Live to 100: Secrets of the Blue Zones Season 1, Episode 4
Dan Buettner visits Singapore 🇸🇬 , then shares his discoveries in the United States to find out if we can create new Blue Zones in a rapidly changing world.
( birds twittering )
Dan: I wanna tell a story about the one person who changed my entire way of thinking about Blue Zones, a man who lived on Ikaria, Greece, named Stamatis Moraitis.
( ethereal music playing )
( chuckles )
That's him.
As a young man, Stamatis leaves Ikaria and moved to the United States because he wants to make a life for himself.
A hard-working Greek, he gets a job as a painter, quickly starts making money.
He earns enough to buy a Chevrolet, to marry a Greek American, and he buys a house in the suburbs.
Has a few kids, lives a nice American life.
But at age 66, he finds himself short of breath.
He goes to three doctors, all of whom give him the same diagnosis.
"Terminal lung cancer. You'll probably be dead in six months."
So he says to himself, "Well, you know, I get buried here in America, or I can get buried in Ikaria, the land of my forefathers."
So he and his wife move to Ikaria to basically die.
( church bell tolling )
( pensive music playing )
Dan: But over that next six months, he starts breathing the air, drinking the Ikarian wine, he reconnects with his friends.
And he goes out back, and he plants a vineyard.
And he thinks to himself, "Well, I'm not gonna be alive to see these grapes, but my wife will, and my wife will think of me when she harvests these grapes."
( video camera whirs )
Dan: Months go by, then a year, and more years.
Dan on video: How are you?
Dan Buettner.
Nice to see you.
Thank you.
( Dan laughs )
Dan: For some reason, I thought you would look old.
I'm old.
Yeah, but you don't look old.
( laughing )
Dan: Thirty-five years later, when I'd meet him at 102, he's not only still alive, he's harvesting all these grapes.
Being a journalist, I asked him, "What's your secret?"
He just kinda shrugs his shoulders and goes, "I don't know!" "I guess I just forgot to die."
( both laughing )
Dan: So Stamatis didn't start exercising more.
He didn't start a new drսg regimen.
In fact, he didn't do anything consciously to try to get healthier.
All he did was change his environment.
( mysterious music playing )
Dan: I'm a big believer if you're overweight and unhealthy in America, it's probably not your fault.
We've engineered most of the physical activity out of our lives with mechanical gadgetry.
You can't walk more than a few steps without running into cookies or chips or sodas.
And we're genetically hardwired to crave fat and salt and sugar and take rest whenever we can.
We evolved in this environment of hardship and scarcity, and now we live in this environment of ease and excess.
I think we're mostly victims of our environment.
And it leads to this bigger idea that if we want a healthier America, we shape our environment the way that the environments are in places that are producing the longest-lived people on earth, which is to say, Blue Zones.
So after exploring all these Blue Zones, collecting thousands of pages of research, amassing years of observation, even though these are disparate places, you start to see a pattern emerge.
No matter where you go in the world and you see longevity, you see the same things happening over and over and over again.
So, by and large, they're not exercising.
Instead, every time they go to work or a friend's house or out to eat, it occasions a walk.
They have gardens out back where they're doing gentle, low-intensity physical activity.
They don't have mechanical conveniences to do their housework or their yard work.
The point is they're moving naturally, and I believe that they get way more physical activity than if they went to the gym.
( in Japanese ) This is the key to health.
Moving fast.
( in English ) Look at that!
( laughing )
They have the right outlook.
They suffer from the same stresses that we suffer, but they have these sacred daily rituals to help unwind that stress and the inflammation that comes with it.
I would say I'm generally at peace.
Worry can do nothing for you.
Dan: They tend to belong to a faith-based community, and they show up.
They take naps.
They do happy hours.
They also have a vocabulary for purpose.
The Okinawans have ikigai.
The Costa Ricans have plan de vida.
But the point is, they know why they wake up in the morning, and they're putting their gifts to work every day.
When it comes to what they eat, the big point is they enjoy eating delicious food.
