(HS reader) The Greek and Costa Rica Chapter Reflection [Blue Zone]

Please read pages 166 – 259 of The Blue Zones. Write a two-page reflection on the following:

1. Similarities and differences in the cultures that contribute to the longevity of the areas.

2. What Blue Zones lessons could we apply from these regions to the Bay Area. What level(s) on the Spectrum of Prevention would be most useful to apply these lessons in the Bay Area (please explain).

A Sample Answer For the Assignment: (HS reader) The Greek and Costa Rica Chapter Reflection [Blue Zone]

Title: (HS reader) The Greek and Costa Rica Chapter Reflection [Blue Zone]

Published by the National Geographic Society Copyright © 2008, 2012 Dan Buettner All rights reserved. Reproduction of the whole or any part of the contents without written permission from the publisher is prohibited. Illustration Credits: 1.1: Coneyl Jay/Photo Researchers, Inc.; 1.2: Bettmann/Corbis; 1.3: David McLain/Aurora Photos; 2.1: Alinari Archives/Corbis; 2.2: David McLain/Aurora Photos; 2.3, 2.4, 3.1: David McLain/NGS Image Collection; 3.2, 3.3, 3.4: David McLain/Aurora Photos; 4.1: Ellen G. White Estate, Inc.; 4.2, 4.3, 4.4: David McLain/Aurora Photos; 5.1, 5.2, 5.3, 5.4, 5.5, 6.1, 6.2, 6.3, 6.4, 6.5: Gianluca Colla; 7.1: David McLain/NGS Image Collection; 7.2, 7.3: David McLain/Aurora Photos; 7.4: David McLain/NGS Image Collection. The Library of Congress has cataloged the first edition as follows: Buettner, Dan. The blue zones : lessons for living longer from the people who’ve lived the longest / by Dan Buettner. p. cm. Includes bibliographical references. eISBN: 978-1-4262-0949-9 1. Longevity. 2. Medical geography. I. Title. RA776.75.B84 2008 613.2—dc22 2007044375 The National Geographic Society is one of the world’s largest nonprofit scientific and educational organizations. Founded in 1888 to “increase and diffuse geographic knowledge,” the Society’s mission is to inspire people to care about the planet. It reaches more than 400 million people worldwide each month through its official journal, National Geographic, and other magazines; National Geographic Channel; television documentaries; music; radio; films; books; DVDs; maps; exhibitions; live events; school publishing programs; interactive media; and merchandise. National Geographic has funded more than 10,000 scientific research, conservation and exploration projects and supports an education program promoting geographic literacy. For more information, visit www.nationalgeographic.com. For more information, please call 1-800-NGS LINE (647-5463) or write to the following address: National Geographic Society 1145 17th Street N.W. Washington, D.C. 20036-4688 U.S.A. Visit us online at www.nationalgeographic.com For rights or permissions inquiries, please contact National Geographic Books Subsidiary Rights: [email protected] v3.1 For Roger and Dolly A MESSAGE TO THE READER This publication contains the opinions and ideas of its author. It is intended to provide helpful and informative material on the subjects addressed in the publication. It is sold with the understanding that the authors and publisher are not engaged in rendering medical, health, or any other kind of personal professional services in the book. The reader should consult his or her medical, health, or other competent professional before adopting any of the suggestions in this book or drawing inferences from it. The authors and publisher specifically disclaim all responsibility for any liability, loss, or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any of the contents in this book. Contents Cover Title Page Copyright Dedication A Message to the Reader Acknowledgments Preface Get Ready to Change Your Life Chapter One The Truth About Living Longer Chapter Two The Sardinian Blue Zone Chapter Three The Blue Zone in Okinawa Chapter Four An American Blue Zone Chapter Five Discovering Costa Rica’s Blue Zone Chapter Six The Greek Blue Zone Chapter Seven Your Personal Blue Zone Reflecting on the Lessons Bibliography Acknowledgments W ITHOUT THE UNIVERSITY OF MINNESOTA’S Dr. Robert Kane, who endorsed and helped shape the Blue Zones premise, this book would have never materialized. He and his colleagues from the National Institute on Aging, Dr. Jack Guralnik, Dr. Luigi Ferrucci and Dr. Paul Costas; Dr. Thomas Perls from the New England Centenarian Study; Dr. Greg Plotnikoff, Medical Director of Allina’s Institute for Health and Healing; University of Louvain’s Dr. Michel Poulain and University of Illinois, Chicago’s Dr. S. Jay Olshansky would spend countless hours sharing expertise, identifying locations, developing methodologies, and ultimately keeping me on the path of science and off the short cuts of conjecture and hyperbole. I cannot thank them enough. Of the many experts around the world who contributed to this project, I am especially indebted to Dr. Craig Willcox, Dr. Bradley Willcox, Dr. Mokoto Suzuki of the Okinawa Centenarian study; Dr. Tatsama; Dr. Luca Deiana of Sardinia’s AKEA Study and his incandescently brilliant protégé Dr. Gianni Pes; Dr. Paolo Francalacci; Drs. Gary Fraser and Terry Butler of the Adventist Health Study; Dr. Luis Rosero-Bixby of the Central American Population Center; and Dr. Leonardo Mata. They not only lent their expertise but also extended their hospitality and generosity of spirit. Dr. Len Hayflick, Dr. Jack Weatherford, and Dr. Richard Suzman graciously consented to many long interviews. The faculty at the University of Minnesota’s School of Public Health, including Dr. Robert Jeffreys, Dr. Tatyana Shamliyan, Dr. Robert W. Jeffery, Dr. John Finnegan, Dr. Cheryl Perry, and especially Dr. Leslie Lytle have been and still are my academic partners. Many of the experiences on which this book is based reflect a shared effort by the members of Quest Team who have traveled with me to the Blue Zones. Photographer and longtime expedition partner David McLain deserves much of the credit in developing the Blue Zones idea. Nick Buettner, Damian Petrou, Gianluca Colla, Sabriya Rice, Rachel Binns, Sayoko Ogata, Dr. Elizabeth Lopez, Eliza Thomas, Tom Adair, Michael Mintz, Meshach Weber, Thad Dahlberg, Eric Luoma, Joseph Van Harken, and Suzanne Pfeifer all shared their ample talents and endured many long days and nights to bring Blue Zones to life. This story would have never been told without Peter Miller, my editor at National Geographic. He backed the idea for the original magazine story and guided me through my first drafts of the book. Michelle Harris further improved the book through her thorough fact checking, and Dr. Robert M. Russell’s review of our chapters helped keep us on track. Also at National Geographic, I thank Lisa Thomas and Amy Briggs for orchestrating this book; Rebecca Martin for shepherding us through the Expeditions Council grant process; Valerie May and Miki Meek for bringing Blue Zones to life online; and picture editor Susan Welchman for her fiercely relentless friendship and guidance. Assistants Jorge Vindas (Costa Rica), Marisa Montebella (Sardinia), and Kadowaki Kunio (Okinawa) were the unseen engines behind our successful stories. No project of this magnitude happens without sponsors and financial partners. I wish to especially thank Marty Davis, the Davis family, and DAVISCO for their commitment to health and vast generosity; Jane Shure from the National Institute on Aging who was instrumental in obtaining our initial funding from the National Institutes of Health; Becky Malkerson, John Helgerson, Laura Juergens, and Maria Lindsley who championed Blue Zones at Allianz Life; Valerie May and Nancy Graham for navigating the waters at AARP; Nishino Hiroshi who found most of the funding in Japan; the Target Foundation, the Best Buy Foundation, Lawson Software, and the National Geographic Expeditions Council. At Blue Zones’ Minneapolis headquarters, Scott Meyer has been our mentor and marketing guru from the very beginning. The office team: Matt Osterman, Sarah Kast, Phil Noyed, Amy Tomczyk, Nancy Fuller McRae, and Jennifer Havrish have endlessly helped with research, proofreading, and have patiently endured my nonlinear methods; and the extended team including PR maven Laura Reynolds; Remar Sutton, Dr. Mary Abbott Waite, and the late George Plimpton, who provided crucial editorial assistance; Britt Robson for his help on the Okinawa and Loma Linda Chapters; our advisors including Tom Rothstein, Frank Roffers, Elwin Loomis, Jon Norberg, Ed McCall, Tom Gegax, Kevin Moore, Molly Goodyear, Chris Mahai, John Foley, and John Gabos who lent generous business advice; Thad Dahlberg, Dan Grigsby, and Bruno Bornstein, who built the Blue Zones website; and Keiko Takahashi, who created the Blue Zones identity. I also want to thank cameraman Tom Adair; ABC’s David Ketterling for producing a stellar segment on 20/20; AARP’s Nancy Graham, who marshaled in the expertise of thousands of Senior Explorers; Nick Buettner, who handled all satellite technology; our senior producer, Damian Petrou from Brave New Media; photographer Gianluca Colla; logistics expert and designated drinker Terry Haltiner; and, especially, CNN’s Emmanuel Tambakakis, who joined our team as both a cameraman and champion cliff diver. He taught us all to believe in miracles and that sometime our greatest blessings can emerge from disaster. And to the members of the media who have taken a chance and made the Blue Zones a national story I’d like to thank: Diane Sawyer, Rob Wallace, Jennifer Joseph, Anderson Cooper, Barbara Walters, Sanjay Gupta, Alyssa Caplan, Ned Potter, Patty Neger, and especially Walter Cronkite. And finally to writer Stephanie Pearson, who helped me flesh out this book during hundreds of phone conversations over the past seven years. Preface Get Ready to Change Your Life T HE FIRST TIME I MET SAYOKO OGATA, SHE was wearing the sort of fashionable gear one might expect a young Tokyo executive to take on a safari: hiking boots and cuffed socks, khaki shorts and shirt, and a pith helmet. Never mind that we were in Naha, a high-tech city of 313,000 on the main island in Okinawa, Japan. When I gently poked fun at her by saying that I could see she was ready for adventure, she didn’t blush. Instead, she responded with one of her joyous, staccato laughs, wagged a finger at me, and scolded, “I’ll get even with you, Mr. Dan.” But I never saw the pith helmet again. At the time, in the spring of 2000, Sayoko was a young, fastclimbing executive in Tokyo. Her company had brought me to Japan to explore the mystery of human longevity, a topic that would likely spark the imagination of a large audience. For more than a decade, I’ve been leading a series of interactive, educational projects called “Quests,” in which a team of Internet-linked scientists investigated some of Earth’s great puzzles. Our goal was to engage the imaginations and brainpower of tens of thousands of students who followed our daily dispatches on the web. Previous Quests had taken me to Mexico, Russia, and throughout Africa. I’d first learned about Okinawa’s role in longevity studies a few years earlier, when population studies indicated it was among the places on our planet where people lived the longest, healthiest lives. Somehow Okinawans managed to reach the age of 100 at a rate up to three times higher than Americans did, suffered a fifth the rate of heart disease, and lived about seven good years longer. What were their secrets to good health and long life? I landed in Okinawa with a small film crew, a photographer, three writers, and a satellite technician to keep us connected to about a quarter million school kids. We identified gerontologists, demographers, herbalists, shamans, and priestesses to contact, as well as centenarians themselves, who were living emblems of Okinawan longevity. Each morning our online audience voted to decide whom we should interview and where the team should focus its research. Each night we reported back to the audience with a variety of dispatches and short videos. Sayoko had brought a team of translators with her, a computer filled with spreadsheets, and an intimidating plan to make sure that our daily reports and videos were translated into Japanese and transmitted by midnight to Tokyo. We spent ten hectic days asking questions about life on Okinawa and summing up what we found. I met lots of