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Health & Exercise Forum

Celebrating Life: Part 3 of 5

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Jun 15, 2015

Dr. Mackarey's Health & Exercise Forum10th ANNIVERSARY

Series of 5 Columns Celebrating Life! Part 3 of 5

“Health and Exercise Forum” by Dr. Paul Mackarey, completes its 10TH year in June of 2015 …THANK YOU! Thank you for your kind words, positive (and negative) feedback in the form of phone calls, texts, emails and simple chats on the streets. I am grateful and humbled. In honor of the 10th anniversary of “Health and Exercise Forum,” I decided to write a series of columns that encapsulates the most important messages regarding health and wellness, base on current wisdom. Readers in NEPA seem to be consistently interested in is health, wellness and longevity. While I have written about this repeatedly, in many different ways, over the past 10 years, I thought this would be the perfect time to share some new information. Please enjoy and embrace the wisdom of those centenarians both from NEPA and from around the globe and let me know your thoughts.


Academics have long suspected that there are specific clusters of people around the globe who significantly outlive the general population. This concept provoked National Geographic Explorer Dan Buettner, to travel around the world in an attempt to study geographic locations around the world that had the greatest concentration of centenarians. He and his research team further studied their cultures and social habits to determine commonalities among these people and their habitats. He discovered that DNA is only one of many ingredients for a long and healthy life. His book, The Blue Zone, details his findings and here is a summary of what they found…

Buettner and his team identified five specific locations on the planet where people seem to have found the “secrets of a long life:” Sardinia, Italy; Okinawa, Japan; Nicoya, Costa Rica; Ikaria, Greece; Loma Linda, California. But, Buettner and his team were not just impressed with the age of the people they met in these zones, but the active lifestyle they maintained, even at 102 years of age. For example, he met a 94 year old man from Costa Rica, who continues to work as a farmer and a 102 year old woman from Sardinia, who hikes at least 6 miles every day. He designated these “Blue Zones” as special places where several common traits contributed to longevity; strong social structure, plant-based diet, moderate consumption of food and daily physical activity. Researchers hope that with lessons learned from the “blue zones” and their people, in combination with scientific discovery, technology and modern medicine, that other people can create their own healthy spaces, change lifestyles and live longer, healthier and happier lives. 


Okinawa is a small island in the Pacific Ocean 360 miles off the coast of Japan known for its beautiful beaches, turquoise waters, and temperate climate. It has long been recognized as “the land of the immortals.” However, in recent years, with outside influence and fast foods, younger generations are not enjoying the same longevity as their predecessors and parents are beginning to outlive their children. Despite these changes, Okinawa still enjoys one of the largest numbers of centenarians on the planet, with lower rates of cancer, heart disease or dementia than Americans. Okinawans practice an eating habit called “Hara Hachiu Bu” in which they purposely limit the amount of food (calories) they eat at every meal by eating only until they are 80% full. This practice is scientifically supported because it takes the stomach 20 minutes to communicate with your brain when you are full. So, by Hara Hachiu Bu you will stop eating 20 minutes sooner than you would otherwise. Okinawans also pride themselves in maintaining a fruitful garden. It is the primary source of healthy and fresh foods, some of which offer protection from diseases like malaria. Additionally, laboring in the garden keeps them strong and mobile, while the exposure to the sun produces vitamin D to keep bones strong. Lastly, much like the Sardinians, Okinawans are generally good natured and enjoy a positive outlook on life. They maintain strong ties with family and friends (moais) throughout their lives for social, emotional, and financial support.

Healthy Living in Okinawa:

  • Walk as part of your daily routine. Challenge your body: Climbing up and down hills on rough terrain maintains a good vestibular (balance) system which prevents falls.
  • Physical labor maintains muscle tone and bone density.
  • Healthy diet/Maintain a garden: based on living in an area with a 12 month growing season, Okinawan’s pride themselves in growing much of their own fresh vegetables. Consequently, they benefit from the exercise of garden work, the mental stimulation of planning and maintaining it and the physical value of eating fresh and untainted vegetables for vitamins and nutrients. In climates with shorter growing seasons, grow in the summer and stock up (can, dehydrate, freeze) for winter.
  • Limit food and caloric intake – 80% rule: Okinawins believe this habit promotes moderation.
  • Be social (maintain relationships with family and friends) and have purpose (assist family members in chores)…elderly on this island feel it is the only reason to live long!
  • Smile! Centinarians in Okinawa credit there positive outlook, despite suffering the same hardships as others on the planet, as a critical component to their longevity.


As in many regions whose people enjoy longevity, Nicoya, Costa Rica is an isolated island.  Located south of Nicaragua on the Pacific Coast, and accessible only by ferry until recently it enjoys a long tradition of peace, health and wellness. Since 1948, Costa Rica has not had an active army and is proud of it. Instead, the government shifted its emphasis on education, health and culture. In this spirit, President Oscar Arias Sanchez was the recipient of the Nobel Peace Prize in 1987 for his role in bringing peace to Central America. This pervasive national attitude, along with other admirable life-style traditions, has contributed to the health and longevity of its citizens. While Costa Rica spends only 15% of what the United States spends on healthcare, its citizens can expect a longer and healthier life than those in the USA. In fact, a man in Costa Rica is twice as likely to live to be 90 years of age, as compared to men in the USA, France or Japan. Moreover, Costa Ricans fortunate enough to live on the island of Nicoya, enjoy even greater health and longevity with the lowest cancer rates in the entire country. We can learn some valuable lessons on healthy living from the inhabitants of Nicoya.

Healthy Living in Nicoya, Costa Rica:

  • Plan de Vida!” “Reason to Live” Centenarians in Costa Rica feel strongly, as previously mentioned by many others, that having a reason to live, purpose or reason for living, is an essential motive to get up every day. It may be as simple as spending time with children (grand and/or great grand) or complex as assisting in providing for the family by cleaning, cooking, gardening etc.
  • Active Lifestyle in the Sun – Costa Rican’s enjoy daily physical activity outdoors in the sun for Vitamin D. They walk everywhere, tend to their gardens and livestock, and perform manual labor, all as part of daily living.
  • Faith – it is deeply engrained in Nicoyan culture and lifestyle that relinquishing control of one’s life to a higher spiritual being (God), fosters a healthy mind, body and spirit by alleviating stress and anxiety.
  • Sleep – as a consequence of living without electricity, Nicoyan’s go to bed at sunset (8:30 PM) and awake at sunrise to enjoy at least 8 hours of sleep each day.
  • Eat Well and timely – colorful fruits and pears, rice, beans, and corn are Nicoyan staples. Moreover, they eat their largest meals at breakfast and lightest meals at evening dinner.
  • Drink Hard Water – In the USA, we are too quick to get water softeners to protect our plumbing, but maybe we should think twice. Scientists believe that Nicoyan’s receive high amounts of calcium and magnesium from their hard water which contributes to their tremendous bone density, despite their low body weight and limited diet.

Read Dr. Mackarey’s Health & Exercise Forum – Every Monday in the Scranton Times-Tribune. Next week read: Part 4 of 5 “Longevity”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.