is mostly ethnically intact, this suggests, according to Makoto Suzuki, that
lifestyle trumps genetic factors. He has identified four crucial factors: the island's highly
unusual dietary habits, people's active and mobile lifestyle, a religion and philosophy of life
that relieves stress, and social participation and mutual support in the local community.
"Personally, I believe that a continued active role for old people in society and the particular
Confucian philosophy of life on Okinawa are as essential as food and physical activity," says
Makoto Suzuki. Almost all old people on Okinawa have an altar at home where they stop by
every morning to greet their ancestors. The feeling is that whatever happens, it was meant to.
The Okinawans are known not to rush, and one of the most common expressions is "Nan kuru
nai sa". "Don't worry, it will be okay".
When we drive up to Ogimi a few days later, we stop at Emi's restaurant in a small alley off
the main road. Emiko Kinjo worked as a dietician in Nago, in the middle of the elongated
island, when she decided, 23 years ago, that she wanted to learn how to cook the traditional
food eaten in fishing villages like Ogimi.
"In the past, there was nothing to buy in the shops and people had to grow everything they
ate. These were poor regions without rich soils and they could only cultivate what grew
naturally in the forests, such as papaya and goya (bitter melon)," Emiko Kinjo tells us after
we've taken our places around a table.
Just as the best wines are made from grapes that struggled on poorer soils, the vegetables on
Okinawa grow a little more slowly and don't grow to quite the same size, but they are also
more nutrient-dense than those grown on more fertile soils.
The year had two seasons, Emiko Kinjo continues her story. One when food was taken from
the sea and another when it came from the mountains.
Everybody was a fisherman, and what was left over was dried. Every family also had a pig
that was bred for the New Year's feast. They ate up just about everything on the pig and the
leftovers lasted for the whole year. The everyday food was fish. Beef or lamb didn't exist at
all. From the sea they also collected seaweed and algae, which remain an important part of the
island's cuisine.
Thanks to the climate on Okinawa there is always something ripening that can be eaten when
it is richest in vitamins. But Emiko Kinjo thinks the process of cultivating itself is equally
important for health. "Three times a day, 365 days a year, the elderly go to their gardens to
water them. They love to see their fruit and vegetables growing, they get great exercise and
they always have fresh vegetables to eat."
How do you live to a ripe old age?
"We already know the answer from history", says Mitsuhiro Yanaguida. He is one of the top
researchers recruited by OIST, the Okinawa Institute of Science and Technology, in which the
Japanese government has invested billions to create a world-class research institute. "The road
goes through semi-starvation, good and very nutrient-rich food, and physical activity. But
today, the challenge is not only to prolong life itself, but also to stay healthy longer. Above
all, it's about the brain."
One lesson from Okinawa is that 30 years ago, those who lived to over 100 were almost
completely free from dementia. Mitsuhiro Yanaguida believes the explanation lies partly in
some of the particular vegetables, herbs and algae belonging to the traditional cuisine. The
isolated island of Okinawa, sometimes called the Galapagos of the East, boasts a rich flora
with a great many rare herbs. While the island's elderly see their gardens as a place to grow
vegetables, Mitsuhiro Yanaguida thinks they are more like pharmacies bursting with healing
herbs.
But the nutrient-dense food is not the whole truth behind ageing. There is also starvation.
"Starving is excellent as long as you don't die of it. It puts your cells on their mettle, so they
can cope with hardship. Here on Okinawa the soils are red and poor. I myself have tried
gardening, and it's almost impossible to make anything grow. This has been a famine region
for many years", says Mitsuhiro Yanaguida.
Perhaps knowing that hunger is always lurking around the corner has encouraged thrift and
popularised the adage ”hara hachi bu”, which means roughly "eat only until you are 80
percent full." It takes the stomach 20 minutes to tell the brain it is full. This means you can
stop eating early and wait for satiation. If you eat until your stomach is full instead, you will
overeat by 20 percent.
"In the past, the longevity typical of Ogimi was a mystery, but not any more. We know what
to do to avoid becoming expensive oldies", says Mitsuhiro Yanaguida.
Eat little but well. Grow your own vegetables if you can. Get moving every day. Try to
achieve mental stability, and find security in your family. And finally interact within the local
community, so that neighbours help each other. "Let's be honest, there's little choice. The
alternative is ten years on your back in a hospital bed. "
84-year-old Iha Setsuk recently won the title of Miss Kitanakagusuku in a beauty contest
broadcast nationwide on Japanese national TV. The little village of Kitanakagusuku has just
overtaken the fishing village of Ogimi in the internal Okinawa age league - not because it has
more very old inhabitants, but because the slightly younger generation is managing to stay
healthy. Because so few middle-aged people die prematurely, Kitanakagusuku now has a life
expectancy of 89.3 years, the highest on Okinawa.
To ease the pressure on health care, a campaign for healthy lifestyle and ageing has been
launched. Iha Setsuk is now the health campaign's foremost ambassador. Kitanakagusuku in
the green hills is a slightly more prosperous, well-established middle-class area than the
simple fishing village of Ogimi. The older people there have rarely lived in the traditional
way of the people in the poor villages, but they have had education and the capacity to learn
from their experiences. I ask her what she thinks is the secret of healthy ageing. "Stay active",
says Iha Setsuk, smiling. "Do everything you can yourself, don't let anyone else do it for you."
