Healthy Longevity
Models for Healthy Long Lifestyles
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Gerontology
A Training Resource
By Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T
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Part 1: The Blue Zones – Anti-Ageism at its Best
What began as a National Geographic expedition, lead by Dan Buettner, to uncover the secrets of longevity, evolved into the discovery in 2004 of the 5 places around the world where people consistently live over 100 years old, dubbed the Blue Zones. These locations are:
1. Okinawa, Japan
2. Sardinia, Italy
3. Icara, Greece
4. Nicoya, Costa Rica
5. Loma Linda, California
1. Okinawa, Japan, is well-known for its women centenarians. They have a soy-rich diet and live stress-free. Their “moai” provide belongingness and support, being groups of five formed in childhood responsible for their members through life. Okinawans practice “Hara hachi bu” (“Stop eating when you’re 80% full”) and “Ikigai” (“sense of purpose”).
2. The oldest men on earth live in the mountain community of Ogliastra, Sardinia. They are sheep farmers, walking at least five miles up and down mountains. They enjoy red wine in moderation and have low-stress levels
3. Ikaria, a small Greek island, has an average lifespan of 8 years longer than the average American. With low rates of cancer, cardiovascular disease, and almost no dementia, they follow a Mediterranean-type diet, take afternoon siestas, and live stress-free.
4. In Costa Rica, the Nicoya peninsula community lives well into their nineties with few healthcare costs. They thrive on faith, family, and work, with a characteristic sense of purpose (“plan de vida”). Their water is rich in calcium and magnesium, promoting bone and cardiovascular health.
5. the Seventh-day Adventists (SDA) of Loma Linda, California, have many people who continue working in and after their nineties. They have a weekly 24-hour holiday when they rest and enjoy themselves. They are strict vegetarians with family- and faith-centered lifestyles.
Dan and his team of demographers, scientist and anthropologists were able to distill the evidence-based common denominators of these Blue Zones into 9 commonalities that they call the Power 9.
They have since taken these principles into communities across the United States working with policy makers, local businesses, schools and individuals to shape the environments of the Blue Zones Project Communities.
What has been found is that putting the responsibility of curating a healthy environment on an individual does not work, but through policy and environmental changes the Blue Zones Project Communities have been able to
- increase life expectancy
- reduce obesity
- make the healthy choice the easy choice for millions of Americans.
(Buettner & Skempk, 2016)
Efforts like the Blue Zone Communities are helping to close a growing gap between how long we live (lifespan) and how many of those years are spent in good health (healthspan). And doing so has never been more critical (Nania, 2021)
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Characteristics of Blue Zones
The long and healthy lifespan of Blue Zone populations is attributable to lifestyle factors since genetic factors contribute only 20-30% to longevity. Buettner & Skemp (2016) isolated nine traits and habits of Blue Zone populations – the so-called Power 9.
1. People in Blue Zones eat mostly plant-based food. Among omnivorous Blue Zone communities, meat servings come to about 3-4 ounces, and meat is served on average about five times a month.
2. Blue Zone communities also habitually fast or restrict their caloric intake.
3. Alcohol is avoided or drunk in moderation, mostly red wine rich in antioxidants such as resveratrol and quercetin.
4, They have a sense of purpose in life.
5. People living in such regions have a lifestyle that encourages natural, vigorous movement. They garden, walk, cook daily, clean, farm, and do other daily chores.
6. They incorporate stress relief in a purposeful, regular manner into daily life, whether through prayer, a nap, or a glass of wine with the family.
7. Faith is central to Blue Zone communities.
8. These communities have stable and extended family structures, with young and old living together in monogamous lifelong relationships.
