LONGEVITY: DIET, PHYSICAL ACTIVITY AND STRENGTH TRAINING

Many of us have heard about the “blue zones” that exist in five areas around the world, such as Okinawa, Japan, and Ikaria, Greece. In these “blue zones”, we find a large number of elderly centenarians enjoying excellent physical and mental health.

What is observed in these populations in the “blue zones”?

Lots of physical activity and consumption of mainly plant-based diets. Meat is consumed, on average, once a week, in small portions.

Eat like a Mediterranean

The longevity diet must follow a general eating pattern and the Mediterranean diet is considered the gold standard for a longer and healthier life.

The Mediterranean diet is characterized by a high intake of fruits and vegetables; whole grains; herbs; healthy fats from oilseeds (nuts such as walnuts, macadamia nuts, pistachios, Brazil nuts, almonds, and others), olive oil, and avocado, as well as seafood, a few times a week. Meat can be replaced in meals with legumes (beans, lentils, peas, and chickpeas). There should be a moderate consumption of dairy products, eggs, and wine and a limited intake of meat and sweets.

On the other hand, many studies link the use of green tea to a lower risk of heart disease, cancer, type 2 diabetes, Alzheimer’s, and obesity. A six-year follow-up study involving older Japanese adults showed that those who drank a greater amount of green tea — seven or more cups a day — were 76% less likely to die during the study’s follow-up period. Another study involving more than 40,000 Japanese adults, followed for up to 11 years, indicated that women who drank at least five cups of green tea a day had a 23% lower risk of death from any cause.

However, we must emphasize that the “longevity diet” aims to provide a better life, with greater mental and physical well-being, with a reduction in senile dementia. Although genetics play an important role, lifestyle is a significant factor in longevity, and here nutrition is a fundamental part of positive results.

Eating more fruits and vegetables is one of the most important habits you should adopt.

A meta-analysis published in the British Medical Journal found that higher consumption of these foods is associated with a lower risk of mortality from all causes, especially heart disease. Researchers suggest consuming at least five servings per day.

Are there advantages to eating more nuts?

There is no doubt about that. Many claim that oilseeds are linked to life extension. And what do oilseeds offer? They provide healthy fat, plant-based proteins, fiber, antioxidants, essential vitamins, and minerals such as potassium and magnesium.

A study that brought together more than 7,000 men and women for almost five years, comparing three different types of diets, additionally demonstrated that, compared to those who did not eat walnuts, almonds, chestnuts, and others, those who consumed more than three 30-gram servings of nuts per week had a lower risk of overall mortality of 39%.

What about physical activity?

Well, the Danish study “Danish Twin Study” reports that only 20% of our longevity is determined by genes. The other 80% is down to lifestyle and environment. This means that, even though getting older is inevitable, the way we age has everything to do with our choices.

Photo — Marcos Santos/USP images

The lessons from the “blue zones” are extremely valuable: they are advice for a good life and a good old age from those who have already been through it and are going through it successfully.

And where did it all start? It all started in Sardinia. It was the first “blue zone”.

And why the name “blue zone”? Demographic experts, when delimiting the island’s longevity study area, marked the map blue, giving rise to the first “blue zone”.

Today, five “blue zones” are described around the world: Okinawa, in Japan, Loma Linda, in the United States, Icaria, in Greece, the Nicoya Peninsula, in Costa Rica, and Sardinia, in Italy. We know that these places are far from each other and have very different cultures, but North American researcher and writer Dan Buettner managed to identify some common points in them that make these blue regions have a high life expectancy.

And what are these common points?

Buettner boiled it down to a few lessons. And what’s surprising is that we can apply all these lessons to our city.

The first lesson is “move naturally”. What do people do in “blue zones”?

These people do not run marathons or go to gyms, but they walk on “steep mountains” to get to work and live in vertical houses with 2 or 3 floors (using the stairs several times during the day, this example comes from Sardinia). They tend their vegetable gardens and a walk in nature is their usual entertainment. It is worth noting that regular low-intensity exercise is beneficial for muscle tone, mobility, and stress relief.

