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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

House Call: There’s no single prescription for living longer

Dr. David Ward For The Spokesman-Review

Hello, Spokane. I’m taking over the House Call column as Dr. Markin retires and am looking forward to sharing research and ideas to help you live a longer, healthier life and navigate challenges when they do come.

The question of a prescription for a long, thriving life is fascinating – there are as many individual ways to live with vigor and health as there are patients. I’m a family physician at Kaiser Permanente in Spokane and see many patients who are thriving and maximizing life into their 80s and beyond. These octogenarians are traveling the world, hiking and fishing with grandkids, and sometimes continuing to be sexually active.

What’s their secret? Genetics probably only account for 20 to 30% of longevity, according to research. Instead, we can look to studies of “Blue Zones,” or communities around the world where people consistently live to be over 90 or 100 years old.

I had that chance to experience one of these longevity hot spots for myself. Although I lived in Walla Walla, I studied medicine at Loma Linda University in California, which is in a Blue Zone, where people live an average of 10 years longer than the national average.

I practiced in Loma Linda as faculty for five years before moving home to the great Northwest in order to raise my children in Spokane. While in California, I routinely saw patients who were over 100 and enjoyed stories from World War II veterans, several women who walked to the grocery store and carried their goods home, a gentleman who ran a marathon in his 90s, and a couple in their 80s who invigorated their 60-plus year marriage with regular intimacy in many different forms.

On the surface, people’s lives in these communities don’t seem that similar – centenarian (people who live to be 100) Italians in Sardinia work on farms, socialize a lot, eat fish and drink red wine every day. Women in Okinawa, Japan, have a soy-based diet, practice meditative tai chi, and plant medicinal gardens. In Loma Linda, the community centered around a plant-based diet, regular exercise and faith.

So, if you want to live for a long time, should you spend time drinking red wine and laughing with friends or should you join a meditation practice and drink tea? Yes, to any of these, is the answer.

There’s no one single method for the habits that lead to longevity, but lifestyles in the Blue Zones do all have common threads and they aren’t specific to one kind of person, diet or activity. Here’s what we can learn from these thriving older adults:

Eat a plant-based diet. People in the Blue Zones eat a diet focused on vegetables, legumes, nuts and whole grains; about 95% plant-based. There’s variation in what that looks like for different people. In some places, their diet is accented by some meat and fish. In Greece, it’s the “Mediterranean diet” that includes some potatoes and pasta. They practice moderate alcohol consumption or not at all.

Eating in moderation and with purpose is a common trait. Some Blue Zone cultures eat a big meal in the middle of the day, practice fasting, or follow the rule of stopping eating when they feel 80% full, rather than 100% full, known as “hara hachi bu” in Okinawa.

Exercise as part of daily life. I have patients that mow their own lawn or chop wood at 80 years old and who regularly walk to the store, to church or friend’s houses. Exercising at the gym can build muscle and get your heart rate up, but the goal is to keep moving. When it’s built into daily activities like gardening, evening walks and raising animals, as it is in Blue Zones, it’s easier to stay active.

Cultivate a sense of purpose in life: That can seem like a tall order, but communities where elders have a sense of purpose tend to have more longevity. Several of the Blue Zone places even have terms that roughly convey “why I wake up in the morning”; called “ikigai” in Japan and “plan de vida” in Costa Rica. Elders are also revered members of the community with a valued role. Spokane is one of the most connected cities I’ve ever lived, and we do a good job supporting older adults, so think about what you can do to continue to connect every week.

Keep loved ones and community first: Blue Zone communities overall have close family and social ties, with a network of support throughout life and as people age. There are recent studies directly linking positive long-term relationships with longer life and better health (more on that in a future column). Meaningful relationships come in lots of forms – it might be close family or friends, a higher power or the community around you – whatever brings you joy and connection.

People who live in Blue Zone communities also have the advantage of “social encouragement” - living among other people with the same healthier lifestyle and approach which encourages us to each do the same.

Rest: The faith group in Loma Linda in the study takes one full day of rest a week, and others take regular afternoon naps, and find other ways to recharge, like mediation. Rest and sleep help reduce stress and support our whole physical wellbeing as well as mental well-being. Socializing and connecting is restful for some, others recharge by being alone. Either works – again there’s no one prescription.

There are other factors that support longevity – including getting regular screenings for cancer and wellness checks with your health care provider. The community you live in may be walkable, have access to healthy food, and high quality of life, or it may need to do more work to help support a high quality of life as you age. Find the recipe that works for you in your community and circumstances, to adapt your lifestyle for these healthier Blue Zone behaviors and approaches to wellbeing.

I recently talked with someone whose grandmother lived, and lived well, into her 90s. Her approach was to walk to the donut shop every day to socialize and have a treat – whatever works to keep you moving and connected! A lifelong artist, she started teaching painting to some of the coffee shop staff and formed new friendships later in life. Too many donuts isn’t a good thing, but a daily walk, staying creative with a purpose, being physically, socially and mentally active help support us as we age.