Live to 100: Secrets of the Blue Zones
Season 1, Episode 2
An Unexpected Discovery
From the mountain villages of Sardinia, Italy ๐ฎ๐น to a sunny suburb of California, USA ๐บ๐ธ, Dan Buettner explores what has contributed to these communities' amazing lifespans.
( gentle acoustic guitar music playing )
Dan: Around 1999, a virtually unknown Italian researcher spoke at an international longevity conference and reported an exceptional concentration of centenarians.
It was so remarkable, in fact, that many members of the scientific community refused to believe him.
That man was Dr. Gianni Pes.
And he was reporting that in Sardinia, Italy, he found an area with almost ten times more 100-year-olds than you'd expect to find in a similar population in the United States.
Even more fascinating, he had this map, and every time he discovered a location with an unusually high concentration of centenarians, he marked it with a blue dot.
On one area, there were so many blue dots that it formed sort of a blue blob, and that's what gave birth to the name Blue Zone.
By now, I'd been in Okinawa, where I'd just begun exploring why people there were living so long, so when I heard about this Blue Zone, just six or so rural villages, I suspected it could offer new clues.
And I also knew that the only way to find out for sure was to travel there and investigate.
( curious music playing )
man singing in Italian:
♪ Baunei is a well-located village ♪
♪ In a place of hard stones ♪
♪ Above the plain ♪
♪ Under the mountain, And in the middle of the coast ♪
♪ Everyone who goes by Makes a stop for its beauty ♪
♪ It looks so good ♪
♪ All those who pass by crave it ♪
♪ For its beauty and its view ♪
( curious music building )
Dan in English: You see the longevity in the Blue Zone mostly among the mountainous areas.
What do you observe?
man: Exactly.
The altitude was our first hypothesis, no?
So it was a working hypothesis.
We found the villages are above 700 meters.
Dan: Meters. Twenty-two hundred feet.
man: Exactly.
But the altitude is not necessarily the explanation.
Dan in Italian: Good morning.
( in Italian ) Good morning.
Now you show up?
We already finished cooking!
Dan: A little fiesta!
Gianni: Good morning, ma'am.
Woman: Good morning.
Dan: What are you making?
woman: Gathulis.
Dan: Is it sweet?
Woman: No, it's not sweet.
Potato and cheese.
( in English ) Would she say her health is good, very good, or excellent? Self-report.
( in Italian ) If you had to judge your own health, would you say it's bad, good, very good or excellent?
Woman: For the age I have, I'd say it's good.
Gianni: Good? Not excellent?
Excellent. Maybe excellent.
Gianni in English: It's good, not excellent.
( in Italian ) woman: It can't be absolutely excellent.
Dan in English: Why does she think she has lived so long and stayed so healthy?
Vittoria in Italian: For me, as I said before, faith and hope are the two.
So it's that.
It's not down to my merit.
Dan in English: How often do you go to church?
( Vittoria speaking Italian )
Gianni: Every day.
Vittoria in Italian: If I walk slowly, ten minutes.
( in English ) See, I find that incredible because I know right outside her house, it's straight uphill.
man in Italian: When I was a kid, there were only wheat fields here.
Do you remember the post office used to be here?
man 2: Yes. Mrs. Lavinia worked there.
man 2: Yes, I remember that.
man 1: Good evening! Hello!
man 3: Where are you going? Out for a walk?
Dan in English: It feels like 99% of all trips in the Blue Zone are either uphill or downhill.
There's a number of other villages lower down the mountain, but they don't have extraordinary longevity, so Gianni actually studied this.
He interviewed about 300 centenarians, and then he correlated that with the pitch of their village and found out very clearly that one of the biggest predictors of longevity was how steep your village is.
Gianni: So the steepness for us is very important.
You can see here, just by walking, you have an additional energy expenditure.
Many homes have two, three, or four stories.
Every day, have to walk up and down 30 steps.
Dan: Who would have thought that steepness of a village would correlate to longevity?
None of them have big biceps or could do a triathlon.
They're walking.
So I'm thinking back on Okinawa and about how they're gardening almost every day and getting up and down from the floor, and I'm seeing a commonality.
They don't even know it, but they're exercising.
They're moving naturally all day long.
Most people spend about half of their day sitting down.
