"Lucky you live Hawaii ” was an expression I heard a lot while growing up in Hawaii Honolulu
As a teenager, I ran away to attend college in the Mainland where I then stayed to work. My parents, both seniors but not retiring types, remain in 
This time as a budding gerontologist, I decided my field visit would be an opportunity to study healthy aging in
E Loa Ke Ola (May Life Be Long)
One of my first stops to obtain information was at the State Department of Health’s Executive Office on Aging (http://hawaii.gov/health/eoa/index.html), which is conveniently located in the same building as the
Successful aging
At the Center on Aging at
- Hawaii’s population is aging much faster than the U.S. national average, with a higher life expectancy of 81, and the fastest growing population being those 85 years and older, increasing at a rate of 72.2% between 2000 and 2010, compared with a national increase of 29.6%.
- Keep active:
- Go along to get along:
What I liked about Hawaii
Falls Prevention
Mo’ili'ili Community Center (http://moiliilicc.org/moiliili-senior-center) charges annual dues to participate in its
- Every five hours a kupuna is injured severely in a fall that must be treated at a hospital
- 85 kupuna die each year due to falls, a leading cause of injury-related death
After discussing risk factors, she asked for volunteers to do a “get up and go” test for fall risk, which involved getting up from seat, walking around a cone and then sitting down within 8.5 seconds. Most participants were small-boned Asians, who went about this exercise in typical, island pace so they exceeded 8.5 seconds. We then did several exercises intended to challenge our balance sensors—eyes, inner ear and ankles—by letting go one at a time. (More about falls prevention at http://www.hawaiiadrc.org/Portals/_AgencySite/2013Falls.pdf).
Disaster Preparedness
In the bimonthly Generations magazine (http://generations808.com/), I learned about this half-day course on Natural Disaster Awareness for Caregivers of Senior Citizens, presented by Natural Disaster Preparedness Training Center at UH (https://ndptc.hawaii.edu/). During our workshop, we were treated to manapua (BBQ pork bun) and pork dumpling from Chinatown ’s Char Hung Sut (which makes super-sized local versions of dim sum) and instructor Letha DeCaires’ home-baked chocolate chip cookie.
This course focused on tsunami, hurricane and tornado scenarios—though Hawaii Hawaii
FEMA uses the 72-hour rule (prepare to be on our own for at least that duration after a disaster; SF site at http://72hours.org/). But Hawaii
While the State Department of Health emphasized stocking up on low-sodium foods in A Natural Disasters Safety and Readiness Guide for Seniors (http://www.emprints.hawaii.edu/training/sp.pdf), the City and County listed local favorites like Vienna sausage, SPAM, and corned beef hash (http://www1.honolulu.gov/dem/57dayfoodlist8x14mar09pdf.pdf). This high-sodium, sat fat diet sounds like a man-made disaster! To avoid BPA poisoning in canned foods, see http://www.treehugger.com/green-food/7-companies-you-can-trust-to-use-bpa-free-cans.html.)
Life without SPAM
I found my parents ill-prepared due to their pantry’s lack of canned foods because my Mum insists on eating fresh foods. Non-GMO papaya and mango are homegrown: when ripe, just pick and eat.
SPAM on sale (Longs Drugs), but banned in my parents’ home. Note: My failure to eat SPAM confirmed my outsider status growing up.
Generations: Chinese Families in Hawaii 1850-2000 exhibit at Hawaii Heritage Center . Chinese immigrants to Hawaii
·
Ohana support: based on
Confucian filial piety among Asians that make up 40% of Hawaii’s
population.
