Chapter 7
Why Do We Age? — Part 1
The concept of the Blue Zones grew out of studies published in 2004, when social biologists Gianni Pes and Michel Poulain identified a province in Sardinia as the region with the highest concentration of centenarians. As the two men zeroed in on the cluster of villages with the highest longevity, they drew thick concentric blue circles on the map and began referring to the area inside the circle as the ‘Blue Zone’, thus cementing the title in scientific and public parlance. Dan Buettner is a journalist who, although he had no specific expertise in science or gerontology, became interested in Poulain’s Blue Zone studies. Together with Pes and Poulain, the term ‘Blue Zone’ was broadened by Buettner to apply to other validated longevity areas: Okinawa, a Japanese island in the Pacific Ocean; the Seventh-day Adventists community in Loma Linda (Spanish for ‘beautiful hill’) in San Bernardino, California; Nicoya, a peninsula on the Pacific coast of Costa Rica and Ikaria, a Greek island and small archipelago in the Aegean Sea. This broader concept was published in National Geographic in 2005 and became one of the most highly cited articles ever published by the magazine. Based on data and first-hand observations of life in the zones, scientists began to offer explanations for why these populations live healthier and longer lives. Their studies underpin today’s understanding of longevity.
Chapter 2: Why Do We Age?
Remarkably, all of the peoples in the Blue Zones share similar lifestyle characteristics, despite the fact that the zones are many miles and even continents apart. The factor of paramount importance is that ample physical activity, such as walking, gardening and housework, is embedded in daily routines. For Blue Zone centenarians, exercise is not a fixed purposeful action like a gym session or class but rather built into every opportunity. At a recent lecture I attended, Poulain showed a striking video of a woman in her late nineties chopping firewood, something she did every morning of her adult life.
Another feature of Blue Zone centenarians’ lives is having a purpose. The Okinawans have a special name for ‘purpose’, they call it ikigai, while the Nicoyans call it plan de vida – knowing when you wake up in the morning what your plans and achievements of that day will be. Subsequent research has established that having a purpose in life makes us healthier, happier and, amazingly, can add up to seven years of extra life. Having a sense of belonging and strong, close family connections with spouses, parents, grandparents and grandchildren contributes to the sense of purpose and is commonplace for Blue Zone centenarians’ life histories. In the case of the Adventists, their ‘purpose’ is being part of a faith-based community, which adds 4 to 14 years to life expectancy.
Whereas stress is part of everyday life for all of us, some of us struggle more than others to cope with it. Blue Zone centenarians have longstanding stress-relieving rituals built into daily routines. Ikarians take an afternoon nap; Sardinians do ‘happy hour’, sharing wine and conversation with friends and family; Adventists have communal prayers – all of which are ‘downtime’ destressing activities. Relaxation, social engagement, laughter, friendship and meditation are part of many of their lifelong rituals. Later on, I will explain how downtime benefits the nervous and cardiovascular systems and slows the biology of ageing.
Chapter 2: Why Do We Age?