We move from our cars to our desks to our couches, and that prolonged physical inactivity increases our risk for diabetes and heart disease, both of which cut our lives short.
But in Sardinia, they've suffered only a fraction of the rate of these diseases and, therefore, are living longer.
This gives us an interesting clue.
If we want to live longer, instead of paying for an expensive gym membership, maybe start by skipping the elevator and taking the stairs.
Dan: So the Blue Zone in Sardinia is actually the region of Barbagia... which comes from the same word as "barbarian."
( goat bleats )
Dan: About 13,000 years ago, a population colonized the entire island.
And then the Phoenicians came, and then the Romans, and then the Arabs, and with every succeeding wave of people, they tried to subjugate these founder population.
Eventually, people moved up into the highlands.
People here were largely left alone because they had this fierce reputation.
Strangers meant trouble, so when strangers wandered into these highlands, they were often met with the business end of a sword.
And for 2,000 years, this lifestyle incubated a set of traditions, a code of conduct, a certain set of values, a certain diet.
What we see now is not that different than what you might have seen a thousand years ago here.
woman in Italian: Did it heat up?
( in Italian ) It won't be easy to warm it up quickly.
You have to stir it, then leave it alone for a little while.
You're really not good at this!
( woman chuckles )
woman 2 in Italian: Where is the salt?
And the onion?
Dan in English: If you want an idea of what Sardinians eat to live to be 100, one of the best places to look is in the kitchens of older ladies.
They've been cooking the same things for generations.
But what really shocked me was the pasta and the bread.
Coming from America, I'm like, "Wait a minute." "Carbs are the enemy, right?"
Breads, pastas, there's no getting around that these are simple carbs.
But the point here is how these simple carbs are prepared.
Let's take sourdough bread, for example.
When you're making sourdough bread, the process is very different than your average white bread because sourdough bread is actually leaven with a bacteria called lactobacillus, which lowers the glycemic load of an entire meal.
That means this sourdough bread actually lowers sugar absorption, and that might explain why people have lower rates of diabetes and, therefore, higher longevity.
But mostly here, you see complex carbohydrates, like whole grains, greens, and beans.
Minestrone has been a feature of this diet for centuries.
What's minestrone? It's essentially beans, sometimes pasta, and the available vegetables, whatever happens to be growing in the garden.
All the ingredients have a wide variety of fibers, and that keeps your inflammation in check and your immune system strong.
Is it okay if I...
( in Italian ) Check this out!
( both laughing )
Dan in English: Something they're eating every day, and that's the majority of the caloric intake, this beautiful vegetable soup.
( whimsical music playing )
So, just like Okinawa with their purple sweet potatoes, Sardinia is eating a high-carb diet.
And this got me thinking, maybe carbs aren't so bad after all... if they're prepared right.
( church bell tolling in distance )
Dan: How many centenarians are in this cemetery?
Gianni: I've counted nearly 30 centenarians.
Dan: Thirty centenarians?
Gianni: Thirty centenarians, yes.
Dan: Wait, is that 103? 1880 to...
Gianni: Exactly.
Dan: 103.
Gianni: 103.
Dan: 103-year-olds buried on top of each other.
Gianni's like, "Big deal!"
Gianni: Sometimes you can find tombs with the husband and wife, both centenarians.
Dan: I didn't have to spend long in any Sardinian cemetery to realize that they're living a long time.
But as I looked past the surface, I noticed something really interesting.
You see, statistically, women tend to live longer than men.
In America, for every male centenarian, we have five female centenarians.
But here in Sardinia, the proportion was one to one.
This is the highest concentration of male centenarians in the world.
man in Italian: I had two aunts.
One died at 103, another 102.
Dan in English: How old are you guys?
( in Italian ) He's an old man!
I'm not yet as old as he says.
( laughing )
Dan: What's going on here?
What are these males doing that's special here?
They weren't farmers.
They weren't craftsmen.
They didn't run, you know, bars and restaurants.
It turns out that men were traditionally always shepherds.
( bells clanging )
( bleating )
Gino in Italian: First, we milked the animals early when it started to get light.
The wall wasn't there yet, so we had to follow the animals everywhere.
Dan in English: What is it about shepherding that could actually contribute to the longevity of men here?
They spend time with their animals.
They're up in the hills walking.
