The Mediterranean island of Sardinia is dotted with prehistoric stone ruins called nuraghi. Little is known about the nuraghi, or the ancient people who built them, except that they predate the earliest invaders to Sardinia, the Phoenicians, who arrived here about 9,000 years ago.
I passed a number of nuraghi as I drove up into the island’s interior through mountains of limestone and granite, on a terrifying road, into a region called the Ogliastra. It’s never been an easy ramble into Sardinia’s mountains. Neither the Phoenicians nor any of other invaders who came to Sardinia later — Romans, Vandals, Byzantines, Carthaginians, Arabs, Genoese, Catalans — were ever able to the penetrate them. The villages of Ogliastra have had very little contact with the outside world since about the 11th century. Even now, the region is considered by many to be a wild, dangerous place and travelers like me are regularly warned about bandits and kidnappers.
Ignoring those overheated warnings, I traveled into the Ogliastra anyway. I’d been sent into the wild interior of Sardinia on assignment by AARP Magazine. Researchers had recently documented an abnormal cluster of modern-day Methuselahs residing here. At least one man in this region lived to 112 and, until his death, was the oldest man in the world. And there were many other centenarians living in isolated Ogliastra villages.
Basically, my AARP assignment called for me to barge in on very old Sardinians and ask: How can our readers, too, live such a long life? The editors wanted tips, nuts and bolts, practical “how to” nuggets. Of course, I wanted to know these things, too. Like most other human beings, my desire to live forever — or at least as long as I possibly can —knows no bounds. And I, like many, have been fooled before in this quest for longevity. I remember, for instance, a widely reported tale of men in the Caucasus Mountains who lived to the ripe of old age of 120 by subsisting solely on a diet of yogurt. After gorging myself on yogurt, it was soon reported that whole story was a hoax. The men’s birth records were wrong. Faulty data. Sorry.
But in Sardinia, the story is different. This time, after rigorous study, all the Sardinian centenarians’ birth records checked out. The demographers on the case confirm that the age data are perfect. No hoaxes, no inaccuracies.
In fact, researchers have detailed an astonishing longevity hot spot in which they have documented 90 centenarians among a population of 18,000. That means that one out of every 200 people in Ogliastra has lived to celebrate a 100th birthday. It’s an extraordinary figure, about 50 times the rate of the United States, where only one person out of every 10,000 people lives to see 100.
“These are people who not only have a very long life, but they are healthy up to a very old age,” says Luigi Ferrucci, chief researcher of longitudinal studies at the U.S. National Institute on Aging (NIA) and a co-author of the Ogliastra study. “These are not people who’ve gotten diseased or dementia at 70 years old and somehow lived another 30 years.”
This research project is called Akea, an abbreviation of a traditional Sardinian language greeting, “akentannos,” or “to 100 years” (meaning, may you live that long), and it’s made up of researchers from Sardinia, mainland Italy, Belgium, France, and NIA. Since the Akea findings were published in 1999 and 2004, more teams of scientists have arrived on Sardinia, and they now monitor several isolated mountain villages of the Ogliastra as if they were petri dishes. The scientists ask the same questions that any of us would: Why do so many of these people live so long? What’s their secret?
“It’s still an amazing mystery,” says Michel Poulain, the Belgian demographer whose work on the Akea project verified the Sardinians’ age claims. “To be sure, everyone wants to live as long as possible. And everyone is looking into our study to find the recipe.”
In the Ogliastra village of Arzana, I enjoyed a glass of wine with a tiny 107-year-old woman named Raffaela Monni, who was dressed in the traditional black shawl and headscarf of Sardinian women. Sitting in the living room of her niece and niece’s husband, the family doctor at her side translating from Sardinian into Italian, we all toasted “akentannos!”
Raffaela told me about a walnut tree that stands in her front yard and how, up until she was 103, she would climb it. She teared up briefly when she spoke of her husband, whom she was married to for 76 years and who lived until almost 101.
I asked her the obvious question: What’s the secret to a long life?
Raffaela told me that she’s eaten the wild grasses of the mountains her whole life, and that she worked hard from the age of 10, tending to her fields and flock of sheep. Her doctor, Raffaele Sestu, said she takes no medicine at all, but that she does drink a little aquavit each night before bed.
But Raffaela wasn’t the only resident of Arzana in her second century — the sleepy village of 3,000 actually boasted three living centenarians. In addition to them, there were 41 nonagenarians, and a total of 89 people over the age of 85.
The following day, Dr. Sestu’s assistant took me to visit Federica Muceli, 102. She greeted me wearing the same traditional garb and holding a string of rosary beads in her hands. “Do you think you can find her a husband in the United States?” joked the assistant.
