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Category: Exercise

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Looks like another procedure is found not to be beneficial and possibly harmful - this time arthroscopic surgery as a treatment for the middle aged or older person with a painful arthritic knee or torn meniscus (the shock absorbing cartilage between the knee bones). The researchers also found that "exercise therapy" had more benefits. From Medical Xpress:

Benefit of knee surgery for middle aged or older patients 'inconsequential', say experts

The benefit of surgery for middle aged or older patients with persistent knee pain is inconsequential and such surgery is potentially harmful, say researchers in a study published in The BMJ this week.Their findings do not support arthroscopic surgery as a treatment for the middle aged or older person with a painful arthritic knee or torn meniscus (the shock absorbing cartilage between the knee bones).

The article is part of The BMJ's Too Much Medicine campaign - to highlight the threat to human health and the waste of resources caused by unnecessary care. Over 700,000 knee arthroscopies (a type of keyhole surgery) are carried out in the USA and 150,000 in the UK each year on middle aged and older adults with persistent knee pain. Yet the evidence for arthroscopic surgery is known to be weak, with all but one published trials showing no added benefit for surgery over control treatment.Despite this, many specialists are convinced of the benefits of surgery.

So researchers based in Denmark and Sweden reviewed the results of 18 studies on the benefits and harms of arthroscopic surgery compared with a variety of control treatments (ranging from placebo surgery to exercise) for middle aged and older people with persistent knee pain.s.

Overall, surgery was associated with a small but significant effect on pain at three and six months (but no longer) compared with control treatments. No significant benefit on physical function was found. A further nine studies reporting on harms found that, although rare, deep vein thrombosis (DVT) was the most frequently reported adverse event, followed by infection, pulmonary embolism (a blockage of the main artery of the lung), and death.

"Interventions that include arthroscopy are associated with a small benefit and with harms," say the authors, and the benefit is "markedly smaller than that seen from exercise therapy." These findings "do not support the practice of arthroscopic surgery as treatment for middle aged or older patients with knee pain with or without signs of osteoarthritis," they conclude.

"It is difficult to support or justify a procedure with the potential for serious harm, even if it is rare, when that procedure offers patients no more benefit than placebo," argues Professor Andy Carr from Oxford University in an accompanying editorial.

 

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Could this be true? Eating fermented foods linked to fewer social anxiety symptoms? Fifteen years ago before the world of bacteria could be explored with state of the art genetic tests, this would have sounded too woo-woo. And now we say - could be. Next the researchers will test an experimental version of this study to see if they find causation. Right now all we can say they are linked or that we see an association.

But note that exercise also reduced social anxiety (this was also a finding in other studies). From Science Daily:

Decreased social anxiety among young adults who eat fermented foods

A possible connection between fermented foods, which contain probiotics, and social anxiety symptoms, is the focus of recent study...The researchers found that young adults who eat more fermented foods have fewer social anxiety symptoms, with the effect being greatest among those at genetic risk for social anxiety disorder as measured by neuroticism. "It is likely that the probiotics in the fermented foods are favorably changing the environment in the gut, and changes in the gut in turn influence social anxiety," said Hilimire. "I think that it is absolutely fascinating that the microorganisms in your gut can influence your mind."

The researchers designed a questionnaire that was included in a mass testing tool administered in the university's Introduction to Psychology courses during the fall 2014 semester; about 700 students participated. The questionnaire asked students about the fermented foods over the previous 30 days; it also asked about exercise frequency and the average consumption of fruits and vegetables so that the researchers could control for healthy habits outside of fermented food intake, said Hilimire.

"The main finding was that individuals who had consumed more fermented foods had reduced social anxiety but that was qualified by an interaction by neuroticism. What that means is that that relationship was strongest amongst people that were high in neuroticism," Hilimire said.The secondary finding was that more exercise was related to reduced social anxiety. 

