Live to 100: Secrets of the Blue Zones (2023) s01e04 Episode Script

The Future of Longevity

[birds twittering]
[Dan] I wanna tell a story
about the one person
who changed my entire way
of thinking about Blue Zones,
a man who lived on Ikaria, Greece,
named Stamatis Moraitis.
[ethereal music playing]
That's him.
As a young man, Stamatis leaves Ikaria
and moved to the United States
because he wants to make
a life for himself.
A hard-working Greek, he gets a job
as a painter, quickly starts making money.
He earns enough to buy a Chevrolet,
to marry a Greek American,
and he buys a house in the suburbs.
Has a few kids,
lives a nice American life.
But at age 66,
he finds himself short of breath.
He goes to three doctors,
all of whom give him the same diagnosis.
"Terminal lung cancer.
You'll probably be dead in six months."
So he says to himself, "Well,
you know, I get buried here in America,
or I can get buried in Ikaria,
the land of my forefathers."
So he and his wife move to Ikaria
to basically die.
[church bell tolling]
[pensive music playing]
[Dan] But over that next six months,
he starts breathing the air,
drinking the Ikarian wine,
he reconnects with his friends.
And he goes out back,
and he plants a vineyard.
And he thinks to himself,
"Well, I'm not gonna be alive
to see these grapes,
but my wife will,
and my wife will think of me
when she harvests these grapes."
[video camera whirs]
[Dan] Months go by,
then a year,
and more years.
[Dan on video] How are you?
Dan Buettner. Nice to see you.
- Thank you.
- [Dan laughs]
[Dan] For some reason,
I thought you would look old.
I'm old.
Yeah, but you don't look old. [laughing]
[Dan] Thirty-five years later,
when I'd meet him at 102,
he's not only still alive,
he's harvesting all these grapes.
Being a journalist,
I asked him, "What's your secret?"
He just kinda shrugs his shoulders
and goes, "I don't know!"
"I guess I just forgot to die."
[both laughing]
[Dan] So Stamatis
didn't start exercising more.
He didn't start a new drug regimen.
In fact, he didn't do anything consciously
to try to get healthier.
All he did was change his environment.
[mysterious music playing]
[Dan] I'm a big believer if you're
overweight and unhealthy in America,
it's probably not your fault.
We've engineered most
of the physical activity out of our lives
with mechanical gadgetry.
You can't walk more than a few steps
without running into cookies
or chips or sodas.
And we're genetically hardwired
to crave fat and salt and sugar
and take rest whenever we can.
We evolved in this environment
of hardship and scarcity,
and now we live in this environment
of ease and excess.
I think we're mostly
victims of our environment.
And it leads to this bigger idea
that if we want a healthier America,
we shape our environment
the way that the environments are
in places that are producing
the longest-lived people on earth,
which is to say, Blue Zones.
So after exploring all these Blue Zones,
collecting thousands of pages of research,
amassing years of observation,
even though these are disparate places,
you start to see a pattern emerge.
No matter where you go in the world
and you see longevity,
you see the same things happening
over and over and over again.
So, by and large, they're not exercising.
Instead, every time they go to work
or a friend's house
or out to eat, it occasions a walk.
They have gardens out back
where they're doing gentle,
low-intensity physical activity.
They don't have mechanical conveniences
to do their housework or their yard work.
The point is they're moving naturally,
and I believe that they get
way more physical activity
than if they went to the gym.
[in Japanese] This is the key to health.
Moving fast.
[in English] Look at that! [laughing]
They have the right outlook.
They suffer from the same stresses
that we suffer,
but they have these sacred daily rituals
to help unwind that stress
and the inflammation that comes with it.
I would say I'm generally at peace.
Worry can do nothing for you.
[Dan] They tend to belong
to a faith-based community,
and they show up.
They take naps.
They do happy hours.
They also have a vocabulary for purpose.
The Okinawans have ikigai.
The Costa Ricans have plan de vida.
But the point is, they know
why they wake up in the morning,
and they're putting their gifts
to work every day.
When it comes to what they eat,
the big point
is they enjoy eating delicious food.
The vast majority of it
is whole, plant-based food,
like whole grains,
tubers like sweet potatoes,
Bean seems to be the cornerstone
of every longevity diet in the world.
