by Dan Buettner-
NPR.org, June 7, 2008 =B7 When Juan Ponce de Le=F3n landed on the
northeast coast of Florida on April 2, 1513, he was searching, it's
been said, for a Fountain of Youth =97 a fabled spring of water that
could bestow everlasting life. Historians now know there was more to
the story. The reason the Spanish explorer set out to investigate
lands north of the Bahamas was probably because Spain had reinstated
Christopher Columbus's son Diego as military governor, effectively
removing Ponce de Le=F3n from the office. Nevertheless, the legend
behind Ponce de Le=F3n's voyage stuck.
The idea of discovering a magic source of long life still has so much
appeal today, five centuries later, that charlatans and fools
perpetuate the same boneheaded quest, whether it comes disguised as a
pill, diet, or medical procedure. In an all-out effort to squash the
charlatans forever, demographer S. Jay Olshansky of the University of
Illinois at Chicago and more than 50 of the world's top longevity
experts issued a position statement in 2002 that was as blunt as they
could fa****on it.
"Our language on this matter must be unambiguous," they wrote. "There
are no lifestyle changes, surgical procedures, vitamins, antioxidants,
hormones, or techniques of genetic engineering available today that
have been demonstrated to influence the processes of aging."
The brutal reality about aging is that it has only an accelerator
pedal. We have yet to discover whether a brake exists for people. The
name of the game is to keep from pu****ng the accelerator pedal so hard
that we speed up the aging process. The average American, however, by
living a fast and furious lifestyle, pushes that accelerator too hard
and too much.
This book is about discovering the world's best practices in health
and longevity and putting them to work in our lives. Most of us have
more control over how long we live than we think. In fact, experts say
that if we adopted the right lifestyle, we could add at least ten good
years and suffer a fraction of the diseases that kill us prematurely.
This could mean an extra quality decade of life!
To identify the secrets of longevity, our team of demographers,
medical scientists, and journalists went straight to the best sources.
We traveled to the Blue Zones =97 four of the healthiest corners of the
globe =97 where a remarkably high rate of the longest-living people
manage to avoid many of the diseases that kill Americans. These are
the places where people enjoy up to a 3 times better chance of
reaching 100 than we do.
In each of the Blue Zones, we used a survey developed in collaboration
with the National Institute on Aging to identify the lifestyle
components that help explain the area's longevity =97 what the
inhabitants choose to eat, how much physical activity they get, how
they socialize, what traditional medicines they use, and so forth. We
looked for the common denominators =97 the practices found in all four
populations =97 and came up with what I consider to be a cross-cultural
distillation of the best practices of health, a de facto formula for
longevity.
Herein lies the premise of The Blue Zones: If you can optimize your
lifestyle, you may gain back an extra decade of good life you'd
otherwise miss. What's the best way to optimize your lifestyle?
Emulate the practices we found in each one of the Blue Zones.
Facts ABOUT Aging
When taken together, the Blue Zones yielded nine powerful lessons to
achieve a longer, better life. But before we get into the details, I
think it's crucial to understand a few things about just how people
age and establish some basic principles and definitions. How long can
each of us expect to live? What really happens to our bodies when we
age?
Why can't we just take a pill to extend our lives? How can we live
longer? How can we live better? And why does changing our lifestyles
add more good years?
To answer these and other fundamental questions, I've asked some of
the world's experts to describe their latest research in everyday
terms. Together these scientists represent the best thinking in
biology, geriatrics, and the science of longevity.
Steven N. Austad, Ph.D., studies the cellular and molecular mechanisms
of aging at the University of Texas Health Center at San Antonio. A
professor at the Sam and Ann Barshop Center for Longevity and Aging,
he is the author of Why We Age: What Science is Discovering About the
Body's Journey Through Life.
Robert N. Butler, M.D., is President and CEO of the International
Longevity Center-U.S.A., a policy and education research center in New
York City. A professor of geriatrics and adult development at Mount
Sinai Medical Center, he is the author of Why Survive: Being Old in
America.
Jack M. Guralnik, M.D., Ph.D., is chief of the laboratory of
epidemiology, demography, and biometery at the National Institute on
Aging in Bethesda, Maryland.
Robert Kane, M.D., is director of the Center on Aging and the
Minnesota Geriatric Education Center at the University of Minnesota in
Minneapolis. He is a professor in the School of Public Health, where
he holds an endowed chair in Long-term Care and Aging.
Thomas T. Perls, M.D., M.P.H., is director of the New England
Centenarian Study, an associate professor of medicine and geriatrics
at the Boston University School of Medicine, and author of Living to
100: Lessons in Living to Your Maximum Potential at Any Age.
