Long Lives Well Lived

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Huang Maliang, who is 104 years old, keeps a coffin in her house. Her two-year-old great-great-grandson plays on it, and Huang herself uses it as a rest stop on her slow journeys from the open-pit fire in the back of her house to the front porch. Other family members—seven Huangs, from five generations—share the huge, mud-brick dwelling. They aren't in the least troubled by the sight of the matriarch sitting atop the rough wooden box. And anyway, Huang says, lightly tapping the cover with her fingernails, "this one isn't for me. This is for my youngest son."

The son in question, a lithe 78-year-old, bounds by in pursuit of a fleeing toddler. Having caught his prey and carefully wiped away a smear of dirt from the child's face, he glances up at the coffin. "Oh, that," he says. "Yes, that one's mine. Mom's had hers for 44 years, but it's up at my brother's house. We use them for storing grain."

Although they live with these constant reminders of their own mortality, the Huangs aren't particularly morbid. In the tiny hamlet of Pinghan, nestled deep among a stand of limestone hills in a remote region of southwestern China, locals honor an old, national tradition of buying a coffin at the age of 61. Most of the locals get many decades of workaday use out of their sarcophagi before pressing them into service as eternal resting places. That's because the people of Pinghan and surrounding Bama county, located 250 kilometers northwest of Nanning in Guangxi province, are exceptionally long-lived. The county (pop. 238,000) has more than 74 centenarians and 237 residents who have reached their 90s. That's one of the highest per-capita concentrations of old-timers in the world, according to Chen Jinchao, a surgeon who for the past 10 years has run the Guangxi Bama Long Life Research Institute.

You won't find the county in the Guinness Book of Records because detailed official birth records only began to be kept there after 1949. But Bama is nonetheless renowned as a place where the sight of sprightly centenarians is no rarity. Elsewhere in Asia there are other, similarly fabled pockets of longevity, where, for reasons not fully understood, life expectancy exceeds global norms by wide margins.

The Japanese, of course, live unusually long lives—reaching an average of 81.6 years. By comparison, in the U.S. the average life expectancy in 2002 was 77.1 and only 74.5 for men, about the same as Cuba's. Okinawa, the southernmost prefecture in the Japanese archipelago, boasts the longest-lived population on the planet, with an average life expectancy of 81.8. Meanwhile, Japan is currently home to the world's oldest man (Yukichi Chuganji, 113) and woman (Kamato Hongo, 115).


At Asia's other extreme, the average life expectancy in Afghanistan is just 43.1 years. But in neighboring Pakistan there is the geriatric oasis of the Hunza Valley. High in the country's northern mountains, it's a place of such pristine beauty and with such a reputation for fostering longevity that author James Hilton was inspired by a visit there to write Lost Horizon, the 1933 novel about an isolated valley called Shangri-La whose residents lived for hundreds of years. Another death-defying region, currently being studied by gerontologists, is a cluster of villages in Sunchang county located in South Korea's mountainous southwest, where some local farmers continue to work the fields until they are well into their 90s.

Is it something in the water? Why do some communities, located in disparate places and harboring very different cultures, seem to be built atop a fountain of youth? Scientific efforts to uncover the secrets behind these mysterious, mini Shangri-Las have varied enormously in scope, ranging from a sporadic, amateur attempt by a busy general practitioner in the Hunza Valley to a quarter-century study in Okinawa during which researchers carefully amassed and analyzed data on everything from eating habits to the preferred hobbies of the oldest of the old (they enjoy playing the Okinawan three-string sanshin and singing traditional folk songs). There are tantalizing consistencies in research findings, offering priceless clues to aspiring centenarians on what it takes to live a long and healthy life.

You've heard some of the secrets of Asia's most senior citizens before (probably from your mother): eschew an excess of meat, eat your vegetables and get plenty of exercise. Other lessons from their lives are downright depressing, particularly for gastronomes who regard Asia as a place where one lives to eat rather than the reverse. For example, it's best to eat only until you are hara hachi bu, or "8 parts out of 10 full," as the Okinawan phrase puts it. An old wives' tale, perhaps, but scientific evidence has been steadily mounting for years that gives credence to this simple adage. A daily diet restricted to between half and three-quarters of the 2,100 calories recommended by the U.S. government appears to boost health in humans, and an equivalent reduction has extended the lives of lab rats.

But simply restricting your diet to watercress and celery won't get you to your personal centennial. There are no magic potions or simple regimens that automatically bestow longevity. It's the total package that counts: diet, exercise, mental attitude, family and societal support—and, of course, your genetic makeup. Some of the longest-lived Asians appear to have an extended shelf life hardwired into their anatomy by their progenitors. "My parents and grandparents lived until they were in their late 80s and early 90s," says Hide Nakamatsu, a 1.47-meter-tall, 91-year-old bundle of life force wrapped in a white cotton frock, cotton gloves and a bright blue-and-white bonnet. The headgear is necessary to shade her darting eyes during her daily game of gateball, a fiercely competitive Okinawan version of croquet that, in Nakamatsu's case, involves lots of running from one hoop to the next. Once she's dispatched her opponent's ball from the field with a sharp crack, Nakamatsu returns to the shade of palm trees sheltering the gateball court. None of her three children, 10 grandchildren or nine great-grandchildren has ever suffered a major disease, she says; they rarely go to the doctor. "I suppose it's something I gave them in my blood."