And the good news?
There's a little bit of wine.
What's the best tea
to drink on a daily basis?
- [speaking Greek]
- [in English] Wine.
[Dan and women laugh]
[Dan] So it's also about
what they don't eat.
The Okinawans have this ingenious saying,
"hara hachi bu,"
which reminds them to stop eating
when their stomachs are 80% full.
They eat with family.
They express gratitude before their meal,
and they're slowing down
because they're having conversation
with their food,
so at the end of the day,
they're not mindlessly overeating.
So the most important is how they connect.
It's probably 50%
of the longevity formula,
the fact that they put family first.
I found that they keep
their aging parents nearby
as opposed to putting them
in a retirement home.
They invest in their partners
and their spouses so people stay together,
and they invest in their children
so their children don't end up
putting them in retirement homes.
And then they pay special attention
to their immediate social circle.
You know, the Okinawans call it a moai,
but it's a circle of friends
that you invest in for life.
Having the right friends,
that is the biggest secret
to help these people
in Blue Zones do the right things
and avoid the wrong things
so they're not developing a disease
that will foreshorten their lives.
So I know, beyond a shadow of a doubt,
that these common denominators
of all five Blue Zones, they work!
Now what I needed
was a chance to prove it.
[tape whirring]
[all chattering]
[man on video] After the mayor speaks,
you take it over and expand.
Oh, okay, great.
- [man] All right?
- Great.
- All right. You guys ready?
- [camera clicks]
The goal of this project is to give
an extra 10,000 years of life expectancy.
Sounds like a big, grand number,
but what does that mean?
The goal is to give
participants in Albert Lea
an extra two years of life expectancy.
[Dan] So, in 2009,
I actually started thinking,
could I take these ideas
I'd learned in the Blue Zones,
apply them in America,
and put them to work
in a community that actually needs it?
I reached out
to the top experts at the time.
They told me,
"If you wanna create a Blue Zone,
start with a city of about 20,000 people."
That's enough people
so you have a city hall.
We ended up choosing
this city of 18,000 people
called Albert Lea, Minnesota.
Like most small towns,
it pretty much reflected
the health of the rest of America,
but it had the bones of a beautiful city.
I remember our first day in Albert Lea.
I got all the town's leaders in a room,
and I give this presentation.
It means that they'll look younger,
feel younger,
um, they should live longer,
but they also have
lower rates of cardiovascular disease.
[Dan] And people were kind of befuddled.
Like, you know, I was sweating
'cause I just thought,
"They don't get it."
Are there any questions?
But I remember
the local State Farm Insurance salesman,
a tall guy,
stood up, and he said,
"This city needs this."
And Bob Graham,
you know, another stalwart of the city,
a kind of older guy, he said,
"Yes, we need to make it happen here,"
and then, you know,
once these leaders say it,
it falls like dominoes.
[drumming and chanting]
[Dan] We developed something
called the True Vitality Test
to calculate
the average person's life expectancy.
So we learned people's BMI, what they ate,
and many of their other health behaviors,
which gave us a starting point.
And then we started
methodically changing their environment,
little by little.
Traveling throughout the five Blue Zones,
I now knew
what the longest-lived people did
to live a long time.
They ate wisely, they moved naturally,
they had the right outlook,
and they knew how to connect.
But the big idea
was trying to put these ideas to work.
The first thing we tried
is this idea of a moai.
We gathered people in Albert Lea together
and then broke them up into little groups.
And I didn't even know if this would work.
I had no idea.
I challenged them.
"For the next ten weeks,
I want you to walk together."
And you know what? A few years later,
news reports actually found
that nearly half
of all these friendships lasted,
all thanks to those moai.
Alice, would you have ever
run into each other
if not for this walking group?
I No. No, I don't think so.
- [reporter] Brand-new friendships?
- New friendships.
All these Blue Zones
have a vocabulary for purpose.
Loma Linda taught us
the power of volunteering,
of taking care of others.
We immediately set up
curated volunteer opportunities for them.
We know that people who volunteer
have lower rates of heart disease,
they weigh less,
and they have
measurably lower healthcare costs.