The vast majority of it is whole, plant-based food, like whole grains, greens, tubers like sweet potatoes, nuts.
Bean seems to be the cornerstone of every longevity diet in the world.
And the good news? There's a little bit of wine.
What's the best tea to drink on a daily basis?
( speaking Greek )
( in English ) Wine.
( Dan and women laugh )
Dan: So it's also about what they don't eat.
The Okinawans have this ingenious saying, "hara hachi bu," which reminds them to stop eating when their stomachs are 80% full.
They eat with family.
They express gratitude before their meal, and they're slowing down because they're having conversation with their food, so at the end of the day, they're not mindlessly overeating.
So the most important is how they connect.
It's probably 50% of the longevity formula, the fact that they put family first.
I found that they keep their aging parents nearby as opposed to putting them in a retirement home.
They invest in their partners and their spouses so people stay together, and they invest in their children so their children don't end up putting them in retirement homes.
And then they pay special attention to their immediate social circle.
You know, the Okinawans call it a moai, but it's a circle of friends that you invest in for life.
Having the right friends, that is the biggest secret to help these people in Blue Zones do the right things and avoid the wrong things so they're not developing a disease that will foreshorten their lives.
So I know, beyond a shadow of a doubt, that these common denominators of all five Blue Zones, they work!
Now what I needed was a chance to prove it.
( tape whirring )
( all chattering )
man on video: After the mayor speaks, you take it over and expand.
Oh, okay, great.
man: All right?
Great.
All right. You guys ready?
( camera clicks )
The goal of this project is to give an extra 10,000 people years of life expectancy.
Sounds like a big, grand number, but what does that mean?
The goal is to give participants in Albert Lea an extra two years of life expectancy.
Dan: So, in 2009, I actually started thinking, could I take these ideas I'd learned in the Blue Zones, apply them in America, and put them to work in a community that actually needs it?
I reached out to the top experts at the time.
They told me, "If you wanna create a Blue Zone, start with a city of about 20,000 people."
That's enough people so you have a city hall.
We ended up choosing this city of 18,000 people called Albert Lea, Minnesota.
Like most small towns, it pretty much reflected the health of the rest of America, but it had the bones of a beautiful city.
I remember our first day in Albert Lea.
I got all the town's leaders in a room, and I give this presentation.
It means that they'll look younger, feel younger, um, they should live longer, but they also have lower rates of cardiovascular disease.
Dan: And people were kind of befuddled.
Like, you know, I was sweating 'cause I just thought, "They don't get it."
Are there any questions?
But I remember the local State Farm Insurance salesman, a tall guy, stood up, and he said, "This city needs this."
And Bob Graham, you know, another stalwart of the city, a kind of older guy, he said, "Yes, we need to make it happen here," and then, you know, once these leaders say it, it falls like dominoes.
( drumming and chanting )
Dan: We developed something called the True Vitality Test to calculate the average person's life expectancy.
So we learned people's BMI, what they ate, and many of their other health behaviors, which gave us a starting point.
And then we started methodically changing their environment, little by little.
Traveling throughout the five Blue Zones, I now knew what the longest-lived people did to live a long time.
They ate wisely, they moved naturally, they had the right outlook, and they knew how to connect.
But the big idea was trying to put these ideas to work.
The first thing we tried is this idea of a moai.
We gathered people in Albert Lea together and then broke them up into little groups.
And I didn't even know if this would work. I had no idea.
I challenged them.
"For the next ten weeks, I want you to walk together."
And you know what?
A few years later, news reports actually found that nearly half of all these friendships lasted, all thanks to those moai.
Alice, would you have ever run into each other if not for this walking group?
I... No. No, I don't think so.
reporter: Brand-new friendships?
New friendships.
All these Blue Zones have a vocabulary for purpose. Loma Linda taught us the power of volunteering, of taking care of others.
We immediately set up curated volunteer opportunities for them.
We know that people who volunteer have lower rates of heart disease, they weigh less, and they have measurably lower healthcare costs.
And then we start bringing in the food policies, and we start getting healthier grocery stores and healthier restaurants.
