Henrik Ennart

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How is it That People Living in Cilento Can Live So Long?

The people who live in Cilento, a mountainous coastal area just south of the Salerno Bay in southern Italy, live to remarkable ages, but how is this possible? Not only do they live longer lives, they retain more of their cognitive abilities and suffer fewer heart diseases than the rest of us in their later days. This autumn, together with the super-pro health coach and yoga instructor Charlotte Fredriksson, I lead a trip with Go Active Travel to the small village of Acciaroli where more than one in ten inhabitants are over one hundred years old.

According to the Italian statistics agency, ISTAT, the latest calculations (for 2016) show that there are 183 hundred-year-olds living in the area, 143 women and 40 men. Average life-expectancy in Cilento is also off the charts, 92 years for women and 85 years for men. In the village of Acciaroli there were 81 centenarians within its population of 700. For comparison, take Sweden for example, where the average is about 20 centenarians per 100,000 inhabitants. For the skeptics, this phenomenon is not the result of all the young people moving away or because Acciaroli is some sort of hot spot for wealthy pensioners. Those who live there have lived most of their lives there as poor fishermen and had to pay with sweat for every lire(local currency) earned.

In recent years, scientists from all over the world have been drawn to Cilento and Acciaroli to try to understand the secret of healthy aging, which means the area is on its way to qualifying as a scientifically confirmed blue zone, alongside the Japanese island of Okinawa, the Nicoya Peninsula in Costa Rica, Ogliastra in eastern Sardinia and the Greek island of Ikaria. As in the other blue zones, there is hardly just one reason why so many people are over 100 years old. For a long life, a combination of healthy food, physical activity, stable social networks and a sense of meaning in life are all needed.

While all of this characterizes life in Acciaroli it is the food which stands out in their society. Cilento is an ancient cultural land that has long been identified as the cradle of the Mediterranean. You may have heard of the American biologist and nutritionist Ancel Keys. In recent years, he has often been criticized for his role in 1960’s of pointing out fat and cholesterol as the major health hazard while ignoring the risks of sugar. That analysis is largely wrong today, and has been abandoned, but this should not obscure Keys’ perhaps most important contribution, putting the traditional Mediterranean diet on the map.

Ancel’s launchpad for the diet was Cilento in the 1950s after having been struck by the high proportion of centenarians. After retirement, he lived for 28 years in Pioppi, a neighboring town of Acciaroli and left just before his 100th birthday to move home to Minneapolis where he died a year later, just before his 101th birthday. Most certainly there are aspects of Ancel’s work that can be discussed however, Ancel Keys did in the end live a long life after eating a Mediterranean diet and growing his own vegetables in his garden.

In addition to the traditional ingredients of the Mediterranean diet such as vegetables, legumes, fruits, whole grains, seeds, fish, olive oil and some red wine, the herbs have attracted the most interest in Cilento. Just like on the Greek island of Ikaria, they grow wild in the mountains and an analysis has shown that people have traditionally picked upwards of 90 different sorts, of which at least 40 had medical effects and were used extensively in cooking. Rosemary has been particularly pointed out as it grows abundantly in the mountains around Acciaroli. In recent years, researchers have discovered that healthy 100-year-olds in Cilento are characterized by very good blood circulation. This is interesting because the body’s ability to balance the flow of the many miles of microscopic blood vessels that traverse us plays a central role in regulating blood pressure but also our ability to regulate body temperature, keep the skin elastic, heal wounds, counteract tumors and keep us free of toxins. Interesting findings now indicate that bioactive substances in rosemary and other herbs could be an important explanation that contribute to a good and balanced microcirculation. Look at that! A great reason to go to Acciaroli to learn more! Cilento is, by the way, a forgotten part of Italy by most but is located just a few notches south of the popular Amalfi Coast, only here you can find temple ruins.

The awe of history here is slightly stunning. It was here that the founder of Rome, Aeneas, is said to have made shore first in western Italy after the battle of Troy, and it is also said to be here along the coast that the sirens called on Odysseus with their songs. Whether it is the food, the herbs or the genes is yet to be completely determined, but one thing is for sure, there is certainly lust for life here. Researchers even report an unusually active sex life far up in the years among the old in Cilento.

