Food in Relation to the Elderly People of Okinawa Japan

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This article explores the impact of food on the health of elderly people in Okinawa Japan. It discusses the benefits of the Okinawa diet, such as low prevalence of diseases and high life expectancy, as well as the negative impacts, such as oxidative stress and malnutrition. It also suggests ways to remove the negative health implications from the Okinawan diet.

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Running head: GLOBAL PROSPECTIVE 1
Food in Relation to the Elderly People of Okinawa Japan
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GLOBAL PROSPECTIVE 2
Introduction
Social Determinants of Health (SDH) refers to the situations in which people are born,
grow, age, live, or work. In simpler words, these are the circumstances that controlled power,
money distribution, and global resources, at local or national levels. Additionally, the SDH are
held responsible for the health inequalities such as the avoidable and unfair disparities that
determine the health status within countries worldwide. Further, the SDH may be categorised
under the intangible factors such as cultural constructs, socioeconomic, and political that are
characterized by accessible education systems, health care, safe conditions in the environment,
presence of healthy foods, and well-designed neighbourhoods (Ohlsson, 2019). Therefore, food
is selected as the social determinant of health and the elderly population of Okinawa Japan is the
chosen population.
The relevance of the Social Determinant of Health to the Selected Population
To begin with, the selected population is recognized to have the highest life expectancy
rates in Japan for the last 30 years before the 20th century. Most of the residents in Okinawa
Japan live the longest life span and about two-thirds of the population who hit 100 years seemed
to live an independent life until when they were 97 years. This specific population is associated
with a low prevalence of diseases like stroke, heart disease, diabetes, and cancer. It is clear that
the Okinawa are keen on the diet as the vital factor that is why they have a long life span. This is
because most of the elderly people at Okinawa Japan eat a traditional local diet that include soy
products, vegetables, and kinds of seafood as outlined by scientists from the Eat-Lancet
Commission (Le Couteur et al., 2016). From a wider perspective, Okinawa’s consumed foods
that included green leafy or yellow roots vegetables, sweet potatoes, lean meat, and
contemporary kinds of seafood, bitter melons, tofu, tea, and fruits. The Okinawa’s also ate the
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GLOBAL PROSPECTIVE 3
miso soup, freshly jasmine tea, and vegetable stir-fry that included a side dish (Le Couteur et al.,
2016). Clearly, Okinawa’s consumed a diet that had low-calories, high carbohydrates that were
acquired from the sweet potatoes, nutrient-rich, and moderate proteins.
In most cases, elderly people preferred refined grains, sparse amounts of meat, dairy
products, or sugars. The ratio of proteins to carbohydrates in the Okinawa’s diet is one is to ten
and it is the key factor that helps to optimize the life span of the elderly population. According to
Shelley Maniscalco who is a dietitian, the eating habits of the Okinawans in Japan have a variety
of positive impacts even though she did not say that people should follow them exactly. The
main reason why the Okinawa diet is recommended is that it constitutes many fruits that are
associated with significant health benefits (Darwiche et al., 2016). Additionally, the kinds of
seafood and whole grains provide significant benefits that ensure the elderly people live long and
stay healthy. By comparing the Okinawa diet for elderly people with that of the United States, it
is clear that the latter does not include enough fibre and other important nutrients. The diet for
the people in the United States is sophisticated with sugar, fat, cholesterol, and salt that
minimizes the life span of the elderly.
Further, the Okinawans practice the Hara Hachi Bu that requires them to eat until they are
80% full to avoid consuming a lot of calories. High-calorie intake is associated with increased
risk of illnesses that are related to aging factors such as cancers, heart disease, and Type 2
diabetes, and others such as obesity and overweight health issues (Tacon&Metian, 2018). People
are not encouraged to switch to the Okinawan diet to acquire the benefits but the most crucial
thing is to recall that there is an opportunity for individuals to blend into cultures of others
particularly on the basis of healthy diets. This is because in case an individual attempts to follow
the Okinawan diet, they may not have access to plentiful fish and native vegetables
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GLOBAL PROSPECTIVE 4
(Tacon&Metian, 2018). However, there is a likelihood that people can adapt to consuming other
leafy vegetables and lean protein. Leading healthier lifestyles is important especially for the
older people of Okinawa are an important aspect as it increases the sense of belonging and their
social role.
