How to Eat Like Blue Zones In America with Dan Buettner

Mark Hyman, MD

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Introduction: Coming up on this episode of the Doctor's Pharmacy. Dan Buettner: If you want to get healthier, don't try to change your behavior because that fails for almost all the people, almost all the time. Shape your ecosystem, shape your environment. Dr. Mark Hyman: Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman. That's pharmacy with [inaudible 00:00:21] place for conversations that matter. If you care about living long and living healthfully as you get older, we're going to have a great conversation today with one of my favorite humans, Dan Buettner, who has introduced to us the concept of the blue zones, places where people live very long and very well and don't seem to die these long, painful, expensive deaths, but live long, happy and engaged, connected lives. Dan is an amazing guy. He's a National Geographic fellow. He's an award-winning journalist, producer, New York Times bestselling author. He's discovered the five places in the world, and I've been to three of them thanks to Dan who's helped me, called Blue Zones hotspots, where people live the longest, healthiest lives. His articles about these places have been in National Geographic, the New York Times, and also his new book, which is just coming out, Blue Zones American Kitchen is amazing. In it, Dan uncovers the traditional roots of plant forward cuisine in the United States with wisdom from more than 50 food experts, chefs and cooks around the country. Dan's road trip across America sheds light on some of its most under-recognized plant forward communities as Dan shares the ingredients, recipes and lifestyle tips that will make living to 100 both delicious and easy. Welcome, Dan. Dan Buettner: Thank you. Mark, what a wonderful introduction. I'm kind of blushing. Dr. Mark Hyman: Oh, well I think you are quite a guy. You're like one of those guys who's like Indiana Jones of longevity. You kind of go wherever you need to go to figure out what needs to get figured out about how we can live better and live longer. Dan, I think the question is sort of perturbing me now, and as we are talking about longevity as, more research money is going into it, as more books are being published on it, including my own coming out next year. At the same time we're seeing this interest in longevity, we're seeing this dramatic drop in life expectancy, which is pretty disturbing to me. Why is this happening? Dan Buettner: Well, I think we can trace it to our food supply, actually. You're right, life expectancy has dropped for the first time in living history over the last couple years and it's largely because of chronic disease. Of course COVID is part of it, but if you look at who's dying of COVID, it's mostly the oldest old and the people suffering from one or more chronic diseases. Those diseases are almost all, and I would argue mostly driven by the food we eat. Dr. Mark Hyman: Which is ... Dan Buettner: Overwhelmingly ultra process food with added sugar. About 70% of all products in a grocery store are processed or have added sugar. We eat about 220 pounds of meat a year, which is not to say a little meat isn't bad for us, but that's just way too much. About 140 pounds of sugars and added sugars into our diet. This just isn't the way humans have evolved. The idea behind Blue Zones was to look at the way people are actually making it to eighties, nineties, and a hundred without these chronic disease, how they've eaten over time. It's vastly different than the way we're eating today. Dr. Mark Hyman: Yeah, it's quite different. Our diets are quite different. So our view of aging, and I wrote a lot about this in my book, is often anchored in what we see around us and the consequences that we see of people getting older in America, which is decrepitude, memory loss, less agile, many chronic diseases, less functional, nursing homes, but these are really not necessarily necessary for aging. They're not necessarily natural consequence of aging. They're signs of disease that actually can be prevented in reverse. So what do you think the biggest drivers of this abnormal aging that we see so much in America is, and what are the biggest factors controlling this and making it happen? Dan Buettner: Well, I think the average maximum life expectancy of the human machine, your body, my body, everybody listening right now is about 95. Right now there's not a lot we can do to lift that ceiling. I know there's been a handful of people who've made it into their hundred and above, age 115, but your chance of making it to a hundred in America right now are about one in 2,500. So in blue zones we found these populations who are making it into their mid nineties, not because they have better genes or better bodies, but because they're alluding the diseases that shorten our lives. So they suffer about one fifth the rate of diabetes, about a quarter of the rate of heart disease, and at least one of the blue zones, Acadia about a 10th, the rate of dementia. So here we have real human populations showing that we can avoid these chronic diseases in also you and me, and that it's these chronic diseases that are lopping off about 14 years of potential life expectancy for the average American. Again, part of it is we drive a lot, part of it we're stressed, part of it we spend too much time, I believe, on our devices. I think we violently agree on these, but I would say 60% of the chronic disease and therefore the unnecessary aging is due to the food we eat. I'll go a step forward to say