Dan Buettner at TEDMED 2011

Summary

In this talk, the speaker discusses findings from his work with National Geographic on Blue Zones—areas where people live significantly longer. The key factors include plant-based diets, a sense of purpose, strong community ties, and an environment that promotes physical activity without formal exercise. He emphasizes that public health strategies often fail because they focus on individual responsibility rather than systemic changes. Successful long-term health improvements come from creating environments that make healthy choices easier, as seen in community projects in Minnesota and Scandinavia.

Takeaways

• 🌍 Geographic zones where people live measurably longer have been identified, such as Okinawa, Italy, and Costa Rica.
• 🌱 A plant-based diet high in beans and nuts is common among long-lived populations.
• 🍷 Moderate wine consumption, around two glasses per day, is associated with longevity, but binge drinking does not provide the same benefit.
• 🎯 A strong sense of purpose adds approximately seven years to one's life expectancy.
• 🙏 Being part of a faith-based community and attending four times a month can extend life by 4 to 14 years.
• 🚶‍♀️ Physical activity in these communities is not formal exercise, but part of their daily environment, burning more calories through non-exercise activity.
• ⚕️ Around 80% of chronic diseases are caused by lifestyle and environment, not genetics.
• 🔄 Diets and exercise routines often fail for the majority of people over time, highlighting the need for long-term lifestyle changes rather than quick fixes.
• 🏙 Environmental factors like easy access to physical activity and nutritious food, as well as social networks, play a key role in public health.
• 💡 Sustainable health interventions must focus on community-wide systems, not just individual responsibility, to create long-lasting improvements.

Q & A

What are the Blue Zones, and what common factors contribute to longer lives in these areas?

Blue Zones are regions where people live measurably longer lives. These areas, such as Okinawa, Japan, and Nicoya Peninsula, Costa Rica, have common factors like plant-based diets, low intake of simple carbohydrates, consumption of beans and nuts, moderate wine intake, a strong sense of purpose, belonging to faith-based communities, and frequent physical activity through daily life rather than formal exercise.

Why does the speaker emphasize that no diet has worked for a significant proportion of people in the long term?

The speaker points out that diets are generally ineffective in the long term because they have high recidivism rates. Most people who start diets fail to maintain them, with only a small percentage staying on a diet after several years. This highlights that short-term dietary solutions are not sustainable for long-term health improvements.

What is the significance of a strong sense of purpose in longevity, according to the speaker?

The speaker mentions that individuals who have a clear sense of purpose and can articulate it tend to live about seven years longer than those who don't. This is a key factor contributing to longevity in Blue Zones.

How do faith-based communities contribute to longer lifespans?

People who belong to faith-based communities and attend regularly, about four times a month, tend to live four to fourteen years longer than those who don’t participate. This social engagement and support system plays a crucial role in increasing life expectancy.

What is the role of physical activity in Blue Zones, and how does it differ from traditional exercise?

People in Blue Zones do not exercise in the way we traditionally think of exercise. Instead, their environments encourage constant, non-exercise physical activities, such as walking and manual tasks, which result in them burning five times more calories through daily movement than the average person.

What is the speaker’s critique of public health spending in the United States?

The speaker argues that the United States spends too much on treating diseases and not enough on prevention. Around 80% of diseases are driven by lifestyle and environment, but only 4% of healthcare dollars are spent on prevention, with 88% spent on treating problems after they occur.

Why does the speaker believe that individual responsibility is not enough for successful public health outcomes?

The speaker suggests that focusing solely on individual responsibility doesn't work because people are part of a larger system. Long-term health improvements require changes in the environment and policies that make healthier choices easier, rather than relying on individuals to change their behaviors independently.

What successful public health initiatives did the speaker highlight from around the world?

The speaker highlights two successful public health initiatives: the EPODE project in northern France, which reduced childhood obesity rates and maintained them for eight years, and a project in Scandinavia that reduced cardiovascular disease by 90% and sustained these results for decades.

How did the Albert Lea, Minnesota project implement changes to improve community health?

In Albert Lea, Minnesota, the project focused on optimizing the environment, such as creating walkable paths, community gardens, healthier food options in restaurants, and policies in schools to reduce eating in classrooms. These changes helped increase physical activity, improve diet, and lower BMI in the community.

What is the speaker’s argument about why diets, exercise, and supplements are insufficient public health solutions?

