Category: Lifestyle

Lifestyle Habits: “The Blue Zones”

Back in my Alameda 7 post, I made reference to “The Blue Zones,” which is a demographic study of areas of the world where people live measurably longer periods of time.The Blue Zones idea and suggested conclusions (more on that in a moment) were vaulted into the consciousness of health-minded folks largely due to Dr. Oz and an entire episode on Oprah outlining the 4 Blue Zones that had been discovered at that time (there are now 5).

I’ll give a brief rundown of the gist, outline these zones, list the found similarities in how these groups live, and offer some criticism as to the conclusions drawn.

 

Origins

The main thrust of the Blue Zones starts with a study, known as the Danish Twin Study. This study followed 2872 Danish Twins born between 1870 and 1900. After all of these pairs had died, statistical analysis was performed and determined that ~25% of the variance in longevity can be attributed to genetic factors. Later studies give a slightly larger range, from a high of one-third to a low of 15%. So if we’re pessimistic, only one-third of our longevity is related to genetic factors, thus the remaining 70% is due to lifestyle. This was the thrust of the Alameda 7 study: follow some simple habits and you’ll gain quality years of life.

The book is based on the work of Michel Poulain, who identified a mountainous region of Sardinia where men lived longer than women, but both live longer than the rest of Sardinia. Fun fact: it’s a “Blue Zone” because that’s the color they used to identify the region. Really, take a look:

After the statistical analysis was found to be accurate, that there was in fact a positive longevity outcome, the search for more of these places around the world began. Many Don Quixote-types claim that their area of the world has a positive outcome on longevity. My wife even spent a year in one of these places: Vilcabamba, Ecuador.  In her own words, “The guy who probably convinced the gringos that you lived forever there was my host father. He was a fantastic story teller.” I mean it’s a gorgeous place, but no longevity advantage has been found:

The Five Blue Zones

So after digging and intense statistic analysis, these 5 zones have been confirmed:

bluezonesmap

From these 5 spots, the authors attempted to “tease out” a de facto longevity formula, which is this:

Now I won’t spend time unpacking those, but I would suggest that they’re directionally accurate and very similar to what was found in the Alameda 7 study. If you were able to follow the above list regularly, then you’d likely be in a good place to maximize your longevity free of chronic diseases.

Criticism

I have some problems with the conclusions derived from the Blue Zones. Not enough to throw it out (it’s really a great piece of work) but to bring attention to things that I feel are worth reducing the importance of when compared to the authors of the book:

  1. The book goes on about all of the exercise of a decent intensity that these people are doing, but then concludes that if you “move naturally” you don’t need to exercise. They’re not talking Movnat-style exercise, but maintaining a high level of physical activity through gardening, walking, or “inconveniencing yourself.” This is great stuff, mind you, but the audience of the books needs to be considered. I learned in graduate school how if a researcher is not on top of a person, they’d count walking to the mailbox as “10 minutes of moderate intensity physical activity.” For Americans, I feel there needs to be some sort of intervention of activity to demonstrate meaning of “moderate physical activity” while also addressing the musculoskeletal imbalances these people have. It’s not like I’m talking out of my ass here: I’ve made a career of this because it’s so common. Eventually, when you’re in better shape, you want to move more, like you can’t sit still. This isn’t accounted for: the conclusion ignores the cause of why these people move so much, which is that they’re already healthy and fit. It’s the same reason all the fat people on the “Biggest Loser” are forced to move a ton. Correlation and causation are flipped.
  2. It’s also noted that all of these groups are isolated, which means that there is a significant “Founder Effect” to consider. That is when a population splinters off from a larger population, thus reducing genetic variation. While the Blue Zones demonstrate a founder effect that selects for a genetic maximization of these good habits (e.g. phenotypic expression), other founder effects lead to things like the incredibly high rate of deafness on Martha’s Vineyard, leading to things Martha’s Vineyard Sign Language. Remember that while genes play a relatively small part of longevity, these populations may have the most important reduced genetic variation to maximize the longevity effects of their lifestyles.
  3. It’s hard to prove a negative. In the New York Times article about the Ikarian blue zone, Gary Taubes asks this question: “Are they doing something positive, or is it the absence of something negative?” So while they are eating more vegetables than your average American, they’re also eating very little white flour and sugar compared to your average American. If it’s not there, you can’t see its effect. What is being contributed to veggies might actually be the lack of sugar and flour. It’s especially hard to compare the lifestyle effect; again these are isolated populations. Would the lifestyle-credited longevity benefits remain if sugar and flour were added?