“Oh, I’m too old for marriage!” Federica said in Sardinian, with a laugh.
Federica told me about her older sister, who died three years ago at 103. She said she also had two brothers who lived into their 90s. She also spoke of working many years in the fields and pastures.
I had to ask her the obligatory question: What’s your secret?
“Everybody wants to know the secret,” she said, “but there is none.”
“Has it been a good life?” I asked.
“Not so much. Many sacrifices. Too much hard work.”
“But,” she said with a smile, “the other girls had a nice, quiet life. And they died young.”
I knew getting to the bottom of the longevity riddle would be difficult. But I didn’t realize how strange it would be, too.
On my first day in Sardinia, in its second biggest city of Sassari, I’d met with Luca Deiana, a professor of clinical biochemistry at the University of Sassari and the lead researcher on the Akea project. Deiana, I was told, is the gatekeeper for anyone seeking contact with Sardinia’s centenarians. Several of Deiana’s colleagues on the Akea project described him as “a politician” and told me to be wary.
The fact that Deiana insisted on meeting me in a local café rather than in his office or lab seemed a little odd. But we ordered espressos and began our conversation, helped along by his interpreter, Antonio.
“Here in Sardinia, we have always understood that one can live for a long time, and live well,” Deiana said grandly. “We have wild olive trees here that have lived for 3,000 years.” He then disparaged some of the other centenarian research going on around the world. “There are a lot of lies in other places, but our records are certified.”
Near the end of our brief meeting, Deiana looked me in the eye and said, “After studying centenarians for a long time, I now understand there are certain common characteristics. When I see a person, I don’t usually say anything, but I can tell if someone has the characteristics of a centenarian.”
“What about me?” I ask.
“Yes,” Deiana said. “You seem like you have the characteristics of someone who might become a centenarian.” Like a fortune-teller, he did not elaborate on what those characteristics might be. I told him this surprised me — I hate to admit it, but I’m not exactly the one you’d want to bet your money on in the Great Centenarian Derby.
“How old was your father?” he asked.
“He’s still alive. He’s only 58.”
“How old are your grandfathers?”
“Well,” I said, “one died at age 68 and the other in his mid-50s.”
Professor Deiana concluded our interview soon afterwards.
Later, two of Deiana’s fellow researchers asked me if he’d demanded money in exchange for arranging meetings with centenarians. For the record, I can say that Deiana did not ask me for money. But I can also say that he didn’t introduce me to any centenarians, either, which he had promised he would do.
Common sense tells us that the keys to longevity stem from both the genes with which we’re born, and the lifestyle we lead — what and how much we eat, whether we drink and smoke, where we live, how much stress we experience. Yet the science of longevity has only begun to unravel the mysterious relationship between genes and lifestyle.
“We have little chance of discovering a longevity gene,” says Gianni Pes, a researcher at the University of Sassari, and formerly a member of the Akea team. “Longevity is a complex thing. Centenarians are not a homogenous group. I wonder if what we’re seeing today is more an act of natural selection or what we’re seeing is because of habit or lifestyle.”
Before the Akea Project, one of the most comprehensive and high profile studies on longevity and lifestyle was the Okinawa Centenarian Study, a 25-year study of 600 centenarians in Okinawa, Japan carried out by the Pacific Health Research Institute in Honolulu. In Okinawa, another longevity hot spot, the islanders’ regimen of regular exercise combined with low-fat high-fiber diet rich in fruits and vegetables, resulted in very low rates of heart disease. Okinawans also have shown the importance of strong bones as they age — they suffer less than half as many debilitating hip fractures as do people in the United States. Researchers attribute this bone strength to high antioxidant consumption, mainly flavonoids and carotenoids, particularly from high vegetable and soy intake.
In fact, Okinawans are the world’s largest consumers per capita of soy. Researchers believe this is linked to a low incidence of hormone-dependent cancers. Breast and prostate cancer are almost unheard of on Okinawa — only about six deaths per 100,000 for breast cancer compared to 33 per 100,000 for Americans. And only four deaths per 100,000 for prostate cancer, as compared to 28 per 100,000 for Americans.
But even more important than what Okinawans ate was how much they ate. An Okinawan man’s daily intake of no more than 1,800 calories was significantly less than the American average of 2,500 calories. Eating fewer calories seems to have a direct correlation with lowering blood levels of damaging free radicals.
Just as important as nutrition was the Okinawans’ state of mental health. Researchers attribute this to what they call the Okinawans’ excellent “psycho-spiritual health.” In personality tests, the researchers found that the centenarians scored low when it came to feelings of “time urgency” and “tension” and high in “self-confidence” and “unyieldingness.” They also found that the Okinawan centenarians had worked well into old age. One result of this is an extremely low prevalence of dementia — only ten percent of Okinawans 85 or older suffer from dementia, versus over 35 percent in the U.S.