And then we start bringing in
the food policies,
and we start getting
healthier grocery stores
and healthier restaurants.
And then, finally,
there was this great main street
that was dying a little bit,
and of the four neighborhoods
in Albert Lea,
none of them had
a clear walkway to this downtown.
So we worked with the city
to make it more walkable and livable.
We built bike lanes.
We put walking paths around a nearby lake,
and we built sidewalks
so people from nearly every neighborhood
in Albert Lea could walk downtown.
So we administered the True Vitality Test
a second time,
and we found that life expectancy
was going up even more than we thought,
and it was generating all this excitement,
so much so that we had
national TV crews coming out to cover it.
You did even better than expected.
You were hoping to add
maybe two years on to people's lives,
and you have added
- 3.1 years. It's amazing.
- 3.1 years!
[crowd cheering]
[uplifting music playing]
[Dan] So, we now knew we could manufacture
a Blue Zone in small-town America,
but could it work for a nation?
That question took me
to the other side of the planet,
where I found an island that offered
a vision for a future Blue Zone,
a Blue Zone 2.0.
[mellow electronic music playing]
Singapore is
a completely manufactured society.
Here we have this little island
in Southeast Asia,
only about 30 miles long
and 16 miles wide.
This is a complex urban society
filled with futuristic high-rises
and 5.8 million residents.
But it's not only producing
the happiest population in the world
by many measures.
It's also one of the richest.
And what makes it really extraordinary
is you go back a little over a generation,
Singapore is essentially a fishing village
with below-average life expectancy.
And now a global study shows it
to have the healthiest life expectancy
in the world,
where a person can live in full health
without disease or disability.
So, Dr. Chow, let me ask you,
you know, we are here in Singapore
because studies show that people here
have the longest healthy life expectancy
in the world,
and it occurs to us
that you're a perfect example of that.
You're 93 years old,
and you still do surgery.
You still do calligraphy.
How do you explain
this incredible vitality?
I never expected I can live until today.
I enjoy that work.
I treat that patient. Then I feel the joy.
[Dan] So, uh, what are we gonna do here?
Check your blood pressure.
[Dan] All right. I have to
Very good!
[Dan] Oh, good! What am I?
[Dr. Chow] 122 over 80.
This is very standard.
- Good, good.
- [Dr. Chow] Yeah.
[Dan] So, if I wanted to live to 100,
what advice would you give me?
[Dr. Chow] We have to work hard
every day, honest.
[Dan] Work hard, be honest.
[Dr. Chow] Yeah.
Then most important, humble.
Humble is not easy.
[Dan] I heard you're a good tennis player.
I found out that of all sports,
people who play tennis
have the highest life expectancy.
Was that for tennis?
Oh, no, this is karaoke.
- [Dan] Oh, karaoke? [laughs]
- Yes.
[Dan] That's amazing.
You're good at everything.
I spent the better part of 20 years
finding these Blue Zones,
and in most of them,
it's a culture that's been around
for hundreds of years
or a millennia.
But life expectancy here in the 1960s
was about 20 years less than it is today.
- Mm-hmm.
- So, how does Singapore achieve that?
We don't have natural resources.
People are our natural resource.
To be in politics
is about improving the lives of people.
And that's why, in Singapore,
we have very severe penalties on drugs
and for people who carry guns,
so that our people
would not fear for their safety.
But it's not just that.
There's a saying in the civil service.
"Policy is implementation.
Implementation is policy."
Singapore works on nudges.
There's a war on diabetes,
for instance, in Singapore.
People are taking too much sugar.
They eat the wrong foods.
So, what do we do?
What does the government of Singapore do?
They try to help you help yourselves.
[Dan] In past decades,
Singapore's food environment
wasn't all that healthy.
They had junk food.
They had lots of oil
and sugar in their food.
But they were able to take steps
to change their environment
so it was easier
to make the healthy choice.
For example, brown rice is
a lot healthier than white rice.
Brown rice has more fiber in it,
so they subsidize brown rice
to make it more affordable
and more popular.
Soda pop, sugar-sweetened beverages,
number one source of refined sugar
in most diets.
Well, Singapore made an agreement
to actually cap
the amount of sugar allowed in soda,
an idea nearly unheard of
in places like the United States.
