Blue Zones: Longevity Lessons From The World’s Oldest People

Dan Buettner

Yeah. So the idea of Blue zones was in a sense to reverse engineer longevity. And instead of looking for answers to live longer, better life. And by the way, the average American could live about 14 extra years if they optimize their lifestyle. But instead of looking at a test tube or Petri dish, Our idea was to find demographically confirmed populations where people were making it into their 80s, 90s and even hundreds without chronic disease. And there’s a well accepted assumption that when it comes to longevity only about 20% at the population level is dictated by genes, the other 80% is something else. So if we can find populations that, you know, living a long time, we know it is in their genes or at least that’s a minority explanation. 

And so it was probably 2002. I had the idea and I code called Ancel Keys and Ancel Keys is the guy most responsible for identifying the Mediterranean diet through seven country studies which followed cohorts of men from Finland down to Corfu at five year intervals and noticed that the men eating the least amount of animal pro products were having the lowest rate of heart disease. Now at the time you couldn’t make such a broad statement because as a scientist, you expected to find the micronutrients. So, you know, he identified the correlation between saturated fat and cholesterol and heart disease. But actually the original work was just with animal protein, the more animal protein, the more heart diseases. And but I knew he was famous for his work was very similar to the work I was proposing. He’s 99 years old. He listened what I said, he said, I’m too old, I love what you’re doing, fax it to me and I’ll see what I can do. And he he introduced me to Dr. Robert Kane who was the Dean of the School of Public Health in Minnesota,

Joel Kahn, MD, FACC

University of Minnesota

Dan Buettner

University of Minnesota. That’s right. And it was with his endorsement and collaboration that I got the original funding from the National institutes on aging to do the demographic work to identify these five areas where people are living statistically longest. The so called blue zones.

Joel Kahn, MD, FACC

And well, let’s list in a second. The five. Did you have a clue? It was gonna be five. Could have been two. Could have been nine when you very much launched the project.

Dan Buettner

No, I had no clue. No clue. I only knew one for sure. Which was Okinawa Japan And that’s been verified for some time now, largely thanks to the will, the Wilcox brothers. But once I started digging into it, I found two more emerging Blue Zone, well, one more emerging blue zones. And then I named Loma Linda California, the adventist, another Blue Zone. And I wrote a cover story for National Geographic and the first Blue zones book, which was a big success. And with the proceeds of that book, I went off to fund the discovery of the second or the fourth and the fifth Blue Zone,

Joel Kahn, MD, FACC

Which one didn’t make it. I mean there were the elderly women in Georgia. USSR eating Dannon yogurt. I mean people were talking 30 years ago, that was longevity. There were a few

Dan Buettner

120 year olds who drank 1/5 of vodka a day, smoked two packs of cigarettes, eight Dan and yoga in and had 40 year old girlfriends never happened. What Stalin during the time of Stalin. These villages wanted to elude the draft for their young men. So these young men bribed city officials into changing their birth certificate birth dates to make them appear 40 years older. So then when the draft board came down from Moscow, they looked at all these, you know, guys who were 60 who were really 20. And later on when National Geographic writer alexander Leaf came down to explore all these, you know, 100 100 110 year olds, they were too afraid to admit that they had, their birth records changed decades back and they just went along with the ruse a couple other places that didn’t pan out. The Vilcabamba Valley of Ecuador, the Hunter valley of Pakistan were both thought to be longevity hotspots, they’re not, we look for a while at New Finland among the Acadians who are long lived people in Canada, but not quite as long lived as the people we’ve identified. 

