Review and summary of "The Blue Zones"

The book is titled "The Blue Zones: Lessons for living longer from the people who've lived the
longest" by Dan Buettner.  The big idea is that some parts of the world have significantly more people living to 100 years old than the global average, so let's see what's different or notable about how them and their ways of living, because maybe there's something to learn from them.  There's a smattering of input from scientists at the beginning and end of the book, but the bulk of the content is personal observations, anecdotes from centenarians, and travelogue of Buettner's "Blue Zone Quest".

Warning: "look at the successful people" is a common approach popularised by the "get rich" sub-genre of self-help books. But what the approach finds is possibly-spurious correlations.  For example, Dan observed that several centenarians are fond of an evening glass of red wine , or port, or saki - but it is a massive jump from observing moderate red wine consumption in some old people to concluding that a nightcap will  add years to your life.  Yes, look at the centenarians to generate hypotheses, but life is much too short to take up everything that seems notable about their behaviour without solid evidence for cause-and-effect.

Why did I blog about this?  The book has been on my shelf since 2009, mostly a waste of space and money.  Blogging is the motivation to read it before giving it to charity.  And, I've decided that if I read something (non-fiction), I may as well take some time to summarise it, and if I've summarised it I may as well blog it.

Buettner picks out four "Blue Zones" (Wikipedia article, worth reading): "Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece; and among the Seventh Day Adventists in Loma Linda, California" - communities which have well-above-average number of centenarians per capita.

The next three paragraphs are actually all points from the first chapter:

About aging:

  • Twin studies find genetic factors explain about 25% of variation in lifespan.
  • Gerontologists define aging by the risk of dying.  Increasing age is the overarching factor in the continuous risk of dying, but it's not the sole determiner.  
  • Many of the changes described as associated with ageing - becoming farsighted, graying and loss of hair, loss of collagen in skin - are not universal.
  • On average, a 30 year old alive today has a reasonable chance of living to late 70's or early 80's. It would be a decade more, but for a few major risk factors (heart disease, cancer, stroke).
  • Bodies are like cars built for 200,000km: a few such cars will go to 300,000km or more, but all deteriorate over time even with the best upkeep.  With deterioration comes frailty: when you hit a bump, you are less capable of bouncing back.  At some point there's no bounce-back, and then you die (paraphrased from Tom Pearls)
  • Estimating chances depends on current age.  Chance of a 80-year-old living to 100 is much better than a newborn.  Looking backwards, most centenarians were quite healthy at 80.
  • Living to 100 is like picking 5 lottery balls to win.  Removing major risk factors can reduce the required balls from 5 to 4.
Improving chances:
  • There is no pill that universally "extends life". 
    • Anti-oxidants? Bah humbug: junk foods like twinkies are full of them to ensure long shelf-life.
    • Vitamins? Get your basic requirements, which is easily attainable by eating fruit and veg.  Any more does not help, and large quantities may cause problems.
    • Hormones? Simply dangerous. Forget about it.
  • Diet: reasonable diet, looking for moderation in calories, and balancing the calories across carbohydrates, fats, proteins.  Taking in what you really need. 
  • Exercise: prefer changes to your lifestyle, over exercise for the sake of exercising.  Bike or walk instead of driving.  Exercise built into your lifestyle has better chances of being sustained.  
    • Swimming is a great cardiovascular exercise.   But for bones, exercises that use gravity (like walking) are better.    
    • Marathon runners have great cardiovascular systems, but their joints give out.
    • Walking helps muscle and bone, without the joint pounding of running.
  • Living more "good years".  Who wants to live an extra 2 years on life support?  The real question is: how can you delay the onset of disability?   Aim for "successful aging" rather than mere lifespan.
Things that may help with living longer:
  • Social connectedness.  If nothing else, it makes life more worthwhile.
    • But it's very individual. For example, you can't say that "family support" is universally good: some people are very anxious and upset about their families.
  • Doing something you find interesting and worthwhile.  If your work is driven by internal passion, rather than externalities like money, then it's less stressful.
  • Get rid of anti-aging quackery.  It costs you money, and often harms you.  

And this is all from the last chapter, which picks out the common observations from the previous five chapers:

Buettner's "9 lessons" for living longer:
  1. Move Naturally: incorporate exercise into your lifestyle. 
  2. Hara Haichu Bi: Confucian reminder common in Okinawa, to stop eating when you are 80% full.  Combined with eating the right foods, it keeps obesity away.  It's the difference between stopping when you are full, and stopping when you are no longer hungry.  Weight gain is not from stuffing yourself, rather it's from eating a bit more than you need every day.  Prefer foods with lower caloric density.
  3. Prefer plant foods.  A mostly plant-based diet accented with meat. We do need protein at each meal, but not much. Also, eat legumes. 
  4. Wine at 5.  Note: the "glass of red in the evening" advice is not on a solid evidential footing.  When it comes to health benefits of alcoholic beverages, it's all swings and roundabouts.
  5. Sense of purpose: live longer by having something worth getting up for in the morning.  Take up something new, so you don't stagnate.
  6. Have down-time: regular times to slow down, unwind, de-stress.  "Life is short, don't run so fast you miss it"
  7. Belong (to a community): Buettner lists religious communities. I would add that there are many of communities built around common interests, that don't require their members to believe in fairy tales.
  8. Loved ones first: the centenarians live in multi-generational homes where younger generations care for the older ones, with strict "honor the elders" cultural norms.  That's a rarity now in Western societies, and fewer healthy years for the elders is the price.
  9. "Right Tribe" (being around the right people): the Blue Zones have tight-knit communities for social connectedness, and social circles that promote healthy lifestyles. The centenarians also tend to be likeable: "there was not one grump amongst them".

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