All of these findings were published in two recent books, The Okinawa Program and The Okinawa Diet Plan.
When I spoke with Michel Poulain, the Akea demographer, he snidely referred to the Okinawa books as “How to Become A Centenarian in Four Weeks.” He dismissed them as “such a typically American idea.”
Poulain went on to say that he’d visited Okinawa to verify the centenarians’ ages there. “I’ve had some problems,” he said. Apparently many important documents on Okinawa were destroyed during World War II and subsequently rewritten. Poulain said he was preparing his Okinawa findings for publication — which may call the validity of this centenarian cluster into question.
But even Poulain’s age data from Sardinia was initially called untrue by rival demographers — though, so far, the Sardinian ages have held up under further scrutiny. This type of sniping between rival researchers is fairly common when it comes to centenarian research, which is controversial within gerontology. “There is so much guardedness, fear, and paranoia in this field,” says Poulain’s colleague, Pes.
None of which has stopped The Okinawa Diet Plan and The Okinawa Program — and other books like them — from becoming bestsellers. In fact, they are prime examples of a burgeoning genre of healthy-eating books and articles: How To Eat If You Want To Live Forever.
An example: Several studies in the past few years have shown that laboratory monkeys and rats fed very-low-calorie diets live significantly longer than junk-food-eating monkeys and rats. Health reporters jumped on these findings. This led some brave people, on an endless search for the fountain of youth, to experiment with draconian calorie-restricted diets — just like the Okinawans’ — even though the effectiveness of these diets remains largely unproven.
Meanwhile, Nature reported last fall that a substance in red wine, resveratrol, protected mice from the ill effects of obesity and extended their life spans. The mice were fed a McDonald’s-esque diet, and led long, active lives despite becoming obese. “The mice were still fat, but they looked just as healthy as the lean animals,” said David A. Sinclair, the Harvard biologist who led the study, as quoted in the Washington Post. Of course, the researchers were quick to warn against beginning a high-fat, all-you-can-eat diet. You’d have to drink gallons of red wine in order to reach the levels given to the mice. We may be many years away from harnessing the potential benefits of resveratrol — for now everything’s hypothetical.
So if I’m the kind of person who’s keen to increase my longevity — and who isn’t? — it seems I have two options:
a) Struggle to eat 30 percent fewer calories than “normal.”
b) Eat whatever I want, but find the time (and the capacity) to ingest the equivalent of 100 glasses of red wine every day.
Apparently, the science of longevity has become a little like that drinking game where you answer such uncomfortable questions as: Death by fire, or drowning? Would you rather pee in your pants every time someone calls your name, or develop the worst case of acne ever recorded?
Still, the “Would You Rather?” question of ascetic-versus-hedonist is fun to play. While we’re playing, let me ask another question: Would you rather live a decidedly shorter life in a world of 24/7 stress, but still be able eat foie gras, candy bars, and Big Macs whenever you wanted to? Or would you rather, say, live forever as a poor, illiterate sheepherder in an isolated mountain village where resources are scarce?
In Sardinia, the homogenous populations of several of the Ogliastra mountaintop villages have drawn the interest of several major genetic research teams. In an effort to find the mysterious genetic links with old age, a private life sciences company called Shardna has created what it calls a “genetic park” in two particular Ogliastra villages, Urzulei and Talana (each with a population of a little over 1,000). Shardna is run by a leading Italian molecular geneticist named Mario Pirastu who was able to obtain blood samples — after receiving legal consent — from over 80 percent of the villages. Additionally, because of good church record keeping — birth, death, and marriage records and family census — Shardna has been able to construct genealogy charts for every person who’s lived in the villages over the past 450 years.
“We don’t only study centenarians,” says Pirastu, who worries about putting too much emphasis on the extreme end of the longevity pool. Shardna instead focuses on the entire adult populations of the villages, a much larger task. “We chose Urzulei and Talana because they simplify our job,” he says.
What’s fascinating about the two villages is just how genetically homogenous and pure they are — the creation of something called a “founder effect” in genetics. Urzulei and Talana were each founded by about 20 ancestors, and most of the residents descend from one or more of these. In Talana, for example, there has been less than one percent immigration into the village in the past 400 years. Over those four centuries, 95 percent of Talana residents have married someone else from Talana.
Shardna is now studying common disorders such as incidences of obesity, hypertension, and kidney stones. Pirastu cites one example in which Talana’s residents have more than double the rate of obesity of Urzulei’s. “If you visit the villages, you will see that they have a very similar style of life,” says Pirastu, explaining that people in both villages eat and drink the same things and work almost identical jobs. “We feel this must be genetic,” he says.
