Exploring Longevity with Author Dan Buettner

Episode Transcript

Dr. Daniel Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa

Dr. Katy Peters:
And I am Dr. Katy Peters, and this is the Brain & Life podcast.

Dr. Daniel Correa:
We've heard all about wellness on TV and even podcasts that many of you're listening to and we also keep hearing about longevity. What does it really mean? For me, it's maximizing the quality of our lives and the time and connections that we have in our community throughout all of our life, but also particularly in the later years of life. Katie, have you seen the Netflix documentary show Live to One Hundred: The Secrets of the Blue Zones?

Dr. Katy Peters:
Yes, I have seen this documentary and it is very interesting to learn the secrets of our centenarians.

Dr. Daniel Correa:
Yeah, I mean, I had previously read Dan Buettner's books. He's had several books that he's been categorizing and talking about these communities around the world for several years and he has a new book, The Blue Zones Secrets for Living Longer, The Lessons from the Healthiest Places on Earth, and it's amazing to put those words into imagery and actually get to meet those people on the show. Did you learn anything that you've been incorporating into your days or cooking?

Dr. Katy Peters:
Of course. I think keeping your mind and body active is definitely a lesson there. And then on the diet it would be beans, greens, and oh so leans, so that's where it's at. And I like to incorporate, I guess nuts and seeds and I'm saving up a lot of money because I'm going to plan to move to one of those zones soon.

Dr. Daniel Correa:
Impressive, okay. Wow, you're thinking about big changes. I've been eating more whole grains and I've always been a fan of beans and have them several times a week, so it just kind of spoke to the things that I was already very interested in, but it definitely challenged me to think about tweaking a little bit, those healthy foods. Being in New York City, I'm jealous of all those communities growing gardens right there outside their places. So as much as I can, trying to get a little bit of better access to fresh foods. I was also impressed by the level of daily movement and physical activity just with day-to-day activities that many of these centenarians and communities that are featured in the show demonstrate throughout all of their life. We hope you enjoy this discussion with Dan Buettner about his books, the show, and what he's learned from the Blue Zone communities around the world.

Dr. Katy Peters:
In honor of Epilepsy Awareness Month, we'll be sharing with you an interview with Tiffany Kairos, who lives with epilepsy and is advocating for others in the community with this neurologic condition.

Dr. Daniel Correa:
Later on, we will also have an interview with Dr. Casey Albin, who joins us to share some valuable information that you should know when it comes to the intensive care unit, neurologic emergencies and decision-making with you and your families in that setting, something all of us can benefit to learn more about. Now, make sure that you follow and subscribe so you don't miss these and upcoming episodes.
Welcome back to the Brain & Life podcast. Over the last 20 years, our guest today has been learning from some of the healthiest communities around the world. Like many, he started searching for the single secret food or supplement that might be an effective silver bullet that could answer why these communities and why some people live full and healthy lives well past 100 years old. This has been the work and the topic of his books and articles and what is referred to as the Blue Zones. We're excited to have Dan Buettner here today to hear more about these fascinating communities, his books, and the recent really released Netflix series, Live to 100: Secrets of the Blue Zones. Dan, thank you so much for joining us.

Dan Buettner:
Daniel, it's a delight to be here.

Dr. Daniel Correa:
Before you started this work and studying the Blue Zones, what was your understanding about the path to health and happiness?

Dan Buettner:
I was looking for, as you point out, silver bullet, and I remember in Okinawa, coral calcium was being marketed to us as the secret. In Sardinia, there was a discovery that they're very genetically pure. There's some genetic component to longevity we could isolate and replicate for others. And then an herb maybe, we heard that people drink herbal teas all the time, so perhaps there was an herb that was giving people an extra eight years of life expectancy and by the way, with almost no dementia. That very quickly proved to be a fool's errand. I don't believe there's a silver bullet to longevity. There's not one now, and I don't even think there's one on the scientific horizon.

Dr. Daniel Correa:
We've talked about it in your books, this limitation of focusing on a supplement, a gym membership, fitness classes, the numbers of steps and the minutes of exercise. As you started to get into this work and understanding things from these various different communities, what really changed for you the understanding about types of exercises to incorporate into your daily living?

