Dr. Victoria Maizes: Hi Andy.

Dr. Andrew Weil: Hi Victoria

Dr. Victoria Maizes: So today, we’ll be speaking with Dan Buettner who brought the concept of Blue Zones to the world.

Dr. Andrew Weil: Yeah, he's his writings have really been extremely popular and I think he's done a great deal to foster healthy longevity and also. Put into action. A lot of what he's observed in his travels.

Dr. Victoria Maizes: Yeah. I think his work helping cities become healthier is really fascinating.

Dr. Andrew Weil: Well, let's talk to him

Dr. Victoria Maizes:  Listeners, you may notice some bird noise when Dan speaks and that's because he is in beautiful Miami, Florida with the door open.

Intro Music

Dr. Victoria Maizes: Dan Buettner is a National Geographic Explorer and the author of the best-selling book, the Blue Zones, as well as Blue Zones Kitchen, the Blue Zone Solution and the Blue Zones of Happiness. Welcome Dan.

Dan Buettner: It's a pleasure. And an honor to be here with you

Dr. Victoria Maizes: Well, I'm so glad that you're here to join us. And it just has to start with tell us what Blue Zones are, and maybe their implications for longevity.

Dan Buettner: Blue Zones was a collaboration between the National Institutes and Aging, National Geographic, and me to identify the parts of the world where people live the longest and then reverse engineer what they're doing in a sense.

So instead of trying to look for the secret to longevity in a Petri dish or a test tube, we found verified populations that who have achieved the outcomes we wanted. And then by bringing another team in to find out what correlates with that highlights, expectancy or centenarian, the high centenarian rate, and look for the common denominators we feel like we have a pretty good idea of some lessons that the rest of us might want to follow if we want to live long.

Dr. Victoria Maizes: So Andy you have visited, I think, many of the Blue Zones. And you specifically wrote about Okinawa and Sardinia in your book on healthy aging. What were, what were your takeaways?

Dr. Andrew Weil: Well, I went to Okinawa some years ago and was very struck by the different cultural value placed on aging there compared to our society that the, the very old people were honored, valued, made to feel part of the community. And it seemed to me that that was the major factor that accounted for the differences that I saw in there. I mean, obviously there were so many [00:02:00] lifestyle factors that were that promoted, healthy aging. They had a fabulous diet you know, rich in antioxidants. They were physically active.

They lived in a place that had clean air and water. But all that seemed to me to be secondary to the cultural value placed on aging. And that seems such a contrast to what I see here.

Dan Buettner: Yeah, you're right. I mean, we, we tend to celebrate youth here in the United States and in Okinawa, the biggest year of your life is your 96th  birthday.

The whole village will turn out and celebrate that. So older people are honored, their wisdom is harnessed. They’re continue to be part of the active participants in the family, instead of warehousing them in a retirement home, their resiliency, their wisdom is put to work and raising children and cooking the food, keeping the food traditions alive. You know, there's something called the grandmother effect that has even shown that home with a grandparent in there actually the children have lower rates of mortality and disease. So it's a wonderful virtuous circle.

Dr. Andrew Weil: Yeah. Victoria, you've heard me say that. In traditional Okinawan society, a common cause of sibling fighting is over who is going to get to take care of the aging parents, a little different from what we see here.

Dr. Victoria Maizes: So that is such a huge societal difference that perspective on how valuable, how valuable life is as life proceeds. What do you think of the other societal factors that makes such a difference?

Dan Buettner: So you bring up a really good point about the societal factors. And I agree with Andy and that, that those are, I would say, major driver to longevity, Okinawa their vocabulary does not [00:04:00] include the word “retirement”, which I really think is a powerful idea that so there's no kind of artificial punctuation between your life, your productive life and your life in repos. And in Japan anyway, the highest mortality rates post retirement are among policemen and professors, people with really high status over there suggesting that having a sense of purpose is also very important. And Okinawa is, don't have a word for retirement, but they have a word ikigai, which roughly means the reason for which I wake up in the morning. And I suspect Andy, you and I would violently agree on the importance of having a strong sense of purpose when it comes to longevity.

