HEALTHY AGING AND LONGEVITY – LIVING THE PRINCIPLES OF THE BLUE ZONES
(BY DR. SOLOMON OMIKEN OKORO, DEPARTMENT OF PUBLIC HEALTH, FMC ASABA)
There are multiple factors that result in healthy aging and longevity. It could result from a combination of genetic, environmental and lifestyle factors. It has further been observed that a healthy lifestyle helps individuals survive into their nineties without any major chronic diseases. However, some believe that genetics may play a major role in survival into centenarian and supercentenarian ages. Not just long years for the sake of a calendar number, but vitality in the years too.
Thus, it has been discovered that there are areas of the world where a common combination of healthy aging and longevity occurs. To validate population longevity, several indices such as Centenarian Prevalence, Centenarian Rate and Extreme Longevity Index, are used as objective measurements. Statistics from the World Health Organization (WHO) showed that global average for life expectancy is 73 years of age – 71 for males and 76 for females.
A US demographer and longevity expert, Dan Buettner, and his team of anthropologists, medical researchers, epidemiologists and demographers were able to map out these different areas of the world with the largest concentration of people living the healthiest and longest lives. In these places they consistently reach the age of 100 and above; without much of the chronic diseases that affect the general population – it is common to find a lot of centenarians and supercentenarians here. Buettner and his team called these areas the ‘BLUE ZONES.’ The team originally identified five of these places in the different parts of the world:
- Sardinia, Italy
- Okinawa, Japan
- Loma Linda, California, USA
- Ikaria, Greece
- Nicoya, Costa Rica
The team laboured to find evidence – based common denominators in these areas that could explain their longevity. They were able to identify nine principles that were central to the health and longevity of these population groups. These principles include:
- Making movement a natural part of the day
- Having a sense of purpose
- Prioritizing stress relief
- Eating until about 80% full
- Eating a largely plant-based diet
- Drinking alcohol in moderation
- Connecting with a community
- Putting family first
- Choosing social circles that support healthy behaviours
According to Buettner, the people in the blue zones are just naturally living their lives oblivious of the life -long benefits embedded in their daily routines. They have unwittingly created engagements and environments through their daily habits, rituals and cultural norms that promote health and longevity. Though, it may not be realistic to trade places with these folks, yet a lot can be learnt from their simple habits and cultures. Let us now explore these principles and see how they can be incorporated into daily living.
People in the blue zones are always on the move throughout the day. They stay in engagements and environments that constantly nudge them to move without even thinking about it. In the life of centenarians of the blue zones, the role of exercise is one the major longevity secrets. Most residents of these areas use aerobic exercise such as walking, household chores, working and growing a garden, et cetera, as their form of daily activity. The very idea of sitting for hours in a spot is antithetical to the principles of the blue zones. The effects of physical activity on cardiovascular health, body weight, glycemic control, cholesterol and chronic diseases are massive.
Furthermore, in Okinawa Japan, it was observed that while at home, the people spend more time sitting or squatting on the floor than sitting on their chairs. Buettner recalled an incidence where he sat on the floor with an Okinawan 104-year-old woman who got up and down the floor so many times. This practice has helped them maintain strength in the muscles of the lower body and the core. It has also helped to maintain flexibility and balance especially as they got older. Falls is a leading cause of morbidity and mortality among old people. These ‘move’ strategies prevent weakness of the limbs and injuries. So, shape your surroundings in such a way as to nudge you for easy movement.
There is no better anecdote for muscle weakness and low muscle mass in old age than bodily exercise. Look for any form of physical activity that you enjoy and regularly engage in it. The Adventist Health Survey (AHS) showed that you need not be a marathoner or have a gym membership to maximize life expectancy. Just getting involved in regular, low-intensity exercises helps reduce the chance of having chronic diseases with increased life span.
DEVELOP A SENSE OF PURPOSE
According to Buettner, all the people in the blue zones have a sense of purpose which has helped to increases their life expectancy. This means that they have a daily reason for waking up. The Nicoyans in Costa Rica call it “plan de vida.” People in Okinawa call it “ikigai.” Both translates to ‘why I wake up in the morning’. Satisfaction in life sky rockets when there is a sense of purpose. It can be in religion, career, business or family and this impacts on quality of life, health and feeling of well-being. Finding a sense of purpose helps one stay active and puts depression into abeyance. It adds up to the years of life expectancy. There should always be something to do; something to live for.
