Staying healthy: What works for you?
Published 8:30 pm Saturday, September 26, 2009
Kevin Boyer weighed 265 pounds a year ago. He would come home, sit in front of his computer or television and drink pop all evening.
The 53-year-old Albert Lea man was diagnosed with diabetes and his eyesight was worsening. He began to exercise and by May reached 252 pounds. That’s about when the Blue Zones organization kicked off its Vitality Project for Albert Lea.
Boyer was looking for something he could achieve. He made the small changes suggested by the Vitality Project.
He now weighs 215 pounds and exhibits no signs of diabetes.
He said he is eating more than he did on diets, but the key is eating smarter — fruits, veggies, salads. He eats a solid breakfast. He has not drank any pop since May, not even diet pop. And he participates in a walking moai that gathers at Memorial Park. The exercise doesn’t seem a chore because he looks forward to it.
“There are days I don’t feel like walking, but I do it because I enjoy the social factor,” Boyer said at Memorial Park on Tuesday just before a walk. “I look forward to getting together here and talking about whatever.”
“In Defense of Food” author Michael Pollan writes about how Americans are confused about food choices. Nutrition science has taught scientists more about food but also is used to deluge the public with food fads and diet programs. Pollan notes that unhealthy food often costs less than healthy food, and unhealthy food is what gets the most advertising. Cheap food, deceptive labels, mixed messages and food engineering have Americans bewildered, he writes.
Does the AARP/Blue Zones Vitality Project presently happening in Albert Lea lend to this confusion?
Blue Zones founder Dan Buettner, author of “The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest,” agrees there is confusion about what to eat, “and it is overwhelming.”
He said the world is full of failed public health initiatives. Diet and exercise programs have a long record of failure.
Buettner said his book seeks to do two things: “Here are places around the world where people live the longest and here is what they do. You can choose to take it or not.”
Indeed, the project is inspired by the book; however, the project is different. Its core is “to optimize the environment so the right behaviors pursue,” Buettner said.
He said Americans are not any less-disciplined than they were 150 years ago, but “we are victims of our environment.” The Vitality Project offers messages of diet and exercise, he said, “but for the most part the 25 or so things are designed to be permanent or semipermanent changes to people’s environment.”
Buettner is a National Geographic explorer. Some Minnesotans know him from calling into radio shows from far off places.
He said his Blue Zones work is not a deviation from his explorer roots. He said exploration requires bringing back something people care about. In 2000, he read research from the World Health Organization that Okinawa, Japan, was the place with the longest-lived people.
“I thought, huh, this is an interesting mystery,” he said. “This must be cultural.”
Buettner and teams of experts visited Okinawa and other Blue Zone regions trying to understand their behaviors and how to bring their findings back to the prairies of Minnesota.
“Cut away all the clutter, it boils down to changing people’s environment. If we get 3 percent of people to change, we will be more successful than anything like this before.”
Social welfare
There are Vitality Project naysayers in Albert Lea. Though because of the presence of pro-Blue Zones direction of much of the community, they are reluctant to speak against it much except perhaps at bars, in private conversations and online anonymously.
The refrains are similar: They are skeptical of hype. They don’t like the online aspect of the Vitality Project. They think the lifespan-predicting Vitality Compass is an exaggerated gimmick. They have an existing diet or exercise plan that works for them. They don’t like to walk. They don’t want to change their diet. They don’t want lifestyle advice.
A New York Times story with the headline “Are Your Friends Making You Fat?” published Sept. 10 this year. It details a recent discovery from the same study that made scientists aware of “good” cholesterol — the Framingham Heart Study.
“Founded in 1948 by the National Heart Institute, the study has followed more than 15,000 Framingham residents and their descendants, bringing them in to a doctor’s office every four years, on average, for a comprehensive physical,” according to the Times.
Social scientists Nicholas Christakis and James Fowler, looking at information from the study, found “some solid basis for a potentially powerful theory in epidemiology: that good behaviors — like quitting smoking or staying slender or being happy — pass from friend to friend almost as if they were contagious viruses. The Framingham participants, the data suggested, influenced one another’s health just by socializing.
“And the same was true of bad behaviors — clusters of friends appeared to ‘infect’ each other with obesity, unhappiness and smoking. Staying healthy isn’t just a matter of your genes and your diet, it seems. Good health is also a product, in part, of your sheer proximity to other healthy people.”
Buettner said Christakis and Fowler’s results square with the findings from the world’s longest-lived places.
Even people who haven’t participated in the Vitality Project likely have made changes to their lifestyle, whether they intended to or not. Buettner said this summer in Albert Lea has yielded an “omnipresence” of health and socialization: moais, sidewalks, purpose workshops, grocery shelf labels, gardens, among other items.
“Even people who say they don’t want anything to do with these things are influenced because they have a friend of a friend who pledged,” Buettner said.
Living on the pledge
The Vitality Project asks people to take a pledge that includes going online to take what’s called the Vitality Compass, a series of questions that let you know your age of death.
Skeptics say the computer-generated results are exaggerated, that the predictions seem far-fetched. One online comment maker said: “It says I’m going to live to be 92. I don’t believe it.”
And an Albert Lea woman who survived a battle with cancer, speaking anonymously, said the compass told her she would live to 93.1. She remarked the cancer didn’t seem to be a factor.
“I don’t think it gave it any weight,” she said.
