The Dr. Hyman Show - Dan Buettner on What Makes Blue Zones the Healthiest Places on Earth

Episode Date: June 20, 2018

Dan Buettner is a National Geographic fellow, in charge of leading expeditions - he’s essentially a real life Indiana Jones. Having him on my podcast meant we got to discuss all the incredible places he has been and how it has led to his work on Blue Zones, a term he’s coined to designate the healthiest places on earth. Through research and study, Dan and his team were able to identify the 9 commonalities between all the Blue Zones - and those 9 things might surprise you. Tune into this brand new episode of The Doctor’s Farmacy for more! Also, it would be mean so much to me if you left a review - for whatever reason, those go a very long way, and they mean a lot to us. They also help more people find this podcast, so please consider writing one up! For more great content, find me everywhere: facebook.com/drmarkhyman youtube.com/drhyman instagram.com/markhymanmd

Hi, this is Dr. Mark Hyman. Welcome to The Doctor's Pharmacy. Today's guest is Dan Buettner, who's an explorer, National Geographic fellow, an award-winning journalist and producer, and a New York Times bestselling author. He discovered the five places in the world dubbed blue zones where people live the longest, healthiest lives. His articles about these places in the New York Times Magazine and National Geographic are two of the most popular for both publications. Buter now works in partnership with municipal governments, large employers, and health insurance companies to implement Blue Zones projects in communities, workplaces, and universities. Blue Zones projects are well-being initiatives that apply lessons from the Blue Zones to the entire community by focusing on changes to the local environment, public policy, and social networks.

The program has dramatically improved the health of more than 5 million Americans to date. Welcome, Dan Buettner. So welcome, Dan. I'm so happy to have you here on The Doctor's Pharmacy. I want to just get into first a little bit about your background. How did you get into this whole idea of longevity and wellness? You were a journalist and an adventurer, and somehow you kind of came upon this new career path of being an advocate for health and wellness. So for years, I led expeditions for National Geographic science expeditions that tried to unravel mysteries. And they were mysteries like, why did the Maya civilization collapse?

Did Marco Polo go to China? The human origins. Sounds like the best job in the world. It really was. I had a full-time staff of Harvard archaeologists and MIT scientists and National Geographic photographers. And our job was to find two cool mysteries every year and solve them. So you're like the Indiana Jones for National Geographic almost. Yeah, probably. But yeah, I didn't have a whip. And a hat. Only in my bedroom. Just kidding.

Scratch that. But it was actually a company that led an online audience of mostly students, direct teams of experts to solve mysteries. And around that experience, we wrote curriculum. I'm more interested in solving mysteries. And I'm really an explorer that my sense of purpose and what I'm good at is going to parts of the world uh diving deep into the culture and pulling out wisdom that the rest of us can use probably uh translational communications is probably my expertise more than anything but in 2000 my team came across an interesting fact the world health organization um named okinawa as the place in the world with the longest disability-free life expectancy in the world. So they have what we want.

They live a long time, manage to elude most chronic disease, and then die fairly quickly. Yeah, we call that the rectangularization of the survival curve. You don't die a long, painful, slow death. Yeah, you live a long time, healthy, well, and boom, you're dead. Yeah, yes that's kind of what you want to do you know go to bed one night and you know have good sex and wake up and that's right you're that's how i'm gonna go i'm gonna go rent a lake a cabin by the lake

make love with my wife yeah have a bottle of wine take a swim and then that's it and ideally we want to see you do that at 120, which is possible. So Okinawans were doing that better. And I thought, aha, that's a great mystery. And really, that was kind of the founding of Blue Zones in 2000. And that expedition was hugely successful. And I had the idea that if there's a Blue Zone area, an area where people live a long time in Asia, there must be other areas in Europe and Latin America and the United States.

And I got funding from the National Institutes on Aging to hire demographers to do the science of populations of fine statistically longest-lived and then recruited a team of experts to help me distill the sort of common denominators. And most of these are correlations. They're not causation. But when you see the same correlations in Asia and Europe and Latin America, this layering of correlations starts to approach causation. And so you see a very clear pattern emerging

and that's what I've focused on since then. Amazing, such great work. So as you travel around and learn about aging, what are the biggest myths you've had? And if we all do things right, can we live to be 100 or more? So the first half of that question, I think the biggest myths are

we can diet our way to good health. If you look at the recidivism curve of diet, they work pretty well for nine months and they fail for 95% to 97% of people after two years. Not food, but diets you're talking about. Diet, yeah. I think eating the right diet, but getting on a diet is what doesn't work. Exercise has been a public health

failure in my opinion and i know that's disruptive but the average american burns fewer than 100 calories a day engaged in exercise so you know we we tell people to go to the gym and do marathons and triathlons but we don't do it about 20 of americans get the necessary amount of exercise i thought it was eight that's an improvement well. Well, I think that's 20% of Americans did 30 minutes of physical activity, including walking, but it is an unmitigated failure. Supplements, I don't believe there are any supplement that will stop slow or reverse aging.

There are some people who are vitamin deficient, I think it's okay. So I would say those are the three big myths. And the second part of the question... If we do everything right, can we live to 100 or more? Okay, so the maximum average life expectancy of humans living in the first world, in a place where there's not high infectious disease, is about 92.

90 for men, 92 for women, somewhere in there. So in other words, right now if you do everything right, you can expect 90 or 92. And that's about a dozen more years than we're getting. So the value proposition is fairly significant. But if you look at... Another 10% of life or more. Yes.

