HEALTHY AT 100 (13 page)

If we are going to get serious about cancer prevention, there is much to be learned from the elder Okinawans. Why? Because when it comes to cancer, the medical data for these fortunate people are nothing short of amazing. Despite living to such extremely old ages compared to North Americans, their cancer rates are orders of magnitude better than those found in the West.
Compared to someone in the United States, an Okinawan elder is 85 percent less likely to die from breast cancer, 88 percent less likely to die from prostate cancer, 70 percent less likely to die from ovarian cancer, and 70 percent less likely to die from colon cancer.

These are staggering statistics. And behind these numbers is the unrelenting reality of how many people in the West are suffering and dying needlessly.

While prostate cancer is the most common cancer in males in North America and Europe, and the second leading cause of death from cancer among males in the modern industrialized world, it is extremely rare in Okinawa. When researchers in the Department of Urology at Ryukyus university conducted a study on prostate cancer in Okinawa, they found so few cases that they never bothered to publish the results.
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Most Okinawan men have never even heard of the disease.

Breast cancer kills forty-six thousand women in the United States each year. On average, each of these women has her life cut short by twenty years. But these numbers tell us nothing of the personal anguish and suffering, the immense financial burdens, the motherless children, and the shattered families that result.

Just about every adult in the Western industrialized world knows someone who has breast cancer or who will get it. It is so common
that if one of your sisters doesn’t develop it, one of your daughters or cousins probably will. In contrast, the Okinawan medical research team tells us:

If you are an Okinawan woman, the chances are that no one you know has breast cancer or will develop it. You may have heard of it but never seen it—it is that rare.…You have to put 100,000 Okinawan women in a room to find six who will die from it.
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This is a stunning finding for a fully industrialized society. You might imagine that if such low breast cancer rates were to be found anywhere, it would be some place like Hunza or Vilcabamba, places so pristine that their residents have remained unexposed to the carcinogenic chemicals that permeate our environment today. Or perhaps such a low breast cancer rate would be found in a society where people do not live long enough to get cancer.

But the extremely low rate of breast cancer among the elders in Okinawa cannot be explained by a lack of chemicals or pollution, nor by shortened life spans. Three of Okinawa’s rivers now rank among the five most polluted rivers in Japan.
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And life spans among women in Okinawa are the longest ever fully documented for any nation or region in world history.

Another of the afflictions that cause a great deal of suffering among older people in the United States, particularly among postmenopausal women, is osteoporosis. You can probably guess what I’m going to say next. Yes, Okinawans are immensely favored here, too. The Okinawans have much stronger bones, and less than half as many hip fractures as North Americans.
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In the West, postmenopausal women have often been told to take estrogen replacement therapy to protect their bones and their hearts and to reduce menopausal symptoms. They’ve been told that if they don’t take estrogens, their risk for heart disease and osteoporosis will
skyrocket. For years, Premarin was the best-selling pharmaceutical drug in the United States—even though we now know it had the unfortunate side effect of elevating breast cancer rates.

In Okinawa, however, aging women have not sought help from drug companies. For them old age is typically a time of vitality, peace, and opportunity. While millions of women in the West have taken estrogen replacement therapy, virtually no elderly Okinawan women have done so.

One of the reasons is that you don’t have to replace what you haven’t lost. According to the Okinawa Centenarian Study, the average 100-year-old Okinawan woman has about the same estrogen level as the average woman in the United States who is thirty years her junior.
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This is a remarkable finding, because estrogen levels in women naturally decrease as they age, and very low estrogen levels are often a marker for advanced aging. And it helps explain why—without taking drugs—menopausal and postmenopausal women in Okinawa have far fewer hot flashes, less than half the hip fractures, and 80 percent less heart disease than do women in the United States.

While postmenopausal estrogen decline in women has received a great deal of press, there is a parallel problem in men. In the United States and other modern Western nations, testosterone levels peak in most men during their thirties and decline after that at a rate of between 1 and 2 percent per year. It is increasingly recognized that this decline can have serious health implications in older men, particularly when it is severe.
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Classic signs of testosterone deficiency include thinning hair, decreasing libido, increasing body fat, declining muscle mass, memory problems, decreasing vitality, and higher rates of depression.

The Massachusetts Male Aging Study is one of many studies to confirm that good health among older men correlates with higher levels of testosterone. This study and others have found higher levels of bioavailable testosterone to be associated with greater bone density,
decreased risk for hip fractures, increases in muscle strength, and better heart health.

Men who maintain higher testosterone levels as they age have significantly less heart disease and fewer symptoms of mental senility when compared to men with low levels of testosterone.
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Higher testosterone levels are also correlated with improved erectile capability in men. Not surprisingly, an ever-increasing number of older men in the West today are beginning to experiment with testosterone products, hoping to attain the benefits of the levels they enjoyed when they were younger. In Okinawa, however, this is not necessary.

The Okinawa Centenarian Study found that elder Okinawan men have testosterone levels nearly identical to those found in American men thirty years younger.
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Hence the following story:

A very elderly gentleman was sitting on an Okinawan bus. The bus was crowded, and people were standing in the aisles. The elder noticed a pretty girl standing in front of him. Chivalrously, he offered her his seat. “I know I’m an old man, but I would be pleased if you would take my seat.”

“Thank you,” she said with a smile, “but I don’t mind standing.”

The bus continued along its jerky way, until it stopped abruptly, throwing the standees about, with the young woman landing on top of the elder gentleman. As they disentangled, the man offered again. “I don’t want to see you tossed about. If you won’t take my seat, why don’t you just sit on my lap so there won’t be so much crowding?”

She smiled and perched herself on his lap. The bus bumped its way along its route.

