Since 1999, researchers at Igelosa have been studying the effect of lifestyle and nutrition on health. This research was initiated to learn how to help patients waiting for heart and lung transplantations stay healthy enough to receive a new organ Researchers examined various long-term, evidence based studies from around the world. During this investigation they learned about the people on the island of Okinawa – one of the healthiest and longest living populations on earth.
The island of Okinawa has a very small population, but the largest concentration of people living to over 100 years old in the world.
They have not only a long life expectancy, but also a low incidence of various diseases that are common in Sweden, including heart disease, type 2 diabetes and cancer.
A closer look at their lifestyle provided insight into their daily lives and how it affected their health. Some key principles of their daily life include:
This lead to an in depth investigation of the foods these people lived on by following a traditional Okinawan diet. During two weeks, a group of participants at Igelosa ate a strictly Okinawan diet. It consisted of brown rice at most meals, lean fish, tofu, seaweed, bitter melon, sweet potatoes and other foods common to Okinawa. The researchers found promising health results from eating an Okinawan style diet, but also discovered the participants missed the foods they usually ate. Rather than recommending unfamiliar food proven to improve health, we needed to develop recipes based on the Okinawan lifestyle that were appetizing to people in Sweden.
The principles remained the same but the ingredients changed
With this knowledge, chefs, researchers and nutritionists at Igelosa began to adapt the principles of the Okinawan diet to fit traditional Swedish recipes and preferences. Over time, this lead to the development of an Okinawan-based Nordic diet® (OBND). The principles remained the same but the ingredients changed, based on the raw ingredients and traditions of the Nordic region. Whole intact grains, vegetables, fruits, fish, game and beans and lentils formed the base of the diet.
In 2014, Igelosa initiated collaboration with researchers at Lund University to study the effect of this modified diet. The first study conducted tested two breakfast alternatives on a healthy patient group, one based on a traditional breakfast and one based on the modified food principles. The results showed an improvement in several biomarkers including glucose and insulin response, as well as satiety in patients after eating the breakfast based on the Okinawan-based Nordic diet. [1, 2]
During the course of twelve weeks, all meals and snacks were prepared at Igelosa and delivered to the patient’s homes.
In 2015, Igelosa continued the research with collaborators at Lund University and conducted a pilot study on 30 patients with type 2 diabetes in southern Sweden. During the course of twelve weeks, all meals and snacks were prepared at Igelosa and delivered to the patient’s homes. This prospective interventional study demonstrated a considerable improvement of anthropometric and metabolic parameters and health-related quality of life in Scandinavian type 2 diabetes patients when introducing a modified Okinawan-based Nordic diet, independently of exercise or other interventions. Through these dietary changes, anti-diabetes treatment could be decreased or cancelled. [3,4,5,6,7]
In 2016, Igelosa initiated a collaboration with researchers at Kristianstad University and studied the effect on medical and dental conditions in patients with type 2 diabetes after the consumption of the Okinawan-based Nordic diet. After changing their diet for two weeks, all patients lost weight and six out of seven that were treated with insulin could reduce their insulin intake by an average of 34%. The reduction in gingival bleeding was as substantial as might be expected from one session of professional tooth cleaning. 
After changing their diet for two weeks, all patients lost weight.
During the autumn of 2018, Igelosa performed a follow-up clinical study together with the group from Kristianstad University. This time comparing the effect of a meal plan based on the Okinawan-based Nordic diet to meals already served to type 2 diabetics in southern Sweden today. During a four week period, two patient groups were randomly assigned to one of the plans and received prepared meals daily to eat throughout the study. This was the first time Igelosa studied the affect of food based on the Okinawan-based Nordic diet against another meal plan already approved for, and served to, patients with type 2 diabetes. Preliminary results show positive improvements in health for the patients following an Okinawan-based Nordic diet as in the previous studies.
Ohlsson B, Höglund P, Roth B, Darwiche G. Modification of a traditional breakfast leads to increased satiety along with atten¬uated plasma increments of glucose, C-peptide, insulin, and GIP in human. Nutr Res 2016. Apr;36(4):359-368
Ohlsson B, Darwiche G, Roth B and Höglund P: Two meals with different carbohydrate, fat and protein contents render equivalent postprandial plasma levels of calprotectin, cortisol, triglycerides and zonulin. Int J Food Sci Nutr 2016. Nov;67(7):872-80.
Darwiche G, Höglund P, Roth B, Larsson E, Sjöberg T, Wohlfart B, et al. An Okinawan-based Nordic diet improves anthropometry, metabolic control, and quality of life in Scandi¬navian patients with type 2 diabetes: a pilot trial. Food Nutr Res 60: 32594, 2016.