fascinating people, which made me happy. Sayoko made her deadlines, which made her happy. And when the project was over, her team and mine celebrated with karaoke singing and sake and then parted ways. That was that. THE BLUE ZONES QUEST Five years later, I returned to Okinawa with a new team of experts. I’d just written a cover story for National Geographic about the “Secrets of Long Life,” which profiled three areas of the world with concentrations of some of the world’s longest-lived people—areas we dubbed “Blue Zones.” Demographers had coined the term while mapping one of these regions on the island of Sardinia. We expanded the term to include other longevity pockets around the world. Okinawa still ranked among those at the top of the list. I was determined to delve deeper into the lifestyle of Okinawans as part of a new online expedition—the Blue Zones Quest. More than a million people a day would follow our progress online. It was a huge opportunity to make a difference, and I knew we couldn’t miss any deadlines. I decided to track down Sayoko. She wasn’t easy to find. I tried her old e-mail address and queried all of my old teammates concerning her whereabouts. I contacted her former boss, who told me she’d left her high-powered job behind to become a full-time mom. This news blew me away. By now I expected her to be a senior executive at Sony or Hitachi. Instead, she’d left Tokyo, he said, and moved to the island of Yaku Shima, where she lived with her husband, a schoolteacher, and their two children. When I phoned her, she was ebullient. “Mr. Dan!” she said. “It makes me happy, really, to hear your voice.” I told her about my new project in Okinawa and said I hoped she could join us. “Dan,” she replied, “you know I loved Quest, and for me it was really something quite powerful in my life. But now I have two small children, and I cannot leave them.” We talked for a few more minutes and then I hung up, disappointed. I’d have to find someone else. But a few days later, she called me back and abruptly accepted the offer. I had no idea why. I was just relieved to have her back on the team. We set up our Blue Zones headquarters in a traditional guesthouse on the remote northern half of Okinawa. I’d recruited a team of scientists, writers, video producers, and photographers, and Sayoko had arrived with a team of Japanese translators and technicians. Gone was Sayoko’s fashionable expedition wear. Now she wore sandals and earth-toned cottons. A few strands of gray streaked her hair, and she exuded calm. But when she opened her computer to a spreadsheet, I could see she’d lost none of her organizational zeal. “Okay, Mr. Dan, let’s talk about our deadlines.” For the next two weeks, we rarely saw each other face-to-face. During the day, my team gathered information and produced stories. Each night Sayoko’s team translated them and published them to the Web. Since I was waking up about the time she was going to bed, we saw each other only at dinnertime, when both of our teams—20 of us —ate together. Our midnight deadline dominated all the dinner conversation. Sayoko and I never really got around to catching up on our personal lives. LIFE CHANGES Midway through the project, our online audience voted for my team to travel to Ogimi, a tiny fishing village, to interview a 104-year-old woman named Ushi Okushima. Sayoko and I had visited with her before when I had profiled her in my National Geographic article. She’d impressed us with her amazing vigor, saying she grew most of her food and hosted drinking parties for her friends. Since turning 100, she’d somehow become a media darling. It seemed like every major news organization in the world, including CNN, the Discovery Channel, and the BBC had come to see her. When Sayoko heard about our plans to visit Ushi again, she asked to come along. On the hour-long car ride to Ogimi, we had our first opportunity to really talk. We were sitting in the back seat as the vivid foliage of northern Okinawa zipped by. “You know Dan, Ushi really changed my life,” she began. “I’d been working in the center of Tokyo. I’d go from 7:30 in the morning until late at night, five to seven meetings a day, then dinner and karaoke until one or two in the morning. It was hard work, and I loved it. I did a good job. I made lots of money. But my life lacked something. I felt empty right here.” She brought her hand to her chest. “Dan, you remember,” she recalled, “when we met Ushi I first saw her big smile. You were a man from another country, but she talked to you like a friend. In Japan, we’re usually wary of strangers. Ushi immediately welcomed you. The atmosphere was like a big hug. You could tell that she made everyone happy around her—her family, her friends, and now even strangers. And even though she never even talked to me, I felt a big energy from her.” After our first meeting with Ushi, Sayoko said, she had gone into the street to drink some juice. “I was thinking, ‘This is something for me.’ For the rest of our trip in Okinawa, I thought of Ushi—the simplicity of her life, how she made people around her feel good, how she was not worried about getting something in the future or sad that she had missed something in the past. Gradually I was starting to think, ‘I want to be like her. That is my goal.’ “When I returned to Tokyo, I told my boss that I was quitting. My dream had always been related to business. But I realized that I was like a horse chasing a carrot. I realized that I wanted to be like Ushi. I thought, ‘How can I organize this?’ I called my boyfriend in Yaku Shima and told him I wanted to visit. I moved to Yaku Shima and learned to cook. A year later, we were married. “When my first child was on the way, my husband and I came back to Okinawa to meet Ushi again. I wanted her to bless my child. I don’t think she remembered me. But my baby was born healthy. Now I have two children, and they are my life. No one knows about my career in Tokyo.” By this point, we’d almost reached Ogimi on a road that ran parallel to the sea. “What have you done to be like Ushi?” I asked. “I’ve learned to make my own meals for the family,” Sayoko said. “I put love into my food. I care for my husband and my children, the husband comes home, and I have a good family. Also, I try to mentally check to make sure that I haven’t hurt anyone, that the people around me are okay. I take time each night to think about the people around me, and think about what I eat, and what is important to me. I also do this during dinner. I take time to reflect. I’m not chasing the carrot any more.” RETURN TO USHI By the time we arrived at Ushi’s house, it was mid-afternoon. She lived in a traditional Okinawan wooden house with a few rooms separated by sliding rice paper doors and tatami mats on the floor. We removed our shoes and stepped inside. Though it is customary to sit on the floor, Ushi sat queenlike and serene on a chair in the middle of the room. When I first met her, she’d been anonymous. Now she had become a celebrity—a sort of “Dalai Lama” of longevity. Wrapped in a blue kimono, she motioned for us to sit down. So like kindergartners around a teacher, we sat cross-legged at her feet. I noticed that Sayoko, however, barely entered the room. For some reason, she seemed reluctant to get too close to Ushi. By way of greeting, Ushi raised her arms above her head as if to show off her biceps and shouted, “Genki, genki, genki,” or “Vigor, vigor, vigor!” “What a treasure,” I thought. So many people fear getting older. But if they could see this vibrant woman, they’d look forward to it. I showed Ushi the photograph of her in National Geographic. I was beaming with pride that the story I’d written had made the cover. She looked at it blankly, put it down, and offered me a piece of candy. I interviewed Ushi again, asking about her garden, her friends, and how things had changed in the five years since we’d last visited with her. She’d cut back on gardening some, she said, but had taken a job bagging fruit at a nearby market. She still spent much of her day with her grandchildren and the three surviving women in her circle of friends she’d had since childhood. She still ate a dinner of mostly vegetables and drank a cup of mugwort sake before bed. That was her secret, she told me. “Work hard, drink mugwort sake before bed, and get a good night’s sleep.” As I spoke with Ushi, I caught Sayoko’s eye. She was sitting off to the side, watching my interview. “Sayoko,” I said, conscious of the fact that I was raising my voice inappropriately, but also figuring that Sayoko was too polite to approach Ushi without being beckoned. “Don’t you want to tell Ushi your story?” Sayoko hesitated but then came forward and knelt in front of Ushi. “Five years ago I came here, and you changed my life,” she said. “Because of you, I decided to quit my job and get married. I owe you a big debt of thanks.” Sayoko’s eyes welled up with tears as she spoke. Ushi looked bewildered. She didn’t remember their meeting. “Then I came back a few years later,” Sayoko continued. “You touched my belly when I was pregnant.” This recollection now sparked recognition. Ushi smiled and then grabbed Sayoko’s hands. Her thumb caressed Sayoko’s thumb. “You inspired me, and now I am very happy,” the younger woman said. “I had to come to thank you.” Speechless, but understanding, Ushi patted Sayoko’s hand. “I share my blessings with you,” she said. On the street outside Ushi’s house, I caught up with Sayoko, who looked dazed but serene. I asked her what she was thinking. She smiled. “I feel like something is a little bit closed,” she said in her own poetic Japanese-tinged English. “I feel complete.” CENTENARIAN WISDOM This book is about listening to people like Ushi who live in the world’s Blue Zones. The world’s healthiest, longest-lived people have many things to teach us about living longer, richer lives. If wisdom is the sum of knowledge plus experience, then these individuals possess more wisdom than anyone else. So we’ve packed this book with insights from centenarians about living life well. Their stories cover everything from child rearing to learning how to be likable, from getting rich to finding—and keeping —love in your life. From them, we can all learn how to create our own personal Blue Zones and start on the path to living longer, better lives. When it comes to the science of living longer, however, centenarians can no more tell us how they reached age 100 than a seven-foot man can tell us how he got to be so tall. They don’t know. Does Ushi’s nightly cup of sake infused with mugwort provide some healthful benefits? Perhaps, but it doesn’t begin to explain why she doesn’t have cancer or heart problems or why she possesses such vigor at age 104. The way to learn longevity secrets from people like Ushi is to find a place where there are many Ushis—to find a culture, a Blue Zone, where the proportion of healthy 90- or 100-year-olds to the overall population is unusually high. Then science can kick in. Scientific studies suggest that only about 25 percent of how long we live is dictated by genes, according to famous studies of Danish twins. The other 75 percent is determined by our lifestyles and the everyday choices we make. It follows that if we optimize our lifestyles, we can maximize our life expectancies within our biological limits. When we first set out to investigate the mysteries of human longevity, we teamed up with demographers and scientists at the National Institute on Aging to identify pockets around the world where people live the longest, healthiest lives. These are the places where people reach age 100 at rates significantly higher, and on average, live longer, healthier lives than Americans do. They also suffer a fraction of the rate of killer diseases that Americans do. We worked with some of the world’s top longevity experts to distill lifestyles into the characteristics that could help explain their extraordinary longevity. LONGEVITY LESSONS This book begins by tackling the realities of aging. What are the chances that you will actually reach 100? What promises do supplements, hormone therapies, or genetic intervention offer? What are some of the scientifically proven ways for you to increase your years of healthy life? In the following chapters, we’ll take you to the world’s confirmed