And the real value proposition is you're biologically a decade younger almost every decade until then. So people want to look good, they want to feel good, they want to have energy. That's the real value proposition. And then living a long time and then dropping off that cliff you talked about, dying quickly. So when you add all that up and then the health care savings, we spend about 90% of our lifelong health care dollars

the last few years of our life, two or three years of our lives. And people who die quickly, they're not spending money on life support. So, that's a value proposition. They die quickly, painlessly and cheaply as opposed to long, painful, expensive deaths. Yeah, they're not kicking and screaming on the way out. So, can we live to 100 so interestingly life expectancy uh for humans has gone up about one year for every four years since about 1840 so if you look at the projection that the curve the trend of that

life expectancy curve if you're middle-aged theoretically yes you should be able to make a hundred now there's people who were born with the genetic lottery sure and have great genes yeah but that's fewer than one like ub blake he said the musician he said if i'd known he would live to be over 100 if i'd known i was gonna live so long i would have taken better care of myself ain't it the truth so um you sort of suggest that life expectancy is possible, it's increasing, but there's some new data that's pretty alarming, particularly in areas in the South and other areas where there's high diabetes and obesity rates, where life expectancy is actually going down.

And it's suggested we may be raising the first generation of kids to live sicker and die younger than their parents. Yeah, S.J. Olshansky calculated that first. And he's calculated it could be as much as a five-year drop in life expectancy. Now, they oscillate, you know, life expectancy jumps and then it drops. You know, the year that we had the swine flu, there was a big drop in life expectancy, the human species. So if you follow that trend line, it's going up. But I would tend to agree with agree with what mark with what you're saying here yeah that um our environment is toxic and it probably is going to portend uh uh lower life expectancy unless we do something about it yes um but here we're at this milking conference and i don't know

if you feel any hope but the financiers for the first time are really starting to pay attention to the right things not just maximizing their i mean they had jane goodall here uh talking about the importance of a plant-based diet and you know the mike melkins of the world the steven cones are all drinking it up so yeah those are the guys that are going to make the difference you know i've seen that too i've seen you know i was talking to one of the top guys at Nestle, which I had a pretty negative opinion about. And they're focusing on regenerative agriculture. They're focusing on shifting to organic.

They're focusing on changing the quality of their products. They're being pushed by the market forces that are driving them to make better choices. Same thing with, you know, Pepsi. I was talking to the vice chair of Pepsi, and they're looking at how do we actually move towards a different form of agriculture and preserve water and soils. It's very interesting when you've got these big players starting to change their thinking about what they're doing. And I still am a little dubious about it, but I think it's a good trend. And there's a huge amount of investment, all the venture capitals here talking about how do we

invest in these new businesses that are driving more plant-rich diets uh you know even memphis meat which is laboratory grown meat that sort of takes away the all the environmental and the moral issues around me right right which is pretty fascinating i'm not sure i want to eat it but um so you i'm an investor so i have no in memphis me yeah all right all right well there you go i think's phenomenal. I think it's pretty interesting. Yeah. I mean, when you look, I mean, it's all the environmental issues around meat eating is... First of all, let me just say, in Blue Zones, people ate some meat, but it's about five

times per month. Yeah. Because they had to wait to kill the goat and then they all ate the goat. Yeah. I mean, they're being in Nepal. They're like, they're mostly eating rice and beans and then they kill a goat and they all have a feast and then they wait ate the goat. I mean, they're being in Nepal, they're mostly eating rice and beans and then they kill a goat and they all have a feast and then they wait till next year. Yeah, and then it's rice and beans,

but they're delicious rice and beans. But you just look at all the issues around, or meat eating, health issues notwithstanding, but also just the carbon emissions and methane emissions and cruelty. People's eyes are open. It's devastating. I mean, I think people are understanding the impact on climate,

on environmental degradation, on even the sort of antibiotic use. Even the ethical and moral issues are becoming more understood. And I think that's a challenge that is now being looked at by big groups that are starting to face this. And I think at this meeting, it's the first time I've heard, you know, the power players start to talk about this, politicians, you know, business leaders, food companies. It's really shifting. It's fascinating. Yeah. And it's the Gen Xers, you know, it's the, it's not the, it's not our generation, Mark. We're, you know, we're, we're all over the hill.

But yeah, we're screwed. It's the 20-year-olds. I just heard this morning that a generation that includes 20-year-olds, they're eating about 50% or five times more tofu than we did and about seven times more non-dairy milk, you know, the nut milk. So, I mean, at least they're conscious, you know, who knows? Yeah, they're shifting the practices. And, you know, I actually heard something very encouraging today

that the Grocery Manufacture of America, which is a sort of a lobby group that's an association of all the food producers and, you know, the big food companies, has essentially disbanded, that they were this powerful multi-billion dollar organization, and all the food companies started pulling out, like Nestle's and Campbell's. I mean, and they were not agreeing with the trends,

for example, transparency and GMO labeling. First of all, in Europe, there's no GMO because they don't allow it. But here, you know, these grocery manufacturers in America were lobbying and actually paying for political candidates surreptitiously and influencing elections in a collusion with all the food companies. And a lot of them said, this is not what we want to do,

like Nestle's and Campbell's. And Campbell's is voluntary eliminate all GMO from their food supply. So these are really great trends. You know, big food and big egg and big beverage, they're often the whipping boys. But I actually don't blame them. Until about 1960, there weren't enough calories mid-60s there weren't enough calories in america to feed americans so when we were in the cold war the mission was to produce more food yeah produce more food and

american innovation went to work and we've just over innovated the fact that there are so many calories out there and marketers can take those calories and repackage them in a number of different ways and market that, make them taste good. I mean, they did exactly what they were supposed to do. They've just done it too well. And now the epiphany is that, well, we've over-innovated in a certain way.