Photo captions:
97-year-old Sayo Miyagi is weeding outside her house in Ogimi. She is in a good mood and is
taking the opportunity to tidy up the garden before her great-grandchildren come to visit at the
weekend. She believes that she has stayed healthy because she walked to and from her job
almost 10 kilometres away every day for many years.
"Plenty of people here are 90 years old. Old? Maybe you start to get a bit old at 85 or 90.
Those who are 70 or 80 are still young", says 93-year-old Hatue Yoshihama.
Like many others in Ogimi, she produces fabrics from palm leaves. The result, called bashofu,
is very thin and breathable but still a bit stiff, and it is perfect to wear as a kimono in the warm
and humid climate. Hatue Yoshihama usually works at the plantation between nine and eleven
in the morning. Then she returns home for a simple lunch and a short rest. At three she goes
back and works for three more hours.
Every evening her friends gather in the well-kept little garden to spend a few hours chatting
while the sun goes down. "We've known each other since we were children. We see that
everyone is well and talk about what we're going to do tomorrow. If someone doesn't turn up,
we know what she was planning to do," Hatue Yoshihama explains.
This kind of small group, known as 'moai', is based on an old tradition. Friends help each
other when necessary, by providing food or lending small amounts of money or other things.
"In the big cities many die alone. Here I have my life and my friends. "
Facts:
Is the sweet potato an elixir [sic] of life?
It wasn't until the hardy sweet potato was brought here in the 17th century that people finally
had a staple that wasn't immediately blown away by typhoons. A hundred years ago, four out
of five calories came from sweet potatoes. They were eaten for breakfast, lunch and dinner,
but nobody liked the taste of them, and as soon as new alternatives appeared in the 1950s
consumption fell rapidly.
However, the remarkable fact remains that the oldest ever generation on our planet lived
largely on sweet potatoes for the first 50 to 60 years of their lives.
None of the researchers on Okinawa would claim that this poor man's crop is an elixir of life.
That said, sweet potato is actually ranked the healthiest vegetable and is recommended by the
UN for consumption in countries struck by famine. The sweet potato, which is not related to
our potato, consists almost entirely of carbohydrate but is very rich in fibre which, unlike the
ordinary potato, gives it a low GI. It is a rich source of almost everything missing from
famine regions: energy, vitamin C and beta carotene, which counteracts blindness, plus
protein, calcium, potassium, magnesium and iron. In addition, the sweet potato is said to
stimulate the body's production of sex hormones.
The term "blue zones" was coined by two famous demographers, the Belgian Michel Poulain
and the Italian Gianni Pes, and was first used in a scientific article in 2004.
"We used to sit with a map and circle the villages with the oldest people with a blue ballpoint
pen. That's why it seemed natural to call these areas blue zones", says Gianni Pes when
interviewed in the book Åldrandets gåta.
A standing stone near the beach in Ogimi bears a medieval proverb engraved in its surface:
"At 70 you are nothing but a child,
at 80 you are barely a youth,
and at 90, if your ancestors invite you to Heaven, ask them to wait until you are 100
... then you can think about it."
The interest in regions where people live unusually long took off in the early 1970s, when
National Geographic sent out Harvard researcher Alexander Leaf on a number of expeditions.
Many of the places he reported on were later discarded, as the ages the inhabitants claimed –
up to 167 years – could not be documented and were clearly incorrect in many cases.
The research fell into disrepute and has only recovered in recent years, when a new generation
of researchers with new methods and a critical approach has taken on the task. Many places
that were declared 'blue zones' have therefore been written off, but in a handful of cases
research results show that islands of longevity really exist.
Long life menu:
Islanders who ate a traditional diet consumed an average of 18 different plants every day.
Important ones were seaweed and algae like konbu, wakame, hijiki, mozuku and nori.
Seaweed is rich in vitamin B12, which explains why old people have done so well on a
virtually meat-free diet. The vegetables, like goya, often have a distinct smell and colour, a
somewhat sticky texture and a bitter taste. Goya contains at least three substances that lower
blood sugar.
A common spice is turmeric, which contains curcumin. It is anti-inflammatory, boosts the
body's defence against free radicals and has been promoted for its effect against cancer. The
traditional diet on Okinawa is low in calories. A typical meal is three to four times the size of
a hamburger and has more vitamins and minerals, but only half as many calories. The
consumption of green and yellow vegetables is very high.
The diet contains practically no dairy products or eggs.
The protein, about 75 grams per day, was mainly from tofu and on Okinawa they produce a
more solid type with a higher concentration of protein, flavonoids and various fatty acids than
in the rest of Japan or China. The food contained very little fat, mostly mono- and
polyunsaturated fat.
The carbohydrates came mainly from sweet potato, rather than rice. The food contained
almost no sugar and significantly less grains and cereals than in the rest of Japan.
The content of this article does not reflect the official opinion of the European Union. Responsibility for the information and views expressed therein lies entirely with the author(s).