Mandates, boosters and global supply. Georgetown University's Lawrence Gostin talks about what is legal -- and what might be most effective -- when it comes to getting Americans vaccinated.
Guest Host: Susan Page
Human longevity is thought to be explained by a combination of genetic and environmental factors. But recent studies show that as much as 90 percent of life expectancy may be determined by habits. Several years ago, a team of National Geographic scientists identified four regions in the world where people live the longest. In these so-called “Blue Zones,” residents experience far lower rates of chronic disease than Americans do. And people who live in these zones share common habits: they eat mostly plants, are spiritual and have strong ties with family and friends. Now, researchers have identified a fifth Blue Zone: the island of Ikaria, Greece. Author and explorer Dan Buettner on lessons for a long life from the world’s oldest people.
- Dan Buettner Author, explorer, fellow, National Geographic Society.
Dan Buettner presented “How to live to be 100+” at TED in September 2009. To find the path to long life and health, Buettner studies the world’s “Blue Zones,” communities whose elders live with vim and vigor to record-setting age. In his talk, he shares the nine common diet and lifestyle habits that keep them spry past age 100.
Read An Excerpt
Excerpt from “The Blue Zones, Second Edition: 9 Lessons for Living Longer From the People Who’ve Lived the Longest” by Dan Buettner. Copyright 2012 by Dan Buettner. Reprinted here by permission of National Geographic. All rights reserved.
MS. SUSAN PAGEThanks for joining us, I'm Susan Page of U.S.A. Today, sitting in for Diane Rehm. Studies show that lifestyle habits, not genetic factors, are better predictors of life expectancy. In a new book titled, "The Blue Zones: 9 Lessons for Living Longer," National Geographic Fellow, Dan Buettner, explains how people in five regions of the world manage to live longer.
MS. SUSAN PAGETheir secrets include eating mostly plants, napping regularly and connecting with friends and family. And Buettner explains how the state of Iowa is creating its own Blue Zone in partnership with Blue Cross Blue Shield. Author and explorer Dan Buettner joins me in the studio. Welcome to "The Diane Rehm Show."
MR. DAN BUETTNERDelighted to be here.
PAGEWe look forward to hearing from our listeners. Later in this hour, you can call us at our toll-free number, 1-800-433-8850 or send us an email to email@example.com or find us on Facebook or Twitter. So Blue Zones, what is a Blue Zone?
BUETTNERA Blue Zone is a part of the world where you can measure -- you can measure longevity, a demographically confirmed, geographically defined area where people are either, a, reaching age 100 at extraordinary rates or they have the highest life expectancy or the lowest rate of middle age mortality. Which in other words means that people at 40, 50, have the best chance of reaching 90 which is probably the capacity of the human machine.
PAGEAnd why are they called Blue Zones? Why blue?
BUETTNERI wish I had a wonderfully exotic and scientific answer for that but the reality is, was when we were honing in on it in Sardinia, our team of demographers was drawing concentric circles with blue ink on a map and we just started referring to the area inside the smallest circle as the Blue Zone. And the name stuck and we have extended it now to four other parts of the world.
PAGESo you started out with four original Blue Zones. Where are they?
BUETTNEROkinawa, Japan, longest lived women on the planet are there. The Highlands of Sardinia, not the whole island but in the middle of the island, there's a bronze age culture, the Nuoro Province, the Nicoya Peninsula of Costa Rica, it's in the far Northwestern tip of the country. And then in America, it's among the Seventh Day Adventist and these are conservative Methodists who, on a whole, live about ten years longer than their North American counterparts.
PAGEAnd that Blue Zone would be where?
BUETTNERAround Lomo Linda, Cali., only because there's the home of the highest concentration of Adventists.
PAGEAnd then, for this new addition of your book, you've added a fifth Blue Zone, where is that?
BUETTNERIkaria, Greece, it's about 20 miles off the coast of Turkey. It's 99 square miles, about 10,000 people. And it is most extraordinary because not only are people living a really long time there, they have about a fifth the rate of dementia. In America, here, if you reach age 85, there's about a 50 percent chance you're suffering from dementia. Here, they not only live long, they -- they stay sharp until the very end.
PAGEAnd it's interesting, you've got these five zones and they're different kinds of -- I mean, they're different parts of the world and they're different kinds of places. One's a very traditional culture, but Lomo Linda, Cali., is a perfectly modern American place. So that's not the thing that -- the string that unites these places, what is the theme that links these five places where you have such extraordinary longevity?
BUETTNERWe found nine common denominators in all, all Blue Zones. Most -- they eat mostly a plant based diet which won't come to a shock to most people, but, oddly enough, pork. I struck off on this expedition, hell bent, on thinking I'd find that the closer you were to being a Vegan, the longer you were going to live. But actually, people in Blue Zones, except for the Advents, just love pork. And it figures into their diet. I would say, when it comes to food, beans is probably the cornerstone of longevity diets everywhere. Fava beans in Sardinia, soy beans in Okinawa, black beans in Costa Rica.