longevity hot spots, the Blue Zones themselves: the Barbagia region of Sardinia in Italy, Okinawa in Japan, the community of Loma Linda in California, the Nicoya Peninsula in Costa Rica, and the Greek island of Ikaria. In each of these places we’ll encounter a different culture that has taken its own unique path to longevity. We’ll meet longevity all-stars like Ushi and the experts who study their lifestyles and cultures. We’ll show how history, genes, and time-honored traditions conspire to favor each population. We’ll tease out the lifestyle components and let science explain why they seem be adding good years to people’s lives. The final chapter boils it all down into nine lessons, a cross-cultural distillation of the world’s best practices in longevity. This, we believe, amounts to a de facto formula for longevity—the best, most credible information available for adding years to your life and life to your years. Of course this information will do you no good unless you put it into practice. So, leading behavior experts will also offer an action plan to put these longevity secrets to work in your own life. And here’s the good news: You don’t have to do it all. We present an à la carte menu of sorts. You can pick and choose the most appealing items, follow our advice for converting items from the longevity menu into everyday habits, and know that whatever you choose, chances are you’ll be adding months or years to your life. Encoded in the world’s Blue Zones are centuries—even millennia— of human experiences. I believe that it’s no coincidence that the way these people eat, interact with each other, shed stress, heal themselves, avoid disease, and view their world yields them more good years of life. Their cultures have evolved this wisdom over time. Just as nature selects for characteristics that favor the survival of a species, I believe that these cultures have passed on positive habits over time in a way that most favors the longevity of their members. To learn from them, we need only be open and ready to listen. Sayoko was ready to listen. Her brief time with Ushi led to a transition, helping her change from being a chronically stressed, marginally healthy professional to becoming a more serene, physically fit person living a life that matches her values. Maybe you’re ready to listen too. Who knows? It may change your life just as profoundly. The Truth About Living Longer The Truth About Living Longer You May Be Missing Out on Ten Good Years W HEN JUAN PONCE DE LEÓN LANDED ON the northeast coast of Florida on April 2, 1513, he was searching, it’s been said, for a Fountain of Youth—a fabled spring of water that could bestow everlasting life. Historians now know there was more to the story. The reason the Spanish explorer set out to investigate lands north of the Bahamas was probably because Spain had reinstated Christopher Columbus’s son Diego as military governor, effectively removing Ponce de León from the office. Nevertheless, the legend behind Ponce de León’s voyage stuck. The idea of discovering a magic source of long life still has so much appeal today, five centuries later, that charlatans and fools perpetuate the same boneheaded quest, whether it comes disguised as a pill, diet, or medical procedure. In an all-out effort to squash the charlatans forever, demographer S. Jay Olshansky of the University of Illinois at Chicago and more than 50 of the world’s top longevity experts issued a position statement in 2002 that was as blunt as they could fashion it. “Our language on this matter must be unambiguous,” they wrote. “There are no lifestyle changes, surgical procedures, vitamins, antioxidants, hormones, or techniques of genetic engineering available today that have been demonstrated to influence the processes of aging.” The brutal reality about aging is that it has only an accelerator pedal. We have yet to discover whether a brake exists for people. The name of the game is to keep from pushing the accelerator pedal so hard that we speed up the aging process. The average American, however, by living a fast and furious lifestyle, pushes that accelerator too hard and too much. This book is about discovering the world’s best practices in health and longevity and putting them to work in our lives. Most of us have more control over how long we live than we think. In fact, experts say that if we adopted the right lifestyle, we could add at least ten good years and suffer a fraction of the diseases that kill us prematurely. This could mean an extra quality decade of life! To identify the secrets of longevity, our team of demographers, medical scientists, and journalists went straight to the best sources. We traveled to the Blue Zones—five of the healthiest corners of the globe—where a remarkably high rate of the longest-living people manage to avoid many of the diseases that kill Americans. These are the places where people enjoy up to a 3 times better chance of reaching 100 than we do. In each of the Blue Zones, we used a survey developed in collaboration with the National Institute on Aging to identify the lifestyle components that help explain the area’s longevity—what the inhabitants choose to eat, how much physical activity they get, how they socialize, what traditional medicines they use, and so forth. We looked for the common denominators—the practices found in all five populations—and came up with what I consider to be a cross-cultural distillation of the best practices of health, a de facto formula for longevity. Herein lies the premise of The Blue Zones: If you can optimize your lifestyle, you may gain back an extra decade of good life you’d otherwise miss. What’s the best way to optimize your lifestyle? Emulate the practices we found in each one of the Blue Zones. LONGEVITY PIONEER In 1550, Italian Luigi Cornaro wrote one of the first longevity best sellers. His book, The Art of Living Long, said that life could be extend through practicing moderation. His book would be translated into French, English, Dutch, and German. Cornaro may have been on to something; sources differ on his exact age, but he lived well into his 90s and possibly beyond. FACTS ABOUT AGING When taken together, the Blue Zones yielded nine powerful lessons to achieve a longer, better life. But before we get into the details, I think it’s crucial to understand a few things about just how people age and establish some basic principles and definitions. How long can each of us expect to live? What really happens to our bodies when we age? Why can’t we just take a pill to extend our lives? How can we live longer? How can we live better? And why does changing our lifestyles add more good years? To answer these and other fundamental questions, I’ve asked some of the world’s experts to describe their latest research in everyday terms. Together these scientists represent the best thinking in biology, geriatrics, and the science of longevity. Steven N. Austad, Ph.D., studies the cellular and molecular mechanisms of aging at the University of Texas Health Center at San Antonio. A professor at the Sam and Ann Barshop Center for Longevity and Aging, he is the author of Why We Age: What Science Is Discovering About the Body’s Journey Through Life. Robert N. Butler, M.D., is President and CEO of the International Longevity Center-U.S.A., a policy and education research center in New York City. A professor of geriatrics and adult development at Mount Sinai Medical Center, he is the author of Why Survive? Being Old in America. Jack M. Guralnik, M.D., Ph.D., is chief of the laboratory of epidemiology, demography, and biometry at the National Institute on Aging in Bethesda, Maryland. Robert Kane, M.D., is director of the Center on Aging and the Minnesota Geriatric Education Center at the University of Minnesota in Minneapolis. He is a professor in the School of Public Health, where he holds an endowed chair in Long-term Care and Aging. Thomas T. Perls, M.D., M.P.H., is director of the New England Centenarian Study, an associate professor of medicine and geriatrics at the Boston University School of Medicine, and co-author of Living to 100: Lessons in Living to Your Maximum Potential at Any Age. I interviewed each of these experts separately, then sorted the best of their answers to each question. Here’s what they told me. WHAT EXACTLY IS AGING? Robert Kane: That is a very profound question. Number one, aging starts at birth. If you think about it, there is a constant development that occurs within all species. You can think of it as the balance between the individual and the environment. In essence, we can think of aging as a loss of coping mechanism, a failure to be able to maintain internal control and balance. We start out as children, and we gradually accrue various changes in our characteristics. Children are susceptible to the environment and must be protected. In the case of humans, we probably peak in our mid-20s. We hold our own for a while, then at some point, perhaps in our mid-40s, we start to decline. Some people would say we actually begin to decline at age 30. It depends on the system that you track. The skin is often where we first notice the outward signs of the aging process. (illustration credit 1.1) Old age is another period when the balance favors the environment; older people need help in protecting themselves. The frailty we associate with old age is basically the loss of autonomy, the inability to withstand external pressures and perturbations. Aging includes both the positive and negative changes that occur. A gerontologist would define aging as the risk of dying. Irrespective of the presence of disease, there is, given this finiteness of a life span, a continuous risk of dying. In most cases this increases as our age increases. Other factors can change your risk of dying as well as aging, so it’s not that aging alone is the determiner, but it is the overarching change. People have been searching for biological markers of aging, and so far nobody has found any that are absolutely constant and separate from the onset of diseases. People look at, for example, the loss of accommodation in the lens of the eye. Most people become farsighted, usually in their early 40s. It doesn’t happen to everyone, so you can’t say it’s a universal sign of aging. Graying of hair, loss of collagen in the skin, all of these are changes that have been described with regard to aging. There’s a change in body composition as people get older. It can obviously be influenced by exercise and diet, but in general, we lose muscle mass and gain body fat. The immune system changes with age and becomes less competent, but again, not in any universal way that we can say is a characteristic of aging. Steven Austad: I would define aging as the gradual loss of physical capabilities, whether you’re talking about the ability to run, to think, all those things. It’s a gradual and progressive loss of physical and mental abilities, the ability to do things that you previously could do. What it means is that basically, you’re not designed to maintain your physical integrity forever. Robert Kane: There are several theories about aging. One is that there are genes in your system that turn on and turn off, either to ameliorate or to expedite aging. Another theory is the “GarbageDump Syndrome,” which theorizes that you accumulate toxins as you go along and things happen. But again, the question you have to ask is why does the body accumulate toxins? Well, you probably accumulate toxins because some of the intracellular mechanisms that were working at one point have stopped working. So are the toxins really a sign of aging or merely a concomitant of some other biological process that has changed, presumably driven by some genetic clock that exists inside the body? We honestly just don’t know. PEARLY WHITES A vital part of your digestive system, a bright smile can last a lifetime. Healthy teeth allow us to eat the wide variety of foods found in a balanced diet, but cavities, ill-fitting dentures, and other oral problems can make chewing painful and may sometimes even lead to eating disorders. Be sure to make regular dental visits and brushing and flossing a priority to keep your smile healthy. WHAT IS THE AVERAGE AMERICAN LIFESPAN? Robert Kane: I would imagine that a 30-year-old person today has a reasonable chance of