that if you're overweight and unhealthy living in America today, it's probably not your fault. If you want to dive into that, I'll tell you exactly why it's not your fault. Dr. Mark Hyman: Okay, well let's dive into that because I want to talk about your book, the Blue Zone's Kitchen and the American Kitchen in particular because it's out and it takes us through the landscape of America and, in very surprising ways, uncovers populations that have kept food ways that have promised to keep us living longer. But before we get into that and what you discovered, which is a really cool story, I want you to explain what you just said and why it's not our fault. Dan Buettner: Well, if you go back 40 or 50 years back in the United States, Americans had about one third the rate of obesity, one fifth to one seventh, depending on how you measure the rate of diabetes, about a fifth the rate of dementia for older people. You start asking yourself, well is that because people who were living in the seventies and eighties had better diets or they had better sense of individual responsibility or better discipline than we do? Or they love their children more than we love our children? The answer is none of these. The answer is our food environment has changed and the vast majority of choices that we have on a day to day basis are bad choices. The number of fast food restaurants have gone up by a factor of five, over 50% of all retail outlets, including where you get your tires changed and you pick up your diabetes medicine, have sugar sweet and beverages and candy bars and cookies and chips. So you can't escape it. As a result, we are fatter. Well, we weigh more and we're less healthy. It's not because we lack basic goodness. Dr. Mark Hyman: Yeah, I think that's right. I think we live in a toxic environment both from the perspective of our food environment, sedentary lifestyle, stress, environmental toxins. The list goes on. So what's really exciting is that, because of you, I got inspired to go visit some of these blue zones in Sardinia, in Icaria, I don't want to say Icaria, I don't know. But anyway- Dan Buettner: You're choice. Dr. Mark Hyman: It was a real eye opener to me. I got to go into the homes and harvest of these people to see what they were eating and it was so different. In Icaria they were eating a lot of wild foods like wild greens and wild mushrooms and wild sage tea, which has really high levels of these catkins that are found in green tea. Clearly the diet played a huge role, but it wasn't only that. So tell us about a little bit about how you figured out what these blue zones were, what they are, and what are those habits of the world's healthiest, longest the people. Dan Buettner: So it's a two step process, and both I did under the Ages of National Geographic and with funding from the National Institutes on Aging. So you begin with the widely accepted assumption that only about 20% of how long we live is dictated by our genes. The other 80% is something else. Then we funded the demographers to parse through worldwide census data to find these areas where people are living statistically longest. The number we most like to look at is the rate of middle aged mortality. So where in the world are people our age most likely to reach a healthy age 95. Then we found these five so-called blue zones. Then to discern what they've been eating, we did a meta-analysis. I know you know what that means, but it's essentially a big average. We found, if you want to know what a centenarian ate to live to be 100, you can't just ask him what he's been eating lately. You have to know what he was eating when he was a young kid and middle age. So for that, we found dietary surveys done in all five blue zones over the past 80 years. We see very clearly exactly what they're eating. When you average that all up, the diet is basically a whole food plant-based diet. Dr. Mark Hyman: Yeah, yeah, it's true. I remember this woman, Julia, she was 100 and three months. She was like, "I'm 100 and three months." I guess it's like when you're five, you go, I'm five and three quarters. She said when she was little, they were so poor, they would eat one egg between the family of 12. One egg, and they would share it. Dan Buettner: Not a big omelet. Dr. Mark Hyman: No. They would have one potato and minestrone soup. It was fascinating to see how honestly sparse her diet was and how struggle it was to get food, and how it wasn't sort of accessible as it is now. I think their diet has changed quite a bit. But there's still a lot of very old people there. Even now, even them having more adapted to eating more varied diet, they're really still pretty old than robust. It's more than just the food. It's their social connections and their activity. I remember Pitero was 95. I don't know if you know this guy, but he was in in Sardinia. He was a shepherd and he literally just retired I think the year before and was hiking up and down these rugged mountains five miles a day. I'm like, God, I haven't sent a 95 year old like that in America in a long time. He had this booming voice and sang me this song, this great Italian song. So tell us more about some of these, I think you said there's like nine characteristics in these blue zones that you identified that contribute to longevity. Dan Buettner: Yes. So they tend to have vocabulary for purpose. They know why they wake up and they're not stressed out to figure out what their place in the world is. They tend to have very strong family values. They belong to faith. We know people belong to faith live four to 14 extra years. They have these