BUETTNERBut probably seven times as many beans as we do. They don't think of exercise the way we do, it's kind of a choir you have to do every day but rather their physical activity is laced in their daily life or landmine. Their -- they don't have a button to push for yard work and a button to push for housework and a button to push for kitchen work. They knead their own bread, they have a garden, their idea of physical recreation is often walking.
BUETTNERSo they get the right amount and the right intensity of physical activity. And more important than this, and we'll expand on this, but the -- it's not so much they eat right and they get the right amount of physical activity, as they have an equal system around them that helps keep these otherwise, kind of, restrictive behaviors happening in their daily life. And I would say, that's the big key.
PAGEAnd what do you mean by ecosystems around them?
BUETTNERThere's vocabulary for purpose, there is -- they tend to belong to a faith based community. They have good social networks. I could give you, Susan, the absolute Blue Zone diet. I know exactly what they ate and I could tell you exactly how to do it but the reality is, the recidivism curve of diets everywhere is about nine months, you lose 90 percent of people after nine months and you lose about 97 percent after two years.
BUETTNERSo even though I could tell you exactly what to eat, if the right sort of scaffolding isn't set up underneath you, you're not going to do it. And I think the big lesson that Blue Zone's gives us is what is that ecosystem necessary to be in place -- to keep eating right and moving the right amount and staying connecting in place for the long term.
PAGEAnd, you know, it's interesting because none of the factors that you mention involve having parents who live a long time or a family with no history of cancer or things about over which we don't have any control. These are all things that people could control in their own lives if they chose to.
BUETTNERRight, so just to clarify, the gene part, there are -- there's a small percentage of people who could eat bean sprouts and walk every single day and be completely engaged and die of cancer at 50. And there is another end of the spectrum of people who can smoke two packs of cigarettes, drink a fifth of whiskey and live to a 100. You know and they get centenarians a bad name. Most of us, 80 percent of us, are in the middle where the capacity of our human machine is about 90 or 91. And most of us could reach that age if we optimized our lifestyle. But people with really bad genes and people with really good genes, they're outliers.
PAGEWell, there has been this recent research about a gene for longevity, a study that found that scientists can guess, with 77 percent accuracy, whether a person can live into their late 90s or longer based on whether they have this particular gene. So that's part of it for some people.
BUETTNERYeah. I think that's come under a little bit of fire. There's a little bit of controversy around that. That the genetic role -- you think -- we have about 30 trillion cells in our bodies and there's so many things that can kill us. Your arteries can become clogged, you could develop Alzheimer's, you could get hit by a bus. So every time our cells turn over, that happens about once every seven years, they reproduce and they do so imperfectly. And there's a buildup of damage, there's a buildup of genetic and cellular damage.
BUETTNERThat's why an 80-year-old person is aging at a rate of about 250 times faster than a 12-year-old person. So getting ahead of that, the true mechanical underpinnings of aging is not something we're going to understand anytime quickly. But there are -- the things that shorten our lives, those are things that can enable us to reach that healthy age, 90, which is a promise to everybody.
PAGEThings such as?
BUETTNERWell, heart disease, cancer and diabetes, they collectively cost our country about $2.2 trillion a year and they knock about 11 years off of our life expectancy. We can avoid most of them.
PAGESo what is life expectancy in the United States, now?
BUETTNERIt' about 79. And we should be able to reach age 90. You go to places like Okinawa, the women there, their life expectancy is 87. So they're very close to that ceiling.
PAGEAnd so, tell us about Okinawa. You mentioned Okinawa, one of your Blue Zones. Tell us about the characteristics there that you think contribute to these very long life spans in Okinawa.
BUETTNERSo there's no vocabulary for the word retirement. You know that you -- your retire -- you're -- there's a threefold spike in mortality, in other words, you're three times more likely to die the year you retire then your last year of work. Well, they don't have retirement, they have the construct of something they call Ikigai, which I know sounds like that creepy guy at the end of the bar, but it actually means, the reason for which I wake up in the morning. And their life is imbued from that, from early adulthood until they're in their 90s and 100s.
PAGEAnd actually you found there are similar kind of mental -- similar words in other cultures that are Blue Zones, this idea that there is a reason that you're waking up in the morning.
PAGEAnd living your life.
BUETTNERPlonday (sp?) Veda in Costa Rica -- Dr. Robert Butler was the first director of the National Institute on Aging, authored a study that showed that people who could clearly articulate their sense of purpose, lived about seven years longer than people couldn't. And I think the reason we don't hear about it in America is because there's nothing to sell you. I can't put purpose in a pill and charge you $9.99 a month for it. So we don't hear about it. But actually, it's enormously important. It keeps you taking your medicine, it keeps you active, keeps you engaged.
PAGEAnd you talked about, in your book, in terms of Okinawa, that they -- people there eat sitting on the floor and that is probably helpful in keeping elderly people active and limber and able to get up and down a couple times a day.
