One day in 1976, Stamatis Moraitis of Boynton Beach, Florida, felt short of breath. Climbing stairs was a chore; he had to quit working midday. After reviewing his X-rays, his doctor concluded that Moraitis had lung cancer. As he recalls, nine other doctors confirmed the diagnosis. They gave him nine months to live. He was in his mid-60s. Moraitis, a Greek war veteran who had arrived in the United States in 1943, considered staying and seeking aggressive treatment. That way, he and his wife, Elpiniki, could be close to his adult children. But he decided to return to his native island, Ikaria, where he could be buried with his ancestors in a cemetery that overlooked the Aegean Sea. He and Elpiniki moved in with his elderly parents, into a tiny, whitewashed house on two acres of stepped vineyards on the north side of Ikaria.
At first, Moraitis spent his days in bed. On Sunday mornings, he hobbled up the hill to a tiny Greek Orthodox chapel where his grandfather once served as a priest. When his childhood friends started showing up every afternoon, they’d talk for hours, an activity that invariably involved a bottle or two of locally produced wine. I might as well die happy, he thought.
In the ensuing months, Moraitis started to feel stronger. One day he planted some vegetables in the
garden. He didn’t expect to live to harvest them, but he enjoyed being in the sunshine, breathing the ocean air.
Six months came and went. He didn’t die. Easing himself into the island routine, he woke up when he felt like it, worked in the vineyards until midafternoon, made lunch, and then took a long nap. In the evenings, he often walked to the local tavern, where he played dominoes past midnight. His health continued to improve. He added a couple of rooms to his parents’ home so his children could visit. He built up the vineyard until it produced 400 gallons of wine a year.
For more than a decade, I’ve been organizing a study of places where people live longest. In 2008, my colleagues Michel Poulain, PhD, a Belgian demographer, and Gianni Pes, MD, a researcher at the University of Sassari in Italy, and I began investigating Ikaria. Ninety-nine square miles and home to almost 10,000 Greek nationals, the island lies about 30 miles off the western coast of Turkey. We concluded that people on Ikaria were, in fact, two and a half times as likely to reach age 90 as Americans. Ikarian men, in particular, are nearly four times as likely as their American counterparts to reach 90. Ikarians were also living about eight to ten years longer before succumbing to cancers and cardiovascular disease, and they suffered less depression and about a quarter the rate of dementia.
Life on Ikaria
Seeking to learn more about the island’s reputation for long-lived residents, I called on Ilias Leriadis, one of Ikaria’s few physicians. On an outdoor patio, he set a table with kalamata olives, hummus, heavy Ikarian bread, and wine.
“People stay up late here,” Dr. Leriadis said. “We wake up late and always take naps. We simply don’t care about the clock.”
Dr. Leriadis also talked about local “mountain tea,” made from dried herbs endemic to the island, which is enjoyed as an end-of-the-day cocktail. He mentioned wild marjoram, sage, a type of mint tea, rosemary, and a drink made from boiling dandelion leaves and adding a little lemon. The teas double as traditional Greek remedies. Wild mint fights gingivitis and gastrointestinal disorders; rosemary is used to treat gout; artemisia is thought to improve blood circulation.
When Ioanna Chinou, a professor at the University of Athens School of Pharmacy and one of Europe’s top experts on the bioactive properties of herbs, tested Ikaria’s most commonly used herbs, she found that they showed strong antioxidant properties. Most also contained mild diuretics, which doctors use to treat hypertension. Perhaps by drinking tea, Ikarians have gently lowered their blood pressure all their lives.
On a trip the year before, I visited a slate-roofed house built into the slope at the top of a hill. I had come here after hearing of a couple married for more than 75 years. Thanasis and Eirini Karimalis clapped their hands at the thrill of having a visitor.