living—depending on whether a man or a woman—to his or her late 70s or early 80s. If you took away major risk factors such as heart disease, cancer, and stroke, you would be adding, I would guess, maybe 5 to 10 years to that initial life expectancy. Tom Perls: For most of us, our bodies are like cars built to go 100,000 miles. A few cars can go 150,000 or more miles with the right genetic makeup. But they do deteriorate over time, even with the best upkeep. With that deterioration comes frailty. When you hit a bump in the road, you are less capable of bouncing back. There comes a point, with continued decline, where there’s no bounce back, and that’s when you pass away. WHAT ARE THE CHANCES OF LIVING TO 100? Jack Guralnik: Well, they are small of course, probably less than one percent. Again, figuring it out depends on what age you currently are. If you’re talking about someone at birth, it’s a different estimation than for someone who’s already made it to 80. Also, if you want to consider health status, that plays a large role. Most people who make it to be centenarians when you look back, they were quite healthy at 80. Tom Perls: I used to equate living to 100 to picking all five numbers in the lottery: The odds are pretty small. If you have longevity running in your family paired with good health behaviors, your chances are greater. Centenarians today are the fastest growing segment of our population, partly because we’re doing a better job of screening for high blood pressure. That’s one important lottery ball that we don’t need to leave to chance. Now instead of five numbers, it’s down to four. Another one that we’ve pretty much gotten rid of is substantial childhood mortality. With much better public health measures like cleaner water supplies, more years of education, improved socialeconomic status, these things are all reducing the number of lottery balls. The best way to think about reaching 100 is: “The older you get, the healthier you’ve been.” Ponce de León’s legendary search for the Fountain of Youth is one of the many tales that illustrate the desire to overcome aging. (illustration credit 1.2) Steven Austad: The question is—and here’s where I think the best health practices are really important—if you live to be 100 years old, what sort of 100-year-old are you going to be? Are you going to be bedridden and unable to take care of yourself? Or are you going to be reasonably independent and alert? To me, that’s what the best health practices can really have an impact on. IS THERE A PILL THAT CAN EXTEND LIFE? Robert Kane: There are a lot of nostrums out there. None of them has credibility. None of them has been even close to rigorously tested, everything from human growth hormone to antioxidants. Every time anyone has studied them with any degree of rigor, they do not pan out. That does not mean that some new discovery may not be just over the horizon, but at the moment that is probably not the path. Just think about it: If antioxidants were so healthful, the whole generation that grew up eating Twinkies, Wonder Bread, and the like (the kinds of foods that are loaded with antioxidants to assure that they had a long shelf life and would never spoil) should never grow old. LEADING KILLERS • Heart Disease: For both U.S. men and women, the leading cause of death • Cancer: The second largest killer of American men and women • Prevention: The Centers for Disease Control and Prevention advocates practicing a healthy lifestyle and regular medical checkups and screenings Robert Butler: DHEA, human growth hormone, and melatonin are all extremely questionable, and are probably ill-advised. Using human growth hormone in human beings bulks them up. But it does not just mean more muscle mass. With it can come hypertrophy of the heart, fluid retention, and other problems. And of course there’s a disease, acromegaly, which is actually characterized by an excess of human growth hormone. DHEA is what’s for years been called the “junk hormone.” In large quantities in our bodies, it converts to both testosterone and estrogen. Most of the studies on almost all of these hormones have been very short-lived, that is, six months to a year. So the long-term effects are not well known. The best source of information on hormones is Marc Blackman at the Washington, D.C., Veterans Affairs Medical Center, or Mitchell Harman at the Kronos Longevity Research Institute in Phoenix, Arizona. They’ve done the most sophisticated studies and probably the best ones we presently have on the hormone story. ARE VITAMIN SUPPLEMENTS HELPFUL? Robert Butler: Of course you should maintain your basic daily vitamin requirements. But you shouldn’t get carried away either. Vitamin E was under study by the National Institute on Aging in the hopes that it would prove to be very valuable with Alzheimer’s disease. But it was not. So I think, like so many things in nature, it’s a matter of amount, what might be called proportionality, or just plain wisdom. People used to think if a multivitamin was good for them, then more of it would be even better, but that’s just not true, unfortunately. Most vitamin requirements are best achieved by eating six to nine servings of fruits and vegetables a day. Very few people do that, so probably the cheapest, least expensive multivitamin you can buy is not a bad idea to help achieve them. If you’re an older man, you should not have a supplement with iron because iron accumulates in the heart and can lead to a condition called hemosiderosis. Look on the market for vitamin supplements that do not have iron that are designed specifically for men. WHAT’S A SMART DIET FOR LONGEVITY? Robert Kane: Eating a reasonable diet makes a lot of sense. Again, it doesn’t mean that I think you have to be a vegetarian. One of the goals to a healthy lifestyle is moderation in all things. What one is looking for is moderation, taking in a level of calories that is necessary and balancing those calories across carbohydrates, fats, and proteins. Taking in really what you need. There are some things we know that are just generally bad. Most fast foods are not necessarily healthy. We seem to like a lot of the things that are bad for us: salt, sugar, fat. There is something about humans that is inherently selfdestructive, at least when it comes to eating. The best diet is basically one of moderation. You hear about all these people that live on legumes and plant foods and that’s probably okay, but I don’t think it’s necessary. One certainly can metabolize a certain amount of meat, but again it’s a question of are you eating European portions or American portions? Are you eating meat a couple of times a week, or are you eating it every day for two meals a day? Are you eating processed meats that are filled with fat? Or are you eating good cuts of fairly lean meat? To me, I just come back to moderation. Assuming that you were in pretty good shape in your 20s, if you could maintain that weight, you would be in good shape. The truth is at 20, you could for all sorts of reasons eat all sorts of terrible things and maintain that weight, because you were more physically active, because your system was just more resilient. As you get older, you lose that resilience. So you are more susceptible to lifestyle behaviors that can do you harm than you were when you were younger. WHAT CAN ADD ON MORE GOOD YEARS? Robert Kane: Rather than exercising for the sake of exercising, try to make changes to your lifestyle. Ride a bicycle instead of driving. Walk to the store instead of driving. Use the stairs instead of the elevator. Build that into your lifestyle. The chances are that you will sustain that behavior for a much longer time. And the name of the game here is sustaining. These things that we try—usually after some cataclysmic event has occurred, and we now want to ward off what seems to be the more perceptible threat of dying—don’t hold up over the long haul. We find all sorts of reasons not to do it. The second thing I’d tell you is don’t take up smoking. The biggest threat to improving our lifestyles has been cigarette smoking. That trumps everything else. Once you’re a nonsmoker, I would try to get you to learn to develop a moderate lifestyle in regard to your weight to build into your daily routine enough exercise to keep you going. DOES GOING TO THE GYM HELP? Robert Kane: Exercise has several quite distinct functions. You have cardiovascular exercise, which we describe as aerobic exercise, which increases your body’s capacity to process oxygen. That’s where you go out and work really hard and raise your heart rate. Swimming would be a good way to get that kind of exercise. There’s also antigravity exercise. For example, if you’re trying to prevent osteoporosis, swimming isn’t the optimal activity, because it doesn’t increase the strength of your bones. There, working against gravity, walking, standing does more to increase bone metabolism than swimming does. Frank Shearer first put on water skis in 1939. At age 99, he still enjoys the activity. “I like the outdoors and the exercise,” he says. (illustration credit 1.3) Then there are exercises designed to improve your balance. Tai Chi is one people talk about, or yoga. Those are exercises that have been associated with reducing the risk of falls. Then there are strength exercises, which run all the way from weight lifters, who probably put themselves into a disadvantageous state from overdeveloping their muscles, to people who do some modest amount of weight lifting or antigravity exercise that strengthens their muscles. The data suggest that a moderate level of sustained exercise is quite helpful. There are studies that show that people who run marathons tend to have much better cardiovascular systems than people who don’t. You could say that that says more is better, but those exercises generally take a toll on your joints. So marathoners have good cardiovascular systems, but they will probably have to have their joints replaced. But in general, if somebody could do a minimum of 30 minutes—maybe we could raise it to 60—of exercise at least five times a week that would help. And it doesn’t appear to have to be all at one time, although that seems to be better. If you did that and you could sustain it, that would be good. HOW CAN WE MAXIMIZE THE GOOD YEARS? Robert Kane: Again, there are two issues here. How long can I live? The other is: How well can I live? And those are different questions. Living an extra two years on life support may not necessarily be your goal. The question is: Can you delay the onset of disability? “Good years” is a very important concept. There are some things I’d certainly recommend for what people would call successful aging. One of them is, in fact, to have a sense of social connectedness. Most people enjoy the company of other people, particularly other people who they feel care about them. That seems to give you a sense of well-being, whether that raises your endorphin level or lowers your cortisol level. We don’t know why. People have looked for biological markers, and they haven’t been successful at finding them. But something happens that makes life more worthwhile. The days take on more meaning. SMOKING & SKIN The most preventable causes of death and disease in the U.S.A. are caused by smoking tobacco. In addition to the damage done to internal organs, smoking also prematurely ages the skin and makes people look older. Recent studies have shown that a smoker’s skin bears more wrinkles and other signs of premature aging. The causes are still under investigation. The other thing that helps a lot of people is doing something they feel is either interesting or worthwhile. Again, different people have different things they like to do. For instance, people talk about workaholics as being at higher risk for stress-related illness. But there is no evidence that workaholics are necessarily at higher risk if they really are enjoying what they’re doing. If they are driven by some externality and feel like they have to earn more money, it creates stress in their lives, which is probably not very healthy. So it’s very individual when it comes to what people want to do. For example, you can’t just say family support is good, because some family support is good for some people, and some isn’t for others. There are people who derive