·
Hawaiian time: things happen when they do, so no
rush, no stress—even in traffic, just go with the flow (http://www.staradvertiser.com/news/breaking/20130108_Honolulu_traffic_congestion_among_the_worst.html & http://www.hawaiinewsnow.com/story/18599683/honolulu-ranked-worst-in-country-for-traffic)
·
Year-round sunshine: helps grow local
produce, make vitamin D for bone health, and encourage more
physical activity; NIH study finds leisure-time physical activity extends life
expectancy as much as 4.5 years (http://www.nih.gov/news/health/nov2012/nci-06.htm)
· Wild caught seafood from Pacific Ocean: provides local source of heart-healthy and anti-inflammatory long-chain omega-3 fatty acids, so Hawaii residents consume three times more seafood than Mainlanders (http://www.sfgate.com/hawaii/alohafriday/article/Sustaining-Hawaii-s-seafood-3776481.php)
· Hawaii Prepaid Health Care Act (http://www.healthcoveragehawaii.org/target/prepaid.html) requires employers to offer coverage to employees working at least 20 hours per week. (In contrast, the federal Affordable Care Act, aka local boy ObamaCare, requires employers to offer coverage to employees working at least 30 hours per week, effective January 1, 2014.)
· Low rate of obesity: Hawaii has the second lowest adult obesity rate in the U.S. (http://healthyamericans.org/report/98/obseityratesbystate) due to large Asian population, but Pacific Islanders are at risk (http://honoluluweekly.com/story-continued/2013/01/defeating-obesity/). UH President MRC Greenwood said, “While Hawai‘i has had some of the best health statistics in the nation, in the last 15 years we have seen our rate of obesity increase from 11 percent in 1995 to 23 percent in 2010 (http://www.bigislandvideonews.com/2012/05/08/hawaiis-role-in-solving-the-weight-of-the-nation/; yet, she fails to explain how the obesity epidemic was created on June 17, 1998, when NIH lowered the “normal” BMI upper limit from 27 to 25, so suddenly over 30 million Americans went from “normal” to “overweight” –representing a 50% increase in overweight Americans overnight, per http://www.cnn.com/HEALTH/9806/17/weight.guidelines/. Further, there are no BMI guidelines specific to older adults, and BMI may not be a reliable indicator of obesity because it uses weight as a measure of risk, when it is actually a high percentage of body fat and waist size that makes a person obese.)
· Short height: At the last GSA annual meeting, Honolulu-based geriatric Dr. Bradley Willcox, Co-Principal Investigator of the Okinawa Centenarian Study (http://www.okicent.org/team.html) and Hawaii Lifespan Study, noted that short height is associated with longevity.
Broke da mout’ food, but where da greens?
Several physicians who practiced in Hawaii, like John McDougall (http://www.drmcdougall.com/misc/2012nl/nov/honor.htm), Michael Klaper (http://doctorklaper.com/), William Harris (http://www.vegsource.com/harris/) and Terry Shintani (http://www.bizjournals.com/pacific/blog/2013/01/hawaii-diet-author-shintani-says.html) advocate plant-based diets for health and longevity, but it’s rare to see greens on local plates.
Local fast food chain Zippy’s serves breakfast from 11 pm to 10:30 am, like this bento with white rice, scrambled egg and choice of two meats (Portuguese sausage, corned beef hash, or SPAM). Zippy’s founders are Okinawan but they don’t serve Okinawan food, except for white rice.
More banchan (Yummy’s Korean)
Longevity diets
Dr. Willcox’s Okinawa Diet Plan (http://okinawa-diet.com/index.html) attempts to offer a “practical diet program rooted in Okinawan traditions” of the “longest-lived people on earth,” yet he recommends industrial processed soy-based products (which aren’t healthy whole foods) and dairy (which is mucus-promoting). Okinawan cooking is heavily influenced by southern Chinese cooking, emphasizing vegetables, soybean, rice, wheat noodle, fish, pork and tea (http://211.76.170.15/server/APJCN/Volume10/vol10.2/Sho.pdf & http://www.westonaprice.org/traditional-diets/food-in-china).
Bitter melon and sweet potato tempura appetizer (Hide-Chan Restaurant)
Goya chanpuru (bitter melon stir-fried with tofu, eggs and pork) served with white rice and miso tofu soup (Hide-Chan).