sacred daily rituals that help unwind some of the stress of everyday living, including ancestor veneration, nap taking, prayer works, even happy hour, as you might have seen in Sardinia. They tend to have a very closely knit group of immediate friends. In Okina we call this a [inaudible 00:12:28], a group of friends who they can count on a bad day who are there to have meaningful conversations with them and reinforce the right behavior. So friends, their idea of recreation tends to be gardening or walking. They already have this habit of eating mostly whole food plant based. But the big insight, Mark, to all these blue zones is these people don't possess better discipline than you or I. They don't have better diet plans. They don't have a better sense of individual responsibility when it comes to their health. All they do is live their life. The insight is that if you want to get healthier, don't try to change your behavior because that fails for almost all the people, almost all the time. Shape your ecosystem, shape your environment. People in blue zones, the cheapest and most accessible foods are the food I write about in the Blue Zones American Kitchen, whole food, plant based. Dr. Mark Hyman: Yeah, it's so true. I think I'm curious in your travels and explorations, was there anything super surprising that you found about these communities and some of the things that you found in the blue zones that maybe we wouldn't expect? Dan Buettner: A couple interesting coral mark. When I started this work in 2002, I was really sort of looking for an herb or a compound that explained longevity. And none of that's true. Dr. Mark Hyman: A magic bullet. Dan Buettner: They don't take supplements, they don't take pills. But interesting that we found in Sardinia where I think you met Julia, that there's a strong correlation between how steep your village is and your chance of making it to 100. Dr. Mark Hyman: wow. Dan Buettner: There was a correlation between how many daughters. These guys who had five or more daughters were the most likely to make it to 100. Dr. Mark Hyman: Wow. Why? Dan Buettner: It might be because daughters take care of their aging fathers, or it might be a selection bias. If you can survive five adolescent girls making it to 100, it's no problem, but it's this [inaudible 00:14:35]. I can't explain why. For me, really the exciting thing, I started out a very scientific, hellbent to find the [inaudible 00:14:48] or the metformin or one of these other magical compounds that we could put in a pill and sell. But what I found were that these counterintuitively simple things are vastly more powerful than we think. Waking up with a strong sense of purpose, worth eight years of life expectancy. A strong social circle around you, worth seven years of life expectancy. Eating a whole food plant-based diet as opposed to the standard American diet is worth 13 years of life expectancy for a 20 year old. So these are things that aren't sexy, that you can't make a lot of money off of them, but they are so powerful. They literally hold the answer to this $3.5 trillion healthcare bill we grapple with and the pain and suffering of more than three quarters of a million Americans dying prematurely every day because of eating the diet we're eating. Dr. Mark Hyman: Yeah, so true. Well I think one of the things that people think about when they think about diet is it's hard to do it right. It's hard to shop and cook and do all these things, but people really are, I think, disenfranchised now from their kitchens. In the fifties, there were federal extension workers that went around America teaching young families and mothers how to cook and grow gardens and feed their families. Then the food industry came in and developed the Betty Crocker cookbook, which Betty Crocker was an invention of the food industry to insinuate processed food in the American kitchen. Basically put one can of Campbell's cream of mushroom soup in your casserole and one roll of Ritz crackers on top of your broccoli casserole. Remember that? Dan Buettner: I do. [inaudible 00:16:32]. Dr. Mark Hyman: All the ideas that cooking was drudgery and cooking was difficult and it takes too much time and it's beneath most people. You deserve a break today. Remember all those ads. What have you found about the correlation between cooking and longevity? Dan Buettner: Well first of all, in all blue zones, and I'm sure you observed this, people are cooking for themselves. They might go out to dinner for a wedding or a birthday, but they're cooking three meals a day. So they get good at it. Once you gain the skill, it's actually very easy. Number two, every time you go out to eat in America, you consume about 300 more calories than you would if you just ate at home. Those calories tend to be laden with sodium, added sugars, added fats. That's what's making us sick. So you're right. I think one of the silver linings to the pandemic were people were stuck at home and they relearn the art of cooking and the art of baking. That's definitely the right direction. Dr. Mark Hyman: Baking, I don't know. Baking, I wouldn't have that in there. Dan Buettner: Well, yeah. Dr. Mark Hyman: Cookies, cakes, pies. It's not definitely the longevity diet. Dan Buettner: I'm a fan of the sourdough bread though. I don't know if you tasted the sourdough bread in Sardinia, but it seems that people eat a true sourdough bread with the plant-based meal, they lower the glycemic load of the meal by quarters. Dr. Mark Hyman: Yeah, it's true. Actually, I'll tell you a funny story. Paula and Andora gave me as a present, when you hooked