great satisfaction from being with their families. And then there are those who become very anxious and upset when they are with their families. It is a complex model, which is also very interactive. But if we’re talking about things that give you a sense of fulfillment, a good life, the sense of being valued, the sense of being cared for, and the sense that you are liked—these are all very positive. Tom Perls: A good start to adding more good years to your life would be to get rid of the anti-aging quackery. Some people provide this very pernicious, ugly view of old people that’s completely false in order to get you worried about getting older. They say they can stop—and even reverse—aging, claims which are absolutely false. You’ve got a bunch of people who are professing to be physicians or scientists, who are saying that they can stop or reverse the aging process. I will tell you that real scientists cannot do such a thing, so what makes the public think that these people can? It is mostly hucksterism and charlatanism. They will cost you a lot of money, and these things do not work and, in some instances, can be bad for you. So stay away from it. These guys are just trying to sell you stuff. What does work is living the lifestyle of those who we know are living longer, like those people, I suppose, living in the Blue Zones. INTO THE BLUE ZONES Which brings us back to the Blue Zones project. Over the course of seven years, my team circled the globe, making several trips to each of the four Blue Zones and meeting the remarkable people who lived there. In each place we confirmed that people were as old as they said they were, interviewed dozens of centenarians, worked with local medical experts, and methodically studied each of the local lifestyles, habits, and practices. Each Blue Zone revealed its own recipe for longevity, but, as we were to discover, many of the fundamental ingredients were the same. These common ingredients, our nine lessons of living longer, are deeply embedded in the cultures we studied. I suppose you could say that our quest was for a true fountain of youth, though this fountain does not spring from the ground but comes to us through centuries of trial and error. For us, it all began on a small island off the coast of Italy. The Sardinian Blue Zone The Sardinian Blue Zone Where Women Are Strong, Family Comes First, and Health Springs from the Rugged Hills I N OCTOBER 1999, A SLIGHT BESPECTACLED Italian doctor and medical statistician named Gianni Pes stepped to the podium at an international longevity conference in Montpellier, France, and presented an astonishing paper. For the previous five years, he reported, he’d traced the history of 1,000 Sardinian centenarians, personally examining about 200 of them. During the course of his research, he’d noticed a curious concentration of male centenarians in the mountainous Barbagia region, a kidney-shaped area in the administrative district of Ogliastra. The population there appeared to be the longest-lived in Italy, perhaps even in the world. In one village of 2,500 people, he said, he’d found seven centenarians—a staggering number, given that the ratio for centenarians in the U.S. is roughly one per 5,000. “All of the demographers attending the meeting were skeptical,” Pes recalls. They remembered all too well the longevity claims made decades ago about populations in Georgia in the Soviet Union, in Pakistan’s Hunza Valley, and in Ecuador’s Vilcabamba Valley, which had all turned out to be overstated and based on faulty data. “I had a hard time convincing them,” he recalled. Among those in attendance was Dr. Michel Poulain, a Belgian demographer who’d dedicated much of the past 15 years to studying pockets of long-lived peoples around the world. Among other things, he’d helped devise a widely accepted technique for verifying ages, which he’d used successfully throughout Europe and parts of Asia. RECORD SETTER Born on February 21, 1875, Jeanne Calment lived for a recordsetting 122 years, 164 days. Calment, a Frenchwoman, stayed mentally and physically active for most of her life. She attributed her longevity to port wine, olive oil, and a sense of humor. “I did not believe it,” Poulain told me later. “The number of centenarians in Sardinia was too high to be true. I suspected misreporting. But someone nominated me to go check it out. As it was, I was traveling to Italy anyway, and so I said OK, I will have a look.” A REPUTATION FOR LONGEVITY By the time he arrived in Sardinia in January 2000, word had reached the village of Arzana about its growing reputation as a place with an unusually high number of centenarians. Residents in the village had organized a ceremony honoring four of them. “They invited me to participate, but I had no data,” Poulain said. “I could not publicly confirm that theirs was a long-lived village. I am a scientist, and with no data, no conclusion. “But a half hour before the ceremony, I stopped by the city hall and looked at the birth and death records, and right away I found some preliminary indications that these documents were very accurate. I began to believe Gianni’s findings, and so I participated in the ceremony and decided to go on with a large study to prove the exceptional male longevity in Sardinia.” Three months later, Poulain returned to Sardinia for the first of ten visits to check more records and interview centenarians. He visited 40 municipalities to establish something called the Extreme Longevity Index (ELI). This index considered birth and death records of all centenarians born between 1880 and 1900. Little by little, he realized that this region had a phenomenally high index. As he zeroed in on municipalities that had the greatest numbers of long-lived people, he circled the area on a map with blue ink—giving rise to the term “Blue Zone,” which was later adopted by demographers. Four years later, Poulain, Pes, and six colleagues published a paper in the journal Experimental Gerontology, in which they identified the Barbagia region as one that had some of the longest-lived people in Sardinia. The Blue Zone phenomenon primarily affected men, they reported. These men appeared to retain their vigor and vitality longer than men almost anywhere else. In most developed parts of the world, women centenarians outnumbered men four to one. Here, the ratio was one to one. Their study had shown that the geographic distribution of longevity in Sardinia was not homogeneous. In at least one geographic area, the Barbagia Blue Zone, the probability of becoming a centenarian was higher than in other parts of the island. This area of extreme longevity was located in a mountainous region that had been relatively isolated until recent times. “The specific mechanism by which persons living in this territory were more likely to reach extreme longevity remains unknown,” the researchers concluded. As a demographer, Poulain’s work was describing populations with data, not jumping to conclusions. Other than pointing out that other areas of extreme longevity existed in mountainous areas, his paper did not attempt to explain why the inhabitants of this Blue Zone were able to live so long. Unraveling this mystery would require a multidisciplinary approach to the history, diet, and lifestyle of local populations, he believed. Did people in this region experience stress? And if so, how did they shed it? Did religion play a role? Traditional medicines? Pure air? Something in the water? Did the Blue Zone hold any secrets that might help the rest of us live longer? BLUE ZONE’S BEGINNING In October 2004, National Geographic photographer David McLain and I landed in Sassari, a university town near Sardinia’s northwestern coast, to look more deeply into this Blue Zone’s mystery. Two young Italian journalists, Gianluca Colla and Marisa Montebella, went with us to help set up interviews, translate, and handle logistics. Our plan was to interview at least 20 centenarians who personified the Blue Zone culture of longevity. From these interviews we would distill cultural characteristics, then meet with local experts who could help explain why these characteristics might contribute to the extraordinary longevity on the island. Luckily for us, a Stanford University–trained evolutionary anthropologist named Dr. Paolo Francalacci—“Please, call me Paolo”—was teaching genetics at Sassari University. Cutting the image of a dashing young professor in his sporting blue jeans, tweed jacket, shirt open wide at the collar, and longish brown hair the day I met him, he led me through the narrow cobblestone streets of the town of Alghero, past a large piazza with a fountain and outdoor cafés, to a dimly lit 400-year-old bar. We sat on benches at a corner table and ordered a couple of beers. A man of incandescent intelligence, Francalacci was one of those rare academics able to explain complex concepts in simple, compelling terms, often delivered with an auctioneer’s exuberance and wild gesticulations. He had first become interested in human evolution as a biology student at the University of Pisa, he said. That interest led him to join the laboratory of renowned geneticist Luigi Luca Cavalli-Sforza at Stanford, where he studied human populations by looking at their genes. His specialty was analyzing mitochondrial DNA to identify the origins of peoples—dead or alive. He had examined mummies found in China’s Taklimakan Desert and revealed that they were of IndoEuropean origins, a discovery that had brought him fame. “We have 46 chromosomes, half from our mother and half from our father,” he explained, hands flying about like those of an orchestra conductor. “That means that for each gene we receive two copies, one from each parent, and these two copies interact. This is not true for two small pieces of our DNA: the Y chromosome, inherited from male to male (the females do not have it), and the mitochondrial DNA, inherited from female to female (the males do have it, but they cannot pass it to their offspring). This peculiarity makes it much easier to trace back the history of a population through the female (in the case of mitochondrial DNA) or male (Y chromosome) to its founding ancestors. Using DNA, we’ve traced every human being on Earth back to founding female lineages.” Francalacci had used this technique on Sardinians to trace their origins back roughly 14,000 years, he said. At that time, the world was warming after an ice age. As the snows retreated, a small band of genetically related people in Iberia began a journey out of the Pyrenees Mountains to the Mediterranean Sea. They followed the coast eastward, through what is today the French Riviera and Tuscany, and across the sea to Corsica, where they stayed briefly. Finally they settled in Sardinia’s coastal foothills. “Eighteen thousand years ago, during the period called the Glacial Maximum, humans could survive in Europe only in two refuges, one in Iberia and one in the Balkans,” he said. With the retreating of the glaciers and warming of the climate, people started to repopulate Europe. They moved westward from the Balkans and eastward from the Iberian Peninsula. Sardinia was populated almost exclusively by the Iberian wave—people with the M26 lineage of Y chromosome. Photographed almost a century ago, this child and three Sardinian women dressed in traditional garb gather outside a doorway in 1913. (illustration credit 2.1) “This M26 genetic marker is found in 35 percent of the Sardinians today, and is very rare elsewhere,” Francalacci said. Given the genetic purity of people in this Blue Zone, he theorized that the first Sardinians did not intermarry much with other Mediterranean peoples. They probably survived by hunting, gathering, and fishing. Agriculture came to Sardinia about 6,000 to 7,000 years ago with a Neolithic people from the Levant, where agriculture had been developed at least 3,000 years earlier. “Our Y-chromosome data suggests that contact with these people from the Levant was mainly cultural rather than genetic,” Francalacci said. For that reason, the people of Sardinia remain genetically distinct from the rest of Europe. Some of their unique traits are negative, such as higher incidences of type 1 diabetes and multiple sclerosis. But others are positive, such as resistance to malaria and high longevity rates, especially among