Nakamatsu is almost certainly right. Scientists are only just beginning to unravel how genetic makeup affects aging. But research published in recent months suggests that a single gene or group of genes appear to control the aging process. Scientists at Harvard University and the University of California say a gene related to insulin production seems to control the onset of aging in experiments on yeasts and worms. Although the research is in its early stages, the scientists say there is a high likelihood a similar system for control of the aging process exists in humans.

The most important genetic factor in longevity is no mystery. Women live longer than men all over the world, usually between five and seven years longer in industrialized nations. In Okinawa, as many as 86% of the centenarians are female, according to scientist Craig Willcox, one of three authors—including his brother Bradley—of the 2001 best-selling book The Okinawa Program. Researchers think women might have a not-yet-understood genetic advantage. But DNA isn't entirely destiny—men can improve their chances for a long life by avoiding destructive behaviors, such as heavy drinking, that most women tend to avoid. "From our studies, genetics accounts for about a third and lifestyle kicks in for the rest," says Willcox. "Of course, if you want to make it to 100, you need a very nice set of genes. But these days, making it to 90 isn't so hard, with a bit of luck and a good lifestyle."


Included in a "good lifestyle" is the avoidance of proven killers. Few of Asia's ancients smoke; if they once did, they kicked the vice long ago. Most will happily admit to taking a drink now and then, though, a habit whose benefits in moderation are well enough established that they are acknowledged even by such cautious institutions as the American Heart Association. The Hunza's are partial to "Hunza water"—potent wines made from the area's fruits such as grapes, mulberry and the ubiquitous apricot. Residents of Sunchang county in South Korea swear by their soju and makgoli, fiery rice spirits. Park Bok Dong, who is 101, attributes a major part of her continuing health (until a few years ago she was still working in her family's rice fields) to her practice of downing several daily shots of 50-proof soju. Okinawa, meanwhile, has awamori, a distilled rice spirit that has a whiff of kerosene in its bouquet but is much beloved on the island. "I used to like to drink a lot of awamori when I was young," smiles Asanori Takemura, a beaming Okinawan baker who recently turned 93. "I still like to, but these days I only take one glass a night—no more."

Indeed, dietary moderation is a consistent feature of the lives of the superwrinklies. Protein and animal fat typically play a minimal role in their menus. In Sunchang, for example, rice and boiled vegetables are a staple. "The white-rice-and-vegetables-dominated diet consists primarily of carbohydrate, while remaining low in fat," says Dr. Park Sang Chul, who heads the World Health Organization's aging-research center in Seoul and has spent three years studying the residents of Sunchang. "Low fat content is one of the more crucial keys toward longevity." The story is similar for the locals of Hunza Valley, says Khwaja Khan, a physician in the Hunza town of Karimabad who has treated many of the valley's eldest residents. The Hunza, Khan says, were cut off from the outside world for centuries by the 7,000-meter Himalayan peaks ringing the valley, and until recently were forced to subsist on a spartan menu of apricots, walnuts, buckwheat cakes and fresh vegetables. Many cross the century mark, and a few motor on for another 10 years or longer.

Living in relatively poor conditions in a village free of the industrialized world's dietary sludge—and miles from a fast-food restaurant—isn't required for long life. But eating habits influenced by scarcity appear to contribute to health. Says Chinese longevity expert Chen, the residents of Bama "are not starving, but for many years they weren't often full, either." In Okinawa, researchers found their subjects ate about 20% fewer calories than the Japanese average—which in turn is about 20% lower than the average in the U.S. According to Dr. Makoto Suzuki, leader of the study of Okinawan elders and one of Willcox's co-authors, a restricted-calorie diet might reduce the harmful effects of free radicals—molecules that occur naturally in the body during biochemical reactions but that can damage cells and are implicated in most of the deleterious effects associated with aging, including cancers and cardiovascular diseases.

Happily, living to an advanced age doesn't depend entirely on self-denial. Researchers are also trying to pinpoint particular foods consumed in each of the regions that can help avert the diseases and disabilities associated with aging. The people of Bama, for example, cook with oils derived from hemp and the fruit of tea bushes. These oils are rich in unsaturated fat, vitamin E and vitamin B1—antioxidant nutrients believed to contribute to a healthy cardiovascular system, says Chen, as well as helping prevent certain types of cancers. Suzuki says Okinawans do most of their stir-frying with canola oil, which has been widely shown to protect the body against free radicals.

