Dhanada K Mishra, Hong Kong, 8 October 2023
When I first came to Hong Kong in 2017, I was struck by the fact that most people here are quite slim, and it would be hard to find obese people, unlike in Western countries like the USA and Australia, where I had lived for a few years each. Even in India, I thought our affluent, upwardly mobile urban populations were far more overweight than what I saw in Hong Kong. The other fact that impressed me was the number of fit older people you would see – often walking briskly on the hilly terrain of Hong Kong or cycling or hiking, for example. Later, I learned that Hong Kong has the highest life expectancy in the world at 85.5 years, with women having a life expectancy of 87.9 years as per 2021 statistics.
Recently, I watched a 4 part documentary on Netflix called ‘Live to 100 – Secrets of the Blue Zone’ where a journalist, Dan Buettner – a National Geographic Fellow- visits five communities known for their longevity. They also uniquely boast of the highest number of healthy centenarians as a proportion of the total population compared to the world average. Dan’s objective was to discover the secrets of their longevity and investigate whether those habits can help individuals not necessarily living in the blue zones to live longer.
Blue Zones are so called because Gianni Pes and Michel Poulain, who identified Sardinia’s Nuoro Province as the region with the highest concentration of male centenarians, marked the area in a blue circle on a map. The term “blue zone” was later used by Dan Buettner to refer to other regions with similar longevity hotspots. There are five Blue Zones in the world: Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece; and Loma Linda, California. These regions have been studied by Dan Buettner in his book “The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest”, in an attempt to identify the secrets to their longevity.
The people living in these regions share nine specific lifestyle habits called the Power 9. These are natural movement, or building exercise and activity into everyday life; feeling like they have a purpose; having less stress through habits such as praying, napping or enjoying happy hour; the 80 per cent rule that sees people stop eating when they feel 80 per cent full to avoid weight gain; eating a plant-based diet; moderate and regular alcohol intake; having a sense of faith; focusing on family and relationships; and having a strong social circle that values healthy living. They don’t follow fad diets, go to gyms, or take expensive supplements. Instead, they stick to what’s tried and true, largely living like their ancestors centuries ago.
Interestingly, the five regions compared are from different parts of the world as shown on the map, with widely varying geographic, social, and demographic characteristics. For example, Okinawa is in Japan at the eastern edge of Asia – a relatively flat topography on the sea, whereas Sardinia in Italy and Icaria in Greece are hilly islands helping people get a lot of workout simply going about their daily chores. While the people of Loma Linda in California belong to a very affluent society, the population in Nicoya in Costa Rica belongs to a relatively poverty-stricken society. Some are more urbanised and quite accessible, whereas others are isolated rural communities. In spite of these stark differences, the lifestyle habits that can be easily identified as contributing factors to their relatively longer life expectancy have many common features.
Medical research has established that genetics only has a 20-30% effect on longevity. Thus, lifestyle habits have a very big impact on health, well-being and life expectancy. Many of the beneficial effects of these factors are well supported by medical research. For example, a largely plant-based diet rich in vegetables, fruits, legumes and nuts with an occasional helping of mostly fish, white meat and seafood is known to be highly beneficial. Similarly, movement-based exercise has well-established health benefits. Both these habits help reduce the chances of diseases like diabetes and cardiovascular ailments. Other habits, such as strong social and family bonds and a purpose for staying alive, are well-established factors contributing to longer life expectancy.
After travelling to and studying the five blue zone communities, Dan wondered whether this phenomenon could only apply to small, isolated, mostly rural and traditional communities or can also be applicable in the case of entire countries. He also wondered if such lifestyle habits can be brought about by deliberate government policies. Searching for the answer to this question brought Dan to Singapore. Interestingly, Dan’s studies of Singapore – a city-state with high longevity like Hong Kong – revealed several factors similar to the blue zones. Many of them, such as discouraging car ownership, were due to deliberate government policy to encourage the use of public transport and walking. Another such policy was encouraging joint families by giving tax concessions and other incentives when adult children chose to have their parents live with them.
After studying these five blue zones and Singapore, Dan wanted to bring back his insights to his home country, the United States. One of the wealthiest countries on the planet, America’s life expectancy peaked around 2013 and currently ranks around 60 among countries with average life expectancy lagging by around six years behind the leader, Hong Kong. The obesity epidemic, loneliness, breakdown of joint family, fast food, etc., are among well-established factors contributing to the decline of American health standards and life expectancy. Dan approached a town in Texas – Fort Worth – advising them to implement some policies to encourage lifestyle habits to improve public health and wellness outcomes. His efforts yielded very good results for the Fort Worth community.
Blue Zones Power 9 ® is a program based on the nine lifestyle habits of those who have lived the longest. Blue Zones Project is a community-led well-being improvement initiative implemented by North Texas Healthy Communities, a well-being outreach arm of Texas Health Resources. It partners with businesses, schools, community leaders, and residents to make healthier choices easier to make. More than 95,000 residents and nearly 500 groups and organizations have partnered to make Fort Worth the largest certified Blue Zones Community in the country and improve well-being throughout the city and beyond.
Coming back to Hong Kong, it has many unique ingredients that are similar to the 9 habits discussed, but some supplement it very well. For example, Hong Kong is a very compact metropolis of around seventy lakh people that boasts of the best public transport system in the world. It makes people walk a lot more than in other cities. For example, an average Hong Konger walks on average around 6880 steps compared to only 4780 for the average American based on the mobile phone data of a large sample of users. The food habits of Hong Kongers mostly comprise stir-fried vegetables and seafood without much oily and deep-fried food. The copious amount of green tea taken with all meals is another great ingredient in the diet. Living in relatively small flats, many Hong Kongers tend to stay in joint families, which leaves very little room for the elders to be lonely. Of course, the world-class, almost free universal healthcare services help the elderly population greatly.
I am unaware of any Blue Zones type of study in India, but it will certainly result in some interesting insights. For example, the traditional food of Odisha, famous for the Mahaprasad of Sri Jagannath Temple of Puri, could be one of the healthy habits of the Power 9 formula. Even though the average life expectancy of Indians is around 67, although steadily increasing, I am sure the elderly population in our midst, such as those who lived into their 90s and remained healthy, could teach us many lessons in healthy lifestyle habits. I know at least one such person personally in Sri Padma Charan Nayak, ex-MLA and Gandhian, who, at the ripe young age of 97, remains active in leading a movement to free Odisha from the menace of liquor. I hope we find a Dan Buettner who can take up the task of studying the lifestyle habits of our nonagenarians and centenarians and tell us the secrets of their longevity and health.