Now we have to recalibrate back for health because... Because the unintended consequences, you know, like... Yeah. Yeah, I think Michael Milken was saying that if you look at how much benefit you get and the cost-benefit ratio of eating French fries that are supersized or not, you might pay an extra quarter for the supersized French fries, but it costs you $8 over your lifetime in terms of chronic disease and medical bills and prescriptions. And nobody factors that in yeah it's the externalities

right yes it's but they we we can we conveniently shut our eyes at those and somebody's got to pay for it eventually so you mentioned that you you think we're maybe focused on the wrong things when it comes to pursuing optimal health so what should we focus on? Well, the healthcare system, let's face it, it incents for sickness. Nobody makes money if you stay well. Pharmaceutical companies depend on you to get a prescription. Hospitals depend on you checking in and using their services. Doctors, excuse me, you get paid the same if you cure them or kill them. True. It's not based on outcome. It's like producing a car that doesn't work. You still get paid for it, right?

You don't get a refund. Right. There's no recalls on it. Exactly. Wait, let me do that over. So it was Jack Welsh, the CEO of GE, famously said, point out the folly of incenting for A and hoping for B. So all the incentives in this country are behind sickness. They seek everybody, all business secretly wants us to get sick so they

can get paid to fix us. There are almost no incentives for keeping you healthy in the first place. I know Cleveland Clinic is one of the first places to wake up and smell the cappuccino on that. But there are very few revenue models out there for companies who are really interested in keeping people healthy. Now, I know for employers, there's some. There are incentives for employers, yeah. Yes, but it is minuscule compared to,

out of the $3.4 trillion or so we spend on healthcare and its related expenses, fewer than 10 percent of that less than 10 percent of it's actually spent on prevention yeah and any percent of that bill is for chronic disease it's caused by lifestyle that's right yes so um and you have fixing that so um the problem is we aim at the wrong target we we're putting all of our money, our effort, the heroes and the rock stars are the doctors fixing people and the rock stars should be the people keeping us healthy in the first place. Like Pekka Puska for example in Finland, one of my heroes. Yeah, who's that?

He ran the World Health Organization's Department of Non-Infectious Disease and he created the North Corellia Project, which was the first project ever to change the environment, 140,000 fins, and lower the rate of heart disease by about 80%, lower the rate of stomach cancer by 60%, not by trying to get people to change their behavior, but by changing the environment they lived in. Yeah.

Well, let's talk about that because you did an extraordinary project in a little town in Minnesota. It was sort of an incubator for testing your ideas about the blue zones. And what you did was you didn't go in there with a heavy hand and say, oh, you should change your diet and eat this and don't eat that and exercise more. You just changed the physical environment to change the behavior, which is this whole field of

behavioral economics and we're often naming it the wrong target and you you found dramatic reductions in medical costs increases in productivity and increase in happiness it was really profound can you tell us about that project and then you scaled it through other cities and other places around america so if you go to places around the world where people are living a long time and people in their 90s are still standing on their head and water skiing at 100, it's not because they tried. It's not because they at 50 got on a better diet or joined a gym. Not to join CrossFit or...

Yeah, none of that. In the reality, they don't know... Got blue apron, delivering meals. Well, that might work. But longevity happened to them. They have no idea. By the way, they don't have genetic superiority. The same genes we have, heterogeneous pool of population.

The big aha in these blue zones areas around the world is that longevity was not something that was pursued. It's something that ensued from the right environment. So the healthiest foods, beans and greens and nuts and tubers and grains, they're the cheapest and most accessible. The option to be lonely, which shaves about eight years off your life expectancy, wasn't there because you couldn't walk out your front door without running into somebody you know.

Social structures were different, the families and the communities, yeah. Much closer, I would say, of social structures. And they were nudged into movement every 20 minutes or so. So you don't find people sitting at their desk eight hours not doing anything. They're gardening and they're doing things by hand every time they go to work or friend's house and occasions of walk. So based on that insight and working with AARP at the time and the University of Minnesota School of Public Health, we created a blueprint for our city, auditioned five cities. Albert Lee, Minnesota, won.

And we were looking for cities that were ready and had good leadership, leadership that worked. The mayor who's on your team. Mayor, but you also want the private sector too. These are almost all privately funded and publicly supported. And we went about changing the environment, changing the policies so that the municipal laws favored fruits and vegetables over junk food,

favored the pedestrian over the automobile, favored the non-smoker over the smoker. We created this Blue Zone certification for restaurants, grocery stores, workplaces, and schools. Got about 30% of all the aforementioned certified. So those environments were healthier. And then got 15% of individuals take a Blue Zone pledge to reshape their social network. So they had some healthy people organized around a healthy activity,

either walking or plant-based potlucks. You got the grandparents to walk their kids to the bus. And you sort of included people in the normal cycle of life, right? Yeah. So a big part of it is social, how we connect people socially. And the other big part is shaping their environment. I mean, you took the plates in their houses and move them from like 12-inch to 10-inch plates, A big part of it is social, how we connect people socially. And the other big part is shaping their environment. I mean, you took the plates in their houses and move them from like 12-inch to 10-inch plates,

the smaller plates, right? Like, I hate that when I get the small plates. Because I like to eat a lot. Well, you just fill it up more often. I like to eat a lot. But, you know, that changes your behavior. You changed it with the work with the grocery stores to put in healthy snacks and drinks at the checkout counter

instead of candy and soda. And that changed the behavior of these people. And so the idea, all the things that you said, so we put in place probably 70 or 80 of those defaults and nudges. So people don't even realize it, but as they travel through their day, from the time they wake up to the time they go to bed, they may receive 20 or 30 little nudges, sort of the Adam Smith silent hand, pushing them towards marginally better health choices without them even knowing it. And it makes a huge difference. So over about a two-year period, we saw the health care costs and city workers dropped by about 40%. That wasn't our report, it was the city's own report. We shaved about two tons off their waistline,

and the average person, we took a representative sample of 25% of the adult population. Among those adult population, we saw an almost three-year jump in life expectancy. So that's self-reported. But nevertheless, it indicates that. There's so many implications for how we address this global chronic disease and obesity problem.