And then, finally,
they create this program for vendors,
or hawkers, as they call them,
to put a sign up
if they're offering true healthier food
to attract the customers
who want a healthier choice.
So, you see, they're just making
this environment,
setting up nudges and defaults
to make the healthy choice
the unavoidable choice.
This is the most densely populated country
on earth.
We're driving during rush hour,
and the traffic's not bad.
[man] Yep, because the high cost
of the cars.
[Dan] And this car costs about $100,000
in the United States.
What does this car cost here in Singapore?
[Douglas] 250,000.
- So two and a half times more.
- [Douglas] Yep, that's right.
And then you have to pay
the right to drive, right?
- [Douglas] Yeah.
- How much is that?
[Douglas] Yeah. Right now, that today
is about 100,000 Singapore dollars.
Just the paper. No car, nothing.
[Dan] So I keep hearing about this
and asking,
"What is the wisdom
in making cars exceedingly expensive?"
And to really understand that,
I found that you have to look to America.
You see, after World War II,
we had such a good economy going
that we built new homes
outward from the cities.
And to get to these suburbs,
we built highways to go out even further,
and people had to drive longer distances
until we created this dependency on cars.
The American Dream said
you can get a house, a yard, and a car
and drive to your job in the big city.
And the cost is that the streets
that were once designed for pedestrians
were now expanded to make more car lanes.
Today we're spending
about twice the amount of time in cars
than we did in the 1980s.
All this is great for car companies
and fast food restaurants,
but we bought into that too.
As Singapore grew,
it likely saw a similar problem
as the population
of this small island expanded.
If everybody had two cars,
so you had ten million cars
on this tiny piece of land,
what would this look like?
Uh, a traffic jam.
[both laughing]
Nobody is going anywhere!
[Dan] In the United States,
about 80% of people own cars,
and here, it's about 11%,
but yet you don't see people
having trouble getting around.
[Douglas] The public transport is
very convenient.
Wherever you live,
in about ten, 15 minutes,
you can walk to a train station.
[Dan] Singapore's public transportation
is so widespread and accessible
that it is used
by nearly half the population
on a daily basis,
compared to the U.S. average of 5%.
People reach the trains
and buses using bike lanes
and protected walkways
paid for by the car taxes
and often pass through
one of the island's 350 parks.
Here, you find
government-sponsored exercise programs
that build community and friendship,
and all of this
from favoring people over cars.
Have you always been in this good a shape?
[in Mandarin] I came from Hong Kong, where
we did not have such sports facilities.
When I came to Singapore, I saw
these sports facilities everywhere,
so I started to practice bar and pull-ups.
[in English] Every residence,
there is a fitness corner. See?
And the government encourages us
to exercise.
[Dan] So, how do you get around?
Do you guys own cars?
[in Mandarin] I walk to subway stations
and go shopping.
I'm still working,
so I'm taking the subway.
[Dan in English]
How many kilometers do you walk a day?
[Ngai in Mandarin] Over 10,000 steps.
[in English] That's almost
four miles of walking,
which probably takes an hour and a half.
You're getting three times as much
physical activity just living your life
than you are doing exercise.
[Victor] We are very fortunate.
[Dan] Another interesting dimension
of Singapore is
over 80% of everyone there
owns their own home.
When they own their own home,
they take better care of it.
They invest in their neighbors.
You get a better community.
One exceptional example
is the Kampung Admiralty,
an affordable,
government-subsidized housing project.
It's designed for citizens over 55
to own their own homes.
[woman] This being a kampung,
which is "village" in the Malay language
The vision of the team then was really,
how do we create a kampung here?
The simple concept is a club sandwich.
We will
- [Dan] A club sandwich?
- Yeah, it's a club sandwich.
We want to layer
all the users vertically. Yeah.
At the top, elderly apartments.
Our rooftops are all landscape.
So that's true.
Actually helps the elderly keep active.
The second layer is this medical center.
The bottom layer is the public plaza,
a space where people can find
a lot of space to interact.
The surrounding residents,
they are always streaming through
this building to take the train.
[Dan] So, it's easy to get here
through public transportation?
So you don't necessarily
push them together,
but you nudge them together.
