By Dan Beuttner 7:00AM GMT 05 Jan 2013
Told he was terminally ill, Stamatis Moraitis left America to end his days in his native Ikaria. Thirty-five years later he is thriving alongside his many friends in their 90s and older. How do the people of this Greek island live so long and so well?
Ikaria, 99 square miles and with a population of about 10,000, lies some 30 miles off the western coast of Turkey. Photo: Andrea Frazzetta/LUZphoto/The New York Times Syndicate
In 1943 a Greek war veteran named Stamatis Moraitis arrived in the United States for treatment of a combat-mangled arm. He had survived a gunshot wound, escaped to Turkey and eventually talked his way on to the Queen Elizabeth, then serving as a troopship, to cross the Atlantic. Moraitis settled in Port Jefferson, New York, an enclave of countrymen from his native island, Ikaria. He quickly got a job doing manual labour. Later, he moved to Boynton Beach, Florida. Along the way, Moraitis married a Greek-American woman, had three children and bought a three-bedroom house and a 1951 Chevrolet.
One day in 1976 Moraitis felt short of breath. Climbing stairs was a chore; he had to stop working at midday. After 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 considered staying in America and seeking aggressive cancer treatment. That way, he could also be close to his adult children. But he decided instead to return to Ikaria, where he could be buried with his ancestors. Moraitis and his wife, Elpiniki, moved in with his elderly parents, into a tiny, whitewashed house on two acres of stepped vineyards near Evdilos, on the north side of Ikaria. At first he spent his days in bed, as his mother and wife tended to him. On Sunday mornings he hobbled up the hill to a tiny Greek Orthodox chapel where his grandfather had been a priest. When his childhood friends discovered that he had moved back, they started showing up every afternoon. They would 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, something strange happened. He started to feel stronger. One day, feeling ambitious, 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. Moraitis did not die. Instead, he reaped his garden and, feeling emboldened, cleaned up the family vineyards as well. Easing himself into the island routine, he woke up when he felt like it, worked in the vineyards until mid-afternoon, made himself lunch and then took a long nap. In the evenings he often walked to the local tavern, where he played dominoes until after midnight. The years passed. 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 1,800 litres of wine a year. Today, he is 97 years old – according to an official document he disputes; he says he is 102 – and cancer-free. He never went through chemotherapy, took drugs or sought therapy of any sort. All he did was move home to Ikaria.
Stamatis Moraitis tends his vines and olive trees on IkariaI met Moraitis on Ikaria in July during one of my visits to explore the extraordinary longevity of the island's residents. For a decade, with support from the National Geographic Society, I have been organising a study of the places where people live longest. The project grew out of studies by my partners, Dr Gianni Pes of the University of Sassari in Italy and Dr Michel Poulain, a Belgian demographer. In 2000 they identified a region of Sardinia's Nuoro province as the place with the highest concentration of male centenarians in the world. As they zeroed in on a cluster of villages, they drew a boundary in blue ink on a map and began referring to the area inside as the 'blue zone'. Starting in 2002 we identified three other populations around the world where people live measurably longer lives than everyone else: Okinawa, Japan; Nicoya, Costa Rica; and Loma Linda, California.
In 2003 I started a consulting firm to see if it was possible to take what we were learning in the field and apply it to American communities. We also continued to do research and look for other pockets of longevity, and in 2008, following a lead from a Greek researcher, we began investigating Ikaria. Poulain's plan was to track down survivors born between 1900 and 1920 and determine when and where individuals died. The data collection had to be rigorous. Earlier claims about long-lived people in such places as Ecuador's Vilcabamba Valley and the Caucasus Mountains of Georgia had been debunked after researchers discovered that many residents did not actually know their ages. For villagers born without birth certificates, it was easy to lose track. One year they were 80; a few months later they were 82. Pretty soon they claimed to be 100. And when a town discovers that a reputation for centenarians attracts tourists, who is going to question it? Stories like the one about Moraitis's miraculous recovery become instant folklore, told and retold and changed and misattributed.
The study would try to cut through the stories and establish the facts about Ikaria's record for longevity. Before including subjects Poulain cross-referenced birth records against baptism or military documentation. After gathering all the data, he and his colleagues at the University of Athens concluded that people on Ikaria were, in fact, reaching the age of 90 at two and a half times the rate Americans do. But more than that, they were also living about eight to 10 years longer before succumbing to cancers and cardiovascular disease, and they suffered less depression and about a quarter the rate of dementia. Almost half of Americans who are 85 and older show signs of Alzheimer's. On Ikaria, however, people have been managing to stay sharp to the end.
Ikaria, an island of 99 square miles and home to almost 10,000 Greek nationals, lies about 30 miles off the western coast of Turkey. Its reputation as a health destination goes back 25 centuries, when Greeks travelled to the island to soak in the hot springs near Therma.
Seeking to learn more about the island's reputation for long-lived residents, In 2009 I visited Dr Ilias Leriadis, one of Ikaria's few physicians. On an outdoor patio at his weekend house, he set a table with Kalamata olives, hummus, heavy Ikarian bread and wine. 'People stay up late here,' Leriadis said. 'We wake up late and always take naps. I don't even open my office until 11am because no one comes before then.' He took a sip of wine. 'Have you noticed that no one wears a watch here? No clock is working correctly. When you invite someone to lunch, they might come at 10am or 6pm. We simply don't care about the clock here.'
Pointing across the Aegean towards the neighbouring island of Samos, he said, 'Just 15 kilometres over there is a completely different world. There they are much more developed. There are high-rises and resorts and homes worth a million Euros. In Samos, they care about money. Here, we don't. For the many religious and cultural holidays, people pool their money and buy food and wine. If there is money left over, they give it to the poor. It's not a "me" place. It's an "us" place.'
