Okada Health and Wellness Program, a Whole-person Health Program with Diet, Art, and Biofield Therapy, to Support Integrative Medicine in Japan

In various diseases and conditions, a combination of health programs, including lifestyle interventions and psychological approaches, is often used to improve physical symptoms and Quality of Life (QOL). In the previous report entitled ‘the influence of a multimodal health program with diet, art, and biofield therapy on the quality of life of people in Japan,’ [1] the authors described the effectiveness of Okada Health and Wellness Program (OHWP). OHWP is a multicomponent health program that comprises the three components of diet, art, and biofield therapy (Okada Purifying Therapy [OPT]). The concurrent practice of all three components of OHWP described above was more likely to improve QOL among individuals across different demographic backgrounds. 

Biofield therapy (energy medicine) is defined as the act of channeling and manipulating the energy that courses through the body for the purpose of healing. According to this theory, the physical body is instilled with a subtle energy (biofield), or animating life force, the flow of which must be balanced for good health [2,3]. Use of biofield therapy in combination with other practices is expected to enhance the effectiveness of both practices and contribute to better health [4]. However, few studies have examined its advantage when practiced in conjunction with other health methods [5]. 

The concept of OHWP developed in Japan is based on the philosophy of Mokichi Okada (1882-1955). Since 2000, the MOA International Corporation (MOA) [6] has provided OHWP as a method to promote physical-mental-spiritual well-being. Although there are several reports on the effectiveness of OPT alone [7-13], OPT is more often practiced in combination with the other components of OHWP.

According to the authors' study, frequent practice of the diet and/or art components of OHWP was an independent factor associated with the improvement of QOL. Interestingly, the frequency of receiving OPT had no association [1]. These results may have been caused by differences in attitudes toward the practice of each component. The OPT is a passive practice in which recipients need only sit and/or lie down in front of the practitioner. As their symptoms were relieved and their QOL improved, they may have reduced the frequency of receiving OPT and have practiced the other health programs more often. Others may have received OPT more frequently with the hope of alleviating the existing symptoms which reduced their QOL. These explanations may help understand why there was no relationship between the frequency of receiving OPT and the improvement of QOL. The practitioners’ skill, duration of OPT, location of administration, and practitioner-recipient relationship may also have influenced the outcome [8]. 

It is generally considered that diet is the key to maintaining physical health and art can help promote mental well-being [14]. If there were to be any concerns, the diet and art components require one’s own volition to engage in practice. Methods like OPT may be a good way to help people recover to the point where they can think positively about their own health. From this perspective, a combination of diet, art and OPT may be an ideal way to achieve whole-person health.

Medicine originally provided both treatment (cure) and healing (care), but as Western medicine advanced, care was left behind. New coronavirus infections have shown the limits of treatment, coupled with the aging of the population and the increase in lifestyle-related diseases. The importance of care is being reevaluated. 

The OPT practitioners shares time with the recipients during the administration of OPT which is also a display of empathy and compassion. A good practitioner-recipient relationship through OPT would not only enhance the effectiveness of the treatment, but also bring satisfaction and happiness to themselves [8]. Since the COVID-19 pandemic, people have been encouraged to refrain from meeting and talking. During this period, it became more difficult to practice or receive OPT, and hence OPT was practiced less frequently. The authors had heard that OPT practitioners often felt lonely and had difficulty maintaining their health and well-being. Some said they were also less willing to practice diet and/or art components. As they became able to interact with people and practice OHWP as before, they were reminded of the importance of OPT as a whole-person health program.

Integrative medicine in Japan has taken a rather unique path compared to other countries. Since 2000, the Society for Integrative Medicine Japan (IMJ) [15] has defined the concept of integrative medicine in Japanese and has played a major role in promoting it. The authors translate the society's definition into English as shown in table 1. 

Table 1: Definition of integrative medicine by the Society for integrative medicine Japan (English translation by the authors). 

The distinguishing feature is the presence of two models of integrative medicine: the medical model and the social model. The medical model is not much different from the definition of integrative medicine in many other countries. Whereas the social model, which focuses on local residents and local communities, is a concept not found in other countries as far as the authors have investigated. This has emerged in relation to Japan's health insurance system and national policies that were formed through the knowledge gained from the experience of overcoming natural disasters that have struck Japan from time to time.

In principle, all citizens in Japan are covered by public insurance and can receive high quality Western medical care at a relatively low cost anywhere throughout the country. While its excellence is acknowledged, one drawback is that most types of Complementary and Alternative Medicine (CAM) are not approved for use in combination with Western medicine. If a patient requests the use of CAM, all treatments, including Western medicine, will not be covered by public insurance and would require a full self-payment. Some self-funded clinics incorporate both Western medicine and CAM for better treatment, however, insured hospitals and clinics rarely use CAM as a treatment modality. The fact that combined use of CAM results in higher medical costs is one of the reasons why the medical model of integrative medicine is not widely accepted in Japan.

Integrative medicine has gained attention for its effectiveness in unexpected ways. The trigger was the 2011 earthquake and tsunami in Japan. Almost all hospitals and clinics were extensively dysfunctional. The main reason for this was not only the damage to buildings and equipment, but also because Western medicine could not function optimally without clean water and electricity. While medical personnel from various professions came to the rescue, acupuncturists, various massage therapists, and art therapists were especially appreciated. In fact, many people who had symptoms that weren’t improving from receiving necessary treatment from doctors found that their symptoms improved after receiving these therapies. Various types of CAM have been reported from around the world as being effective for Post-Traumatic Stress Disorder (PTSD) [16-20]. These therapies are inherently time-consuming and involve listening to the clients’ story. Such a caring attitude of the practitioner could help to heal their hearts.