You create a space
where they're gonna bump into each other.
[Pearl] Correct.
When I think about Costa Rica
or Okinawa or Sardinia,
I see people who live in a village.
They're very close to nature.
- The old and the young interact.
- [Pearl] Hmm.
[Dan] There is a center
where you can find a place to eat.
[Pearl] I think that's very healing,
but sometimes it's really hard
to scientifically quantify it, you know?
[Dan] There's actually been a study
that has shown
that the casual social interactions
we have during the day with the postman,
with the person you meet at the bus stop,
with the baristas,
are actually a better predictor
of longevity than diet and exercise.
And I think what people miss
is that loneliness
is a function of our environment.
[Pearl] Because I'm in the environment,
it's different from the past.
We are living in a very urbanized setting,
and we need to create a prototype
for the present and the future.
[man] Long before I retire,
they say one of the things you do
is not to sit down
and watch the TV all the time.
- That make you a potato, a couch potato.
- [Dan laughing]
[Tze] Yeah, I know I got to keep
both my body and mind active,
have to go out and mix with people.
[Dan] I love that.
And then
Because no man is an island, right?
So you have to be with people
to be happy.
Because then we come to the next element.
If you are not happy,
then you cannot live long.
No point living alone, you know,
and never speaking to anybody, you know.
- Do you live here with your family?
- Yes.
[Dan] Do you think living with your family
is helping with your longevity?
[Tze] Definitely, yeah.
They are quite happy that I'm here,
and I'm very happy to be here.
My grandchildren, I took the opportunity
to give them tuition in mathematics
because I
- [Dan] So, you're their tutor?
- I'm quite good in mathematics.
And in return,
they will help me with the computer
because I'm a computer idiot.
[laughs] Computer idiot? I love that.
So yet another two-way street.
[Tze] Yeah.
Oh-two, uh? Now this two becomes six
because it's times three.
[Dan] How does your father contribute to
Oh, he helps out
with my younger kids, you know, um,
when I was still working full-time.
I'm now doing part-time.
He helped me to bring the younger two home
when I'm working late.
Uh, making sure they have good breakfast
because I tend to go very early
and kind of rush them for breakfast.
He takes them out for breakfast
before sending them
to school for me, yeah?
I'm the strict mom. I'm the
- [Dan] Tiger mom?
- Yeah, the stick mom.
- And he is the carrot grandad.
- [Dan] The carrot grandad! I love that!
And he says, "If you do the math
and score all correct, you get a dollar."
[Dan] I love that.
Do you think
that when you guys become parents
that you'll invite your parents
to live with you?
- I guess, yes.
- [Dan laughs]
- [Wei] You guess?
- [all laughing]
[Chan] When the founding fathers
started building Singapore,
we were a young nation there.
There were more young people
than there were old people.
But as the society matured,
longevity, aging became an issue.
Now we have an aging problem coming up.
By 2030, 25% of our population,
one in four, will be above 65.
It means, you know,
there's stress on your healthcare system.
We are trying to deal with this issue.
You know, the government
has been playing with the idea
of how to get children
to look after parents
and take care of them.
The government of Singapore has a policy
called the Proximity Housing Grant,
which encourages families
to live near each other.
You get a sum of money just given to you
if you are parents
choosing to live near your son or daughter
or your son or daughter
chooses an apartment
in a public housing estate near you.
If children look after their parents,
it means people don't get sick that often.
[Dan] A study called Aging Alone
in America reported that 100 years ago,
70% of American widows and widowers
moved in with their families.
Today nearly the same proportion
of widows and widowers live alone.
Singapore's Proximity Housing Grant
is succeeding in combating
that kind of trend.
Between 2015 and 2018,
the Housing Development Board
announced that some 11,000 households
have bought resale apartments
near their parents or married children
with the help
of the Proximity Housing Grant.
We know in the United States when you put
an older parent in a retirement home,
their life expectancy drops
between two and six years.
So there's a genius in this idea
that you're not forcing Mom and Dad
to live with you,
but you incent them to live nearby,
which is not only good for the family,
it adds life expectancy.
If you scroll through social media
or look at #longevity,
in America anyway,
it's always about anti-aging drugs
and diet and exercise programs.