Dan Buettner:
The idea of exercise has been largely a public health failure. It's not working, and this idea that we're going to give people this program that they need to muster discipline and they need to get to a gym or they need to have this presence of mind to follow a workout has not been working. I mean, it works for single digit percentages of people, but not for a population. You look at Blue Zones, people are getting 10,000 steps a day mindlessly, because every time they go to work or a friend's house or out to eat, an occasion to walk. They have gardens out back. They haven't adopted mechanized conveniences to do all their work, they're still doing work by hand.
So when you count up all the calories burnt in this sort of unconscious physical activity as the result of having the right environment, you find a far more active population. And I think until we lose the whole parlance of exercise and shift the focus away from trying to manipulate people's behaviors, which is almost completely a long-term failure and engineering their surroundings so that active choice is the easy choice, I don't think we're going to see a big difference here in America.

Dr. Daniel Correa:
So instead of just really focusing on everyone having a set number or access to certain classes, sure those things are fine, but the ability to make the choice to be more active, to get up and go as the easier process instead of scheduled and prescribed exercises for everyone.

Dan Buettner:
The opportunity lies in the unconscious choice. So I'll give you another example. This was a study done in London and people who take public transportation to work, it probably occasions about 19 minutes of physical activity a day walking to the bus or subway and then walking from there to work and then doing it in reverse at the end of the day, they have about 20% lower rate of cardiovascular disease or cardiovascular mortality than people who drive their cars to work. So I would much rather see a walkable city than a city with the fanciest gyms and CrossFit studios in every corner because most people aren't going to muster the discipline for the decades necessary to avoid a chronic disease. And it's got to be easy and in your way or it doesn't work at the population level.

Dr. Daniel Correa:
And how have you incorporated what you've learned about activity and movement in your own life as you learn from these different communities?

Dan Buettner:
So if people could see right now, I live on a parkway. In front of my house, there's a walking trail and there's a bike path or there's bike lanes for me to get downtown. And I'm in Minneapolis right now and then I spend most of my time in Miami Beach where I'm right on the beach. I look out at the ocean every day and go swimming. I don't get in my car for weeks at a time. I bike everywhere. I'm 63, but I have very consciously and proactively chose walkable communities because I know people who live in walkable communities mindlessly get more exercise, mindlessly live longer and report significantly levels of happiness or subjective wellbeing than people who live in car dominated communities

Dr. Daniel Correa:
In your book and in the Netflix series, you interviewed and met several members in the Okinawa community and just observing them, you saw how much they moved in their day-to-day. So maybe they didn't necessarily change location, but I could see how some people think, well, I can't necessarily move, so how can I increase my activity in my day? What's something that you learned from those centenarians in Okinawa about how much they move just in their day-to-day practice?

Dan Buettner:
Well, I started first with the data. We hired demographers and we knew Okinawa, when we started this project in 1999, were producing the longest lived, healthiest people in the world. And I've relied somewhat on studies, epidemiology, somewhat on the science of studying these communities, but some of it was by observation. And there's a few things. They'll have gardens three seasons a year, and even 90 to 100-year-olds are working in the garden for two or three hours. I mean, that's a workout. The other really interesting piece of insight is they sit on the floor. So think about that for a second. I spent a day and a half with a 104-year-old woman who got up and down from the floor about 30 times. That's like 30 squats and they're hip openers too, whereas falling down is one of the top killers for people over 65.
It's not significant or not nearly as significant in Okinawa because they have much better lower body strength and lower body balance, not because they're going to the gym, not because they're doing CrossFit or anything else, they don't have furniture and they sit on tatami mats and they work in their gardens, and of course they walk to their neighbors, very few centenarians own cars. But that's what we got to start thinking about because what we're doing, we do it every decade and we've been doing it for 70 or 80 years trying to get Americans more fit and we just get less and less fit. So time to try something new in my opinion. People from the Blue Zones give us a very good model of what we could be aspiring to.

Dr. Daniel Correa:
And so much of it seems to be cultural. Most people have absorbed some lessons on longevity, maybe thinking about farming communities and what they've learned about the Mediterranean diet. I have known patients and community members from Latin American and Asian countries who feel like ideas of the Mediterranean diet doesn't exactly apply to their culture. But you've studied and worked with community members, and Okinawas and Costa Ricans who don't necessarily have what people would describe as the Mediterranean diet, but still falls within that structure. Tell us about some of these communities and their unique approaches culturally to health and longevity.

