The DOI matches its Crossref record; 61 of the 61 references it cites were found in a registry or an index.
Caloric Restriction, the Traditional Okinawan Diet, and Healthy Aging: The Diet of the World's Longest‐Lived People and Its Potential Impact on Morbidity and Life Span
Open accessAbstract
Long-term caloric restriction (CR) is a robust means of reducing age-related diseases and extending life span in multiple species, but the effects in humans are unknown. The low caloric intake, long life expectancy, and the high prevalence of centenarians in Okinawa have been used as an argument to support the CR hypothesis in humans. However, no long-term, epidemiologic analysis has been conducted on traditional dietary patterns, energy balance, and potential CR phenotypes for the specific cohort of Okinawans who are purported to have had a calorically restricted diet. Nor has this cohort's subsequent mortality experience been rigorously studied. Therefore, we investigated six decades of archived population data on the elderly cohort of Okinawans (aged 65-plus) for evidence of CR. Analyses included traditional diet composition, energy intake, energy expenditure, anthropometry, plasma DHEA, mortality from age-related diseases, and current survival patterns. Findings include low caloric intake and negative energy balance at younger ages, little weight gain with age, life-long low BMI, relatively high plasma DHEA levels at older ages, low risk for mortality from age-related diseases, and survival patterns consistent with extended mean and maximum life span. This study lends epidemiologic support for phenotypic benefits of CR in humans and is consistent with the well-known literature on animals with regard to CR phenotypes and healthy aging.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The Okinawans’ diet, characterized by a substantial consumption of vegetables, legumes, and sweet potatoes, is inherently plant-based and low in calories [7,156,157,158,159,160,161].”
From The Power of Environment: A Comprehensive Review of the Exposome's Role in Healthy Aging, Longevity, and Preventive Medicine-Lessons from Blue Zones and Cilento (2025) · cites this paper as [157]
Experimental — accuracy not yet measuredIn the citing paper
“Japanese diets have been of considerable interest, particularly from Okinawa, which until recently experienced among the lowest rates of CHD in the world.111”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [111]
In the citing paper
“Appropriate energy balance and little age-related weight gain are also important features of the Okinawan diet pattern.111”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [111]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
A Potential Decline in Life Expectancy in the United States in the 21st Century
Olshansky, S. J., Passaro, D. J., Hershow, R. C., Layden, J., Carnes, B. A., Brody, J., Hayflick, L., Butler, R. N., Allison, D. B., & Ludwig, D. S. (2005) · New England Journal of Medicine · doi:10.1056/nejmsr043743 · Cited by 2,612
The Effect of Retarded Growth Upon the Length of Life Span and Upon the Ultimate Body Size
McCay, C. M., Crowell, M. F., & Maynard, L. A. (1935) · The Journal of Nutrition · doi:10.1093/jn/10.1.63 · Cited by 2,264
A Potential Decline in Life Expectancy in the United States in the 21st Century
Olshansky, S. J., Passaro, D. J., Hershow, R. C., Layden, J. E., Carnes, B. A., Brody, J. A., Hayflick, L., Butler, R. N., Allison, D. B., & Ludwig, D. S. (2005) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000167407.83915.e7 · Cited by 1,947
Sirtuin activators mimic caloric restriction and delay ageing in metazoans
