01x04 - The Future of Longevity

[bunniefuu]

[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]

[chuckles]

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,

greens,

tubers like sweet potatoes,

nuts.

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 g*ns,

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 w*r 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 w*r 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]