But the United States is
the most prosperous country
in the history of the world.
Yet three-quarters of us
are overweight or obese.
Happiness has dropped.
Life expectancy has dropped.
Is what Singapore doing now,
is it scalable?
- Could the United States, for example
- Um
I You know, I often say
Singapore is sui generis, one of its kind.
[lively electronic music playing]
[Chan] We are a small nation.
It's really a city-state,
you know, and so it helps.
You know, the city can write
free trade agreements.
You can negotiate.
But some measures
perhaps could be borrowed.
First, you have to have a vision
and a desire and have those objectives.
Then you have to have people
that have an investment
in providing healthy lives,
healthy families.
How do you create
this public-private partnership?
I think if you can tell Americans
that "I can help you
reduce your healthcare costs,"
I think half your battle is won.
So you make the economic argument
to produce a human benefit.
- [Chan] Right.
- [Dan] Such a powerful idea.
What Singapore teaches us is you can make
enormous changes population-wide.
And I believe that, arguably,
the most powerful tool we have
at shaping healthier environments
is through policy,
and that's the lesson
America needs to learn.
We need to identify the good policies
and implement.
[pensive music playing]
After proving a Blue Zones approach
could work in a small town, Albert Lea,
then I decided to scale it.
And we discovered that insurance companies
and hospital systems
and private foundations
were willing to make the investment
in keeping cities healthier.
We were then able to take
the Blue Zone project from Albert Lea
to the beach cities of Los Angeles,
to the whole state of Iowa.
The Blue Zones project
continues to roll out
easier ways to be healthy where you live.
[Dan] But it wasn't until
Fort Worth, Cowtown,
that we showed that this could really work
anywhere in America.
We met the mayor, the city council,
the superintendent of schools
[reporter] Fort Worth's child obesity
rates have dropped 6%.
A Gallup Poll
of America's healthiest city says,
"Cowtown is changing its tune."
[Dan] And after five years,
Gallup calculated that we saved that city
more than a quarter of a billion dollars
a year in projected healthcare costs.
So I realized
that how we applied Blue Zone wisdom
is ten times more important
than having identified it
in the first place.
What Blue Zones has now done
is go into communities
that are interested in creating
a better environment.
So we're here in South Phoenix,
launching a Blue Zone project.
Any Blue Zone community
begins with listening.
The next step is to make permanent
or semi-permanent changes
to their surroundings.
I'd love to hear
where in your neighborhoods
we can make it better for human beings
so the healthy choice is the easy choice.
We had a whole busload of experts,
and we started just by doing assessment.
You know, I would argue
this is the best team in America.
I would like to now challenge you
to tell us how we're gonna really raise
the happiness level,
raise the life expectancy.
We have this open space.
What do we do with it?
[Marion] Make a park!
A place where the community
could come together,
where you could have gardens.
You know, you could have community gardens
that are going to make it possible
for them to appreciate healthier food,
but people have to learn how to do that.
They have to have the seeds,
and there has to be somebody
who encourages this kind of thing.
You only have one choice,
and that's to go out to a busy street.
People won't walk.
This used to be a primary route.
It had to carry 40,000 cars
before they had the freeways.
So today it doesn't carry
anywhere near that traffic.
If we could take out all the lanes
except for one in each direction,
now the sidewalks become usable.
[Dan Buettner] Cities have amazing power.
If you have clear objectives,
in just a handful of years,
they can make complete transformations.
America, within the next ten years,
could be a Blue Zone.
All we have to do is shift the focus
from thinking that we're gonna change
330 million people's minds
to changing their environment.
[curious music playing]
[Dan] Imagine a community
where the cheapest,
most accessible, and most delicious foods
are whole, plant-based foods.
Imagine roads
that are not just built for cars,
but they're also built for humans.
Where it's easy to connect and socialize,
where people are putting their purpose
to work every day.
These are all things
that Blue Zones teach us are attainable.
We have a new lens
to look at how to generate health
and well-being in our country,
a legitimate recipe for longevity.
But at the end of the day,
the big epiphany
is that the same things
that help us live a long, healthy life
are the things
that make life worth living.
[uplifting music playing]
[gentle music playing]
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