The couple were born in a nearby village; they married in their early 20s and raised five children on Thanasis’s pay as a lumberjack. Their daily routine: Wake naturally, work in the garden, have a late lunch, nap. At sunset, they either visited neighbors or neighbors visited them. Their diet was also typical: a breakfast of goat’s milk, wine, sage tea or coffee, honey and bread. Lunch was almost always beans, potatoes, greens (fennel, dandelion, or a spinachlike green called horta), and seasonal vegetables from their garden; dinner was bread and goat’s milk. At Christmas and Easter, they would slaughter the family pig and enjoy small portions of larded pork for the next several months.
Just after sunset, another couple walked in, carrying a glass amphora of homemade wine. The ninety-somethings cheek-kissed one another and settled around the table. They gossiped, drank wine, and occasionally erupted into laughter.
The Healthy Magic of the Ikarian Diet
Meanwhile, my colleagues and additional researchers fanned out across the island and asked nonagenarians a battery of lifestyle questions. They were joined by Antonia Trichopoulou from the University of Athens Medical School, an expert on the Mediterranean diet.
She estimated that the Ikarian diet, compared with the standard American diet, might yield up to four additional years of life expectancy. Low intake of saturated fats from meat and dairy was associated with lower risk of heart disease; olive oil reduced bad cholesterol and raised good cholesterol. Goat’s milk contained serotonin-boosting tryptophan and was easily digestible for older people. Some wild greens had ten times as many antioxidants as red wine. Wine—in moderation—prompts the body to absorb more flavonoids, a type of antioxidant. Local sourdough bread might reduce a meal’s glycemic load. You could even argue that potatoes contributed heart-healthy potassium, vitamin B6, and fiber. And because islanders eat greens from their gardens, they consume fewer pesticides and more nutrients.
Ikarians’ sleep and sex habits might also affect their long lives. A 2008 paper by the University of Athens Medical School and Harvard School of Public Health found that napping at least three days weekly was associated with a 37 percent reduction in the risk of coronary heart disease. In a preliminary study of older Ikarian men, 80 percent claimed to have sex regularly, a habit also linked to longevity. A quarter of that group said they were doing so with “good duration” and “achievement.”
When Thea Parikos moved from America to Ikaria and opened a guesthouse, she stopped shopping for most groceries, instead planting a huge garden that provided most of their fruits and vegetables. She lost weight without trying to. I asked her if she thought her diet would make her family live longer. “Yes,” she said. “But we don’t think about it that way. It’s bigger than that.”
Although unemployment is high—perhaps as high as 40 percent—most everyone has access to a family garden and livestock, Parikos told me. People who work might have several jobs. Someone involved in tourism, for example, might also be a painter. “We may not have money for luxuries, but we will have food on the table and still have fun with family and friends,” she said. “We may not be in a hurry to get work done during the day, so we work into the night. At the end of the day, we don’t go home to sit on the couch.”
Ask the very old on Ikaria how they’ve lived past 90, and they’ll usually talk about the clean air and the wine. Or, as one 101-year-old woman put it, “We just forget to die.” They have no idea how they’ve lived so long.
But if you pay careful attention, it appears that a dozen subtly powerful, mutually enhancing, and pervasive factors are at work. It’s easy to get enough rest if no one else wakes up early and the village goes dead during afternoon nap time. It helps that the cheapest, most accessible foods are also the most healthful—and that your ancestors have spent centuries developing ways to make them taste good. It’s hard to get through the day without walking up 20 hills. You’re not likely to ever feel the stress of arriving late. And at day’s end, you’ll share a cup of herbal tea with your neighbor. Even if you’re antisocial, you’ll never be entirely alone.
The last time I spoke to Moraitis was in July 2012. Elpiniki had died in the spring, and now he lived alone. I had one last question: How does he think he recovered from lung cancer?
“It just went away,” he said. “I actually went back to America about 25 years after moving here to see if the doctors could explain it.” I had heard this part of the story before. It had become a piece of the folklore of Ikaria. Still, I asked, “What happened?”
“My doctors were all dead.”
Moraitis died in his home on February 3, 2013, at the age of 98, according to official records. By his own reckoning, he was 102.
Dan Buettner’s latest book, The Blue Zones Solution, reveals how Americans can adopt healthier lifestyles. It will be published this spring.