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Becoming a centenarian

February 11, 2022
By Boca Grande Health Clinic

By Dr. Raymond James, Boca Grande Health Clinic

If you’re looking to have a long, productive life, there’s a lot to be learned from the lifestyle choices made by people in the world’s “Blue Zones” – places where people live the longest and are healthiest. These “secrets to longevity” were discussed in the January 25 Grande Rounds virtual event, “How to Live to be 100 … Lessons Learned from Indians and Italians.” This webinar is archived and can be viewed at

During the webcast, Yale Cardiologist Sandip Mukherjee, MD, FACC, shared treatment strategies for reducing heart disease, the most common cause of death in the U.S. He discussed how lowering your cholesterol, controlling diabetes and blood pressure, and reducing obesity can contribute to a long, healthy life. 

How to prevent a heart attack

In the U.S., we’re lucky to have access to a vast network of hospitals that specialize in heart disease, with doctors who are experts in life-saving heart procedures. But how do we prevent cardiac disease from developing? While genes account for less than 25 percent of how long we live, the remaining 75 to 90 percent is determined by how we live. 

By studying people in the Blue Zones, scientists have arrived at a set of common daily patterns that contribute to longevity and do not rely upon pharmaceutical intervention. While you’ve no doubt heard of some of these practices, like a healthy diet and exercise, others may surprise you.

Blue Zone patterns

• Eat less: eat a low-calorie, mostly vegetarian (and in some cases vegan) diet, eating more in the morning and less at night.

• Keep moving: intentionally build physical activity into everyday life, including walking in nature and gardening. In fact, retired men who walk just two miles a day cut their risk by nearly half.

• Maintain connections: have a network of friends who reduce loneliness and act as a positive influence.

• Have a sense of purpose: know your reason for being alive and getting up in the morning.

What is striking to me is how important friendship is. Dr. Mukherjee shared that “Friends are perhaps the most significant thing to add more years to your life and more life to your years.” People in the Blue Zones have six relationships; the rest of us average just 1.5. 

And when it comes to exercise, it doesn’t need to be hard-core gym workouts. We really just need to keep moving – 30 minutes a day, five days a week. Even breaking that 30 minutes up into 10-10-10 over the course of a day helps. Walking is not only a great physical exercise, it also provides the opportunity for mindfulness. We have an advantage here in Boca Grande with the great outdoors right at our doorstep.

A few more cardiac health 

takeaways from Dr. Mukherjee

• There is no magic vitamin pill to reduce cardiovascular disease. In fact, trial data has shown no value from vitamins or hormone replacement therapy. In some cases, like with folic acid and B12, there can even be a negative effect.

• Aspirin therapy isn’t for everyone. People who have low risk of cardiovascular disease should not take aspirin for prevention, especially those over 60. An aspirin a day is advised only if you have coronary disease.

• Inflammation may promote the growth of plaques, loosen plaque in your arteries and trigger blood clots — the primary cause of heart attacks and strokes. To reduce inflammation, stop smoking, bring your body mass index below 25 and control your sugar intake.

• The Mediterranean and Pacific diets are the way to go.

• The average LDL (low-density lipoprotein, often called the bad cholesterol) in the U.S. is close to 130. Average should not be confused with what’s normal. If you look at hunter-gatherer populations, where there is no coronary disease, the LDL is as low as 50-75. When born it’s 30-70! So, how low should you go? The lower, the better.

• Someone asked if they could ever stop a statin taken for high cholesterol. The answer – probably not. We use risk calculators to estimate the 10-year risk of heart attack, and due to multiple factors including cholesterol, decide who benefits from statin therapy. The minute you stop, your cholesterol will start to rebound and be back to where you started within two to four weeks.

• High blood pressure puts people at greater risk of having a heart attack. The old goal was under 140/90. Ongoing cardiac studies have shown us that people have less heart attacks and strokes if the stay UNDER 130/80 so in 2017 this new upper limit was published. You should check and record your blood pressure five to six times a week to get an average. To check your BP, sit down at a table, wait five minutes, take your pressure and keep a written log to take along on your next doctor’s visit. You should talk with your physician about ways to control high blood pressure.

More than 200 people participated in the event sponsored by the Boca Grande Health Clinic and the Boca Grande Health Foundation in partnership with the Healthnetwork Foundation. Grande Rounds events are free of charge as part of the Clinic’s and Foundation’s mission to educate the community. Please join us for these informative sessions, which are also planned for February and March 2022. 

Event information, including program recordings, are available on the Clinic’s website at