BUETTNERSo it's more than that. So I actually have a great editor at National Geographic, Peter Miller, who told me to go live with the 100-year-olds. And you'd watch them throughout the course -- they don't have any furniture. So they're getting up and down 20 or 30 times a day, which is equivalent of a squat. So they have one of the things that kill older people, is simply falling down or falling down and breaking your hip.
BUETTNERThey don't have to worry about it as much because they have better lower body strength, better lower body balance. And that's, again, because they've engineered physical activity back into their lives or they've never engineered it out of their lives.
PAGEAnd you write about a particular 102-year-old woman who was living in Okinawa who had this adage, Eat until you are 80 percent full.
BUETTNERHara hachi bu, it's actually a Confucian adage, it goes back 2,500 years. And it's immensely powerful. And it's sometimes manifested at the plate, they'll put 20 percent of their food aside. But more often than not, you see it happen at the counter. People will pre-plate their food, put the leftovers away and then bring the right amount of food to the table. And our partner, Dr. Brian Wansink from Cornell was found that that practice alone occasions eating about 20 percent fewer calories, no diet, no exercise program, just hara hachi bu.
PAGEWe're going to take a short break and when we come back, we're going to talk about what the effect has been, even in Okinawa, to some addition of American food and American style lifestyles there. And we're going to take your calls and questions, your own comments. Our phone lines are open, 1-800-433-8850. Stay with us.
PAGEWelcome back. I'm Susan Page of USA Today sitting in for Diane Rehm. And with me in the studio, Dan Buettner. He's an explorer and a National Geographic Fellow. He's the author of "Thrive: Finding Happiness the Blue Zones Way. And we’re talking today about his -- the new edition of his book "The Blue Zones: 9 Lessons for Living Longer." You were talking about the extraordinarily long lives of people in Okinawa, especially women and yet there've been some effect for the new generation, the younger generation in Okinawa because of changes. Talk about that.
BUETTNERSo the longest living people on the planet are Okinawan women over a certain age. But people under age 55 actually have the highest rates of cancer, the highest rates of cardiovascular disease in all of Japan's 42 prefectures. And you look around and Okinawa's the home of the American army base and it is completed surrounded by fast food restaurants. The biggest A & W Root Beer in the world is in Okinawa.
BUETTNERSpam, which was introduced -- it's pork, salted pork shoulder was introduced by GIs in 1945 and it has taken on. Now Okinawa imports about five million pounds of spam a year. So the dietary habits that got these 100-year-olds to be 100 are evaporating along with the influx of the American food culture.
PAGEAnd is this a concern to Okinawans?
BUETTNERI think there's a certain portion of the population that laments the culture of longevity disappearing. But you ask a 14-year-old if he'd rather live to be 100 or have a big hamburger and a soda now, they're going to pick the hamburger and a soda. So...
PAGEAnd you did find a Blue Zone in America. As we said, Loma Linda, Calif. Talk a little about this community and how it is different from -- how the lifespan is different even from other places nearby.
BUETTNERYeah, so they're Adventists and conservative Methodists and they distinguish themselves from other Methodists in number one, they evangelize with health. Adventists run some of the biggest hospitals in America. But number two, they take their Sabbath on Saturday. And, as I said, they live about ten years longer -- Adherent Adventists live ten years longer than their North American counterparts. And you start asking yourself, well why is that.
BUETTNERWell, number one, they take their diet directly from the Bible. Genesis chapter 1 verse 28, God talks about seeds and green plants. And that's, for the most part, what they follow. But while other Blue Zones were geographically isolated and I think kept the globalism in American food culture at bay, they're kind of culturally isolated. They don't dance on Saturday. They sort of keep to themselves. They go to church on Saturday morning. They have some practices that I think keeps most of their social network being other Adventists so they don't have the other influences.
BUETTNERBut when you think of this power of 24 hours a week where you stop everything, you focus on your God, you build your social network, and hardwired right into their scriptures is a nature walk on Saturday afternoon. So when you're looking for secrets to longevity you can't look for something that I'm going to do today and for the next month and I'll live longer. You have to look for things that last years, decades or a lifetime. And the Adventist lifestyle, because of the way their social life is set up keeps these behaviors going on for decades.
PAGENow one of the Seventh Day Adventists you write about in the book is a woman named Marge Jetton. Tell us about her.
BUETTNERMarge was fantastic. At 101 she got her license renewed. She'd wake up every morning at 4:00 am. She'd read her Bible. She'd eat oatmeal followed with something she called a prune juice shooter. I'm not going to elaborate on that one but you can get that in your mind for a minute and then move it out. But then she would go pump iron, ride her bike and get in her 1994 root beer colored Cadillac Seville where she barreled down the San Bernardino Freeway still volunteering for seven organizations. She'd go into the Loma Linda Senior Center where she helped out what she called the old folks who all, of course, were 70.