Wood, J. G., Rogina, B., Lavu, S., Howitz, K., Helfand, S. L., Tatar, M., & Sinclair, D. (2004) · Nature · doi:10.1038/nature02789 · Cited by 1,868
Gene expression profile of aging and its retardation by caloric restriction
Lee, C.-K., Klopp, R. G., Weindruch, R., & Prolla, T. A. (1999) · Science · doi:10.1126/science.285.5432.1390 · Cited by 1,473
Extended Longevity in Mice Lacking the Insulin Receptor in Adipose Tissue
Blüher, M., Kahn, B. B., & Kahn, C. R. (2003) · Science · doi:10.1126/science.1078223 · Cited by 1,155
Weindruch, R. H., Walford, R. L., Fligiel, S., & Guthrie, D. (1986) · Journal of Nutrition · doi:10.1093/jn/116.4.641 · Cited by 992
Long-Term Calorie Restriction Is Highly Effective in Reducing the Risk for Atherosclerosis in Humans
Fontana, L., Meyer, T. E., Klein, S., & Holloszy, J. O. (2004) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0308291101 · Cited by 902
Overview of caloric restriction and ageing
Masoro, E. J. (2005) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2005.03.012 · Cited by 879
(1978) · Social Science & Medicine Medical Psychology and Medical Sociology · doi:10.1016/0160-7979(78)90117-0 · Cited by 831
Flagged first, then by citations
Research works printed but not linked: 12
- Hokama T., 1967, Nutrition survey of school children in Okinawa, Sci. Bull. Coll. Agr. Univ. Ryukyus, 14, 1
- Japan Ministry of Health, Labor and Welfare, 2002, Results from Ministry of Health, Labor and Welfare Nutrition Survey, 2000
- Willcox D.C., 2005, Okinawan longevity: where do we go from here?, Nutr. Dietetics, 8, 9
- Division of Health, Labor and Welfare, Okinawa Prefectural Government, 1976, Health and Welfare Dataset 1880–1976
- Sanabe E., 1977, Social and medical survey of centenarians, Okinawa J. Pub. Health, 9, 98
- Sas Institute Inc., 1999, The LIFEREG Procedure, SAS/STAT® User's Guide, Version 8
- National Center for Health Statistics, 1998, Vital Statistics of the United States, 1995, preprint of Vol. II, Mortality, part A, section 6, life tables
- Japan Health and Welfare Statistics Association, 1996, 1995 Annual Statistical Report of National Health Conditions
- Okinawa Prefectural Government, Division of Statistics, 1996, 39th Okinawa Statistics Annual, 1995
- Japan Ministry of Health, Labor and Welfare, 2000, Prefectural Life Tables
- Willcox B.J., 2000, Serum estrogen and long term survival in Okinawan‐Japanese men and women, J. Am. Geriatr. Soc., 48, P348
- Willcox B.J., 1995, Isoflavone intake in Japanese and Japanese‐Canadians, Am. J. Clin. Nutr., 61, 901
Cited by
Sorted by citations
Items 301–368 of 368
Adipose Tissue and Skeletal Muscle Plasticity in Obesity and Metabolic Disease
Ukropec, J., & Ukropcov, B. (2012) · InTech eBooks · doi:10.5772/28506
Aerobic Exercise, Diet, and Neurocognition among Individuals with High Blood Pressure
Smith, P. J. (2009) · DukeSpace (Duke University)
Calorie Restriction the Fountain of Youth
Dar, B. A., Dar, M. A., & Bashir, S. (2012) · Food and Nutrition Sciences · doi:10.4236/fns.2012.311198
Calorie Restriction: The Natural Way of Slowing Down Aging
Nauli, A. M. (2013) · Journal of Biosafety & Health Education · doi:10.4172/2332-0893.1000e103
Fu, Z. D. (2013) · KU ScholarWorks (The University of Kansas)
Avaliação nutricional de longevos
Martins, P. C. R. (2014) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Defining an Overdue Requiem for Palliative Cardiovascular Medicine
Esselstyn, C. B. (2016) · American Journal of Lifestyle Medicine · doi:10.1177/1559827616638647
Dietary Patterns that Decrease Cardiovascular Disease and Increase
Holligan, S. D., & Kris‐Etherton, P. M. (2013)
Can Nutritional Intervention Counteract Immunosenescence in the Elderly?