You know, it's like we, we now to rethink the delivery model in the environment. Paul Farmer talks about structural violence. You know, what are the social, economic, and political conditions that drive disease? Now, how do we reshift those to change the environment? Like he did that in Haiti with TB and AIDS where he didn't focus on better drugs or surgery, but by changing the structural environment, by having clean water, by having people have a place to live, by having them have a watch so they don't need to take their medications, by having their neighbor come and check on them.

It's really profound. And I think we haven't implied those insights into health care. And I think we talk about prevention, but it's really about often treatment of chronic disease with lifestyle. Like we know we can reverse type 2 diabetes with changing people's diet. And that's not something that we're actually focused on medicine, unfortunately. So, um, you know, one of the things that, uh, you know, really was, was powerful was, you know, this, this idea of, of this sort of power nine that you came up with, which is this, what are the qualities of these

societies and what are the surprising things that are in there that we may not think are connected to longevity. So you, you mapped out the characteristics of these societies and what are the surprising things that are in there that we may not think are connected to longevity. So you mapped out the characteristics of these people in the blue zones and I read through them and they were really pretty smart and pretty profound and relatively simple and collectively they have a huge impact. Yeah. So the first book I wrote, Blue Zones, Lessons for Living Longer from the People Who Live the Longest, the idea was it told a story of finding these places and then the common denominators. And this Power Nine, I just came up with this.

It's kind of a dumb name, but anyway. No, it's good. It's good. But I just wanted to, you know, curiously, no matter where you go and you see people living a long time, they're doing the same nine things. And they're clustered in four areas. Number one, they're moving naturally as opposed to exercise.

So nudge into movement. They tend to have a sense of purpose. They can identify, they articulate that sense of purpose. They're downshifting. There's sacred daily rituals to downshift them. So stopping and being as opposed to doing. Yes. But it's less conscious and more rote. For example, Okinawan women or older Okinawans will always stop what they're doing.

Before they eat, they'll say three words, hara hachi bu, which reminds them to stop eating when their stomachs are 80% full. Adventists, who are the longest-lived Americans, they'll say a prayer. So there's some punctuation between their busy life and their food. So they'll slow down and eat slower. Costa Rica and Ecaria, they take a nap. Sardinia, they do happy hour. That sounds good.

Happy hour, nap, I don't know. But everybody does it. So it's not like you're the outlier by having a couple of glasses of wine after work or taking a nap at 3 in the afternoon. And then when it comes to what they eat, 95% to 100% of their dietary intake comes from plants. The pillars of all longevity diets in the world, I mentioned before, greens, grains, whole grains, nuts, beans and tubers. So no matter matter where you go those five things make up the daily diet eat meat about five times a month fish maybe two times a week not less than you'd think

a lot of these communities are coastal communities right they look coastal so they're sardinia uh italy icaria gree, Okinawa, Japan, the Nicoya Peninsula of Costa Rica, and Loma Linda. Three of those fives are kind of island. One is peninsula. But the blue zone areas are always inland. They're always up in the highlands. They tend to live on a slope.

In fact, one of the biggest correlates to women a long time is the slope of the land on which you live. So live on a hill. Exactly. Yes. I live on a hill. Exactly. Yes. I live on a hill. I got a place up there. Well, yeah. Is that because you have to walk a lot up and down?

Yeah. I mean, that makes sense to me. But that was studied very carefully in Sardinia. And the steeper the village, the longer the people lived so and then the the the foundation the power nine foundation was um keeping your uh investing in your family being part of a faith no matter what faith it was and then really paying attention to the people you hang out with yeah uh probably the biggest determinant of your long-term health there so if your friends are drinking beer and eating cheeseburgers and fries and drinking coke. Guess what you'll be eating, yeah. And if you're all friends are drinking green juices and doing yoga,

you'll be healthy automatically, right? Yeah. Well, I wouldn't tell you to dump your old friends, unhealthy friends. I will say. Get new healthy friends? Yeah. Kathy Freston's out there. They're healthy vegans.

I know. That changed your life. How did that change your life? Well, I eat a lot more vegetables, I'll tell you that. Yeah that yeah well you look more trim and healthy and fit than i've seen you in a long time so that's good alcohol consumption went down by about 50 oh that's okay depends where you started still be good yeah so um you know one of the things that uh you talk about is cooking and longevity and people say they don't have time to cook and it's a pain, it takes too long. You know, how do you address that?

And what's the connection between cooking and longevity? Well, if you're going out to eat, on average you're consuming 300 extra calories than you would if you stayed home because you can control the sodium, you can control the portion, you tend to eat what you want. I mean, you hear this all the time, I'm so busy that I don't have time. control the sodium you can control the portion uh you tend to eat what you want i mean i just you hear this all the time i'm so busy that i don't have time well the reality if americans like took stock in their lives and thought about where that what things they really get satisfaction out of

yeah i'm guessing they could cut a lot of you know soccer games or running off to the movie or where the kids need to be driven. Seven hours of screen time for the average person in America. Is it that high now? Two hours on the internet. Yeah, and that didn't even exist before. Yeah. So when people tell me they don't have time,