The speaker argues that diets, exercise, and supplements are insufficient because they don't have long-term adherence or widespread impact. Most people abandon diets and gym memberships after a short time, and while certain supplements can be beneficial, they don't achieve critical mass for population-wide health improvement. A broader, system-level approach is needed.

Outlines

00:00

🌱 Secrets of Longevity Revealed

The speaker, working with National Geographic, has spent a decade identifying regions where people live longer, known as Blue Zones. Across the world, in places like Japan, Italy, Costa Rica, and Greece, common lifestyle traits are found among these long-living populations. They share habits like plant-based diets, regular consumption of wine, and active lifestyles, but the most surprising findings are the benefits of having a strong sense of purpose and belonging to faith-based communities. These populations live longer without traditional forms of exercise, instead engaging in environments that naturally promote activity.

05:00

💪 Why Diet and Exercise Alone Won't Work

The speaker argues that diets and exercise, as traditionally conceived, are not effective for long-term health. Most people abandon diets and gym memberships within months or years. Instead of focusing on individual responsibility, efforts should target system-level changes. Many public health initiatives in the U.S. have failed because they rely on short-term interventions. The speaker cites successful long-term projects in France and Scandinavia that focused on changing the environment rather than expecting individuals to sustain healthy habits on their own.

10:02

🏙️ Optimizing Communities for Health

The speaker explains that most people live within a 'life radius' of about 20 miles around their homes, and it’s this environment that influences their health. Policies, infrastructure, and social networks all play a significant role. Simple changes like improving parks, creating safe walkways, and modifying social networks can increase physical activity by up to 40%. The focus should be on making healthier choices the easier option in the community, rather than expecting people to rely on willpower.

15:04

🏫 A Case Study of Albert Lee, Minnesota

The speaker shares the success story of Albert Lee, Minnesota, where community leaders adopted a health-focused blueprint. Experts helped the town create walkable environments, improve food options, and enact policies in schools to reduce childhood obesity. Changes like banning food in classrooms and designing paths around a local lake led to significant improvements in health. The experiment demonstrated that environmental changes, rather than individual efforts, were key to success, with media coverage and local involvement amplifying the results.

Keywords

💡Blue Zones

The term 'Blue Zones' refers to regions in the world where people live longer than average, often into their 90s or even past 100. The concept was identified by studying geographically defined areas with populations that share common lifestyle habits. In the video, the speaker highlights places like Okinawa (Japan), Sardinia (Italy), and the Nicoya Peninsula (Costa Rica) as examples, and shares the insights gained from studying these areas.

💡Plant-based diet

A plant-based diet emphasizes consuming whole foods derived primarily from plants, such as fruits, vegetables, legumes, and nuts. In the video, the speaker mentions that one of the common traits in Blue Zone populations is their consumption of a diet low in simple carbohydrates and high in plant-based foods, which contributes to their longevity and health.

💡Sense of purpose

Having a clear sense of purpose is associated with living a longer life. According to the video, individuals who can articulate their purpose tend to live up to seven years longer than those who cannot. This strong connection between a sense of purpose and longevity was observed in the Blue Zone populations and is an important non-physical aspect of health.

💡Non-exercise physical activity

Non-exercise physical activity refers to movements and activities people engage in as part of their daily lives, without deliberate 'exercise' routines. In the video, it is highlighted that the longest-living people don't follow formal exercise programs but remain active through their environment, such as walking, gardening, and doing manual work, which keeps them healthy.

💡Chronic disease

Chronic diseases are long-term health conditions like heart disease, diabetes, and cancer. The speaker emphasizes that lifestyle and environment, rather than genetics, account for around 80% of chronic diseases. These diseases are largely preventable through better lifestyle choices, which are naturally embedded in Blue Zone communities.

💡Built environment

The built environment refers to man-made surroundings that provide the setting for human activity, such as buildings, roads, and parks. The speaker explains that a community’s built environment can influence physical activity levels, with safe, walkable streets and inviting parks encouraging more movement. In Blue Zones, such environments naturally promote healthy behaviors.

💡Social networks

Social networks, in this context, refer to the close-knit relationships people maintain, which can impact their health and longevity. In the video, the speaker explains that individuals whose friends are obese are more likely to be overweight themselves, showing the powerful influence of social networks on lifestyle habits. Optimizing social connections is one strategy used to improve community health.

💡Prevention

Prevention is the proactive approach to stopping health problems before they occur, rather than treating them after they have developed. The speaker argues that most of the healthcare spending is focused on treating diseases after they arise, rather than investing in preventive measures like healthy environments, which could reduce the occurrence of chronic diseases.