Calorie restriction is important. Stopping eating when you are 80% satisfied usually brings benefits to the body. The brain takes a while to “understand” satiety, on average, this occurs in 20 minutes, and the decision to stop before 100% satisfaction helps avoid overdoing it. So, always put small portions on your plate, eat slowly, and try to understand your body’s reactions. It is not uncommon for us to go beyond the moment of satisfaction at each meal.

As we indicated previously, as all inhabitants of the “blue zones” do, meat and animal products must have a secondary role. It is not necessary to adopt a vegetarian diet, but the “centenarian diet” is based on fresh produce and vegetables. Greens, fruits, vegetables, and nuts, always fresh and prepared at home, are the foundation of longevity. Although there are more recent controversies in scientific publications regarding the advantages of using alcoholic beverages (particularly red wine); in these “centenarian populations”, in particular, in Sardinia, it is common to consume a glass of red wine a day. Researchers who suggest consuming a glass of red wine a day indicate that the presence of polyphenol resveratrol can have a positive effect on circulatory problems and heart health.

One of the lessons is to seek your “ikigai”, as the Okinawans do. Find the reason why you get out of bed. The inhabitants of the “blue zones” have this very clear: work, family, and friends (a good conversation with friends in the afternoon).

Don’t lead a fast-paced life, aim for lower levels of stress. Go hiking with friends.

Slow down and do things that nourish the soul: For some, it could be religious work or even a walk with friends. Lower stress levels mean less chronic inflammation.

Priority to family — the majority of centenarians from the “blue zones” live with younger generations of the family, an interaction that is beneficial for everyone, for the oldest and the youngest (an important exchange of information and experiences). This represents a “two-way win” for these generations. Researchers have already demonstrated that when family is prioritized, there is usually a return in the form of care and affection.

Be around the right people. This helps you gain deep social connections that are directly linked to longevity. And if your contacts follow healthy habits, your chances of following these habits increase.

It is worth highlighting that the first “blue zone”, which is in a mountainous region of the island of Sardinia, among 14 villages in the province of Nuoro, has the highest concentration of centenarian men in the world. Families of shepherds and small farmers predominate there, however, as already highlighted, meat is not the main source of food for the inhabitants. Typical foods are bread made with durum wheat semolina, goat’s milk, a typical wine from the region, and seasonal vegetables.

There is also a very interesting fact in Sardinia. Many Western cultures consider aging to be a burden; in Sardinia, elders garner esteem and are considered cultural treasures. The inhabitants of this “blue zone”, when they grow old, are looked after by their families. But, another important aspect of this population, the elderly do not retire, they just change jobs, going up and down hills with their goats and sheep, cutting firewood, and slaughtering animals.

There is also a lot to learn from the inhabitants of other “blue zones”, but that is for next time.

As we have already seen, diet and physical activity gain importance for the elderly’s quality of life and longevity.

And what can elderly people do in terms of physical activity, other than just walking? What else can you do? Weightlifting?

Dr. Brandon Grubbs, Ph.D. (Middle Tennessee State University) commented that aging is one of the greatest threats to individual freedom and independence due to the progressive deterioration of muscles. As we age, there is a decrease in the production of hormones responsible for maintaining muscle mass. This researcher added that this situation is even worse because elderly people tend to be less active and eat less protein (protein consumption is important for maintaining strong muscles).

On the other hand, in the elderly, the cells responsible for muscle repair show a diminished response.

How to resolve this situation?

Dr. Brandon suggests a solution: weight lifting. Strength training helps stop the loss of muscle function associated with aging. This researcher commented that weight training “stimulates muscle growth and improves the quality of muscle tissue, which means that it is possible to generate more strength with a given amount of muscle.”

Its practice is seen by many as just a way to increase muscle mass, however, this training has numerous benefits. Strength training improves cardiorespiratory conditioning, reduces the amount of fat, helps you lose weight, reduces the risk of diabetes, increases autonomy in the elderly, and ensures more physical disposition.