"However, if we rely on the animal models that have come before us and the human experimental work that has come before us in other anxiety and depression studies, it does seem that there is a causative mechanism," said Hilimire. "Assuming similar findings in the experimental follow-up, what it would suggest is that you could augment more traditional therapies (like medications, psychotherapy or a combination of the two) with fermented foods -- dietary changes -- and exercise, as well."

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Study after study finds health benefits from exercise of all sorts, but what about those people who are so fit that they run marathons longer than normal marathons of 26.2 miles?

This study looked at those who participate in extreme events include ultramarathons, which tend to be 30 to 50 miles long, but can be more than 100 miles long or even last 24 hours. One study published in 2014 found that "compared with the general population, ultramarathon runners appear healthier and report fewer missed work or school days due to illness or injury...have a higher prevalence of asthma and allergies than the general population" and they may get some "exercise-related injuries such as stress fractures involving the foot."

But this newly published study found that the effects of extreme exercise (because it causes changes in the gut wall and allows bacteria to leak into the bloodstream) can be very serious if you haven't trained properly and over a long period of time.

From Medical Xpress: Extreme exercise linked to blood poisoning

Researchers have discovered that extreme exercise can cause intestinal bacteria to leak into the bloodstream, leading to blood poisoning. Experts at Monash University monitored people participating in a range of extreme endurance events, including 24-hour ultra-marathons and multi-stage ultra-marathons, run on consecutive days.

"Blood samples taken before and after the events, compared with a control group, proved that exercise over a prolonged period of time causes the gut wall to change, allowing the naturally present bacteria, known as endotoxins, in the gut to leak into the bloodstream. This then triggers a systemic inflammatory response from the body's immune cells, similar to a serious infection episode. Significantly the study found that individuals who are fit, healthy and follow a steady training program to build up to extreme endurance events, develop immune mechanisms to counteract this, without any side effects.

However individuals who take part in extreme endurance events, especially in the heat and with little training, put their bodies under enormous strain above the body's protective capacity. With elevated levels of endotoxins in the blood, the immune system's response can be far greater than the body's protective counter-action. In extreme cases, it leads to sepsis induced systemic inflammatory response syndrome, which can be fatal if it is not diagnosed and treated promptly.

The study, led by Dr Ricardo Costa, from the Department of Nutrition and Dietetics, is the first to identify a link between extreme endurance exercise and the stress it may place on gut integrity. "Nearly all of the participants in our study had blood markers identical to patients admitted to hospital with sepsis. That's because the bacterial endotoxins that leach into the blood as a result of extreme exercise, triggers the body's immune cells into action."

Dr Costa said anything over four hours of exercise and repetitive days of endurance exercise is considered extreme...."It's crucial that anyone who signs up to an event, gets a health check first and builds a slow and steady training program, rather than jumping straight into a marathon, for example, with only a month's training," he said.

The research team found that people who were fitter and trained over a longer period of time leading into the ultra-marathon event had higher levels of Interleukin 10 – an anti-inflammatory agent, which allowed them to dampen down the negative health impacting immune response.

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Once again, research results finding that some daily physical activity (here 30 minutes 6 days a week) is linked to a lower risk of death (here 40% lower risk from any cause for elderly men).

The researchers said the increased physical activity levels was as good for health as giving up smoking, and the men who regularly engaged in moderate to vigorous activity lived on average 5 years longer then sedentary men. In this study the men had been observed over a 12 year period.

From Science Daily: Half hour of physical activity 6 days a week linked to 40 percent lower risk of early death

Thirty minutes of physical activity -- irrespective of its intensity -- six days a week is linked to a 40 percent lower risk of death from any cause among elderly men, finds new research. Boosting physical activity levels in this age group seems to be as good for health as giving up smoking, the findings suggest.

The researchers base their findings on people taking part in the Oslo Study, which invited almost 26,000 men born between 1923 and 1932 for a health check in 1972-3 (Oslo I).Some 15,000 agreed....These were categorised as sedentary (watching TV/reading); light (walking or cycling, including to and from work for at least 4 hours a week); moderate (formal exercise, sporting activities, heavy gardening for at least 4 hours a week); and vigorous (hard training or competitive sports several times a week).

