The Okinawa Diet Newsletter

May, 2007

In this issue:

Greetings from the Okinawa Diet Team

Dear Subscriber,

Can you believe that it is already May? Soon it will be summer and out will come the blazing hot sun and we will all be heading to the beach. Beach visits of course are accompanied by beach wear and we will all be getting a good look at just what those extra pounds have done to our figures over the winter season.

The challenges of weight maintenance as we grow older are formidable; however, we all seem to know someone who has maintained the same weight since they graduated from high school. Most of us are envious of such people but as we point out in the May newsletter, looks can be deceiving; as some people who appear thin on the outside may actually be very fat on the inside!

This interesting revelation is followed by a look at the world's oldest person, who just happens to be from the Kyushu/Okinawa area. A coincidence? Well, with the world's highest concentration of centenarians coming from the Kyushu/Okinawa area there are bound to be a few who turn out to be competing for the world title.

This article is followed by our latest delicious recipe to cool your heated summer palates, Chilled Watercress Vichyssoise straight from Sayaka's kitchen. Enjoy!

Best of Health and Happiness!

The Okinawa Diet Team

Medical News and Views

Are You a TOFI?

Dr. Bradley Willcox
by Dr. Bradley Willcox

We have all heard that it's what is on the inside that counts. New research from Imperial College in London supports that old adage. This work suggests that some people who appear thin on the outside, that is, they don't "look fat" may actually be very fat inside. These people may be part of a new class of previously unrecognized obese people called "TOFIs" (Thin Outside, Fat Inside).

How do you know if you are a TOFI? Dr. Jimmy Bell may help you find out. Bell, a professor of molecular imaging at Imperial College, London has studied TOFIs since 1994. Bell and his team used magnetic resonance imaging (MRI) to scan approximately 800 people to create "fat maps" showing where most of us store fat.

In what amounts to a blow for those who maintain their slim figures through diet only, Bell's study, funded by the British Medical Research Council, suggests that such dieters are more apt to develop large deposits of internal fat, even if they look thin. "The whole concept of being fat needs to be redefined," according to Bell.

So what is new about this work? The concept of internal fat is not new. Scientists have known for years that some people tend to store fat around the middle and that this fat is part of "metabolic syndrome" a constellation of risk factors including obesity, high cholesterol, high blood pressure and high blood sugar and insulin levels. However, as our many years of research in Japan and Hawaii has taught us, some of us tend to store fat internally-around and inside organs and muscles.

This is partly due to genetics and partly due to lifestyle. Genetically, Asians are at higher risk for being a TOFI than most ethnic groups. Asians tend to have a higher percent body fat than whites even at the same body mass index (BMI) as Whites or Blacks, a way to estimate obesity.

Although being lean usually helps it does not automatically mean that one is immune to obesity related disorders such as diabetes or heart disease. Some people with normal BMI - a common measure that estimates body fat by dividing your weight by the square of your height - have unusual levels of fat deposits inside their bodies. Bell and his collaborators, found about 45 percent of those with normal BMI scores (20 to 25) had high levels of internal fat. In the men, the percentage was nearly 60 percent.

Needless to say, Bell's "TOFIs" were surprised to find out their body types with thinner people (even some models) being the most surprised. Bell's work suggests that people who are fat on the inside are "pre obese" but they are not yet truly "fat". Some scientists believe we accumulate fat internally then begin to accumulate it in other spots. Despite not being able to point out the exact location of body fat stores, BMI is not yet out of the picture as it is still an extremely useful clinical screening tool.

There is no universal agreement on the dangers of internal fat but it may increase the risk of heart disease and diabetes. Experts have long known that heavy, active people can be healthier than their skinny, inactive counterparts. Dr. Steven Blair, an obesity expert at the University of South Carolina makes an important point when he says: "Normal-weight persons who are sedentary and unfit are at much higher risk for mortality than obese persons who are active and fit."

I give the last word to Dr. Bell who points out that despite being super-sized, "sumo wrestlers probably have a better metabolic profile than some of their slim, sedentary spectators", since their fat is stored mainly under the skin, not surrounding the organs.

The Bottom Line:

The good news is that internal fat can be easily burned off through exercise or even by improving your diet to include lower Glycemic Index carbs, healthy fats and lots of vegetables, fruit and legumes. "Even if you don't see it on your bathroom scale, caloric restriction and physical exercise have an aggressive effect on visceral (internal) fat," says Dr. Bob Ross, an obesity expert at Queen's University in Canada.

Eating according to our Okinawa Diet Caloric Density Pyramid, drinking sanpin tea, getting regular exercise are all part of the reason that the Okinawan elders kept lean all their lives. We doubt any of them were closet TOFIs!! For more information on BMI, how to estimate your body fat percent, and healthy body fat ranges see The Okinawa Diet Plan.

Nuchi Gusui!

Dr. Bradley Willcox

News from Okinawa

The World's Oldest Person

Dr. Craig Willcox
by Dr. Craig Willcox

Hello All,

In the May newsletter, I have chosen to write about a recent local event. That is, the Kyushu/Okinawa region has reclaimed the title of world's oldest person. This will mark the 3rd time in recent memory that this has happened. Yone Minagawa, 114, became the world's oldest living person after Emma Faust Tillman, also aged 114 years, recently passed away at a nursing home in Connecticut. According to recent news reports:

.... Minagawa, was born in 1893 in a small town in Kyushu, is in good health and currently resides in a nursing home in Fukuoka (Kyushu). She celebrated her 114th birthday on Jan. 4 with two of her grandchildren and the staff members of the nursing home while giving words of thanks many times before blowing out the candles on her birthday cake.

Apparently, her life was not easy as she was widowed early and raised her five children by selling flowers and vegetables in a coal mining town. She now has a daughter, seven grandchildren, 12 great-grandchildren and two great-great-grandchildren.

While she now spends a lot of time in bed, Minagawa is usually in good spirits and asks about the well-being of nursing home staffers and jokes with them according to nursing home staff. She reportedly loves sweets but often gives them away whenever others are around. While wheel-chair bound she also reportedly participates in club activities "dances" when feeling well ....

Although I have yet to personally meet Minagawa-san, I have met many of the world's oldest people. Although they have all been unique, most seem to share a few things in common: good genes, good health habits (including diet) and a sense of ikigai (joie de vivre) that makes their lives worth living. Okinawa's oldest living person, recently turned 110 years old.

I last saw her in November and that was the 4th time we had met. Although she was not as genki (energetic) as when I first met her years before she still impressed me with her sense of joie de vive as well as the act that she still paying careful attention to her diet and eating very much the Okinawa way. A coincidence? I think not.

We hope that you can join us at and maximize your own chances to make it to one hundred in superior health!

Yours in good health!

Dr. Craig Willcox

Sayaka's Kitchen

Chilled Watercress Vichyssoise

Sayaka Mitsuhashi
by Sayaka Mitsuhashi

Chilled Watercress Vichyssoise

Serves 4


3 small red skin potatoes
1 tsp. olive oil
3 cups chopped watercress
1/3 cup water
1 vegetable bouillon cube
2 cups plain soymilk
freshly ground black pepper
pinch sea salt


1. Steam or boil the potatoes until cooked through. Peel.
2. Heat the olive oil in a large skillet and cook watercress for 1 1/2 minutes or just until tender.
3. Warm the water in the microwave and dissolve the vegetable bouillon.
4. Transfer the potato, watercress, vegetable stock, soymilk, black pepper and salt in a blender or a food processor and process until smooth.
5. Chill in the refrigerator before serving.

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

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