Amanda: Hey guys, welcome back to the podcast. I am Amanda.
Laura: I'm Laura.
Kendra: And I'm Kendra.
Amanda: And today we are going to do part two of our Blue Zones book club. Last time we talked about Sardinia And today we are going to talk about Nicoya, Costa Rica. We're doing this because we care about you, and we want you to live better and longer.
So you spend all of your time taking care of others and you can only be your best when you're taking care of you too. And actually, we just care more about you anyway. So, that's just selfishly.
Kendra: Facts.
Amanda: We think you're pretty great people. So before we start, we aren't doctors. We aren't your medical doctor.
Laura: Wait, we are
doctors.
Oh, is that what I said? Okay. So before we start, we are doctors, but we aren't your doctor. Sorry. I'm just like blasting through this thing. This is not medical advice. This is just purely educational because it's interesting.
Kendra: That's awesome. Yes, we are doctors. That's funny. Yes. And we do care about you actually and this is a very unique situation. These blue zones and talking about them is interesting because how we intro part one was we have B as in billions of dollars spent in the industry of Health and wellness like, you know, exercise, supplements, nutrients, vitamins, all the things saying that take this, you'll, you know, you're going to.
You know run faster work hard work smarter all the things and all these empty promises and really guys The biggest thing is just to model ourselves after some of these communities that are like doing nothing but living their everyday lives Not adding anything not taking anything away, but just focusing on what it does to create not only community but eat food Foods that. I love dr.
Amen. He says eat foods that love you back. So they definitely eat foods that love them back. And they are keeping their selves sharp by getting outside, experiencing nature, by sleeping well , by keeping active and movement and their brains going and you know. You know continuing to solve complex problems You know, functions and make decisions and do all the things and, you know, all of that together means that they're not really a burden on their families.
Like, we are in the US and with all the, you know, millions and billions of dollars spent on long term acute care and nursing homes. That has a place. But what if you were? Making it to you a centenarian and still walking on your own make, balancing your own checkbook and handling all your affairs I think. That is not burdensome to your family and you're contributing just as much to the community as they are to you. So that has to be something that you know, reading these books in and Discovering these tight knit communities.
We definitely can learn quite a bit from them. So once again, just to recap, we are covering the series, the Blue Zone: Secrets for Living Longer Lessons from the Healthiest Places On Earth. And the author of this wrote a book, but there's also a Netflix series, so you Netflix, binge Watchers. There's a four part series on Netflix you can check out, but basically the off author Dan Buettner, studied these communities called blue zones, which means that the per capita amount of people, centenarians in that area. So they have a denser population of centenarians plus, cause it's not just reaching a hundred. I mean, they're surpassing a hundred, but they have more per capita centenarians in that area than anywhere else.
And so it's interesting that we can pinpoint these communities and really study what they do, how they live, you know, what their With what their communities are like. So he published this book out of studying these communities and we're going to travel to Costa Rica today and talk about them. Yahoo, so while, and we mentioned this last time, while true genetics, do play a role It really only counts for about a fourth of the differences in longevity between people. So whereas people are like, oh, they just have a good great genes, or they just have a family line with great genetics.
That really doesn't account for a lot of what we're going to talk about. And considering that only a fourth, so there's three fourths of it left to your, what we call epigenetics, or the environment for which you were raised and and the learned behaviors that you have. So just to recap, the blue zones eat a whole food plant forward diet.
Instead of going to the gym and killing it three to four days a week, they just move naturally and frequently throughout the day. So they walk everywhere. And in some of these communities, there's steep inclines. They just walk everywhere. They walk to the store. They walk to see their neighbors. They do a lot of their jobs on a daily basis are outside.
And it's a lot of walking. Shepherding, they mentioned that they walk five to six miles per day. So. They also have a very keen sense of community. They tend to honor and keep their elders close. There's no SNFs or long term acute care facilities in these areas. They have great support, social support systems, and they maintain a sense of purpose.
And that's multi generational. So even the younger generations that are taken care of by some of the older generations, they hand down this generational sense of purpose. That they're all very clear on the role that they play in this process, and they hand it down. And those people feel honored the older generations to be taking care of the younger generations and vice versa the younger generations feel honored to be able to care for these centenarians.
So we've talked about this before how important community is. That isolation and loneliness are an independent risk factor for coronary artery disease for cardiovascular disease for a ton of things. So we have, we're saying it again, community is important people. Find your people and get together with them and do it intentionally.
It makes a difference.
Laura: Yeah. And the disclaimer, that doesn't mean if you have toxic relatives that you need to do that.
Kendra: Yeah. This is always, this is not only family of origin. Yeah. This can be your people, like really finding your people and your community.
Laura: Right. It's, I'd say toxic family members probably shorten your life.
Oh, a hundred percent. Definitely.
Don't know if you want to live to a hundred. Anyway. So we talked about Sardinia last time. What were you going to say Amanda? Sardinia.