9. Finally, they have supportive social networks that encourage healthy, happy lifestyles.
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WHAT to expect from the Blue Zones Life Plan
1. Learn to eat the Blue Zones way without dieting
2. Dramatically Decrease Stress
3. Feel and Look Better
4. Increased Energy
5. Get Better Sleep
6. Enjoy Better Relationships
7. Find and Stay at your Ideal Weight
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Blue Zones Life: Four Foods Always, Four Foods to Avoid
at:
https://www.bluezones.com/four-best-foods-four-worst-foods-blue-zones-life/
FOUR ALWAYS:
- 100% Whole Grains: Farro, quinoa, brown rice, oatmeal, bulgur, cornmeal
- Nuts & Seeds: A handful a day
- Beans, Legumes, Pulses: A cup of cooked beans / pulses per day
- Fruits and Vegetables: 5-10 servings per day
FOUR TO AVOID:
- Sugar-Sweetened Beverages: Empty calories
- Salty Snacks (Potato chips, Cheese doodles, etc): Too much salt and preservatives
- Packaged Sweets (Candy, Packaged cookies and sweets): Empty calories, preservatives, additives
- Processed Meats (Bacon, Sausage, Cold cuts): Linked to cancer, heart disease
For Whole Grains: You can include 100% whole grain pasta and bread in this category, but the whole grains (like the ones listed above) are preferable.
For Beans: Blue Zones include all pulses and legumes in this category, including chickpeas, lentils, broad beans, and green beans.
For Nuts: You can include seeds in this category, as they are also common in blue zones regions.
For Sugar-Sweetened Beverages: This includes the fancy coffee drinks so popular all over America. Try to drink unsweetened coffee or tea, or slowly reduce the amount of sugar you use. They don’t include smoothies in this category if you eat them as a light meal.
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Blue Zone Community 12 Pillars
Taking the life radius (life radius—the environment where people spend most of their lives) approach forward, Blue Zones Project communities focus on 12 “pillars.”
1-3: The first three pillars are areas in which city governments can make a difference known as:
1. the built environment - the physical parts of where we live and work (e.g., homes, buildings, streets, open spaces). The built environment of a community influences a person’s level of physical activity. For example, inaccessible or nonexistent sidewalks and bicycle or walking paths contribute to sedentary habits.
2. food policy
3. tobacco policy
The approach is to start with a conversation, gradually introduce best practices, and ultimately get local leaders to choose 10 priorities and coach them to fruition. Buettner and Blue Zones Project experts have found that this is the best investment and has the biggest impact for the population.
4-9: The next six pillars are the places where people spend their day:
4. employers
5. schools
6. restaurants
7. grocery stores
8. faith organizations
9.home
The Blue Zone team developed checklists of revenue-neutral ways that these environments can be optimized for health, and it offers blue zone certification for those that implement a certain number of changes.
10-12: The last three pillars are programs for
10. creating new social networks
11. getting people involved in volunteering
12. helping them define a sense of purpose
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Life Radius
In Blue Zones’ work building healthier, stronger communities, they focus on a “life radius,” or the area close to home where people spend 90 percent of their lives. In a full Blue Zones community transformation, they optimize:
1. The built environment: Improving roads and transportation options, parks, and public spaces
2. Municipal policies and ordinances: Promoting activity and discouraging junk food marketing and smoking
3. Restaurants, schools, grocery stores, faith-based organizations, and workplaces: Building healthier options into the places people spend most of their time
4. Social networks: Forming and nurturing social groups that support healthy habits
5. Habitat: Helping people design homes that nudge them into eating less and moving more
6. Inner selves: Encouraging people to reduce stress, find their purpose, and give back to the community
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BLUE ZONES PROJECT COMMUNITIES HAVE EXPERIENCED:
1. Double digit drops in obesity, smoking, and BMI (body mass index)
2. Millions of dollars of savings in healthcare costs
3. Measurable drops in employee absenteeism
Blue Zone’s Projects success in cities, businesses, and states across America makes Blue Zones Project a proven model for transforming the health of large populations.
A good example is Albert Lee, Minnesota
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Report on Albert Lea, Minnesota
Albert Lea lies about 90 miles south of the Twin Cities, and, as a quiet city with a population of around 18,000, probably isn’t often on your radar, and probably doesn’t come to mind when thinking of your next travel destination.
But Albert Lea deserves a place squarely in the spotlight as an example of great city planning in action, and as a potential model for future cities in Minnesota and beyond.