Some 6000 of the surviving men repeated the process in 2000 (Oslo II) and were monitored for almost 12 years to see if physical activity level over time was associated with a lowered risk of death from cardiovascular disease, or any cause, and if its impact were equivalent to quitting smoking.During the monitoring period, 2154 out of the 5738 men who had gone through both health checks died.

The analysis indicated that less than an hour a week of light physical activity was not associated with any meaningful reduction in risk of death from any cause. But more than an hour was linked to a 32% to 56% lower risk.

Less than an hour of vigorous physical activity, on the other hand, was linked to a reduction in risk of between 23% and 37% for cardiovascular disease and death from any cause.The more time spent doing vigorous exercise the lower the risk seemed to be, falling by between 36% and 49%.And men who regularly engaged in moderate to vigorous physical activity during their leisure time lived five years longer, on average, than those who were classified as sedentary.

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Much has been written in the past few months on how to keep your brain sharp and avoid cognitive and memory declines due to aging, and especially how to lower the risk of dementia.

Many studies have shown the following to be beneficial to brain health: exercise (any exercise, including walking, is good), having friends and social networks to interact with, eating a lot of healthy foods (fruits, vegetables, whole grains, legumes (beans), seeds, nuts, and fish), having a purpose in life, using the computer, playing video games (action puzzle games such as Portal 2 and NeuroRacer, but according to one study - not Lumosity), participating in arts or crafts, and learning new skills - that is, try out and learn new things (a musical instrument, a new language, take a class, a new craft, etc), or even visit new places.

Many of these can be summarized as: feed your brain and body, and keep your brain and body active. Here is one recent study of aging, from Medical Xpress:

Civic engagement may stave off brain atrophy, improve memory

Instead of shrinking as expected, as part of the normal aging process, the memory center in the brains of seniors maintained their size and, in men, grew modestly after two years in a program that engaged them in meaningful and social activities, new Johns Hopkins Bloomberg School of Public Health-led research suggests. At the same time, those with larger increases in the brain's volume over two years also saw the greatest improvements on memory tests, showing a direct correlation between brain volume and the reversal of a type of cognitive decline linked to increased risk for Alzheimer's disease.

The research, published online in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, studied participants in the Baltimore Experience Corps, a program that brings retired people into public schools to serve as mentors to young children, working with teachers to help them learn to read in understaffed school libraries."By helping others, participants are helping themselves in ways beyond just feeding their souls. They are helping their brains. The brain shrinks as part of aging, but with this program we appear to have stopped that shrinkage and are reversing part of the aging process."

For the study, Carlson and her colleagues randomized 111 men and women to either participate in the Experience Corps (58) or not (53).... The control arm of the study, those not involved in Experience Corps, exhibited age-related shrinkage in brain volumes. Typically, annual rates of atrophy in adults over age 65 range from .8 percent to two percent. The men who were enrolled in Experience Corps, however, showed a .7 percent to 1.6 percent increase in brain volumes over the course of two years. 

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Get up every hour from your seat and walk a few minutes, and cut your risk of early death by 33% (by 41% in those with chronic kidney disease). Standing won't do it - have to move. Just make sure that little walk is not to the refrigerator. Other studies have found that sitting for long periods may increase the risk for chronic disease and early death. From Scientific American:

A Little Bit of Walking Can Add up to Improve Your Health

Want to reduce your risk of dying at a young age? Try walking casually for as little as 2 minutes per hour.While it is well known that intense exercise can help you get fitter, a new study has found that even a little exercise can still go a long way. Study participants who traded time on the sofa for a total of 30 minutes of walking during the day reduced their risk of dying over a three-year period by 33 percent.

For the participants with chronic kidney disease, the risk of dying was reduced by more than 40 percent, according to the findings, published today (April 30) in the Clinical Journal of the American Society of Nephrology.