And then, finally, there was this great main street that was dying a little bit, and of the four neighborhoods in Albert Lea, none of them had a clear walkway to this downtown.
So we worked with the city to make it more walkable and livable. We built bike lanes.
We put walking paths around a nearby lake, and we built sidewalks so people from nearly every neighborhood in Albert Lea could walk downtown.
So we administered the True Vitality Test a second time, and we found that life expectancy was going up even more than we thought, and it was generating all this excitement, so much so that we had national TV crews coming out to cover it.
You did even better than expected.
You were hoping to add maybe two years on to people's lives, and you have added... 3.1 years.
It's amazing. 3.1 years!
( crowd cheering )
( uplifting music playing )
Dan: So, we now knew we could manufacture a Blue Zone in small-town America, but could it work for a nation?
That question took me to the other side of the planet, where I found an island that offered a vision for a future Blue Zone, a Blue Zone 2.0.
( mellow electronic music playing )
Singapore is a completely manufactured society.
Here we have this little island in Southeast Asia, only about 30 miles long and 16 miles wide.
This is a complex urban society filled with futuristic high-rises and 5.8 million residents.
But it's not only producing the happiest population in the world by many measures.
It's also one of the richest.
And what makes it really extraordinary is you go back a little over a generation, Singapore is essentially a fishing village with below-average life expectancy.
And now 2023 a global study shows it to have the healthiest life expectancy in the world, where a person can live in full health without disease or disability.
So, Dr. Chow, let me ask you, you know, we are here in Singapore because studies show that people here have the longest healthy life expectancy in the world, and it occurs to us that you're a perfect example of that.
You're 93 years old, and you still do surgery.
You still do calligraphy.
How do you explain this incredible vitality?
I never expected I can live until today.
I enjoy that work.
I treat that patient.
Then I feel the joy.
Dan: So, uh, what are we gonna do here?
Check your blood pressure.
Dan: All right. I have to...
Very good!
Dan: Oh, good! What am I?
Dr. Chow: 122 over 80.
This is very standard.
Good, good.
Dr. Chow: Yeah.
Dan: So, if I wanted to live to 100, what advice would you give me?
Dr. Chow: We have to work hard every day, honest.
Dan: Work hard, be honest.
Dr. Chow: Yeah. Then most important, humble.
Humble is not easy.
Dan: I heard you're a good tennis player.
I found out that of all sports, people who play tennis have the highest life expectancy.
Was that for tennis?
Oh, no, this is karaoke.
Dan: Oh, karaoke?
( laughs )
Yes.
Dan: That's amazing.
You're good at everything.
I spent the better part of 20 years finding these Blue Zones, and in most of them, it's a culture that's been around for hundreds of years or a millennia.
But life expectancy here in the 1960s was about 20 years less than it is today.
Mm-hmm.
So, how does Singapore achieve that?
Woman: We don't have natural resources.
People are our natural resource.
To be in politics is about improving the lives of people.
And that's why, in Singapore, we have very severe penalties on drսg and for people who carry guns, so that our people would not fear for their safety.
But it's not just that.
There's a saying in the civil service.
"Policy is implementation. Implementation is policy."
Singapore works on nudges.
There's a war on diabetes, for instance, in Singapore.
People are taking too much sugar.
They eat the wrong foods.
So, what do we do? What does the government of Singapore do?
They try to help you help yourselves.
Dan: In past decades, Singapore's food environment wasn't all that healthy.
They had junk food.
They had lots of oil and sugar in their food.
But they were able to take steps to change their environment so it was easier to make the healthy choice.
For example, brown rice is a lot healthier than white rice.
Brown rice has more fiber in it, so they subsidize brown rice to make it more affordable and more popular.
Soda pop, sugar-sweetened beverages, number one source of refined sugar in most diets.
Well, Singapore made an agreement to actually cap the amount of sugar allowed in soda, an idea nearly unheard of in places like the United States. [In Singapore, it's only 12% allowable, but in USA its unlimited sugar in soda.]
