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The Healthiest Place on Earth

We remain fascinated by the idea that there are certain places on the planet where people live a very long time. Naturally we look at these places and ask, “What is it that’s different there?” “Why do people live so long?” “Can we somehow copy what these people are doing and live as long as they do?”

Usually the question turns to diet—“What do these people eat?” Our intuition tells us that there must be something unique, exotic, or fundamentally different about the diets of those populations that live a very long time. Although simply looking at populations and their diets isn’t going to give us definitive scientific answers about a healthy diet, it does provide us with some interesting insights.

The University of Washington’s  Institute for Health Metrics and Evaluation has provided a useful set of data to help us explore this question. They conduct an ongoing analysis of the longevity of every county (all 3,187 of them) in the United States. This is more difficult than it sounds. The goal is to evaluate the longevity of those who remain in a particular geographic area for most of their lives, and not simply where people happen to be living when they die.

Note: Living a long life is not exactly the same as living a long healthy life. However overall longevity is a good proxy for health. In populations with long life spans, people will tend to be functionally healthier at every stage of life as well.

If you look at the top ten counties on the list, all of whom are within a fraction of a year of each other, most are anomalous in some way. Whatever it is that they’re doing we’re not going to be able to copy it.  There is Hawaii which is all one county. Yes, living in an island paradise apparently is healthy for you, but it’s going to get pretty crowded there if we all move in.  There are also some sparsely populated counties in Colorado and Wyoming with only a few thousand residents where the typical ranch is several hundred thousand acres in size. We can’t copy that either. And the rest of the top ten are mostly enclaves of extreme wealth. (For the record, the bottom 10 counties are all in Mississippi and Georgia.)

But among the top ten there is one county that stands out as an example that others might emulate. It has a substantial population of 150,000. It’s quintessentially middle-class, middle-American. It’s the healthiest place in the United States and possibly the healthiest place on Earth.

It’s Stearns County, Minnesota.

Stearns County?

You know Stearns County, right? Just one hour northwest of Minneapolis on I-94. The largest town and county seat is St. Cloud. It includes Sinclair Lewis’s Sauk Center and the cluster of small towns of Freeport, Avon, Albany, Melrose and Holdingford where Garrison Keillor lived in the 1970s and which became the model for Lake Wobegon.  On average, the women of Stearns County live 84.1 years, the men a few years less. If Stearns County were a country, it would be at or near the top of the world’s longevity list. Yes, all the women are strong in Lake Wobegon, and in the rest of Stearns County as well.

I found this longevity list particularly fascinating as I am a native of Stearns County. I grew up in St. Could and after leaving for my education, returned to practice there for 10 years, in all spending about 25 years of my life in Stearns County. So what is it about Stearns County that results in such long lives?

Secrets of the Lake Wobegon Diet

Unfortunately the longevity study does not also track the diets of the different populations. However, as a longtime resident of the area and as a trained researcher I think I can provide a good qualitative analysis of the Stearns County diet. I went to Google Maps and focused on the primary commercial intersection in St. Cloud (33rd Ave and Division St., if you’re interested). It’s sort of the heart and soul and as it turns out, the stomach of St. Cloud. Here’s what I found.

At one corner of the intersection is a Burger King. Across the street is a White Castle. And across the street from that is  a Qdoba, a fast food Mexican restaurant. But on the fourth corner is the smoking gun: an Old Country Buffet. I am confident that this small sample of dining establishment represents a good cross-section of the Stearns County diet. So we have our answer. The secret to a long life includes ready access to a variety of fast food establishments as well as an all-you-can-eat buffet.

Am I being facetious to suggest that the people of Stearns County live a long time because they eat at Burger King and White Castle? Of course. But I am serious when I suggest that the average diet in Stearns County is completely conventional. It’s meat and potatoes, bread and butter. It’s canned vegetables. It’s Cap’n Crunch and Frosted Flakes. Sure, you can get fresh organic produce (including kale), and goji berries and bulk quinoa, but I’m certain that the average Stearns County-ite mostly consumes the much-deplored standard “American Diet.”

What do we learn from this? If we look at the rest of the world and at other countries where people live a very long time we find multiple different diet types represented:

The Dairy Diet. The Swiss are largest consumers of dairy products (milk, butter, eggs, cheese) in the world.

The Carnivore Diet. The Luxembourgians are the largest consumers of red meat in the world.

The Mediterranean Diet. The Italians eat lots of fish and vegetables and pasta, but relatively little red meat.

The Rice and Soy Diet. The Japanese consume the most tofu per capita and are among the largest consumers of rice, but consume very little dairy or red meat.

All of which leads us to Nutritional Postulate #1:  

Good health is compatible with a very wide range of diets.

burgervsushiLet me restate this for emphasis. The evidence indicates that there is a very wide range of dietary habits that will result in a healthy and long life. Diets that are virtually polar opposites of each other—for example, the Japanese diet vs. the Stearns County diet—result in populations with exceptionally long life spans.

Some people are dismayed by this finding. They hope to find some sort of dietary fountain of youth and are disappointed to learn that no such thing exists. But if you’re an Enlightened Hedonist this is very good news. We really are omnivores and we have the opportunity to explore and take pleasure in a vast range of foods and food types and still enjoy excellent health.

So if it isn’t the diet, why do people in Stearns County (or Switzerland, Luxemburg, Japan & Italy) live a long time? We actually know quite a bit about why different populations do or do not live a long time. By far the most important factor is socio-economic. Specifically, an absence of poverty and poverty-related living conditions is the most powerful predictor of a long life.  Beyond pure economics, a vital component of a healthy population is what social scientists call “social capital.” This refers to an individual having a secure and well-defined place within the community. Social capital tends to the highest where there is cultural and ethnic homogeneity. This is why immigrant populations will always tend to have poorer health. It is simply difficult to live as a stranger in a strange land.

A final note. None of the above is the same as saying that nothing about our diets matters and that anything goes. Within each of these dietary practices there are dos and do nots that need to be observed. And as individuals there may be other dietary variables to consider depending on our goals (e.g., weight loss, athletic performance) and these will be explored in due course.



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