Clements, S. J., & Carding, S. R. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-801816-3.00028-5 · Cited by 1
Loniewska, M. M. (2013) · TSpace (University of Toronto)
Centenarian Hotspots in DenmarkPreprint
Hansen, A. V., Mortensen, L. H., & Westendorp, R. G. J. (2017) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/170654
Survivre au régime alimentaire occidental
Millara, É. (2017) · Pratiques en nutrition · doi:10.1016/j.pranut.2017.06.009
Dietary and Caloric Restriction for Human Health
Bloomer, R. J., & Lee, S. R. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.00240-3
A Neurological Perspective upon Diabetes and Obesity, What They Are, and How They Can Be Measured
Ewing, G. W. (2018) · Case Reports in Clinical Medicine · doi:10.4236/crcm.2018.74025
Mineralstoff- und Säure-Basen-Dysbalance als Risikofaktor für Wohlstandserkrankungen
Jacob, L. M. (2018) · Zeitschrift für Komplementärmedizin · doi:10.1055/a-0705-1458
Der kausale Zusammenhang von Prostata-Hyperplasie, chronischer Prostatitis und Prostatakrebs
Jacob, L. M. (2019) · Deutsche Zeitschrift für Onkologie · doi:10.1055/a-0865-8464
Epigenomic reprogramming of caloric restriction on aging
Ribarič, S. (2019) · Nutritional Epigenomics · doi:10.1016/b978-0-12-816843-1.00016-3
Diet and Nutrition in Alzheimer’s Disease and Healthy Aging
Bule, M. H., Shah, M. A., Abdurahman, A. A., Ullah, M. S., Shah, S., Amin, A., & Niaz, K. (2019) · Springer eBooks · doi:10.1007/978-981-13-9636-6_3
Effect of diet on neurological disorders and regenerative processes in the brain
Farooqui, A. A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-821711-5.00002-4
Implications for Treatment and Management
Hoffmann, M. W. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108589246.011
Longevity Areas and Mass Longevity
Hoh, J. W. T., Lu, S., Feng, Q., & Gu, D. (2021) · Springer eBooks · doi:10.1007/978-3-319-69892-2_1128-2 · Cited by 2
Longevity Areas and Mass Longevity
Hoh, J. W. T., Lu, S., Feng, Q., & Gu, D. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_1128
Aiello, A., Caruso, C., & Accardi, G. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_134
EXPLORING CENTENARIANS’ PERCEPTION OF NUTRITION
Holston, E. C., & Callen, B. L. (2016) · Journal of Aging Research and Lifestyle · doi:10.14283/jarcp.2016.111
Shogo, I., Qiu, L., Feng, Q., Dupre, M. E., & Gu, D. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_126
Smil, V. (2013) · Wiley eBooks · doi:10.1002/9781118278710.refs
Nyambiya, I. (2022) · Springer eBooks · doi:10.1007/978-981-16-7861-5_15
Nonhuman Primate Models of Immunosenescence
Rivera, A., Rais, M., Barr, T., Arnold, N. D., Sureshchandra, S., & Messaoudi, I. (2017) · Springer eBooks · doi:10.1007/978-3-319-64597-1_80-1
Anthropometric Indices and Nutritional Parameters in Centenarians
Ferri, E., Casati, M., & Arosio, B. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_119
Life Span and Prolong of Life Span
张, 迪. (2019) · Aging Research · doi:10.12677/ar.2019.62003
Traditional and Modern Eating in Japan
Imada, S., & Furumitsu, I. (2019) · Springer eBooks · doi:10.1007/978-3-319-75388-1_131-1
Brevik, A. (2011) · Norsk tidsskrift for ernæring · doi:10.18261/ntfe.9.3.2
Nodweddu effaith signalu ghrelin-GHS-R ar awtoffagi niwronaidd
Roberts, L. D. (2022) · Cronfa (Swansea University) · doi:10.23889/suthesis.62285