Pes and Poulain set out to track down the island's 164 residents who were over 90 in 1999. They found that 75 nonagenarians were still alive. Then, along with additional researchers, they fanned out across the island and asked 35 elderly subjects a battery of lifestyle questions to assess physical and cognitive functioning. They were joined in the field by Dr Antonia Trichopoulou of the University of Athens, an expert on the Mediterranean diet. She noted that the Ikarians' diet, like that of others around the Mediterranean, was rich in olive oil and vegetables, low in dairy (except goat's milk) and meat products, and also included moderate amounts of alcohol. It emphasised home-grown potatoes, beans (garbanzo, black-eyed peas and lentils), wild greens and locally produced goat's milk and honey.
Every one of the Ikarians' dietary tendencies has been linked to increased life spans. Low intake of saturated fats from meat and dairy is associated with lower risk of heart disease; olive oil – especially unheated – reduces bad cholesterol and raises good cholesterol. Goat's milk contains serotonin-boosting tryptophan and is easily digestible for older people. Some wild greens have 10 times as many antioxidants as red wine. Wine – in moderation – has been shown to be good for you if consumed as part of a Mediterranean diet, because it prompts the body to absorb more flavonoids, a type of antioxidant. And coffee, once said to stunt growth, is now associated with lower rates of diabetes, heart disease and, for some, Parkinson's. Another health factor at work may be the unprocessed nature of the food they consume: as Trichopoulou observed, because islanders eat greens from their gardens and fields, they consume fewer pesticides and more nutrients. She estimated that the Ikarian diet, compared with the standard Western diet, might yield up to four additional years of life expectancy.
During our time on Ikaria, my colleagues and I stayed at Thea Parikos's guesthouse, the social hub of western Ikaria. Local women gathered in the dining-room at mid-morning to gossip over tea. Late at night, tables were pushed aside and the dining-room became a dance floor, with people locking arms and kick-dancing to Greek music. Parikos cooked the way her ancestors had for centuries, giving us a chance to consume the diet we were studying. For breakfast she served yogurt and honey from the 90-year-old beekeeper next door. For dinner she walked out into the fields and returned with handfuls of weedlike greens, combined them with pumpkin and baked them into savoury pies.
Despite her consummately Ikarian air, Parikos was actually born in Detroit to an American father and an Ikarian mother. She attended high school, worked as an estate agent and married in the United States. After she and her husband had their first child, she felt a 'genetic craving' for Ikaria. When she and her family moved to Ikaria and opened the guesthouse, everything changed. She stopped shopping for most food, 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 simple diet was going to 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 per cent – nearly everyone has access to a family garden and livestock, Parikos told me. 'People are fine here because we are very self-sufficient,' she said. 'We may not have money for luxuries, but we will have food on the table and still have fun with family and friends. 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.' Parikos was nursing a mug of coffee; the waves of the nearby Aegean could be barely heard over the din of breakfast. 'Do you know, there's no word in Greek for privacy?' she said. 'When everyone knows everyone else's business, you get a feeling of connection and security. The lack of privacy is actually good, because it puts a check on people who don't want to be caught or who do something to embarrass their family. If your kids misbehave, your neighbour has no problem disciplining them. There is less crime, not because of good policing, but because of the risk of shaming the family. You asked me about food, and yes, we do eat better here than in America. But it's more about how we eat. Even if it's your lunch break from work, you relax and enjoy your meal. You enjoy the company of whoever you are with. Food here is always enjoyed in combination with conversation.'
If you pay careful attention to the way Ikarians have lived their lives, it appears that a dozen subtly powerful, mutually enhancing and pervasive factors are at work. It is 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 is hard to get through the day in Ikaria without walking up 20 hills. You are not likely ever to feel the existential pain of not belonging or even the simple stress of arriving late. Your community makes sure you will always have something to eat, but peer pressure will get you to contribute something too. You are less likely to be a victim of crime because everyone at once is a busybody and feels as if he is being watched. On Sunday you will attend church, and you will fast on certain Orthodox holy days. Even if you are anti-social, you will never be entirely alone. Your neighbours will cajole you out of your house for the village festival to eat your portion of goat's meat.
Every one of these factors can be tied to longevity. But it is difficult to change individual behaviours when community behaviours stay the same. In the West you cannot go to a film, walk through the airport or buy cough medicine without being confronted by a battery of chocolate bars, salty snacks and sugary drinks.
And despite Ikaria's relative isolation, its tortuous roads and the fierce independence of its inhabitants, modern food culture, among other forces, is beginning to take root there. Village markets are now selling crisps and fizzy drinks. As the island's ancient traditions give way before globalisation, the gap between Ikarian life spans and those of the rest of the world seems to be gradually disappearing, as the next generations of old people become less likely to live quite so long.
I called Moraitis a few weeks ago. Elpiniki died in the spring at the age of 85, and now he lives alone. He picked up the phone in the same whitewashed house that he had moved into 35 years ago. It was late afternoon in Ikaria. He had worked in his vineyard that morning and just woken up from a nap. We chatted for a few minutes, but then he warned me that some of his neighbours were coming over for a drink in a few minutes and he would have to go. I had one last question for him. 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 to me.'
I had heard this part of the story before. It had become a piece of the folklore of Ikaria, proof of its exceptional way of life. Still, I asked him, 'What happened?'
'My doctors were all dead.'
This is an edited version of an article first published in the New York Times