Dr. Andrew Weil: Yeah. And also I think in my experience, and I think there are also statistics to bear this out with men, especially here, how many within a year of retirement develop a serious illness or die. And that's just a very common pattern.

Dan Buettner: I think the second, most dangerous year of your life, most dangerous years you die. I mean, you you're born actually. But, but the year of retirement, there seems to be a mortality spike. The, the other interesting, you know, there's a lot of talk lately about loneliness in the country here that I'm not having three friends you can count on is associated with about eight, fewer years of life expectancy in Okinawa. They have this wonderful social construct known as a moai M O AI, which is a committed social circle originally formed centuries ago because they didn't have banks. So people came together and, you know, four or five people, they threw money together.

Every time they met. So somebody needed a seed to start the season, the growing season, they could count on their moai because banks wouldn't give loans, but that is morphed really into these beautiful social circles with a security net underneath. And when you do well you're expected to share, and when things go south, these moais are there to either financially or, or psychologically to kind of pick up the slack.

Dr. Andrew Weil: We should also note that in Okinawa, in recent years, longevity has plummeted and this has been attributed mainly to a greatly increased consumption of American type fast food. So in some, some of these cultures the phenomena that we've written about, they're fragile and they're subject to change.

Dr. Victoria Maizes: One of the things that I, that I have really enjoyed learning about Dan is the work you're doing to help societies, cities, governments create the equivalent of Blue Zones and to line up the factors so that doing the healthy thing, doing the thing that's pro longevity is the easy thing to do.

And I'd love to hear some of that work and where you think you've been most successful.

Dan Buettner: So, Andy brings up, you both bring up, very good points. When I started working in Okinawa in 1999, it was producing the longest lived disability, free people in the history of the human race. And now they're the least healthy prefecture in Japan.

And you start asking yourself, well why is that? And I attribute it largely to the fact that the American base has attracted this forest of fast-food restaurants. The biggest A&W Root Beer stand in the world is an Okinawa. And the G.I.s have also brought this idea of spam. I don't like to pick on one product, but it is a very high sodium and it's, and they've adopted these spam with zeal.

And as soon as they start adopting the Standard American Diet or something that looks like a standard American diet, their life expectancy, plummets obesity, and diabetes rise. So the key insight in all Blue Zones, these places are genetically heterogeneous. So they they're, they're a melting pot.

They don't have any genetic advantage over the rest of us listening right now. They don't have better discipline. They don't have greater senses responsibility. They don't have better diets or better education. So you start asking yourself, why are they living 8 to 10 years longer than the rest of us without chronic disease.

And the realization I had was that they live in environments where the cheapest and most accessible foods is peasant food. It's mostly whole plant-based food. They're nudged into movement every 20 minutes. Every time they go to work or a friend's house, out to eat is occasions a walk. The option to be lonely doesn't really exist because there's a societal expectation to participate in the daily community. Parties, religion, being out in the street. And so based on that insight, 12 years ago, I developed a population health blueprint for cities that would methodically go through all facets of city life.

And optimize that environment to nudge people into eating more whole plant-based food, moving more socializing more. And then the other big point and we do this city wide is give people a workshop, help them identify their values, their passions, and what they're good at, and then put them to work.

And we've had extraordinarily luck dropping the, lowering the obesity rate of entire cities by adopting insights for blue zone.

Dr. Victoria Maizes: So that's really good news for a country that's struggling obviously with an obesity epidemic, as well as all the consequences. Which [00:10:00] cities have been most successful. And why is it, what did they do right?

Dan Buettner:  I would say the most successful large city is Fort Worth Texas. They've been with us for five years and they've seen BMI or basically obesity rate dropped by 3%.

Smoking dropped by 6%. You may say to yourself, “big deal, it doesn't sound like much”,  but the rest of Texas has gained. And just a, a, a lowering of 3% of BMI, average BMI, occasions about a quarter of a billion dollars of healthcare savings per year. And those are numbers from Gallup, not from me. We always have third-party measurement. And the approach we take, we come in with three teams.