I kind of secretly roll my eyes. So taking the time to cook, especially with your family, can be one of the most pleasant things. And I know it's daunting for people to begin with, but if you really want to eat healthy, one of the keys is having the skills to make a few, I would say plant-based meals. Beans, I would say, should be the main ingredient

because they're hearty and they give you the protein you need. You've got to cook them. You probably know the plant paradox. Yeah, raw beans definitely. Yeah, don't crunch raw kidney beans. I want to come back to that about how do you take care of beans. They take care of you as opposed to the way around. But the investment we should all be making

is to learn how to make a half a dozen plant-based meals that we like. And you might have to fail at 50% of them before you make it and add and like that or it didn't turn out well. But Blue Zone's website, we've tested now probably 500 and we picked the top 100 recipes they're all free yeah and um try one of those recipes they're all plant-based and if you find a half a dozen you like you'll make them over and over it'll be easy it'll be a default and and i could tell you that eating broccoli will add six years to your life expectancy but if you don't like broccoli yeah

forget it you're not going to eat it you'll eat it for a while because, oh, damn, Buechner said. But six months, you'll be back to burgers and fries. Yeah. No, it's true. I mean, I think we've been brainwashed to believe that cooking is drudgery, that it's difficult, that it takes too much time, and that eating healthy food is expensive. And these are all the memes of the food industry that help subvert the kitchen.

And essentially they've hijacked our kitchens. Now most families eat less dinner, less than 20 minutes together, all eating different meals, produced in different factories, all heated in the microwave while they're watching TV or on their phones. And I think the power of the communal meal,

the power of the family meal, the power of celebrating food together and nourishment is something that I think has really left our society. 50% of meals were eaten outside the home. 2% were eaten out in 1900. And so that's created this huge shift in our health and our behavior. And I think you're right. We need to reclaim our kitchens. We need to actually teach cooking.

I think people don't know how to cook. It's amazing to me that, you know, I went to this trailer where this family of five lived in South Carolina. And I said, let's just cook a meal together. They were all very unhealthy. When the father had diabetes and kidney failure, the son was like, you know, massively overweight. So was the mother. And they never cooked a meal in their home. They never stir fried a vegetable. They didn't know how to make chili. They didn't know how to make a salad or salad dressing. They didn't know how to bake anything. It was, it was really astounding. They didn't have a knife or a cutting board. Uh, you know, we had to cut, uh, sweet potatoes with a butter knife, which is not easy or chop onions with a table.

And, and so I showed them just how to cook one meal and they realized how easy it was, how fun it was. We did it together. That's a they realized how easy it was how fun it was we did it together that's a great idea and it was like this family lost literally 300 pounds as a family by just simply it's like losing two children yeah right it's astounding i did this again with another family it was like they lost six of them lost 335 pounds by simply how many times did you have to teach it to once it was one meal it was just amazing to me it was just wow so they just you just gave it i said here's all the junk that you're eating here's all the junk that you're eating in your cupboards here's what's in your food and i showed them the labels i showed them the ingredient list i explained what the foods where there weren't

even foods things were in there that what they were doing to their health and i showed them how to just prepare a meal and i gave them a little guide on how to eat well for less and i gave them them a cookbook. I said, you guys try this, you know, and I didn't know what's going to happen. And it was really extraordinary. And they said it wasn't that more expensive. They live on food stamps and disability. And I think, you know, we need to sort of break down this myth that, you know, we need convenience as the major value. And I know, you know, I've learned basic cooking, so I'm very busy like you are. And I've learned simple meals you can make really quickly without a lot of fuss and that are nourishing and delicious. Let me give you two pieces of advice.

Yes, please. The crock pot and high-quality glass Tupperware. Yeah, for storing your leftovers. Yeah. Well, Sunday is my day because, you know i work i travel all the time but i usually i have a half a dozen crockpot meals it's sargenia minestrone and ikarian stew with fennel and um all the ingredients i can chop it i wake up in the morning chop it up it takes me 15 minutes throw it in the crockpot turn it on at dinner i have bubbling deliciousness waiting for me yes

and we'll have dinner that night and then i'll take the the all the leftovers and i put them in these glass one serving containers and they have a plastic top and i freeze them like that so it's like a big hockey puck so when i go to work you know i like to bike to work i'll just pull one out throw it in my briefcase because it's frozen yeah and then when i get to work i take the plastic top off i throw in the microwave so yeah it's so easy and then i you know put the top on bring it home to wash it right but um it's so so those meals cost me probably a dollar and a quarter yeah um they have as much protein as a regular hamburger a healthier program fiber a lot more phytonutrients, vitamins, minerals.

Yeah, it's like one giant supplement, a stew of healthy amino acids. And yeah, it gets me through the day. So the bean thing is interesting because you talk about how a lot of these cultures consume a lot of beans. And there's been a lot of popular books out there lately saying that lectins are an issue and beans are concerning and that they can cause autoimmunity and inflammation.

But you didn't really find that. And you sort of talk about actually how to prepare them to minimize some of these adverse consequences of beans. And when you look at these traditional cultures, they had very sophisticated ways of actually combining different foods, of cooking them, of breaking down these things that actually may be problematic. So can you talk a little bit about that? Yeah, I think that was unfortunate propaganda about that. About the lectins, you mean? Yeah, I mean, yes, if you eat them raw, they're a problem. But, I mean, here we have 70% of Americans who are obese,

a third are pre-diabetic, dropping dead of heart disease, and we're worried about lectin, for crying out loud. It's silly. I can tell you beyond a shadow of a doubt, the five cultures who are living the longest were eating beans almost every day and probably a cup of beans. And I would say that, I mean,

as long as you soak them, cook them to a boil, the lectins aren't an issue. But the big issue is... So pressure cooking helps too? Pressure cooker will double... And the kombu, what does that do, the seaweed? Yeah, seaweed, if you soak it with seaweed... Takes care of the gas problem?

