Saturday, October 27, 2012

There's No Silver Bullet For Long Life

97-year-old Stamatis Moraitis tending his vineyard and olive grove on Ikaria.
Below is the story making rounds about 97-year-old Stamatis Moraitis who was expected to die from lung cancer in his mid-60s. A move from Florida to the Greek island of Ikaria is thought to have saved his life. But there's something fishy about this story:

The Island Where People Forget To Die, New York Times Magazine, 24 October 2012

Here's a snapshot of how Ikarians live:
"Like that of almost all of Ikaria’s traditional folk, their daily routine unfolded much the way Leriadis [an Ikarian physician] had described it: Wake naturally, work in the garden, have a late lunch, take a nap. At sunset, they either visited neighbors or neighbors visited them.

Their diet was also typical: a breakfast of goat’s milk, wine, sage tea or coffee, honey and bread. Lunch was almost always beans (lentils, garbanzos), potatoes, greens (fennel, dandelion or a spinachlike green called horta) and whatever seasonal vegetables their garden produced; dinner was bread and goat’s milk."
Here's a little more about their diet:
"The Ikarians’ diet, like that of others around the Mediterranean, was rich in olive oil and vegetables, low in dairy (except goat’s milk) and meat products, and also included moderate amounts of alcohol. It emphasized homegrown potatoes, beans (garbanzo, black-eyed peas and lentils), wild greens and locally produced goat milk and honey.

[Ikarians] consumed about six times as many beans a day as Americans, ate fish twice a week and meat five times a month, drank on average two to three cups of coffee a day and took in about a quarter as much refined sugar — the elderly did not like soda. She also discovered they were consuming high levels of olive oil along with two to four glasses of wine a day."
So, If I lived in Ikaria, I would wake up late, say 11 am. I would have some wine, bread, milk, and honey then tend to my garden. I would come in for a big afternoon meal, wash it down with wine, take a long nap, have some tea, wine, bread, and socialize until late in the evening.

Do you see it? Where does the midday meal come from? Who is cooking all those beans? Who is doing the dishes? The laundry? Who is cleaning the house? Who is going to market? Who is caring for the children? (75% of the population is under 65.) Do children rise at 11? What about school? Who is running the businesses? How do you run schools and businesses without clocks (which the story said explicitly are not used)? Do Ikarians have personal assistants, maids, and cooks? I wonder what the lifestyle of women is like in Ikaria, and if it differs from men. I wonder if they are as relaxed with abundant time to sleep, socialize, and imbibe. Perhaps, but I noted that Moraitis' wife, 12 years his junior, died at the age of 85, having spent 30-plus years in this supposed idyllic existence.

This story is too romanticized. It's not realistic. It will have people longing for a utopia that doesn't exist. One other thing not mentioned in this story is healthcare. Who would pay if Moraitis needed a foot amputated? Needed eye surgery? Needed kidney dialysis? The government, because Ikaria has Universal Healthcare.

You know what helps people live a long life? I'll entertain my arrogance and tell you ... No. One. Thing. There were very likely elements of Moraitis' diet that worked against long life, but were offset by positives. Gary Taubes (who was consulted for his opinion in the story) may have said that all that bread would do him in. Drs. Esselstyn and Campbell may have said all that meat and dairy would lead to chronic ailments and early death. Ikarians drank almost enough daily alcohol to invite a label.

The story may have been romanticized, but it was also telling, especially the guts of this paragraph that began:
"If you pay careful attention to the way Ikarians have lived their lives, it appears that a dozen subtly powerful, mutually enhancing and pervasive factors are at work."
And this:
"For people to adopt a healthful lifestyle, I have become convinced, they need to live in an ecosystem, so to speak, that makes it possible. As soon as you take culture, belonging, purpose or religion out of the picture, the foundation for long healthy lives collapses. The power of such an environment lies in the mutually reinforcing relationships among lots of small nudges and default choices."

There’s no silver bullet to keep death and the diseases of old age at bay. If there’s anything close to a secret, it’s silver buckshot."
Buckshot. So, a lot of small things, done over and over, in an environment where everyone else is also doing those small things, could very well keep us sipping the mountain tea into our 90s.
Photo from the NYTs story.