The first team is a policy team and we have aggregated best practices and policies that favor fruits and vegetables and whole foods over fast food and junk food and junk food marketing to favor the pedestrian over the motorist and the favor of the non-smoker and smoker. And we don't come in heavy handed, telling cities they have to adopt these…we come in with menus of 30 of them and say, look, if you want to use our time, we're here for you. Don't waste it. We won't waste yours, but we expect you to come to consensus around a half a dozen feasible and effective policies that we know have worked elsewhere for your city.

And we can usually. You know, probably 20 policies implemented in a 5 year 10 year where they're at, which make an enormous… according to the CDC, the most cost-effective way to make population healthier is through policy. But we also then have a Blue Zone certification program for restaurants, grocery stores, workplaces, schools, and churches.

Once again it's sort of menu driven and we have 30 or so different. Evidence-based [00:12:00]tweaks and designs and policies that these places can commit to. And if they, if they do 75% of them, we give Blue Zone certification. And then we have a third team who over the course of five years manages to get about 15% of the adult population, which there's some tipping point science around 15% to optimize their own homes and their social networks. And between the people, places, and policy perfect storm, we can usually exert enough positive pressure on changing the environment in every city we've been doing, we've worked in 54 cities. Every city that's hired us, we've managed to lower their BMI and also raised life satisfaction as measured by Gallup.

Dr. Andrew Weil: That's very impressive. I think that's just terrific work and I wonder, are you up against any vested interests that work against this?

Dan Buettner: So we've had a little pushback from certain political parties that favor… for whom freedom is really important. This notion that we're limiting junk food choices. Doesn't sit well with everybody, but you know, we, we always couch it as an option. It's like, you don't have to pick any of these policies.

You've asked us to come help, make your city healthier. So that's what we're here for. And, Andy were really careful ahead of time to interview the mayor, the city council, the chamber of commerce, the CEOs, the superintendent of schools, and be very transparent. You know, we are here to reshape your environment so the healthy choices are salient and the unhealthy choices don't get as much emphasis. So if they don't like that idea, we don't, we just say, you should keep doing what you're doing and we go elsewhere. So we've got about 400 cities requests us, and we've said yes to 54 of them. And most of the ones we've said no to[00:14:00] prefer to take another approach.

Dr. Victoria Maizes: Well, I don't know if Tucson the city that we're in ever contacted you, but it would be wonderful. Who funds this?

Dan Buettner: They're publicly supported, but privately funded. So we're funded through either a local health foundation, often cities sold their hospital, but they have a a mission to make the community healthier.

They'll fund us. Blue Cross Blue Shield plans have been big funders and then hospital systems. And we hold our feet to the fire. We put our fees at risk. If we don't lower the BMI, the BMI is sort of a north star. You know, in a city of a million people. If you lower the BMI of that city by 1%, it occasions about 19,000 fewer heart attacks over time, many thousands of fewer cases of diabetes.

And Andy probably has better data on this than I do, but, but at least one hospital system we work with says that an average heart attack cost about $120,000. So you don't have to prevent many heart attacks before this becomes a real cost effective approach for a community.

Dr. Victoria Maizes: Yeah. And the health economics data is so helpful.

Andy you have often spoken about another possible solution, which is, can you make doing the right thing fun. And I know you sometimes pointed people to a website called thefuntheory.com and how our society could use more

Dr. Andrew Weil:  It's .org. And it was an advertising campaign of Volkswagen Sweden.

And I've described this it's worth seeing, but the idea is to make healthier choices, more fun for people. But the other, another possibility that I've talked about is to try to make healthy choices more fashionable. And I think it would [00:16:00] be terrific if we could enlist celebrities and in various fields to get behind this, this movement, that healthy choices that this is the in thing to do that it’s what, you know, the people that we look up to are doing. So I'd love to see a campaign of that sort.