I interviewed each of these experts separately, then sorted the best
of their answers to each question. Here's what they told me.
What exactly is aging?
Robert Kane: That is a very profound question. Number one, aging
starts at birth. If you think about it, there is a constant
development that occurs within all species. You can think of it as the
balance between the individual and the environment. In essence, we can
think of aging as a loss of coping mechanism, a failure to be able to
maintain internal control and balance.
We start out as children, and we gradually accrue various changes in
our characteristics. Children are susceptible to the environment and
must be protected. In the case of humans, we probably peak in our
mid-20s. We hold our own for a while, then at some point, perhaps in
our mid-40s, we start to decline. Some people would say we actually
begin to decline at age 30. It depends on the system that you track.
Old age is another period when the balance favors the environment;
older people need help in protecting themselves. The frailty we
associate with old age is basically the loss of autonomy, the
inability to withstand external pressures and perturbations.
Aging includes both the positive and negative changes that occur. A
gerontologist would define aging as the risk of dying. Irrespective of
the presence of disease, there is, given this finiteness of a life
span, a continuous risk of dying. In most cases this increases as our
age increases. Other factors can change your risk of dying as well as
aging, so it's not that aging alone is the determiner, but it is the
overarching change. People have been searching for biological markers
of aging, and so far nobody has found any that are absolutely constant
and separate from the onset of diseases.
People look at, for example, the loss of accommodation in the lens of
the eye. Most people become farsighted, usually in their early 40s. It
doesn't happen to everyone, so you can't say it's a universal sign of
aging. Graying of hair, loss of collagen in the skin, all of these are
changes that have been described with regard to aging. There's a
change in body composition as people get older. It can obviously be
influenced by exercise and diet, but in general, we lose muscle mass
and gain body fat. The immune system changes with age and becomes less
competent, but again, not in any universal way that we can say is a
characteristic of aging.
Steven Austad: I would define aging as the gradual loss of physical
capabilities, whether you're talking about the ability to run, to
think, all those things. It's a gradual and progressive loss of
physical and mental abilities, the ability to do things that you
previously could do. What it means is that basically, you're not
designed to maintain your physical integrity forever.
Robert Kane: There are several theories about aging. One is that there
are genes in your system that turn on and turn off, either to
ameliorate or to expedite aging. Another theory is the "Garbage-Dump
Syndrome," which theorizes that you ac***ulate toxins as you go along
and things happen.
But again, the question you have to ask is why does the body
ac***ulate toxins? Well, you probably ac***ulate toxins because some
of the intracellular mechanisms that were working at one point have
stopped working. So are the toxins really a sign of aging or merely a
concomitant of some other biological process that has changed,
presumably driven by some genetic clock that exists inside the body?
We honestly just don't know.
What is the average American lifespan?
Robert Kane: I would imagine that a 30-year-old person today has a
reasonable chance of living =97 depending on whether a man or a woman =97
to his or her late 70s or early 80s. If you took away major risk
factors such as heart disease, cancer, and stroke, you would be
adding, I would guess, maybe 5 to 10 years to that initial life
expectancy.
Tom Perls: For most of us, our bodies are like cars built to go
100,000 miles. A few cars can go 150,000 or more miles with the right
genetic makeup. But they do deteriorate over time, even with the best
upkeep. With that deterioration comes frailty. When you hit a bump in
the road, you are less capable of bouncing back. There comes a point,
with continued decline, where there's no bounce back, and that's when
you pass away.
What are the chances of living to 100?
Jack Guralnik: Well, they are small of course, probably less than one
percent. Again, figuring it out depends on what age you currently are.
If you're talking about someone at birth, it's a different estimation
than for someone who's already made it to 80. Also, if you want to
consider health status, that plays a large role. Most people who make
it to be centenarians when you look back, they were quite healthy at
80.
Tom Perls: I used to equate living to 100 to picking all five numbers
in the lottery: The odds are pretty small. If you have longevity
running in your family paired with good health behaviors, your chances
are greater.
Centenarians today are the fastest growing segment of our population,
partly because we're doing a better job of screening for high blood
pressure. That's one im****tant lottery ball that we don't need to
leave to chance. Now instead of five numbers, it's down to four.
Another one that we've pretty much gotten rid of is substantial
childhood mortality. With much better public health measures like
cleaner water supplies, more years of education, improved social-
economic status, these things are all reducing the number of lottery
balls.
The best way to think about reaching 100 is: "The older you get, the
healthier you've been."
Steven Austad: The question is =97 and here's where I think the best
health practices are really im****tant =97 if you live to be 100 years
old, what sort of 100-year-old are you going to be? Are you going to
be bedridden and unable to take care of yourself? Or are you going to
be reasonably independent and alert? To me, that's what the best
health practices can really have an impact on.