So the longest of women are in Okinawa Japan. The longest of men are in the highlands of Sardinia on the island of. We have a population of 10,000 people who live about seven years longer than Americans with half the rate of heart disease and 1/10 the rate of dementia in the Sequoia peninsula of Costa Rica. We have a population that spends 1/15. The amount we do on health care and they have half the rate of middle age mortality, which means Joel Guys like you and me have about a two full better chance of reaching a healthy age, 95 than the average American death. And then finally among the seventh day adventist in Loma Linda California, population of adherent Christians who are living about a decade longer than their north American counterparts. So these are people who have achieved the outcomes we want. They’ve lived a long time, probably the capacity of the human machine without the diseases that foreshortened our lives. And my the last 20 years of my career focus has been trying to explain what and how they did it. And more importantly, is how we can do it. And the findings have been completely counterintuitive. They’re not what people think, but it is a powerful set of data and I believe a powerful answer for a country that’s very sick, spending over $3.5 trillion a year on largely avoidable health care. And we gotta start looking back if we want answers

Joel Kahn, MD, FACC

And just to circle back to one statement, if anybody’s listening and there a history of medicine geek or history of nutrition geek like I am and I gotta say you are Ancel keys and his team of experts around the world that produced this massive seven countries study. There always were seven country study, he was their team was the father of the Mediterranean diet, probably the most acknowledged healthy diet pattern in the world and their teachings have proved to be long lived and accurate despite an internet full of naysayers and it just comes up in waves over and over. It’s researching now, but we’ll shut that down. Tell us, you know, let’s talk about the power nine, the blue zones, the nine findings. But then real quickly, but maybe focus on what you observed in these five areas. Commonality of diet, commonality of nutrition lessons. People listening today can say, I didn’t know that and I’m going to adopt more of the following one or two super foods.

Dan Buettner

Yeah, I’m not a big believer in Superfoods. So that Power Nine actually hate that term, but I said it once and it’s stuck, but it’s really the nine common denominators. So no matter where you go in the world and you see long enough people, you see the same factors occurring over and over and you know, just not going through all nine of them, but to start where I think you want to start as the diet. So we did a meta analysis. If you want to know what 100 year old eight to live to be 100 you can’t just ask him what he’d been eating for one reason. For one reason. It only reflects, you know today. And the second reason is they don’t really remember, you know, if I asked you what you had for lunch a week ago Tuesday other than knowing it was vegan, you probably can’t remember what exactly you ate. 

So by the same token, you can’t ask 100 year old what they were eating when they were little kids or teenagers or young adults or middle age or newly retired. So to get at that my team aggregated dietary surveys done over the past 100 100 years at all. Blue zones, sorry about them. Longevity expert dies. I’m just getting over covid. But so the, we found 100 and 55 dietary surveys done in all five blue zones over the past 100 years and when you add it all up, they are eating 90 to 100% whole plant based foods. Their diet is very verily highly focused on complex carbohydrates. You know, my paleo and keto brethren, they’re largely afraid of carbohydrates and indeed simple carbohydrates. Your, your cookies and white flours and sugars and and high fructose, corn syrup. Yes, they’re all toxic. 

But the five pillars of every longevity diet in the world are whole grains, greens, tubers, like sweet potatoes, nuts and beans and the cornerstone of every longevity diet in the world seems to be about a cup of beans a day, which we believe adds about four years of life expectancy if you could adopt that, but Joel, they also have a strong sense of purpose, we know conveys life expectancy. They have very vibrant social lives surrounded by people who reinforce good behaviors but also care about them on a bad day. They tend to be religious, they tend to be very family focused. They drink a little bit a glass or two of wine a day and they move naturally. They don’t exercise in the way we think of exercise, which I know is often disruptive, but they live in villages where every time they go to work or a friend’s house and occasions a walk, they have gardens out back, their houses are not full of mechanical conveniences to do their work. So they’re kneading bread by hand and you know, sweeping floors by hand, etcetera and all this adds up to movement every 20 minutes or so, which is keeping their metabolism at a higher level and burning far more calories than the average person with the gym membership does, who in reality they think they’re gonna go four or five times a week. But if you look at the average is it’s closer to one once or twice a month.

