Podcast Transcript

Faith: Welcome to Health Matters — your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Faith Salie.

Today we’re going to explore the question: Is the secret to living to 100 in what we eat? 

The answer to this question may lie in the Blue Zones, regions of the world that have the highest percentage of centenarians. The five Blue Zones are scattered around the world, but people who live in these areas all follow similar lifestyle habits and live longer.

I talked with Dr. Michelle Loy, an integrative medicine physician at NewYork-Presbyterian/Weill Cornell Medical Center. Her specialties include lifestyle medicine, integrative medicine, and culinary medicine. So she was the perfect person to walk us through the nine tenets that Blue Zones have in common, and how they build the foundation for a longer, healthier life. 

Faith: Dr. Loy, thank you so much for joining me. Today we want to explore the question, can what you eat help you live longer?

Dr. Loy: Definitely, how we eat can affect our vitality and our longevity, so “years in life” and “life in years.”

Faith: Let’s jump into the Blue Zones. We have research showing that people who live in these Blue Zones around the world live longer and they also share common eating habits. So, will you describe these Blue Zones for us?

Dr. Loy: Sure. So these are places across the world where people are living measurably the longest, like sometimes into their 90s or 100 or past 100. And what’s really interesting is that in all these places, they are largely free of afflictions like heart disease, obesity, cancer, and diabetes. So these are dubbed the Blue Zones. So: Loma Linda…

Faith: Loma Linda’s in California.

Dr. Loy: Yep, Loma Linda’s California.

Faith: So, USA made the list. OK.

Dr. Loy: Okinawa, Japan, Sardinia, Nicoya in Costa Rica, and Ikaria in Greece. And these Blue Zones, even though they actually have very different cultures and actually different dietary patterns, they share some commonalities, actually nine commonalities.

One is: Stop eating when your stomach is about 80% full. So if you’re in Japan, they call it if hara hachi bu. If you’re in the U.S. we call it mindful eating. Part of this first point is eating the smallest meal of the day at the end of the day.

The second point is to eat mostly plants, especially beans. Although many of them do consume meat, it’s quite rare and in small portions like three to four ounces. You know, I think of it sort of like as a condiment rather than as a major food group.

Faith: Mmhmm.

Dr. Loy: Some of them drink alcohol, moderately and regularly. And that’s like maybe one to two glasses a day, usually in a very social setting.

The fourth point is the social connection. Most of them are either born into, or —this is really important — they choose to create social circles that support healthy behaviors. So for example, the Ikarians, they have their tight-knit communities where they socialize frequently together. The Okinawans have this special group of like five friends that they grew up with and they commit to each other for life through all of life’s vicissitudes, and they’re called moai.

There are numerous studies showing that social connection is super important in health. You know, not having it is on the same par of certain risk factors like smoking. And that’s very important

The fifth one is belonging. So, the majority of these people belong to some kind of civic or maybe like a faith-based organization.

The sixth one is, loved ones first. So again, family, connection, friends.

The seventh one is knowing how to downshift. So this is knowing how to reduce stress. And you might think that if they live in these places, they don’t have any stress, but they do. They do have stress, but they know how to downshift. They have routines to help, you know, shed that stress. So, you know, for example, the Okinawans, they will spend a few moments a day to remember their ancestors. The Loma Linda Seventh Day Adventists, they pray. The Ikarians take a nap, and the Sardinians have a time where they enjoy their alcohol in a social setting.

The eighth point is they know their purpose, and having a sense of purpose is really linked with health, longevity. There are definite studies showing that individuals who have a clear goal in life do live longer than those who don’t.

And then the last point is that people move naturally. They’re not like pumping iron or running marathons but they live in environments where they’re just constantly moving without thinking about it. So, you know, they’re gardening, they’re, you know, walking to their friend’s home, so they’re just moving naturally in their environment.

Faith: I’m feeling pretty good with this list. I’m feeling like I’m nailing some of these. I mean, as a New Yorker I walk almost everywhere, when I can.

Dr. Loy: Yes.

Faith: Dr. Loy, I think it’s really interesting. Our focus today is on culinary medicine and food, but it’s only a third of the list that you just named.