It helps the gas problem. The reality of the gas problem is this. If you're eating meat, cheese, and eggs all the time, your gut bacteria is going to proliferate to optimally digest meat, eggs and cheese. When you shift and all of a sudden if that's all you're eating, egg McMuffins and then all of a sudden you shift to a healthy bean-based food, your gut bacteria is going to say, what the hell is going on here?

It's going to be a war. Yeah, but that war only lasts for about a week or a week and a half. And then all of a sudden your gut bacteria shifts so it can break down those long-chain carbohydrates that are in beans to digestible carbohydrate, and you don't have that issue. I eat beans every single day, I have zero issue. And you talk about how to start out with these smaller beans, like rather than kidney beans or lima beans or fava beans,

start with lentils and beans that are easier to... Fava are the gaseous if you're not eating them regularly. But again, after two weeks, if you start with lentils or peas and move your way up... And that's an important thing that people don't realize about the microbiome and the role it plays in all chronic disease, including obesity and diabetes. And so the way to cultivate your inner garden is by eating a lot of plants, by eating a lot of fiber-rich foods.

I like that, inner garden. Yeah, I mean, we got to tend our inner garden. We got a lot of weeds growing in there that are causing disease. And the way you get the weeds out is you put in the good stuff and it crowds it out. So when you look at these traditional cultures, and I've done this in Burkina Faso in Africa, they looked at

the microbiome of these people eating more traditional diets and then compared to Western diets and what the microbiome is in there. And they're completely different. And, you know, this is really an important thing that I think probably is happening in these cultures where they all have much healthier digestions, much less autoimmune disease, much more anti-inflammatory diets, which is really what's driving their longevity. Because we know that longevity is really related to two things. One is inflammation or lack of it, and two is your ability to handle sugar and insulin.

So insulin sensitivity is a huge driver of longevity. So all the things that you're talking about help those properties. Yeah, the bacterias that favor meat, cheese, and eggs are going to also produce as a byproduct inflammatory biochemicals. It's interesting though, in the context, this guy at Cleveland Clinic did this interesting study, Stan Hazen, where he took meat eaters and then measured a molecule called TMAO. You know about this data?

Yeah, yeah. And he measured this molecule that seems to be linked to heart disease. And then he somehow convinced vegans to eat a steak and then measured their levels. And they didn't produce this nasty molecule, even though they were eating the steak. Oh, interesting.

And it's because they had healthy gut bacteria that was not producing these chemicals. So, you know, there's some interesting data on like, you know, meat and whether it's harmful or helpful. And a lot of it has to do with like what the context of the overall diet is. You know, when they looked at meat eaters and vegetarians who shopped at health food stores, they both had the risk of death reduced in half.

When they looked at meat eaters who eat a traditional, you know, unhealthy diet, which typically was what meat eaters do because everything's meat's bad for you. So people who eat meat are basically unhealthy and don't care about their health. They weighed more, they smoked more, they drank more, they ate less fruits and vegetables, they didn't exercise. That's why we see these trends and these correlation studies. But you look at what is the overall context of your diet. Like these populations had low amounts of meat.

It was more of a condiment or a condi-meat, I call it. That's what Thomas Jefferson characterized meat as, a condiment. Yeah, right. And it's like that, you go to like... I used to live in China and you know, it was mostly vegetables with a little bit of piece of meat in there. It wasn't like a 32 on steak with one string bean and a baked potato. Yeah, you know, my view on meat eating... I mean, in all honesty in in Blue Zones, people did eat meat.

It was, you know, they typically knew the name of the animal and they took care of the animal for a long time. And then... Jimmy the goat. Yeah, it was time for the wedding. But it was infrequent, often as a condiment. But for my Blue Zones work, and I work now in 26 cities with 26 blue zone

projects and i have you know website meal planner we made the decision to stay 100 plant based on what within the blue zone uh family because i find that you know i used to talk about the fact that people in blue zones ate pork and people would say you know, I used to talk about the fact that people in Blue Zones ate pork. And people would say, you know, when you talk to a population, oh my God, pork, they eat that in Blue Zones? Yeah. I'm going to have my pork chop for lunch and pork rolls for dinner. So the longest lived American cohort are the Seventh-day Adventists

and Adventists who are either pescatarian, which means they eat up to one serving of fish a day, and are otherwise 100% plant-based or 100% plant-based. So if you're eating 100% plant-based, most people that you can pretty much turn off your brain if you're eating a% plant-based, most people that you can pretty much turn off your brain if you're eating a whole food, diverse, you know, the five foods I was talking about, you can be pretty sure you're getting all the nutrients. So there's some argument for pregnant women or, you know,

especially older people have a harder time digesting protein. But I just figure within the blue zone aura, 100% plant-based and outside of blue zones, people can do whatever they want. It's true, but there is some evidence that long-term vegan diets can lead to nutritional deficiencies unless you supplement, such as B12, omega-3 fats, vitamin D, iron, and even protein as we get older. There's some studies that show that people who eat less protein when they're younger do better but as they get older you need more protein for

muscle mass and there's a real sort of scientific debate going on now about you know the protein requirements as we get older and muscle mass and muscle mass is the single misdeterminant of your insulin sensitivity your hormone levels and aging yeah so you know you need three cups of beans to get what you'd get in a you know six ounce piece of fish or chicken right so how do you well but you know spinach ounce for ounce you get more protein out of spinach than you would out of beef so the thing is if you're but you need an ounce of an ounce of spinach is like a ton of spinach and i figured out you need like i think 84 cups of broccoli to get what you'd get in like your daily protein requirements if you're eating.

