Forever Young? : Okinawa has the highest proportion of centenarians in the world. But the islands' next generation may not live so long.

Every morning Seiryu Toguchi rises at 6 o'clock, washes his face and performs exercises in the lush front yard of his home in Okinawa. He prepares a breakfast of rice and miso soup with spinach and egg. Then he tends his nearby farm, where he grows carrots, cabbage and other vegetables. At 5 p.m., he takes a hot bath and cooks homegrown radish with pork for supper. His wife passed away a few years ago and his children live in other cities. But he is a lot more self-sufficient than many Japanese men. He reads newspapers and magazines, does his own laundry and sewing, and when he gets cravings for brown-sugar doughnuts, he takes a bus to the nearest town to buy them. In his spare time, he plays the sanshin, a traditional three-stringed instrument. It's nothing out of the ordinary--until you consider that Toguchi is nearly 102 years old.

Lean and fit, Toguchi jokes that the key to his long life is a special drink he takes before bed: a mixture of garlic, honey, turmeric and aloe poured into awamori, the local distilled liquor. His sharp mind and high energy may be rare among the elderly in other parts of the world, but he's not so unusual in Okinawa, the southern group of islands located between Japan's main islands and Taiwan. Toguchi is one of about 600 centenarians out of a population of 1.3 million. Indeed, Okinawa has the highest proportion of centenarians in the world: 39.5 for every 100,000 people, compared to about 10 in 100,000 in the United States.

What's their secret? In 2001, three specialists published a study of the locals' longevity in a book called "The Okinawa Program," which reached best- seller lists in the United States. (The Japanese translation comes out this spring.) The authors--Okinawa International University gerontologist Makoto Suzuki, Bradley J. Willcox, a former geriatrics fellow at Harvard Medical School, and his twin brother D. Craig Willcox, a medical anthropologist-- found that elderly Okinawans had remarkably clean arteries and low cholesterol. Heart disease, breast cancer and prostate cancer were rare, which they attributed to the consumption of locally grown vegetables and huge quantities of tofu and seaweed, rigorous activity and a low-stress lifestyle. Suzuki and the Willcox brothers also determined that Okinawans have no genetic predisposition to longevity: when they grow up in other countries, they take on the same arterial disease risk as those in their adopted land. The book, which prescribes a plan for healthy eating, says: "If Americans lived more like the Okinawans, 80 percent of the nation's coronary care units, one-third of the cancer wards, and a lot of the nursing homes would be shut down."

But increasingly, Okinawans are living more like Americans. That means less bean curd and walking, more burgers and stress. The islands' children aren't expected to live nearly as long as their grandparents. Heart disease, cerebral hemorrhage and lung cancer are all on the rise. Okinawan women now face a higher than average risk of uterine cancer, and mortality rates are climbing. Worst of all, the latest government ...