The Okinawa Diet Newsletter

April, 2007

In this issue:

Greetings from the Okinawa Diet Team

Dear Subscriber,

Welcome to the April newsletter. We hope you have enjoyed the Easter holidays. As you may or may not be aware, part of the Easter tradition has included a fast on Good Friday or least an abstention from eating meat and/or a switching from meat to fish.

Cutting back on calories through short fasts or choosing fish rather than meat has not only symbolic merit as part of Easter traditions for Christians but could benefit persons of all faiths in terms of lowering risk for diabetes or cardiovascular disease through lower caloric intake and better nutrition. In keeping with this theme we bring you some shocking facts about heart disease in so-called "healthy men" along with some valuable advice on what you can do to lower your risk for this killer disease.

We also bring you a real life example of the health problems faced by younger Okinawans who stray from the traditional Okinawa diet and follow a western fast-food diet and sedentary lifestyle. Finally, from Sayaka's kitchen we bring you our Okinawan version of "hot-cross buns," that is, Chinbin...we hope you like them as much as we do!

Wishing you all a happy and healthy Easter holiday!

The Okinawa Diet Team

Medical News and Views

To Scan or not to Scan, that is the Question

Dr. Bradley Willcox
by Dr. Bradley Willcox

One of the problems with heart attacks is they often come with no warning. For about a third of victims the first sign of coronary heart disease (calcified and clogged arteries) is death. Before that time they can be completely symptom free. This is a rather scary thought. I have seen it many times as a physician over the years and had to deal with grieving families who lost their loved ones suddenly and without warning.

But a new technology called a "coronary calcium scan" uses a high speed, multi-slice, computerized tomography (CT) machine to scan the heart in just minutes and can provide early diagnosis of problems, sometimes years before they occur.

Coronary calcium scans provide detailed 3D images of the coronary arteries so your physician can look for calcium in the arteries. Calcium indicates arteriosclerosis or hardening of the arteries. Standard calcium scores have been developed. A moderate or high calcium score markedly increases your heart attack risk. An absence of calcium markedly reduces your risk.

So should I get one? Shouldn't everyone? Well, as with any new technology it needs to be thoroughly studied before one can recommend it widely. The widespread use of coronary calcium scans is controversial but the evidence that they can be helpful is growing.

Some Shocking Facts about Heart Disease in "Healthy" Men

One of our research goals is to study the utility of this novel technology. We are adding to the evidence that suggests coronary calcium scoring can be a lifesaver at our research institute in Hawaii. We have two studies of coronary calcium. These studies assess lifestyle risk factors for heart disease and whether such scans can be helpful. One study is looking at "young" (aged mid-forties) Japanese-American men and comparing the coronary calcium score to Japanese men in Japan. In this study the results have been rather shocking. Many of the men in our study of otherwise healthy Japanese-American men (no heart disease diagnosis and no other serious disease) have a high coronary calcium score suggesting that are at serious risk of a future heart attack. Yet, the men in Japan have virtually no calcium in their coronary arteries. We don't yet know why--but better diets, lower body fat levels and other lifestyle factors are highly likely. Stay tuned for more.

Our other study, this of very old men (average age mid-80s) showed that coronary calcium score was the best predictor of death in older men-better than cholesterol, obesity, or other risk factors.

While some doctors and researchers dispute who can actually benefit from heart scans and whether coronary calcium score is useful we believe that this will become a standard test for heart attack risk in the future.

In 2006, the American Heart Association (AHA) published a position statement stating that coronary calcium scans might be a good test for those at "intermediate" risk of coronary artery disease, but not for people at very low or very high risk. This risk score can be calculated from something called the Framingham Risk Score.

What is the Process Like?

The beauty of a coronary calcium scan is its simplicity. No sedation, no needles, and you can get the scan done in your street clothes. You merely lie on a table with some electrodes attached to your chest, hold your breath for a few seconds and the table moves into a ultra-fast CT scanner or an EBCT scanner (electron beam CT scanner). The scanner then takes very fine and thin images which are put together into a score.

Some insurance policies cover the cost of the scan, generally about $500, but most people just pay out of pocket.

The Bottom Line: Is a Coronary Calcium Scan right for you?

Coronary calcium scans can inspire some people to change their lifestyles set you on your way preventing further clinical heart disease.

In conjunction with any scan, you should see your physician for a medical exam focusing on cardiovascular risk factors. The exam should include review of your medical history and your family history and:

Don't Forget the "Big Five"

Coronary calcium scans are a potentially valuable assessment tool for assessing your cardiovascular risk and may even predict ct events such as non-cardiac death. This deserves further study. However, don't forget the traditional risk factors such as (1) smoking, (2) high blood pressure, (3) high cholesterol, (4) diabetes, (5) family history. Other risk factors such as obesity, physical activity and poor diet should also be taken into account.

Bottom line: if you do have a scan, and have any coronary calcium, you should consider lifestyle changes that can slow the progression of heart disease. Or better, get real aggressive with diet and other lifestyle changes and reverse the disease. See our 4 week turnaround plan in the Okinawa Program for a great start.

To your good health!