Dr. Loy: Yes! Yes! And that is a very, very good point. I actually, I bring this up with my patients all the time. These are the nine points and how many points are related to food? Actually really only two or three. So there are a lot of tools in the toolbox. And actually if you look at it, many of these are related to connection, social connection, which is one reason why I find that the group visits actually that I’m involved with are so effective because not only are we changing habits through education and nutritional literacy, but there is the group connection that is so important.

Faith: Let’s focus a little more on the kinds of foods, an explanation of how these foods work together to, to keep people healthy and vital.

Dr. Loy: Yeah.

Faith: What foods do these Blue Zones have in common? Fruits, nuts, oils? Can you talk about what they supply our bodies with?

Dr. Loy: The Blue Zones dietary pattern is plant forward, but if you look at the specifics from each location, they seem kind of different. So let me give you an example. In Ikaria their top foods include things like lemons, potatoes. They really like chickpeas and black-eyed peas and fava beans, barley, wild greens, sage, marjoram…

Faith: Not to be confused with margarine.

Dr. Loy: [Laughs] Thank you. Yes. They eat some fruit, relatively small amounts of fish and, they include goat’s milk. They don’t eat lamb and they infrequently get goat meat. So that’s Ikaria.

Now, Okinawa. It’s totally different. They eat a lot of sweet potato, turmeric, bitter melon, tofu, garlic, brown rice, green tea, and shiitake mushrooms.

Now, when we moved to Sardinia, they eat a lot of goat’s milk, sheep’s cheese, sourdough bread, like a barley-type flat bread, fennel, fava beans, chickpeas, tomatoes, almonds, , a milk thistle tea, and their special local wine from specific types of grapes.

Faith: What is inspiring to hear about this is that it’s achievable for anybody.

Dr. Loy: Yes.

Faith: I’m probably not going to have goat meat tomorrow, but there’s a lot on that list that I could have.

Dr. Loy: Yeah, and that’s what I love about culinary medicine — it’s accessible, it’s affordable, and it can be applied to all backgrounds and all cultures.

Faith: What are some things that most Americans are missing in our diets?

Dr. Loy: We are not getting the nutrients that we need in our diet. The beneficial nutrients, not just the beneficial macronutrients like, fats and proteins and carbohydrates, complex carbohydrates, but we are missing all the phytochemicals that are very, very important.

And we are missing the fiber. Only 5% of the U.S. meet the recommended daily target of fiber.

Faith: Whoa.

Dr. Loy: If just a thousand people transitioned from their low-fiber diet, that would prevent 13 deaths and six cases of heart disease.

Faith: OK, that’s astonishing.

Dr. Loy:  And I will say eating a fiber rich diet has been shown in multiple studies to be associated with reduced heart attacks, strokes, high cholesterol, obesity, Type 2 diabetes, and even some cancers. If fiber were a medication, a prescription medication, it would be a blockbuster medication.

Faith: Does it require a difficult or expensive diet plan to incorporate these Blue Zone insights into a daily routine? I mean, for instance, if you live in a city like New York.

Dr. Loy: Absolutely not. It does not. There are resources that I will give patients sometimes that — American College of Lifestyle Medicine has one — where they give like a shopping list and a meal plan of recipes. And I believe it’s comes out to $25 to $35 per week. And that’s like three meals per person.

Faith: What?

Dr. Loy: Yeah. And of course now with inflation has gone a little bit more, but I think you could safely say $50 a week, including three meals, three healthy meals rich in vegetables, fruits, legumes, whole grain seed, spices, and including like desserts.

Faith: So Dr. Loy, I just have to ask, what is your favorite not Blue Zone indulgence?

Dr. Loy: I mean, every night I have a huge like bowl of popcorn that I like to flavor with all kinds of spices or eat plain.

Faith: Do you use butter?

Dr. Loy: I don’t usually.

Faith: We were so close to being soulmates on the popcorn.

Dr. Loy: But there’s nothing wrong with adding butter to it.

Faith: OK, OK. All right. Good. Dr. Loy, thank you so much for sharing these insights.

Dr. Loy: Sure. It’s my pleasure.

Faith: Our many thanks to Dr. Loy. 

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