males. When we finished our beers, I needed a break. Interviewing Francalacci was a bit like witnessing a verbal volcano; I hadn’t had to prompt him at all. He invited me back to the small rooftop apartment he shared with his lovely Greek wife, Christina. The view from their kitchen window looked out across a jumbled plateau of red clay shingles to the sea. Francalacci popped a disk of Barbagia folk music in his player and the apartment filled with the nomadic, faraway sounds of Sardinia’s highlands—shepherds’ voices harmonizing to the multi-pipe instrument called launeddas. The musician plays it by producing a constant airflow by inhaling through his nose and exhaling out his mouth. Francalacci opened a bottle of Sardinian Cannonau red wine, and his animated conversation resumed. During the middle Bronze Age, a tribal culture called the Nuraghic civilization (in a sense, the root culture of the Sardinian Blue Zone) began in Sardinia, he said. The Nuraghi people are named after the stone towers found all over the island. By the time of Christ, other civilizations had also discovered Sardinia’s riches and charms, and for most of its early history the island was knocked around like a rugby ball—invaded, conquered, and exploited by outsiders. The Phoenicians and Romans arrived with their superior military might, taking over the coasts and lowlands of the south. Native Sardinians, who had lived throughout the island, escaped to the hilly central area. By most accounts, the invading barbarians were nomadic and largely interested in tending their flocks. The etymology and meaning of the word Barbagia derives from the Latin name “Barbaria,” land of the Barbarians. Latins called a foreigner barbarus, from the ancient Greek word barbaros, which supposedly mimics the sound of someone trying to speak Greek. They had no interest in the arduous tasks associated with agriculture, although they possibly learned rudiments of farming from the Romans. “Even if ancient Sardinians knew of farming techniques, it didn’t take,” Francalacci said. “They carried on largely as huntergatherers and later as shepherds.” Perhaps that’s why Sardinians developed an intense wariness and disdain for visitors. Newcomers had always meant subjugation, exploitation, and taxes. So they turned inward, developing an intense dedication to their families and community and earning a reputation for toughness. One Barbagia proverb said it all about foreigners: Furat chie benit dae su mare (He who comes from the sea is here to steal). SARDINIA FACTS • Nation: Italy • Location: Island located 120 miles west of mainland Italy • Sardinia Population: 1.6 million people As the centuries, passed on the island, the isolated native Sardinians evolved in their own unique environment. Many villages even retained their pre-Roman names. “In this region,” says Francalacci, “the names of the Sardinian villages such as Ollolai, Illorai, Irgoli, Ittiri, Orune, to name a few, sound very exotic to a continental Italian ear like mine.” The region north of Alghero is called Nurra, which some linguists think comes from nur, meaning “heap of stones” in the Nuraghian language. It is also a good description of the nuraghi, the Bronze Age towers found all over Sardinia. The original Sardinians, in fact, did not keep their ancient Nuraghic languages. The Romans had subjugated them long enough that by the time they escaped to the mountains they had adopted Latin, which has survived the centuries remarkably intact. In the Sardinian dialect spoken in the Blue Zone, for example, the word for house is still the Latin word domus. Their pronunciation more closely resembles Latin too. The English word sky is cielo in Italian but it is kelu in Sardinian, preserving the hard K sound as it was pronounced in the original Latin caelum (ka-AY-lum). The same goes for sentence structure. A modern-day Italian says io bevo vino (I drink wine) but Sardinians would say it as an ancient Roman would have, io vino bevo (I wine drink). What does this have to do with longevity? “It suggests that the Sardinians’ lifestyle in the Blue Zone hasn’t changed much since the time of Christ,” Francalacci said. “The laws of evolution dictate that a species will not evolve in a comfortable, isolated environment where reproduction is easy. By contrast, a species will evolve quickly in a tough environment where individuals of different backgrounds and conditions interact. Similarly, in a place like the Sardinian Blue Zone, there is less pressure to adapt. The people there maintained not only their genetic features, but also their economic isolation and traditional social values, such as the respect for elders as a source of experience, the importance of the family clan, and the presence of unwritten laws—all of which proved to be effective means for avoiding foreign domination over the centuries.” In other words, the self-imposed isolation of Sardinia created a genetic incubator of sorts, amplifying certain traits and subduing others. Some preliminary genetic studies, for example, seem to show that the red blood cells of an unusually high proportion of Blue Zone centenarians are smaller than normal, providing both a resistance to malaria and a lesser chance of dangerous blood clots. But genetic and cultural isolation go hand in hand, Francalacci said, putting down his wine glass and clasping his hands. “When you put the two together you get a very interesting result.” Francalacci and I stayed up well past midnight that night and continued our conversation later via e-mail. Before 1950, I learned, Sardinia had looked more like a backwater than a centenarian’s Shangri-la. Poor hygiene, poor water quality, and a scarcity of water led to rampant infectious diseases. Dysentery, plague, tuberculosis, malaria, and diarrhea killed many young Sardinians. As English traveler William Henry Smyth wrote in his 1828 Sketch of the Present State of the Island of Sardinia, “it is surprising that with such inconvenient residences, and uncleanly habits, the natives should remain so generally healthy as they do.” IS IT IN THE GENES? When D. H. Lawrence traveled across Sardinia in 1921 in search of a lifestyle of simplicity, he found a Barbagia suited to his imagination. “Here, since endless centuries man has tamed the impossible mountainside into terraces, he has quarried the rock, he has fed his sheep among the thin woods, he has cut his boughs and burnt his charcoal, he has been half domesticated even among the wild fastnesses. This is what is so attractive … Life is so primitive, so pagan, so strangely heathen and half-savage.” Prosperity came to Sardinia after the late 1940s. The Rockefeller Foundation financed an effort that wiped out malaria, and a postwar economic boom in Italy brought jobs and paved roads to Barbagia. Along with them came vaccinations, antibiotics, and modernized health care. Only now could the Sardinian Blue Zone’s combination of genes and lifestyle work its real magic on the population. Before we left Sassari, photographer David McLain and I picked up a few more useful bits of information. Dr. Luca Deiana, a local politician who headed the Akea study, one of the first investigations of Sardinian centenarians (akea is a Sardinian greeting that means roughly “may you live to be 100”) pointed us in the direction of the G6PD gene. A defect on the gene is connected to favism, a disease triggered by consuming fava beans. We know the G6PD gene also protects some Sardinians from malaria, said geneticist Dr. Antonio Cao, who was himself a poster boy of healthy aging at 78. Diet probably plays an important role, he added. “Barbagia is not like the rest of the Mediterranean. They don’t eat a Mediterranean diet.” Dr. Gianni Pes, the scientist who first delivered the Blue Zone data to demographers, also told us that environment and lifestyle might be more important factors than genetics to explain the longevity of Sardinians. “Consider, for instance, the genes of inflammation. We expected to find something interesting in Sardinian DNA. We studied several tens of gene variants related to inflammation but we didn’t find any evidence of their role in survival of Sardinians. The same for genes related to cancer, and those related to cardiovascular disease. I suspect that the characteristics of the environment, the lifestyle, and the food are by far more important for a healthy life.” Armed with these insights and a backpack full of academic papers, David, Gianluca, Marisa, and I finally left the coast for Sardinia’s Blue Zone. As we drove into the island’s central highlands, we entered quite another world. The road snaked upward through increasingly rocky terrain that showed little evidence of human impact. Indeed, Sardinia consisted almost entirely of mountainous terrain as it rose toward the massive Gennargentu range to the east. Except for patches of hardwood forests where blackthorn, yew, oak, and ash trees grew, and the occasional vineyard, we saw only rough pastureland. “My tongue still works perfectly,” says Raffaella Monne, 107. “I can talk a lot.” (illustration credit 2.2) I recalled the many warnings we’d seen or heard about Barbagia. “You might think twice about wandering around many of the desolate villages of the interior, especially in Nuoro province,” wrote the author of one guidebook. Our friend Franco Diaz from Cagliari, Sardinia’s largest city, confirmed our initial impression of Barbagia as a difficult place where people eke out a living from a rugged land by raising sheep and goats. The residents there have a reputation for kidnapping, stealing, and settling scores at the end of very long knives, he said. “A vendetta can last generations. A son of one family might get shot today for something his father did decades ago.” Franco’s daughter agreed. “If a boy catches you looking at his girl, expect to be confronted,” she warned. “And remember, everyone in Barbagia has a knife in his pocket.” DUELING CENTENARIANS As we drove into the village of Arzana on a drizzly October day, we saw smoke curling out of chimneys into the lingering mist. Villages at the heart of Sardinia’s Blue Zone—Fonni, Gavoi, Villagrande Strisaili, Talana, and Arzana—have evolved over the centuries from clusters of shepherd huts to modern communities of a few thousand residents. Most towns still possess a precarious charm, with ancient whitewashed houses cascading down cobblestone streets. The streets of Arzana seemed all but deserted. I could see why residents here might be physically fit. A trip to a friend’s house or the local market meant a workout more rigorous than a half hour on a StairMaster. But the ominous creep of modernization was easy to see. Cars and trucks were parked in front of most houses, satellite dishes faced out from rooftops, and pizza, hamburger, and ice cream shops dotted the main street. To unlock Sardinia’s longevity secrets, we needed to focus on Barbagia’s traditional lifestyle—the one that existed before prosperity arrived in the 1950s. Our plan was to track down as many as a dozen Blue Zone centenarians. Everybody in town knew them, we discovered, and people treated them like celebrities. On tavern walls, instead of posters of bikinied women or fast cars, you’d see calendars featuring the “Centenarian of the Month.” EQUAL EXERCISE Everyday hikes taken by Sardinian shepherds can burn up to 490 calories an hour; to get the equivalent, try 120 minutes of brisk walking (about 3.5 mph), 90 minutes of gardening, 2 hours of bowling, or 120 minutes of golfing (be sure to carry your bag). All we needed to do was ask a villager where the centenarians lived and a helpful finger would point out the house. We’d knock on the door, introduce ourselves, and invariably be invited in. During the first week, I met 17 centenarians—8 men and 9 women. Most centenarians, we discovered, spent their time somewhere between their bed and their favorite sitting chair. Their days were punctuated by meals with their families and perhaps a stroll to meet friends. As a rule, they had worked hard their whole lives as farmers or shepherds. Their lives unfolded with daily and seasonal routines. They raised families who were now caring for them. Their lives were extraordinarily ordinary—with one exception. In Silanus, a village of some 2,400 people on the slope of the Gennargentu Mountains whose