It can also be in form of volunteerism. Communities of the blue zones always encourage and provide opportunities for its members to volunteer. People in the blue zones do not think of retirement. The Okinawans do not have a word for retirement in their local language. Ikigai or “life worth living” or “why I wake up in the morning” is one of the most important psychosocial aspects of an Okinawan’s life. Centenarians like Marge Jetton found a sense of purpose by focusing on helping others and this has made her to stay active and staved off depression. So even the centenarians have a reason for waking up daily (having found their worth in life) and look forward to it.
Chronic stress leads to chronic inflammation which is associated with many age – related diseases. Though people in the blue zones are not exempted from the experience of stress, they have, however, successfully developed routines for dealing with stress. In Loma Linda, the people engage in prayer as their own way of handling stress. In Okinawa, they take time to remember their ancestors in their own way and also take a nap. In Sardinia, they engage and celebrate a happy hour to relieve stress. Meanwhile, the people of Ikaria take a nap too – and almost all of them naps. These were their regular routines for dealing with stress. Studies have shown that taking a siesta lowered stress levels and reduced the risk of cardiovascular disease and mortality. In addition, people of the blue zones also get plenty of sleep at night. This sleep is restorative in nature. Other studies have shown that poor quality sleep is associated with increased risk of suffering from chronic non – communicable diseases. So how do you handle your own stress? Develop a routine for dealing with it.
THE 80% RULE
People in the blue zones practice portion control. The Okinawans have a chant before meals to help remind them to stop eating when they are 80% full. That gap of 20% can make a lot of difference, cumulatively, in weight and other body processes. Eating mindfully has been shown to help slowly eat their food. One of the ways to do this and be aware of how much you’re eating is to put away your electronic devices from the dining table when you want to eat and see the dining table as a place to it slowly and savour your food. The people of the blue zones don’t go to bed on full stomach. They eat their least meals of the day in the afternoons or early evenings and do not eat anything else till the next day. Having a light dinner early in the evening prevents flooding the body with calories during the remaining inactive parts of the day and this seems to promote a better sleep and a lower body mass index.
EATING A LARGELY PLANT – BASED DIET
Diets in the blue zones are based on daily consumption of healthy real food which is mostly plant – based. Even though the blue zones are in different geographic areas of the world, their diets seem similar. The top five pillars of the blue zones’ diets are whole grains, vegetables, greens, beans and tubers such as sweet potatoes. Buettner says that “people in the blue zones are eating the cheapest peasant foods.” Plant-based diet is related to longevity and this is partly due to the wholesome consumption of fruits and vegetables which are protective factors against cardiovascular and other chronic diseases.
Also, the blue zone people mostly cook their meals and so use a lot of herbs in their cooking. In Sardinia, rosemary is a favourite. The Nicoyans love cilantro while fennel, oregano and sage are more popular with the people of Ikaria. The people of the blue zones know how to make their foods taste delicious using herbs. When Buettner and his team reviewed about 150 dietary surveys conducted in the blue zones over the years, they found that “if you average them, more than 90% of their dietary intake comes from complex carbohydrates — whole plant-based foods” This translates to a low consumption of meat and processed foods.
The Mediterranean diet is popular in Ikaria and Sardinia. It consists of consumption of fat originating from monounsaturated fatty acids, increased intake of fruits, vegetables, legumes, nuts, whole grain cereals, moderate consumption of fish and free range – poultry; minimal consumption of red meat, sweets and other foods that are rich in trans fatty acids. Olive oil is also a major component of the Mediterranean diet and it is believed to have cardioprotective effects.
MODERATE INTAKE OF ALCOHOL
“These people who are living the longest of anybody on Earth are enjoying a little bit of their favorite alcoholic beverage every day,” says Buettner. The way blue zone people consume alcohol is mindful and intentional just like the rest of their diet. Buettner continued; “If you drink a little bit of red wine with a plant-based meal, it will about quadruple the flavonoid or antioxidant absorption and lower cortisol levels at the end of the day,”
In Sardinia, they enjoy a red wine called ‘Cannanou’ made from grapes and has triple the number of flavonoids compared to other wines. Meanwhile in Okinawa, ‘Awamori’ which is a rice-based, distilled liquor oftentimes mixed with water, is their choice of wine. But again, the significant thing is that they are consuming alcohol in moderation and with a mostly plant-based diet, while surrounded by good friends and family as part of social connectedness.