Sarcopenia (or muscle loss due to aging) begins around age 35 and increases after age 60. The loss of muscle mass is progressive. Sarcopenia, according to previous studies, has been associated with type 2 diabetes, high blood pressure, and obesity. Sarcopenia can increase the risk of heart disease and stroke and “steal” years of life. The freedom to live independently can be compromised by sarcopenia, damaging not only the ability to lead everyday life but also many things that have been planned for old age, such as, for example, leisure trips.

There are some simple things we can do at home to mitigate this process of muscle deterioration. An example: 1 to 3 sets of squats, 8 to 15 repetitions, with lifting and lowering with control, and 3 to 6 repetitions, with lifting quickly and lowering slowly. A 2 to 3-minute rest between sets is recommended.

What helps maintain physical shape? Dr. Brandon recommends: climbing stairs (avoid the elevator when possible), getting out of the car (walking more), getting out of a chair, and carrying groceries.

There is a very useful test for evaluating the elderly, which is getting up from a chair with arms crossed and sitting down five consecutive times. This assessment test called the “Five Times Sit-to-Stand Test (FTSST)” was considered reliable, safe, and valid for measuring the muscular strength of the lower limbs of healthy adults and for determining balance control, fall risk, and exercise capacity of older individuals. But it is also valid as a physical activity.

It is worth highlighting that the existence of diseases commonly related to older populations — arthritis, cardiovascular disease, diabetes, dementia, osteoporosis, and stroke — “is not in itself a contraindication to exercise”, even if a single person has all these diseases. The guidelines indicate that “for many of these diseases, exercise provides benefits not achievable through medication alone.” Older people share the common fear of pain or injury, but experts indicate that “a sedentary lifestyle appears to be a much more dangerous disease than physical activity among older people.”

A small study including very elderly people (86 to 96 years old) showed remarkable results; after eight weeks of weight training, participants improved their muscle strength by 174% and there was a 9% increase in thigh muscle mass. The study participants lived in a long-term care institution and did not have an acute illness, however, they were not extremely healthy.

Dr. Brandon points out that this study demonstrated that even “the oldest of the old” showed improvements in muscle strength and mass and added, “I don’t know of any age at which these results cannot be improved.”

Older people do not gain muscle and strength as much as younger people — response to training may be slower — but they can achieve significant improvements in strength and muscle mass.

Elderly people can and should ask their doctor for guidance so that they can adopt a physical activity and bodybuilding program that is best suited to their health conditions.

There are recommendations for people aged 65 and over to train two to four times a week in sessions lasting 30 to 60 minutes. But Dr. Brandon’s more cautious words catch our attention. Just one workout a week to get started; and this researcher pointed out that a previous study of people over 75 suggested that just one hour of strength training per week can improve walking speed, leg strength, and the ability to rise from a chair.

There is one more important recommendation from Dr. Brandon: Do multi-joint exercises — traditional strength movements such as squats, overhead presses, vertical seated bench presses, seated rowing, and strengthening the back region. These exercises prepare us better for activities of daily living than isolation exercises (those that work a specific muscle) or equipment exercises — although equipment may be better for people with balance problems or other difficulties that make multi-joint and free-weight exercises difficult to do.

Source of images: Dr. Brandom Grubbs, Ph.D. — WebMD

However, any type of exercise can be modified to suit the fitness level of a particular senior. If a deep squat is not possible, a half squat (that is, performing a quarter of the movement) may be satisfactory.

On the other hand, an exercise that all seniors should practice is the “sit to stand”, according to the instructions of the coordinator of the health and well-being education program, Laura Grissom (USA). Mrs. Grissom’s instructions are: “Sit on the edge of a chair, with your feet on the floor, and cross your arms over your chest. Lean back until your back touches the back of the chair, prepare your abdomen, and then go forward and stand up.” Start with three sets of 10, and then work on doing them faster, like power training.

Ms. Grissom further added, “If you have a health problem, the best thing you can do is exercise.”

And it doesn’t matter how old you are.

References

# Forbes Life Fashion — Second Edition — 2022, June.

# Medscape — 2023. August, 15.

# Preventive Medicine — Volume 87, June 2016.

# Dtsch Arztbl Int 2011 May; 108 (20): 359–364