Positive Impacts
Food for Okinawa’s elderly people is associated with positive and negative impacts. To
begin with the positive impacts, the Okinawa's diet plays a significant role in ensuring that they
age well. It is important to note that they not only live longer, but they also age gracefully as
centenarians research showed that they were energetic, lean, and they also experienced low rates
of chronic diseases like cancer (Tacon&Metian, 2018). Willcox, Willcox, Todoriki& Suzuki
(2011) argues that the foods for the elderly Okinawa people have less free radicals based on the
tests conducted for their blood. This benefit is evident as older Okinawa people eat food with a
low amount of calories. Low amounts of calories result in low radicals as they form during the
digestive process (Willcox, Scapagnini & Willcox, 2014).
Another benefit of the Okinawa diet is that the hearts of older people are in great
conditions. Gavrilova &Gavrilov (2012) indicates that 80% of Okinawans are at low risk of heart
diseases. Additionally, Okinawans have healthy arteries, and they consume foods with low
homocysteine and cholesterol levels. Further, the older Okinawans are engaged in regular
physical activity, they take low alcohol intake, embrace positive attitudes, and they are
nonsmokers. Another benefit of the Okinawan diet is that older people are at lower risks of
cancer. Particularly, 50% are at low risk of colon or ovarian cancer, while 80% are at low risk of
prostate or breast cancers (Willcox&Willcox, 2014; Willcox, Willcox, Todoriki& Suzuki, 2011).
Due to the Okinawan diet, the older women experience menopause naturally. Most of the women

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GLOBAL PROSPECTIVE 5
do not require the replacement of estrogen even when they experience menopause-related
problems. Another benefit of the Okinawan diet to the older people is that they are happy. This is
because most of them maintain positive lifestyles, and also, they are stress-free. Okinawans also
have unique coping skills that reflect their purpose, meaning, and spirituality. The bottom-line of
the Okinawan diet to the older people is that they live a healthy lifestyle; they are free from
illnesses hence they live longer.
More benefits of the Okinawan diet is that it is antioxidant rich particularly the low-Gi
sweet potato. Notably, sweet potatoes are dicotyledonous plants that are often mixed with greens
and miso soup. Sweet potatoes are recognized as highly nutritious foods that limit the prevalence
of chronic diseases among elderly people. Additionally, sweet potatoes are used as traditional
medicine for the elderly people of Okinawa Japan over the years. As mentioned earlier,
flavonoid-rich tofu and soy foods make the Okinawan diet and they have significant health
benefits among the elderly population of Okinawa Japan. The significant health benefit is that
they have a low content of calorie and they are rich in fibre. They also have antidiabetic elements
such as vaccine, charantin, and polypeptide. The Konnyaku is also among the Okinawa foods
that have significant health benefits among the elderly. This is because it also constitutes low-
calorie intake, and also, they are rich in calcium and fibre that strengthens the bodies of the
elderly population. Further, the mushrooms are highly consumed by the elderly population of
Okinawa and they are linked to immunomodulatory, lower lipids, antitumor, and other
therapeutic impacts. The seaweeds have health benefits such as high iodine content, folate,
nutrient-dense, and low-calories. Lastly, the older Okinawas consumes the turmeric as it has folk
medicinal properties.
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GLOBAL PROSPECTIVE 6
Negative Impacts
On the other hand, the food as a social determinant of health has significant impacts on
the elderly population of Okinawa Japan. For instance, the paradigm of the Free Radical Theory
of Aging is associated with oxidative stress due to aging. As mentioned earlier, Okinawa is
recognized as the population with the longest-lived people. However, the issue of oxidative
stress among the elderly population is not very well researched. Suzuki et al (2010) argue that
human longevity is viewed as a complicated phenomenon that is influenced by genetics,
environment, or opportunity. For this reason, the mechanism that links to aging and contributes
to longevity needs to be analyzed to provide various advantages to the elderly population of
Okinawa Japan. Suzuki et al (2010) find that during aerobic respiration, elderly people of
Okinawa produced oxygen radicals like any other person that results in oxidative destruction in
the DNA, tissues, cells, and other organisms that later causes aging and death. Most foods have
different concentration of the tocopherol. For instance, soy oil constitutes 60% tocopherol, while
the sunflower oil constitutes 90% tocopherol. After evaluating the Okinawa diet, few of the
foods are endowed with a significant content of tocopherol but the traditional ones such as hot
red peppers, brown seaweed contains tocopherol. The current research depicts that the Low
Plasma (LPO) level increase with age particularly in Okinawa Japan that impacts the long-lived
populations as they drop at a significant rate. The elderly people of Okinawa Japan are also
characterized to have low lipids in the blood, and also, they have lower tocopherol levels that the
other population.