Joel Kahn, MD, FACC

That’s fascinating with the five traditional pillars of longevity and the five food groups. But I know I’ve heard you lecture about, you know, of those five, the number one, I think you kind of intimated it already, but which, you know, listeners right now say, I want four x years of life, what do they need to eat more of across the five blue zones, you know, lessons across the world.

Dan Buettner

Okay, we, we all need protein. The average American as, you know, gets about twice as much protein as they need. But especially as you get older, you need protein. And it’s my observation from Blue zones that the number one source of protein is beans. And they’re they’re getting that protein by combining a bean with a grain. So in Costa Rica, it’ll be corn tortillas and black beans. And in Ikaria it will be pharaoh and chickpeas. And and in Sardinia it’ll be a ministro knee, which is almost always some barley with three or four kinds of beans, including lentils and and can and and navy beans. And also sour dough bread. But when you, when you have a grain and a bean and you mix them, you have all the amino acids necessary for human sustenance that will build muscle that will take care of your protein needs.

Joel Kahn, MD, FACC

I appreciate that. So the lagoon family, of course, we have a famous cardiac surgeon in Palm springs California. Aix years ago gave lagoons a bad name. Without a science support. Your 20 years of research on longevity zones would argue the opposite. True.

Dan Buettner

I can tell you beyond a shadow of a doubt if all you have to do is look in the academic literature. People in blue zones, their main source of protein for most of the last century has been beans. Now, that’s not to say they don’t eat meat. They eat meat as a celebratory food no more than five times a month in Okinawa was less than 2% of their diet until about 1980 among the seventh day adventists, you have the longest lived adventists eat no meat at all. So, but beans are, you know, they’re there, you can store them, they’re cheap and they have these phenomenal recipes that make beans taste good. I mean, I think that one of the biggest longevity secrets that people in Blue zones offer us is they know how to make beans taste delicious and we’re kind of stuck in the, you know, Boston baked bean era or you know, sprinkling them on salads, which aren’t bad, but they’re certainly don’t represent the potential the culinary potential beans. You know, I wrote this book, the Blue zones kitchen That found 100 recipes to live to 100 and actually went into the homes of these 80 and 90 year old women who been cooking the same way for a lifetime. And it represents in many cases of millennia of food wisdom. Almost every main meal has beans in it and they’re phenomenal.

Joel Kahn, MD, FACC

So it’s interesting, you brought up protein. Most Americans eat twice as much protein as nutritional experts would argue they need. You know, there’s a movement right now called the muscle centric movement of longevity that more skeletal muscle longer life. And the two ways to get skeletal muscle are to lift weights and eat an enormous amount of protein. And most of these advocates for muscle centric longevity are talking about eating tons of animal protein. I mean, is that what You have seen in your 20 years in the blue zones where there actually is longevity proven they’ve got weight machines all over and they’ve got, you know, butchers carving left and right to make sure you get 200 g of protein a day.

Dan Buettner

They’re not wrong in that muscle mass is important, especially as you get older, if you, you know, you we lose our muscle mass at one or 2% a year and that can accelerate over time if you’re not getting enough protein. But if you’re eating 200 g of protein of animal protein, you’re also getting the saturated fats and the hormones and the antibiotics and and the aggregation of of toxins that meat brings along with it. So people in blue zones have muscle mass, not because they’re going to the gym, but because they’re doing daily chores all day long. Many of them are still farmers, they all gardens out back where they’re working a couple of hours a day. They’re they’re repairing their own homes, they’re walking. So they are using their bodies constantly and they’re using doing weight bearing lifting, which keeps their muscles, but the I believe there Maja Their protein is not coming from me and it’s coming from plant-based sources.

Joel Kahn, MD, FACC

I mean, would the physical appearance of a room of people in their 90s in Sardinia be relatively thin? I mean, they wouldn’t describe as muscle bound average appearance. I mean, they’re also probably not.

Dan Buettner

No, they’re not. It’s very rare to find an obese 90 year old in fewer than 1% in the original blue zones. They also won’t be frail, they will be active. And you know, these places like Sardinia Ikaria guys are tough. They’re, you know, they’ll still have a handshake that feels like a vise grips. But it’s not for me to meet its not from going in the weight room. Nobody has a gym in the blue zone. Not traditionally things are changing. And I know, you know, people travel to modern day Sardinia and you know, see people eating pizza and french fries and burgers and say damn, you know, is wrong. But National Geographic Project that was capture what these people have done for most of their 100 years and for, you know, 80 90% of their time. No gyms, no hamburgers. No coca cola’s. They’re eating whole plant based food and they’re moving naturally to keep strong and keep their cardiovascular system in good shape.

Joel Kahn, MD, FACC

So tell me about new book the blue zones, American kitchen, what’d you accomplish? And why does everybody here need a copy in their kitchen right now

Dan Buettner

If you want to eat to live to be 100 ft like a centenarian and what the blue zones American kitchen has done is we found that diet here in America. I work with an N. Y. U. Researcher And we know more or less what the dietary guidelines are. And we found that not all Americans but between about 1890 and 1920 African Asian native and Latin Americans were essentially eating the blue zone diet and National Geographic photographer David Mclean and I spent three years traveling from Maine to Miami to Minneapolis to Maui, finding these historian chefs who could reproduce this, you know, alternative standard American diet. And the book is 100% whole food plant based. But there’s more culinary genius I believe in this book than you’ll see in any quote unquote quote cookbook. It’s you know, National Geographic Photography. And it’s also here it is right here. You know, it’s gorgeous photography but it’s also 100 recipes to live to be 100. And I’m very,

Joel Kahn, MD, FACC

I think you’ll see beans

Dan Buettner

In about half the recipes. Its predecessor Blue zones kitchen was a number one New York times bestseller and a number one Wall Street Journal best seller. And I just think that you know, we’ve arrived To a place in America where 72% of us are obese or overweight and we’re ready to try something new and you know from my research, the old is the new new, I mean much of much of this cooking. People who have grandparents or great grandparents will recognize, but it’s inexpensive. It’s fast to make And its ingredients are accessible to anybody. And a new Meta analysis came out of Norway. This last February followed about 700,000 people for 30 years and found that people who are eating mostly a plant-based diet with limited amounts of fish and meat just halfway between a standard American diet and a blue zones diet. 

Those people for a 20 year old woman, it’s an extra 10 years of life expectancy and for a 20 year old man, it’s an extra 13 years of life expectancy. And even at our age eating a whole food, plant based diet is worth about eight extra years of life expectancy. So the value proposition is huge here and we’ll spend literally trillions of dollars on pills and supplements and dietary plans and, and gym memberships and superfoods and on and on and on and completely overlooked that the secret to our health lies in a bag of beans some healthy grains, some fresh greens and some fruit. And if we could just learn how to make that taste delicious and set up our environment. So it’s easy to eat that way, you’re on your way to another half a dozen or even dozen extra years of good life expectancy,

Joel Kahn, MD, FACC

Powerful stuff and actually segways, two questions left. You know, somebody listening might say, well that works in Costa Rica and it works in Ikaria, but I live in Peoria Illinois and maybe I actually should pick a city in Iowa give us one example of a city who has applied for been approved and has adopted a blue zones municipal plan and some of the outcomes for adults and Children pick any one town and just a brief report. It works in America.

Dan Buettner

Yes. So my day job for the past dozen years have been working with insurance companies and cities to not try to convince everybody in the city to eat a whole food plant based diet. Though we try that a little bit, but mostly the key insight from blue zones is if you try to change your behavior, you’ll fail. What we need to do in America or as individuals is optimize our environment, our surroundings so that our unconscious choices are better. So our city work involves working with city council to adopt policies that favor healthy food over junk food in favor of the pedestrian over the motorists. We are teams then go in and certify restaurants, grocery stores, workplaces, schools and churches whose policies also favor healthy food over junk food in favor walking instead of driving. And then we reach about 15% of the adult population. Also to have them change their kitchen and their social circles so it’s easier for them. 

T plant based. Now I argue one of the best and most powerful things you can do if you want to eat more healthy Plant based food is make friends with the vegan or vegetarian because they’re going to show you not only where to find this food, but more importantly, they’re gonna show you where to find delicious plant based food. And at the end of the day, if you don’t like it, you’re not gonna eat it. And most restaurants, as you’re pointing out, they don’t know how to make good plant based food. So unless you’re going to the right restaurants or learning how to make it yourself, you’re right. It’s very hard to do it in America. But making that effort to set up your ecosystem, learn a few plant based recipes and incorporated into your daily routine. The payoff is enormous. You can throw away a lot of your statins, you can throw away a lot of your diabetes medicines if you just adopt this way of eating early enough and stick to it.

Joel Kahn, MD, FACC

And you’ve shown that, you know, when you measure metrics in a whole city, that you can actually determine that, although there may be pushed back in resistance in cities, the United States, there’s enough change that weight and other parameters have improved. I mean, right, you’re phenomenal studies. Okay, so one last question.

Dan Buettner

So Fort Worth Texas, just 55. They worked with us for five years. We had a staff of 30 people there working full time for five years. The rest of Texas over that time. Their obesity rate went up in fort worth. The obesity rate went down by 30%. They’re raking and gallops well being index went up about 50 points to the middle of the pack from the bottom and by their own calculations that are now saving a quarter of a billion dollars a year in health care costs because of the Blue Zone project. And now those, because what we implement is long term, it has lasting savings and has a long tail on it. So now I’m a big believer and this is the type of direction we need to go rather than trying to mop up the problems sicknesses after they’ve occurred.

Joel Kahn, MD, FACC

Fantastic. Last question. Elon musk calls you and says, I want to go visit one blue zone and have a good time. I don’t want to put a shadow on the other four. You’re not picking. But you know, where have you found it to be the most festive or where would you go today? If you got that call,

Dan Buettner

I’d probably take him to Kona Hawaii or Hilo, Naples Florida is another fun place to visit. Another big Blue Zone city. So those, I guess those three, the beach cities of Los Angeles are another big success story with good surfing McCoy. A Costa Rica. Yes, it’s got beaches, delicious tropical fruit, jungles, howler monkeys, you know, great ocean, great surfing and there’s been a big kind of, I would say new age community that has grown up in a place called no Sarah and in the original blue Zone, I believe, largely because of my books, but it’s a yeah, it’s a mecca for health and well being

Joel Kahn, MD, FACC

And not been destroyed by Mcdonalds and KFC and burger king

Dan Buettner

Starting in the original city of Nagoya burger king and pizza hut have come in and and not coincidentally, the diabetes rates and the obesity rates have have taken off and life expectancy is already starting to plumber

Joel Kahn, MD, FACC

Tragic, but you know, an important lesson. I think everybody’s gonna benefit tremendously from our conversation. I personally want to thank you so much for taking time out of such a world changing schedule. You have, it’s fantastic and I hope to catch up in person soon. But much gratitude to you really

Dan Buettner

Thank you very much Joel and keep you know, you, you’re a doctor. People listen to you. You walk the talk. You’ve been a powerful voice for advocating for this kind of, you know, it’s actually not in your best interest to keep people healthy because they’re not coming to you for your services, but yet you’re, you do more than most any other doctors I know in keeping people out of the doctor’s office. So I just want to say,

Joel Kahn, MD, FACC

I appreciate that health does not happen in the doctor’s office. It happens in a blue zone, new American kitchen cookbook. That’s what happens. So get back to my treadmill desk, that’s the closest I can get to being a Sardinian farmer pulling greens, but have a great day.

Dan Buettner

All right, Joel. Nice, congratulations.