PAGEAnd so volunteering, is that one of the things -- or volunteering, kind of living for others, doing things for others, is that one of the things that you found in all of these cultures?
BUETTNERThere were analogs to volunteering, but it works very well in our culture. Volunteering stimulates the exact same neuro pathways as sugar and crack cocaine. So you taste altruism and you tend to get addicted to it. And we know that people who volunteer regularly have lower BMIs, they have lower rates of cardiovascular...
PAGEBMI, body mass index, yes.
BUETTNER...body mass, thank you, they're less fat.
BUETTNERThey have less chance of heart disease and this really great study out of Baltimore, they actually have lower health care costs. So you want something better than any supplement you'll buy online to help you live longer, go down the street and volunteer.
PAGEIsn't that interesting? Well, let's go to speak to Haly calling us from Fayetteville, N.C. Hi, you're on the air.
HALYGood morning. So happy to be here. Um, I just wanted to reiterate, culturally I was born and raised Adventist actually out in Oregon. And a lot of the things that your guest said regarding culture are definitely right on. However, we don't dance period. That is a vast no-no. Like I said, I was born and raised in the church. And there are a couple of things that I wanted to bring up in addition to this was the -- what your thoughts and if there has been any studies that you're aware of regarding Adventists and celiac disease. I would venture to say that nine out of ten people that I am in contact with, friends, family -- and I'm not practicing right now, but the majority of them are Adventists who have celiac disease.
HALYAnd I also wanted to bring up we -- I say we loosely -- Adventists have our own brands of fake meats. And I personally choose not to eat them because they are full of chemicals and preservatives. And I suppose it's my personal running joke, well, yes, Adventists live -- tend to happen to live longer because they're so well preserved. So...
PAGEHaly, thanks so much for your call.
BUETTNERYou get like a tofu turkey there. I've seen the co-op there in Loma Linda, Calif. and just about any meat you can imagine, there's a nonmeat analogue for it. And, yes, if you look at the ingredients they often have a lot of sodium in them and lots of ingredients, the words of which you cannot pronounce. But I don't know your answer to your question about celiac disease but I know probably the best source. And if you Google something called the Adventist Health Study, Gary Frazier out there at Loma Linda University, he keeps the best track on the lifestyles of Adventists. And there you might find an answer to that question.
PAGEHaly, thanks so much for your call. You know, these five different Blue Zones, five different cultures, different faiths, but does there seem to be a connection between having a faith like Seventh Day Adventists and longevity?
BUETTNERWithout a doubt. I had a chance to personally interview over 260 centenarians and all but five believe in something bigger than themselves. And there's various definitions of it. But we know that people who belong to a faith-based community -- and it doesn't matter if you're Adventist or Muslim or Jewish or Buddhist. But those people who show up at least four times a month are living four to fourteen years longer than people who don't.
BUETTNERAnd the fourteen years, by the way, go to inner-city minorities. They get the biggest bump, especially sort of younger middle-aged minorities. And we don't know if that's because there's ritualized stress reduction or if because you have a better social network or you're less likely to engage in risky behaviors or if because god said. But the bottom line is you sure stack the deck in your favor by, you know, showing up to church.
PAGELet's talk to Dan. He's calling us from Hot Springs Village, Ark. Hi, Dan. You're on "The Diane Rehm Show."
DANGood morning. Thank you for taking my call. A few minutes ago your guest referred to a Bronze Age diet and I'd like -- I wonder if he could expand and -- define and expand that term, please? I would've thought the Bronze Age would've been hunters and meat eaters. But apparently that doesn't seem to be the case. I'm going to take my answer off the air. Thank you.
PAGEDan, thank you so much for your call.
BUETTNERWell, what I said was Bronze Age culture and that's the people who live in the Highlands -- the Blue Zone of Sardinia actually originated in what is today Spain and they were pushed up there by the Finicians and the Romans 2 to 3,000 years ago. And they have incubated, as you point out, a diet that we think favors longevity, but it's mostly plant based. They do eat some meat, but it's usually celebratory, maybe the size of a deck of cards, four or five times a month.
BUETTNERBut mostly what they're eating are whole grains. They're eating sheep's milk cheese, pecorino. They have a wine called (word?). It's a grenache that has the highest levels of polyphenols in the world, artery scrubbing antioxidants and fava beans. And if I were to pick one of those, I would pick fava beans to be the key.
PAGEYou know, you -- when writing about this region of Sardinia that you studied, you say 95 percent of people who live to 100 there have a daughter or a granddaughter to care for them. How common is that in these Blue Zones that there is a next generation or a generation after that that is taking care of these very elderly people?
PAGEUnlike America, that seems -- tend to celebrate youth, they celebrate age. And the older you get the more celebrated. And almost always in these traditional cultures you see the aging parent either living in the home or very near the home. In Cutty (sp?) you see it, Okinawa. And I think as this 107-year-old, her name was Rafael, put it to me and I think it sums up the general idea. She says because my parents keep me -- my kids keep me close I feel like I'm loved, which of course is important. We all need to feel that.