The Physical Activity Guidelines for Americans, a complement to the government's diet guidelines, recommend that people do at least 75 minutes of high-intensity aerobic physical activity (such as running, swimming or biking), or 150 minutes of moderate-intensity activity (such as brisk walking) every week to reduce the risk of obesity, diabetes and other chronic diseases. But the researchers on the new study wanted to know what the minimum threshold was—the lowest amount of physical activity that could still provide health benefits, said Dr. Srinivasan Beddhu, a kidney specialist at the University of Utah School of Medicine in Salt Lake City and lead author of the new study. [How Many Calories Am I Burning? (Infographic)]

"This study specifically looked at what intensity of activity should be used to replace sedentary activity.... being sedentary is an active choice to indulge in activities that barely raise the energy expenditure above basal metabolic rate." That threshold of intensity, Beddhu said, appears to be low. The study found that "light-intensity activities," such as casual walking, are beneficial. In contrast, activities that are "low intensity," such as standing or writing at a desk, aren't enough to provide any meaningful health benefits, the study found.

For this study, Beddhu and his colleagues at the University of Utah and the University of Colorado used information from the National Health and Nutrition Examination Survey, which includes data collected from an accelerometer, a device that measures motion. This enabled the researchers to study the activities of more than 3,600 adults representing the general U.S. population, including 383 adults with chronic kidney disease. Over the course of three years, 137 of these participants died as a result of various causes. In general, those who exercised more were less likely to die during the study period.

Positive effects of exercise could be seen down to the level of 30 minutes per day of any kind of light activity....it could be attained merely by getting up to move around a few minutes every hour. The finding could be particularly beneficial for people with kidney disease, who tend to be sedentary and inactive throughout most of the day, Beddhu added.

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There has been a lot of discussion in the last few years of our gut bacteria (hundreds of species), the microbiome (the community of microbes living within and on a person (gut, nasal cavities, mouth, sinuses, etc.), probiotics, the finding of a link between bacteria and some chronic diseases, and how the modern lifestyle and antibiotics are wiping out our beneficial gut microbes. I am frequently asked how one can improve or nurture the beneficial bacteria in our bodies.

While no one knows what exactly is the "best" or "healthiest" microbial composition of the gut, it does look like a diversity of bacteria is best (may make you healthier and more able to resist diseases). Research also suggests that the diversity and balance of bacteria living in the body can be changed and improved, and changes can occur very quickly. And that the microbial communities fluctuate for various reasons (illness, diet,etc.). Diet seems to be key to the health of your gut microbial community. Prebiotics feed the beneficial bacteria in the gut, probiotics are live beneficial bacteria, and synbiotics are a combination of prebiotics and probiotics. But don't despair - you can improve your gut microbial community starting now. The following are some practical tips, based on what scientific research currently knows.

SOME STEPS TO FEED AND NURTURE YOUR GUT MICROBES:

Eat a wide variety of foods, especially whole foods that are unprocessed or as minimally processed as possible. Eat everything in moderation.

Eat a lot of plant based foods: fruits, vegetables, whole grains, seeds, nuts, and legumes. Think of Michael Pollan's advice: "Eat food. Not too much. Mostly plants."

Eat more washed and raw fruits and vegetables (lots of bacteria and fiber to feed and nurture the bacteria). Some every day would be good.

Eat more soluble and insoluble types of fiber, and increase how many servings you eat every day. A variety of  fiber foods every day, and several servings at each meal, is best. Think fruits, vegetables, whole grains, legumes, nuts, seeds. (See How Much Dietary Fiber Should We Eat? - also has a chart with high fiber foods, and Recent Studies Show Benefits of Dietary Fiber)

Eat as many organic foods as possible. There is much we don't yet know, and pesticides are like antibiotics - they kill off microbes, both good and bad. Somehow I think that lowering the levels in your body of pesticides (as measured in blood and urine) can only be beneficial. Also, organic foods don't contain added antibiotics and hormones. (Eat Organic Foods to Lower Pesticide Exposures).  But even if you can't or won't eat organic foods, it is still better to eat non-organic fruits, vegetables, and whole grains than to not eat them.