Albert Lea was once well below both the national and Minnesota standard for health indicators, ranking 68th out of 87 Minnesota counties. But, in just one year, Albert Lea was able to turn around both its flailing economy and the poor health of its residents to take the #3 spot on Realtor.com’s list for the Top 10 Affordable Small Towns Where You’d Actually Want to Live.
So, how did they do this? And in such a short amount of time?
Albert Lea was chosen in 2009 to be the first in the nation to test out the pilot program of the Blue Zones Project. Created by explorer and researcher, Dan Buettner, the Blue Zones Project is a health and longevity initiative that models the principles of communities around the world that have the longest living people and applies those principles to our own cities and communities.
According to the Blue Zones Project website, “Almost all Americans spend 90% of our lives within 20 miles of home.”
That’s a lot of time and moments of our lives spent in one place. That place should be a good one.
Albert Lea certainly thought so and decided they had nothing to lose. The town jumped on board to radically change their community.
The Blue Zones Project follows a ‘quality of life’ and ‘people first’ design.
The project focuses mainly on making permanent policy and city changes to optimize city streets, create bike lanes, sidewalks, improve public spaces such as parks and nature paths, and switch to healthier food choices in schools, restaurants, and grocery stores.
They wanted to create an atmosphere in Albert Lea that encouraged natural movement (walking to the grocery store, school, work) and community gathering spaces (better parks, downtown centers).
More than 3,600 (20 percent) of Albert Lea’s residents have taken on lifestyle-changing challenges of the AARP/Blue Zones Vitality Project, spearheaded by Blue Zones research with AARP The Magazine as a partner and sponsored by United Health Foundation (MinnPost, 2019).
The town added
- more than seven miles of new sidewalks
- three miles of bike lanes
- created enjoyable public spaces
These changes created a domino effect which led to not only an increase in exercise, but generated more foot traffic for downtown businesses, which then attracted more businesses to the area creating opportunities for community engagement and also raised the property value in the downtown area by 25%.
The city also made changes to encourage healthy eating by
- expanding the community garden space by 150%
- implementing a grab-n-go breakfast and healthy snack cart program in public schools
- adding more aisles of healthy foods in grocery stores.
By the end of the pilot project, adopting the Blue Zone model made a significant difference in Albert Lea:
- 90% increase in community satisfaction
- 40% drop in city worker healthcare costs
- 25% increase in property values
- 40% increase in biking and walking
- 3 additional years of life added to the participants’ life expectancy
- Moved up from #68 to #45 in Minnesota County Health Rankings
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Sense of Purpose in Life
Importance of Sense of Purpose for Older Adults: A growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical.
The Purpose Checkup
Examines 3 Dimensions of Personal Purpose in Life
1. Having (Outer Life)
2. Doing (Inner Life)
3. Being (Spiritual Life)
You can download this Purpose Checkup at: https://www.bluezones.com/the-purpose-checkup-2/
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Sites of Blue Zone Projects in USA
1. Albert Lea, Minnesota
2. Beach Cities, California
3. Klamath Falls, Oregon
4. Southwest Florida
5. Spencer, Iowa
6. Hawaii
7. Fort Worth, Texas
Blue Zones Project Communities benefit from
1. Better health
2. Significant medical cost savings
3. Productivity improvements
4. Increased economic vitality
5. Lowered obesity
6. Lowered smoking rates.
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References on Blue Zones
Thomas, L. (2023) Unlocking the secrets of Blue Zones A Blueprint for Longevity and Health
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Healthy Longevity
Models for Healthy Long Lifestyles
Part 2: Healthy People 2030 Building a healthier future for all
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Office of Disease Prevention and Health Promotion’s
“Healthy People 2030” Program
Resources Available for "Healthy People 2030" on OASH website:
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Healthy Longevity
Models for Healthy Long Lifestyles
Part 3: Global Roadmap for Healthy Longevity (2022)
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Findings from Global Roadmap for
Healthy Longevity (2022)
The National Academy of Medicine announced their findings on the Global Roadmap for Health Longevity in November 2022. In this effort the international organizations involved in this process had identified the following key issues confronting the goal for healthy longevity.