Meanwhile, the social model of integrative medicine has simultaneously gained attention. The 2011 earthquake and tsunami forced more than 125,000 people to evacuate, creating a major social issue. The experience of the nuclear facilities’ explosion and the tsunami has deeply been embedded in their memory. Chronic physical illness, anxiety about life, unemployment, loss of social connections, and anxiety about compensation were also associated with PTSD [21]. Data showed that when damage was extremely severe, suicide rates tended to increase immediately after the disaster and several years later. The data also revealed that suicide rates were lower in areas where social ties were strong before the disaster and in areas where social ties strengthened after the disaster [22,23]. These findings indicate that mutual support in a family-like community functioned as a protective factor towards stress and may play a significant role for healthy longevity. Hence the social model of integrative medicine has been revisited.

Since 2010, IMJ has been discussing integrative medicine with the Diet members. After the disaster, they recognized that many types of CAM could relieve symptoms and help create a healthy community of mutual support. When the Party of Japan Parliamentarians for the Promotion of Integrative Medicine [24] was established in 2015 by the Liberal Democratic Party Diet members, 277 (38.8%) of the then 717 Diet members participated. At that time, the federation worked with IMJ to define the concept of integrative medicine in Japanese. The authors translate the federation's definition into English as shown in table 2. Its meaning is almost the same as the IMJ definition, which stipulates that integrative medicine consists of a medical model and a social model, with both models working together to improve QOL and to achieve a healthy longevity society. 

Table 2: Concept of integrative medicine by the Party of Japan Parliamentarians for the Promotion of Integrative Medicine (English translation by the authors). 

In 2016, the Office of Integrative Medicine Planning and Coordination was established in the Ministry of Health, Labor and Welfare. Since then, representatives of all ministries and agencies concerned with the health and welfare of the people, including the following ministries, have been participating in general meetings and workshops held by the federation: the Ministry of Education, Culture, Sports, Science and Technology, the Ministry of Agriculture, Forestry and Fisheries, the Ministry of Economy, Trade and Industry, the Ministry of Land, Infrastructure, Transport and Tourism, the Ministry of the Environment, and the Ministry of Internal Affairs and Communications. In collaboration with the Planning and Coordination Office, they have worked on specific policies for integrative medicine. Due to the COVID-19 pandemic, the general meeting and workshops were self-imposed for three years beginning in 2020, but resumed in 2023. Currently, the policies of various ministries reflect the principles of integrative medicine, although it is not explicitly stated.

OHWP is now offered as a whole-person health approach at MOA facilities nationwide. The MOA facilities (Ryo-in) in major cities across the country include clinics operated by medical foundations that provide insurance care and MOA-operated facilities that offer a variety of health programs. Ryo-in also focuses on regular care within the context of medicine, providing integrative medicine as a whole [6]. The advantage of Ryo-in is that while patients receive Western medical diagnosis and treatment, they also receive advice from a variety of specialists on ways to improve their lifestyle and ways to deal with their concerns. Moreover, the practice of OHWP enhances the patient’s self-awareness toward the fact that they are actively working to improve their illnesses. In fact, among hypertensive patients, those who regularly attended Ryo-in clinics were more likely than those who attended other medical clinics to have stable blood pressure and to be able to reduce or eliminate the need for anti-hypertensive medications [25]. Patients with menopausal syndrome who received frequent OPT showed improvement in symptoms such as hot flush and palpitations [7]. Many patients, such as those with cancer, also come to Ryo-in to receive whole-person care. They have described experiencing changes in perception and assigning new meanings toward their illness, ultimately leading to satisfaction, and improved quality of life [26,27]. These are some of the effects derived from the aspects attributed to the medical model of integrative medicine offered in Ryo-in [28]. 

In addition, Ryo-in works with the local community (MOA Healthy Life Network), providing consultation for community concerns [29] and supporting activities for community health and welfare in cooperation with the local government [11]. This is the function attributed to the social model of integrative medicine. For these reasons, Tokyo Ryo-in is certified by IMJ as an accredited facility for both the medical and social models of integrative medicine [15]. The fact that such facilities are working with local communities to achieve a healthy longevity society shows the great potential of integrative medicine in the future.

As an integrated medical care facility adapted to Japan's medical insurance system, Ryo-in focuses on care that should be inherent in medicine. Doctors, nurses, various therapists, and other professionals work together to sincerely address each patient's symptoms and wishes, and provide Western medicine and various health methods including Okada Health and Wellness Program suited to that patient. The healthcare system provided in facilities such as Ryo-in can greatly assist in the whole-person care of patients. Furthermore, the fact that such facilities are working with local communities to realize a healthy longevity society shows the great potential of integrative medicine in the future. Okada Health and Wellness Program, a whole-person health program with diet, art, and biofield therapy, could be a concrete means of achieving both the medical and social models of integrative medicine.

The authors are deeply grateful to Professor Emeritus Toshinori Ito, President of the Society for Integrative Medicine Japan, for his valuable comments on the definition and activities of integrative medicine.

Suzuki, Katamura, and Tanaka are engaged in research of the Okada Health and Wellness Program, and Nakajima is engaged in the promotion of OHWP and management of Ryo-in. Suzuki and Katamura work at the medical foundation's clinic in Tokyo Ryo-in. MOA Health Science Foundation and MOA International Corporation collaborate through the Okada Health and Wellness Program, but have no financial or managerial relationship.

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