Dr. Victoria Maizes: It seems to me, some of that is happening because I think millennials, for example, are more likely to have the kind of environmental consciousness that suggests that they eat either a vegetarian or a vegan style diet. I think that this next generation coming is more tuned into health.

Dan Buettner: I've seen those statistics too. I think my generation about 3% self-identified as vegetarian or vegan. And now the generation that's just graduating from college right now. I've seen numbers as high as 15% identifying as vegetarian and vegan. And that is definitely directionally exciting because it has ramifications for not only health, but environment and animal cruelty for people who care about those things.

Dr. Victoria Maizes: And what did this lifelong commitment to studying Blue Zones? What effect has it had on your own life or choices?

Dan Buettner: I used to eat all a lot of animal products. I eat almost none now. No meat. I eat mostly whole food plant-based. I am naturally social and I've discovered through this process that actually connecting socially, even casual low-intensity social interactions are predictive of longevity.

I've reconnected with my faith. Though, not as much as my mother wishes I would, you know, I'm really conscious about one statistic that really stuck out to [00:18:00] me, you know, is your zip code is a bigger predictor of your life expectancy than just about anything else you take many counties in Kentucky and the pop and the life expectancy is 20 years less than they are in places like Boulder, Colorado and Santa Barbara. So that's not a coincidence. That's not because people in Boulder are somehow inherently better people or smarter or better discipline or better Americans. It's just that in the cities where people live a long time, they’re walkable and bikable, there's easy access to nature.

They've they've tried to mute traffic, so there's not as much pollution, noise and accidents. There's easy access to healthy food. So I've proactively, you know, I'm sitting in my, the Southern tip of Miami beach right now, which is very walkable and, you know, later on you know, show what I I'm looking at right now.

I'll be out there. In about two hours and, and, you know, I probably wouldn't be swimming if our backup in Minneapolis, but Minneapolis is actually a walkable community. I also spend time there. So I'm very conscious about living in places where I'm mindlessly will move more, connect more and eat better food and that is the big opportunity.

Dr. Andrew Weil: Dan, I just thought that just sticks within Tucson of a 20-year difference in longevity between zip codes in south Tucson and zip codes and the Foothills of the Catalina mountains. And it's a complex of factors. It's, you know, it's everything from noise, pollution, high crime, dietary choices.

You know, it's a lot of things, but it's certainly points up the disparities based on economic and social factors.

Dan Buettner: And this is exactly what we do. And I don't think we do enough. It's very easy to identify many, or if not, most of the factors in a place where people are living longer and then [00:20:00] present them or put them to work in these communities where their life expectancy challenged.

So, you know, you can, there's something called a complete street policy. Every city manager, since the Eisenhower administration has been trained to get as many cars down the street as possible, not really thinking about the human, but when you design streets for humans with a wide sidewalk, a safe sidewalk, trees, bike lanes, and narrow lanes with, with reasonable speed limits, you can see a bump and physical activity levels of that whole community by 20%.

Commensurate drop an accidents and the asthma from breathing the fumes and, and just the stress of being around motorized transportation, the roar, you know, if you thought birds were bad, you should here on a busy street.

Dr. Andrew Weil: What's your what's your assessment of the impact of the pandemic on all of this, how much has that reduce the opportunity for social interaction impacted eating habits adversely.

Dan Buettner: Yeah, I think it's I think it goes two ways. First of all, as you probably know, life expectancy has dropped by about a year because of the pandemic. You know, life expectancy upwards since about 1900 and now it's depth to actually about a year and a half in the last three years, largely due to the pandemic.

On the other hand, I do think, every time you go out to eat, you eat about 300 more calories than you would if you ate at home and people are starting to cook at home, there's been a sourdough bread craze, which I don't think is a bad idea. I think in many cases it's forced families to come together and, you know, I know losing a job is incredibly traumatic, but according to Gallup, only about 31% of Americans [00:22:00] actually find purpose in their work.