Issues Impeding Healthy Aging
1. Prosocial strengths for older people
2. Ageism and age discrimination
3. Social Inclusion
4. Financial security in retirement
5. Digital literacy
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Demographic Change Impacts
In all countries the rate of population aging stands to fundamentally impact how families, communities, societies, industries and economies function
- Family structure and relationships
- Social infrastructure
- Social insurance and retirement programs
- Housing, transportation, and public space
- Chronic conditions: patterns and prevalence
- Health care delivery and financing
- Workforce size and composition
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Principles for Healthy Longevity
1. People of all ages, particularly older adults, reach their full potential to live life with good health, functioning, meaning purpose, and dignity.
2. Societies enable the best health and functioning that individuals at all ages are capable of attaining.
3. Societies reduce disparities and enhance equity within and among countries to realize the well-being and contributions of all people, including those of older ages.
4. The human, financial, and social capital of older people is realized for the benefit of all of society.
5. Societies use data and meaningful metrics to track the achievement of outcomes and guide decision making.
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Importance of Healthy Longevity
1. Healthy longevity is about living healthier and more productive lives at all ages; achieving it requires a life course approach
2. Health is “a state of complete physical, mental, and social wellbeing”
3. Healthy longevity is characterized by learning and growth, diverse and intergenerational relationships, engagement in productive and rewarding activities, and work and societal roles with meaning and purpose
4. Longevity dividend: “If longer lives in good health are combined with the structures needed to enable healthier older adults to be productively engaged in life, society and individuals of all ages will benefit.” (Commission Report)
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Healthy Longevity Domains
1. Social Infrastructure
2. Physical Environment
3. Health Systems
4. Longevity Dividend (education, work, retirement)
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The Costs of Inaction
The Global Roadmap for Healthy Longevity identified the costs of inaction on these issues would have financial cost for society because they pointed out the following costs to society:
1. Ageism costs billions annually (Officer, et al., 2020)
2. Loneliness is associate with depression, dementia, heart disease and other conditions (Singer 2018)
3. In the US social isolation increases Medicare spending by an estimated USD 6.7 billion (Flowers, et al., 2017)
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The Benefits to Social Infrastructure
The Global Roadmap for Healthy Longevity identified the benefits of action on these issues as:
1. Social protection schemes for older people reinforce social cohesion while reducing poverty and inequality (UN, 2013)
2. Social engagement is associated with better physical and mental health (Umbertson, 2013)
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Determinants of Health in Physical Environment
24 percent of death and disease can be linked to environmental hazards (WHO, 2022)
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Longevity Dividend Background
People in high-income countries will need to work more years to support longer lives, and healthy longevity will enable them to do so (Gratton & Scott, 2016)
Delaying the onset of chronic conditions by one year is estimated to be worth $37 trillion in US alone (Scott, et al., 2021)
Age diversity improves team performance (Li, et al., 2020)
Labor force participation rates among older people are positively correlated with labor force participation rates of younger people (Böheim, 2019)
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References for Part 2 & 3
Bloom, D. E., Khoury, A. Algur, E. & Sevilla, J. (2020). Valuing productive non-market activities of older adults in Europe and the US. De Economist 168(2):153–181.
Flowers, L.A., Houser, C., Noel-Miller, J., Shaw, J., Bhattacharya, L., Schoemaker, L. & Farid, M. (2017), Medicare spends more on socially isolated adults. Insight on the Issues 125:1119-1143.
Gratton, L., & Scott, A.J., (2016). The 100-year life: Living and working in an age of longevity. London: Bloomsbury Publishing.
Li, W., Wang, X., Haque, M. J., Shafique, M. N., & Nawaz, M. Z. (2020). Impact of Workforce Diversity Management on Employees’ Outcomes: Testing the Mediating Role of a person’s Job Match. SAGE Open, 10(1). https://doi.org/10.1177/2158244020903402
Officer, A., Thiyagarajan, J.A., Schneiders, M.L., Nash, P. & De La Fuente-Nunez, V. (2020). Ageism, healthy life expectancy and population ageing: How are they related? International Journal of Environmental Research and Public Health. 17(9): 3159.