BUETTNERBut more importantly, and I remember she extended a bony finger and shook it at me and she said, more importantly I'm expected to love. So think about that. That's a big idea because what got her out of bed every morning, out of the easy chair kept her brain engaged was taking care of the kids and cooking and running the garden and being told in a very real way you count. You're not just -- we're not warehousing you somewhere in a retirement home and sending a check every month.
PAGEAnd you also found, I think, a common theme was napping. What about -- what did you find when it comes to napping as a help to having a very long life?
BUETTNERWell, that we saw in the Costa Rican Blue Zone and in the Blue Zone in Arcadia. And a nap was a daily -- napping has been associated with about 35 percent lower rate of cardiovascular disease. And we don't know if that's because nappers have lower stress hormones, if it's the nature of nappers to live with less stress or they just get more sleep so they live longer. But napping at midday is probably a pretty good idea, and even a better idea after turkey.
PAGEI'm Susan Page and you're listening to "The Diane Rehm Show." We're taking your calls, 1-800-433-8850. Let's go to Paulette. She's calling us from McLane, Va. here in the northern Virginia suburbs of Washington. Hi, Paulette.
PAULETTEHi. I'm so interested in this because I grew -- I was born and raised on the Island of Okinawa as an army brat. And I wonder -- and your guest may have just talked about this when I was on hold, I don't know. But the multigenerational families that live together in the villages on Okinawa I think are a big part of this. Because I think we know from many cultures when the young and the old live together they learn from each other. They are interconnected in the daily life of helping one another.
PAULETTEAnd also the elderly may not be able to do a lot of the hard manual labor, but I sure saw a lot of them out in those rice paddies in an unbelievably deep squat that I think our personal trainers here in America tell us not to do. But it has kept them active. It kept them involved in, you know, daily sustenance. They bring in their vegetables.
PAULETTEAnd as far as napping goes -- in fact, my Okinawan maid would laugh at American moms because they nap too much. They would rest -- I think what they do is the Okinawans take time to rest every day, but not necessarily cuddle up and really, you know, cut the Zs for two hours. They take little rests. But I think it's fascinating and I'm thrilled to hear about his study.
PAGEAll right, Paulette. Thank you so much for your call.
BUETTNERYeah, I was just talking with the editor of AARP, Nancy Graham, right before this and she was lamenting how AARP is struggling a little bit with the notion of getting old, that it's not -- it's something people want to avoid here in America. In Okinawa the biggest day in your life is your 97th birthday. So the...
BUETTNERIt's some sort of a lunar calendar thing. But if you reach age 97 the whole village will come out, your family will come from near and far and celebrate it. You go to the cemeteries on Sunday and people are having picnics on grandma's grave. The nicest room in the house has an ancestor shrine where people will spend a few moments every day remembering where they came from. So it's this whole idea that you're constantly worshipping the generation that came before you.
BUETTNEREvery mammal including whales that keep aged -- the grandparents nearby have a better survival rate than those mammals that sort of discard the grandparent generation.
PAGELet's talk to Karen. She's calling us from Salt Lake City. Hi, Karen.
PAGEYes, please go ahead.
KARENAll right. I just wanted to go back to that bit about taking naps and how that can make your life longer. My great grandmother who survived the Armenian genocide, she just passed away this past summer at 107 and she ate a horrible diet, ate butter, meats, the whole gamut. But she walked a lot and she napped a lot. She always said that she never got a full night's sleep, but she'd take 20-minute naps all day long. And I wondered if that had anything to do with her long life.
PAGEInteresting, 107. That's a pretty good age to reach.
BUETTNERI wish I would have met her. Well, I think, you know, it's one of the things, the ways that we learn when we're in kindergarten, the power of taking a nap. And in southern Mediterranean cultures were doing it up until very recently. Again, you -- if you're napping at least five times a week, about a half hour a time your chance of cardiovascular disease are about a third that they would be if you muscle through the afternoon.
PAGESo tell us, how did you get interested in this field of study?
BUETTNERWhen most people are off doing useful and productive things with their life after college, I rode my bike. I rode -- set a record for biking around the world through the Soviet Union. I biked the length and width of Africa and I biked from Prudhoe Bay, Alaska, to Tierra del Fuego, Argentina, 15,536 miles, which sounds impressive but anybody...
PAGEIt sounds very impressive, yes.
BUETTNERIt's all downhill.
PAGEAnd yes, I was just going to say that.
BUETTNERBut then I got involved with National Geographic organizing these quests, Mia quests, Asia quests. And the idea behind them was to let an online audience direct teams of experts to solve mysteries, and got very good at learning how to first bring the best experts in a field together. But also in making the connection with big audiences to kind of harvest the wisdom of the crowd. And that evolved into doing this Blue Zone work in 2000.
PAGEAnd there -- you have taken teams of experts to explore each of these Blue Zones.
PAGEAnd who is on these teams?