And I think, you know, the restaurants can't find people to work there anymore. I think a lot of people have lost their job, reassessed and said I'm going out for something that speaks to my heart more. So I think there's a chance that while we're experiencing a temporary dip in life expectancy that five years from now we'll look back at the good old days of the pandemic.

I know that's probably a bold prediction, but you know hardship often yields strange blessings and I'm, I'm not dismissing the pain and I'm not dismissing the sickness and the death. But I'm hoping for silver lining.

Dr. Victoria Maizes: I have a different question for you, which is, I've always been curious about what it means to be a National Geographic Explorer.

Dan Buettner: It basically you get paid for being a professional truant.

Well, I've taken it to a whole new level,

Dr. Victoria Maizes: So you’re Ferris Bueller.

Dan Buettner:  Yeah instead of Ferris Bueller's day off. It's Dan Buettner’s life off.

You know, I write frequently for national geographic. In fact, I have a brand new book out this week and it's published today in fact, called the Blue Zone Challenge, which takes all the things I learned about how you optimize your surroundings, shows people how to set up their homes so the healthy choices, the easy choice. But for about 16 years now, I've regularly written for their magazine and books. And I've led about 16 expeditions. And, you know, once you, once you hang around the national geographic society enough, you wear them down and they give you a title.

Body of Wonder General Ad

Dan Buettner: There's a lot of discussion about diet there's keto and paleo and, and vegan. And I'm wondering what, what, what your definition is of the optimal diet for long.

Dr. Andrew Weil: I think first of all, exclusion of as much as possible refined processed and manufactured foods I think that's the overriding recommendation.

Then I think it is obviously good to lower on the food chain to reduce the percentage of animal foods in the diet. To eat a, a, a wide variety of fresh produce, especially vegetables of good quality. I think other than that, I think those are the best general recommendations that I can give.

And I think there is no… I see so much a diet fascism today of people saying you have to eat this way. You have to eat that. And also a tendency to eat very restrictive diets. I think the keto diet is a very unhealthy diet. I think paleo and keto eating to exclude all grains and beans. I think that's just silly. No beans are wonderful food. They're cheap good sources of fiber protein, slow digesting carbohydrate. And as a tell people, those are bad foods I think is very silly. So that's just my general sense. And, and I, I think there, there \is no one, right? Optum diet people are different biochemically.

We come from different ethnic and cultural traditions and that has to be allowed for, but as I say, I think the overriding concern is to not eat refined, processed, and manufactured food as much and possible probably to also, I would say. In, in our country, we're in such a mess with regard to food and diet and the consequences of it.

It's hard to know even where to start, but where I would start is to try to get people to not drink sweet liquids. You know, if we could make that one step and it's not just soda, it's fruit juice, it's energy drinks, it's sweetening coffee and tea. All of that, that would, that one step would put us significantly ahead of the.

Dan Buettner: No, I, I did a meta-analysis, which is sort of a worldwide average of all five Blue Zones that so if you want to know what centenarian ate to live to be a hundred, you can't just ask them because they don't remember if I, if I asked you what you had for lunch a week ago, Tuesday, you probably couldn't tell me, but we found 155 dietary surveys done in all five blue zones over the last eight years and aggregated those.

And Walter Willett from Harvard helped me do this. So it's done with some rigor. I wrote up the results in the Blue Zone Kitchen, which is sort of a diet, my diets, and we found that 90 to a hundred percent of the calories in-took where whole plant-based they eat meat on average, traditionally speaking, before the, you know, the A&W root beer, the five times a month meat was a celebratory food.

And you probably saw that Okinawa, you know, with the pork and not nearly as much as you think most of the Blue Zones are actually inland. They don't need a lot of fish, but the, the five pillars of every longevity diet in the world were whole grain, rice, corn, and wheat. [00:28:00] Sardinians the longest of men in the history of the world until 1950, 60% of their calories came from wheat, various kinds of wheat, sourdough, breads, pastas, et cetera.

Greens, interestingly greens are cheap and they grow up, you know, the kind of stuff we weed whack in our backyard. Many of them have 10 times the antioxidants of wine. Tubers in Okinawa until 1970, about 60% of their dietary intake came from an emo, which is a purple sweet potato, which grew abundantly and cheap.