💡Silver buckshot

The term 'silver buckshot' contrasts with the idea of a 'silver bullet,' suggesting that there is no single solution to improving public health. Instead, multiple evidence-based strategies need to be implemented together to create lasting change. The speaker explains that altering policies, environments, and social structures collectively, rather than relying on individual effort alone, leads to healthier populations.

💡Life radius

Life radius refers to the area within a person’s daily travel patterns, usually within 20 miles of their home and work. The speaker argues that by optimizing this life radius—making healthy choices easier and more accessible in this space—communities can significantly improve the overall health and wellbeing of their populations. This idea underscores the importance of creating environments that naturally promote better health choices.

Highlights

For over a decade, the speaker has worked with National Geographic to identify areas where people live longer, geographically defined and demographically confirmed.

Research shows that certain populations worldwide, like in Okinawa (Japan), Italy, Nicoya Peninsula (Costa Rica), and Ikaria (Greece), have common habits that contribute to their longevity.

A strong sense of purpose, which can be clearly articulated, is associated with living about seven years longer.

People who belong to faith-based communities and attend services four times a month live four to fourteen years longer.

None of the longest-lived people in the world engage in traditional exercise, but their environments encourage constant physical activity.

Chronic disease prevention is crucial; about 80% of what drives disease and costs is lifestyle and environment, not genetics.

Despite spending billions on health prevention in the U.S., focusing on diet and exercise hasn't produced long-term results for a majority of people.

Long-term strategies like diets and gym memberships fail due to high recidivism, with over 90% of people abandoning them within a few years.

Health initiatives in certain global regions, such as France's EPODE project and a Scandinavian program, successfully reduced chronic diseases like childhood obesity and cardiovascular disease.

Health interventions in communities need to address the system rather than focusing solely on individual responsibility.

Key influences on a person’s 'life radius' (about 20 miles from home) include local policies, the built environment, and social networks.

Making the 'active option' the easy option in communities can increase physical activity levels by 30-40% without the need for formal exercise programs.

Social networks play a critical role in health, with a strong correlation between your closest friends' health habits and your own.

Albert Lea, Minnesota, adopted a health blueprint that resulted in increased life expectancy, reduced obesity, and a 40% drop in healthcare costs for city workers.

America’s healthcare system spends disproportionately on treatment rather than prevention, with only 4% of healthcare dollars allocated to preventive measures.

The speaker advocates for a 'silver buckshot' approach, using multiple evidence-based strategies to improve health across entire communities rather than relying on individual changes.

Transcripts

[Music]