When I join my parents for weekly dim sum brunch, we eat steamed dumplings and stir-fry noodles but nothing deep-fried and never bother using condiments like Aloha soy sauce (Happy Days Restaurant). Traditional Chinese will drink hot or room temperature tea before and after a meal to preheat and lubricate the digestive tract. Drinking too much liquid while eating is discouraged because it dilutes gastric juices; however, southern Chinese (Cantonese) began a rebellion when they combined yum cha (drink tea) + dim sum! Eating is a leisurely affair while we talk story, averaging two hours of bliss :-)
Iced drinks are a no-no because cold constricts digestion. Since our body's internal temperature is 98.6F, drinking anything more than 60F colder will shock the system, causing stomach cramping and slowing metabolism. Other no-nos in Chinese-American restaurants: MSG (Japanese invention), forks (use chopsticks) and fortune cookies (eat fresh fruit instead; see http://www.fortunecookiechronicles.com/ for origin of fortune cookie).
Iced drinks are a no-no because cold constricts digestion. Since our body's internal temperature is 98.6F, drinking anything more than 60F colder will shock the system, causing stomach cramping and slowing metabolism. Other no-nos in Chinese-American restaurants: MSG (Japanese invention), forks (use chopsticks) and fortune cookies (eat fresh fruit instead; see http://www.fortunecookiechronicles.com/ for origin of fortune cookie).
Mum’s lo han jai (vegetable stew dish for Chinese New Year’s) features mung bean noodles for long life. (Recipe and symbolism of ingredients at http://archives.starbulletin.com/98/01/14/features/story1.html.)
When Mum noticed gray hairs sprouting out of my head, she immediately brewed up he shou wu ("He with a Head of Black Hair"), a Chinese tonic herb to prevent premature aging. I actually like my graying head (wanna-be Maxine Hong Kingston), but also liked the earthy taste of he shou wu so I drank it up!
InHawaii
When Mum noticed gray hairs sprouting out of my head, she immediately brewed up he shou wu ("He with a Head of Black Hair"), a Chinese tonic herb to prevent premature aging. I actually like my graying head (wanna-be Maxine Hong Kingston), but also liked the earthy taste of he shou wu so I drank it up!
In
http://marcdelorme.com/getting-involved/
ReplyDeleteUnsurprisingly, Hawaii is the most relaxed state in the union — a title it’s held for the past five years.
ReplyDeleteRead more: http://newsfeed.time.com/2013/04/25/the-five-most-stressful-places-to-live-in-the-u-s/#ixzz2RvZHaYUJ
Health of seniors in Hawaii ranks second in nation
ReplyDeleteThe state's insurance mandate has been a boon for residents, notes an official
By Susan Essoyan
POSTED: 01:30 a.m. HST, May 21, 2014
Seniors in Hawaii are healthier than in any state except Minnesota, with good access to medical care and the nation's lowest rates of obesity and hip fractures, according to a national report released Wednesday by United Health Foundation. Hawaii climbed to No. 2 in the America's Health Rankings Senior Report, up one notch from the first Senior Report released last year by the nonprofit organization. Minnesota was the healthiest state for seniors, while Mississippi was the least healthy . . .
http://www.staradvertiser.com/s?action=login&id=260083701
http://cdnfiles.americashealthrankings.org/SiteFiles/StateSummaries/Hawaii-Senior-Health-Summary-2014.pdf
http://www.huffingtonpost.com/2014/05/16/food-only-hawaii-understands_n_5326566.html
ReplyDeleteFeeding Hawai‘i
ReplyDeleteBY MAUREEN NANDINI MITRA – JUNE 18, 2014
Could small, biodiverse farms help the Aloha State transition to growing enough food to feed itself?
The early Hawaiian settlers, who arrived in the uninhabited islands around A.D. 300 from Polynesia, developed a unique system of resource management to support their growing population. Recognizing the connection between the mountains and the oceans and the key role of freshwater in linking the two, they divided the islands into self-sustaining units called ahupua‘a. The ahupua‘a were usually wedge-shaped sections of land that ran from the mountains to the sea (extending into coastal fishing grounds) and contained a freshwater source such as a stream, spring, or river. Each ahupua‘a contained within it all the resources needed for a community to sustain itself independently.