Eat some fermented foods such as kimchi and sauerkraut (they contain live bacteria), kefir, and yogurts with live bacteria. Eat other bacteria containing foods such as cheeses, and again a variety is best (different cheeses have different bacteria).

Try to avoid or eat less of mass-produced highly processed foods, fast-foods, preservatives, colors and dyes, additives, partially hydrogenated oils, and high-fructose corn syrup. Read all ingredient lists on labels, and even try to avoid as much as possible "natural flavors" (these are chemicals concocted in a lab and unnecessary). Even emulsifiers (which are very hard to avoid) are linked to inflammation and effects on gut bacteria.

Avoid the use of triclosan or other "sanitizers" in soaps and personal care products (e.g., deodorants). Triclosan promotes antibiotic resistance and also kills off beneficial bacteria. Wash with ordinary soap and water.

Avoid unnecessary antibiotics (antibiotics kill off bacteria, including beneficial bacteria).

Vaginal births are best - microbes from the birth canal populate the baby as it is being born. If one has a cesarean section, then one can immediately take a swab of microbes from the mother's vagina (e.g., using sterile gauze cloth) and swab it over the newborn baby. (See post discussing this research by Maria Gloria Dominguez Bello )

Breastfeeding is best - breastfeeding provides lots of beneficial microbes and oligosaccharides that appear to enrich good bacteria in the baby’s gut.

Live on a farm, or try to have a pet or two. Having pets, especially in the first year of life,  ups exposure to bacteria to help develop and strengthen the immune system, and prevent allergies. Pets such as dogs and cat expose humans to lots of bacteria.

Get regular exercise or physical activity. Professional athletes have more diverse gut bacterial community (considered beneficial) than sedentary people.

Can consider taking probiotics - whether in foods or supplements. They are generally considered beneficial, but not well studied, so much is unknown. The supplements are unregulated, and the ones available in stores may not be those that are most commonly found in healthy individuals. Research the specific bacteria before taking any supplements. Researchers themselves tend to stay away from probiotic supplements and focus on eating a variety of all the foods mentioned above (fruits, vegetables, whole grains, seeds, nuts, legumes, fermented foods) to feed and nurture beneficial bacteria.

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The statements in this editorial may be obvious to many, but it is nicely written and needs to be said. Basically it says that exercise will not help you overcome the ill effects of a poor diet. I agree with what was said, but felt that what was missing was mention that a poor diet also has negative effects on the microbiome (the community of microbes living within the person) - which we know is linked to health problems.

From Medscape: Workouts Do Not Work Off Ill Effects of Poor Die

Exercise enthusiasts cannot work off the ill effects of an unhealthy diet, say the authors of an editorial published online April 22 in the British Journal of Sports Medicine. "Let us bust the myth of physical inactivity and obesity," the authors write. "You cannot outrun a bad diet."

Physical activity levels in Western nations have remained flat during the past 3 decades, even as obesity rates have exploded. That observation is just one sign that calories, not lack of exercise, are driving the obesity crisis, argue Aseem Malhotra, MD, honorary consultant cardiologist at Frimley Park Hospital, United Kingdom, and science director for Action on Sugar, United Kingdom, and colleagues.

"However, the obesity epidemic represents only the tip of a much larger iceberg of the adverse health consequences of poor diet," the authors write. They say that the Lancet global burden of disease reports concluded that poor diet contributes to more disease than a combination of inadequate physical activity, alcohol, and smoking. As many as 40% of people with normal body weight will suffer from metabolic abnormalities typically associated with obesity, the authors write, including hypertension, dyslipidemia, nonalcoholic fatty liver disease, and cardiovascular disease.

