Health & Wellbeing

Wellbeing is a bit of a buzzword at the moment and no doubt overused. However, it is useful since it covers all the aspects of living a long and healthy life. Amongst other things, It encompasses diet, movement, friendship, life purpose and relaxation. Whilst it would be brilliant if we lived in a Blue Zone, wherever we find ourselves, the more of these tenets we manage to include in our lives, the healthier and more long lived we will become. Please note that this is not an in-depth analysis of these principles, simply a review to stimulate further thought and exploration. There will be some links and references at the end.

I think that it is worth mentioning at this point, the review article about Blue Zones by Saul Justin Newman PhD. As is so often the case, anything which appears to ‘debunk’ the health profile of plant based diets tends to gain widespread media coverage; the message that sticking with meat, dairy and eggs, etc, is always popular – everyone loves good news about bad habits! Dr Newman’s paper is critiqued here a little later. We also link his papers (not officially published in a journal and not peer reviewed) at the end, together with peer-reviewed, published, age validation research for some of the disputed areas. Let’s take a look at the main principles.

Sleep

It is vital that we get enough sleep – the right amount and at the right time. Whilst there are small variations in how much adults need and their ideal sleep window, there are some generally accepted figures. Most adults should obtain between seven and nine hours of sleep per night, to include the majority of the 2am – 6am circadian low. This enables the brain to do it’s housekeeping and cleaning duties – after a day of hard work for the mitochondria, busy supplying energy, there are lots of waste products and oxidation products which need to be removed. If these toxins are not cleared, the risk of Alzheimers disease and other degenerative conditions increases considerably.

Perhaps somewhat unexpectedly, poor sleep (less than around 7-8hrs per night) has a number of deleterious effects on the cardiovascular system; the artery walls stiffen and fail to dilate, resulting in high blood pressure – hypertension. Another effect of sleep deprivation can be disruption of the heart rhythm and the coordinated contraction of the chambers – cardiac arrhythmia and atrial fibrillation.

Disruption of the circadian rhythm has far reaching effects, including the development of various cancers, such as breast and colorectal. One of the most alarming aspects of this is promotion of cancer cell migration (metastasis) and the subsequent growth of new blood vessels to the metastatic tumours – angiogenesis.

Movement

The choice of this title was very deliberate. Whilst a lot of emphasis is being placed on exercise, as is so often the case, this is not necessarily the entire story. It has been shown, time after time, that regular exercise is a key foundation element for longevity. It also appears that cardio and resistance styles have differing, complimentary effects. Amongst other things, exercise leads to enhanced cardiovascular health and a reduction in dementia risk.

This is all well and good, but not everyone has the desire, determination, willingness or time to go to the gymn three, four, five times a week. Many of us are not especially enamoured with being surrounded by a bunch of sweaty, grunting, mirror-loving muscle-heads; perhaps this is just my personal image of the places! Either way, for many of us, constant workouts are not sustainable, so what’s the alternative – can we derive the same benefits in a more gentle fashion?

This comes back to the title…. when we study the habits of the longest living populations around the globe, what we don’t see is a bunch of fitness nuts, doing weights or HIT sessions. Instead, they simply move a lot. They walk a lot, they garden and just engage in consistent moderate physical activity each day. So if this, as it appears, is enough, why is moderate to vigorous exercise given such prominence? The answer is quite straightforward – that’s what the research has covered! Finally though, there is ongoing work on the long term efficacy of short duration (fifteen minutes) exercise and ‘Blue Zone’ types of activity… watch this space!!

Diet

Having said all that, still the most important part of the health-span and lifespan puzzle is diet. The cornerstone of any truly healthy diet is plants; whilst not necessarily being completely vegan, it should certainly be plant-centric. This means that around 90% of every meal should be plants. What does that mean? When we refer to plant foods, we mean whole/minimally processed foods including; peas, beans, legumes, green vegetables, the rainbow of vegetables and salads, potatoes and sweet potatoes, rice (preferably brown), whole grains, whole grain breads and pastas, fruit including apples and berries, especially the darker berries such as blueberries and blackcurrants.

