The secrets of longevity are not so secret any more.

Scientists know a lot about how diet, exercise, and social connections can extend the human lifespan. But experts have yet to figure out how to convince people to change their behaviors, so they can live longer, healthier lives.

Enter Dan Buettner, best-selling author of The Blue Zones, who wrote a fascinating account of four places in the world where people live the longest – outliving Americans by more than a decade.

Buettner analyzed what these disparate cultures had in common and described which of their health habits Americans should adopt.

But Buettner knew that even people motivated to improve their health need more than a book to change their ways. So, he devised a promising new method to encourage preventive care – one that could easily become a national model for the federal health care reform law’s initiatives to promote healthy living.

“We like to say discipline is good,” said Buettner, speaking at the Gerontological Society of America’s annual meeting in Boston last month. “But discipline is a muscle, and muscles get fatigued.”

In our junk-food laden world, where people are often tethered to their computers or stuck in their cars, it’s no wonder that the path to optimal health is so hard to follow.

Yet it’s clear that a healthy lifestyle is the key to longevity.

Study after study has shown that genes don’t affect life expectancy nearly as much as the environment. “Genes appear to play their biggest role at the extremes of age, affecting infant mortality, as well as to whether people will live to be 100”, said Dr. Thomas Perls, director of the New England Centenarian Study and medical professor at Boston University.

“Overall, genes have only a 30 percent impact on people’s lifespans”, he said.

“Average Americans could live a dozen years longer – or more, if they improved their lifestyles,” Buettner says.

Instead of asking individuals to change their lifestyles, though, Buettner thinks it’s much more effective to change the environments where people live. He’s now trying to change the American culture, town by town.

“We live in an environment of ease,” he said, but modern conveniences like highways, fast-food restaurants, and shopping malls with parking lots make it difficult to get enough physical activity.

“We want to make the active option the easy option,” he said. By rejiggering people’s neighborhoods, making 60 or 70 small changes, Buettner contends he can nudge people into eating less and moving more.

Buettner settled on the tiny town of Albert Lea, Minn., population 18,000, to launch a pilot for his Blue Zones Vitality Project, working closely with town leaders and 3,400 citizens who agreed to participate. He remade everything from the town’s grocery stores to its sidewalks. He dissuaded the citizens from widening its main street, so they could increase the speed limit – a move that would have made walking more difficult and dangerous. Instead, he convinced the town to spend its tax dollars on connecting two to three miles of sidewalks and create a walking path around the town lake.

He knew how important it was to create enjoyable ways for people to get together and move more. In his Blue Zones research, Buettner found that the longest-lived people engaged in year-round, low-intensity physical activity. Exercise was never a chore, let alone a distinct endeavor. It was simply part of the fabric of people’s lives.

In the Blue Zone of Sardinia, Italy, for instance, where there are eight times more centenarians than in the United States, men work as shepherds, often walking five miles a day. Gardening is common in many Blue Zones, providing not only low-intensity physical activity, but also a daily ritual that can help shed stress.

In these places, “you see the same nine things happening over and over,” Buettner said. Besides being active, these long-lived people often make family a priority, find a purpose for their lives, and participate in various communities – including spiritual communities. They make the time to reduce daily stress, eat little meat or processed food, and drink red wine in moderation. They eat less food than others, too.

In the Blue Zone of Okinawa, Japan, where women have the longest-lived disability-free life in the world, centenarians typically begin each meal by uttering a Confusion-inspired saying: “hara hachi bu,” which means “eat until you are 80 percent full,” Buettner says. It’s a constant reminder not to overeat.

These people also eat eight times more tofu than others and consume lots of sweet potatoes – as much as a pound each day by some estimates.

Having a purpose is so important in this culture that there is no word for retirement, Buettner says.

The only Blue Zone in the United States is Loma Linda, California, home to 9,000 Seventh Day Adventists, a religion that emphasizes healthy living.

In Albert Lea, Buettner devised ways to import as many Blue Zone practices as he could. He created four public gardens, launched seminars to help people find purpose in their lives, and convinced some townspeople to let experts revamp their kitchens. Studies show that people can substantially cut calories simply by using smaller plates and glasses. Changing the way food is served can reduce calorie intake, too. When people put food on plates and then immediately store leftovers before eating, they cut their calories by 25 - 30 percent, studies show.

Buettner even got local restaurants to change their ways – a critical move, given that the average American eats out 120 times each year. Instead of automatically putting bread baskets on diners’ tables, the participating restaurants served bread only when people requested it.

The results of all these changes were dramatic. After 10 months, participating citizens had lost on average 2.8 pounds, while city workers’ healthcare costs dropped 40 percent, Buettner said.

The success convinced Buettner to expand his experiment, holding a competition with about 50 cities to choose the nation’s first official “Vitality City.” The winner was a trio of California cities: Redondo Beach, Hermosa Beach, and Manhattan Beach, which launched their health makeover earlier this year. They received a $3.5 million grant from Healthways, a Tennessee-based company focused on improving well-being.  

The next expansion is already underway. Iowa is currently preparing to become the healthiest state in the nation by 2016. It currently ranks as the nation’s 19th healthiest state, according to the Gallup Healthways Well-Being Index.

The state will choose 10 communities to become local Blue Zones next year, with the expectation that more cities will become Blue Zones in years to come.

If all goes according to plan, all the state’s residents will be winners, leading longer, healthier lives.          

Rochelle Sharpe attended the Gerontological Society of American's annual scientific meeting as part of the MetLife Foundation Journalists in Aging Fellowship, a project of New America Media and the Gerontological Society of America.

Contributing Writer Rochelle Sharpe is a Pulizter Prize-winning journalist with more than 25 years of health writing experience. Sharpe’s bi-monthly news feature for the Health Policy Forum focuses on issues related to health, wellness, and prevention. As a leading nonprofit health care research and consulting institute dedicated to improving human health, Altarum encourages open discussion and debate about the many challenges in health care today. All postings to the Health Policy Forum (whether from employees or those outside the Institute) represent the views of the individual authors and/or organizations and do not necessarily represent the position, interests, strategy, or opinions of Altarum Institute. Altarum is a nonprofit, nonpartisan organization. No posting should be considered an endorsement by Altarum of individual candidates, political parties, opinions, or policy positions.