Dan Buettner:
There's no real culture of longevity. None of these people went to Sardinia or Icaria, Greece or the Nicoya Peninsula. None of them were pursuing a culture of longevity, they were just living their lives. And I don't like to talk about culture that much because it's too vague. It's very hard to measure, it's very hard to replicate. But Winston Churchill famously said, "If you shape your environment, it will shape you." And I've emerged from this 20 years of work with a very clear idea how we can shape our homes, our workplaces, our commutes, our social circles, and indeed our entire cities so that people unconsciously are making better micro decisions throughout the day.
And then all of a sudden, lo and behold, we have a culture of longevity. Albert Lea, Minnesota was the first city that we made into a Blue Zone city. They lowered their obesity rate, they rose their life expectancy by a couple years, they lowered healthcare costs by 30%, but now they self-describe as a healthy city. They've gotten a bunch of recognition throughout the nation, and you could say there's a culture of health there, but once again, it starts with something tangible. It starts with shaping our surroundings, and then you get the longevity culture. `

Dr. Daniel Correa:
As I was learning about some of the Blue Zone project implementations that you guys have tried to move forward, I saw that concept of a community that you describe in Okinawa community as this moai concept, and you guys tried implementing that with walking groups in one of the Blue Zone communities. Tell us some more about these efforts to try to apply these concepts of building healthier communities within the United States in places where a Blue Zone didn't previously exist.

Dan Buettner:
So you start out by auditioning cities. We have to make sure cities want it. A city basically has to say, "We're tired of being 75% of us obese or overweight, we're ready to make some changes." And once we find they're ready, and that usually means making the healthy choice easier and making the unhealthy choice harder and more expensive. So far, we've had 72 cities and the approach is we're going to change your environment. We have full-time teams that work with city councils to help them identify policies, food policies, built environment and tobacco policies that have worked elsewhere to create a healthier community. And then we have a certification program for schools, restaurants, grocery stores, workplaces, and churches so that if we can get 30, 40% of those places certified so people are mindlessly nudged into moving more, socializing more and knowing and living their purpose, we know that this is contributing to life expectancy.
And then a third team works with about 10% of the population to become Blue Zone ambassadors, and they take purpose workshops, volunteer and optimize their own surroundings. And if we get those three people, places, and policy with enough tension on it, enough focus for five years, we have never failed yet at lowering healthcare costs, lowering the BMI and rising life expectancy, but it's very different from the way we think of it. It's not no pain, no gain, it's not jazzercise or the veggie run. It is shaping people's surroundings so that they're unconsciously making better choices comprehensively.

Dr. Daniel Correa:
It's good to think of it that it's such a comprehensive effort and project and not just, oh, we're only adapting one thing about people's activity or their diet, because I think so many people will just end up focusing on whether it's a supplement or making that one change in their activity and not changing everything about their lifestyle.

Dan Buettner:
There's a massive meta-analysis of supplement takers and non-supplement takers, and it found that supplement takers actually have higher mortality than non-supplement takers. Now, there could be a number of confounding factors involved, but it certainly is not a big endorsement of taking supplements. You don't see people in Blue Zones taking supplements. They're eating a whole plant-based diet, largely beans and grains, which are cheap and combined make a whole protein, greens that grow like weeds, which they make tea out of. Okinawa, until 1970 or so, two thirds of their dietary intake came from purple sweet potatoes and snacking on nuts. So those are the supplements in the Blue Zone, real food.

Dr. Daniel Correa:
In your newest book, you simplified it just as four things to have always and four things to avoid. So what would be those four that you learned from these different zones?