me up with in Sardinia to go around to these places. They gave me this starter jar of sour dough starter that was 150 years old and I brought it home with me, but the jar broke in my suitcase. Dan Buettner: Oh no. Dr. Mark Hyman: It went all over everything, so I didn't get to use it. I have to go back. I'm actually going back this summer. Dan Buettner: You could probably still scrape it off your underwear and bake a loaf of bread. Dr. Mark Hyman: I don't know how that would taste. I'm going back next summer actually in April. I'm going to go back and get some more. But yeah, I think you also know, Icaria, they made this incredible bread with Philip. Remember Philip? In this oven that was outdoor wood oven, but it was a zia wheat, which was this ancient wheat that was used by Alexander the Great to fortify him on his expeditions to conquer the world. It's high in protein, it's low in starch, it's full of minerals, it's really quite interesting. Very low gluten. It was delicious bread. It was very different. So yeah, it's not necessarily bread is bad. It's the kind of bread we're eating in America. Dan Buettner: Yeah, and how we bake it. But getting back to this notion of cooking. Dr. Mark Hyman: Cooking. Yeah, how is it connected to longevity? Dan Buettner: Well, if you've ever seen somebody bake bread, the kneading takes a half hour and they're in there getting a workout, breaking a sweat. Some of these old ladies have Popeye arms from kneading bread. So we see in blue zones, people really aren't exercising. I think you'll remember, you didn't see any gyms in Icaria or in Sardinia. Dr. Mark Hyman: No. Dan Buettner: People are staying in shape because they're moving naturally. So they're still doing things by hand. So they're getting that mindless physical activity. Cooking also tends to be a social activity. Ladies baking bread together, families cooking together, and they can control the ingredients. Mark, when it comes to longevity, there's no short term fix. There's nothing you can do today, this week, or this month that's going to make you live longer in 50 years, short of not dying. So when it comes to longevity, you want to think of things that you're going to do for a long time. And learning the skill of cooking and learning how to cook with beans, I think are the greatest super foods in the world. The people in blue zones have a gift for making beans taste delicious. Getting your protein from beans, soaked and well cooked so the lectins aren't an issue. Pairing them with a whole grain, adding some greens in there. Man, I'll tell you what, it's another 13 years of life expectancy. Dr. Mark Hyman: So what I'm really excited about is your new book, which is the Blue Zones American Kitchen. So it's kind of like, wait a minute, blue zones are not in America because we're all sick and overweight and dying fast and early and it's getting worse. But you took a trip around America and you found four food traditions in America that match a longevity diet and they're kind of unexpected. I'd love you to tell us about these historical diets in various demographic groups in America and how they can help the average America live another decade or two or more. Dan Buettner: Yes. So the Blue Zone Kitchen, which we talked about was number one, New York and number one Wall Street Journal best seller. I thought, well, if there's diets and longevity around the world, if you looked hard, maybe you could find diets of longevity in the United States. So we knew the dietary pattern from these other blue zones. Then I hired a researcher from BYU, Marianne Nestle helped me on this. Dr. Mark Hyman: Oh yeah. Dan Buettner: We went deep in the archives, and it turns out that there was a researcher named Atwater, Wilbur Atwater, who between 1890 and 1930 or so sent out teams of people in America to do dietary surveys. We found, not among my ancestors, the central Europeans and Northern Europeans, they brought their pigs and their cows and their pickles over. They weren't eating such a healthy diet. But among the African, Asian, Latino, and Native Americans, according to these dietary surveys, they were eating a dietary pattern almost exactly the same way of the ones you and I observed in Icaria and Sardinia and even Costa Rica. So National Geographic photographer, David McClain and I, after identifying this dietary tradition, then during the pandemic we traveled from Maine to Miami to Minneapolis to Maui. We found these chef historians who either could recreate or who never stopped cooking this way. The Blue Zone American kitchen is a hundred recipes to live to 100 from Americans. It's the lost diet of longevity. Dr. Mark Hyman: Amazing. So give us some examples of the traditions and what the foods were and what they're making. Dan Buettner: So there's descendants of enslaved Americans in the Southeast known as the Gullah Geechee people. The Gullah Geechee were imported, enslaved from West Africa, largely because of their rice growing ability. They brought a type of a rice, it's not an Asian strain, but an African strain of rice and started growing it. In fact, the biggest manmade feature in the world is called the Ace Basin. They got very good at growing this type of rice called Carolina Gold, very healthy rice. And because they were better at it than their masters were, they were afforded some freedoms. They lived in buildings next to their rice patties and they made friends with the Native Americans. They had European influences from their overlords, and they fused a type of cuisine that includes the black eye peas, the scotch bonnet peppers, the sesame