HEALTHY AT 100 (12 page)

When it comes to authenticated supercentenarians (those who have lived to 110 and beyond), Okinawa is in a class by itself. Okinawa today accounts for 15 percent of the world’s documented supercentenarians, despite being the home of only 0.0002 percent of the world’s population.
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The authors and principal investigators of the Okinawa Centenarian Study have impressive credentials:

• Makoto Suzuki, M.D., Ph.D., is a cardiologist and geriatrician, professor emeritus and former director of the Department of Community Medicine at the University of the Ryukyus in Okinawa. Currently he is the chair of the Division of Gerontology at Okinawa International University. He has written more than two hundred peer-reviewed scientific publications.
  

• Bradley Willcox, M.D., is physician-investigator in geriatrics at the Pacific Health Research Institute and clinical assistant professor in the Department of Geriatrics, John A. Burns School of Medicine, University of Hawaii. He is also the principal investigator of the U.S. National Institutes of Health–funded study “Genetics of Exceptional Longevity in Okinawan Centenarians.”
  

• D. Craig Willcox, Ph.D., is a medical anthropologist and geron-tologist. A professor at Okinawa Prefectural University, he is also a research associate with Harvard University’s New England Centenarian Study.
  

I emphasize the credentials of the Okinawa Centenarian Study’s authors in order to make the point that the people who have developed the extraordinary body of information we have about health and longevity in Okinawa are a group of well-respected clinicians and scientists. Science is not, however, the only valid way of obtaining knowledge, nor must people have credentials to be wise. Many of the world’s most outstanding people have had only limited schooling. Winston Churchill, for example, as well as Will Rogers, Irving Berlin, Walt Disney, Frank Lloyd Wright, Pablo Picasso, and Henry Ford never went beyond high school.

Sometimes an overabundance of education can turn people into walking encyclopedias who forget that there are vast realities that cannot be measured or analyzed. I find it deeply meaningful, though, when a group of highly educated scientists use their specialized skills and knowledge for the greater good of all. And this is what the researchers who have conducted the Okinawa Centenarian Study have done, bringing both scientific expertise and human understanding to their investigation of wellness and longevity in Okinawa.

Along with their research teams, they have visited and studied more than six hundred centenarians and thousands of other elders in their eighties and nineties. Their vans have been loaded with equipment to collect vital information for complete geriatric assessments. They’ve taken syringes for drawing blood for biochemical and genetic analyses, reflex hammers for assessing the health of the nervous system, electrocardiographs for measuring the health of the heart, questionnaires and surveys for assessing mental status, and cutting-edge heel-bone densitometers (portable machines that measure bone health and osteoporosis risk).
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Having meticulously studied the elders in Okinawa, these researchers tell us that it is an everyday occurrence in Okinawa to find “energetic great-grandparents living in their own homes, tending their own gardens, and on weekends being visited by grandchildren who, in the West, would qualify for senior citizen pensions.”
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They say it is commonplace for people in Okinawa to live past the age of 100 and remain active, healthy, and youthful looking. Pointing out that the word “retirement” does not exist in the traditional Okinawan dialect, they add:

By 1990, Okinawan life expectancy figures had even
surpassed
the absolute limits of population life expectancy assumed by the Japan Population Research Institute. Limits had to be revised
upwards
simply to account for the phenomenal longevity of the Oki-nawans.
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After more than thirty years of ongoing study, the medical research team reports that among the elders of Okinawa, heart disease is minimal, and breast cancer is so rare that screening mammography is not needed. The three leading killers in the West—coronary heart disease, stroke, and cancer—occur in elderly Okinawans with the lowest frequency of any elder population ever thoroughly studied by modern science.
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The medical research team states:

