How the Okinawan diet can improve your health

According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), 80% of heart disease and Type 2 Diabetes Mellitus along with 40% of cancers could be improved simply by eating better, moving more and quitting smoking!

Okinawans over the age of 65 have some of the world’s highest life expectancy.  Men live to about 84 and women live to about 90. They have one fifth the rate of heart disease, breast and prostate cancer.  They also have less than half the rate of dementia seen in Americans. Given these amazing statistics, it is worthwhile exploring their dietary habits to see what lessons we can learn.

The core of the traditional Okinawan diet was sweet potato (imo), green-leafy or yellow-root vegetables and soybean based foods.  Sweet potatoes are excellent sources of vitamins such as A, C, and E. They also contain many anti-inflammatory phytochemicals. In addition, they have a low to moderate glycemic index (34 to 55).

Surprisingly, there is very little dairy, rice, and grains in the traditional Okinawan diet. Roughly 33% of calories from traditional Okinawan diet are from grains versus 75% in the Japanese diet. Also, most of the grains consumed have low glycemic load.

Although traditional Okinawans were not vegetarians, their eating patterns were close. Part of this reason had to do with finances. The typical traditional Okinawan family could rarely afford meat, processed foods such as sugar, salt, cooking oils or imported polished white rice.

When meat was eaten, it was usually around a celebration. For example, a pig slaughtered early in the year at festival time might be consumed over the remainder of the year. Interestingly, the livestock that was kept was very different from what we see in the western world. The animals were “free-range” and fed vegetables that were being thrown away. Consequently, the animal meat had higher levels of Omega-3 fatty acids and less saturated fats and Omega-6 fatty acids.

Unfortunately, a lot of this changed post World War II. Milk, meat, eggs and chicken consumption has increased seven-fold. This has resulted in an increase intake of protein, saturated fat, cholesterol, sodium and refined carbohydrates. The staple sweet potato is being replaced with white rice, breads and noodles. The availability of less healthy foods has resulted in more obesity, diabetes, heart disease and cancer.

There is a lot to be learned from the traditional Okinawan diet and returning to that style of eating is more important than ever before. The action steps you can take to eat more like the traditional Okinawan diet are:

  1. Eat lots of unrefined, low glycemic index carbohydrates such as vegetables, legumes, fruits
  2. Incorporate fish into your diet
  3. Minimize red meat and focus on lean meats.
  4. Minimize fat and opt for foods with high monounsatured and polyunsaturated fats to saturated fats ratio.
  5. Focus on high fiber foods
  6. Add soy based foods.


Willcox DC, Willcox BJ, Todoriki H, Suzuki M. The Okinawan Diet: Health Implications of a Low-Calorie, Nutrient-Dense, Antioxidant-Rich Dietary Pattern Low in Glycemic Load. J Am Coll Nutr. 2009 Aug;28 Suppl:500S-516S.

Willcox DC, Scapagnini G, Willcox B. Healthy aging diets other than the Mediterranean: A Focus on Okinawan Diet. Mech Ageing Dev. 2014; 136-137: 148-162. Doi:10.1016/j.mad.2014.01.002

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Sean Hashmi MD
Articles: 56

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