After a minute or so, the elder Okinawan gentleman tapped the young lady on the shoulder. “Young lady,” he said, “I think you had better stand up again, because I am not as old as I thought I was.”

What could account for the many marvelous health advantages enjoyed by the elder Okinawans? As in Abkhasia, Vilcabamba, and
Hunza, there is in Okinawan culture a tremendous respect for the elderly, and also a profound sense of sharing and caring for others at all stages of life. And as is true in these other societies, Okinawans have always had a great deal of physical exercise built into the daily practices of their lives. One difference, though, is that instead of living at a high elevation with thin, pure air and a lot of uphill exercise, most Okinawans live at or near sea level.

If you ask the elder Okinawans themselves for the key to their legendary health and longevity, they most often point to the simple, nutritious, and wholesome food they eat.

In the West, we often look to food for entertainment, amusement, distraction, and compensation for emotional and sensory deprivation in other areas of our lives. But in Okinawa, people think about food in an entirely different way. Many of the traditional Okinawan proverbs about eating sound like phrases you might find on the wall of a health food store in the West. One such proverb translates as “Food should nourish life—this is the best medicine.” And another: “One who eats whole food will be strong and healthy.”

What does modern science say about all this? According to the researchers who conducted the Okinawa Centenarian Study, the elders’ diet has indeed played a profound role in the health they have attained. Thanks to these researchers’ meticulous investigations, we have an extraordinarily detailed picture of the foods the elders have eaten. And we can see that the diets of the world’s exceptionally healthy and long lived peoples have a great deal in common:

• They are all low (by Western standards) in overall calories.
  

• They are all high in good carbohydrates, including plenty of whole grains, vegetables, and fruits.
  

• They are all “whole-foods” diets, with very little (if any) processed or refined foods, sugar, corn syrup, preservatives, artificial flavors, or other chemicals.
  

• They all depend on fresh foods, eating primarily what is in season and locally grown rather than relying on canned foods or foods shipped long distances.
  

• They are all low (though not super-low) in fat, and the fats
  come from natural sources, including seeds, nuts, and in some cases fish, rather than from bottled oils, margarines, or saturated animal fats.
  

• They all derive their protein primarily from plant sources, including beans, peas, whole grains, seeds, and nuts.
  

One of the most telling of all the differences between the traditional diets in Abkhasia, Vilcabamba, Hunza, and Okinawa and the modern American diet is that they are all much lower in overall calories. Even with their very active lifestyles, the average man in these regions consumes only around 1,900 calories a day. In the United States, in contrast, where lifestyles are far more sedentary, the average man consumes 2,650 calories a day.

And many Americans eat far more than that. In the documentary
Super Size Me
, filmmaker Morgan Spurlock ate all his meals at McDonald’s for a month, easily consuming more than 5,000 calories a day. Of course, it’s not just McDonald’s. A single order of fries and a Thickburger at a Hardee’s restaurant add up to more than 2,000 calories. On the dessert front, a single slice of Cheesecake Factory’s carrot cake has more than 1,560 calories. And Americans typically eat huge desserts
after
consuming fatty, high-calorie meals.

From the point of view of people in the longest living cultures, however, they aren’t eating a “low-calorie diet.” From their perspective, the food
we
eat is
high
in calories. And they have a point in seeing our caloric standards as extravagant rather than seeing their intake as restricted. While we are busy consuming greasy burgers, sugar, white flour, and other high-calorie, low-nutrition foods, these societies have attained extraordinary health and longevity on diets that provide far more essential nutrients than standard American fare while remaining far lower in overall calories.

The Okinawans almost never overeat, because they like to leave some room in their bellies at the end of each meal. They don’t like feeling “stuffed.” This actually makes quite a bit of sense, because of an interesting quirk in human physiology. You may have noticed that you sometimes feel more full about twenty minutes after you stop
eating than you did while you were still eating. This is because it takes the stretch receptors in your stomach about twenty minutes to tell your brain (via the hormone cholecystokinin) how full you really are. If you eat until you experience yourself to be 100 percent full, you actually go about 20 percent over capacity with every meal. And if you do that regularly, your stomach will stretch a little bit each time to accommodate the extra food. Then you have to eat more next time to get the same feeling of fullness.
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This is one of the reasons it is more satisfying and healthful to eat slowly. When you aren’t rushing, your stomach has time to signal to the appetite centers of your brain that food has arrived, and you experience greater pleasure and contentment.

The elder Okinawans say they stop eating when they are 80 percent full. They say they “eat less in order to live longer.” For them, this is just common sense and the way of their traditions. But everything we are learning from the latest medical research on successful aging confirms the wisdom of their principles.

When Dr. Richard Weindruch and Dr. Rajinder Sohal, world leaders in studies of low-calorie diets, wrote about the Okinawans in
The New England Journal of Medicine
in 1997, they pointed to the low (by American standards) caloric intake of the elder Okinawans as a key factor in their outstanding health and life expectancy.
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Similarly, Professor Yasuo Kagawa of Jichi Medical School, who has studied the Okinawans, attributes their longevity and health primarily to the relatively low amount of overall calories they consume.
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These researchers have good reason for thinking this way. One of the most remarkable findings of modern scientific research is that no intervention, including the elimination of smoking, has been found to be as important in overall life extension as cutting back on calories while maximizing dietary nutrients.

Many researchers have contributed to the development of this understanding, but few more than Roy Walford, M.D., who has long been recognized internationally as one of the top experts in the field of gerontology. His research at UCLA was funded for more than thirty-five years by the National Institutes of Health, and he published more than 350 articles on aging and health in medical journals. He writes: