Horizon (1964) s44e06 Episode Script

How to Live to be 101

It's basically simple.
Now, many operations can be difficult.
Sometimes just finding the coronary artery can be difficult.
Dr Ellsworth Wareham has just turned 92 and is about to perform open heart surgery.
I've seen open heart surgery right from the very beginning, find it to be very stimulating and invigorating.
Marge Jetton is finishing a six-mile bike ride and lifting a few weights before she plans what to do for her 103rd birthday.
I was lifting ten pounds when I If something doesn't hurt, it's not worthwhile.
On the other side of the world, 92-year-old Mr Miyagi has just started teaching karaoke.
Among the members of this group, he's considered a mere youngster.
You may not have heard of the island of Okinawa, the town of Loma Linda or the village of Ovodda, but if you want to live a long, healthy life, there's no better place to look.
These are the places on earth where people live longer than anywhere else.
In these unique communities, a group of scientists have dedicated their lives to trying to uncover their secrets.
Now within this tomb, some of the secrets to healthy ageing are contained so that is your longevity, too.
The secrets are right there.
Horizon has travelled the globe to meet the people who can show us all how to improve our chances of living longer, healthier lives.
From the first time that my brother and I landed in Okinawa, the feel and the smell of the place, I just, I was inspired.
You walk down the street and there's an elderly lady sweeping outside of a little restaurant.
You look at her and think, "There's a nice 65-year-old lady, "she's probably retired, a part-time job, keeping busy," and then you find out she's 90 or 95 or 99.
the market and you see "Oh, there's a lady, she looks like she's in her 70s," and you find out, "Oh, yeah she's 101.
" And I thought, wow! Do we have a Shangri la here, a real Shangri la? The remote island of Okinawa is home to one of the longest-living communities in the world.
In a population of only one million, there are 900 centenarians, a percentage that's over four times higher than Britain and America.
It's a place where age has a different meaning .
where people like Mr Miyagi can expect to live way beyond his 92nd year.
He's lived in Ogimi Village in the north of Okinawa all his life.
Unaware of the latest diet or lifestyle fad, Mr Miyagi has developed his own way of defying the ageing process.
The Okinawans themselves don't think about cheating science or beating science.
They're not thinking about, "Gee if I do this, I'm not going to live as long.
" "If I have one extra drink or if I eat this food.
" They're not thinking about that at all.
Most of them couldn't care less what the scientists think.
They just go about their business and live They just happen to live a very long time.
Since the 1970s, scientists like Bradley and Craig Willcox have been trying to understand what is enabling Okinawans to combat old age so successfully.
For the past 30 years, we've focused on a lot of different things.
We look and see if there's a family history of longevity, past medical history of all of the people in their network - their parents, their their brothers and sisters, their children.
Year after year, this research has revealed a remarkable fact - the Okinawans actually age more slowly than almost anyone else on earth.
The calendar may say they're 75 or 80, but their body says they're 50, and the most impressive part of it is that a good lot of them are healthy until the very end.
Over 70% of Okinawan centenarians are still functioning independently at age 97.
That's 97% of their life has been healthy.
But finding the cause of their exceptional longevity has not been simple.
Thousands of tests have been run in an attempt to unlock the Okinawan secret.
In the last few years, the first answers have begun to emerge.
The spotlight has fallen on one particular hormone, known as DHEA.
DHEA, it's a precursor of both oestrogen and testosterone.
It's produced in the adrenal glands.
We don't know exactly what it does - nobody knows exactly what it does - but we do know that DHEA as a hormone drops with age.
But as Okinawans grow older, their levels of DHEA appear to decline at a much slower rate.
You might think of DHEA as the marker on the clock.
Maybe think of it as backward, the clock's gone backward, right? You're at 12, it goes to 11, 10, 9, 8 1.
When it hits 12 again, life's over, OK? So Okinawans, their clock runs more slowly.
Something about the Okinawan lifestyle is slowing down their ageing clock, keeping their levels of crucial hormones higher and their bodies fitter and healthier for longer.
Here we have a society that has the lowest, it seems, of everything - the longest lifespan, the lowest breast cancer, the lowest prostate cancer, the lowest colon cancer, the lowest coronary heart disease, so those kinds of things fascinate me.
How could it be low in almost every disease and have this incredibly long lifespan? The explanation for this extraordinary phenomenon begins in the most ordinary of places.
Like every town in Okinawa, the fruit and vegetable shop in Ogimi lies at the heart of village life.
It's here that Bradley and Craig believe the source of the Okinawan miracle can be traced.
These veggies are a type of a sweet potato.
It's called, in the local dialect it's called beni-imo and beni-imo, it's a purple sweet potato and that Oh, look at that purple colour.
The purple really comes out more when you cook it.
The key is to get a lot of vegetables that are very colourful - oranges like these carrots here, dark greens and yellow vegetables.
You might think of it as a rainbow diet.
For the past 20 years, Bradley and Craig have been analysing the life-enhancing Okinawan ingredients.
Got reds here in the tomatoes, the peppers, you've got green peppers here.
They've identified a number of crucial properties that guard the Okinawans from disease, from the anti-oxidant rich vegetables that protect against cell damage to the high quantities of soya protein.
The Okinawans probably consume more tofu and more soy products than any other population in the world.
We believe that this is playing a part in their low rates of hormone-dependent cancers.
Okinawans have among the lowest rates of breast and prostate cancer in the world.
Studies suggest that this could be to do with the levels of soya they consume across their lifetime.
I am amazed by those statistics because if we lived in the west more like the Okinawans, you could probably close down 80% of the coronary care units, one third of the cancer wards and a lot of nursing homes would be out of business, simply because these people are so healthy.
He passes the test, this is really good.
Go ahead, sample.
Thank you! But it's what the Okinawans don't eat that may be at the heart of their exceptionally long lives.
In Ogimi, 100-year-old Matsu is preparing a traditional Okinawan dish using all the vital ingredients.
It's only after the food is served that the most significant Okinawan tradition can be observed.
The Okinawans developed, also, cultural habits over the years that appear to have health-protective properties.
They have a saying called - eat until you're only 80% full, and that's something you hear in the rest of Japan as well, but it was particularly common to hear that in Okinawa where people tended to push away from the table when they were only 80% full.
In a typical day, Matsu only consumes around 1,200 calories, about 20% less than most people in Britain and America.
It's a phenomenon scientists call caloric restriction.
Nobody understands entirely in science why caloric restriction works, but what we do know is that caloric restriction seems to signal to the body that there is going to be an impending famine.
What do you do when there's a famine about or some type of crisis? Well, the body goes into this self-preservation mode for a future when food becomes more plentiful.
It's this ability to trick their bodies into starvation that may be keeping Okinawans physiologically so young.
It's a stark contrast with the cultural habits that drive food consumption in other parts of the world.
In the west, we're very much focused on getting more for our money.
I mean, one of the most popular things is these "all you can eat" restaurants.
You go, and you load up at the all you can eat restaurant and you walk away with this bloated feeling and you may have got your money's worth, but you probably didn't get your health's worth because what you're doing is just digging yourself into an early grave.
6,500 miles away in the mountains of Sardinia, there's another place competing for the title of the world's longest-living community.
In the town of Ovodda, Alessandro Vacca and his family take a very different approach to living a long and healthy life.
Today, he's invited his relatives to celebrate the birth of a new addition to the family.
The Vaccas don't count their calories or watch what they drink.
And none of them had met a vegetarian before.
The Vacca family history is littered with centenarians.
The oldest lived to 107, and most of the family live well into their 90s.
And in the town of Ovodda, the Vaccas are not alone.
In this small town, there are five centenarians, but perhaps even more remarkably, it's the only region in the world where as many men as women live to be 100 years of age.
It's a phenomenon that Professor Luca Deiana has spent his life trying to understand.
He's convinced that the long-known benefits of a Mediterranean diet cannot fully explain the unique longevity he's observed in Sardinia.
TRANSLATION FROM ITALIAN: There are other countries with the same Mediterranean diet and there are centenarians there, but not as many as in Sardinia.
It's even true that Sardinians who emigrated at 20, 30 or 40 years of age still manage to reach 100.
Over the past ten years, Deiana has tested every single Sardinian centenarian.
Today, he's visiting the oldest member of the Vacca family, 104-year-old Maria.
Deiana is particularly interested in Maria because as a member of the Vacca family, she comes from a long line of centenarians.
There are a great number of last names in Sardinia - more than 30,000, but not many last names for the centenarians we have certified.
Among these, there are some last names that show a fairly consistent percentage of centenarians.
It's these ultra-healthy families like the Vaccas that make Sardinia unique.
The challenge for Professor Deiana is to find out why.
Maria's nephew, Alessandro Vacca, can trace his family history in Ovodda back over several generations.
For hundreds of years, the Vaccas have lived in relative isolation from the rest of the world, marrying into almost every other family in the town.
In fact, most people living in the town today are descended from only a few original settlers.
Marriage among relatives is not the rule, but there are some cases of this taking place.
From a genetic point of view, when this happens, there's a higher probability of having genetic diseases but also of having positive results - like centenarians.
In Ovodda, this in-breeding actually seems to have enabled people to live longer .
and the limited gene pool created by this isolated community now provides a unique opportunity to discover specific genes that are associated with long life.
After years of searching, Deiana has detected a number of unusual genetic characteristics that seem to link the centenarians of Ovodda.
One particular gene on the X chromosome seems to be faulty, failing to produce an enzyme known as G6PD.
This can often have a negative impact on health, but in Ovodda, it may well have had a positive effect.
We have been discovering things of great interest, such as how certain genetic characteristics could have determined diseases like malaria which may be associated with the lack of a very significant enzyme in our centenarians.
The role G6PD may play in living longer remains a mystery, the genetic elixir of life lies with the families of Sardinia.
For those without Sardinian genes, there is still hope.
In Loma Linda California, there's another community that proves that anyone can increase their chances of living a longer, healthier life.
Today, Dr Ellsworth Wareham is preparing to perform open heart surgery on a patient many years younger than himself.
There was no open heart surgery when I took my residency.
I've seen open heart surgery right from the very beginning, so that's 37 years, I guess.
And I probably do three or four a week, something like that.
Do the patients know that a 92-year-old will be supervising? I would hope not.
I, I personally am sort of less than anxious because there's a lot of incompetence associated with age.
I think the figure is at 85, 85 years of age, 50% of people have Alzheimer's.
Dr Wareham's extraordinary longevity may not have anything to do with his genes.
I don't have a particularly good heredity.
Three of my grandparents died at 72.
Nobody in my family has lived to be my age.
The community living in Loma Linda have discovered a secret that's much easier to find than any gene.
Its effect is so powerful that it enables them to live longer than anyone else in the United States.
I've lived in California all my life.
I was two years old and I can remember the San Francisco earthquake.
I can remember the water being splashed in the trough.
We lived on a ranch and I asked my father, "The horses won't have anything to drink, why is that water splashing?" At 102, Marge Jetton is the oldest resident of Loma Linda, but reaching such a grand age has taken some discipline.
Her daily routine involves cycling at least six miles before breakfast.
I've been getting lazy, I do 15 minutes.
Today I rode seven miles - no, six-and-a-half miles - and then I ride instead of going this way, you ride back.
Something that doesn't hurt you, it's not worthwhile.
For Marge, sticking to a gruelling exercise regime isn't about living longer.
It's a matter of faith.
The whole world should be exercising.
The television is full of it, everything is full of why you should exercise.
Your body is a temple of the holy spirit.
Marge is a Seventh Day Adventist, a religion whose members live between five and ten years longer than their fellow citizens.
Our research indicates that we are in control of at least ten years of extra life just by virtue of the choices that we make or we don't make.
There's no proof, it's tempting to wonder if the way they live is affecting some fundamental force of ageing.
Adventists don't drink or smoke and many stick to the vegetarian diet that the church advises.
You read your bible, we're supposed to eat fruits, nuts and vegetables.
No meat in heaven, no.
You eat from the garden, the tree of life, give you vitamins and you're going to live for ever.
Not all Adventists are able to stick to Marge's strict health regime, but even THEY live significantly longer than average.
In this community, living longer isn't only about what people are doing.
It's also about what they believe.
I'll take the highway Straight up to heaven And I won't stop Till the good lord lets me in Lets me in I'm leaving this old life behind me And I'm so glad I finally found my way Jesus lived to be 33, 33-and-a-half 30 years of which are almost virtually gone in the mists of time.
At this point, we have to imagine that the good experience that Adventists have with health may not only be related to their diet because after all, they are religious people, and so it does certainly raise the question if there's something about spiritual life that also has an impact.
At this moment, we don't really know that, but there's been one interesting fact that's been known now for 20 or 30 years and that is that people that go to church regularly - whatever faith they have - live longer and there's no question about that.
The data is very robust, but it's probably not sitting in the hard pew that does that.
There's probably something else.
As part of a longer-term study on Adventist health, Dr Kelly Morton is running a clinic examining the effect of religion on life expectancy.
We are following a particular theory that says that the effects of stress accumulate across your entire life so each major stressor of your life is pushing on your organ systems and these organ systems slowly but surely have effects of all of these stressors that are accumulating.
From samples of their blood and saliva, Dr Morton is testing for lower levels of stress hormones such as cortisol.
This would be a sign that they may be better equipped to cope with the challenges in life.
There's many things in life, many stressors that are not controllable, that are not really your choice, but you still have to cope with them, and religion and connection to something higher than oneself, connection to the sacred, connection to a tight-knit religious community allows you to modulate your reactions, your emotions, to believe that there is a broader purpose, and therefore, your body can stay in balance and not be destroyed by those stressors and traumas over time.
Who's that? That's me.
Who are you with? And that's me and that, there, that's my husband.
He died two days before our 77th anniversary.
Is it hard living a long time? Hard living a long time? You lose people? Oh, yes, it is, there's nobody you can talk to the same as that person, so You know, time heals things a lot, so Where do you think he is now? Well, sleeping up here on a hill, waiting for me to come and occupy the rest of the room.
The Adventists aren't the only people who have learnt to cope with stress.
It's the one thing that links all the world's longest-living communities together.
Although Mr Miyagi and his karaoke partners try not to take life too seriously, always been easy.
We call their personality stress-resistant personality.
They certainly don't lead stress-free lives, they never have.
They had to survive famines when they were young - poverty - they had to survive the Second World War, in which a quarter of the population died.
These people are survivors.
Now how did they survive? Part of it, we think, was the stress.
They built coping mechanisms over time which we can all learn from.
They have this expression - "Don't worry, it'll work out.
" You hear that always, over and over - and those that age the most healthily tend to have this attitude.
Mr Miyagi attends this silver club several times a week.
The club was first established to provide financial assistance in times of hardship, but today it provides a different but equally crucial function.
Most of these people have a sense of what they call "ichi gai" - in other words, something that gives their life a sense of meaning, coherence, purpose - something that gets them out of bed in the mornings, something that they look forward to doing.
You know whether it's your gardening - whether it's a volunteer activity, whatever these older people are involved in - it's meaningful to them.
Without that, it makes ageing successfully difficult.
We're going to the first house that I can ever remember .
and just on the right-hand side here, there's these modern houses now .
but that's 230- and it's still 230- and that was where I used to stay, up at the top flat, but it didn't look like that when I came here.
It was just dirtier and greyer looking.
I have great memories.
Some sad ones, obviously.
When my dad died, I remember I remember being locked in a bathroom and I could see people passing by with a big, big box andI didn't know what it was at the time, but it was my dad.
47, he was.
Graham still lives in Glasgow with his wife Moira.
Five years ago, just after his own 47th birthday, Graham was rushed into hospital.
He died three times and I'm saying to my children, I think youse better prepare yourselves.
I don't think your dad's going to make it through the night and then I stood back and looked at myself standing there, and thought, "Who said that?" It was so unreal.
But we came through it.
The next morning There was intensive care and I says, "How are you feeling?" He says, "I just feel really tired," and, "When am I getting out of here?" Moira and Graham's experiences are a familiar story in Glasgow, where in parts of the city, life expectancy is amongst the lowest in Europe.
In some areas, male life expectancy is as low as 57, no better than it was 50 years ago.
Comparing Glasgow around the world, you can see that we don't fare too well.
Some of the poorer parts of Glasgow have a life expectancy that's on a par with poorer parts in central Europe or even in South America.
A life expectancy of just below 60 years is not is not a good thing to have.
Hello, welcome.
Thanks for coming today, Moira.
Professor Chris Packard is studying families like the Jacksons to try to understand why Glasgow is at the wrong end of the life expectancy charts.
And we'll see how many you can do within the two minutes, OK? Go.
Been treated for a few things - damage to Physiotherapy, sciatica.
I feel about 70, maybe 80 sometimes, trying to get out of the seat when I can't.
I can actually stand, but my right leg stays bent and will not straighten.
It's like.
I think I'm learning to cope with it.
Moira's body is showing signs of age-related disease.
We're interested in the carotid artery here.
Quite happy with that, actually - that's quite nice and clear.
But the most obvious causes - like diet, smoking and alcohol may not be to blame.
One of the challenges for Glasgow is to explain why it has this record of ill health.
We start where everybody starts in looking at the classical risk factors - diet, smoking, blood pressure.
When we compare Glasgow with other cities around the UK, we find comparable levels of these things and therefore our ill health - our excess ill health - is not explained properly by them.
We're left with a large proportion of the problem that we have to find new explanations for.
Coming up to Maryhill.
This is the north of Glasgow now and this was where my mum and dad spent the early years of their married life in a place called Hopehill Road.
They lived in a single end which means just the one room for to eat, sleep and cook and There was my mum and dad, my brother and my sister, myself and a gran that I don't remember, all living in the one room, all sharing beds except me.
I was in the pram.
Sort of glad I don't remember it, but this is it - this is Hopehill Road - and didnae look like this as far as I know.
In the early years of the 20th century, Glasgow underwent a period of rapid industrialisation.
Tenements were thrown up to house the expanding population.
In the area where Moira and Graham lived as children, there were a million people living in just a few square miles.
In Glasgow in the middle of the last century, we had wave after wave of childhood infections - scarlet fever, typhoid - which were rife throughout the city, and overcrowding was very common and in those conditions, of course, infections passed from person to person very quickly.
In order to survive their conditions, the people living in the tenements at the time developed heightened immune defences to combat infection, a condition known as inflammatory response.
So if you have a tendency towards a high inflammatory response, then when childhood infections come, you tend to survive long enough to have children yourself, so people with that tendency will be increased in the population.
Inflammatory response evolved to protect those living in the tenements at the time, but it also had a trade-off later in life.
An over-active immune system can end up attacking the body it is meant to protect.
But of course, when they reach adult life or late adult life, they've got more of a propensity for inflammatory-related diseases like diabetes, heart disease and arthritis, which of course, are common in Glasgow.
Even though their environment has changed and their lifestyle is healthy, Moira and Graham are still showing signs of a heightened immune response they inherited from their parents.
The tenements themselves have gone, the overcrowding is a thing of the past and the city fathers have put in new housing where people are being moved to, and it's improved dramatically their conditions, but the legacies - through the processes we've described - are still there.
The ill health still hangs over us to some extent and we have to allow that to work out of the system.
So how can you make it to 101 without trying? The answer is not only to look at your own life, but also to understand how your parents and grandparents lived theirs.
Every community has a delicate relationship between past and present, between the environment our ancestors evolved to survive and the one we live in today.
Nowhere is the delicate nature of this relationship revealed more starkly than on the islands of Hawaii.
This is bad for his health, right? He lived till 100, let him eat whatever he wants! 101 year old Donald Nago moved from Okinawa to Hawaii as a child.
He's been healthy his entire life.
But the same cannot be said of his children and grandchildren.
I didn't know that I had high blood pressure until the Okinawans sent a team of doctors here to Hawaii to investigate all the Okinawans in Hawaii and they put down the reason, obese.
Was your family already here, or did you? Alongside his work in Okinawa, Bradley Willcox has also been analysing the health of Okinawans who now live in Hawaii.
One of the things we've noticed with subsequent generations, their risk for coronary heart disease goes up.
The third generation were born here and are getting much more culturated, are more obese, have higher blood-sugar levels, higher insulin rates, higher levels of calcium in their coronary arteries and we're worried that they may not achieve the right balance like their parents did, and they may have actually a shorter lifespan than their second generation parents.
Bradley has studied the health of over 8,000 Japanese-American men analysing the impact of immigration on life expectancy.
So, you've got you know a population of Japanese Americans in Hawaii that evolved eating different foods in Japan and then, after a couple of generations on a typical Western diet, they're at higher risk, I think, for certain diseases like diabetes than are populations that grew up eating western food.
The American lifestyle appears to be far more detrimental to people of Japanese descent than other Americans.
Having evolved to thrive on a low-calorie diet, to survive periods of famine, it seems their bodies are simply not suited to the abundance of food.
It's a case of they've got good genes, but they're in the wrong environment so, very much healthy ageing is a gene environment interaction, so there's many changes that have occurred across human populations that grew up in certain circumstances that affect modern-day populations.
It's a lesson that needs to be heeded even in the places where people live longer than anywhere else on earth.
What Bradley has discovered in Hawaii may being replicated in Okinawa itself.
are a younger generation of Okinawans who have failed to learn the lessons from their grandparents.
In two generations, Okinawans have gone from the leanest and most robust of the Japanese to the heaviest of the Japanese, and some diseases such as diabetes are now higher here than in mainland Japan.
Okinawans are at a crossroads right now with regard to the future of health in Okinawa.
They go down one path, they try to recapture the old ways.
Then population health will improve in the younger generations and they'll continue to lead the world in terms of longevity.
But if they go down the other pathway, then they'll continue to lose ground in future generations and may end up even the shortest-lived of the Japanese if things continue.
But for the time being, at least, many of the secrets of long life can still be found by observing the people who are the living examples of healthy, active old age.
What's the best thing, Marge, about being older? The best thing? I can't, I don't know of any.
I don't know, maybe wiser? No.
Just Oh, I know, I get more attention.
But the race is on to learn their unique lessons before it is too late.
There's a pressing need to study these cultural habits that have led to this longevity phenomenon before it disappears.
I mean, anthropologists could be out of a job in a couple of generations because we're all getting this homogeneous culture where we're all eating the same foods and local traditions and knowledge is being lost and unless we try to preserve some of these traditions, then then we WILL lose it for ever.
Bye-bye! Bye-bye! I might have to go study the Sardinians.