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Rao, M., S. Prasad, F. Adshead, and H. Tissera. (2007). The built environment and health. The Lancet 370(9593):1111–1113.
Scott, A. J., Ellison, M. & Sinclair, D.A.(2021}. The economic value of targeting aging. Nature Aging 1(7):616–623.
Singer, C. (2018). Health effects of social isolation and loneliness. Journal of Aging Life Care. 28(1): 4-8.
Substance Abuse and Mental Health Services Administration and Health Resources and Services Administration,(2016) Growing Older: Providing Integrated Care for an Aging
Population. HHS Publication No.(SMA) 16-4982. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Umberson, D., Crosnoe, R. & Reczek, C. (2010). Social relationships and health behavior across the life course. Annual Review of Sociology 36:139–157.
UN. (2013). Convention on the rights of persons with disabilities. Geneva, Switzerland: United Nations.
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Part 4: Mayo Clinic Publications
Promoting Healthy Longevity
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Mayo Clinic on Healthy Aging
An Easy and Comprehensive Guide
to Keeping Your Body Young, Your Mind Sharp and Your Spirit Fulfilled
Drs LeBrasseir and Chen share in their book:
1. What aging is and what determines how we age
2. How to prevent and treat common age-related changes
3. How diet and exercise can offset the aging process
4. How to build better habits that will pay dividends later
5. Essential tips for a healthy retirement and beyond
“No matter your age, it’s never too late to change the course of your future health!”
- Nathan K. LeBrasseur, Ph.D. and Cristina Chen, M.D.
In this Book you will learn facts like:
1. Only about 15% ti 25% of aging is dependent on your genes
2. Healthy sleep habits are associated with a better response to vaccinations – and better outcomes when you do get an infection
3. "Prehabilitation” – preparing for surgery with exercise – can improve outcomes and shorten recovery
4. Loss of muscle mass and muscle strength has a much to do with inactivity as it does with age
This book will teach you what we currently know about the aging process and what you can expect as you get older.
More importantly, you’ll learn how to remain healthy as you age and enjoy the active retirement you deserve!
Topics include:
1. Discovering the true impact of genetics on aging
2. Preventing and treating common age-related conditions and ailments
3. Eating smart and exercising safely to maintain an active lifestyle as you age
4. Nurturing your holistic health – mind, body, and spirit
5. Finding inspiration in stories of people embracing their golden years
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Live Younger Longer
6 Steps to prevent Heart Disease, Cancer, Alzheimer’s and more
Stephen Kopecky, M.D. in his book details how:
1. Today’s top killers are caused not by outside forces, but by our own daily habits.
2. Dr. Stephen Kopecky a Mayo Clinic cardiologist offers holistic, evidence-based insights on how anyone can prevent debilitating conditions such as heart disease, Alzheimer’s and obesity, and live a long life of pleasure and purpose.
3. Dr Kopecky points out in the book that the top causes of death have shifted from infectious diseases, such as flu and pneumonia, to long-term chronic illnesses, such as heart disease and cancer. (Dr. Kopecky is a two-time cancer survivor so that his book is very personal and insightful.)
Dr Kopecky asks:
Is living longer enough? Most of us also want to live well – to enjoy the good health, vitality and happiness of our younger years all the way into our later years. This book answers how do we do this.
Live Younger Longer outlines six steps to preserving the essential characteristics of youth while also fighting disease and extending life.
You don’t need to make big life changes or summon depths of willpower; in fact, evidence indicates these tactics really aren’t that effective.
What you need instead is an open mind, some creativity and a commitment to living your life at its fullest.
The Six Steps recommended in this book are:
Step 1: Recognize that Food is Fuel and use it wisely
Step 2: Be active and fit and keep at it
Step 3: Prioritize Sleep and insure it is a routine that never stops
Step 4: Get a handle on stress, manage it and use social support to lessen it
Step 5: Avoid smoking and other pollutants
Step 6: Be thoughtful about alcohol use and abstain or at least use in moderation
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