Yeah, if you're just eating broccoli. Well, first of all, according to CDC, the average American gets about twice as much protein as they need. So to your point, yes, when you get to be 70 or 80, you may need a more easily digestible form of protein. But I would argue that most Americans, our disease comes from overeating and overeating the wrong kind of the food, which is usually meat. Not always, I mean, there's a few, 1% of meat is grass-fed

and if we ate it once or twice a week, there'd be no problem. But the reality is to send the message that it's okay to eat meat or the longest lived people in the world eat meat, people take it the wrong way. And if we continue eating it the way we eat it and we continue as experts keep sort of endorsing it, of course people want to hear it. People love nothing more than Dan Dugan to say, eat your pork because it would justify, you know, bacon tastes good.

I know a guy who's a baconitarian. He only eats vegetarian and vegan except for bacon. I can't wait to see him when he's 70. So I think, you know, I personally take it upon myself to be kind of an evangelist to bring people more. First of all, I know not everybody's going to go over and be vegan. I don't think everybody should necessarily be vegan. But if I can pull them from their, you know, on average, two servings a day to two servings a week, I feel like I've done a big service.

Yeah, no, clearly. I mean, most of our diets, 75 to 80% of our diets should be plants at a minimum. And the problem, you know, they say everything in moderation. Well, people don't know what moderation is. No. And you're right, defining the quality of the meat moderation. Well, people don't know what moderation is. No. And you're right. Defining the quality of the meat matters.

If it's all a grass-fed bison from Montana. Yeah, but nobody gets that. That's different, right. But that's increasing. There's an increasing movement to shift agriculture from factory farms to... Yeah, but there's no way that 320 million people, if we all had a serving of grass-fed beef every day, there's not enough land in America to feed. So the reality is we end up defaulting to the factory-raised beef and pork and chicken.

Yeah, right, and that needs to stop, absolutely. It's a huge issue. I could sell a lot more books if I endorse meat, but I'm not going to. Well, it's an interesting dialogue right now. I think it's still emerging, and I'm sort of on the fence about it because I just need to see the data on regenerative agriculture. If it's true that we can sequester all enough carbon to take us back to pre-industrial era,

that we can produce larger amounts of meat, not necessarily the amount that we're producing now, which I don't think is sustainable, and that would reverse climate change, hold soil, water, and actually produce healthier animals. Have you ever looked at the Plains Indians at the turn of the century? They were like the highest number of centenarians

of any population. And they lived primarily on bison. How do we know that, that they were the highest? I think there was data, census data that was collected. I mean, of course, maybe they didn't know when they were born. Yeah, I can guarantee you that- Maybe they just looked 100.

Yeah. Because they were out in the sun all day. Well, you know, they used to think the Hansa Valley of Pakistan and the Vilcabamba Valley of Ecuador. And same thing with the plane industry. When you don't have accurate birth records, you always get age exaggeration, always. We're always thinner and live longer than we actually are.

We didn't really have decent record keeping in the United States until like 1914. So one of the things you've done to help make it easier for people is you've created this new app called the Blue Zones app. Tell us about how that works, what the benefits are, how people can find it and use it. Yes, so it is a tool, very quick and very easy, that helps you load in your your dietary restrictions you load in how many people you are you load in if you like to eat a lot if you're trying to eat for immediate

health or for longevity and it generates not only grocery lists but also recipes and if you live in certain cities that will actually place your order with the local grocer and the uh your house yeah it will show up your house ready to go and does it come with cooking videos how to prepare the recipe because that would be awesome that we're waiting for mark hyman to come in we'll do it together we'll cook some great meals together no but it took out and yeah chopping it's the newest thing i'm actually very excited about because like you so i started out with blues i was talking about purpose and the importance of the family and downshifting. But at the end of the day, you realize that the runway for health for most Americans is what we eat through our mouth.

We eat three times a day, there are networks, people love to eat. So in the last year or two, I've been really focusing on food and trying to really think through what the longest lived people ate and how to translate it for american populations and the meal app is one and in these recipes that we we've uh curated and i'm also i'm doing a book with national geographic now and another story for the magazine where we've gone back to all five of the Blue Zones areas, got people over 70 to cook for us because in all the Blue Zones areas since about 1970 is a big sea change. Yeah, they started adopting the standard American diet.

So their health is starting to go to hell. But we captured, we had these old people cooking their traditional recipes and they're all peasant, they're delicious, they have hundreds of years of culinary wisdom baked into them and the techniques and the amounts and the way they cook them. So I had this great photographer, David McLean, I think he's the best photographer at National Geographic, shoot the setting, the preparation, the people cooking, the final dish

and then I'm trying to take the science. So the final book will be kind of a blend between a cookbook and a National Geographic. I love that. Well, if you ever need a doctor to go along your trips, you know, trip, travel. There we go. I'm down. I'm going to go. All right.

Okinawa next week. So if you were king for a day and had the power to change our landscape around health and wellness and longevity, what would you do in terms of policy, law, change the community? I love that question. I've thought about that. Yeah. Number one, I'd raise the price of gas. You'll hate me for it.

People are going to hate the spit on my grape for this. That's okay. I'd raise the price of gasoline to 15 a gallon that will drive us out from behind our steering wheels onto our feet which is about half of the problem and if you have olive oil you get thousands of miles per gallon right but i want people you know the happiest i just wrote a cover story on happiness for national geographic i saw that the happiest people in america are living in places where it's very bikeable and walkable.

There's a very high correlation. And we're not going to start designing our cities for humans until we wean ourselves from the car habit we have. The amount we've driven since 1980 has about tripled. We spend way too much money in our car. And then the biggest problem... Okay, so I'd say part of the problem with what we eat is our eating as much animal food as we do.

And the reason we do is because the inputs, the corn, soybeans, wheat, are so heavily subsidized. The real cost of a $5 hamburger is probably $80. Exactly. If you take all... So if we actually had to pay the real price of a hamburger, we'd eat it once a week, which would be fine.