BUETTNERMy main partners are Dr. Michel Poulain who's a demographer from Belgium and Dr. Gianni Pes, who is a physician from Sardinia. Also Dr. Craig and Bradley Willcox from (word?) Harbor, but they work mostly in Okinawa. And then I bring -- Arcel Georgia (sp?) is another physician. We have then researchers, Sabriya Rice who's a medical journalist. And what -- our process is we first hear about this place. We confirm people are really as old as they say they are. And then our teams are really good at going into the culture to try to find what are the characteristics that seem to associate or correlate with longevity.
PAGEWe're talking this hour with Dan Buettner. He's an explorer and National Geographic Fellow and his book is called "The Blue Zones: 9 Lessons for Living Longer." We're going to take a short break. When we come back we'll go back to the phones and take some of your comments and questions. Our toll free number 1-800-433-8850. You can always send us an email firstname.lastname@example.org. Stay with us.
PAGEWelcome back. I'm Susan Page with "USA Today" sitting in for Diane Rehm. She'll be back on Monday. We're talking with Dan Buettner, an explorer, "National Geographic" fellow, talking about his new book, "The Blue Zones: Nine Lessons for Living Longer." Now you've got five blue zones, you originally had four. You added Ikaria, Greece to this list. So tell us about that area.
BUETTNERIt's off the coast of Turkey, 99 square miles. Remember Icarus, the Greek god who pasted wings to his back and then flew up to the sun. Supposedly he fell into the sea right there. But this was, for most of, as the rest of Western civilianization was developing it was called a garbage dump. It was largely overlooked by the development of Western civilianization. There were no natural harbors.
BUETTNERAs a result, a completely different culture grew up there. One that was more isolated and one that's really only had much exposure to the rest of the world since about 1970, a very mountainous place.
PAGEAnd, you know, we have an email from Joyce in Tampa, Fla. and she writes, "I do not want to live long unless my brain functioning is also good." Well, one thing you found in Ikaria is that the signs of dementia are much lower than they are, even in Athens, even in the same nation.
BUETTNERYes, we found, a follow-up study from our original find, interviewed 95 percent of people over age 70 on the whole island. About 650 and found the rate of dementia about one-fifth the rate that it is here in the United States. So these people not only living a long time, they're staying sharp to the very end and that, I think, is the great promise here.
BUETTNEROne of the reasons we think might have something to do with the teas they drink. An oregano, rosemary and thyme teas, which are anti-inflammatories but they're also diuretics, which we think may be chronically lowering blood pressure and might reduce the inflammation load which is correlated with Alzheimer's.
PAGENow, you actually have quite a remarkable personal story about a man who was from Ikaria, came to this country. Tell us what happened with him.
BUETTNERYes, his name is Stamatis Moraitis, came here in World War II, got a job as a painter. Married a Greek-American, he painted Rose Kennedy's house, bought a Chevrolet. In short, achieved the American dream. When he was 65 though, doctors diagnosed him with lung cancer and said he had six months to live. He went to several more doctors, all of whom said the same thing.
BUETTNERSo he figures, well I can die in America where it's going to cost $2,000 to be buried. This is in 1970. Or I can go back to Ikaria, get buried with my ancestors and for $200 have a really nice burial and leave money left over for my bride. So he moves back to Ikaria, moves in with his parents, who are now in their late 80's, starts drinking the wine, eating the food, breathing the air, connecting with his friends, going back to church.
BUETTNERSix months comes and go, he doesn't die. Today, 37 years later, he's still alive. He has his own vineyard and produces 200 liters of wine a year, which he drinks all himself with his friends, of course.
PAGEAnd so what do you make of that story? It sounds like a miracle.
BUETTNERWell, there are lots of Ikarian men who lived tough lives in America then go retire there. I wrote it originally for The New York Times magazine because it illustrates the power, I think, of changing your environment. For none of these centurions, none of them said, you know, I'm going to try really hard and eat the right foods and live to be 100.
BUETTNERIt happened and he was an outlier mascot of the power of living in the right environment or creating the right environment. And, you know, I called him last summer and I asked him if he ever figured out how he got to be, he got rid of his lung cancer, and he said, "You know, I did a lot of thinking about that and 15 years ago I went back to America to ask my doctors if they could do tests."
BUETTNERAnd I said, yes, well, what did you find out, and he said, nothing, all my doctors were dead. So, but he's still kicking, you can go visit him.
PAGENow, Diane in Washington D.C., sent us an email. She says, "Everyone dies, how do these blue zone folks eventually die? Is there anything that you would say that is different about their deaths when they do eventually take place?"
BUETTNERYes, so there's two types of aging. One time of aging is, or longevity, is dying from diseases that foreshorten our lives, cardiovascular disease, cancer, diabetes. The other type of aging just comes, and this is the technical definition, of the buildup of cellular and molecular damage over time. It's like owning a 1976 Pinto and driving it for a long time and one day it just dies on the side of the road.