Is there a pill that can extend Life?
Robert Kane: There are a lot of nostrums out there. None of them has
credibility. None of them has been even close to rigorously tested,
everything from to human growth hormone to antioxidants. Every time
anyone has studied them with any degree of rigor, they do not pan out.
That does not mean that some new discovery may not be just over the
horizon, but at the moment that is probably not the path.
Just think about it: If antioxidants were so healthful, the whole
generation that grew up eating Twinkies, Wonder Bread, and the like
(the kinds of foods that are loaded with antioxidants to assure that
they had a long shelf life and would never spoil) should never grow
old.
Robert Butler: DHEA, human growth hormone, and melatonin are all
extremely questionable, and are probably ill advised.
Using human growth hormone in human beings bulks them up. But it does
not just mean more muscle mass. With it can come hypertrophy of the
heart, fluid retention, and other problems. And of course there's a
disease, acromegaly, which is actually characterized by an excess of
human growth hormone. DHEA is what's for years been called the "junk
hormone." In large quantities in our bodies, it converts to both
testosterone and estrogen. Most of the studies on almost all of these
hormones have been very short-lived, that is six months to a year. So
the long-term effects are not well known.
The best source of information on hormones is Marc Blackman at the
Wa****ngton, D.C., Veterans Affairs Medical Center, or Mitchell Harman
at the Kronos Longevity Research Institute in Phoenix, Arizona.
They've done the most sophisticated studies and probably the best ones
we presently have on the hormone story.
Are vitamin supplements helpful?
Robert Butler: Of course you should maintain your basic daily vitamin
requirements. But you shouldn't get carried away either. Vitamin E was
under study by the National Institute on Aging in the hopes that it
would prove to be very valuable with Alzheimer's disease. But it was
not. So I think, like so many things in nature, it's a matter of
amount, what might be called pro****tionality, or just plain wisdom.
People used to think if a multivitamin was good for them, then more of
it would be even better, but that's just not true, unfortunately.
Most vitamin requirements are best achieved by eating six to nine
servings of fruits and vegetables a day. Very few people do that, so
probably the cheapest, least expensive multivitamin you can buy is not
a bad idea to help achieve them. If you're an older man, you should
not have a supplement with iron because iron ac***ulates in the heart
and can lead to a condition called hemosiderosis. Look on the market
for vitamin supplements that do not have iron that are designed
specifically for men.
What's a smart diet for longevity?
Robert Kane: Eating a reasonable diet makes a lot of sense. Again, it
doesn't mean that I think you have to be a vegetarian. One of the
goals to a healthy lifestyle is moderation in all things. What one is
looking for is moderation, taking in a level of calories that is
necessary and balancing those calories across carbohydrates, fats, and
proteins. Taking in really what you need. There are some things we
know that are just generally bad. Most fast foods are not necessarily
healthy. We seem to like a lot of the things that are bad for us:
salt, sugar, fat. There is something about humans that is inherently
self-destructive, at least when it comes to eating.
The best diet is basically one of moderation. You hear about all these
people that live on legumes and plant foods and that's probably okay,
but I don't think it's necessary.
One certainly can metabolize a certain amount of meat, but again it's
a question of are you eating European ****tions or American ****tions?
Are you eating meat a couple of times a week, or are you eating it
every day for two meals a day? Are you eating processed meats that are
filled with fat? Or are you eating good cuts of fairly lean meat?
To me, I just come back to moderation. Assuming that you were in
pretty good shape in your 20s, if you could maintain that weight, you
would be in good shape. The truth is at 20, you could for all sorts of
reasons, eat all sorts of terrible things and maintain that weight,
because you were more physically active, because your system was just
more resilient. As you get older, you lose that resilience. So you are
more susceptible to lifestyle behaviors that can do you harm than you
were when you were younger.
What can add on more good years?
Robert Kane: Rather than exercising for the sake of exercising, try to
make changes to your lifestyle. Ride a bicycle instead of driving.
Walk to the store instead of driving. Use the stairs instead of the
elevator. Build that into your lifestyle. The chances are that you
will sustain that behavior for a much longer time.
And the name of the game here is sustaining. These things that we try
=97 usually after some cataclysmic event has occurred, and we now want
to ward off what seems to be the more perceptible threat of dying =97
don't hold up over the long haul. We find all sorts of reasons not to
do it.
The second thing I'd tell you is don't take up smoking. The biggest
threat to improving our lifestyles has been cigarette smoking. That
trumps everything else. Once you're a nonsmoker, I would try to get
you to learn to develop a moderate lifestyle in regard to your weight
to build into your daily routine enough exercise to keep you going.
Does going to the gym help?