And then, finally, they create this program for vendors, or hawkers, as they call them, to put a sign up [sticker] if they're offering true healthier food to attract the customers who want a healthier choice.
So, you see, they're just making this environment, setting up nudges and defaults to make the healthy choice the unavoidable choice.
This is the most densely populated country on earth.
We're driving during rush hour, and the traffic's not bad.
man: Yep, because the high cost of the cars.
Dan: And this car costs about $100,000 in the United States.
What does this car cost here in Singapore?
Douglas: $250,000 .
So two and a half times more.
Douglas: Yep, that's right.
And then you have to pay the right to drive, right? [Certificate of Entitlement, COE to buy a car prior driving it on the road]
Douglas: Yeah.
How much is that?
Douglas: Yeah.
Right now, that COE today is about 100,000 Singapore dollars.
Just the paper. No car, nothing.
Dan: So I keep hearing about this and asking, "What is the wisdom in making cars exceedingly expensive?"
And to really understand that, I found that you have to look to America.
You see, after World War II, we had such a good economy going that we built new homes outward from the cities.
And to get to these suburbs, we built highways to go out even further, and people had to drive longer distances until we created this dependency on cars.
The American Dream said you can get a house, a yard, and a car and drive to your job in the big city.
And the cost is that the streets that were once designed for pedestrians were now expanded to make more car lanes.
Today we're spending about twice the amount of time in cars than we did in the 1980s.
All this is great for car companies and fast food restaurants, but we bought into that too.
As Singapore grew, it likely saw a similar problem as the population of this small island expanded.
If everybody had two cars, so you had ten million cars on this tiny piece of land, what would this look like?
Douglas: Uh, a traffic jam.
( both laughing )
Nobody is going anywhere!
Dan: In the United States, about 80% of people own cars, and here, it's about 11%, but yet you don't see people having trouble getting around.
Douglas: The public transport is very convenient.
Wherever you live, in about ten, 15 minutes, you can walk to a train station.
Dan: Singapore's public transportation is so widespread and accessible that it is used by nearly half the population on a daily basis, compared to the U.S. average of 5%.
People reach the trains and buses using bike lanes and protected walkways paid for by the car taxes and often pass through one of the island's 350 parks.
Here, you find government-sponsored exercise programs that build community and friendship, and all of this from favoring people over cars.
Have you always been in this good a shape?
( in Mandarin ) I came from Hong Kong, where we did not have such sports facilities.
When I came to Singapore, I saw these sports facilities everywhere, so I started to practice bar and pull-ups.
( in English ) Every residence, there is a fitness corner.
See?
And the government encourages us to exercise.
Dan: So, how do you get around?
Do you guys own cars?
( in Mandarin ) I walk to subway stations and go shopping.
I'm still working, so I'm taking the subway.
Dan in English: How many kilometers do you walk a day?
Ngai in Mandarin: Over 10,000 steps.
( in English ) That's almost four miles of walking, which probably takes an hour and a half.
You're getting three times as much physical activity just living your life than you are doing exercise.
Victor: We are very fortunate.
Dan: Another interesting dimension of Singapore is over 80% of everyone there owns their own home.
When they own their own home, they take better care of it.
They invest in their neighbors.
You get a better community.
One exceptional example is the Kampung Admiralty, an affordable, government-subsidized housing project.
It's designed for citizens over 55 to own their own homes.
woman: This being a kampung, which is "village" in the Malay language... The vision of the team then was really, how do we create a kampung here?
The simple concept is a club sandwich. We will...
Dan: A club sandwich?
Yeah, it's a club sandwich.
We want to layer all the users vertically.
Yeah.
At the top, elderly apartments.
Our rooftops are all landscape.
So that's true.
Actually helps the elderly keep active.
The second layer is this medical center.
The bottom layer is the public plaza, a space where people can find a lot of space to interact.
The surrounding residents, they are always streaming through this building to take the train.
Dan: So, it's easy to get here through public transportation?
So you don't necessarily push them together, but you nudge them together.
You create a space where they're gonna bump into each other.
