Live long and prosper: lessons from the world s oldest and healthiest people

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1 Live long and prosper: lessons from the world s oldest and healthiest people How long can we live? The capacity of the human life span is on average is years. A small proportion of people live longer into 90 s or 100 s. In industrialized nations, centenarians (age 100+ years) occur at a prevalence rate of about 1 per 6,000. Supercentenarians, people who are 110+ years old occur at a rate of about 1 per 7 million. In Australia our current life expectancy (for people born in ) is approximately years; 79.9 years for males and 84.3 years for females 1. Approximately 1 in 5750 people in Australia are centenarians 2 Genes vs lifestyle? Gerontologists often cite studies of lifespans amongst identical twins reared apart to describe the genetic and environmental components of aging. Based upon these studies, how long we live is due to 70-80% environment and 20-30% genes. Studies such as the Seventh Day Adventists at Loma Linda University have shown diet and lifestyle can make a difference of approximately 8-10 years. According to the Boston University New England Centenarian Study there are both genetic and lifestyle predictors of reaching 100. The lifestyle predictors include: o A healthy weight. Few centenarians are obese. In the case of men, they are nearly always lean. o Not smoking. Substantial smoking history is rare amongst centenarians. o Good stress management. A preliminary study suggests that centenarians are better able to handle stress than the majority of people. Genes play a larger role in exceptional longevity - especially for those age 106 years and older. Healthy disability- free older years The concept of a happy older life encompasses more than just how many years a person lives it also includes how many of those years are spent in good health or without disability or chronic illness. According to the Boston University New England Centenarian Study centenarians markedly delay disability towards the end of their very long lives, at an average age of ~93 years Most people have the genetic makeup to live into their mid to late eighties in very good health. In Australia people are living longer and living with more years free of disability. However there is still scope to increase each individual s capacity to live longer healthier lives.

2 In 2011, 90% of all Australian deaths were caused by a chronic disease: Cardiovascular diseases, cancers, chronic obstructive pulmonary disease (COPD) and diabetes - account for three- quarters of all chronic disease deaths. Four common behavioural risk factors are attributed - smoking, physical inactivity, poor nutrition and harmful use of alcohol. The Blue Zones clues to living longer Longevity scientists and demographers have uncovered locations where people are living longer disability free lives than anywhere else in the world. These unique places have been called blue zones. The phrase "blue zone" was first coined by Belgian demographer, Michel Poulain when was referring to the Barbagia region of Sardina. Journalist, explorer, and author of The Blue Zones, Dan Buettner, extended the term to include other demographically confirmed geographical areas where people lived measurably longer. These are areas that have the highest centenarian rate, the highest life expectancy or the lowest rate of middle age mortality. Buettner, in conjunction with the National Institute of Ageing, National Geographic Expeditions Council, and his research team, have reported on five blue zones to date: o Barbagia, Sardinia o Okinawa, Japan o Ikara, Greece o Nicoya Peninsula in Costa Rica o Seventh Day Adventist community in Loma Linda, California. Sardinian secrets of Barbagia Dan Buttener s research into the blue zones started with Barbagia in Sardinia where demographer Gianni Pes had first reported the presence of seven centenarians in one village of 2500 people. Barbagia is one of the only places in the world where men live as long as women. Sardinians carry the M26 marker, linked to exceptional longevity, at much higher rates than other populations Lifestyle has also played a significant role in their longevity The majority of Sardinian men in this region are shepherds, an occupation that involves several hours of low intensity physical activity per day. Their diet is lean and largely plant based consisting of: o Unleavened wholewheat bread, beans, garden vegetables, fruits, and meat consumed no more than once a week. o Pecorino cheese from grass fed sheep, high in omega- 3 fats o Mastic oil - antibacterial and antimutagenic properties. o Goat s milk - anti- inflammatory components o 1-2 glasses of Cannonau wine per day - rich in flavonoids. Flavonoids have significant anti- inflammatory activity and this local wine has 2-3 times the flavonoids than other wines.