Robert Kane: Exercise has several quite distinct functions. You have
cardiovascular exercise, which we describe as aerobic exercise, which
increases your body's capacity to process oxygen. That's where you go
out and work really hard and raise your heart rate. Swimming would be
a good way to get that kind of exercise.
There's also antigravity exercise. For example, if you're trying to
prevent osteo****osis, swimming isn't the optimal activity, because it
doesn't increase the strength of your bones. There, working against
gravity, walking, standing does more to increase bone metabolism than
swimming does.
Then there are exercises designed to improve your balance. Tai Chi is
one people talk about, or yoga. Those are exercises that have been
associated with reducing the risk of falls. Then there are strength
exercises, which run all the way from weightlifters, who probably put
themselves into a disadvantageous state from overdeveloping their
muscles, to people who do some modest amount of weightlifting or
antigravity exercise that strengthens their muscles.
The data suggest that a moderate level of sustained exercise is quite
helpful. There are studies that show that people who run marathons
tend to have much better cardiovascular systems than people who don't.
You could say that that says more is better, but those exercises
generally take a toll on your joints. So marathoners have good
cardiovascular systems, but they will probably have to have their
joints replaced. But in general, if somebody could do a minimum of 30
minutes =97 maybe we could raise it to 60 =97 of exercise at least five
times a week that would help. And it doesn't appear to have to be all
at one time, although that seems to be better. If you did that and you
could sustain it, that would be good.
How can we maximize the good years?
Robert Kane: Again, there are two issues here. How long can I live?
The other is: How well can I live? And those are different questions.
Living an extra two years on life sup****t may not necessarily be your
goal. The question is: Can you delay the onset of disability? "Good
years" is a very im****tant concept.
There are some things I'd certainly recommend for what people would
call successful aging. One of them is, in fact, to have a sense of
social connectedness. Most people enjoy the company of other people,
particularly other people who they feel care about them. That seems to
give you a sense of well being, whether that raises your endorphin
level or lowers your cortisol level. We don't know why. People have
looked for biological markers, and they haven't been successful at
finding them. But something happens that makes life more worthwhile.
The days take on more meaning.
The other thing that helps a lot of people is doing something they
feel is either interesting or worthwhile. Again, different people have
different things they like to do. For instance, people talk about
workaholics as being at higher risk for stress-related illness. But
there is no evidence that workaholics are necessarily a higher risk if
they really are enjoying what they're doing. If they are driven by
some externality and feel like they have to earn more money, it
creates stress in their lives, which is probably not very healthy. So
it's very individual when it comes to what people want to do.
For example, you can't just say family sup****t is good, because some
family sup****t is good for some people, and some isn't for others.
There are people who derive great satisfaction from being with their
families. And then there are those who become very anxious and upset
when they are with their families. It is a complex model, which is
also very interactive.
But if we're talking about things that give you a sense of
fulfillment, a good life, the sense of being valued, the sense of
being cared for, and the sense that you are liked =97 these are all very
positive.
Tom Perls: A good start to adding more good years to your life would
be to get rid of the anti-aging quackery. Some people provide this
very pernicious, ugly view of old people that's completely false in
order to get you worried about getting older. They say they can stop =97
and even reverse =97 aging, claims which are absolutely false. You've
got a bunch of people who are professing to be physicians or
scientists, who are saying that they can stop or reverse the aging
process. I will tell you that real scientists cannot do such a thing,
so what makes the public think that these people can?
It is mostly hucksterism and charlatanism. They will cost you a lot of
money, and these things do not work and, in some instances, can be bad
for you. So stay away from it. These guys are just trying to sell you
stuff. What does work is living the lifestyle of those who we know are
living longer, like those people, I suppose, living in the Blue Zones.
Into the Blue Zones
Which brings us back to the Blue Zones project. Over the course of
seven years, my team circled the globe, making several trips to each
of the four Blue Zones and meeting the remarkable people who lived
there. In each place we confirmed that people were as old as they said
they were, interviewed dozens of centenarians, worked with local
medical experts, and methodically studied each of the local
lifestyles, habits, and practices.
Each Blue Zone revealed its own recipe for longevity, but, as we were
to discover, many of the fundamental ingredients were the same. These
common ingredients, our nine lessons of living longer, are deeply
embedded in the cultures we studied. I suppose you could say that our
quest was for a true fountain of youth, though this fountain does not
spring from the ground but comes to us through centuries of trial and
error.
For us, it all began on a small island off the coast of Italy.
Reprinted with permission of the National Geographic Society from the
book The Blue Zones: Lessons for Living Longer from the People Who've
Lived the Longest by Dan Buettner. Copyright =A9 2008 Dan Buettner.
Available where all books are sold.
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