Pearl: Correct.
When I think about Costa Rica or Okinawa or Sardinia, I see people who live in a village.
They're very close to nature.
The old and the young interact.
Pearl: Hmm.
Dan: There is a center where you can find a place to eat.
Pearl: I think that's very healing, but sometimes it's really hard to scientifically quantify it, you know?
Dan: There's actually been a study that has shown that the casual social interactions we have during the day with the postman, with the person you meet at the bus stop, with the baristas, are actually a better predictor of longevity than diet and exercise.
And I think what people miss is that loneliness is a function of our environment.
Pearl: Because I'm in the environment, it's different from the past.
We are living in a very urbanized setting, and we need to create a prototype for the present and the future.
man: Long before I retire, they say one of the things you do is not to sit down and watch the TV all the time.
That make you a potato, a couch potato.
( Dan laughing )
Tze: Yeah, I know I got to keep both my body and mind active, have to go out and mix with people.
Dan: I love that.
And then... Because no man is an island, right?
So you have to be with people to be happy.
Because then we come to the next element.
If you are not happy, then you cannot live long.
No point living alone, you know, and never speaking to anybody, you know.
Do you live here with your family?
Yes.
Dan: Do you think living with your family is helping with your longevity?
Tze: Definitely, yeah.
They are quite happy that I'm here, and I'm very happy to be here.
My grandchildren, I took the opportunity to give them tuition in mathematics because I...
Dan: So, you're their tutor?
I'm quite good in mathematics.
And in return, they will help me with the computer because I'm a computer idiot.
( laughs )
Computer idiot?
I love that.
So yet another two-way street.
Tze: Yeah. Oh-two, uh?
Now this two becomes six because it's times three.
Dan: How does your father contribute to...
Oh, he helps out with my younger kids, you know, um, when I was still working full-time.
I'm now doing part-time.
He helped me to bring the younger two children home when I'm working late.
Uh, making sure they have good breakfast because I tend to go very early and kind of rush them for breakfast.
He takes them out for breakfast before sending them to school for me, yeah?
I'm the strict mom. I'm the...
Dan: Tiger mom?
Yeah, the stick mom. And he is the carrot grandad.
Dan: The carrot grandad!
I love that!
And he says, "If you do the math and score all correct, you get a dollar."
Dan: I love that.
[Dan looking at the five children]
Do you think that when you guys become parents that you'll invite your parents to live with you?
Wei: I guess, yes.
( Dan laughs )
Wei: You guess?
( all laughing )
Chan: When the founding fathers started building Singapore, we were a young nation there.
There were more young people than there were old people.
But as the society matured, longevity, aging became an issue.
Now we have an aging problem coming up.
By 2030, 25% of our population, one in four, will be above 65.
It means, you know, there's stress on your healthcare system.
We are trying to deal with this issue.
You know, the government has been playing with the idea of how to get children to look after parents and take care of them.
The government of Singapore has a policy called the Proximity Housing Grant, which encourages families to live near each other. [ Details Here]
You get a sum of money just given to you if you are parents choosing to live near your son or daughter or your son or daughter chooses an apartment in a public housing estate near you.
If children look after their parents, it means people don't get sick that often.
Dan: A study called Aging Alone in America reported that 100 years ago, 70% of American widows and widowers moved in with their families.
Today nearly the same proportion of widows and widowers live alone.
Singapore's Proximity Housing Grant is succeeding in combating that kind of trend.
Between 2015 and 2018, the Housing Development Board announced that some 11,000 households have bought resale apartments near their parents or married children with the help of the Proximity Housing Grant.
We know in the United States when you put an older parent in a retirement home, their life expectancy drops between two and six years.
So there's a genius in this idea that you're not forcing Mom and Dad to live with you, but you incent them to live nearby, which is not only good for the family, it adds life expectancy.
If you scroll through social media or look at #longevity, in America anyway, it's always about anti-aging drսg and diet and exercise programs.
But the United States is the most prosperous country in the history of the world.
Yet three-quarters of us are overweight or obese.
Happiness has dropped.