Our study found the elders to have incredibly young arteries, low risk for heart disease and stroke, low risk for hormone-dependent cancers (healthy breasts, ovaries, prostates and colons), strong bones, sharp minds, slim bodies, natural menopause, healthy levels of sex hormones, low stress levels, and excellent psycho-spiritual health.…If North Americans lived more like the elder Okinawans, we would have to close eighty percent of the coronary care units and one-third of the cancer wards in the United States, and a lot of nursing homes would also be out of business.
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There is something deeply poignant about the contrast between the health and longevity enjoyed by the elders in Okinawa and the experience of aging that is common among elders in the United States and other Western countries today. If you visit most nursing homes in North America, you’ll see a less than pretty picture. You’ll find elders in various states of decrepitude, helplessness, and, all too often, despair.

And it’s not just in the last years of life that the difference is dramatic. In Okinawa, elders tend to stay remarkably fit and healthy until the last year or two of life, but in the modern Western world, the prevailing lifestyle takes a toll far earlier in life. In the United States and similar countries today, most of us hit our peak between twenty and thirty and gradually decline after that. By the age of seventy,
most of us have lost 60 percent of our maximal breathing capacity, 40 percent of our kidney and liver functions, 15 to 30 percent of our bone mass, and 30 percent of our strength.
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It’s far different in Okinawa, where many elders are still in good health, completely independent, and still doing active physical work such as farming even a century or more after their birth. In a typical case, a very elderly man being interviewed in the Okinawa Centenarian Study said he was in perfect health. After completing a full geriatric assessment including an electrocardiogram, the researchers concluded that he was correct. Try as they might, they could find nothing wrong with his body. Even at the age of 100, he was utterly healthy.

Was this man a rare case? Far from it. The researchers studying the elderly in Okinawa kept finding people like him, people perfectly healthy at 100.
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The human heart doesn’t actually look very much like a valentine, but it is nevertheless a wondrous and beautiful muscle. About the size of a large pear, it begins to beat only a few weeks after conception, and then proceeds to pump forth the rhythm of our lives through every moment of our uterine and earthly existence. Only at the moment of our death does it cease.

This beating has a definite purpose: to pump blood to all parts of the body. The life of our very cells depends on the oxygen and nutrition brought to them by the flow of our blood. If for some reason any muscle did not receive a fresh flow of blood, it would quickly die.

Since the heart is also a muscle, it, too, must continuously receive fresh blood. You might think that receiving a blood supply would never be a problem for the heart, since its chambers are always full of blood. But the heart is not able to directly utilize any of the blood contained within its pumping chambers. Instead, the heart muscle feeds from the blood supplied to it through two specific vessels, called the coronary arteries.

In a healthy person, the blood flows freely and easily through the
coronary arteries, and the well-supplied heart keeps pumping away as it should. But if one of the coronary arteries, or one of its branches, should become blocked and thus unable to furnish the heart with blood, then even though the heart’s chambers are full of blood, that part of the heart dependent on the blocked-off artery will die.

In medical terms, this is called a “myocardial infarction.” Most of us know it by another name—a heart attack. Heart attacks are the single largest cause of death in the United States today, for both men and women. Every 25 seconds, another person is stricken. Every 45 seconds, another life is lost.

Though heart attacks strike suddenly, and often without forewarning, they do not “just happen.” They are actually the final step of a slow and lengthy process that takes place in our arteries, called “atherosclerosis.”

Atherosclerosis is the process by which arteries gradually accumulate fatty and waxy deposits on the inner walls, thus reducing the size of the openings through which the blood can flow. The foreign deposits which adhere to the inner walls of the arteries are called “atheromas” or “plaques.”

When these plaques become advanced enough, the fatty contents of the deposits will rupture into the artery and form a clot. These clots may clog up the already reduced arterial opening, and thus entirely prevent the flow of blood through the artery. If a clot forms in one of the two coronary arteries that supply the heart with its only source of life-giving blood, and the coronary artery becomes blocked by the clot, the heart is deprived of its supply of blood, and the result is a heart attack.