Ea, H., Gauffenic, A., & Pham, C. N. (2022) · Elsevier eBooks · doi:10.1016/b978-2-294-77859-9.00016-5
Mathangi, D. C., & Hemamalini, A. J. (2023) · Springer eBooks · doi:10.1007/978-981-99-0534-8_7
Protein Restriction in Aging and Disease
Brandhorst, S. (2024) · Springer eBooks · doi:10.1007/978-3-031-49622-6_2
How to accomplish brain fitness: The five brain rules
Hoffmann, M. W. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-29839-4.00002-0 · Cited by 1
Human Populations with Extreme Longevities
Pes, G. M., & Poulain, M. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009007245.018
Caloric restriction in the epigenetic regulation of aging and longevity
Habibian, J. S., Stratton, M. S., & Ferguson, B. S. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-18979-1.00011-3
Dietary habits of Koreans aged 95 years and older residing in rural and metropolitan areas
Mun, J., Kim, S., Kim, S., Kim, S., Park, S. C., Han, J., Park, K., & Park, C. Y. (2025) · Nutrition Research and Practice · doi:10.4162/nrp.2025.19.1.66
The link between dietary patterns and health outcomes
Şimşek, H., & Uçar, A. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-15976-3.00045-3
Bewusstseinsmedizin: Selbstheilung durch Vorstellungskraft
Schmid, G. B. (2025) · Springer eBooks · doi:10.2991/978-3-662-70243-7_5
Ginseng extract improves synaptic resiliency: A key factor for healthy cognitive aging
Almeida, M. F., Pait, M. C., Rentschler, K. M., Norton, C. J., Farizatto, K. L. G., & Bahr, B. A. (2025) · Alzheimer s & Dementia · doi:10.1002/alz.70818
Aging, Nutrition and Lifestyle
Wohlgemuth, S. E. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-385101-7.00012-7
Edjolo, A. (2014) · theses.fr (ABES) · doi:10.70675/17908641z8817z4d4dz9326z1188742e5e8f
Gu, Q., Sable, C. M., Brooks-Wilson, A., & Murphy, R. A. (2020) · Figshare · doi:10.6084/m9.figshare.11992122
ZEMB, P. A., & Joulia, F. (2026) · SSRN Electronic Journal · doi:10.2139/ssrn.6068352
Healthful Patterns of Ageing and Longevity
Martin, P., & Lee, G. (2026) · Springer eBooks · doi:10.1007/978-981-95-4037-2_7
Blood flow and angiogenesis: Major mechanisms mediating healthful longevity
Zhang, J., Vatner, D. E., Gad, A., Graham, R. M., & Vatner, S. F. (2026) · Ageing Research Reviews · doi:10.1016/j.arr.2026.103037
Zhao, E., Schluter, E., El-Abbadi, N., Shea, M., McKeown, N. M., Jacques, P. F., Lords, H. J., Andersen, S. L., Perls, T. T., Paola Sebastiani, B., et al. (2026) · The journal of nutrition health & aging · doi:10.1016/j.jnha.2026.100822
Why Do Blue Zone Populations Live Longer? Mechanistic Insights Into Cardiovascular Longevity
Mehta, K., Senthil, A., Banker, H., Trivedi, Y. V., Manucharyan, A., Sahu, N., & Jain, R. (2026) · Cardiology in Review · doi:10.1097/crd.0000000000001291
Self-selected dietary intake and association with achieved caloric restriction in CALERIE ™ 2
Woolf, E. K., Falkenhain, K., Martin, C. K., & Redman, L. M. (2026) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2026.2676737
How to become a centenarian in four weeks?. Myths and limits of longevity recipes: a critical review
Poulain, M., & Herm, A. (2026) · Minerva Medica · doi:10.23736/s0026-4806.26.09890-3
Fals, E. B., Springborg, E. C., Berthelsen, A. B., Nyeman-Nielsen, J., Larsen, S., & Scheibye‐Knudsen, M. (2026) · GeroScience · doi:10.1007/s11357-026-02362-0 · Cited by 1
