A recording of this presentation can be found HERE.
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Many thanks to Dr. Jesse Perez for an excellent talk on longevity and "the blue zones". A recording is available above.
My notes:
Dan Buettner, a National Geographic explorer and journalist, coined a term called "the blue zones" in 2004 (and later wrote a book about them with the same name) after an exploratory visit to Okinawa to investigate longevity.
Buettner called out these places
- Sardinia, Italy
- Nicoya, Costa Rica
- Ikaria, Greece
- Okinawa, Japan
- Loma Linda, CA USA
These are all geographic centers where, not only do people live longer, but they also have a good quality of life as they age. They all contain a disproportionate number of centenerians (people over 100 years old), who have been able to delay chronic disease by decades and who have also been able to stay physically active and mentally sharp.
In terms of centenarians (per 100K population), Japan boasts 73/100K, the US 24/100K, Canada 33.5/100K, and China 4/100K.
Sardinia, Italy, a Mediterranean island, was one of the first blue zones to be "discovered". They eat a mostly plant-based diet (only 5% of the diet is meat/fish/poultry). They have steep hills that inhabitants must traverse -- going up and down many times per day -- and they have cultural norms that promote stress management.
Loma Linda, CA is a Seventh Day Adventist community which deeply respects the sabbath as a day of rest, is grounded in gratitude and fellowship with community, follows a mostly plant-based diet with the biggest meal earlier in the day. People there partake in regular exercise, and limited alcohol, tobacco and caffeine.
What do these places have in common?
Customs and norms that seem to be replicated in different places and promote longevity include:
- natural daily movement
- purpose (reason to get out of bed)
- stress management
- 80% rule of Okinawa, in which people are taught to eat until they are "80% full"
- plant-based diets
- moderate alcohol use (except Loma Linda, which has none)
- community and religiosity
- keeping family close
- positive influences
There is much debate over the nature vs. nurture in life expectancy. Twin studies show that 50% is likely environmental and 20-30% is genetics. Interestingly people who live over 90 years old have an even stronger genetic influence.
A case study of a town of 9K people in 2009, in which some of the principles of the "blue zones" were implemented town-wide -- found that when you increase people's access to plant based food options, provide healthier options, have children provide no-candy based fundraisers, offer fruit as the default (instead of fries) and improve walking paths -- in just one year, life expectancy was extended by 3.2 years AND health care costs were decreased by 40%.
What are the leading causes of death in the US?
Lifespan vs. Health span
There is also a concept in longevity medicine of considering Health span vs. Lifespan, that is what is the quality of your life not just the longevity of life. Health span takes into account cognitive health, physical health and emotional/mental health.
We know that several lifestyle factors influence cognitive decline: exercise, moderate alcohol use (1/day), sleep, mental stimulation, and social connection.
UCSF has an E Prognosis calculator, which estimates your 6 month mortality based on a number of factors. Evidence shows that patients DO want to understand how much time they have left. Consider trying it out with some of your elders.
Final recs from Dr. Perez to live a long and health life:
- plant based diet
- movement
- stress management
- community
- have a purpose
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