for the past ten years or so I've been

working with National Geographic to

identify geographically defined

demographically confirmed parts of the

area where people live measurably longer

these are populations not just

individual experience tens of thousands

of people in most examples and then

working with other experts to find their

common denominators I wrote this up in a

book called Blue Zones you don't have to

buy the book because in the next 90

seconds I'm going to tell you all the

essential secrets no matter where you go

in the world whether it's Okinawa Japan

certainiy Italy the highlands Nicoya

Peninsula Costa Rica the Katya Greece

I'm on the seventh-day adventists you

see the same nine things happening over

and over and over among the longest live

people a lot of these things are very

intuitive eating a plant-based diet lo

and simple carbohydrates high in things

like beans and nuts the ever-popular

prescriptive to have a couple glasses of

wine a day and no you can't save up all

week long and have 14 on the weekends

people actually ask me that but the

really cool findings come from the

counterintuitive things you do you know

that people who have a strong sense of

purpose and can articulate it live about

seven years longer than people who don't

people who belong to a faith-based

community and actually show up four

times a month lift four to 14 years

longer than people who don't and none of

the longest-lived

people in the world and I interviewed

253 of them ever exercise in the way we

think of exercise they did however live

in environments that constantly nudge

them into physical activity they burnt

about five times as many calories as we

do in non exercise physical activity

they lived anywhere from 7 to 11 years

longer than we did with a fraction of

the rate of chronic disease these are

populations one of them is even an

American population that was a decade

longer than the rest of us but as you

know you can tell people all day long

the things they ought to do to live

longer and to be healthier but how do

you actually get a population to do them

we spend almost a

trillion dollars a year and largely

preventable diseases cancer diabetes

heart disease largely preventable

diseases but I assert we not only are

spending too much but we're aiming at

the wrong target if you look at what

really drives disease and costs in this

country about 80% of it is lifestyle and

environment only about 10% is genes this

is on a population as a whole and

healthcare accounts for another 10% of

it but now look at the way we spend our

money this incidentally comes from the

CDC we spend only about 4% of our our

healthcare dollars on on prevention and

then we spend 88 percent of them on

cleaning up the problem if the problem

has happened we're aiming at the wrong

target instead of the downstream

problems we should be aiming at what to

do before they happen I think most of us

know that we do spend over a hundred

billion dollars a year on prevention so

you may say Dan you know we're are an

overweight population here in America we

don't move enough we nudists we should

be focusing on diets and exercise and

supplements the problem is by and large

they don't work when you think of things

that are going to truly add to longevity

to truly lower your chances of getting a

chronic disease you cannot think in

months or in years you have to think in

decades or a lifetime so you say well

diets a pretty good idea but no diet in

the history of the world has ever worked

for a significant proportion of people

who started we could come up right now

we could spend the next three days and

come up with the TEDMED diet the best

minds on the planet when it comes to

medicine come down and come to Ted come

up with a TEDMED diet we get mark up

here and J up here and we do a man hug

and we get people all pumped up about it

but the reality of diets if a hundred

people start a diet 'day within seven to

ten months you'll lose 90 of them and

within the next two years you'll lose

all but about

percent of them so when it comes to a

long-term strategy diets don't work no

diet in the history of the world

exercise has a similar recidivism curve

we were able to find data on gym

memberships on out of a hundred people

who start a gym membership today in

three years you'll learn lose about 90

percent of them this is a bit of a

heresy I know but when it comes to

public health exercise just isn't

working the average American only burns

100 calories per day engaged in willful

physical activity exercise supplements

whether they're medicinal or

nutraceutical about the same thing we

may say Stanton's and aspirin are really

good for people to take but you don't

get a critical mass you don't get enough

people taking them over time so based on

these findings I went back to National

Geographic and I proposed another blue

zone type worldwide search but this time

I wanted to find communities that were

unhealthy and got themselves healthier

and God blessed that rectangular yellow

heart of National Geographic they funded

me one all over the world and found out

two remarkable things number one of the

tens of millions of dollars we spend on

public health and different initiatives

for that Amed chronic disease none of

them have worked there's one in

Minnesota the heart healthy there's the

one in Stanford Connecticut another one

in California what happens is more or

less the health care equivalent of the

Hawthorne effect as long as the experts

are there paying attention and the TV

cameras are rolling people will do what

they ought to do but as soon as they

leave people revert back to their

baseline so as a long-term strategy it

just the simply don't have them worked

here in America there are two places in

the world where projects have started

out with unhealthy people and made their

populations healthier one in France

northern France the e-poll project

brought down the rates of childhood

obesity and maintain them for eight

years and the

second place was in Scandinavia they

brought down the rate of cardiovascular

disease by 90 percent and maintained it

for decades and I was able to spend

several months with these projects and

really take a look at how they executed

them how they made them work and I

realized that the essence of their

success hinged on a tenant that's very

different than that attendant many of us

subscribe to these projects did not rely

on individual responsibilities to be

successful they didn't look at you and

say it is up to you to get yourself

healthier they realized that we're all

part of a system and you need to address

the system so based on that I used some

of the money of that grant to hire who I

think are the greatest experts in

America when it comes to optimizing an

American system this by the way is not a

program it's not a template it's an

operating system it's a way of thinking

and I pulled together six people from

various different disciplines to help me