Soya foods are incredibly good for you – these being the minimally processed forms, such as tofu (preferably calcium set) and tempeh, as well as soya milk. Products made from isolated soya protein, whilst not being as unhealthy as meat, shouldn’t really be anything more than an occasional item. There is countless information regarding the benefits of soya, which includes reduction the of cancer risk and improved cancer survival rates, particularly for breast and prostate cancer.

Nuts and seeds are also great additions to the menu, allergies permitting of course! In the case of nuts, a small palm full of a mixture of nuts is fine, but remember that they are calorie-dense – they’re not really designed to be eaten by the mug full! Overall, nuts are a super source of trace elements and micronutrients. Seeds are also a storehouse of goodness and some (such as Linseed -aka Flax – and Chia) are anti-oxidant rich and can even lower your blood pressure. To get the most out of the seeds, they are best consumed ground – sprinkle onto your bowl of cereal in the morning (or evening if you’re so inclined!) or add to your smoothie.

When it comes to drinks, a number have been shown to be beneficial in terms of lifespan and/or health span. Whilst most are some form of tea, coffee has been shown to reduce all cause mortality when consumed at levels up to around three cups a day. This can be a little controversial, since a number of those in the plant based community believe coffee to be detrimental. Whilst some of it’s effects may seem negative, the overall effect on health is positive.

One other thing worth having, is a couple of teaspoons of vinegar each day – the most palatable I find is balsamic. This could be on food or even just slurped down in water. It is a short chain fatty acid (SFA) and has anti-inflammatory effects, including the reduction of arterial wall stiffening – which leads to lower blood pressure and a decrease in CVD risk.

Black tea (what we would call ‘normal tea’, like English Breakfast, etc) provides health advantages due to the antioxidant and phytonutrient status. However, the most efficacious brew by far is green tea, as supported by a wealth of epidemiological and interventional data. Just a few of the other good teas are: chamomile, hibiscus, mint, nettle, ginger or combinations.

As you may expect, the foods to avoid are animal sourced ones, most especially those rich in saturated fat, which is arguably the strongest driver of inflammation and CVD. – Currently there seems to be a bit of an obsession with protein – the assumption being than if a bit is good, then more must be better…. As for the source, animal protein really should be avoided at all costs. This is because they contain high levels of the Branched Chain Amino Acids (BCAAs) Leucine, Isoleucine and Valine, as well as Methionine, the latter being connected to what is called oxidative stress. It essentially comes down to this; the presence of methionine causes cells to rev up energy production by our mitochondria (our little power stations), which end up leaking more of the dangerous by-products, which damage our DNA. The highest amounts of this AA are found in fish, poultry (chicken and turkey, etc), eggs, red meat and dairy.

Companionship

Another vital mechanism for adding years to your life and perhaps more importantly, life to your years, is having plenty of human interaction. This could be in pretty much any form, as long is it’s regular and consistent; hobbies, clubs and activities involving others, team sports, team games, of even just meeting for tea and a chinwag. If you can squeeze in a good chunk of laughter into the bargain, that really is a tonic. All of this helps to reduce the levels of stress hormones whilst raising endorphin and oxytocin levels. There is now a wealth of evidence to show that oxytocin has neuroprotective (anti-dementia and anti-Parkinson’s), as well as more general anti-inflammatory effects.

Purpose

Another of the major Blue Zone pillars of wisdom is having a sense of purpose – but what exactly does that mean for you and me? Put simply, we all need to find something that we can really enjoy and maybe even feel passionate about. There are various names for this around the world – Okinawans call it ikigai and Nicoyans call it plan de vida.

It can encompass pretty much anything; being a volunteer somewhere, being a member of a club, doing something which has a positive impact on people, the community or the planet – the possibilities are endless! If you’re sitting wondering what you might door what might ‘light your fire’, then perhaps follow the advice on www.bluezones.com:

Think of your physical, emotional and mental talents, strengths and abilities. Take out a blank sheet of paper and write or type for about 20 minutes. It might take a while, but eventually you’ll clear your mind and get to what you really want to contribute to the world. You’ll know you’re getting close when you have a strong emotional reaction to something you’ve written. Then write your Personal Purpose Statement to incorporate what you like to do and where you can share your talents.