Dr. Mel said...

I don't think this is bogus, but it might be an anomaly. Still, the NYT is usually reliable. The same issue, of men vs women, occurs on Sardinia, where the men who scramble over the hills chasing the sheep live quite long, while their wives, in the kitchen, don't live as long. The Sardinians also eat largely bread, cheese, wine, & veggies, and "live long and prosper"! Btw, Ikaria has a well-developed school system, a substantial tourist trade, and some of the largest "green energy" projects in Europe!

Dr. Mel said...

I've read the article more carefully now, and I don't think it's bogus or a fantasy at all. There's a LOT more strenuous physical activity described in the article, esp. stuff that would be strenuous for older people, and many other factors different from our country that could be quite significant re longevity. And lately in this country, I've been *bombarded* by articles about how healthy it is to nap most days. And his wife, though Greek, was not raised in Ikaria; as well, they talk about one woman well into her 90s who's still quite active. And finally, much to my own chagrin and sadness, I know so many American friends who retired and died within a year. I think there's a lot to this, even though it's not quantifiable. I like your comment about silver buckshot--that's about the sum of it! (Oh, and they aren't eating white bread, but ww sourdough bread.)

Bix said...

There are people on Ikaria who don't sleep late. They get up and work. There are people who don't take long leisurely lunches and naps. They work. They run the schools, the hospitals, the banks, the factories, the utilities. They live by the clock. It is through the work of these people that other people may live a more leisurely existence. I did not see appreciation given for this labor. Will these people also forget to die?

Anonymous said...

Another elitist NYTs article, and sexist as you point out. Yeah give me a couple acres of fertile land and someone to cook and clean for me for free, and free healthcare, I could live to 97 too.

Anonymous said...

I think the article is a bit idealistic and narrow focused. Where does the food come from? Who grows and harvests the goods? Who cleans and laundries? I imagine there are people who provide those services, like a cook and a house keeper but all too often those people and the services they provide are overlooked when a social class is being described. If I were to describe my neighborhood I would talk of the park-like atmosphere, the lack of crime, the peaceful nights, the well stocked stores and well maintained infrastructure. I wouldn’t mention the trash men, or all of the poorly paid retail clerks, or the municipal workers, or busboys and waitresses at the quaint brew pub I walk to.
The lifestyle described is idyllic. The diet does sound more healthy than Big Macs and liter bottles of soda. What contribute to the extended longevity. Is it what they are doing or maybe what they are not doing. Does not eating the typical American crap diet help? Maybe it’s just our penchant for “snacks” and prepared foods that ruins our health.
I don’t think the article was purposely written to mislead. I think it was written to illustrate a lifestyle that seems healthy and the author focused on the aspects of the island that exemplify and focused on the premise of the article. There’s a wider story there that’s not being told.

betlamed said...

Oh, I'm sure the story is romanticized and exaggerated. However, there seems to be at least some truth to the idea that the mediterranean diet has some advantages - as does the Innuit diet, and the japanese diet, and the austrian diet, and basically every diet of every culture before it's taken over by fast food, pizza delivery, and convenience food.

Dr. Mel said...

It's not just about what they eat, but about the physical labor they undertake, and in traditional cultures (such as the one to which Ikaria's older people belong), physical labor differs between the sexes, with the men's labor generally being more "aerobic," for want of a better term. And longevity here, as w/ the other Blue Zones, also depends on a strong network of friends, much socializing, a high value placed on being elderly, and a set of spiritual beliefs. Finally, many Mediterranean countries manage to combine having jobs with leisurely lunches and afternoon naps--e.g., Italy, Spain, etc. It's not a sin to have a slower-paced life! And in most of Europe, people start work later in the morning than we do here & have shorter work weeks, more vacation, more flex time. It's not a sin that younger people work while the elders, who worked all their lives, don't work as hard. It's the way it's always been in traditional cultures. Ours is one of the few that sees the elderly as "disposable."

Ikaria Honey said...

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