3 The Sardinian lifestyle includes a positive attitude towards elders, close ties to friends and family, and plenty of time devoted to laughter. Evidence shows people who have strong social networks and enjoy a regular laugh experience lower rates of depression, suicide and stress. The longest healthiest years in the world Okinawa, Japan Okinawans have the longest disability- free life expectancy and the oldest living female population in the world. The majority of the Okinawan elders still live a traditional way of life they eat a plant- based diet, engage in regular low intensity physical activity (gardening and walking), spend a lot of time with friends and family, and maintain a strong sense of meaning in life. Almost all Okinawan centenarians grow a garden and harvest vegetables, herbs and spices with antioxidant, anti- inflammatory, anti- microbial properties such as mugwort, ginger and turmeric. Their modest plant- based diet includes foods rich in soy, like tofu and miso soup. Flavonoids in tofu have cardioprotective properties and fermented soy foods contribute to a healthy intestinal microbiome (good gut bacteria). Okinawns are also one of the only human populations that purposefully restrict their energy intake by keeping to a principle of Hara hachi bu - eat until you are 80 percent full. Does faith equal a longer life? - Seventh Day Adventist community in Loma Linda, California The average Seventh Adventist in Loma Linda lives eight to ten years longer than the average American. 3 Loma Linda University Medical Center have been studying the Adventists for approximately 50 years and the evidence is that diet and lifestyle plays a significant role in their exceptional longevity. Loma Lima is home to 9000 Seventh- day Adventists, who practice a healthy diet and lifestyle as part of their faith. The Adventists that live the longest and have a significantly reduced risk of lifestyle diseases eat: o a vegetarian diet o two or more servings of fruit per day o legumes three times a week o nuts at least five times a week o a light early dinner The Adventist health study research also suggests that drinking at least 5-6 glasses of water a day could reduce the risk of fatal heart attack in men by 60-70%. The lowest rates of middle- age mortality - Nicoya Peninsula, Costa Rica Lowest rates of middle- age mortality in the world and the second- highest convergence of males age 100 or above. Out of a total population of about 4.5 million as of June 2013, 417 Costa Rican centenarians were reported - the majority of them located in the Nicoya Peninsula in Costa Rica.

4 People not only live a longer life but die of cancer at a rate 23% lower than the rest of the country. Nicoyans are family and faith oriented with strong social networks. They have a plan de vida (reason to live) driving their positive outlook and active lifestyle. Nicoyans eat a plant- based diet, largely based on corn, rice, garden vegetables and vitamin C rich fruit. They supplement this with eggs and a small amount of pork. Most of their food is consumed in the day with only a light meal in the evening. A unique attribute of this blue zone is the calcium and magnesium rich water. The consumption of hard water may be a protective factor against heart disease and bone fractures 4. A population almost free of dementia and chronic disease Ikaria, Greece People live on average 10 years longer than those in the rest of Europe and America around one in three Ikarians lives into their 90s. This population is almost entirely free of dementia and chronic disease. Ikarians walk and garden throughout the day, foster social connections with family and friends, avoid smoking and make time for rest. They eat a mediterranean style diet with: o lots of fruits and vegetables o whole grains o beans o potatoes o olive oil o moderate amounts of wine o goat s milk o herbal teas - oregano, rosemary, sage and thyme - with anti- inflammatory properties. As Greek Orthodox Christians they fast for almost half the year, reducing calorie consumption by about 30 percent. A Blue Zone recipe for longevity? Observing the blue zone communities no one thing can explain longevity. The centenarians owe their long lives to a combination of genes, geography, culture, diet, lifestyle, and outlook. There is even variation in each group s lifestyles and diets. There are however, consistent practices across all of the Blue Zone communities: o strong social networks o faith- based communities o strong sense of purpose o time out to unwind o daily, natural physical activity o mostly plant- based diet with plenty of seasonal vegetables, fruit, and a variety of beans, nuts, and grains o moderate eating with most food consumed early in the day