You may know that most men in North America today die from diseased coronary arteries that lead to fatal heart attacks. But it’s not only men. If you are a woman in North America, you have nearly a 50 percent chance of dying from heart disease—ten times your risk of dying from breast cancer. We take arteriosclerotic heart disease so for granted today that we may not realize it is one of the greatest epidemics mankind has ever faced, carrying off a larger percentage of the population than did the Black Death in the Middle Ages.

This is why it is so significant that according to the Okinawa Centenarian Study, elder Okinawans have only 20 percent as many heart attacks as North Americans do.
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According to the medical researchers who have conducted the study, even in old age the Okinawans have very healthy blood vessels. Their coronary arteries are amazingly young, supple, and clean.
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Furthermore, if Okinawans do suffer a heart attack, they are more than twice as likely as North Americans to survive.
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But there’s still more to it than that. Coronary heart disease dramatically lowers quality of life. The arterial disease that leads to heart attacks not only damages the vessels leading to the heart but also damages the rest of the circulatory system, causing premature aging of the whole body.

I have been deeply moved by the reality that if North Americans were to live and eat the way the elderly Okinawans do, there is every likelihood that we, too, would greatly reduce premature aging, enhance the quality of our lives, and reduce our risk of heart disease by 80 percent.

Can you imagine what would happen if a pharmaceutical company developed a drug that could accomplish these benefits and risk reduction? It would be marketed and sold in a manner that would make the sales efforts for Viagra look modest in comparison. It would be trumpeted in practically every magazine, newspaper, and television health report in the world. And it would make tens if not hundreds of billions of dollars for its manufacturer. But since there is comparatively little profit to be made from encouraging lifestyle changes, the wider public has little idea of the extraordinary benefits such changes can bring.

Yes, you might be saying, but what about cancer? What good would it do me to avoid heart disease as I age, only to succumb to the terrors of cancer?

If you think that way, you are not alone. Many people live in dread of developing cancer. And they have reason. More than thirty
years have elapsed since the war on cancer was officially declared by U.S. president Nixon. And despite the enormous effort expended in terms of manpower, resources, and money, we actually appear no closer to winning the war than we were on the day it was declared. New drugs are constantly being approved, many of which can cause a temporary shrinkage in tumor size. But very few have yet been found that can eradicate any kind of cancer permanently.

On March 22, 2004, a cover story appeared in
Fortune
magazine with the discouraging title “Why We’re Losing the War on Cancer.” The author was Clifton Leaf, the magazine’s executive editor and a survivor of adolescent Hodgkin’s disease. Feeling extraordinarily lucky to have survived, he nevertheless had the courage to ask, “Why have we made so little progress in the war on cancer?” His article revealed how poorly things are going in the world of cancer treatment today:

• More Americans will die of cancer in the next fourteen months than have died from all the wars the United States has fought combined.
  

• Even adjusting for age, the percentage of Americans dying from cancer has not improved since the war on cancer began.
  

• The much-vaunted improvement in survival from cancer is largely a myth. “Survival gains for the more common forms of cancer are measured in additional months of life,” wrote Leaf, “not years.”
  

• Most of the improvement in longevity of cancer patients can be attributed to early detection, not treatment. Patients now often die at the same stage in their cancer’s development as they once did, but since they knew earlier that they had cancer, it can appear that they “survived” longer with the disease.
  

• The few dramatic breakthroughs (such as in Hodgkin’s disease) occurred mainly in the early days of the war on cancer. There has been little substantial progress in recent decades, despite the claims to the contrary.
  

This lack of progress in the world of cancer treatment is largely hidden from the public. Physicians don’t like to talk about their failures,
and drug companies are always hyping the newest drug. This can give the false impression that progress has been made when it hasn’t. But recognizing that the war on cancer has thus far been largely a disappointment doesn’t mean you have to lose hope. It can help you turn your attention to where there are solid grounds for real hope—
prevention.