Nuts. And then beans. I actually think, you know, if there is a super food, and I'm want to ask you about superfoods right after this, but in every Blue Zone they're eating about a cup of beans a day. And I've seen research suggesting a cup of beans day would probably convey about four extra years of life expectancy over, over unhealthy protein.

But what do you think is super food?

Dr. Andrew Weil: Well, I think it's marketing hype mostly. And also I'd like to remind people that we've got plenty of superfoods right at home. I mean, things like blueberries and strawberries. Now I consider those super foods. Or even some of our common nuts. You don't have to buy these expensive exotic things.

So I think it's mostly a marketing. And Dan, just to be contrary, and I have to tell you found a quote from 106-year-old Russian woman who was asked about the secret of her longevity. And her answer was I never eat vegetables.

Dan Buettner: But you know, the thing is, I remember, I remember this great quote…you, you wrote a foreword for the Wilcox and you said something like if you asked centenarians, they'll say everything from something to [00:30:00] cigars, the point is you can't ask a single centenarian and extrapolate. And as Jal Shansky, the famous demographer once said, you can no more ask a hundred-year-old how he got be so old as you can ask a tall man, how he got to be tall.

And our approach at national geographic is we, we do basic, it's mostly epidemiology and anthropology. We find out what the population does and you sort of get a recipe of what the population does. And then you kiss enough frogs until you find prince or princess whose life lines up with what the population does.

And then we profile that person as a way to explain what this, what these people are doing. And but yeah, it's fun. People are people, you know, you put that third digit in people's lives and the certain fascination ensue , people, people are interested in a hundred year olds you know, 99 year olds are yawners, but a day later.

So how about, you know, I get asked a lot about supplements. And I know vitamin B12 is important for vegans, but, but are there any other supplements you recommend people take?

Dr. Andrew Weil: I think it's good to take a mix of antioxidants if you're not eating sufficient fruits and veggies. Which are your best sources of them.

I recommend vitamin D supplementation because I think so many people are deficient and that has so many benefits. I mean, those are the main ones. I think ideally you should be able to get what you need from your diet.

Dan Buettner: I totally agree. No people, nobody in any Blue Zones by the way, are taking supplements

Dr. Victoria Maizes: We have a conference coming up in May. And one of the topics is about the science of aging. [00:32:00] And are there either medicines or dietary supplements that would promote a healthy longevity and, and, you know, protect your brain, reduce the risk of diabetes. Some of the things that are being researched are Metformin, rapamycin, supplements like resveratrol, so it'll be interesting to see whether the biohackers are correct and that there are some things that one can do in addition to all of the healthy lifestyle that we've been talking about that will promote long life.

Dan Buettner: Yeah I see there's two problems with that pursuit. The first one is, if you look at the available data on people taking supplements, or even their prescribed pills the recidivism curve is pretty steep angled downward.

In other words, people start taking them and then forget to take them after a while. So, you know, even if these things do work, I seriously question whether or not people take them long enough to make a difference. And secondly, the type of longevity, Andy and I talk about that. It's not just more years, it's more good years.

Eating a healthy diet, connecting socially, knowing your sense of purpose. These are all things that bring joy to life. And I can continue to believe that pursuing healthy longevity is, is well maybe more, I don't know, more worthy, but just as important to pursue.

Dr. Victoria Maizes: Well, Dan, thank you so very much for your work on the Blue Zones for bringing it to so many people's attention for the work you're doing to create healthier cities. It's been a pleasure to speak with you.

Dan Buettner: And if people have more questions on my handle on Instagram is at Dan Buettner at be very happy to I'm very good at answering [00:34:00] people's questions. And if I may just mention, I have this new book out today called the blue zone challenge four weeks to longer, better life.

And I appreciate first of all, honored to meet you And I would love to help if I can ever help. And I'd love to be in touch with you and hopefully we can meet face to face.