They take naps, and by happy hour, they're usually back in their villages, sharing a glass of wine with their friends.
So men in Sardinia work, but they don't appear to be especially stressed out at work.
Stress is a button that the brain presses which acts as a default mechanism to adapt to the worst-case scenario.
The moment we become acutely stressed, glucose spikes in our blood.
Wow.
Mithu: You also get a spike in inflammatory markers.
We know the evolutionary reason for it.
So if you're running away from an animal and you have an open wound, being in a state of inflammation protects you.
When we're stressed?
Mithu: When stressed.
Seems like a benefit.
Mithu: It's a benefit as long as it's short-term.
The problem is, as soon as you keep the stress-button pressed for very long time, these effects become negative.
Dan: Constant or chronic stress can cause cardiovascular disease and promote illness.
It's not that these shepherds here don't have any stress.
They just seem to have not a lot of chronic stress.
In a global survey of daily stress country by country, Americans report the opposite.
Americans exceed the global average by 20%.
One of the ways in which stress is beneficial is if we overcome it by active coping.
Today, in our urban world, through social media, news media, we are brought all the problems of the whole world.
These are problems you cannot physically control.
( phone buzzing )
But you can control how you treat your goat to make sure your flock is healthy.
( chuckles )
Mithu: And this sense of active coping where you can resolve the problems that you are given is a very important part of mental health, cognitive longevity, and stress resilience.
Dan: So in most of the world, we're driven to get ahead by working hard, day in and day out.
In Sardinia, it's not so much what they do.
It's how they do it.
Here's another clue.
Normally, when you see a lot of old people, you also see a lot of nursing homes.
Not here. In fact, I never saw a nursing home in this entire Blue Zone.
So, if aging facilities are not giving old people their care, where are they getting it?
( in Italian )woman: I never liked going to school for writing.
( chuckles )
woman in Italian: Now she won't give you back your pen.
She's on the last one.
Dan in English: So, you just had your 101st birthday?
Giulia in Italian: When I was 80, a woman asked me about my retirement pension.
Everyone in my family was dying in their 80s, so I said, "What's the point of asking for a pension?"
And now I've missed those 21 years of pension payments.
But you've gained in age.
( speaking Italian )
Gianni: Has she always been single?
women: Yes.
Have you always been single, Aunt Gio?
Yes.
True, she has always been single.
Gianni in English: She remained single.
woman 1 in Italian: We take turns taking care of her every day.
We take her for a walk.
We cook for her.
Even when she was younger, she was invited to lunch by all her nieces.
We never left her alone on Sundays, despite us being busy with our kids.
We always considered her like a mother to us.
She doesn't have children of her own, but she took care of us.
woman 2: Once, she was very ill.
We hospitalized her, and at the hospital, she was always turned towards the wall and wouldn't speak to anyone.
She wouldn't say anything, and we knew we were losing her.
So we started taking turns in groups, and we fed her.
We held her head up because she couldn't stand up.
( woman continues in Italian )
Gianni translating: She would have died if abandoned at that specific time.
Dan: It's very clear that people in Blue Zones keep their aging family members nearby where they can get better care.
One of the quickest ways to take life expectancy away from your parent is put them in a retirement home.
They go into that retirement home, they lose between two and six years, depending on a number of circumstances.
One study estimated that today, a 50-year-old in America has at least a 53% chance of entering a nursing home during his or her lifetime.
But in Sardinia, you'd never see that.
They had to make community a core value.
Sticking together as a community, and the building block to community was the family.
So they're all at home, not only getting much better care, but they're also tapped for their wisdom.
( gentle music playing )
This understanding is best reflected in a story of the abandoned village of Gairo Vecchio.
There's this old tale here that says, once upon a time, when old people became a burden, the oldest son would take you to the top of a cliff and push you off.
But one son secretly refused.
He stuck his 70-year-old father into hiding, and over time, that son became incredibly accomplished.
When the people asked him his secret to success, he revealed that his father was still alive and that his success was because he gained wisdom from his father.
The moral of this parable is that our connection to elders are treasures to be valued, and ultimately, it's them that allows us to excel in life.
Do you enjoy the time you're here, or is it work?
( in Italian ) You want to know something? When we come here, we relax.
( speaking Italian )
( laughing ) We get to relax because she transmits serenity.