seeds, the vinegar, the okra, that West African word for okra is gumbo. They brought that back and they made these fusions of gumbos that, unlike Orleans, which are filled with sausage, here they're filled with beans. So really healthy food that makes your eyes tear up with tears of joy. Dr. Mark Hyman: Aw, that's quite amazing. I actually just watched an amazing movie called Gather. I don't know if you've seen it, but it was a movie about reclaiming Native American food ways and the ways in which they were able to draw from the land these extraordinary foods that actually were far healthier. I remember this one woman was teaching her niece actually how to find and get the mice. They were eating mice, not my thing. But she's like, "We kind of look at where the plants are around where the mice are living, and we can tell how healthy that's going to be from the medicinal plants that the mouse eats that actually get in their system that we then benefit from." It was quite amazing. I was recently reading about a sous chef who has a restaurant in Minneapolis where you're from. I don't know how to say this, oh, a mini restaurant. This is Lakota chef who's gone and actually created a restaurant where they cook only foods that are from America, that were here before, that were the delicious foods that were wild or that they cultivated, and they were quite amazing and delicious foods. So I think a lot of these cultural ancestral foods have been colonized. In other words, they've been displaced. A lot of these people are reclaiming them, whether it's the choke berries they're eating or the various kinds of native foods that they find growing wild, or even the bison that they grow. This is incredible in terms of their cultural food programs that they're now reclaiming. I wonder what else you found in some of the Native American explorations of their diets. Because a lot of these populations are extremely overweight, extremely obese, and have diabetes that rates far exceeding us. Up to 80% of some Native American populations are diabetic by the time they're 30. That's compared to one in 10 of the rest of us, which is still a lot. So what did you learn around their foods and their food ways? Dan Buettner: So the chef that you were talking about is Sean Sherman, the sous chef. He's from Minneapolis. He actually, as part of this book, he contributed three recipes. Dr. Mark Hyman: Amazing. Dan Buettner: He'll point out to you, chickens and beef and pork were never part of the Native American diet, either was refined sugar. Dr. Mark Hyman: No. Dan Buettner: So they've been victims of this food environment imposed upon them. Originally, where I'm from Minnesota, they ate a lot of wild rice. They had some wild game, but they were mostly hunting and gathering on the east coast. Interestingly, part of this book, we found a Wampanoag negative American who lives up near Plymouth Rock and a modern day pilgrim named Paula Marco. She's a historian. They recreated an original Thanksgiving dinner. In other words, a meal that might have been served in the early 17th century. Contrary to what most of us believed, there was probably no turkey at the original Thanksgiving. There was no pumpkin pie. They didn't have flour, they didn't have eggs, they didn't have sugar. So what were they eating? Well, they were eating foods that these native Wampanoag people were providing. It was probably foods like succotash, which is a stew made from beans, corns and squash. There also tamales, but maybe stuffed with hazelnuts, with squash stuffed with dried blueberries and maple syrup, which were all available. So not at all the foods we think were at the original Thanksgiving. But all in all, it was very healthy diet until processed food came on scene. Dr. Mark Hyman: Yeah, I read an article that Sean wrote in Time Magazine about some of the native foods that they are using, like wild mushrooms like chanterelles, morels, ramp, wild ginger, choke berries, wild plums, crab apples, cactus fruit, manzanita berries, wild rice, rose hips, hickory acorns, walnuts, really quite amazing. Corn, obviously some of them use, but it was very ancient varieties of corn that are quite different than what we have. So they had smoked salmon and wild teas and native squash. It's quite a different diet and those foods are so medicinal. We know that. This is what sort of struck me about Icaria. I don't know if you really noticed this, but how much wild food they ate as part of their normal diet. As a doctor, I know that studying phytochemicals in the food, that wild foods are far richer in phytochemicals than are conventionally raised. Obviously organic is a little better, but still wild foods are the most nutritionally dense. So it was kind of very interesting to sort observe that in Icaria. I think when we look at the Native Americans, there was no obesity, diabetes, heart disease, none of the diseases that we see today that are just crippling these populations. Dan Buettner: So to your point about wild foods in Icaria, I don't know if you noticed, they use about 80 types of wild greens. Dr. Mark Hyman: Yeah. Dan Buettner: Even whole foods, you might see spinach and kale and collared greens, but they're using fennel tops and dandelions and the kind of shit we weed out of our backyard, they're making delicious salad out of them and cooking them into pies. A lot of these greens have 10 times the antioxidants of that in a glass of red wine. But this once again goes back to the 1970s when Nixon told his agriculture secretary Earl Butts, we need more food at all costs. Dr. Mark Hyman: At lower cost. Dan Buettner: Right, at lower cost. But the sort of monoculture began that subsidized corn, soybeans, rice and wheat and sugar beets. Farmers actually get penalized when they grow a greater diversity. In fact, you can't get the subsidies if your farm is growing specialty crops, which are some of these more sort of arcane wild like. Dr. Mark Hyman: Well especially crops are fruits and vegetables. They're not even just wild greens. They're just fruits and vegetables. It's crazy. Yeah, it's nuts. We support the growing of foods that are killing us and not the growing of foods that are going to heal us. So it's kind of all backwards. You also found Latin American cuisine, which we typically think of as a lot of starchy stuff. But you found of sources of it that were actually very helpful and more sort of traditional. Can you talk about some of those foods in your Blue Zones American Kitchen? Dan Buettner: Yeah. I argue that the best diet the human species has ever invented are the three sisters. Goes back about 7,000 years in Meso America. It's three simple ingredients. Beans, corn, often ground up into tortilla, and squash. When you combine those three fluids, you have complex carbohydrates, you have all the amino acids necessary for human sustenance, IE a whole protein, high in folic acid, niacin. Latin Americans, we see this in Nagoya, but also the food tradition I captured in the Blue Zone American Kitchen, they're still using those foods. But one of the chefs pointed out, when all you're doing is frying meat or adding oil and sugar, it takes no creativity. But when you're using these simple plant based products, it forces a creativity that evolves over the centuries. So there's Diego Tosini. He's a Argentinian here in Miami, his Love Life Cafe, which takes these basic Latin American food stuffs, it's the hottest restaurant in Miami right now. The mayor eats there all the time. The glitterati is there. I think the Latin Americans among us, we have this Don Madrano we met in Houston. We tend to think of Tex Mex fair as steak fajitas or slathering cheese on enchiladas. But he actually went back and found that the original Texas Mexican cuisine is full of amaranth and pecans and walnuts and moles and peppers, and once again corn and beans. But he's brought back this nuanced flavor and these highly nutritional food ingredients and created a cuisine. He was just honored by the city of Houston. He's been written up in the New York Times. There's all these gems, the under celebrated people who are wildly gifted, but they're cooking in relative isolation. For the Blue Zone American Kitchen, I tried to capture these chefs who are recreating the diet of longevity. Dr. Mark Hyman: It's quite amazing. The book is really beautiful and it's sort of inspiring to think about how right here in America we have a lot of the kind of secrets to our own blue zones if we reclaim some of these old food ways that we've disrupted through our colonized food system. The three sisters thing is quite interesting too from an agricultural point of view because they grew the corn stalks and the beans grew up around the corn as a pole. They don't need bean poles. And the squash they used in between the plants as a cover crop. In other words, it kept the moisture in the soil so they didn't need to water it. So it was this brilliant inter cropping system and the beans put nitrogen in the soil as fertilizer for the corn. So it's just this incredibly beautiful synergistic system. They didn't probably know about nitrogen, they didn't know about fertilizer, they didn't know about all this stuff, but they knew that it created much more delicious food. I think historically we were always going for flavor in our food. Our flavor comes from the phytochemical richness of the food, which comes from how we grow it and the natural qualities of the food. I was sort of fascinated when I went to Korea about the honey because there they have all these different areas where they grow honey throughout the island at different elevations and different micro climates and with different plants that all have different medicinal properties. So it's kind of fascinating. They kind of knew without really knowing, you know what I mean? It was like they kind of had this sort of indigenous knowledge that we completely lost. Our diet has become so depleted. Even if you go to Whole Foods or what you think is healthy food, unless you go to a farmer's market where there really are growing foods that are kind of weird, I call weird foods, that you don't find in the supermarket, that are more heirloom foods that are grown in regenerative ways, that you're going to get some of these kind of plant rich diets that are incredibly healthful. Dan Buettner: I would like to inject a note of optimism there. You're quite right about the scarcity of these phytonutrients, scarcity of these foods. But if you are a mom living in Iowa or Fort Worth, Texas and my daytime job, I'm hired by cities to lower the obesity rate of these entire cities. Moms say, I can't afford to eat healthy, I can't afford to go out and buy organic foods. She's right. But on the other hand, what she probably doesn't realize, that a 25 pound bag of pinto beans from Costco and another bag of brown rice, 25 pound bag of brown rice will set you back about $30. Then with the combination of a little bit of oil, olive oil or some other healthy fat with some herbs, some salt, some spices, you can get about 90% the way there. At least it's a diet absent of a lot of the things we know will kill you. Like high fructose corn syrup, which is in so many products, added sugars, these