Dan Buettner:
You can't tell people to not eat the food they love or you're going to lose them, but you can say, "Don't bring it into your house." And if you can manage to not bring in these bad things, you've just won 75% of the battle. But the four things that never bring in your house are sugar sweetened beverages, number one source of unrefined sugar in our diet. Salty snacks, your potato chips and Doritos and so forth, most highly correlated with obesity. Processed meats, this is like bacon and lunch meat and sausages. World Health Organization puts that in the same category as tobacco as a known carcinogen. And then packaged sweets, which are going to be those simple carbohydrates. Not to say that you can't go out and enjoy ice cream or go out once in a while and enjoy dessert. I think people deserve that, just don't bring them in your house.
And then the four things to always have on hand, number one, nuts. I think that's the perfect go-to snack associated with about two extra years of life expectancy. Beans, probably the greatest longevity food there is. I don't care what kind or how you make them, just don't put a bunch of sugar and meat in there. But a cup of beans associated with about four years of life expectancy. Your favorite fruit, and I believe Americans are on what I call a see food diet. We eat the food we see, so if there's a bag of chips on your counter with a clip on it, guess what you're going to eat when you walk through the kitchen as opposed to a beautiful fruit bowl with your favorite fruit in there. So just keeping that fruit bowl as a nudge to keep it full. And then finally 100% whole grain bread because Americans love sandwiches.
You're halfway there if you start with the right bread, it's got to be 100% whole grain. It can't just say whole grain because they dupe you all the time and look at the label. I mean, you really only want water, wheat, and just a little bit of salt. Sourdough bread I think is pretty good. And by the way, here's a great longevity hack, whole wheat bread and real peanut butter. That's a whole protein. You got a nut and a grain there. You have a fat, there's no sugar in there, not if you don't buy the other processed peanut butters, but just buy real ground up peanut butter and man, you got a perfect Blue Zone lunch peanut butter sandwich.
When it comes to longevity, there's nothing you can do this week or this year to live longer. You have to figure out, Daniel, something you're going to do for decades or a lifetime. All we know about longevity right now, it's basically avoiding the chronic diseases that shorten our lives. Type 2 diabetes, most cardiovascular disease, about half of dementia and several cancers of the GI tract are largely preventable. And we know exactly what to do to prevent them, but we have to do the right thing and avoid the wrong thing for long enough to not get these diseases. So you can give people the exact diet of longevity, but it's that right community, that right tribe, that living in a place when a healthy choice is the easy choice. You having your life underpinned with purpose, surrounding yourself with the right people, that is the mutually supporting web of factors that keep people on the program for long enough.
Like Daniel, if you and I hung out, if you said, "Let's get together and have some fun." I'd talk you into coming to play pickleball or taking a bike ride with me and when you hang out with me, you're mindlessly going to eat better and your mindlessly going to move more as opposed to other friends that you might have whose idea of recreation is sitting around all afternoon watching a football game and drinking beer and eating chips. Not to say that we don't all deserve to treat ourselves once in a while, but your friends have an enormous measurable and long-term impact on your health behaviors. So the difference between Blue zones instead of just giving you the diet, if you read this book, Blue Zone Secrets for Living Longer, it's going to tell you how to set up your ecosystem so you're unconsciously doing the right thing for long enough to make a difference.

Dr. Daniel Correa:
And you mentioned the importance of maintaining and carrying through purpose through your life, not just at an older age when you're trying to prevent dementia, but throughout your life, this is a concept you talk about, particularly in the Okinawan and the Nacoya Costa Rican community. Tell our listeners some of the examples of how you saw that carried through.

Dan Buettner:
Well, Okinawa, they have a word for it, "ikigai", which essentially means reason for which I wake up in the morning. In Costa Rica, it was "plan de vida." The Adventists' is clearly manifested in their religion, which is their easily packaged purpose. But knowing that sense of purpose, and when I say purpose, I mean knowing your values, knowing what you're good at, knowing what you like to do and making sure there's an outlet for it, ideally an outlet that has a service element. We see that in all the Blue Zones. And this is especially important at retirement age. If you retire without a sense of purpose, there's an enormous spike in mortality.
The second most dangerous year in your life is the year you retire on a population level, but when you retire, you not only lose your social network often, but you lose that sense of self-worth and, what am I going to do today? And along with that comes the motivation to take your meds and stay active and eat right, and according to Gallup, only about 30% of Americans find purpose at work. So they're phoning it in. People don't wake up with the existential stress of, what am I doing here? What am I going to do today? They're there for their families. They're in charge of their community's spiritual health, or they're committed to their animals. So purpose is important and worth about eight years of life expectancy over being rudderless.