Amanda: Side note. Yeah. Just avoid toxins of all sorts, including people.
Laura: Yes. Last time we talked about Sardinia. So we're going to talk about Nicoya, Costa Rica.
Now this blue zone is a 30 mile long strip in the Nicoya peninsula of Northwest Costa Rica. A Nicoyan man has twice the chance of a U S man to live until 90, despite Using 1 10th of the health expenditures per person in Costa Rica. That's, that's kind of mind blowing. And it's felt that the longevity of these people is a blend of genetics, traditional foods, effective public health systems, tight family bonds, and active lifestyle, faith in God and sunny, dry environment.
And you know, that's sunny, dry environment. There is something to that. I just feel better when I go to someplace sunny and dry, as opposed to my own beloved, humid and hot place. So it's, this all sounds familiar. It's a lot of the same stuff that was happening in Sardinia, the traditional foods and active lifestyle and tight family bonds.
So, until recently, Nicoya was one of the most isolated parts of Costa Rica. And just like Sardinia, this had helped preserve its traditional way of life. Traditionally, men here worked as ranch hands or farmers, usually in extreme poverty. Their low calorie, low fat plant based diet is influenced by the indigenous people of the area, the Chorotega.
So it sounds similar to that peasant diet that the people in Sardinia were enjoying. Again, you don't have to be rich to live to 100. In fact, maybe living, maybe living a little bit more modestly will help us live longer. The cornerstone of the diet is the three sisters, beans, corn, and squash. You know, that's called the three sisters because they grow them together in a little teepee like formation.
So today rice has largely replaced the squash, but the combination still provides all nine amino acids required by our bodies. And the average Nicoyan consumes about 1800 calories a day, which is one fourth less than the typical American. The way they prepare their corn tortillas is by soaking the corn in lime and their hard or the Calcium rich water that they have there.
It infuses the corn with seven and a half times more calcium than normal. And it unlocks amino acids that would otherwise not be available for digestion in the corn. They think by preparing the corn this way, it explains why people almost never got rickets. And rarely had fractures we frequently see in older people.
I would, I would have to think that being outside in the sunny environment would also help the rickets. Just
Amanda: Yeah. Incidentally. Yes.
Laura: Incidentally. I would think so.
I would think that rickets would be probably pretty rare in Costa Rica, but maybe I'm wrong.
Amanda: So every once in a while, Dan throws a little fact in the book that I'm like, what does that have to do with anything? I don't know. But it's just a book review. Let's go.
Laura: It's a book review. There's some helpful information. Take what you will. So Costa Ricans as a whole have telomeres that would be associated with people seven years younger and their centenarians telomeres are 13 years younger. Strangely in Costa Rica, the lower the household income, the better the telomeres.
Huh. Isn't that fascinating? So my previous supposition was correct that. being poorer there makes you live longer. That's fascinating. So possibly it's because diet can influence epigenetics, especially a fiber and plant forward diet, which is more typical in poverty. Stress and social connections also have an impact.
Families also are supposed to relieve stress and give you purpose and a positive outlook. We know that's not always the case, but for those who do experience that, it is beneficial for their health. And Nicoyans in general were less likely than other Costa Ricans to live alone. We've mentioned before living alone doesn't necessarily mean loneliness, but if we're living alone in loneliness, that is definitely a risk factor for early death.
So those who did live alone had their telomere advantage vanish. So it's just so amazing what community can do for us. The public health care system in Costa Rica, they have rural, a rural health care system where small teams, including a physician, nurse, a record keeper, and a trained health worker are assigned to a specific geographic population to care for between 2500 to 4000 inhabitants. Each household gets at least one visit per year, and the goal is prevention, to provide health education, a clean water supply and vaccines. They are proactive and keep track of anyone who has chronic disease, disability, or is elderly and lives alone.
Since they started this program, deaths from communicable disease have fallen by 94%. I mean, that's a lot.
Amanda: It's pretty good.
Laura: Infant mortality has dropped by a factor of seven, and life expectancy has risen from 66 to 80. I'm just wondering what, if, what the communicable disease, what the, I have to believe it was some diarrheal illness. Like, if they're teaching about sanitation and and I wouldn't have thought it would be measles and vaccinations, I guess, would be helping them.
Kendra: Yeah, I imagine if there's providing immunizations, because it says infant mortality dropped. So it may be like, the county health department providing immunizations.
Amanda: So, the most random trauma credit I ever got was about, like, refugee camps. I don't even know why that qualified for a trauma credit, but the only thing I learned from that was that Number one cause of death was diarrheal illness or cholera or whatever it was.
Yeah. Number two is measles. So it's the one vaccine that the World Health Organization goes into these refugee camps and tries to get them immunized for measles. So that might be.
