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After an amazing vacation in Italy, I’m feeling refreshed, grateful, contemplative, and graced with many new friends and International acquaintances. It was a truly magical and invigorating trip.

Why Italy? There were a few reasons.

Besides the obvious of a bucket-list check-off, experiencing an Andrea Bocelli opera, “connecting with my roots”, and just the fact that it’s Italy, there was another undisclosed purpose for my mini-sabbatical. It was to allow some space for my mind to wander and calmly assess the next stage for me and BreakFree Medicine. The answer was made clear to me and I will share it at the end of this post.


Longevity & Health in Italy

One thing that really inspired me in Tuscany, besides its beauty, was the stability and calmness of its inhabitants. There seemed to be an innate tranquility residing in most of the people that surrounded me. I’m not speaking of an unnatural happy-go-lucky, serene attitude. Rather, Italians seemed as a whole to be a lot more versed in being in the moment to fully enjoy life, regardless of circumstances. Even with customer complaints, yipping dogs, and crowded streets, there was an obvious air about the people of accepting whatever was happening at the time, rather than trying to fix it, change it, or rush through it. This embracing of time took some getting used to for a resident New Yorker, but luckily it became contagious.

In this blog, I’ll review some health tidbits I took away from my trip to Tuscany and explain why Italy is a perfect example of integrated wellness. Besides the fact that Europeans tend to be healthier, the Italian island of Sardinia is reported to have the highest number of male centenarians in the world, and this classifies it as a blue zone.

Blue zones are regions in the world where people tend to live longer, healthier lives. The term was popularized by author Dan Buettner who traveled these 5 areas that spanned the globe. According to NPR:

Buettner partnered with National Geographic and the National Institute on Aging. Several demographers used census data to pinpoint countries with the longest life expectancy…

One of the most striking people he met during his travels was 104-year-old Giovanni Sannai of Sardinia. “He was out chopping wood at 9 in the morning,” Buettner tells guest host Audie Cornish. “He started his day with a glass of wine and there was a steady parade of people coming by to ask his advice. That’s one of the characteristics of the Sardinian Blue Zone — the older you get, the more celebrated you are.”

In our food obsessed culture, one of the most common hypotheses for these centenarians’ long lives has been dietary. One review of centenarians in Italy reported that the commonality of the diets of these 19 people was in fact related to following a low glycemic and Mediterranean diet, high in fruits and veggies. However, the researchers noted, “Overall, our data confirm our previous suggestion that longevity concerns subjects, living in small town, without pollution, with different working conditions, lifestyles and close adherence to a Mediterranean diet.”

So, there is more to longevity than diet, its the interaction of genes, environment, and the modulation of epigenetics with social factors.

As noted above, with the wood-chopping Sardinian, some habits of centenarians seem outright against integrative and conventional health advice!

Can you imagine going to your doc and being told the following at your yearly physical?

  1. To sip a glass of vino rossa (red wine) upon arising. Of course, the caveat here may be that this specific wine would be of the highest quality, made from grapes that are fermented perfectly, raised in a pristine environment, for richness in resveratrol and polyphenols. Furthermore, one glass, not a liter, would do.
  2. After imbibing the vino, you would be told to burn off that glucose-insulin spike with some major cardio-strength resistance training, such as chopping wood. In fact, the antioxidants and polyphenols in your overall diet (such as from the abundance of olives) and the wine may help modulate this rise in insulin from your morning drink and assist your body with the anti-inflammatory effects that allow you to work longer and harder.
  3. A prescription would be written to visit with your friends often and enjoy your life, because your new radical doc would know that social isolation is the number one predictor of death from a cardiac event.

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Dr. Christian Northrup summarizes 5 aspects of centenarians in the following way:

They make rituals of pleasure a part of their day. For example, they might have a shot of whiskey or smoke a fine cigar every day. They aren’t addicted to these substances, rather, they look forward to savoring both the substance and the ritual. Think Japanese tea ceremony.” 

Are not co-dependent. They don’t stay in relationships that are unhealthy or dysfunctional, or with people who have addictions.

Live in communities where they are revered. They surround themselves with people and situations where they are respected for their contributions and wisdom.

Don’t go to doctors—partially because they’ve outlived their doctors. Because they aren’t spending time at doctors, they aren’t focused on their possible decline.

Are future-oriented. They make long-term plans because they see themselves thriving in the future.


Do Blue Zones Support the Recent Push-back on Paleo?

There’s been a recent push-back on the definition of what Paleo really is, specifically regarding how grains and dairy may in fact be more Paleo than once thought. One reason is that evidence for epigenetics and nutrigenomics is becoming more available through articles reporting on genetic variants for salivary amylase and lactose tolerance.

It appears that these Blue Zones also provide further support for going “against the grain” in current Paleo health trends in several ways:

  1. Grains aren’t considered evil and one doesn’t seem to feel guilty about enjoying sourdough bread.
  2. Hard exercise may be considered more harmful than helpful. However, this isn’t totally un-Paleo as many experts agree it can negatively affect stress levels if overdone. Although reserach has shown that some vigorous activity is even better than a moderate amount in a study done with middle-aged and older Australians, this was not a blue zone. Still, I’d consider chopping wood a high-intensity workout, would you? I think this is up for debate and depends on how the physical activity is perceived and the overall stress accumulation.
  3. Coffee is a health food- I’ve already given my opinion on coffee here, but another recent study has reported that coffee drinkers in Athens, a region without GMOs and less pesticides, enjoyed less inflammation and diabetes type 2. (For some, coffee is Paleo, others it isn’t.)
  4. The centenarians aren’t big on butter and high meat intake and legumes are suggested to be eaten regularly. Not very paleo, or is it? (See below)

This video below discusses in depth various aspects of human nutrition across time is based on an anthropologist’s and ancient diet researcher, Christina Warinner.