Research progress on the biological mechanisms of healthy aging in long-lived individuals
Yin, F.-Q., & Qing-peng, K. (2026) · Shengming kexue · doi:10.3724/cbls.2026108
Toward an Optimal Diet for Health in Asia: The Asian–Mediterranean Dietary Pattern
Yang, J., Ling, C., Er, Y. T., Chong, Y. S., Hu, F. B., Hochet, L., Martínez‐González, M. Á., Henry, C. J., & Zhang, C. (2026) · Advances in Nutrition · doi:10.1016/j.advnut.2026.100727
Kimura, A., & Miyagi, S. (2026) · Aging and Health Research · doi:10.1016/j.ahr.2026.100295
Errigo, A., Gómez, G., Vindas-Meza, L., & Pes, G. M. (2026) · Nutrients · doi:10.3390/nu18183072
Shiroma, H., Yokoda, H., Namihira, Y., 宮城, と., Zolfo, M., Utami, M. F., Tokashiki, T., 永山, あ., Murayama, Y., Yamada, T., et al. (2026) · npj Dementia · doi:10.1038/s44400-026-00146-z
Common questions and misconceptions about diets: what does the scientific evidence really show?
António, J., Antonio, B. B., Aragon, A. A., Arent, S. M., Campbell, B. I., Candow, D. G., Eberhardt, H. K., Escalante, G., Evans, C., Forbes, S. C., et al. (2026) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2026.2707252
Pinnelli, V. B., Surendra Babu, T., A., J. C., Mathew, H. A., Kandi, V., R., M. G., Sam, K. T., Sucharitha, A. S., Divyadharshini, M. S., Batchu, S. V. C., et al. (2026) · Cureus · doi:10.7759/cureus.117984
Okinawa Centenarian Study, Investigating Healthy Aging among the World’s Longest-Lived People
Suzuki, M., Willcox, D. C., & Willcox, B. J. (2017) · Springer eBooks · doi:10.1007/978-981-287-082-7_74
Self-citationOhshiro, Y. (2026) · Nutrients · doi:10.3390/nu18203415
Establishing a role for specific nutrients in Drosophila dietary restriction
Grandison, R. C. (2009) · OpenGrey (Institut de l'Information Scientifique et Technique)
Metadata
- Authors
- WILLCOX, B. J., WILLCOX, D. C., TODORIKI, H., FUJIYOSHI, A., YANO, K., HE, Q., CURB, J. D., & SUZUKI, M.
- Affiliations
- University of Hawaiʻi at Mānoa (US)
- Okinawa Prefectural College of Nursing (JP)
- University of the Ryukyus (JP)
- Pacific Health Research and Education Institute (US)
- Corresponding author
- WILLCOX, BRADLEY J.
- WILLCOX, D. CRAIG
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2007-10
- Volume
- 1114
- Issue
- 1
- Pages
- 434-455
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- OpenAlex
- W2165781101
- Cited by
- 370
- References
- 61
- Citations by year
- 2026: 22 · 2025: 20 · 2024: 23 · 2023: 22 · 2022: 24 · 2021: 24 · 2020: 20 · 2019: 23 · 2018: 19 · 2017: 15 · 2016: 20 · 2015: 12 · 2014: 25 · 2013: 26 · 2012: 17
- FWCI
- 2.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the New York Academy of Sciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r03ag021293-01)
- National Institute on Aging (K08AG022788, R03AG021293-01, K08 AG22788-02, R01AG027060)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
- Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- caloric restriction, Okinawan diet, healthy aging, centenarians, energy balance, lifespan extension, energy intake, energy expenditure, body mass index, survival patterns
- MeSH terms
- Aged, Aged, 80 and over, Aging, Animals, Haplorhini, Diet, Female, Humans, Japan, Life Expectancy, Male, Middle Aged, Morbidity, United States, Caloric Restriction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