Laura: So maybe it was measles. Who knows? It's so incredibly. So while the health care system has improved life for Costa Ricans, the blue zone in Nicoya is shrinking because of improved communication with the outside world, tourism, the invasion of junk food and social media.
Oh, but we can learn the lessons while we can and try to live a little bit more that modest lifestyle with that plant forward diet and hold tight to our non toxic relatives.
Amanda: Do some weeding out, every good garden, you pull the weeds, right? Yes. So, one thing that I think is interesting about their public health system is they go to the people. Whereas we are particularly bad for somebody who's in poverty in these impoverished areas. We tend to not have clinics. We tend to make them come to us during operating hours, we make it particularly difficult for the most at risk to get the help that they need. So it's interesting that they pay a visit to people where they are and have so much success with that. So some takeaways from Nicoya are number one, have a plan de vida, which is again, we see that the centenarians still have a strong, strong sense of purpose.
He talks about The one of the people that he met was over 100 and was still hopping up on a horse and rounding up the cattle every day, like at 4 a. m. And then, you know, it was 10 a. m. And he stopped. They feel needed and they want to contribute. So I know, you know, back in the day, I'd be like, oh, if I can just reach to retirement.
Okay, fine, but then have a plan to continue to have a sense of purpose. Number two, drink hard water. That was one thing that was unique about this area is their water has a really high calcium content and maybe that helps contribute to strong bones and lower cardiovascular risk. These are just, you know, it's hard to do a study on it.
It's just some things to think about. Keep a focus on family. Many live multi generational, generationally, like we talked about and provide each other support, purpose, and belonging. Number four, eat a light dinner. Nicoyans eat relatively fewer calories than most Americans and eat just a light dinner in the early evening.
And Nicoyan centenarians typically ate the traditional three sisters diet, which is beans, corns, and squash. That was one thing I went to Mesa Verde, trying to hit some national parks. And that was also what that indigenous community ate was beans, corn and squash, sometimes turkey. But I mean, it's passed through forever.
So, like, clearly societies do well that eat heavy on those sorts of things. And then the corn, you know, I mean, not to get graphic, but sometimes we can't always break down the corn. But you know, they're turning it into those corn tortillas with the, with the special soaks that they do with their hard water.
Okay, moving on from poop talk. We had number six, or sorry, number five, five is maintain a social network network. We see this over and over again. In Nicoya neighbors frequently visit each other. They hold space for each other to laugh and appreciate what they have. And then number six, keep hard at work. Centenarians there continue to do gardening, meaningful work, cook and care for their grandchildren.
Number seven, get some sensible sun. As you might imagine in Costa Rica, they get outside a lot. So the vitamin D they generate from this might help fight off the osteoporosis and heart disease. We're not suggesting tanning beds and sunburns here. Be sensible, but 15 or 20 minutes of exposure on your arms and legs can help supplement your diet.
But certainly have a vitamin D level checked because the thinking is that over the 35th latitude, which is approximately Atlanta, Georgia and north of that during the months of November to February, doesn't have enough UVB rays to convert with your own skin. So. Just get it checked. And then number eight, embrace a common history.
Nicoyans have roots in the indigenous Chorotega and their traditions keep them relatively free of stress. Their traditional diet of fortified corn and beans may be the best nutritional combo for longevity around the world.
Laura: Yeah, I want to just add one more little plug for the getting your vitamin D level checked.
Especially if you're listening to this podcast, because you're experiencing burnout. If you have a low vitamin D level, it is going to be very hard to be at your emotional best. Vitamin D affects, I think it affects every process in our body. It reduces your risk for diabetes, hypertension, cancer, and I had gestational diabetes with one of my pregnancies.
And I read that vitamin D reduces that, I was like, Oh my gosh, I'm going to have this with all of them. No, I started taking vitamin D. I never had any other problems with it again. It helps reduce preeclampsia. I mean, it's magical. It's magical. It's magical. So please. Make sure you have enough
Amanda: On behalf of the nephrologist watching, though, do realize you can get toxic.
So please get that level checked. Susan Woody, K, was telling us like, Oh, my gosh. You can go nuts. You can go nuts on vitamin D if you're just mainlining it. So just be sensible. Yes.
Kendra: Yes. Of course. All of these things are in a good ratio, moderation. Be, you know, use your brain. This is not that we grab on one of these and just go nuts.
We are just simply providing information and take it for what it's worth. But what a good you know, I'm thinking ladies that our next biz retreat, I'm thinking Sardinia, maybe Costa Rica. Let's get it down on the books. Yeah. Yeah. the books. Let's just do a little, little R and D, I think. So, and we want to remind you listeners out there, help us help you please leave a review, help us to get our podcast out there.
You guys are getting so much out of it, so let's get the word out so other physicians can find us and enjoy this lovely podcast and leave a review. So we go to the top of the list. And we want you to check out our new version of our online course, Wellness 911. We just launched recently. So go to our website, www.
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