But how, exactly, the genetic mechanism works is a much more complicated issue. “It’s hard to say someone has ‘good’ genes. Maybe there was a gene that allowed them to eat less and still survive in poorer times. But maybe in richer times, they eat more and become obese.”
I visited Urzulei with Paola Melis, an anthropologist who works at Shardna with Pirastu. Melis is in the process of compiling personal histories of the villagers — a good example of the intersection of genetics and lifestyle in studying longevity.
“We believe history is very important,” Pirastu says of Melis’ work. “Knowledge of history is integral to this type of genetic research. We believe that some day we may use some of this anecdotal knowledge. Perhaps to compare the type of work someone did, or the types of houses they lived in, or the type of daily stress they might have had. To some, this information may sound naïve, but I think this history of health will become important in years to come. More and more, people are realizing the importance of the context of where you live.”
Perhaps unsurprisingly, a lot of the lifestyle elements documented in Okinawa — low caloric intake, a diet high in vegetables, a lengthy, vigorous work life, lack of stress — are all prevalent among old people in the Ogliastra villages.
In Urzulei, Melis and I visited a potential future centenarian, 95-year-old Fortunato Mulas. Fortunato, who lives alone, was hanging his laundry when we arrived and was planning to meet four other 95-year-old friends later that afternoon. Over and over again, “normale” — normal — was the word Fortunato kept repeating as I asked him about what he ate, what work he did, how he lived.
He explained what he consumed during a normal day. In the morning, he drank a little fresh, unpasteurized milk. At lunch, he ate fresh vegetables, rice or pasta, and pecorino cheese, sometimes maybe a hard-boiled egg. And he drank a glass of wine. At dinner, he’d have about the same thing, but less. With perhaps a spot of grappa before bed. “I’ve never been a big eater,” he said. “I’ve never been fatter than I am now.”
Like most people in the village, Fortunato seldom eats meat — only a little pork or free-range lamb on special occasions. Even though the Mediterranean is nearby, eating fish is not a part of the mountain culture. Melis noted that the food in Sardinia is the very definition of organic — grown locally and consumed fresh, without preservatives.
Fortunato was a normal member of the village in every way. He worked as a shepherd until the age of 80, he never went to school, never learned to read or write, only attended church sporadically. He never left the island of Sardinia, except once — to serve in Africa in Mussolini’s army. “I started working in the fields when I was four years old,” he said. “It was a normal way of working. We spent long days walking the countryside. I did not know how to stand still.”
This would seem the idyllic picture of a stress-free life. As Melis said to me later, “The life of a shepherd was hard, but not very stressful.” Fortunato, for instance, would not be bothered by an irritating email or a disturbing story in the newspaper —because he cannot read or write. “What’s in his head?” Melis said. “What does he think about all day?”
But just because Fortunato lived as a poor shepherd on a Sardinian mountaintop, don’t think that he’s escaped life without his share of woes. At 13, Fortunato contracted malaria—which was endemic in Sardinia until the 1950s — just like many other children of his era. And when he was serving in the army, in Africa, he was captured by the British and held as a prisoner of war for eight years. Then, a year after he returned home to the village, his wife died, leaving him with a nine-year-old child he barely knew.
As Fortunato told me about his life, I started to think hard about the whole notion of living forever. Given a life such as this, I wonder how many of us would opt to live to 100. Perhaps many of us might agree with Chekhov, who once wrote, “Death is terrifying, but it would be even more terrifying to find out that are you going to live forever and never die.”
At the same time, I realized such thoughts might eventually doom my piece for AARP Magazine. I was right. Weeks later, my editor would write me an email saying I hadn’t really “delivered” on the “how to” they were looking for. “Are people supposed to eat more soy or not?” she asked. I felt like I couldn’t even begin to answer a question like that.
On my last day in Ogliastra, I visited a woman named Barbara Mossudu, who would turn 100 in two months’ time. She told me he had worked in the fields until the age of 85.
Once again, I asked her for the secrets to living a long life. Her family gathered around in the living room and beamed proudly as they translated from Italian in Sardinian. But Barbara wouldn’t have any of it.
“So what if I’m almost 100 years old?” she says. “I can’t go anyplace I want to go. I can’t work. I can’t hear a conversation between people. The only thing I can do is sew lace. It makes the time pass.”
One of her family members asked, “But it’s been a beautiful life, right?”
“Ah, so-so,” she says. “I have seen beautiful things and I’ve seen ugly things. But I didn’t get very upset about anything.”
As her family members bustled around, serving us afternoon drinks and snacks, Barbara looked me right in the eye and said, “I have lived a long time and I am tired of this life.” • 6 August 2007