Gianni in English: Taking care of Giulia is sort of relaxing, I think.
( laughing )
Dan: When I first started investigating the Blue Zone here, I emphasized the sourdough bread and the minestrone.
But what I've come to believe that is a far stronger determinant to longevity here are these traditions and social norms.
This outsized reverence for the family.
Sardinia and Okinawa, they're isolated.
They're in remote geographical areas which have traditionally kept out the corrosive forces of modernization.
And that's what makes the next step in my journey so fascinating.
You see, back when I started this search for Blue Zones, I just had to know if a longevity hotspot could exist in the United States.
I started at the CDC, and they didn't really have much.
And then I got a hold of county-by-county life expectancy data, and that wasn't very helpful.
And it wasn't until I got a lead to look at this Adventist Health study... which followed, actually, religious group the Seventh-Day Adventists.
I'd never heard of them.
But the Adventist Health study found 96,000 Adventists and not only found how long they lived, but because it asked about habits and lifestyle, you can also start to see what behaviors are associated with longer life.
The real shocker was discovered in an Adventist community, where followers are defying the longevity odds.
This isn't some exotic location halfway around the world.
This is a Blue Zone right in an American suburb.
I remember driving to Loma Linda the very first time.
I flew to Los Angeles International Airport, rented a car, drove about two hours down the Highway 10, the San Bernardino freeway, six lanes of traffic.
And then I get off the exit at Loma Linda, and the first thing I see is a Del Taco, and I'm going, "This is a Blue Zone?"
( cheerful music playing )
Sounds hard to believe, but according to the study, these Adventists live longer than other Californians, 7.3 years longer for men and 4.4 years longer for women.
This typical American community is far from isolated.
So, how is Loma Linda achieving the same results as other Blue Zones?
So here we go. Up and down. Up and down.
Push, pull. Push, pull.
Up and down. Up and down.
Exhale when you lift.
( upbeat music playing )
woman: On the elbow here.
Dan: In the United States, we spend billions on gym memberships that go largely unused.
We're well-intentioned.
We just can't seem to keep exercise routines going long enough to make a difference.
But somehow, the Adventists of Loma Linda are getting physical activity routines and other healthy behaviors to stick.
Wow, what a save!
Okay. Two-five-one.
Dan: Legend has it that you brought pickleball to Loma Linda.
Well, that... I was playing since 2016.
Dan: The godmother of Loma Linda pickleball.
( chuckles )
Dan: So I'm looking out here.
I'm guessing this is any given Friday.
I know there's an 82-year-old.
An 87-year-old was out here earlier.
Loida: Yes, yes.
Dan: You're 84.
I mean, how many hours at a time do you play?
Loida: Three hours.
Dan: Three hours!
Loida: Mm-hmm. Yes.
Dan: So you're a doctor.
Do you think pickleball may be the secret to longevity?
Loida laughs: I'll say it's part. It's part.
Dan: It's part?
But your daily routine in life helps.
I mean, that's the main.
See, longevity is exercise and community.
If you're depressed, you're not going to live very long. So this is community. You're shouting there. You're happy. Dan: Good point. Loida: We call each other like we're high school kids. "Hey, come and play with us." These people, even when they come for the first time, they become friends. And so, when you know that somebody needs you and wants you to, you know, to be in your life, that gives you longevity. Something to live for. You have to... If nobody cares for you, who cares whether I live tomorrow or not, you know? It's somebody needing you. Dan: You can drop your chance of dying on any given year by almost a third by staying active, but most Americans don't stay active. Here in Loma Linda, something seems to be working.
The possible secret is it's not trying to muster the discipline or presence of mind.
But it's building the community around the activity.
Seventh-Day Adventists are conservative Methodists who distinguish themselves from other Christians in that they evangelize with health.
A hundred and twenty years ago, this place was just a bunch of orange groves, and when the Adventists first came, they built two things, a church and a hospital.
And both of them, over the ensuing century, have exploded.
Loma Linda University has one of the best hospitals in America right now, and the Adventist Church has now expanded all over the entire globe.
So Loma Linda isn't geographically remote, but as I started to see, they're a little bit culturally remote.
They really stick together around this doctrine of health, and it's not a physical environment as much as it is a religious and social environment.
The Adventists have these pillars of behaviors that they believe lead to godliness.