As mentioned earlier, the Okinawan diet contains fewer meal portions, fish, and yellow
vegetables as compared to the other population of Japan. Additionally, fish and pork are served
with various herbs and ingredients. The Satsuma sweet potato is the heart of the Okinawa diet
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GLOBAL PROSPECTIVE 7
and they do not have significant impacts on blood sugars of the elderly population
(Teschke&Xuan, 2018). Further, the bitter melon consumed by Okinawans has anti-diabetic
impacts. All the foods outlined that make the Okinawan diet have low calories which are
considered as harmful to the elderly population. Willcox et al. (2010) hold that consuming a diet
with low-calorie restriction in the long-term is associated with reduced age-related illnesses to
increase longevity but its side effects are unknown. However, researchers embark on an analysis
that shows that low-calorie intake causes the Okinawans to lose their dietary advantage in the
long-term. This is because life expectancy also seems to be decreasing especially the men in the
elderly population (Willcox &Willcox, 2014). Another risk of low-calorie intake is that it
contributes to poor lactation and low birth weight. Just like it happens to animals, a low-protein
intake has harmful impacts in humans especially the elderly population of Okinawa as they are
highly vulnerable to pathogens. Notably, the Okinawans pass low-calorie intake from a single
generation to another that leads to low expectancy rates in the long-run.
Gavrilova &Gavrilov (2012) argues that most of the elderly people of Okinawa Japan
suffer from malnutrition that risks longevity. It is important to note that Japan is highly known to
have the shortest life spans compared to the western countries such as Singapore and Australia
despite that the Okinawan people were said to live longest. It is clear that most Okinawans
restricts their diet assuming that it is a way of extending their life but it contributes to severe
malnutrition. The main implication of malnutrition is that mothers pass devastating impacts on
the younger generations. The Okinawan diet compromises the health of the mothers and their
children hence there are higher mortality rates among the older people. This is because the older
people of Okinawa have a low weight that also compromises their longevity. Research shows
that low birth weight is associated with increased risks of chronic illnesses on the life of elderly

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GLOBAL PROSPECTIVE 8
people of Okinawa Japan (Willcox&Willcox, 2014). At some point, the Okinawans Japan tends
to westernize their diet and it has been seen to contribute towards their loss of the longevity
advantage. However, regardless of the negative impacts, the Okinawa diet has high nutrient
intake and it contributes to long life spans among the elderly population.
Removing the Negative Health Implications from the Okinawan Diet
While the Okinawa diet has been proven to have all the aforementioned benefits, there
are still some downsides to the diet. One of the drawbacks of the diet is that it is fairly restrictive
in the sense that it excludes multiple groups of foods which would be certainly healthy to the
body (Rizza, Veronese & Fontana, 2014; Dato et al., 2013). Among other things, this means that
one cannot one can hardly adhere to diet hence limiting essential nutrient sources. Also,
depending on one’s location, it may not be possible to have access to the Okinawan foods. For
instance, the diet is comprised of less of nuts, dairy, seeds, and fruit. When these foods are
combined, they can be a crucial source of vitamins, minerals, antioxidants, fiber, among other
important nutrients (Wahl et al., 2016). One important thing to note is that restricting such types
of foods may auger poorly for a person’s health, and this could cause detrimental implications in
the scenario one does not seek to replace the restricted nutrients. As such, most individuals opt
for typical, weight loss variety provided by the Okinawa diet as it presents more flexibility with
regards to the food choices.