origins date to Nuraghic prehistory, David and I met 102-year-old Giuseppe Mura. We stepped out of the hard, hot midday sun into the 19th-century whitewashed home Giuseppe shares with his 65-year-old daughter Maria and her family. Inside it was cool and pleasantly damp; it smelled vaguely of sausages and red wine. Giuseppe sat at the end of an ancient, wooden table, flanked by Maria and his son, Giovanni, who’d stopped by for a visit. Both father and son wore shepherd’s caps, wool suit coats, and black boots—the daily uniform of the Sardinian peasant. Muted afternoon sunlight sifted through finely embroidered, diaphanous curtains. Giuseppe’s eyes caught mine and he nodded agreeably. “These men are from America,” Maria shouted in her father’s ear. “They’d like to interview you for National Geographic magazine.” “What?” He shouted back. “They want to interview you for a magazine article. The National Geographic!” “Fine with me,” Giuseppe snapped. “But if they want money, tell them they can go to hell.” I blanched, but Maria and Giovanni burst out laughing. They understood their father’s biting sense of humor, which was, I’d soon learn, characteristically Sardinian. I had some questions that Drs. Paul Costa and Luigi Ferrucci from the National Institute on Aging had given me to pose to centenarians. They were nonleading questions, carefully crafted to tease out the lifestyle by eliciting a narrative. Instead of asking a man what he ate when he was a child, the question would inquire, “Can you think about things you do every day or have done most days of your life?” I posed my questions to Maria, who translated them for her father. I learned that Giuseppe had worked steadily his whole life, first as a farmer, and then as shepherd. He’d usually put in a plodding, 16-hour day tilling the earth or following his sheep into pasture. On most days he came home for lunch, took a nap, and then spent an hour or two in the late afternoon with his friends in the village square. He’d return to the fields until dark. He never much busied himself with raising his eight children. He left that and all other affairs of the house to his wife. Giuseppe’s diet consisted largely of fava beans, pecorino cheese, bread, and meat as he could afford it, which was rarely in the early days. Maria estimated that her father drank a liter of Sardinian wine every day of his adult life, and more during festivals, when he tended to be the life of the party. “Is there anything unusual about Giuseppe’s upbringing?” I asked. Giovanni paused and looked questioningly at Maria. “Yes, there is,” Giovanni answered. “Giuseppe was raised by a single mother. His father got his mother pregnant and then went off to war. When he returned, he took up with another woman and soon got her pregnant too, leaving my father’s mother to have her baby alone.” Giuseppe listened to the story staring down at his folded hands, head hanging down. I could tell that even though more than a century had passed, the story was a source of shame for the family. “Well, it looks like Giuseppe turned out all right,” I added hopefully. “Yes,” Giovanni replied. “But there’s more. One Sunday morning, when Giuseppe’s father was on his way to church with his new wife, Giuseppe’s mother intercepted him and shot him dead, murdered him right on the church steps. The police put her in jail, but everyone in the village knew that her honor had been violated. The police let her out after only four months.” What happened to the other woman and her child then? I was guessing that life was pretty difficult for a single mother in the village in the first few years of the 20th century. “That’s another story in our village’s lore,” Maria said, taking up the tale. “The other child, Giuseppe’s half brother, was named Raimondo Arca. Giuseppe did not even know he had a half brother until one day when he was 17 years old and was playing a Sardinian game with other boys in the village square. “It was a game of elimination,” she continued, “much like rock, paper, and scissors, but the Sardinian version often turns aggressive. Giuseppe and Raimondo found themselves in a final round of elimination when a dispute erupted and a fistfight ensued. “Raimondo was giving my father a licking when a passing villager who knew the story of their mothers broke them up saying, ‘Brothers shouldn’t fight.’ The secret was out, and once they learned it, they became friends and remained so ever since. In fact, Raimondo is still alive and lives right down the street. The whole village celebrated when the two of them turned 100 two years ago.” David and I looked at each other slack-jawed. In the United States only about one male in 20,000 reaches age 100. The chances that there would be two centenarians in the same family is astronomically unlikely, unless of course their father passed down an extraordinary set of genes to both of his sons. The interview continued another 90 minutes. Maria served us wine and cured ham, followed by cups of hot coffee. In the course of our conversation, we learned that Giuseppe had a special box where he kept his meager life savings and other important objects that he had collected through his long life. He wore the key to the box on a string around his neck, which he closely guarded. David, always on the lookout for a telling picture, envisioned a portrait of Giuseppe with his life’s treasures. He asked Maria if it were possible for Giuseppe to open up the box for us. “Papa,” Maria again shouted in her father’s ear. “These men want to see what’s in your box.” “What?” Giuseppe murmured back. “These men want to see what’s in your treasure box, where you keep your money,” she repeated, this time reaching for the key around his neck and holding it up for him to see. “You tell those Americans to go to hell,” he shrieked, slapping the key out of her hand. Spittle shot from his mouth and splattered on the table before me. “I show them what’s in my box, all right. Right up their nose!” Even though Maria and Giovanni once again laughed at their father’s outburst, we took this as our cue to leave. WINE, GOAT’S MILK, AND MASTIC OIL Though most centenarians we met were sharp enough to hold a conversation and answer questions, a majority of them were homebound and under the care of a daughter or granddaughter. What I learned directly from them was limited by their imperfect memories. I realized that if I wanted to get a sense of the authentic Sardinian lifestyle, I needed to spend time with someone younger who was still working and living in the traditional way. I suspected that clues to the extraordinary longevity in this Blue Zone were the kind I needed to observe rather than hear described in an interview. I figured if I could participate in a day in the life of a true Barbagian Sardinian I could observe nuances. FLAVONOIDS Sardinian red wine isn’t the only place to find flavonoids. Brightly colored fruits and vegetables and dark chocolate also contain them. Studies have shown that a diet high in flavonoids is associated with a reduced incidence of certain cancers and heart disease. As it happened, photographer David McLain had already met such a person. While I had been working my way through interviews in the eastern part of the Blue Zone, David had been canvassing the western part for situations to illustrate our story (National Geographic photographers and writers rarely travel together). He called me on the phone one afternoon to say he’d met a 75-year-old shepherd in the 3,000-year-old village of Silanus who still tended his own sheep, made his own wine, and lived in a traditional Sardinian home. His name was Tonino Tola, David said, “but I call him ‘The Giant.’ ” When I caught up with Tonino a week later, he was slaughtering a cow in the shed behind his house, his arms elbow-deep in the animal’s carcass. A strapping, barrel-chested man, he withdrew his fist from the steaming mess and then strongly gripped my hand, viselike, with a moist, bloodied handshake. “Good morning,” he boomed, then plunged his hands in again, this time to reel out several yards of glistening intestines. It was 9:45 a.m. on a cool November morning. Tonino had been up since 4 and had already pastured his sheep, cut wood, trimmed olive trees, fed his cows, and eviscerated this 18-month-old cow that was now hanging spread-eagle from the rafters. Members of his family surrounded him. Tonino’s son and three sons-in-law helped while his daughter cradled his five-month-old, wide-eyed grandson, Filippo, who regarded the scene with a cooing glee. With rolled-up sleeves and high-water pants, Tonino jumped from pulling cow’s intestines to tickling his grandson with equal exuberance. The men joked as they followed the age-old ritual of reducing the cow to meat for their family. The butchering was timed for late fall, when cooler temperatures minimize maggot-laying flies and make the meat easier to preserve. The cow would provide meat for two families for the season as well as for several friends who would receive gift packages of beef. Butchering cows within city limits was illegal, Tonino told me, but this giant of a man lived by a more traditional Sardinian code. What would happen if the police caught him, I asked. “We’ll pay a fine,” Tonino replied breathlessly, addressing a gaping cavity, the insides of which he was scraping with a menacing blade, “or give him a piece of meat.” Shepherd Tonino Tola, 75, has climbed the hills of Sardinia for his entire life. Regular physical activity is one reason why Sardinians live so long. (illustration credit 2.3) Later I was invited into his low-ceilinged kitchen for papassini—a Sardinian cookie made with raisins, almonds, and a jam made from cooked wine (saba). Inside, a small fire from a wood-burning stove heated the room. Tonino’s wife, Giovanna, a heavyset woman with quick, intelligent eyes, sat at the table. She offered us wine. (“No thank you” was not an option.) Tonino may have ruled the butcher shed, but Giovanna ruled the house. I posed questions to Tonino, and she answered them. “Tonino lives to work,” she told me, with her husky arms folded, “from early morning to late night. Look at him; he’s aching to get back to butchering the cow right now.” Sure enough, Tonino was drumming his fingers impatiently on the table; his eyebrows arched guiltily when his wife pointed at him. “Meanwhile, I take care of the house, the children, and the finances. I make sure we don’t run out of money,” she sighed. “He works, I worry.” I asked Tonino and Giovanna both about their past. They often finished each other’s sentences. Tonino had raised sheep since he was five years old. He and Giovanna married when they were in their early 20s, and they quickly had four children. When their family was young, in the 1950s, they were very poor. They ate what they produced on their land—mostly bread, cheese, and vegetables (zucchini, tomatoes, potatoes, eggplant, and most significantly, fava beans). Meat was at best a weekly affair, boiled on Sunday with pasta and roasted during festivals. They usually (Giovanna made the call) sold their animals to buy grain staples, from which they made their pastas and traditional breads—the flat, squarish pistoccu made with barley or bran flour and potatoes, and the famous lined, paper-thin carta da musica (also known as pane carasau) named for its resemblance to sheet music. Sheep and goat milk products contributed most of the protein. Their small vineyard grew Cannonau grapes for wine. Their diet was fairly typical of families in the region before the American-style food culture arrived, as surveys from before the 1940s revealed. “Shepherds and peasants in Sardinia have an exceptionally simple diet, which is extraordinarily lean even by Mediterranean standards,” a 1941 survey reported. “Bread is by far the main food. Peasants leave early in the morning to the fields with a kilogram of bread in their saddlebag … At noon their meal consists only of bread, with some cheese among wealthier families, while the majority of the workers are satisfied with an onion, a little fennel, or a bunch of ravanelli. At dinner, the reunited family eats a single meal consisting of a vegetable soup (minestrone) to which the richest add some pasta. In most areas, families ate meat only once a week, on Sunday. In 26 of 71 municipalities surveyed, meat is