One of them is staying physically active, and we are seeing this clearly.
Another one is volunteering.
So tell me what's going on.
This is the nugget.
This is just a good nugget.
The nerve center.
Exactly.
This is where the adrenaline starts growing in the morning.
It's like, you know, "Oh Lord, help us to be your feet."
Do you feel any benefits right now?
Right here, now, for doing this work?
Marijke: It creates sheer joy.
And we all have choices every day.
Do we want to be dormant, or do we want to be productive?
To lead a productive life and to serve humanity in all aspects.
It is not just the literature that I do.
We do feed people.
We do reach out.
We go and visit the sick.
There is so much to give.
Dan: Volunteering, very counterintuitive route to health, but we know that people who volunteer have better memories, better social connections.
They even report higher levels of happiness.
If you think, it always involves some physical activity, involves some sense of meaning because you're focusing on somebody else other than just yourself.
It's one of these subtly powerful things that is vastly underlooked when it comes to the formula for longevity.
But there's one pillar here that really rises above the rest, and that is the Adventist emphasis on nutrition.
man: Ellen White is one of the founders and leaders of the Adventist Church.
In the middle of the 19th century, she claims that she had a vision on the importance of having a good lifestyle, not only for having good health here, but necessarily to have a clear mind to have a better connection with the Divine.
She proposed a diet with absence of meat, some saying a vegetarian diet.
I mean, it was not just "remove meat from the diet."
I mean, it was "Make sure that a balanced diet has to include fruits, legumes, cereals, vegetables, and nuts."
What is your recipe for remaining vital at age 84?
I think diet.
Dan: Diet.
Diet is the most important thing.
Because that is the one that gives you the energy.
That's the one that feeds your brain.
Dan: Are you a vegetarian?
Loida: Not to start with.
We were very big on fish.
We were very big on meat.
My cholesterol was creeping up, and I did not want to take any medication.
So we slowly converted to vegetarianism.
Dan: What did you notice?
Loida: Well, your endurance is better.
Your figures on your cholesterol is better, and that's why I was so convinced with this way of eating.
Dan: So estimates suggest that about 35% of Adventists are either vegan or vegetarian.
In my research, I found that most of the Adventist diet is fruits and vegetables, with only about 5% of their calories coming from meat, poultry, and fish.
But for the average American, it's at least triple that.
In Loma Linda, eating plant-based is so fundamental to their religion, they actually started a vegetarian food company in 1905.
And even today, when I walk into the Loma Linda Market, it's still predominantly plant-based.
Huge bins of nuts and seeds, a giant produce section.
And then there's a section of all these sort of fake meats, but it's a different experience than in a regular grocery store.
I think for much of human history, eating meat was associated with better health.
Meat on its own is a risk factor for some diseases.
Obesity, cardiovascular disease, some cancers, diabetes.
In addition, in the last 20 years, research has shown that there are components in plant foods that do not exist in animal foods that are necessary, I mean, to have good health and longevity.
We found that having fruit often reduces the risk of lung cancer.
We know that those that eat a handful of nuts on a regular basis have three years longer life.
Oh my gosh.
Joan: They reduce the risk of cardiovascular disease.
Eating beans often reduce the risk of colon cancer.
So it's not only the absence of meat that is beneficial.
It's the presence regularly in the diet of wholewheat grains, legumes, fruits, vegetables, and nuts.
Dan: We often get sent the negative message about food, but what their research is uncovering, it's not just avoiding the animal products, but when you add fruits and vegetables and nuts and beans to your diet, it actually helps you lose weight, improves your immune function.
Morning.
Hello. How are you?
Good.
Dan: The point being is the way they're able to frame their health messages are in the positive, instead of the finger wagging, "You can't do that!"
We know that Adventists who are plant-based are living the longest and weigh about 20 pounds less than their meat-eating counterparts.
So the Adventist study, it gives us a very clear action item.
Simply eat a plant-based diet.
And it's accessible to everyone.
Ernest: Come this way.
Dan: All right.
And I'll show you where we've been in our lifetime.
Dan: Were your ancestors from China?
Ernest: Yeah.
Dan: Did I get that right?
Where in China?
Ernest: Uh, Canton.
Dan: So, in the south?
Ernest: Yeah.
When you look at these pictures, which one means the most to you?
Ernest: My daughter.