What's the real cost of a can of Coke, right? Yeah, same thing. There's all these subsidies. So I would take away those subsidies, those agricultural subsidies that enable us to buy these really cheap inputs and then create these pretty unhealthy foods. And those, by the way, came under Nixon

because the price of meat and milk were going up and he thought it was bad to get elected in that environment. And so he changed agricultural policies to promote the production of excess food at lower costs earl butts earl butts yeah that was his real name earl butts yeah it was yeah secretary of agriculture under nixon you know it wasn't a bad idea then actually you know we didn't have an obesity problem in 1968 we thought we did but we didn't yeah it was about one third of what it is today so and then i think in schools, we teach kids how to cook.

You know, the no child left behind, instead of teaching them math, they should be taught right away. There's a very successful program in France called the EPOD program that teach first graders, it's a six week program that teach first graders what a vegetable is, what it smells like, what it sounds like, finally, what it smells like, what it sounds like,

finally what it tastes like. And there's so many kids. We work in the beach cities of California here and about 40% of the kids in that community could not correctly identify a banana as a fruit. Or yeah, Jamie Oliver did that show where he looked at in West Virginia, these kids trying to ask him what an eggplant was or a tomato or an apple.

They couldn't identify them. So, I mean, what we eat drives our productivity, it drives our health care costs, it drives our happiness. We should be teaching this in the first grade. Like math, it should be a basic skill. And also basic school performance is driven by what kids eat. Exactly. So we have this huge achievement gap where we're... It should be a basic skill. And also basic school performance is driven by what kids eat, right? Exactly.

So we have this huge achievement gap where we're, you know... You feed the kid Cocoa Puffs for breakfast and he gets a spike in insulin and then he crashes and during math he's not enough. And all the dyes and the colors and additives cause these kids to bounce off the walls. It's a problem. So what else would you do if you were a king? Yes. So I would limit the number. I'm not saying there shouldn't be fast food,

but cities can choose to limit the number of fast foods. I wouldn't have any billboards at all anyplace. The happiest cities in America have no billboards. Who likes billboards, by the way? Nobody. Except the guy who owns them in the advertiser. There is a direct correlation between the amount of billboard junk food advertising and the obesity rate of the adjacent population.

And food marketing as a whole. Yes. Billions of dollars. So a law that completely eliminates that, I would probably make sodas a lot more expensive. They are the number one source of refined sugars in the American diet. I would say second only to tobacco as a public health menace. Actually, they've exceeded in terms of global chronic disease,

obesity and diet-related diseases far outstripping smoking now. I didn't know that. So the industry ought to pay for that. Or we ought to pay the real costs for it so and that would make the problem go away right so i it would make me unpopular with no it's good but no the externalities have to be included in the price you know prince charles talked about accounting for sustainability in his book the future of food it was a speech he gave at george washington university and basically said you know we're not accounting for all the hidden costs of the degradation of the environment

uh the climate's change the loss of, the depletion of our water supplies, the chronic disease burden, the educational productivity losses, and kids who can't function and go to college. I mean, all those things are not included in the price of the food we're eating. And you're right, we've subsidized food so that fast food and junk food is 40% less and fruits and vegetables are 40% more since the 1970s. Yeah, so that's why people... Now you know why people are buying those things. The last thing I do is I take a big chunk of the healthcare budget and probably tighten up on the number of heroic interventions

that typically are very expensive and shift that money to prevention. So Costa Rica, which I just covered in this book, Blue Zones of Happiness, every man, woman, and child in that entire country has the right of one visit a year from a health care ambassador. They'll spend a half hour with you. They'll take your blood pressure, check you for diabetes, for depression. They'll go out in your backyard and look for standing water. They'll look in your kitchen to look for signs of chronic disease. They'll give you a half hour of advice.

And if you're showing signs, early signs of a chronic disease, you're immediately sent to a local, they call it Posto de Salud or hospital. So they're catching chronic diseases before it's a three alarm six figure yeah issue um they spend one fifteenth the amount on health care that we do in the united states and have about 20 percent lower rate of or uh lower mortality middle-aged mortality than we do so they're healthier they spend a fraction but they're instead of spending a thousand dollars fixing the disease they're spending $1 to prevent it. And we ought to be doing that, but we don't have the political courage. Our leaders don't have the political courage to shift.

That's true. We're looking at food pharmacies as a sort of a medical intervention. That's a great idea. Doctors create prescriptions. They found for a diabetic, $1,000 prescription that we pay for, we'll save $24,000 on the back end. Yeah. You know, it's pretty amazing24,000 on the back end. Yeah. You know, it's pretty amazing.

Well, this has been a great conversation. People can find you where at? Bluezones.com. Bluezones.com. Yes. Amazing work. It combines the two things that I'm most passionate about, which is the power of food and the power of community and building that sort of social structures that drive healthy behaviors, which is like where we have to go.

It's all interconnected. Diets and exercise, they don't stand on their own. I think of it, it's like collagen. It's like what holds your good-looking face in place. It's that collagen. And it's the sense of purpose, it's the right social network, it is living in the right community that hold the right kind of eating and physical activity in place so you do them for long enough to not get a chronic disease.

It's amazing. Well, this has been Dan Buettner talking about the blue zones, longevity and health, The Doctor's Pharmacy. We'll see you next time. Thank you very much, Mark. Thank you for listening in to today's podcast and The Doctor's Pharmacy with Dan Buettner talking about how we can all live long and well. And if you enjoyed this podcast, please subscribe at iTunes and also share with your family and friends

and leave a review because it matters to us. See you next time on The Doctor's Pharmacy.