Henrik Ennart together with Niklas Ekstedt is the author of the recently published book Happy Food 2.0. Currently only available in Swedish however you can get their first book Happy Food in english on amazon here.

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Henrik Ennart

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Cancer Treatment, Common Medications and the Food We Eat

What an exciting impact my recent article series (in a swedish paper) had! The series was about correlations between food and cancer and got thousands of shares not to mention that several of those I interviewed ended up in TV interviews in the following days!. Pretty cool!

It’s about time for some debate on this issue! After talking with doctors, nurses, researchers, patients and dieticians, there’s no doubt that everybody only means well.  What separates them, is their perspectives. Doctors focus often on the short term and on the patients who are the worst. For patients with severe weight loss or nausea and vomiting, it can be about life or death and the need to supply their bodies with enough nutrition. So if it only works with juice or ice cream and nothing else, then serve juice and ice cream for heaven’s sake!

But not all patients have such difficult symptoms, and for those who may have undergone a breast or prostate cancer surgery that very same ice cream and juice or cold ham sandwich could almost be considered offensive.

A research group at Sahlgrenska who has surveyed how Sweden’s cancer clinics work with this issue have concluded that “the advice to avoid fiber should no longer be given”. Partly because good food reduces the risk of a new cancer later in life, and partly because radiation therapy can quite often cause chronic intestinal problems which, according to a new study, appear to be reduced among those who early on ate most fiber.

It seems that the emergency diets for those with the worst symptoms in many places have become the standard diet offered to everyone. Not how it should be obviously and many in health care are working to push the recently updated recommendations from the World Cancer Research Fund, WCRF, who says that anyone who does not suffer from weight loss or eating problems should be advised to follow WCRF dietary advice, which are for example to eat fiber rich foods and avoid sugary drinks.

However, the links between food and health care has more dimensions than this. Some might have noted the report that was published last spring, which showed that common drugs affect our intestinal bacteria.

In work with my and Niklas Ekstedt’s new book Happy Food 2.0  I called Peer Bork, research director at the European Molecular Biology Laboratory (EMBL) in Heidelberg, Germany. It was his team who did the study and went through 923 common drugs which were not antibiotics and discovered that 250 of them killed or affected in other ways the bacterial species that inhabit a healthy intestinal flora.

He thought the results were alarming.

– It is highly probable that the effect is actually much greater. We only measured the effect on 40 of the approximate one thousand bacteria most common in the intestine. The doses we gave correspond to those given on a regular basis, says Peer Bork.

This is the first time this question has been investigated. Until now, no one has the slightest idea that many of our most common drugs affect our intestinal bacteria. Peer Bork emphasizes that it is difficult to determine so far whether the effect in individual cases is good or bad. Occasionally, the effects on the intestinal bacteria may be a part of the positive effects of the drugs and sometimes something that causes side effects.

– This is the first time this is being investigated and I am convinced that it will be of great significance. In future, a doctor will need to consider how the drug affects the patient’s individual intestinal flora, “says Peer Bork.

Henrik Ennart together with Niklas Ekstedt is the author of the recently published book Happy Food 2.0. Currently only available in Swedish however you can get their first book Happy Food in english on amazon here.

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Henrik Ennart

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110-Year-Old Panchita’s Healthy Breakfast

Two years ago, 110-year-old Maria Francisca Castillo Carrillo died (her name was a bit long and complicated so everyone called her Panchita). A few months earlier, I met her when I visited the blue zone on the Nicoya peninsula in Costa Rica. Blue zones are places where you would have the highest chance of living to 100 years old, and other such zones are located on the Japanese island of Okinawa, on the Greek Island of Ikaria and in the Sardinian mountains.

I have visited all these blue zones and interviewed both researchers and elders, always surprised by the well-being, energy and health of the elderly living in the blue zones. The most alert of all was Panchita. For more than 60 years, she had lived in a wooden shed in the tropical forest. She shared the house with her oldest son Pablo, 93, who would soon move out to live with his new girlfriend.