Dr. Daniel Correa:
And it was impressed, particularly with some of these communities, like you said, that the purpose didn't necessarily come from their work or a sense of achievement, it was much more about a role in their community or in the space around them.

Dan Buettner:
Yes, it was more a role in community. It's having vocabulary for it too. I mean, for example, Okinawa doesn't even have a word for retirement in their vocabulary, so we spent our whole adult life preparing for retirement. There's a whole industry around retirement, financial industry. In Okinawa, there's no word for retirement. You're just going to work until you stop. You see 100-year-olds who are still making musical instruments or they still have a stall in the market. What they going to do after they retire? They look at you perplexed. You ask them what their ikigai is, they know right off the top of their head why they wake up in the morning.

Dr. Daniel Correa:
One of the things you talked about essentially, an industry around retirement and aging in the United States and in the western world and several of these communities, you point out really the role that the elders live and have in their families or in their communities, whether it's in Okinawa or in newer areas of the world that are incorporating these concepts like Singapore. Can you explain for us how you see that as being very different from how we live it in the United States and in other places?

Dan Buettner:
America, all you have to do is open up a magazine or turn on the TV, and it's pretty clear that we celebrate youth. In the Blue Zones, the older you get, the more respected you are. And older people, their wisdom is harnessed, their childcare skills are harnessed. They tend to live with the family, taking care of kids, passing down the food traditions. They've seen the ups and downs so they understand resilience and they can pass it on to their kids. At Yale, there's a researcher named Becca Levy who found that people who have a positive view of aging actually have about 40% less mortality than people who are scared to death of aging.
Looking at the older years as a gift, as a time when you become more satisfied, as a time you solidify the gifts you've accumulated through life and start to give them back and looking forward to it, it's a much healthier path and a good longevity strategy over anti-aging, facelifts, and longevity hacks, and running away from it and trying to get back to the youth that we had 30 or 40 years ago, embracing age, embracing the older years. And I'll leave you with one really optimistic note, happiness is kind of a U-shaped curve. We start out pretty happy in our twenties. Our happiness sinks in our forties and fifties. Usually, 50, 55 is the toughest year for people, and then happiness increases again, and actually 100-year-olds as a demographic, as long as they keep their health, are happier than 20 year olds. So we all have a lot to look forward to.

Dr. Daniel Correa:
I hope to be on that path along with them. In your book, you actually also provide some recipes as examples for these types of diets. Is there a favorite that you would like to mention to the listeners?

Dan Buettner:
There's a Sardinian minestrone. I eat it almost every day, and it's made with mirepoix, carrot, celery, onions with some red pepper, some herbs of your choice, and then potatoes, three kinds of beans, a tomato, and then I put a little bit of reduced vegetable stock in there to richen it up. I make it in an Instant Pot. I eat it for breakfast. It's a low glycemic meal, so I'm sustained. I get half my fiber for the day. If there's a longevity cocktail, I think this is the closest thing you're going to find to an authentic one.

Dr. Daniel Correa:
Well, that one sounds delicious. I think that'll be the next one for me to try. But for our listeners, just based on these ideas, I encourage each of you to call a friend, build on your community, talk about some of these ideas, plan some time to sit down and have that minestrone joining together, and then make a plan to read the book and watch the series. Thank you so much, Dan, for joining us.

Dan Buettner:
Thank you, Daniel. It was a pleasure.

Dr. Daniel Correa:
Thank you again for joining us today on the Brain & Life podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life magazine for free at brainandlife.org. Don't forget about Brain & Life en Espanol.

Dr. Katy Peters:
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Dr. Daniel Correa:
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Dr. Katy Peters:
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Dr. Daniel Correa:
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Dr. Daniel Correa:
We are your hosts, Dr. Daniel Correa, connecting with you from New York City and online @NeuroDrCorrea.

Dr. Katy Peters:
And Dr. Katie Peters joining you from Durham, North Carolina and online @KatyPetersMDPHD.

Dr. Daniel Correa:
Most importantly, thank you and all of our community members that trust us with their health and everyone living with neurologic conditions.

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Exploring Longevity with Author Dan Buettner

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