It was the responsibility of the community living with the ahupua‘a to manage the land and water resources in a balanced way. The community’s kahuna, or priests, helped oversee this by imposing taboos on things like fishing certain species during specific seasons, or gathering certain plants at the wrong time. Food, goods, and services were distributed within an ahupua‘a via a system of sharing and mutual cooperation. This kind of resource management helped develop a strong sense of community and interdependence between the people and the natural environment. When Captain James Cook, the first European explorer to land in Hawai‘i, sailed into Kauai in 1778, the islands were supporting a population of about 300,000. (Estimates vary from less than 300,000 to more than 700,000. The current population of Hawai‘i is 1.39 million.)
. . .best way to ensure food production as the world’s population grows (and its climate changes) is by transitioning from the industrial, monocrop model to smaller, biologically diversified, agroecological systems that have proven to be better at addressing the challenges of food sovereignty, preserving biodiversity, and reducing poverty.
In fact, such food systems are already feeding most of the world. According to a 2012 report by the Canadian research and advocacy organization, ETC Group, at least 70 percent of the food the world consumes every year is grown by small-scale rural and urban farmers, . . .
The state of Hawai‘i came pretty close to making that shift on its own just two decades ago. When the plantation economy crashed in the nineties, the state agriculture department considered replacing the plantations with a more community-friendly model that included small farms growing diverse crops.
“Back then the University of Hawai‘i’s agricultural extension agents would come by and say that we were going into diversified ag and truck farming and that they were going to provide us with the training and support to make that transition. But that never happened,” says Walter Ritte, a veteran Hawaiian political and environmental activist based in Molaka‘i. Instead, the governor at the time, Ben Cayetano, began courting the biotech seeds industry. “All of a sudden the best lands were being given to these big chemical companies and we were back to industrial ag again,” Ritte says.
Most of these companies produce commodity crops, mainly genetically engineered seeds, which get shipped to the US mainland and overseas, leaving the islands heavily dependent on food imports.
http://www.earthisland.org/journal/index.php/elist/eListRead/feeding_hawaii/
Why Japan's Longest-Lived Women Hold the Key to Better Health
ReplyDeletePosted: 04/07/2015 1:59 pm EDT
Dan Buettner
The Rise and Fall of Great Longevity Diet
Okinawa is sort of a Japanese Hawaii -- an exotic, laid-back group of islands with warm weather, palm trees, and sugar-sand beaches. For almost a thousand years, this Pacific archipelago has maintained a reputation for nurturing extreme longevity. Okinawans over the age of 65 enjoy the world's highest life expectancy: Men are expected to live to about 84, while women are expected to live to almost age 90. They suffer only a fraction of diseases that kill Americans: a fifth the rate of cardiovascular disease, a fifth the rate of breast and prostate cancer, and less than half the rate of dementia seen among similarly aged Americans.
All Okinawans age 100 or more who are alive today were born between 1903 and 1914. During the first third of their lives, roughly before 1940, the vast majority of the calories they consumed -- more than 60 percent -- came from one food: the imo, or Okinawan sweet potato. A purple or yellow variety related to our orange sweet potato, the imo came here from the Americas about 400 years ago and took well to Okinawan soils. This sweet potato -- high in flavonoids, vitamin C, fiber, carotenoids, and slow-burning carbohydrates -- is one of the healthiest foods on the planet.
The traditional Okinawan diet was about 80 percent carbohydrates. Before 1940 Okinawans also consumed fish at least three times per week together with seven servings of vegetables and maybe one or two servings of grain per day. They also ate two servings of flavonoid-rich soy, usually in the form of tofu. They didn't eat much fruit; they enjoyed a few eggs a week. Dairy and meat represented only about 3 percent of their calories. On special occasions, usually during the Lunar New Year, people butchered the family pig and feasted on pork. . .
Okinawans stewed the pork for days, cooking out and skimming off the fat. What they ate, in the end, was the high-protein collagen.
Fast-Food Invasion
As healthful as they were, some of these Okinawan food traditions foundered mid-century. Following the war, western influences -- and economic prosperity -- crept into traditional life and food habits changed. Okinawans doubled their rice consumption, and bread, virtually unknown before, also crept in. Milk consumption increased; meat, eggs, and poultry consumption increased more than seven-fold. Between 1949 and 1972 Okinawans' daily intake increased by 400 calories. They were consuming more than 200 calories per day more than they needed -- like Americans. Cancers of the lung, breast, and colon almost doubled.
