Senior contributing writer Joanne Kaldy is a freelance writer in Harrisburg, Pa., and a communications consultant for AMDA and other organizations.
Ever wonder why people tend to live longer in some parts of the world? Author Dan Buettner did, and then he decided to do some research and write a book about it. The product is the best seller “The Blue Zones” (2008, Washington, D.C.: The National Geographic Society).
Mr. Buettner recently shared with Caring for the Ages what he's learned about longevity. He also suggested a separate interview with 95-year old Ellsworth Wareham, MD, one of the people featured in the book. Both described what they saw as keys to successful aging and suggested what physicians need to know to help their elderly patients enjoy healthful, quality lives.
Lessons From Around the World
Mr. Buettner set out to identify the optimal lifestyle for longevity. Partnering with National Geographic and several longevity researchers, he sought to identify places around the world where people are living “measurably better.” These “blue zones” are regions where people reach age 100 at rates 10 times greater than those of the general U.S. population. In these areas, people have lower-than-normal rates of heart disease and cancer.
The team interviewed the oldest people in these zones to glean how they live and what appears to contribute to their longevity. Common factors included drinking goat's milk, eating plant-based foods, eating more soy, laughing with friends, drinking a glass of red wine daily, celebrating elders, having a “life plan,” drinking hard water, focusing on family, and planting a medicinal garden.
In his book, Mr. Buettner wrote, “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 area revealed its own recipe for longevity, but, as we were to discover, many of the fundamental ingredients were the same.”
The team studied blue zones in places such as Okinawa, Costa Rica, and Sardinia. It also found one in Southern California.
The Doctor Is In
Dr. Wareham lives in the Loma Linda, Calif., blue zone. He's still in good health, takes no medications, and until recently continued to assist at surgery.
The decision to finally quit the profession was his. “I wanted to stop on my own terms. I wanted it to be my decision and not one forced on me by external circumstances,” he said.
“I try to stay active by working about the yard and around the house. I don't run or participate in physician culture types of activities, but I mow the lawn, run the vacuum for my wife, or mop the floor. I do heavier tasks so that I use my muscles.”
Dr. Wareham said he tries to get plenty of sleep and to make sure it's peaceful. “I've long made it a policy not to solve my problems in bed,” he said. “If you have critically ill patients, things don't always go well, and you have difficult situations that arise. But it's not productive to take these to bed with you. I made it a point to blank out my mind when I went to bed.”
Dr. Wareham claimed that because of that policy, he never has headaches or back pain and doesn't take so much as a low-dose aspirin. “If your cholesterol is under 150—and mine is—you won't have a heart attack,” he explained.
Despite bucking medical opinion in favor of low-dose aspirin, Dr. Wareham declared himself a champion of “lifestyle prevention of health problems such as heart disease.” That the ongoing health care reform debate is generally ignoring prevention is frustrating, he said.
He endorsed financial inducements for healthy behaviors, such as those offered by the grocery chain Safeway. “The company offered employees a financial incentive to maintain normal blood pressure, weight, and cholesterol and to stop smoking. After 4 years, they found that it cut medical expenses 40%,” said Dr. Wareham. “Everyone knows what the problem is, but no one is doing anything about it. We need to keep the population healthy and working longer.”
Dr. Wareham challenged his fellow physicians to set a positive example for their patients. “Many doctors aren't practicing a healthy lifestyle themselves. They don't live up to what is known scientifically. The first thing they should do is commit themselves to eating a healthy diet and not smoking.”
Can LTC Go Blue?
Mr. Buettner said that blue zones have much to teach many practitioners.
“I am convinced that there is a social component to all medical diagnoses that needs to be addressed. It is important to make conversations about the patient's lifestyle a key part of every visit,” he said. “The physician should work with patients to establish a social circle if they don't already have one. To the extent that older people tend to respect and listen to physicians, these practitioners have a voice to suggest a social companion to pharmaceutical and procedural recommendations.”
From his team's research, Mr. Buettner has even come up with some specific prescriptions for social interaction and self awareness: “I think you should spend 200 minutes a day interacting with people socially, 20 minutes downshifting, and 2 minutes a day revisiting your sense of purpose and your calling. I think we lose sight of that.
“You should keep clear sight of your values and passions and how they align with your responsibilities.” Then he added, “Instead of dining with friends or family at a steakhouse, try a vegetarian restaurant.”
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