highly refined grains in processed foods. So is it the Icarian super greens? No, but we have to give Americans a place to start and making tasty, delicious beans with a grain makes a whole protein. You're well on your way. Dr. Mark Hyman: Yeah, no, it's really great advice. I think eating healthy doesn't have to be expensive. You might not be getting a heirloom variety this or that, but you can get really delicious real whole foods at reasonable costs. Walmart's the biggest organic grocery store in the world. So you can get stuff at fairly inexpensive prices if you pick smartly and wisely and use the right foods. I saw this when I was down in easily South Carolina, one of the worst food deserts in America. This family I took care of there, as part of this movie Fed Up, they were family of five living in a trailer. They had food stamps and disability only. The father was 42, already on dialysis from this toxic American diet from diabetes at 42 years old. The mother was huge. The son was 50% body fat and diabetic at 16, almost diabetic. I said, look, rather than actually tell them eat this, do that. I went to their kitchen, I went shopping, I got some real ingredients, simple things, really simple. We made a chili with lots of beans, little ground turkey, salad. We made stir fried vegetables, we made roasted sweet potatoes. They never cooked in their kitchen before. Never, never. Everything was from a box, a can, a package, frozen this or that, microwaved. They loved the food. It was really delicious. I gave them a guide called Good Food on a Tight Budget, which was how to eat well for you and the planet in your wallet. They did it and they lost 200 pounds as a family. They were able to do this, again in one of the worst food deserts within a very limited budget. So I think it's possible. I think it may take a little education, a little training, a little support. That goes to the whole conversation that you really create around community. I want to sort of talk before we close about some of the work you're doing in communities around America because you didn't just go to the blue zones and have a good time and write these books and do talks and all that. But you got serious and you went into really difficult places in America which needed help. You actually recreated in a sense, American blue zones by constructing environments for people that made the easy choice the healthy choice, instead of the easy choice the unhealthy choice. This is what we have now. So can you talk about some of the work you've done there and some of the outcomes? It's pretty dramatic dropping healthcare costs and how you did it and what you're doing in that way. Dan Buettner: So the key insight I drew from 15 years of studying blue zones is they don't have better behavior, better discipline. They live in environments where the healthy choice is the easy choice. So beginning with a small city called [inaudible 00:40:23], Minnesota, we developed a process. It requires a full-time team of people working for five years called the Blue Zone Project. It's funded by hospital systems and insurance companies and we work with city council. We have a policy bundle that favors healthy food over junk food and junk food marketing, favors the pedestrian over the motorist. So we help over a five year period, help the city council pick politically feasible and effective policies that are going to work in that community. That really has a huge impact. Then we have a blue zone certification program for schools, restaurants, grocery stores, workplaces and churches. Over a five year period, we can usually get 50% of all those places certified, which means that they've changed their policies and designs to favor unconsciously healthier choices when it comes to food and movement. Then a third squad with any of these teams works gets 15% of the adult population to become blue zones ambassadors and optimize their homes and their social circles. So they're mindlessly making better choices. Our biggest city, Fort Worth, Texas, over five years, we saw a 3% drop in the obesity rate, which may not sound dramatic, but the rest of Texas got heavier and the city itself figures that it saved them about a quarter of a billion dollars a year in healthcare cost and will continue to do so for every year in the foreseeable future because we made permanent- Dr. Mark Hyman: That's a lot of change. Dan Buettner: Their environment, yeah. Dr. Mark Hyman: Quarter billion dollars is not chump change. So that's huge. This is something that should be done in every city, town, state in America. It's so clear to me that we have to kind of reimagine our communities and it wasn't like hard stuff. You're like, oh, well we're going to get rid of all the crap at the checkout counters or we're going to change people's plates in their home to 10 inches instead of 12 inches. Just simple little nudges that have profound benefits. Dan Buettner: So we're always looking for the silver bullet and the answer lies in silver buckshot. So we have about 120 small interventions like the ones you just mentioned, and our team endeavors, we're going to try all 120. We're going to fail at 40 of them. But the 80 or so that remain in place, they exert a positive influence on people's unconscious decision. And therein lies the power. For example, I'll give you one big macro example. Billboard signs. We know that neighborhoods where there are billboards that are advertising sodas and McDonald's and so forth, those neighborhoods, the BMI are between 10 and 15% higher than the exact same neighborhood with no billboard signs. So I'm not