BUETTNERThat's what we're getting with these people in blue zones. They live a long time, largely without disease, they die very quickly and occasionally, most of the time in their sleep. And that's not only a painless way to die, it's also an inexpensive way to die which, I think, offers us an important lesson with the healthcare costs we have in this country.
PAGEWhat is the lesson there?
BUETTNERThe lesson is that by optimizing our environment and avoiding chronic diseases, that's where we should be spending most of our money as opposed to trying to fix problems after we get it, i.e. spending lots of money in state of the art care for taking care of really sick people as opposed to investing some of that money at the front end.
PAGELet's go to Charlotte, NC and talk to Anita. Anita, thanks for holding on.
ANITAHi, thank you. very interesting topic and as I was listening I had to wonder if one can gain the benefits or expect to see an increase in longevity of senility if we adopted these lifestyle or practices at, say, mid-life?
BUETTNERYes, at mid-life if you have average health you could live probably six to seven extra years of life if you optimize your lifestyle as opposed to eating the standard American diet and being sedentary.
PAGEYou know, you can, listeners can go on "The Diane Rehm Show" website, drshow.org, and calculate your life expectancy using the compass test that you have set up for blue zones.
BUETTNERThe vitality compass.
PAGEYes, the vitality compass. Now, I went on the site this morning and took the vitality compass for myself. My life expectancy was 94.2 years, which sounds pretty good.
PAGEBut it said my healthy life expectancy, which would be more to the point, was 84. So I think that 10 years sounds a little alarming.
BUETTNERYes, so that predicts the first time you're going to see a sign of chronic disease. It doesn't necessarily mean, you know, you're going to end up in bed.
PAGEAnd it says accrued years 10.6. What does that mean?
BUETTNERThat means you've lived overall with very good lifestyle habits. That if, you know, if you smoked cigarettes and sat on the couch and watched reruns of "Leave it to Beaver," you know, you probably have a negative number in that column, but you're obviously engaged and fit and...
PAGEWell, one of the things that I thought was interesting about the questions that were asked, they weren't really medical questions. They were all lifestyle questions, they were, "How often do you have vigorous exercise? What kind of foods do you eat?" I mean, things that are just very much part of your daily habit.
BUETTNERSo the vitality compass was built in collaboration with the University of Minnesota School of Public Health and it starts with CDC life table data for age, gender and ethnicity. So an average woman who's 40, how long are they going to live? And then we called through 335 studies to know how what you eat, how much you socialize, what clubs you belong to, affect your life expectancy, given a baseline.
PAGEIf something happens to me before 94.2 I'll be giving you a call. Let's to talk Cary, who's calling us from Sunfield, Mi. Hi, Cary.
CARYHi, how are you today?
CARYWell, I have a comment and a question. I'm just really enjoying this topic and what a wonderful discussion. Longevity seems to run in my family and as a result I have the expectation of longevity and personally I think that just that expectation makes a difference. Consistent with that expectation, I'm 64, I love my family and I have a three year old daughter.
CARYA three-year-old daughter, just a joy in my life, and currently I think late parenting also makes a difference, as she forces me to think young and enjoy her fascination with the world. Am I right? Does late parenting influence longevity, do you know?
BUETTNERYou're absolutely right. The demographic in America most likely to reach age 100, and this comes from Dr. Thom Perls, are women who have children over age 40 and I assume it extends to men. But also the biggest predictor of how long you're going to live is how long you think you're going to live. Paul Costa at the National Institute of Aging found that one. So I think you're on a very good path for 100 there, Cary.
PAGECary, thanks for your call. You know, you write in the book that your health at age 80 is a pretty good predictor of what's going to happen after that.
BUETTNERYes, so if you make it through 80, especially with men, there seems to be sort of a hurdle, if you will, in your 60's and your 70's. a lot of, big chunk of the American male population are dying of heart disease and cancer at those ages. If you clear that hump your chances of, you have clearer runway, no guarantees but a clearer runway to make it to your early 90's I would say.
PAGELet's go to Mark. He's calling us from Syracuse, Ny. Mark, welcome to "The Diane Rehm Show."
MARKThank you. your topic is interesting to me, I am a Seventh Adventist and back in the 1960s it was not cool to have a healthy lifestyle. It was not cool to exercise, it was not cool to go to church on Saturday. However, as I have grew up, I graduated from Andrew's University, a Seventh Adventist university in Michigan and began to embody their mission which was corpus mens spiritus, "Of Body, Mind and Spirit."
MARKI started thinking about, you know, these issues, on living healthily. I went to medical school at Lo Melinda and became a physician. One of the courses I remember most was not physiology, biochemistry or anatomy but it was whole person care. It was very interesting because the professor took us into the hospital and we would talk to patients.
MARKNot about, you know, their electrolytes or their blood pressure but about their spiritual issues. It wasn't religion at all, it was what is your source of strength, how do you connect with significant relationships in your life. Anyway, my observation is whole person care to me was probably the biggest thing I brought away from undergrad and graduate school. And in your work with these blue zone groups, to what degree do you see community, do you see people concerned with spiritual issues, physical issues and whatnot?