a luxury eaten only during festivals, not more than twice a month. Interestingly for a Mediterranean culture, fish did not figure prominently into the diet.” The report went on to say that shepherds drank wine daily. “In the fields, some peasants drink wine; most of them drink wine only at the evening meal, and no more than a quarter bottle.” The region’s Cannonau grapes endured the harsh Sardinian sun by producing more red pigment to protect from the ultraviolet rays. These grapes traditionally were allowed to macerate longer than in any other part of the island during winemaking. The result was a red wine with two to three times the level of artery-scrubbing flavonoids than other wines. Goat’s milk and mastic oil may be Sardinia’s other two longevity elixirs. Research at the University of Sassari is looking at the question of whether proteins and fatty acids in Sardinian goat milk may help protect people from the typical diseases of aging such as atherosclerosis and Alzheimer’s disease. Mastic oil (with its antibacterial and anti-mutagenic properties) was used in some parts of Sardinia in place of olive oil. Back at Tonino’s house, we washed down a dozen cookies with a few glasses of wine. After a sedentary hour, Tonino could take it no more and erupted out of his seat. Almost every day for the past 70 years, he had walked or ridden his donkey the 5-mile journey to tend his sheep on his family’s mountaintop pasture. But today, because he invited me, we would drive. The road snaked up several hundred feet through forests and around tight curves and many unprotected drop-offs that promised a quick death. In America such a road would be illegal—or at least labeled “dangerous.” Here it was business as usual. We stopped at a high plateau fenced in by an ancient rock wall where 200 sheep had gnawed vegetation down to nubs. At the highest point of the pasture, a teepee-shaped rock-and-stick structure called a pinnetta commanded a 360-degree view of the property. In this structure, the likes of which dated back to the Bronze Age, Tonino slept with his sheep most summer nights. At the moment, though, he was looking jaunty in his leather spats, shepherd’s cap, and riding coat as he strode through a narrow opening in a stonewall, counting his sheep as they followed him. When three sheep tried to squeeze through, they knocked over a section of the wall. With disquieting ease, Tonino hoisted the heavy rocks back into place. Then he leaned back on a rock outcropping and assumed the age-old role of sentinel, cutting a distinguished profile against the emerald green plains below. “Do you ever get bored?” I asked impulsively. Before the words left my mouth, I realized I’d uttered a heresy. Tonino swung around and pointed at me, dried blood still rimming his fingernail. “I’ve loved living here every day of my life,” he boomed. After a pause, he continued. “I love my animals and taking care of them. We don’t really need the cow that I butchered today. Half of the meat will go to my son, and most of the other half we’ll share with our neighbors. But without the animals and the work it takes to raise them, I would be sitting in my house doing nothing; I would have little purpose in life. When I think of them, I think of my children. I like it when my kids come home and they find something here that I have produced.” THE POWER OF LOVING? From everything I had seen in this Blue Zone, Tonino’s values were also those of the region’s population in general. People here possessed a reverence for family. Perhaps it had something to do with their historic isolation, surrounded as they were by hostile outsiders; they had to depend on one another. All the centenarians I met told me la famiglia was the most important thing in their lives—their purpose in life. In America, seniors tend to live apart from their children and grandchildren, often sent off to retirement homes when they become unable to care for themselves. But that rarely happened here. A combination of family duty, community pressure, and genuine affection for elders kept centenarians with their families until death. This gave people over 80 a huge advantage: They received immediate care when injured or ill, and perhaps most significantly, felt loved and a sense of belonging. A happy by-product was that grandparents stayed involved in children’s lives. Maria Angelica Sale and her family were a perfect example of this. I met Maria, called Nona by her family, in Gavoi, one of the island’s highest villages. She was sitting in her living room, a clean, welllighted place with embroidered tablecloths, colorful carpets, and a large window that looked out onto the street. Her 60-year-old daughter, Pietrina, served me coffee and translated my questions from Italian into Sardinian, the only language most of the centenarians speak. Maria had raised her four daughters, survived life under the Fascists, and worked alongside her husband from 4 a.m. to dusk. When her husband died, she moved in with her daughter at age 54. Then she helped raise her grandchildren, cooking food, cleaning house, and, until just two years ago, knitting their clothes. On the day of my visit, Maria seemed subdued. Mostly blind, deaf, and unable to walk by herself, she was confined to a chair. But she was lucid, serene, and exuded a certain feeling of satisfaction with her life. Her gray hair was pulled back in a bun, revealing the soft wrinkles in her face. Leaning forward slightly to hear my questions, she would then sit back and seem to savor the memories they sparked before answering with a smile. The whole time, Maria’s daughter held her mother’s hands, which lay folded in her lap. I asked Pietrina how her mother had managed to live so long, and she gave me a one-word answer: grandchildren. “It’s about loving and being loved,” she said. “Not only has Nona helped raise the children, but she has also always told them they must get educated. Sometimes she gives them money, and she always prays for them. In return the children have felt this love and have returned it. They know that Nona expects them to succeed, so they try harder.” Two years ago, when she was at age 100, Nona got very sick. “She was in bed for days,” said Pietrina. “I thought she was going to die, so I called the family. Everyone came—4 daughters and 13 grandchildren—many of whom traveled back from the mainland. On the day we thought she was going to die, everyone had gathered around the bed to say goodbye. We didn’t actually think she could hear us. But when my nephew, who was a failing student, leaned over to say how much he was going to miss her, Nona opened her eyes and said, ‘I’m not going anywhere until you’re done with the university.’ Nona got better and my nephew went back and graduated.” It would be hard to overestimate the importance of family in the Blue Zone. According to Dr. Luca Deiana, who has studied centenarians for more than a decade, some 95 percent of those who live to 100 in Barbagia do so because they have a daughter or granddaughter to care for them. Grandparents provide love, childcare, financial help, wisdom, expectations, and motivation to perpetuate traditions and push children to succeed. This may add up to healthier, better adjusted, and longer-lived children, and it seems to certainly give the population a healthy bump in longevity. “SARDONIC” IS RIGHT But what is it about men in the Sardinian Blue Zone? Statistically, their story is the most extraordinary. In the Blue Zone, 47 men and 44 women lived past their 100th birthdays in a population of 17,865 born between 1880 and 1900—a rate of centenarians that exceeds America’s by about a factor of 30. If the ratio of men to women among Sardinian centenarians was typical, the region should have produced only 10 male centenarians during the period. But it didn’t. So why are men so extraordinarily long-lived here and not women? Perhaps it has something to do with the different burdens they carry. The men were “quiet, and kind, and sensitive to the natural flow of life, and quite without airs,” D. H. Lawrence observed, while women had “dangerous and hard assurance as they strode along so blaring. I would not like to tackle one of them.” Sardinian men seem to possess a temperament that enables them to shed stress. They are at once grumpy and likable, and often joke at the expense of one another. (It’s probably no coincidence that the word sardonic has its roots on this island.) The things they have in common, according to physician Gianni Pes, are strong will, high selfesteem, and great stubbornness. “This is actually the national character of Sardinian men,” he says, “and may well explain their success in surviving in unfavorable circumstances.” In Talana, one of five whitewashed villages that hang along Barbagia’s coastal mountains like a string of pearls, Marisa and I met a 90-year-old shepherd named Sebastiano Murru. We had heard about his extraordinary vigor and had spent an afternoon searching for him. Early in the evening someone pointed him out to us standing at a bar with a half dozen friends, all much younger. He was wearing a shepherd’s cap, tweed blazer, and black work boots. Though short in stature, he had an erect posture and his sly smile gave him a commanding presence. “Are you Sebastiano Murru?” Marisa asked, approaching him tentatively. “I don’t know. I was too young to remember when they named me,” he replied matter-of-factly. Sebastiano’s friends all laughed. Then she asked how old he was. “Sixteen,” he responded, smirking. His friends erupted in laughter. We noticed an empty beer glass in front of him, and asked him if he drinks. “No, my doctor told me not to drink. Especially not milk.” He accepted a beer anyway and toasted my health. He was standing next to Marisa, who was 39 and attractive, so I returned the toast, recalling Groucho Marx: “May you always feel as young as the woman you’re with.” He looked at Marisa, examined her from head to toe and rejoined, “Do I look like a cradle robber?” HUMBLED BY A HUNDRED-YEAR-OLD At 103, Giovanni Sannai was good-natured, but lacked the edge. He lived alone in small house close to his son in the village of Orosei. He received us at his kitchen table, where he greeted us with open arms and a tumbler of wine—which he insisted we drink with him. It was 9:30 in the morning. Giovanni Sannai, 103, sits at the head of the table surrounded by his extended family. (illustration credit 2.4) With his husky frame and full head of graying hair, he projected the image of a man 30 years younger. He had an easy smile that made us feel sincerely welcome. I interviewed him for about two hours, during which time about a dozen neighbors stopped in to say hello. He greeted each of them with the same smile and tumbler of wine. Soon we had an audience. He had an inexplicable quality that made you want to be around him; he was interesting and interested and up for new experiences. At one point, after he told me how strong he used to be, I gamely challenged him to an arm wrestle. He accepted. His friends surrounded us. I figured I’d just let him win. After all, I was 60 years younger. I clasped his thick hand, fixed his gaze, and easily got the jump, taking his hand off-center. But it was a trick. He held my arm at about a 45-degree angle for several long moments until I tired and let up. Then he slammed my arm down on his side of the table. I couldn’t have won if I had wanted to. Everyone laughed. He confirmed many of the same things other centenarians had told me. He drank goat’s milk for breakfast, walked at least six miles a day, and loved to work. For most of his life, he woke early and spent his day in the pastures. In the winter months, from November to April, he would herd his sheep over 100 miles to grassier lowland pastures. He made these journeys on foot, sleeping in pinnettas at night and eating only carta da musica bread, pecorino cheese, wine, sheep’s milk, and the occasional roasted lamb—which they could obtain along the way. When I asked if he’d ever been stressed in his life, he looked flummoxed. I asked the question in a different way. “Sometimes, but my wife was in charge of the house, and I was in charge of the field,” he said. “What’s there to worry about in the field?” Then he added, “Mostly I’ve always trie…

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