Is it’s really worth all the effort? Well, maybe for the sake of an extra seven more, good quality years added to your life; this is the average gain, which the latest long term data has revealed, for those who live with intention. That seems to us to an astounding result!

Whatever you chose to focus on doesn’t have to be wild, unusual, unique or exotic – or even one big thing… Here are some examples:

Join a local litter pick or even organise one yourself – social media is a great vehicle for this kind of thing.

Volunteer for a charity which you like – help is always welcome!

Help older members of your community with shopping or other tasks they find difficult.

Answering Blue Zone Scepticism

It was only very recently that criticism of The Blue Zones attracted media attention. The source of this censure was Dr Saul Newman, who is a research fellow at The Oxford Institute of Population Ageing and the Centre for Longitudinal Studies at UCL. He has no particular specialism, but does seem to like working with data…. In his Oxford biopic, he says this:

“Saul also has a history of actively pursuing social good in the face of unethical science: speaking out against the Australian government’s support and funding of pro-alcohol research in the face of personal and legal threats, revealing socially questionable practices in the export of high-polluting vehicles from the UK to developing countries, and working to overturn the so-called ‘Blue Zones’ by using using reproducible analyses and open code to reveal how these claims have no connection to empirical reality.”

It seems somewhat strange to put work on the Blue Zones in the same category as his preceding two targets. Even if the longevity data was exaggerated or completely fake, the premises behind them all promote improved health – moving ourselves more, keeping socially interactive, eating mainly fruits, vegetables, legumes and whole grains. So, why take a potshot at a movement which centres around health enhancing lifestyles and diets? It has made him very popular, that’s for sure, since ‘proving’ that plant based living is bunk makes most people feel comfortable!

As I said before, Dr Newman is a generalist who has set himself up as a bit of a ‘debunker’ and clearly did not like the precepts of the BZs. Whatever the reason, he wrote a couple of papers which purport to dismantle the idea of these pockets of centenarians and super-centenarians. Whilst Dr Newman is not a demographer, an epidemiologist, or a nutrition scientist, he is obviously fairly adept at the statistical treatment of data. The issue is, he took very general population data and manipulated it to ‘demonstrate’ that those claiming to live beyond 100yrs are lying. Unlike the demographers and age science researchers, at no stage did he attempt to go and physically check any of the records, be they births, deaths or census’. The paper he wrote in 2019 was only a pre-print – even six years on, it has not been published, or even peer reviewed; Dr Newman has however seen fit to ‘extend the life’ of this article by producing a 2024 version with a new, sensationalist title. Naturally this garnered great media attention, with no critical analysis of the work, merely a straight acceptance of it’s legitimacy. Following the release of this ‘critique’, many well respected scientists in the field have commented on the many serious flaws in the work.

Several research groups in the field of ageing and longevity understood the vital requirement for authentication when it comes to people claiming to be exceptional old. They travelled to several of the BZs (such as Okinawa) and carried out painstaking and rigorous age validation exercises, which showed that these extended longevity groups are indeed real. For the fine detail of how this was done and the refutation of Dr Newman’s claims, please review the references below.

Blue Zone Validation

Willcox DC, Willcox BJ, He Q, et al. They Really Are That Old: A Validation Study of Centenarian Prevalence in Okinawa, J Gerontol A Biol Sci Med Sci. 2008;63(4):338-49

Poulain M, Pes GM, Grasland C et al. Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. Exp Gerontol. 2004;39:1423-9.

Wachter KW (2018) Hypothetical errors and plateaus: A response to Newman. PLoS Biol 16(12): e3000076.

Cockerham WC, Hattori H, Yamori Y. The social gradient in life expectancy: the contrary case of Okinawa in Japan. Soc Sci Med. 2000;51:115-22