Life expectancy has dropped.
Is what Singapore doing now, is it scalable?
Could the United States, for example...
Um...
I... You know, I often say Singapore is sui generis, one of its kind.
[sui generis /soo͞′ī″ jĕn′ər-ĭs, soo͞′ē/
adjective
1.Being the only example of its kind; unique.
2.In a class of its own; one of a kind.
3.By itself; of its own.]
( lively electronic music playing )
Chan: We are a small nation.
It's really a city-state, you know, and so it helps.
You know, the city can write free trade agreements.
You can negotiate.
But some measures perhaps could be borrowed.
First, you have to have a vision and a desire and have those objectives.
Then you have to have people that have an investment in providing healthy lives, healthy families.
How do you create this public-private partnership?
I think if you can tell Americans that "I can help you reduce your healthcare costs," I think half your battle is won.
So you make the economic argument to produce a human benefit.
Chan: Right.
Dan: Such a powerful idea.
What Singapore teaches us is you can make enormous changes population-wide.
And I believe that, arguably, the most powerful tool we have at shaping healthier environments is through policy, and that's the lesson America needs to learn.
We need to identify the good policies and implement.
( pensive music playing )
After proving a Blue Zones approach could work in a small town, Albert Lea, then I decided to scale it.
And we discovered that insurance companies and hospital systems and private foundations were willing to make the investment in keeping cities healthier.
We were then able to take the Blue Zone project from Albert Lea to the beach cities of Los Angeles, to the whole state of Iowa.
The Blue Zones project continues to roll out easier ways to be healthy where you live.
Dan: But it wasn't until Fort Worth, Cowtown, that we showed that this could really work anywhere in America.
We met the mayor, the city council, the superintendent of schools...
reporter: Fort Worth's child obesity rates have dropped 6%.
A Gallup Poll of America's healthiest city says, "Cowtown is changing its tune."
Dan: And after five years, Gallup calculated that we saved that city more than a quarter of a billion dollars a year in projected healthcare costs.
So I realized that how we applied Blue Zone wisdom is ten times more important than having identified it in the first place.
What Blue Zones has now done is go into communities that are interested in creating a better environment.
So we're here in South Phoenix, launching a Blue Zone project.
Any Blue Zone community begins with listening.
The next step is to make permanent or semi-permanent changes to their surroundings.
I'd love to hear where in your neighborhoods we can make it better for human beings so the healthy choice is the easy choice.
We had a whole busload of experts, and we started just by doing assessment.
You know, I would argue this is the best team in America.
I would like to now challenge you to tell us how we're gonna really raise the happiness level, raise the life expectancy.
We have this open space.
What do we do with it?
Marion: Make a park!
A place where the community could come together, where you could have gardens.
You know, you could have community gardens that are going to make it possible for them to appreciate healthier food, but people have to learn how to do that.
They have to have the seeds, and there has to be somebody who encourages this kind of thing.
You only have one choice, and that's to go out to a busy street.
People won't walk.
This used to be a primary route. It had to carry 40,000 cars before they had the freeways.
So today it doesn't carry anywhere near that traffic.
If we could take out all the lanes except for one in each direction, now the sidewalks become usable.
Dan Buettner: Cities have amazing power.
If you have clear objectives, in just a handful of years, they can make complete transformations.
America, within the next ten years, could be a Blue Zone.
All we have to do is shift the focus from thinking that we're gonna change 330 million people's minds to changing their environment.
( curious music playing )
Dan: Imagine a community where the cheapest, most accessible, and most delicious foods are whole, plant-based foods.
Imagine roads that are not just built for cars, but they're also built for humans.
Where it's easy to connect and socialize, where people are putting their purpose to work every day.
These are all things that Blue Zones teach us are attainable.
We have a new lens to look at how to generate health and well-being in our country, a legitimate recipe for longevity.
But at the end of the day, the big epiphany* is that the same things that help us live a long, healthy life are the things that make life worth living. [*A sudden insight or intuitive understanding]
( uplifting music playing )
( gentle music playing )