The Okinawan elders who were part of Suzuki's study got most of their protein from fish, which provides another so-called good fat: omega-3. This oil is particularly prevalent in fish such as salmon, tuna and mackerel, whose established heart-protecting properties are considered by researchers to be an important reason that Japan's incidence of heart disease is one-third that of the U.S.'s. Okinawans have about one-fifth as many heart attacks as North Americans, Suzuki says, and when they do, they are twice as likely to survive.

The differences in rates of cancer deaths are similarly stunning. In Okinawa annually, there are an average of six breast-cancer deaths per 100,000 people; that rate is five times lower than in the U.S. The incidence of prostate cancer is seven times lower than in the U.S. Suzuki's team attributes the differences in part to Okinawans' very high intake of substances called flavonoids, relatively little-understood compounds that appear to help prevent cancer by neutralizing the destructive effect of free radicals. "Okinawa's national dish is a stir-fry called chample," says Suzuki. "The exact recipe varies from house to house but the basic ingredients are always there: tofu, soya beans and goya [a local variety of bitter gourd]. Those three are all very high in flavonoids as well as other compounds like isoflavones, saponins and vitamins B and C that provide protection against free radicals."


Alas, the inhabitants of Asia's Shangri-Las aren't always immune to the temptations of modern eating habits. In 1978, engineers constructing the famed Karakoram highway that links Pakistan with China blasted a route through the mountains and exposed the Hunza Valley to the outside world. Since then, says local physician Khan, consumption of previously unheard-of items such as artery-clogging potato chips and white sugar has risen sharply. The consequences have been swift, too. In the past, "people would die from diarrhea or from falling off cliffs. That was about it," says Khan. "But now they are coming down with hypertension, heart attacks and cancer, just like everywhere else."

It's a similar story in Okinawa, where the island's youth are increasingly succumbing to the lure of fast food. "The young people are eating hamburgers and pork and don't do enough exercise," Suzuki says. "Okinawan male life expectancy used to be No. 1 in Japan. It started to decline 10 years ago, and hit 26th out of 47 prefectures in the 2000 census. I expect it to decline even further in the next census." The change is almost entirely due to a much higher mortality among younger people, according to Suzuki. "The elders are living longer but the young are dying younger." If any further evidence is needed of the dramatic effect a change in diet can produce, Suzuki points to the example of an Okinawan community in South America. Recruited to work on rubber plantations, several hundred thousand islanders moved to Brazil in the 1930s and switched to eating large amounts of beef because it was widely available and cheap. According to Suzuki, they now live an average 64 years—17 years lower than the Okinawa average.

Still, a healthy diet is hardly the only prerequisite for a long life. Scientists say another key factor is your mind-set—that's to say, the emotional resources that enable you to cope with the stresses of daily life from missing the bus to enduring the death of a loved one. Inner strength derives in part from vigorous activity, mental and physical. Bama centenarian Huang Maliang, for example, still prides herself on her ability to thread a tiny embroidery needle, although she no longer works in the fields since injuring her hip two years ago. Okinawan elder Setsuko Miyasato, 90, still spends three hours a day tending to her vegetable and fruit plots. "I used to have someone do the hoeing for me when I was younger," says the animated, silver-haired Miyasato, shielding her mouth as she giggles at the thought. "But I've done it myself since I was 48. The exercise is good for me. You've got to keep yourself busy."

That might be a mantra for elders across the region. Okinawan baker Asanori Takemura rises every morning at 5 o'clock to put in his shift at the bakery he started 50 years ago. At 93, he continues to create new confections for the bakery, which specializes in rakugan, cookies given as gifts on ceremonial occasions such as weddings. "He's still the boss here," says Takemura's son Isao. "He's the one who started the business and he still knows best."

Isao, 68, is smiling as he says this, but he isn't just humoring an old man. His tone is respectful, and his father simply nods his head at being given his due. Such reverence for the elderly is another constant in Asia's longevity oases—and it's apparently healthy. In the Hunza Valley, elders' opinions on critical issues such as when to plant the barley and the buckwheat are listened to with reverence. Haji Sikander, an 84-year-old former schoolteacher, sits with his friends under an ancient chinar tree in the village of Ganish, watching boys dive into a tank of silty brown, glacier-fed water. "The elders have always had a command here in the valley," he says with satisfaction. "What we say is respected."

As Setsuko Miyasato sees it, respect is important because it helps build the inner strength she believes is the key to achieving a long life. "In the end, it's your mental attitude that's most important," she says. "Every morning I wake up and I'm just grateful for being alive and healthy. You have to try not to worry about tomorrow too much. Don't get too serious. Don't think too much. Sing out loud and play your music."

Don't worry. Be happy. Live long. It might not be quite that simple, but it's time-honored wisdom from a woman who has lived by it for almost a century.