Dr Malhotra and colleagues blame food industry marketing for promoting exercise over diet, comparing food industry public relations with discredited tactics used by the tobacco industry in the past. They say Coca Cola "pushes the message that 'all calories count'; they associate their products with sport, suggesting it is ok to consume their drinks as long as you exercise. However science tells us this is misleading and wrong."

The kind of calorie matters too, they emphasize. Calories from sugar promote fat storage and hunger; fat calories induce satiety. For every 150 calories consumed from sugar, there is an 11-fold increase in the prevalence of type 2 diabetes independent of weight or physical activity levels compared with consumption of 150 calories of fat or protein.

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Well worth reading in its entirety. In summary: Anyone who is physically capable of activity should try to reach at least 150 minutes of physical activity per week (walking is good) and have around 20 to 30 minutes of that be vigorous activity. This significantly lowers the risk of dying prematurely. (NOTE: the second study mentioned was in the April 8, 2015 post: Physical Activity That Makes You Sweat Is Good ) From the New York Times:

The Right Dose of Exercise for a Longer Life

Exercise has had a Goldilocks problem, with experts debating just how much exercise is too little, too much or just the right amount to improve health and longevity. Two new, impressively large-scale studies provide some clarity, suggesting that the ideal dose of exercise for a long life is a bit more than many of us currently believe we should get, but less than many of us might expect. The studies also found that prolonged or intense exercise is unlikely to be harmful and could add years to people’s lives.

The current broad guidelines from governmental and health organizations call for 150 minutes of moderate exercise per week to build and maintain health and fitness. But whether that amount of exercise represents the least amount that someone should do — the minimum recommended dose — or the ideal amount has not been certain.

In the broader of the two studies, researchers with the National Cancer Institute, Harvard University and other institutions gathered and pooled data about people’s exercise habits from six large, ongoing health surveys, winding up with information about more than 661,000 adults, most of them middle-aged. Using this data, the researchers stratified the adults by their weekly exercise time, from those who did not exercise at all to those who worked out for 10 times the current recommendations or more (meaning that the exercised moderately for 25 hours per week or more). Then they compared 14 years’ worth of death records for the group.

They found that, unsurprisingly, the people who did not exercise at all were at the highest risk of early death. But those who exercised a little, not meeting the recommendations but doing something, lowered their risk of premature death by 20 percent. Those who met the guidelines precisely, completing 150 minutes per week of moderate exercise, enjoyed greater longevity benefits and 31 percent less risk of dying during the 14-year period compared with those who never exercised.

The sweet spot for exercise benefits, however, came among those who tripled the recommended level of exercise, working out moderately, mostly by walking, for 450 minutes per week, or a little more than an hour per day. Those people were 39 percent less likely to die prematurely than people who never exercised. At that point, the benefits plateaued, the researchers found, but they never significantly declined. Those few individuals engaging in 10 times or more the recommended exercise dose gained about the same reduction in mortality risk as people who simply met the guidelines. They did not gain significantly more health bang for all of those additional hours spent sweating. But they also did not increase their risk of dying young.

The other new study of exercise and mortality reached a somewhat similar conclusion about intensity.  {NOTE: SEE APRIL 8, 2015 POST FOR DETAILS}

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A big question for many adults is: how can one age well and live to a ripe old age? The author of the book The Blue Zones has dedicated a lot of time to studying communities throughout the world where there are a lot of centanarians and they age well (healthy). What are their secrets to aging well? The answer seems to be: while the diets vary, overall they have a lot of plant based whole foods, they have a lot of physical activity, are committed to their families, take time to de-stress, and they have social networks with healthy behaviors. From NPR:

Eating To Break 100: Longevity Diet Tips From The Blue Zones

Want to live to be 100? It's tempting to think that with enough omega-3s, kale and blueberries, you could eat your way there. But one of the key takeaways from a new book on how to eat and live like "the world's healthiest people" is that longevity is not just about food.

The people who live in the Blue Zones — five regions in Europe, Latin America, Asia and the U.S. researchers have identified as having the highest concentrations of centenarians in the world — move their bodies a lot. They have social circles that reinforce healthy behaviors. They take time to de-stress. They're part of communities, often religious ones. And they're committed to their families.