A large number of seniors are aging with a combination of vision loss and hearing loss, and most of the 110-year-olds that I have met get tired in social situations. Panchita, however, was full of energy and did not look a day over 75. She could easily talk for an hour about everything from the story of her life to politics. Turned out, Panchita was a feminist who never married because she despised the macho culture in Costa Rica. “Men are much better nowadays”, she explained.

In order not to become the husband’s property, her lovers were the fathers of her five children. Exactly how many descendants she had, she did not know. Last time someone counted there were 165 children, grandchildren and, believe it or not, great-great-grandchildren’s children.

Panchita had also served as the village’s medicine woman. She prescribed traditional herbal medicines, a knowledge that had been inherited for generations.

So what did she eat for breakfast, I asked? Here is Panchita’s daily breakfast. Unfortunately, the ingredients are not always easy to find outside her Costa Rican forest.

  • 2 oranges
  • Costa Rican sweet lemon (I would compare it to the bergamot orange, grown in France and northern Italy)
  • Zapotillo tea (also sapodilla) – the tea is made from both the green fruits, the bark and the leaves, and is used to treat everything from cough to gastrointestinal disorders. Seems to be available online.
  • A little bit of strawberry yogurt. Homemade.


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Henrik Ennart

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What You Need to Know About Alcohol

During the summer season, most of us socialize more, and maybe drink a bit more alcohol than usual. In the short term, alcohol can cheer you up and relieve stress, but let’s make one thing clear: in the end, alcohol will make you more depressed – not less!

That said, you have probably heard of studies indicating benefits from drinking one (women) or two (men) glasses of wine a day. According to these studies, it’s linked to a lower risk of cardiovascular disease.

But think twice! Higher quantities are harmful to one’s health. That’s also why alcohol is considered the world’s third largest risk factor for disease and disability, and it’s linked to 6 percent of all deaths. In the world. Also, studies have found an increased risk of breast cancer associated with increasing alcohol intake.

But ok, I’m not here to preach. I just want to remind you of what your intestinal bacteria think about all this.

I’ve traveled a lot in so called blue zones – places where you would have the highest chance of living to 100 years old – and realized that many of the very old men and women drink a lot of wine. But not all of them. On the Japanese island of Okinawa, old women drink a small cup of rice wine once in a while, if even so. And alcohol consumption is low on the Nicoya peninsula in Costa Rica as well.

However, alcoholic beverages are more than popular on the Greek Island of Ikaria and in the Sardinian mountains, especially among men. But you still can’t compare it to the habits and behaviors we have here. Unlike them, we don’t drink pure wine made from grapes from the backyard, we don’t walk miles in the mountains every day, we don’t breathe the same fresh air as they do, we don’t eat their fresh vegetables or raise our own animals for food.

The obvious conclusion is, therefore, that you don’t have to drink wine to get old and stay healthy. Some do, as part of an extremely healthy lifestyle. Perhaps they would have lived longer without the wine? Who knows.

When mice drink alcohol, they react as if they were given sugar: it destroys the good gut bacteria, and helps the bad bacteria thrive in the digestive tract. In general, alcohol consumption alters the gut flora and leads to poor bacterial diversity within the intestine. And that’s usually a bad sign.

If you’re looking for a reason to have a glass of red wine, it’s supposed to boost the Lacto and Bifidobacteria in the intestine. Also, feel free to eat some unpasteurized cheese and a piece of dark chocolate. If you’re looking for arguments against that same glass of wine, it will lead to lower levels of good Prevotella bacteria.

Also, a new study suggests that bacteria in the gut may play a role in alcohol addiction. During the first three weeks of sobriety, the addicts suffered from increased inflammation in the intestine. As a result of this, they felt even more anxious and depressed.

Other findings suggest a link between imbalance in the intestine and the risk of developing an addiction. For example, if you disturb an animal’s intestinal flora with antibiotics, it will experience a stronger sense of reward when they get cocaine. 

Ok, this is early research, but it provides new and interesting input to ongoing research.

So, who’s asking for that extra glass of wine? Is it you, or is it your intestinal bacteria?

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