think about how do you optimize an

American community for health and our

first finding was that we all live in a

life radius we most of us spend about

80% of our lives within about 20 miles

of our homes and works so that's the

area that we're trying to make better

now what sorts of things influence a

life radius well number one you have

policy is it easy to smoke in this

community

can i smoke indoors and out is soda pop

and salty snacks are they cheap do day

care centers allow the licensed daycare

centers allow little kids to watch TV

before age - is there an opt-in or

opt-out policy when it comes to organ

donation state these things make a huge

difference on a statewide level the

built environment is it easy to walk

downtown our parks neat and alluring is

it safe you know the number one

inhibitor to old people going out and

getting extra

the perception of safety doesn't even

have to be safe just cleaning up

cleaning up graffiti will get more older

people out Robert Wood Johnson

Foundation found that if you can just

make the after active option the easy

option in communities you raise the

physical activity level of that

community by thirty to forty percent no

gym memberships no yoga classes no AB

master just make the active option the

easy option social networks another

thing that you can modify at an

environment if your three best friends

are obese is a hundred and fifty percent

better chance that you'll be overweight

how do you help people optimize their

social networks or expanded if necessary

then there's structures we spend our

daily life's in schools restaurants you

know we eat out a hundred and ten times

a year you could have a perfect kitchen

but if if you're eating out a third of

the time in places where they're over

serving you it for every meal there's a

problem there schools workplaces and

then sense of purpose how do you in view

people with a clear idea of what their

values are and what they're good at and

give them an outlet so this was a nice

theoretical construct this is where we

got the name silver buckshot

evidence-based ways unleash him on an

environment well thanks to AARP and the

University of Minnesota School of Public

Health we got another big grant to

actually audition five cities and come

into the city most ready to adopt this

blueprint Albert Lee Minnesota one and

they mainly one because the mayor the

city manager the head of public health

the superintendent of schools had a

Chamber of Commerce signed a pledge

saying we're on board for changing the

environment our experts came in and we

just listened we found out for example

that they wanted to widen Main Street

and raise the speed limit something that

we believe would tear the social fabric

in half instead we convinced them to use

some of that money to create one walking

vector from every neighborhood downtown

there was a beautiful place to

recreative on this beautiful lake but

you couldn't get around it so we took

some of the street Wyatt E money and we

created a path which is now full

all the time optimizing the built

environment we built for community

gardens this is a city of only 19,000

people dr. Brian Watson came in and

helped us optimize food environments do

you know the one adjectives that most

assures that you will not order an

entree on a menu the healthy choice

nobody wants a damn healthy choice they

want something good adjectives like

crispy and fresh will get people eating

the same food that was otherwise

mislabeled we have dozen tweaks we can

do to restaurants when in all the

grocery stores got them to flag healthy

foods and even create checkout lanes

where the impulse buys were all healthy

we went in all seven schools and got

them to adopt nine policies the most

powerful one of which a simple policy

that prohibits kids from eating in

classrooms and hallways that one policy

alone much more impactful than whatever

you put in the school lunch that one

policy alone will lower the BMI of that

school by about 11% and it's permanent

we went into about half the workplaces

appeal to individuals and got them to

sign a pledge to make permanent changes

to their homes everybody took a risk a

risk assessment longevity compass we

call the vitality compass so we could

get a baseline we got them to do

permanent things like grow gardens let

our experts come into their kitchens and

trade out the 14 inch blades for 10 inch

plates and do things like put signs on

the counter reminding people to pre

plate their food those two habits alone

equate to about a twenty to thirty

percent fewer calories in any given

sitting and then we went and helped

people optimize their social environment

we took the people or ready to change

their behaviors and fostered long-term

friendships with them over the course of

18 months we got phenomenal media

coverage USA Today Good Morning America

Nightline

Walter Willett the Dean of Harvard

School of Public Health came in and

wrote a two-page story on our on our

little experiment and found the results

stunning

US News and World Report's came in a

year and a half later and found out that

everything we put in place was still

working and then our numbers I think

mirrored the success of the idea

people's life expectancy went up

people's weight went down and there was

a 40% drop in city workers health care

cost that ladies and gentlemen is where

the rubber hits the road I don't have to

tell this audience that we have a

healthcare problem in our country 68% of

us our beefs are overweight and that

numbers going up along with cost

diabetes is on the way up and for the

first time in living history life

expectancy of our children is supposed

to go down is that because we're stupid

or if somehow undergone a degradation of

our moral character or we have less

discipline or love our children less

than our grandparents or kids did now we

live in an environment of ease and

abundance we are evolutionarily

hardwired to crave fat and to crave

sweetness and to crave rest when we can

get it but we cannot go to a pharmacy to

fill up our car with gas to rent a DVD

without being routed through a gauntlet

of salty snacks or sugar sweetened

beverages every single day 278 images

rinse over our brain telling us to buy

it stuff we largely don't need and to

eat food that isn't all that good for us

raise your hand if you walk to school

when you're a kid go ahead rage and look

around almost every hand is up now raise

your hand if your children walk to

school 1970 50% of American children

walk to school we're now down to about

10% just engineered three miles of free

physical activity out of kids is daily a

weekly life when it comes to making this

country healthier and getting health

care cost under control there is no

silver bullet

it's silver buckshot its unleashing

evidence-based long-term ways to change

people's environments and it's doing it

one ready community at a time thank you

[Applause]

[Music]