I am a Cardiologist, and I Am Telling You There is No Magic Bullet to Insure You Live Until 100

Nov 6

By Dr David Mokotoff

Retired Cardiologist, BayArea Heart founder

You might be able to increase your longevity odds, but contrary to recent headlines, there are no sure ways to guarantee it.

“What’s the secret to living to 100?” was an article published by the prestigious Geisinger Medical Clinic last year. The advice is a catalog of the usual and obvious things, like eating “healthy,” exercising, getting enough sleep, avoiding stress, not smoking or drinking too much alcohol, etc. But many people do this and don’t make it beyond their 70s or 80s.

Since 2000, much attention has been focused on “Blue Zones” worldwide, where many residents in mostly small, isolated rural areas live to 100 and beyond. The name was “coined” by researchers who circled these areas on a world map with a blue marker. Dan Buettner’s Secrets of the Blue Zones docu series on Netflix reveals 12 habits that can allegedly add years to your life. I watched the series and have questions and thoughts.

Except for Loma Linda, California, all of the other four Blue Zones are in countries outside of the USA. In addition to the Netflix series, he has written books. There are Blue Zone, Blue Zone Kitchen, Blue Zone Solution, and Blue Zones of Happiness, to name only a few. There are things that Buettner does get right. And there are overlapping traits that the people in these zones practice. The Blue Zones website calls them the Power of 9.

Keys to Blue Zone Longevity

Here are some of these shared qualities:

A shared sense of community and family. They eat wholesome foods, mostly plants, and meals with little to no ultra-processed “foods.” They don’t overeat.
They are always moving as part of their work, play, and lifestyle.
They get enough sleep.
Stress is reduced by playing as well as working.
They have a sense of purpose, and fewer retire from their chosen life’s work compared to Western society.

I cannot argue with the benefits of any of these habits. However, the problem arises when we test the theory by expanding this lifestyle to larger populations. And that epidemiological trial has not happened.

Unanswered Questions Surrounding the Blue Zone Theory:

The use or avoidance of alcohol in the series is problematic. In the Blue Zones docuseries, Buettner points to the drinking of local wine by citizens on the Greek island of Ikayri as one possible source of extreme longevity. But this theory contradicts his description of another Blue Zone populace in Loma Linda, California, where extreme longevity is also touted. The population here is made up largely of Seventh-Day Adventists. Here is the dilemma. Seventh-day Adventists mostly shun alcohol.

Also, except for the US location, most of these zones have minimal pollution. Thus, a cleaner environment’s role in helping people live longer remains untested. There may be a correlation. But is there direct causation? There are likely other factors in the Blue Zones where industrialization lags that may help folks live to 100.

I don’t disagree with any of the beneficial habits described in the Netflix series or Buttner’s books. However, here is the question. Does changing your lifestyle to more of those in Blue Zones help you live to 100?

To better test the hypotheses that Blue Zone habits, and not hereditary, are responsible for centenarians, we need to see what happens to people who move to these areas and are not born and raised there. And this social experiment has not been done, except as noted in the next section.

Buettner supplies one anecdotal case of a man who grew up in Ikaryi, Greece, and then emigrated to the United States. He developed Stage IV lung cancer and decided to move back to the Greek island. Then, after re-adopting his native island lifestyle, he was miraculously cured. I would need more than this one case to believe in the healing power of Blue Zones.

Albert Lea, Minnesota:

And then there is the curious case of Albert Lea, Minnesota. Buettner chose this small town in southern Minnesota with a population of under 20,000. In 2009, the city partnered with AARP, United Health Insurance, and Buettner to make Blue Zone lifestyle changes to see if the residents could add years to their lives. Details of what they did can be read here. Many changes were made to encourage residents to live a “Blue Zone lifestyle.”

In 2009, an article proclaimed that “ It worked. After just one year, participants added nearly 2.9 years to their average lifespan.” However, this article did not provide details on how this leap in longevity was measured. The conclusion seemed to come from weight loss and extrapolating that people would live longer. I could not find any recent data or information to test this hypothesis. In other words, what is the average age of residents there now compared to twenty years ago? And there is even some evidence to the contrary, meaning losing weight makes you not live as long.

The Role of Heredity:

Genetics (heredity) or a family history of certain diseases are now considered important in what illnesses you contract. Here are a few proven to influence what diseases might develop strongly based upon genetics.

Certain types of Breast Cancer
Sickle Cell Anemia
Hearing loss at birth
Cystic Fibrosis
High Cholesterol
Tay-Sachs Disease

Some diseases arise from a strong family history and are, therefore, partially genetic:

Autism
Many cancers
Diabetes
Alzheimer’s Disease
Migraine Headaches
Arthritis
Coronary Heart Disease

There is a probability, although yet to be proven, that a Blue Zone lifestyle can help you live longer. But to get to the age of 100 requires something else. And that may be your genetic makeup. Certain genes have been identified that help you live longer.

My mother’s father lived well into his nineties. Her brother had a heart valve replacement after age 90 and lived to 104. My mother, who, ironically, had the same valve problem but did not have surgery, lived until she was 100. This tendency towards longevity is likely more than coincidence. These three family members lived in disparate country areas (New York, California, and Florida), and none had a Blue Zone lifestyle.

A very technical and long article in the American Heart Journal closely examined the interplay of heredity and environment in longevity. The short answers are a) it’s complicated and b) both are factors in how long we live. Unless we die prematurely due to homicide, suicide, or an accident, our environment, lifestyles, and genes influence how long we live.

Conclusions

The attention paid to Blue Zones is beneficial because it helps focus us on healthy lifestyles with little to no risk and potentially large benefits.

However, even by adhering to a Blue Zone diet and lifestyle, there is no guarantee that you will live to 100 and beyond.

Except for the one Blue Zone in the USA, these other parts of the world are small enclaves, mostly rural, and probably have few people migrating there.

The self-contained nature of these areas and homogenous populace helps support the possible importance of heredity, or your genes, in living nine decades or longer.

The one Blue Zone “created” in the USA has not been definitively shown to increase the longevity of its residents.

Longevity depends on lifestyle choices, heredity, and luck. To quote my deceased Internist father, “If you want to live long, choose your ancestors wisely.”

I am a retired MD passionate about culture, health, science, medicine, sports, and food.