Thirty-eight-year-old Brian Mattson was a skeptic, too. He didn’t plan on doing any of the Blue Zones activities. His mother urged him to give the Vitality Compass a try, and he discovered he would live to his 50s.
“It scared the crap out of me,” Mattson said. “I had just a few more years to live, really.”
Buettner said the Vitality Compass is a motivator.
“People in Albert Lea have changed their behaviors has a result,” he said.
He said it isn’t just a Dan Buettner creation. The Vitality Compass uses life data from the Centers for Disease Control in Atlanta. The CDC figures life expectancy based on factors such as age, gender and ethnicity.
“They know very accurately, by looking at nationwide stats for births and deaths, what behaviors will influence that raw number,” Buettner said.
He said a taker of the Vitality Compass could walk across a street and get killed by a bus tomorrow. Not all factors can be accounted for. “It’s the best online predictor available. … and I’ll stand by that.”
He said the next best predictor would be spending $150 at the Mayo Clinic for a more thorough one.
What about the online requirement? Wouldn’t a paper mail-in form have been handy for some folks?
Buettner said the world is online these days and there is little sense going backward. He also said no matter how successful a project is, there is no way it can be everything to everybody.
The online component is tiny, he said. The AARP/Blue Vitality Project asks participants to take the Vitality Compass twice. The other online features, such as videos and e-mail reminders, are extra, he said. Ninety-five percent of the Vitality Project, he said, is walking moais, gardening, sense of purpose, smaller plates and other “simple changes” messages.
Mattson said he tried many different diets, which had beginnings and ends. He said the Blue Zones is about a lifestyle change.
“It’s not telling me what not to do so much as suggest what I should do first,” Mattson said.
Now when he takes the Vitality Compass, it shows he will live into his 70s.
“A lot of it for me is just getting out and moving,” he said.
He is in the same walking moai as Boyer, and the two have become friends as a result of the Blue Zones initiative.
Finding a purpose — another Blue Zones suggestion — mattered to Mattson, too. He is a social worker at Wapiti Meadows Community Technology and Services, which serves Albert Lea, Austin and Blue Earth. He said being a good social worker is his purpose, but it means being social more outside of work. Not only is he in the moai, he has rejoined the local community theater.
Ch-ch-ch-changes
Living longer. It sounds like something everyone wants. So why do some people resist?
Buettner cited James Prochaska’s well-regarded “Stages of Change Model.” In 1977, the University of Rhode Island professor developed a model and over the next 20 years it was modified through peer review and research. The model is cited frequently in health psychology.
Basically, Prochaska categorizes people into different groups based on their desire or reluctance to change and on the changes they have made. The most resistant is “precontemplation” — people not wanting to take action in the next six months or foreseeable future.
For any random group of people, you will find people in different levels of change. The 2,500 to 3,000 who have taken the Vitality Project’s pledge, Buettner said, were seeking changes in their lifestyles.
And others, he said, might have something else that already works for them.
“We’re not against any other program that inspires people to move more or eat better. I am all for it,” he said.
One aspect, however, is that many diet and exercise programs have profit motives, Buettner said.
“We’re not making any money doing what we’re doing. We’re just trying to pull the best research together,” he said.
The United Health Foundation funds the Vitality Project. It provided the Blue Zones organization with the budget to hire a team of consultants, such as food expert Brian Wansink, walking proponent Dan Burden, University of Minnesota public health professor Leslie Lytle and executive coach and author Richard Leider. The budget is sent to AARP for review, some of which goes for the Web aspects and some of which Blue Zones gets for execution of the Vitality Project.
Buettner credited city officials for showing the enthusiasm for the citywide health makeover, enough so to land the project over four other cities that sought it.
Walking and talking
Despite rumors to the contrary, the Blue Zones did not pay for the new sidewalks.
Albert Lea Community Development Director Bob Graham said no money from AARP, Blue Zones or United Health Foundation goes into the city treasury.
The sidewalks installed last summer were in the city’s capital improvement program. Following Burden’s walkability study last winter, it provided incentive for the Albert Lea City Council to go forward with installation.
“A lot of those projects were scheduled anyway,” Graham said, noting others — linking a loop around Fountain Lake, for one — were added because of the Blue Zones recommendation of moving naturally.
He said the city didn’t build all of the sidewalks it sought, particularly along Main Street because of Minnesota Department of Transportation right-of-way issues and because the idea sought volunteer labor. The Main Street sidewalks could be part of the effort to sustain lessons of the Blue Zones following the project’s end in October.
The citizens of the community are the ones who have benefited, Graham said.
For instance, last summer’s purpose workshops led by Leider normally would have had a $190 ticket price. Residents could attend for no charge.
“Those are gifts to the community,” Graham said.
The city did pay to produce the oft-seen blue Vitality Project T-shirts, but they are sold at $5 to cover the cost. And, of course, the city gets no cut from any books.
The almonds at the workshops? They were donated by Planters. Much of the work is done voluntarily or with donations, Buettner said.
“No one is getting rich,” he added.
Graham told an anecdote from a visit to a coffee klatch at the downtown McDonald’s.
He casually asked the men their plan for the day. One man replied the city should build more sidewalks. Graham, thinking they were kidding, asked, “Really?”
The man said he was serious. Graham asked why.
“Because a lot more people are walking, and that’s good,” he told Graham.
He also said as people age they feel more comfortable as motorists with pedestrians on the sidewalks rather in the streets.
Graham said he has lost 18 pounds since January and is not on a diet. He said he is just more aware of the food he eats and his level of exercise.