Dr. Bradley Willcox

News from Okinawa

Is American Food Killing Okinawans?

Dr. Craig Willcox
by Dr. Craig Willcox

Hello All,

In the April newsletter, I have chosen to feature a recent newspaper article (recently published in the Detroit Free Press) given to me by a Chample study participant last Sunday during our final day of the blood draw. As you may recall from the March newsletter the Chample Study is an interventional study that is focusing upon the health effects of consuming a diet rich in traditional Okinawan vegetables.

So far, we are finding that our 150 American participants are reporting weight loss (despite the diet not being designed as a weight loss intervention), less inflammation in their joints (the diet has proven anti-inflammatory effects) and lower blood pressure, among other health benefits. Therefore, it was with a great sense of irony that I read the newspaper article blaming the American fast food diet for the rising obesity rates in Okinawa. The article was titled Okinawans' Health Problems Blamed on Americans' Food and here is an excerpt:

...Tomomi Inose is overweight and diabetic. Her poor health is a result of six decades of U.S. influence on Okinawa. Growing up in postwar Okinawa alongside the U.S. military's largest overseas bases, she developed a bigger appetite for hamburgers and sodas than for the fish and vegetables that sustained prior generations."My body instinctively craves for succulent meat," Inose, 46, said at the hospital where her blood-sugar level is tested monthly to monitor the type 2 diabetes that has impaired her vision and increased her risk of heart disease...

The U.S. military has about 36,000 people based on Okinawa. Doctors there blame the servicemen for bringing hamburgers, French fries and canned meat to the island earlier than to the rest of Japan. Chains such as McDonald's, Kentucky Fried Chicken and A&W are among the operators of more than 100 fast-food outlets on Okinawa...

Before 1945, Okinawans consumed mostly fish, soybeans, seaweed, vegetables and pork. The diet was rich in antioxidants, minerals, omega-3 fatty acids and proteins that helped protect against strokes and heart attacks...

Those who retained the traditional diet are healthier than their peers. With an average life expectancy of 86 for women and 78 for men, Okinawa's elders have one-fifth the heart disease and a quarter of the breast and prostate cancer of Americans of the same age, according to the Okinawa Centenarian Study.

Dr. Willcox's Response to the Article:

Although the question of "who is to blame" remains open to challenge (i.e. sedentary younger Okinawans, the U.S. military, fast food chains, etc) we too are finding that younger Okinawans who stray from the traditional diet and follow a sedentary lifestyle end up with the same health problems that are being increasingly faced by younger people in the USA, that is, diabetes and other health complications of obesity. The case reported above is typical and obesity is becoming a problem in Okinawa and throughout Japan among the younger generations.

Currently, about a quarter of Japanese men and around a fifth of Japanese women older than age 18 are considered overweight by the World Health Organization while more than two-thirds of Americans are overweight, according to the OECD. What will the future hold? As more and more Americans continue to discover the health benefits of the traditional Okinawa diet will the Okinawans themselves lose their own healthy ways? That would be tragically ironic. Or will younger Okinawans actually rediscover their own traditional healthy food culture? Although at present we cannot answer this question with certainty the Okinawa Diet team will continue its mission to preserve and spread the healthy old ways...please join us in our quest at

Yours in Good Health!

Dr. Craig Willcox

Sayaka's Kitchen

Chinbin: Brown Sugar Crepes with Miso Filling

Sayaka Mitsuhashi
by Sayaka Mitsuhashi

Chinbin: Brown Sugar Crepes with Miso Filling

Makes 8 crepes, serves 4


1 cup water
1/4 cup brown or raw sugar
1/2 cup whole wheat pastry flour
1/4 cup soy flour
1/4 cup unbleached all purpose flour
1 tsp. baking powder
canola oil spray
1/2 Tbs. canola oil
4 Tbs. white miso
1/2 tsp. fresh minced ginger


1. Warm the water in a small sauce pan and put the brown sugar. Stir to dissolve well. Let cool.
2. Combine the whole wheat pastry flour, soy flour, all purpose flour and baking powder and stir to mix. Pour the sugar water into the dry ingredients and stir to mix well.
3. Preheat a hot griddle or a nonstick skillet over medium heat and coat with canola oil spray. Pour about 1/4 cup of the batter onto the skillet and immediately tilt the pan around to spread the batter evenly. Cook for 1 minute, or until the top is bubbly and the edges are dry. Turn and cook for another minute or until golden brown. Set aside.
4. In a separate small skillet, heat the canola oil. Add white miso and stir to toast for a minute and add the ginger. Give it a stir and remove from heat.
5. Spread 1/2 Tbs. of the miso filling in the center of each crepe and loosely role up. Repeat with remaining crepes and serve.

For more great tasting and healthy recipes, cooking tips, plus personalized meal plans and much more, join us at The Okinawa Diet Program today!

We hope you enjoyed this issue of the Okinawa Diet Newsletter
-The Okinawa Diet Team

To find out more about The Okinawa Diet go to To find out more about The Okinawa Centenarian Study go to

The Okinawa Diet Newsletter, © 2007 Okinawa Diet NPO. All rights reserved.

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