Ohlsson B, Darwiche G, Roth B, Bengtsson M, Höglund P. High fiber, fat and protein contents lead to increased satiety, reduced sweet cravings, and decreased gastrointestinal symptoms, inde-pendently of anthropometric, hormonal, and metabolic factors. J Diabet Metabol 2017. 8:733.
Ohlsson B, Roth B, Larsson E, Höglund P. Calprotectin in serum and zonulin in serum and feces are elevated after introduction of a diet with lower carbohydrate content and higher fiber, fat and protein contents. Biomed Rep. 2017 Apr; 6(4): 411–422.
Huang F, Nilholm C, Roth B, Linninge C, Höglund P, Nyman M, Ohlsson B. Anthropometric and metabolic improvements in human type 2 diabetes after introduction of an Okinawan-based Nordic diet are not associated with changes in microbial diversity or SCFA concentrations. Int J Food Sci Nutr 2018; Mar 14;62.
Ohlsson B, Darwiche G, Roth B, Höglund P. Alignments of endocrine, anthropometric, and metabolic parameters in type 2 diabetes after intervention with an Okinawa-based Nordic diet. Food Nutr Res 2018. Mar 14;62.
Holmer H, Widén C, Bengtsson W. V, Coleman M, Wohlfart B, Steen S, Persson R, and Sjöberg K. Improved General and Oral Health in Diabetic Patients by an Okinawan-Based Nordic Diet: A Pilot Study. Int J Mol Sci. 2018 Jul; 19(7): 1949.
Bradley J Willcox, D Craig Willcox, Makoto Suzuki. Based on the Landmark 25-year study. The Okinawa Program. How the world´s longest-lived people achieve everlasting health – and how you can too. Three Rivers Press. New York. 2001.
Bradley J Willcox, D Craig Willcox, Makoto Suzuki. The Okinawa Diet Plan. Get leaner, live longer, and never feel hungry. Clarkson Potter/Publishers. New York. 2004.
Walter C Willet. Eat, Drink, and Be Healthy. The Harvard Medical School Guide to Healthy Eating. A Harvard medical school book co-developed with the Harvard School of Public Health. Free Press. Simon & Schuster, Inc. New York. 2001.
Traditional food ingredients of the Okinawan-based Nordic diet. The development of this modified dietary program has been ongoing at Igelosa since 2006. The dietary principles of Okinawans has been translated to include ingredients, recipes and traditions of the Nordic countries.
Traditional ingredients of the Okinawan diet, used at Igelosa to test the effect of an Okinawan based diet on a Scandinavian patient group. Though they were tasty and showed a positive effect on health, they were too far from what people in the Nordic countries are used to eating. This realization led to the development of the Okinawan-based Nordic diet.
Dr. Makoto Suzuki is the director of the Okinawa Research Center for Longevity Science. He is also the principle investigator of the Okinawa Centenarian Study, the world’s longest continuously running study of one hundred-year olds (established 1975). When Dr. Suzuki welcomed the group from Igelosa to his office in Naha, Okinawa, he shared his experiences on longevity research and learned about the recently published studies on Okinawan-based Nordic diet as a means of preventative medicine in Scandinavia.
One aspect of the Okinawan lifestlye that helped lead to their long and healthy lives was making sure to get natural exercise every day. While in Okinawa, the research group from Igelosa lived according to the traditional lifestyle of Okinawan's. Here, one of the chefs got daily natural exercise by walking through the garden to harvest ingredients for dinner.
During their research trip to Okinawa, the group visited several elders in Ogimi village-the epicenter of the worlds oldest and healthiest people. Here one of the teams chefs spent the afternoon with one of the elders in the kitchen, learning how to use the local produce from their gardens.
The medial clinic is used to document research patients on a long-term basis. It is also used to perform nutritional research, with blood samples collected every 15 minutes after the intake of individual food ingredients, drinks or complete meals. This permits the scientists study how certain foods affect the body.
During a clinical food trial, each participating patient receives breakfast, lunch, dinner, fresh vegetables and snacks throughout the entire study period. The food is prepared, measured and packed at Igelosa and delivered to the patients homes by a designated driver.
Ingredients were prepared fresh using various cooking techniques at Igelosa on a daily basis. They were cooked and then cooled quickly to guarantee quality, safety and freshness.
Along with nutrition, taste and appearance were considered when developing meals. It was important that patients looked forward to meal time to help with compliance throughout the study.
All meals and components were individually portioned and labeled throughout the studies. This helped patients understand what they were getting, how much and when they should eat it.
An example of all the food a patient would receive for a day during the study. The meals were based on the most common dishes eaten in Sweden and adapted using the principles of the Okinawan-based Nordic diet.
Examples of educational tools developed at Igelosa to be used in upcoming clinical trials on preventative medicine. They were designed to communicate the principles of the Okinawan-based Nordic diet, in a positive and encouraging manner.