Diet is an important contributory factor to longevity. I know from experience that people glaze over when a professional speaks about food and diet. I recall doing a radio interview and, as I turned to the subject of diet, the presenter retorted, ‘Oh, not that boring old chestnut again!’ Many scientists maintain that food is the key to ageing well. What is special about the Blue Zone diets is how similar they are, despite the physical and cultural distances between the communities. The diet is predominantly plant-based: beans are its cornerstone and vegetables, fruit and whole grains round it out, with meat eaten only in small amounts. When eating, Blue Zones centenarians apply an 80 per cent rule – that is, they stop when the stomach is 80 per cent full and eat the smallest meal in the early evening. How far removed this is from the chant that certainly I and I expect some of you were familiar with when growing up: ‘Finish up everything on your plate; there are too many people starving in the world.’ Even as a child, that made no sense to me. Below is a list of lifestyle behaviours shared by Blue Zone centenarians that determine longer, healthy lives: 1. Life purpose 2. Stress reduction 3. Moderate caloric intake 4. Plant-based diet – semi-vegetarian 5. Moderate alcohol intake, especially wine 6. Engagement in spirituality or religion 7. Engagement in family life 8. Engagement in social life 9. Regular physical activity It is worth emphasising that older people in the Blue Zones not only have extended longevity but also remarkably good health, with fewer illnesses in old age than we encounter elsewhere. The Blue Zone people therefore have the ideal scenario – better health coupled with longer lives. This is attributable to a delicate balance between the traditional lifestyle still practised in the areas and some modernity, with increased wealth and better medical care. But another key factor is happiness. By and large, Blue Zone centenarians are a happy lot with positive dispositions. Overlap in healthy behaviours in three of the Blue Zones You can well imagine that one of the challenges for research into regions and areas of proposed longevity is verification of the age of so called ‘long-lived’ persons. After all, we have all probably lied about our age at one time or another. How can we be sure that a claimed age is accurate, even when ‘records’ of birth are available? The fact is that falsifications of records do happen. The following is an illustration of this challenge. In the January 1973 issue of National Geographic, the physician Alexander Leaf gave a detailed account of his journeys to communities of purported long-living people: the Hunza from Pakistan, the Abkhazians from the Soviet Union and Ecuadorians from Vilcabamba. According to Leaf, there were ten times more centenarians in these communities than in most Western countries.
Chapter 2: Why Do We Age?
This was despite the fact that, as he pointed out, each of the countries had poor sanitation, infectious diseases, high infant mortality, illiteracy and a lack of modern medical care, thus making the inhabitants’ extreme longevity even more extraordinary. However, unfortunately for Leaf, who I am sure acted in good faith, some years later, ‘age exaggeration’ was proven, predominantly in Vilcabamba, where a large number of the men and women had inflated their age in order to improve social status or promote local tourism. Later, Leaf acknowledged that there was no substantive objective evidence for longevity in the village of Vilcabamba. Further studies confirmed that none of the aforementioned areas survived scrutiny. In light of Leaf’s experience, Poulain and colleagues conducted rigorous surveillance and validation studies for the Blue Zones, eventually confirming that a much higher proportion of persons lived into very old age with good health and lower levels of arthritis, heart disease, dementia and depression in these regions than elsewhere in the world. The observations and details of the Blue Zones withstood scrutiny. At the time of writing, the record-holder for longevity for the human species, at 122 years and 164 days, is a French woman, Jeanne Louise Calment. I really like her life story because, for me, it epitomises all of the elements which make for successful ageing. Calment was born in Arles, Bouches-du-Rhône, Provence, on 21 February 1875. Her father was a shipbuilder who lived to 93; her mother died aged 86. She had an older brother, François, who lived to the age of 97 – a strong family history of longevity. At 21, she married an heir to a drapery business and the couple moved into a spacious apartment above the family store in Arles. Jeanne never had to work, employed servants and led a leisurely lifestyle within upper society, pursuing hobbies such as fencing, cycling, tennis, swimming, roller skating, playing the piano and making music with friends. In the summer, the couple would mountaineer. She enjoyed an idyllic, relatively stress-free and fun-filled life, devoid of monetary worries with much variety, pleasurable activities and exercise. She had one daughter who died of pleurisy aged 36. Her husband died aged 73, reportedly from cherry poisoning. In 1965, aged 90 and with no heirs left, Calment signed a life estate contract on her apartment to André-François Raffray, selling the property in exchange for a right of occupancy and a monthly revenue of 2,500 francs (€380) until her death. Raffray died 30 years later, by which time Calment had received more than double the apartment’s value, and his family had to continue making payments to her. Calment commented on the situation by saying, ‘In life, one sometimes makes bad deals.’ In 1985, she moved into a nursing home, having lived on her own until age 110.