PAGEAll right, thanks very much for your call Mark.
BUETTNERMark, I think you hit the nail right on the head and people ask me, I've been doing this for a while, they want to know the diet of longevity, what the ideal exercise. But it's really this ecosystem that you point out. What keeps people doing the right things for a long time and you're right, it is, I feel like I belong, I have a sense of purpose, I have a faith in my life. I have a harder time with spirituality.
BUETTNERBut social network is huge. If your three best friends are obese there's a 150 percent better chance that you'll be overweight. So you look at these bicentenarians and their social networks, are people who active and/or eating plant-based and they do it naturally.
PAGEI'm Susan Page and you're listening to "The Diane Rehm Show." We've been taking your calls, 1-800-433-8850. Well, we've got a lot of callers who are interested, well, okay these lessons sound great, we'd like to live to be 90 or 100 years old and to be fit and lucid all that time. so are there, there are some efforts you write about, in this country, to establish the kind of ecosystems you talk about that encourage people, that enable people to have a long life. What are some communities doing?
BUETTNERSo I teamed up first with AARP and Healthways for a city called Elbert, 20,000 people and they adopted blue zones...
PAGEAnd where's that?
BUETTNERIt's in southern Minnesota, 20,000 people. And they adopted blue zones tenants by changing their environments, optimizing their policy, their building designs, their built environment, their social network. And we were able to raise their life expectancy on average by three years and lower healthcare costs of city workers by 40 percent.
PAGEAnd how long did it take to do this?
BUETTNERThey've been -- we've been working with them for three years. But...
PAGEBut in three years you increased life expectancy by three years?
BUETTNERYes, we changed the environment so that what people would be doing for the rest of their lives would predict more physical activity, eating more vegetables, more connectivity and more volunteering.
PAGEAnd it was voluntary, right? This wasn't, you didn't have a Stalin-ish state that forced people to do these things. How did you encourage people to adopt these practices?
BUETTNERWe made them audition and we said here is the blueprint and they're slightly Bloomberg-esque by the way, but we only pick cities who are really ready and ready to be partners in innovation and ready to make some long term changes. And we've since taken it to the Beach City health district in Los Angeles, three cities three and the whole state of Iowa, with the governor there, Branstad and with Wellmark. So now 3.2 million people in middle America will be trying to become a blue zone.
PAGEAnd what are you doing in the state of Iowa to make the state of Iowa a blue zone? And what a selling point that would be for business development, right? To make the whole state of Iowa a blue zone, how are you going about that?
BUETTNERWe're, 93 cities competed to pick, to be one of the first 10 cities. So we have 10 cities geographically dispersed throughout Iowa of different sizes. And we have a policy bundle, a policy bundle that makes it hard to smoke, hard to...
PAGEHow do you make it hard to smoke?
BUETTNERYou make it illegal to smoke indoors and outdoors and you actually enforce it.
PAGEIf it's illegal to smoke indoors and outdoors where exactly do you smoke?
BUETTNERIn your house or go out into the country, but the idea is to de-normalize smoking, like San Luis Obispo has the lowest rate of smoking rates in America. Do the policies favor vegetables or do they favor fries and soda pop? Makes a big difference on what people ate. Does the economic thrust of the local community push outward in a sprawl or does it turn inward to create a more sense of community, easier places to walk?
BUETTNERIn schools, can kids eat in hallways and classrooms? If they do, the weight of those kids is 11 percent higher than in a school where you simply prohibit eating in classrooms and hallways. So we have kind of a blue swarm, if you will. Instead of silver buckshot, we have, you know, um, silver, but we have blue, we have silver buckshot, 60 or so small things that we get the community to adopt, all of which move a population one or two percent. We measure it on the front end and measure it on the back end.
PAGEAnd what's been the hardest thing to do or the thing that's proved to be impossible that you'd hoped to do, perhaps, in Iowa? Is there something that's been more difficult than the other steps?
BUETTNERWell, some of the big legislation, the number one, the biggest health threat that we consume is smoking, right? the second biggest one is soda pops, we get most of our refined sugar from soda pop and it's very, I think, taxing soda pop would probably make the biggest impact on lowering the obesity rate. Now, if you're going to pick on one thing, you don't want to just pick one thing, but trying to get that passed
PAGEYou said one of the biggest predictors of how long you'll live is how long you expect to live. How long do you expect to live?
BUETTNERI'd like to live to 120 and I think given the pace of discovery, that's within reason.
PAGEWell, that would be remarkable. Dan Buettner from the "National Geographic," author of "Blue Zones: Nine Lessons for Living Longer." Thanks so much for joining us this hour on "The Diane Rehm Show."
BUETTNERI loved it.
PAGEI'm Susan Page of "USA Today" sitting in for Diane. Thanks for listening.
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