5 These people living well into their 90 s and 100 s haven t cut out carbohydrates, adopted the paleo diet, banned dairy and grains or taken supplements. They eat an unprocessed plant- based diet in moderate portions without strict dietary rules. They live in a supportive community with a sense of purpose and take time out to relax. They move naturally and are happy positive people. The Blue Zones: Lessons for Living Longer From the People Who ve Lived the Longest - The Power 9 1. Move naturally - walk, garden, use fewer laboursaving devices 2. Hara Hachi Bu Eat until you're 80 percent full 3. Eat a plant- based diet - Eat more vegetables and legumes; and less meat and processed foods 4. Drink red wine - in moderation 5. Find a life purpose - a reason to wake up each morning 6. Take time to relieve stress - Rest, meditate and take time out 7. Participate in a spiritual community 8. Make family a priority 9. Strengthen social network Align with those that follow a healthy lifestyle and establish a regular time to meet Simple tips for incorporating the nutrition practices of the world s oldest and healthiest people Boost intake of seasonal plant foods + move naturally + strengthen social network and community ties + relieve stress + daily purpose Plant vegetable and herb gardens at home check out or for tips and inspiration. And perhaps find someone near to swap seasonal foods Find food in your community - pay small amounts or even get food for free: Try a food box scheme suppliers deliver boxes of local, seasonal produce to your door or a central drop off point. Get involved in a community garden or start one up Start up, join, or find a food cooperative or food co- op set up by its members it is usually run not for profit. o Various forms exist, ranging from a small family and friends co- op, to large community run co- ops that operate as a shop or outlet that members or the general public can use. o A food co- op can be a way of sourcing healthy and sustainable foods, such as fresh fruit and vegetables, local and organic produce, or bulk wholefoods. o Food co- ops can also have lots of other benefits for the community, such as providing healthy food at an affordable price,

6 opportunities for volunteers, and a sociable place to shop and meet local people. Visit farmers markets (or form a co- op) to buy seasonal produce such as fresh fruit and veg, grains, lean meats, olive oils, legumes, nuts. Some farmers markets will be organic, vary in price, size and the produce they offer. Check out: Boost intake of nuts People in Loma Linda who ate nuts at least five times a week had half the risk of heart disease and lived about two years longer than those who didn t. This may be because nuts are rich in monounsaturated fat, soluble fibre, and a good source of vitamin E - all nutrition keys to heart health. Ideas for boosting intake of nuts include: 30g handful on their own Nuts and figs as a calcium rich snack In salads, stirfrys, and pastas Toppings on fish, chicken, meats As a base for healthy muffins or loafs almond meal Nut butters on apple, wholegrain breads, crackers or vege sticks Nuts, fruit and yoghurt Blend in smoothies Muesli design your own For information on nuts written by an accredited practising dietitian check out: Download client resources and two great recipe books with creative ways of including nuts in snacks and meals, dips, sauces, desserts and gift ideas Read the latest research on nuts and health, the nutrient composition of nuts, and tips for how to include nuts in your diet Eat until 80% full Slow down when eating, check in with how full you are feeling as you eat, appreciate the food in front of you and how it will postively affect your body and mind Practice mindfulness eating with intention of caring for yourself and attention necessary for noticing and enjoying your food and its effects on your body. Turn off TV, move away from the computer, look and smell what you are eating, savour every mouthful Diaries can be used to track satisification and fullness Apps are available to help with slowing down eating, eat mindfully, increase awareness around speed of eating, and track thoughts and feelings and hunger/fullness levels

7 References 1. Australian Institute of Health & Welfare (2013). Life expectancy. Sourced January 2015 from, expectancy/ 2. Australian Bureau of Statistics (2014). Feature article: population by age and sex, Australia, states and territories. Sourced January 2015 from, ocument 3. Boston University School of Medicine New England Centenarian Study (2015). Why Study Centenarians? An overview. Sourced March 2015 from, 4. Sengupta, P. (2013). Potential health impacts of hard water. International Journal of Preventative Medicine, 4(8): Resources Buettner, D. (2009). The Blue Zones: Lessons for living longer from the people who ve lived the longest. Washington, D.C.: National Geographic Society.