OOGIMI, JAPAN — Almost every morning, Ushi Okushima rises from her futon and heads across the street for a vigorous sunrise walk on a sandy Okinawan beach.
Later, some friends join her for morning tea before she heads to her fields. There, swinging a 4-pound hoe, a barefoot Okushima will chop the weeds around her radish and carrot plants for hours, thinking about her menu for the coming New Year's festivities.
Okushima turned 100 in August.
"I never get sick, and my blood pressure is very stable," Okushima says. "I only feel like I'm in my 80s. I hope to live to be 120."
Here on Japan's southernmost prefecture of Okinawa, blessed with a tropical climate and a tranquil pace of life, Okushima is far from unique.
The World Health Organization reports that Okinawa's people are the healthiest and longest-living in the world. About 427 of the 1.27 million inhabitants are over 100, meaning that 34 out of every 100,000 have lived a full century. In the United States, the comparable figure is 10 per 100,000.
In this hamlet, you'll also find youngsters like Kana Yamakawa, 88. She rides a three-wheel bike to her patch of farmland.
What's her secret to such active longevity?
"Being barefoot on the farm," she says. "Also, five of my grandchildren visit me for lunch every day. ... I have never gone to the hospital in my life."
On rainy days, Yamakawa likes to entertain friends and drink awamori, the potent local sake or rice wine.
"People get sick because they don't have fun in their lives," she says.
Okinawa's elderly have prospered despite the violent history of this steamy tropical island, site of one of the bloodiest battles of World War II. The U.S. military continues to occupy a quarter of the island for bases and training grounds.
Doctors say Okinawa should be famous for its healthy lifestyle as well as its military legacy. Recently, Dr. Bradley J. Willcox, an expert on aging from Harvard Medical School, helped organize the first International Conference on Longevity in Nago, Okinawa.
"There is no one most important factor for longevity," Willcox says. "It is a balance between factors, like four legs of a chair."
That includes diet, exercise, spiritual wellness and psychosocial factors, such as friendships and social support systems - "if you don't have these four legs in balance, the chair will topple over."
"Aging is not a disease," said Dr. Andrew Weil, professor at the University of Arizona and author of best-selling books on wellness, in a keynote address at the longevity conference. "It is the natural process. Successful aging is about awareness of the mystery of aging and the acceptance of mortality."
Weil suggested that because Okinawa's oldest citizens had endured such terrible wartime deprivation, their elder years had become especially joyful and pleasant.
The first to recognize that Okinawan people lived longer was Dr. Makoto Suzuki, who heads the Okinawa Research Center for Longevity Science, a branch of Okinawa International University.
Suzuki already knew that Japanese tend to live longer than other people. But when he checked the data on residents with the government, he calculated that life expectancy on Okinawa and the prevalence of centenarians were significantly higher than elsewhere in Japan.
"Longevity is not desirable solely for the duration of one's life but also must be accompanied by excellent health to be truly celebrated," says Suzuki. With Willcox and his twin brother Craig Willcox, a medical anthropologist, Suzuki recently published The Okinawa Program: How the World's Longest-Lived People Achieve Everlasting Health - and How You Can Too.
While hereditary factors are important for long life, Suzuki says, "environmental factors are more important." He found that the life span for Okinawans who moved to Brazil is, on average, 17 years shorter than for those who remained on the island.
In some cultures, youth is celebrated and the elderly are shunted aside. But in Okinawa, Suzuki says, "aging is a celebration" that helps keep the elderly energetic.
When local residents turn 97, a "Kajimayaa" celebration is held. Kajimayaa in the Okinawan dialect means "pinwheel," and Okinawans believe they return to their childhood once they turn 97. The birthday recipient is showered with pinwheels by family and friends, receives a certificate of merit and a monetary prize from the government, and is treated to a party with 500 to 1,000 people attending.
Okinawan diets are rich in fish, pork and vegetables. Residents often prepare dishes using fennel, good for combating flu. They also use the hirami lemon, touted as a cancer preventative; a bitter spinach known as nigana, easy on the stomach; and goya, a bitter Okinawan cucumber that contains 50 times more vitamin C than regular cucumber.
As the secret of Okinawa's longevity has spread, sales of these Okinawan products have rapidly increased in cities such as Tokyo and Osaka.