Dan: Why is your daughter the most meaningful picture to you?
It's the only one I've got.
( Dan laughs )
You were telling me that you've already lived 30 years longer than your father has lived.
Ernest: That's right.
Dan: And you're an Adventist, but your dad was not an Adventist?
Ernest: He had no idea about health.
Drank, smoked.
If I followed in my dad's footsteps, my lifestyle and things, I would be gone.
Dan: I wanna test drive a theory I have.
You know, Americans are obsessed with a quick fix for health.
A diet, a supplement.
But it's been my observation that unless you're doing the right things for long enough and avoiding the wrong things, and I'm talking not just a few months but years, decades, or a lifetime.
And when you look at the Adventists and the Saturday Sabbath, every week, you're reinforcing these habits.
So, can you describe just briefly from Friday night, when you begin Sabbath, until Saturday?
How does that unfold?
What do you do?
woman: We don't shop.
We don't play sports, for instance.
Dan: What do you do Friday night?
For me, I go to choir practice. ( singing ) ♪ The holy name of Jesus' name ♪ choir singing: ♪ When he shall come with trumpet sound ♪ ♪ Oh, may I then in Him be found ♪ ♪ And in his righteousness alone... ♪
Dan: The American condition is full of stress.
It's worry.
It's hurry.
It's lurching from one thing.
Our schedules are packed.
The Adventists have this sanctuary in time 24 hours between sunset on Friday and sunset on Saturday where they just shut down.
As an Adventist preacher, tell me what it is about the Adventist Sabbath that you think is helping people live longer.
It says on the seventh day, God rest.
So, listening to the instructions that he has given there, okay, I can have real rest in him.
And that rest is not just I'm lying down, sleeping.
But that real rest, contentment, it makes a difference.
Dan: Do you generally worry about things, or are you generally at peace?
David: Well, I would say I'm generally at peace.
Worry can do nothing for you.
It takes your strength.
Your emotional health is not good when you worry about things.
I mean, you know, what should I eat?
What should I drink?
What should I put on?
That's what the others do.
Dan: So I'm seeing this clear trend arise in looking at these Blue Zones of faith. The Adventists are obviously very religious, very adherent.
In Sardinia, we were seeing really strict Catholics, and in Okinawa, we see this ancestor veneration.
And when he prays to the ancestors, what has he asked for?
( in Japanese ) Please protect us.
I ask for protection. Please watch over us.
That's what I pray for.
Keep us healthy.
For my grandchildren.
To be safe.
Dan in English: An analysis shows that people who attend spiritual services more than once weekly can get an extra seven years of life expectancy.
It doesn't matter what religion you are.
What matters is that you're part of a faith-based community, and you show up.
So this is something that's available to all of us.
David: Our Father and our God, you sit high, you look low.
You look at your creation, your sons and your daughters.
We thank you now for this gathering, the young, the un-young.
And we thank you for the service that we give here today, that we have given.
woman: Thank you.
Dan: For these Adventists, I actually think this keeps people on the program. It reminds you to socially connect.
Reminds you what your sense of purpose is.
It reminds you to eat a whole food, plant-based diet, because the problem with most health interventions is they don't last very long.
But we also know that health behaviors are contagious.
Some studies show that if your three best friends are obese, there's a better chance that you'll be overweight yourself.
Elements of smoking and even loneliness may be contagious.
So the most actionable of these lessons is getting yourself into the right tribe.
Surrounding yourself with people whose idea of recreation is gardening or walking has a measurable impact on what your habits are.
And it's not a bad idea to have a vegetarian or vegan in your immediate social network 'cause they're gonna teach you how to eat plant-based food.
And that may or may not work for getting into heaven, I don't know.
But I do know it works for keeping people on the straight and narrow when it comes to healthy habits, healthy behaviors, and therein lies the power.
( optimistic music playing )
Dan: So we found incredibly great examples of longevity in Sardinia and in Okinawa and Loma Linda.
Every place we went, we learned something new.
But I wanted to find more longevity hotspots.
And I heard about a place right off the coast of Turkey, technically in Greece.
It comes to no surprise that people would live a long time here.
But there are 227 inhabited islands in Greece, and only one of them is head and shoulders above all the others when it comes to longevity.
( rousing music playing )
So, what's going on here?
( string music playing )
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