Since these centenarians move naturally all day long, moderate wine drinking and regular exercise is a combination that can be protective against cardiovascular disease – according to a study by the European Society of Cardiology. The study further added that the “combination of moderate wine drinking plus regular exercise improves markers of atherosclerosis.”
Additionally, moderate alcohol consumption especially with plant – based meals can help one not only to de-stress and loosen up, but also to live longer. Consuming wine alongside a plant – based meal can help the body to absorb more of the flavonoids from the food eaten. However, excessive drinking can reduce any potential health benefits and increase the risk of liver damage and other negative health outcomes. It is important to note, however, that the blue zone people are not guzzling sugary cocktails, beer or spirits all day in the name of alcohol or wine.
It is also worth noting that while red wine has been shown to have some health benefits when consumed moderately as part of a balanced lifestyle; other forms of alcohol may not provide these same benefits due to differences in chemical composition Though the connection between alcohol consumption and longevity in the blue zones is still being studied, the evidence so far suggests that moderate drinking of red wine can provide health benefits.
On the other hand, it may not be advisable to start drinking alcohol now if it is not your thing. The longest living people in Loma Linda – the blue zone in California USA – don’t drink alcohol either. They constantly rehydrate instead. The Adventist Health Survey (AHS) concluded that men who drank at least five to six daily glasses of water had a 60% to 70% substantial reduction in the risk of a fatal heart attack compared to those who drank water less considerably.
BELONG TO A COMMUNITY
When Buettner interviewed some 263 centenarians in the blue zones, he found that all of them but 5 belong to some faith – based community. Denomination was immaterial. For most people of the blue zones, faith is an important aspect of their identity and daily life. They derive joy from engagements with those with same beliefs. This might be due to opportunities for social interactions and the positive feelings associated with being with your own kind. Research had shown that attending faith-based services four times per month will add 4-14 years of life expectancy. Loma Linda is home to a large concentration of Seventh day Adventists and the church provides them a foundation. Adventists tend to hang out with other Adventists. They always show up for each other. They live about seven years longer than the average American.
However, if organized religion is not for you, then there are lots of other ways to find community based on your interests. It could be an exercise club, social club, a gardening club or even getting involved in a civic project within your community. Further studies have been done on social connectedness and the conclusion was that ‘social relations provide a strong scientific basis for the prevention and intervention of disease and in promoting longevity.’ By all means, find a community with common interests as yours and get involved in the activities as the blue zone people do.
PUTTING FAMILY FIRST
People in the blue zones have been found to prioritize family and their loved ones. These include biological family or chosen family They commit to a life – long partner which has the capacity to increase life expectancy. They also invest in their children with time and love. These children in turn also take care of them when the time comes. The blue zones are known to have established family as a highly valued and important institution which their lives depend upon and serves as another of way of coping and having fun. Buettner once described meeting a woman called Panchita who was well over 100 years old. He pointed out that each day, her 85-year-old son and his children biked to her house to help feed the chickens. In return, she cooked for them. It is not just that they put family first, but their customs and rituals also ensure to cement these relationships. Old age is celebrated in the blue zones with various awards given to people as they got older or achieved developmental milestones.
BELONGING TO SOCIAL CIRCLES THAT SUPPORT HEALTHY BEHAVIOUR
The world’s longest – lived people in the blue zones were either born into social circles that supported healthy behaviour or they chose one for themselves. Okinawans called this group “moais.” This is a group of five friends that are committed to each other for life. Results of research from the Framingham Studies have shown that obesity, happiness, smoking and even loneliness are contagious. So, the people in the blue zones created social networks that favourably shaped their health behaviours.
According to Buettner, “The best longevity hack is to curate your immediate social circle.” If your aim is to live a healthy and long life, then your odds improve if those around you are committed to the same ideal – this is because habits are contagious. In these days of social media, select your feeds in such a way that you are not only seeing contents from people who share your interests and values but also from those who inspire you to a healthy behaviour.
Finally, it is axiomatic that there is no single health habit that can stand alone and make one age well and live long. It involves taking a lot of consistent small steps on health matters, taking initiatives, a lot of discipline and living by healthy principles like that of the blue zones. This makes healthy living easy. When you take care of your body, it will in turn take care of you. Even though scientific research over the years have validated the blue zone principles, there is the need to keep tab on the ways of modern living as they can become the Achilles heel of successful healthy aging and longevity.
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