Disclaimer: I believe the Paleo Diet is a wonderful protocol for most people, but I believe in individualizing diets and that total avoidance of any food group to the extreme could be detrimental. Dr. Christianson and I discuss this in my latest podcast with DFH and how carb-free may not be “thyroid friendly.”

This brings me to my announcements.


Special Announcements:

1. My interview with Dr. Christianson on the new Clinical Rounds Podcast: Mastering the Thyroid Part 1: Demystifying Hormone Diagnoses, and How to Rest Your Adrenal is released!

You can listen here.


2. Check out my co-authored article with Ben Greenfield: Mint-Chocolate Water, Upper Lip Peppermint Sniffing, Peppermint Fat Bombs & More: How Peppermint Can Enhance Performance


3. Dr. Keesha’s course is about to start!

You may remember my previous announcement of my friend and college’s webinar introduction of “The Libido Cure.” Now, the actual training and course is fast approaching and Dr. Keesha asked me to spread the word.

If you’ve ever wished you had more energy and vitality, you need to know about this.

Over the next 7 weeks, Dr. Keesha will help you ignite your sex life, lose pounds of fat, improve your focus and memory, and get in the mood…for whatever you are passionate about!

All without surgeries, synthetic hormones, prescription pills, or fad diets.

Dr. Keesha will reveal why this is true and share her secrets to boosting your desire and zest for life – without hormones or drugs.

Register and reserve your spot for this amazing training now.


4. Consultations with Me

I’m returning to the Albany area and will be starting part-time phone consults in September. I will be taking a limited amount of clients, as I will also be continuing with DFH as an independent consultant position vs. employee. I missed you guys and needed to head back to New York!

Look for upcoming announcements on how to book an appointment.


References & Sources:

Can ‘Blue Zones’ Help Turn Back the Biological Clock? NPR. June 8, 2008.

About Blue Zones. Accessed August 5, 2015.

Vasto S, Rizzo C, Caruso C. Centenarians and diet: what they eat in the Western part of Sicily. Immunity & Ageing?: I & A. 2012;9:10. doi:10.1186/1742-4933-9-10.

Comparative studies on the antioxidant properties and polyphenolic content of wine from different growing regions and vintages, a pilot study to investigate chemical markers for climate change. Food Chem. 2013 Oct 1;140(3):500-6. doi: 10.1016/j.foodchem.2013.01.006. Epub 2013 Jan 16.

Antioxidant Activity of Different Phenolic Fractions Separated from an Italian Red Wine. J Agric Food Chem. 1998 Feb 16;46(2):361-367.

Effect of viticulture practices on concentration of polyphenolic compounds and total antioxidant capacity of Southern Italy red wines. Food Chem. 2014;152:467-74. doi: 10.1016/j.foodchem.2013.11.142. Epub 2013 Dec 1.

NMR spectroscopy evaluation of direct relationship between soils and molecular composition of red wines from Aglianico grapes. Anal Chim Acta. 2010 Jul 19;673(2):167-72. doi: 10.1016/j.aca.2010.06.003. Epub 2010 Jun 9.

Metabolic and biological profile of autochthonous Vitis vinifera L. ecotypes. Food Funct. 2015 May;6(5):1526-38. doi: 10.1039/c5fo00110b.

Regular wine consumption in chronic heart failure: impact on outcomes, quality of life, and circulating biomarkers. Circ Heart Fail. 2015 May;8(3):428-37. doi: 10.1161/CIRCHEARTFAILURE.114.002091. Epub 2015 Apr 29.

Carbohydrate feeding before exercise: effect of glycemic index. Int J Sports Med. 1991 Apr;12(2):180-6.

Polyphenols-rich natural products for treatment of diabetes. Curr Med Chem. 2015;22(1):14-22.

De Bock M, Derraik JGB, Brennan CM, et al. Olive (Olea europaea L.) Leaf Polyphenols Improve Insulin Sensitivity in Middle-Aged Overweight Men: A Randomized, Placebo-Controlled, Crossover Trial. Nerurkar PV, ed. PLoS ONE. 2013;8(3):e57622. doi:10.1371/journal.pone.0057622.

My Dinner With Longevity Expert Dan Buettner (No Kale Required). New York Times. August 1, 2015.

Dr. Northrup. Do You Have Blue Zone Envy? Accessed August 5, 2015.

My Dinner With Longevity Expert Dan Buettner (No Kale Required). New York Times. August 1, 2015.

Perry GH, Dominy NJ, Claw KG, et al. Diet and the evolution of human amylase gene copy number variation. Nature genetics. 2007;39(10):1256-1260. doi:10.1038/ng2123.

High Endogenous Salivary Amylase Activity Is Associated with Improved Glycemic Homeostasis following Starch Ingestion in Adults. J. Nutr. May 1, 2012; 142(5):853-858.

Mandel AL, Peyrot des Gachons C, Plank KL, Alarcon S, Breslin PAS. Individual Differences in AMY1 Gene Copy Number, Salivary ?-Amylase Levels, and the Perception of Oral Starch. PLoS ONE . 2010; 5(10): e13352. doi:10.1371/journal.pone.0013352

Evolutionary Genetics: Genetics of lactase persistence – fresh lessons in the history of milk drinking. European Journal of Human Genetics. 2005; 13, 267–269. doi:10.1038/sj.ejhg.5201297 Published online 15 December 2004

Identification of a variant associated with adult-type hypolactasia. Nature Genetics. January 14, 2002; 30, 233 – 237. doi:10.1038/ng826

Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians. JAMA Intern Med. 2015;175(6):970-977. doi:10.1001/jamainternmed.2015.0541

Coffee drinking may lower inflammation, reduce diabetes risk. Reuters. July 20, 2015.