going to go in that neighborhood and beg everybody in the neighborhood to start eating healthier food. I'm going to talk to city council, I'm going to show them the data. I'm going to ask who benefits from those billboards and ask them if, well maybe people won't miss those billboards. Sure enough, when the billboards go out, you see the obesity rate drop. We've seen in Vermont, we've seen it in Boulder, Colorado. So why not aggregate interventions like that and put them to work rather than hoping that our food system's going to change or that we're all going to start eating like people in [inaudible 00:44:11] again. It's never going to happen until there is a focused effort comprehensively changing the environment. Dr. Mark Hyman: Yeah, I like that because I'm working on the federal level, which is challenging and there's a lot of obstacles, but you work on a local level and you work with local people and local communities, and people who live in those communities care more about their communities. I think they're more willing to make those changes. People in the city, governments and sort of local governments and town governments actually are more incentivized to do the right thing. Dan Buettner: Sometimes, but you can get shit done. It could take a decade to change major policy in Washington. It could change in three months in a small city, a mayor. Government happens at the local level and the mayors and the city councilmen and women are way more powerful at exerting a healthy influence on people in their city than anybody in Washington. Dr. Mark Hyman: It's so true. I can see it's such a smarter play. I think you're doing amazing work with that, Dan, and I want to sort of close by having you just talk about the last group of the four that we didn't talk about, which is the Asian American population. Because we don't think of that as an indigenous American population. I mean slavery, yes, that brought people a long time ago and they really have brought their indigenous ways from Africa and Native Americans have been here, and Latin America, Central America are clearly Americans. But Asian Americans, you don't think of as originating here. But how has their food ways helped us to live long? Dan Buettner: So it's not necessarily indigenous people that I was focusing on. I was looking at immigrants, people who've come here and the fusion of their homeland cuisines with American influences. So Asians came here. Asians taught us how to eat greens. You see these wet markets or these vegetable markets still in New York City where there are literally dozens and dozens of kinds of greens. I would say Asians, Korean Americans, Japanese American, Chinese American, you look at what they ate around the turn of the century, and it was fewer than 15% animal products. So they got really good at making plant-based food taste delicious and really have excelled in it. So we spent a lot of time in Hawaii where I think the most interesting Asian fusion is taking place because they've had strong influence from the Filipinos, the Japanese, the Koreans, a lot of it in the Los Angeles area. We spent a lot of time in Minnesota with the Mung populations. Dr. Mark Hyman: Oh yeah. Dan Buettner: In all cases, it was sort of an austerity that has forced creativity and innovation, and we captured about 20 of their best recipes that are really American inventions. Dr. Mark Hyman: Give me some examples of the recipes in the book. It sounds like they're just full of these really unusual but incredibly delicious recipes. Dan Buettner: Yes. So these Vietnamese tacos. This is not going to sound Asian, but it's a tofu that's made to taste like feta. On top of that is tomatoes and cherries and sort of a sweet umami flavor on top of that. So it's 100% plant based. It's mainly taking these original recipes you'd expect to see in these countries, but then using the available American ingredients to prepare the final dish. Dr. Mark Hyman: I can't wait until I get my copy, Dan. I'm going to start cooking them. Dan Buettner: I'll send them to you. Dr. Mark Hyman: Dan, you've really done some amazing work. Your work has touched so many people, not just obviously the stuff you done in communities, but just the inspiration to understand how we can start to reimagine creating our lives in ways that make it easier to be healthy and live longer by changing the way we eat, by building community, by naturally moving, by taking time to be and hang and just enjoy life, which I know you do so well. So Dan, thank you so much for your work. Everybody, make sure you go out and get this book right now, the Blue Zones American Kitchen anywhere you get books, on Amazon, Barnes and Nobles, wherever. I hope you enjoy it as much as I know I will, because I'm going to get it right now and go check out some of those recipes, because I think those are important to include in our diet and start to reclaim these old food ways that are so embedded with natural food as medicine principles. So Dan, thanks for doing the hard work and making it happen. Love seeing you as always and keep up the good work. Anyway, if you love this podcast, please share it with your friends and family. Leave a comment, how have you actually used foods that are a little unusual maybe from your ancient traditions of your family and history. I know mine's bagels and lox, which is definitely not good for me, but I think I've got excited to sort of see what we hear from you and subscribe wherever you get your podcasts and we'll see you next time on the Doctor's Pharmacy. Outro: Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health.