For generations, the people of Okinawa prefecture in Japan have enjoyed the reputation of being among the longest-lived humans on the planet.
Medical experts and gerontologists have flocked to these semi-tropical islands off southern Japan in search of the secret to the local population's longevity, with most concluding it was a combination of a nutritious diet, regular exercise and the support of family and the broader community.
Today, however, that is changing. And while the wider Japanese population is living longer than ever before, the people of Okinawa are beginning to die earlier. And the blame is being pinned on younger generations turning their backs on the old way of life in the islands.
In 1980, Okinawa had the highest average life expectancy for both men and women, with men generally expected to reach at least 84 and women going on until the age of 90.
Life expectancy declines
But that enviable record has begun to slip. By 1990, average life expectancy for Okinawan men was only the fifth highest of the 47 prefectures in Japan and by 2020 had fallen to 36th place on the list. Okinawan women were top of the prefectural list until 2005 but were down to seventh spot in 2020.
In the 2020 census, conducted by the Ministry of Health, Labor and Welfare, Okinawan men lived to an average age of 80.27 and women reached 87.44.
Makoto Suzuki has a close interest in the subject; he is 89 years old and has been studying the reasons behind his fellow islanders' longevity all his life.
"The life expectancy of the people of Okinawa is coming down quite rapidly and we believe the problem is that younger people have failed to follow in the footsteps of earlier generations," said Suzuki, who still works part time as a clinical cardiologist and is joint-founder of the Naha-based Okinawa Research Center for Longevity Sciences.
"The people of Okinawa have been influenced by the food and lifestyle choices of other societies, particularly that of the United States," he told DW.
Since Japan's surrender at the end of World War II in 1945, Okinawa has remained home to a large number of US military bases and tens of thousands of troops. A culture of fast food and television over physical exercise has rubbed off on local people, he said, and the results can now be seen.
"Typically, the Okinawan diet included lots of vegetables, local fruit, dishes such as ‘tofu' and fish and meat, although in small portions," he said, adding: "When I was a boy, we had meat about once a week and that is a habit I have stuck with to this day."
"When I was younger, I would also do a lot of walking, climbing and archery, but I do not do so much now, mostly because I just do not have the time for those hobbies any more.
The importance of 'ikigai'
"I also believe the concept of 'ikigai' is important to our lives, especially in older people," Suzuki said, referring to the traditional idea of the reason a person has for living.
"My job at the hospital is very busy and that is my ikigai," he said. "It is important for me to help people who are sick and I do not consider them my patients, I see them as my friends. But being with them also helps me as isolation and loneliness are very dangerous for old people.
"My wife died two years ago so now I often go to the hospital in the night to be with other people as my friends are there."
Tomoko Owan, an associate professor in the faculty of medicine at the University of the Ryukyus, agrees that outside influences have had a negative impact on the islanders' well-being.
"Okinawa has been famous as a place where people live well into old age, but that began to change in the years after the war," she said. "People from overseas moved here and they brought their own cultures with them. Slowly, local people became mixed in with these newcomers and our diet and traditions changed."
Food is one important element that has altered, she says, but there are others.
The lessons of karate
"This was an island society in which the family and community were always very important," she said. "It was peaceful and, in the past, the people had little stress."
A rural backwater in years gone by, many Okinawans have recently adopted the "hurry, hurry" approach to life that is more associated with mainland Japanese, Owan pointed out, while growing commitments to work mean there is less time for relaxation, for friends and family and a person's hobbies.
Karate is closely associated with Okinawa and, to this day, many elderly Okinawans practice the martial art. Owan herself teaches karate in her university and says it is an indispensable part of her daily exercise routine. It is, she emphasizes, training for the body, the mind and the soul.
Yet younger generations of Okinawans seem content with their present way of life, even if it means they are unlikely to live as long as their grandparents.
"This is the modern Japanese lifestyle," said Shuhei Kohagura, a 39-year-old official with the prefecture's tourism agency, admitting that he puts in a lot of overtime hours at work every week, grabs a snack from a local convenience store for his lunch and goes out drinking after work with colleagues.
"I grew up with this way of living so it is comfortable for me now, even though I do complain that I'm too busy a lot of the time," he said. "The traditional way of life here might sound appealing but I think it would be very hard for me to adapt to that because it is just so different to everything that I have become accustomed to."
Pointing out that his own mother lived to be 105 years old, Suzuki stressed that he intends to continue to work as a doctor for as long as possible.
"I think the young people of Okinawa have failed to learn from their elders," he said. "It's unfortunate as they are not living so long, but our society has undergone serious changes in a short period of time."
Edited by: Srinivas Mazumdaru