Another rather profound downside of the Okinawan diet is that it can have high
concentrations of sodium. In fact, some diet versions offered by the Okinawan diet rake in more
than 3,200 mg of sodium on a daily basis (Shao et al., 2017). For people with high blood
pressure, this relatively high level of sodium intake may present some negative implications.
According to the American Heart Association, individuals should aim to restrict their sodium
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GLOBAL PROSPECTIVE 9
intake by as low as 1,500 mg daily, which is for those who have high blood pressure (Das et al.,
2017). Those with normal blood pressure are recommended to take an average of 2,300 mg per
day. Blood vessels increasingly retain fluids in the scenario one takes sodium in high capacities,
which can trigger increased blood pressure.
In light of these facts, some of the ways of improving the diet so that it can be more
useful to the Okinawan population is through removing the restrictive aspect of the diet and
proposing fresh methods of removing excess sodium in the diet (Ohlsson, Darwiche, Roth
&Höglund, 2018 ;Tamaki et al., 2015). To remove its restrictive aspect, perhaps one might
consider combining the diet with healthy alternatives of the limited foods. This means that the
Okinawan diet should be taken with a combination of nuts, dairy, seeds, and fruit as nutrients
found in these foods can be highly beneficial when combined. Additionally, it has been found
that the Okinawan diet tends to present excessively high concentrations of sodium, and this
might not auger well for individuals with high blood pressure (Hopes et al., 2015). In this
regards, it might be prudent for one to replace the sodium aspect of the diet with a potassium-rich
diet. In essence, potassium has been evidenced to counter the negative implications of sodium;
that is, taking potassium in the adequate concentrations can come in handy in assisting the
kidneys to get rid of the excessive fluids, which serves to reduce the blood pressure.
How other populations can use the Okinawan Diet
The Okinawan diet can also be used by other populations who need to improve their
health outcomes, but they must also seek ways of removing the high levels of sodium present in
the diet. The health benefits offered by the Okinawa diet means that anyone who wishes to eat
whole, unprocessed foods can configure the diet into their daily routines. It is high in carbs and
fiber while, at the same time, it comes with reduced concentrations of fat and calories. In
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GLOBAL PROSPECTIVE 10
essence, this could assist in the loss and maintenance of weight. On average, the Okinawan diet
is composed of roughly 1,200 calories each day while the typical populations take in an average
of 2,000 calories (Huang et al., 2018). Hence, the normal population can benefit heavily as such
a plan of eating is associated with fighting chronic ailments and lowering inflammation.
Considering that the Okinawan diet is mostly based on plants, it follows that vegetables and
fruits are its main components. There is also a high amount of vitamins, fibers, and antioxidants,
all serving to lower inflammation (Esselstyn, 2017). Overall, evidence suggests that the
traditional Okinawan diet bears similar characteristics to the diets linked to reduced risks of
chronic ailments; that is, it is heavy in vegetables and fruits, and has reduced amounts of refined
grains, meat, salt, saturated fat, and sugar. Major aspects of the diet such as intake of
antioxidants at a high rate, saturated fats at low levels, and low glycemic load
(Willcox&Willcox, 2014; Vasto et al., 2014)). This means that this diet can also be useful to
other populations.
Conclusion
In summary, this paper seeks to study the diet of the Okinawan population as a SDH. Due
to their diet, the Okinawan people have one of the highest life expectancies, and they rarely
suffer from chronic ailments such as stroke, heart disease, cancer, and diabetes. The Okinawan
diet is associated with various positive and negative implications. One of the positive impacts is
that the Okinawa's diet plays a significant role in ensuring that the Okinawan people age well.
The antioxidant nature of the diet is also another key plus associated with the diet. Looking at the
negative implications, it has been showed that the Okinawan diet is hard to adhere to and also
contains high concentrations of sodium. People with high blood pressure are not advised to take
food high in sodium since a relatively high level of sodium intake may present some negative

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GLOBAL PROSPECTIVE 11
implications. The diet can, however, be improved through the intake of potassium which
generally serves to counter the negative implications of sodium. Generally, the Okinawan diet
can also be adapted to other populations who also wish to increase their life span, but one must
also ensure that they counter the negative implications associated with the diet
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GLOBAL PROSPECTIVE 12
References
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GLOBAL PROSPECTIVE 13
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