But what they put in their mouths, how much and when is worth a close look, too. And that's why Dan Buettner, a National Geographic explorer and author who struck out on a quest in 2000 to find the lifestyle secrets to longevity, has written a follow up to his original book on the subject. The new book, called The Blue Zones Solution, is aimed at Americans, and is mostly about eating.

Why should we pay attention to what the people in the relatively isolated Blue Zone communities eat? Because, as Buettner writes, their more traditional diets harken back to an era before we Americans were inundated with greasy fast food and sugar. And to qualify as a Blue Zone, these communities also have to be largely free of afflictions like heart disease, obesity, cancer and diabetes. So clearly they're doing something right.

But in a nutshell,Buettner in 2004 rounded up a bunch of anthropologists, demographers, epidemiologists and other researchers to travel around the world to study communities with surprisingly high percentages of centenarians. He and the scientists interviewed hundreds of people who'd made it to age 100 about how they lived, then did a lot of number crunching to figure out what they had in common. A year after that book was published, the team announced they'd narrowed it down to five places that met all their criteria. They gave them official Blue Zone status: Ikaria, Greece; Okinawa, Japan; Ogliastra Region, Sardinia; Loma Linda, Calif.; and Nicoya Peninsula, Costa Rica. 

In the new book, which was released April 7, Buettner distills the researchers' findings on what all the Blue Zones share when it comes to their diet. Here's a taste: - Stop eating when your stomach is 80 percent full to avoid weight gain. - Eat the smallest meal of the day in the late afternoon or evening. - Eat mostly plants, especially beans. And eat meat rarely, in small portions of 3 to 4 ounces. Blue Zoners eat portions this size just five times a month, on average. - Drink alcohol moderately and regularly, i.e. 1-2 glasses a day.

Ikaria, Greece You may remember this Blue Zone from Buettner's wonderful 2012 New York Times Magazine article entitled "The Island Where People Forget To Die." As we've reported, health researchers have long praised the Mediterranean diet for promoting brain and physical health and keeping chronic diseases at bay. 

"Their tradition of preparing the right foods, in the right way, I believe, has a lot to do with the island's longevity," writes Buettner. And "what set it apart from other places in the region was its emphasis on potatoes, goat's milk, honey, legumes (especially garbanzo beans, black-eyed peas, and lentils), wild greens, some fruit and relatively small amounts of fish."Ikaria has a few more "top longevity foods:" feta cheese, lemons and herbs like sage and marjoram that Ikarians use in their daily tea...The Ikarians do eat some goat meat, but not often.

Sardinia, Italy ...Buettner writes that the Sardinians explain their exceptional longevity with their assets such as "clean air," "locally produced wine," or because they "make love every Sunday." But when Buettner brought along a researcher to dig deeper, they found that pastoralism, or shepherding livestock from the mountains to the plains, was most highly correlated with reaching 100.

So what are those ancient Sardinian shepherds eating? You guessed it: goat's milk and sheep's cheese — some 15 pounds of cheese per year, on average. Also, a moderate amount of carbs to go with it, like flat bread, sourdough bread and barley. And to balance those two food groups out, Sardinian centenarians also eat plenty of fennel, fava beans, chickpeas, tomatoes, almonds, milk thistle tea and wine from Grenache grapes.

Loma Linda, Calif. There's a Blue Zone community in the U.S.? We were as shocked to learn this as you may be. Its members are Seventh-day Adventists who shun smoking, drinking and dancing and avoid TV, movies and other media distractions. They also follow a "biblical" diet focused on grains, fruits, nuts and vegetables, and drink only water. ...Another key insight? Pesco-vegetarians in the community, who ate a plant-based diet with up to one serving of fish a day, lived longer than vegan Adventists.Their top foods include avocados, salmon, nuts, beans, oatmeal, whole wheat bread and soy milk.