I like this book. I have a dog-eared copy that I’m sure I’ll have to replace at some point because I read it so much. I’m on board with the lifestyle habits that maximize longevity but I like to remind people that, due to a variety of factors, these habits may simply be what maximizes longevity in these populations due to their genetic makeup. Take these habits on and you’ll significantly improve the quality of your life, just don’t expect to live to 110 because some of those in the Blue Zones have.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

 

 

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Habit Formation: The 21 Day Folklore

How long does it take to form a new habit? If you’re like most people, the answer you will say without thinking is “21 days.” This time frame is built into the zeitgeist of our culture, though I’m not sure where it comes from insofar as experimental evidence. Let’s explore this a bit and see where the science takes us.

Willpower is rocket fuel

Changing habits does require some amount of willpower, especially early in the process. In attempting to change habits, many of my clients lament their “lack of willpower” if they are unable to adopt a new habit in 3 or 4 minutes…that’s sarcasm folks, but it’s basically an extension of what I covered in this blog post about giving yourself time to adopt a new habit. However, there is a grain of truth in that so much of our daily habits are on autopilot, totally free of rational inputs beyond process initiation. While some of you will be set to argue this with me, imagine you had to rationally work out every step of the process to get out of bed, get showered, and get yourself to work every morning. The fact that you’re both A) still gainfully employed and B) not mentally exhausted by 8:30am tells me that the vast majority of this process was free of serious deliberation of the alternatives…once in motion you stayed in motion. This is because there things are your habits and, like Newton said, objects in motion tend to stay in motion. Yes he was talking physics but it’s not too far off the mark regarding how we work with habits.

So changing a habit requires new processes, which requires deviations from autopilot, which requires willpower. The thing about willpower is that it is a finite resource: you can very easily use it up. There’s even a cool name for it: ego depletion. Further, there aren’t different silos that have X amount of willpower for different types of tasks. There’s one big pool that you fish out of and then when it’s all gone for the day, you’re more likely to throw caution to the wind with any tempting thing that crosses your path. Hence willpower is great for getting things started, rocket fuel, but it is not to be relied upon for maintenance of long term habits.

Twenty-one Days is a Myth

So if we’re going to gain a new habit, willpower will be used early on until the habit becomes a more integrated part of our routine, where less and less willpower are required to put things in motion, which at that point can be considered a habit. So how long does a habit take to form? As noted above, there is a cultural idea that a habit takes 21 days to form with daily practice. However, the research available doesn’t support that conclusion as absolute. Rather, the complexity of the habit desired determines the length of time to integrate said habit into your daily routine. From a recent study on habits, we have some clues as to what defines complex habits and their integration. The study had 96 individuals take on various habits and log their progress into an internet tracking site. They also tracked out automatic the behavior felt, known as “automaticity.”

So how long did it take? On average, across the participants who provided enough data, it took 66 days until a habit was formed. The complexity (or perceived complexity) determined how long a habit would take to be acquired. People who resolved to drink a glass of water after breakfast were up to maximum automaticity after about 20 days, while those trying to eat a piece of fruit with lunch took at least twice as long to turn it into a habit. And relevant to you, dear readers, the exercise habit proved very tricky. The study provided a “50 sit-ups after morning coffee,” habit, which still was not a habit after 84 days for one participant. However, something simpler like “Walking for 10 minutes after breakfast”  turned into a habit after 50 days for another participant. I’d suggest this is because we are built to walk as human beings, but doing situps is not a requirement for daily living.

Break the Habit Down

So you can see, depending on the complexity of the habit, it can be 12 weeks or more before the habit has stuck. So how do we go from where we are to where we want to be? Like eating a 30 ounce porterhouse, we do this one bite at a time:

  1. Determine the outcome you’d like to achieve and the main habit you’d need to achieve said outcome.
  2. Break the habit down into parts. There parts need to be specific.
  3. Focus on the simplest part of the habit until you have achieved automaticity before moving onto the next part.

So instead of one big habit, you have many small habits. So while the overall habit might take a long time, the feedback of integrating smaller habits creates a foundation to build on toward larger habits. An example would be instead of “I’m going to stop eating all junkfood and eat more vegetables” as a habit, you’d break that down into a few separate habits that are specific and actionable like “I’m going to eat 3 servings of leafy greens each day,” or, “I’m going to limit myself to one snack per day at 3pm in the afternoon.” From there, determine which seems least difficult to accomplish and do only that habit until automaticity sets in. That way, each part might only take 20 days and the success of completion will further move you as the complexity increases. You gain self-efficacy, which means you’re more likely to keep up your efforts and succeed.

So 21 days isn’t set in stone, but if you break a habit down, you might only need to spend that much time on every component, and that’s the secret to habit integration over time.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

Small Health Habits Make A Big Difference

We as a society have (mostly) moved passed the point where the large scale killers are communicable diseases. As a result, what we as a society is dealing with as our health crisis comes from chronic diseases, oftentimes referred to as “diseases of affluence.” Take a look at the top 10 causes of death by disease in the United States (according to the CDC):

  • Heart disease: 597,689
  • Cancer: 574,743
  • Chronic lower respiratory diseases: 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859
  • Alzheimer’s disease: 83,494
  • Diabetes: 69,071
  • Nephritis, nephrotic syndrome, and nephrosis: 50,476
  • Influenza and Pneumonia: 50,097
  • Intentional self-harm (suicide): 38,364

If we remove accidents (because blunt force trauma isn’t a disease) then we have to get all the way down to influenza and pneumonia to reach the point where a communicable disease is the cause of death and it’s not even 1/10th the killer of heart disease. So when the discussion regarding health care costs skyrocketing turns to “preventing chronic illness,” this is to what they are referring.

Researchers have searched for the “fountain of youth,” either by polypill or technology. However, public health researchers have always looked toward the environment and daily habits as a means for attempting to tease out a de facto longevity formula. This is in part because:

  1. You have to live life anyway, so you might as well make some tweaks to set yourself up to win.
  2. Even if we had a fountain of youth in a pill, a full 50% wouldn’t take it anyway.

Daily Habits

Before Oprah gave everyone cars, she outlined places around the world where people were living longer stronger. These “Blue Zones” are the topic of another blog post but understand that researchers have been trying to crack this nut for much longer than the last decade.

YOU GET TO LIVE FOREVER! YOU GET TO LIVE FOREVER!

YOU GET TO LIVE FOREVER! YOU GET TO LIVE FOREVER!

 

If you back the longevity train up a bit further, you’ll find a researcher by the name of Lester Breslow. In 1965, Breslow started a study in Alameda country, California that examined the health habits of 6,928 people, with an eye toward 7 health habits he deemed most important (which is why the study is referred to as the “Alameda 7”). Their behavior was examined over intervals of up to 20 years and the data was parsed with quantitative analysis (which at the time didn’t happen with longevity studies). As a result, Breslow found that a 45 year old who followed at least 6 of the 7 habits had a life expectancy 11 years longer than that of a person who followed 3 or fewer. And these were good, strong, functional years free of major disease or complication, because what does it matter that you live longer if you can’t do anything with it?

What were the habits? Here’s his original list of the Alameda 7:

  1. Avoiding Smoking
  2. Exercising regularly
  3. Maintaining a healthy bodyweight
  4. Sleeping 7 to 8 hours per night
  5. Limiting consumption of alcoholic drinks
  6. Eating Breakfast
  7. Avoiding snacking between meals.

…That’s it. You were expecting some sort of lifestyle calculus? Something only the “chosen few” could accomplish? There’s nothing sexy here and that’s the point: what is done consistently, albeit imperfectly, is what makes changes in the long term. Interventions require rigidity and high effort; lifestyles do not.

Don’t believe that this one study was enough? The good news is that the research has been followed and examined many times over the years. More recently, Dr. Jeff Housman (one of my graduate school professors) and colleague put together a review of the data that came from the study and subsequent reviews. Check this tidbit:

 The linear model supported previous findings, indicating regular exercise, limited alcohol consumption, abstinence from smoking, sleeping 7–8 hours a night, and maintenance of a healthy weight play an important role in promoting longevity and delaying illness and death.

So really the “Alameda 7” is the “Alameda 5,” meaning that 1-5 on my list above are the big lifestyle “tricks” you need to attempt to do in order to set yourself up for a longer, stronger life.

So what happened to Lester Breslow? He died quietly in his home in 2012…at the age of 97. Maybe there’s something to this stuff after all?

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

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