Yet older Okinawans, whose diets had solidified before that time period, are the world's longest-lived people
Top Longevity Foods from Okinawa
BITTER MELONS: Known as goyain Okinawa, bitter melon is often served with other vegetables in a stir-fried dish called goya champuru, the national dish and cornerstone of the Okinawan diet. Recent studies found bitter melon an "effective anti-diabetic" as powerful as pharmaceuticals in helping to regulate blood sugar.
TOFU
SWEET POTATOES
TURMERIC
BROWN RICE
SHIITAKE MUSHROOMS
SEAWEEDS: (KOMBU AND WAKAME)
http://www.huffingtonpost.com/dan-buettner/okinawa-blue-zone_b_7012042.html
Big Gaps in Life Expectancy Among States
ReplyDeleteHawaii has the highest, and Mississippi the lowest, study finds
by Tim Appelo, AARP, June 13, 2018
Where you live in the United States can be a rough indicator of how long you might be expected to live.
In a recent study of mortality rates from 1990 to 2016, published in the Journal of the American Medical Association, Hawaii was found to have the highest life expectancy (81.3 years) and Mississippi the lowest (74.7 years). In a separate category called healthy life expectancy (measuring how long a person lives with "good health"), Minnesota came out on top (70.3 years) and West Virginia was at the bottom (63.8 years).
“There are wide differences in the burden of disease at the state level,” the study authors concluded. Among the factors playing into those discrepancies: drug and alcohol use, obesity and diet.
To combat such inequalities, the report suggests three strategies:
• Focus on “key modifiable risks,” like poor diet; tobacco, alcohol and drug use; and insufficient physical activity.
• “Improve access to … quality of care in key areas, such as chronic kidney disease and ongoing care for substance use disorders.”
• “Address the social determinants of health.”
The report cited previous research that found significant disparities in mortality rates associated with socioeconomic, racial and ethnicity factors.
The study also found that despite progress since 1990 in reducing mortality rates, there was only “limited success in reducing disability.” The authors cautioned that with an aging population, the rate of serious injuries, such as from falls, is increasing. They called for more preventive measures.
https://www.aarp.org/health/healthy-living/info-2018/states-with-longest-shortest-life-expectancy.html
Helping Seniors Survive The Hazards Of High-Rise Living In Honolulu
ReplyDeleteMany older people live in condo towers. Now the push is on to encourage the buildings and their residents to better prepare for disaster.
By Brittany Lyte / July 3, 2019
…An often overlooked part of disaster safety is knowing the limitations of people who may need to evacuate.
Seguirant encourages management of high-rise residential buildings to practice an annual evacuation drill so that residents can determine whether they can reliably climb down several flights of stairs in the event that an elevator stops working.
“We do know that being able to get out quickly improves your chances of survival,” he said. “The fire is never going to care if you are immobile and weak. But it depends on the circumstances whether you should evacuate if you think it would be difficult for you physically to get yourself out.”
High-rises can be difficult to evacuate, especially for older people and those with disabilities. During a fire or other emergency, elevators often shut down and evacuation becomes a serious challenge for anyone with shaky mobility.
In Waikiki, where people 55 years and older comprise about 30% of the resident population, high-rise condominiums are common.
… And while high-rise residential buildings must publicly post a fire evacuation plan, they are not legally required to develop response plans for other emergencies, such as hurricanes, tsunamis or earthquakes.
These are not one-size-fits-all scenarios. For example, an incoming tsunami would generally prompt residents on the first few floors only to evacuate to a higher level of the building, while a fire might force a building-wide evacuation. Proper protocol during a hurricane warning, on the other hand, typically has residents hunkering down in place.
Now a grassroots movement is encouraging Hawaii seniors who live in high-rises to develop personal emergency response plans — and encourage their residential managers to do the same for the entire building.
“After the false ballistic missile alert last year I inquired with our members: ‘What did you do? Were you prepared?’” said Merle O’Neill, program director at the Waikiki Community Center…
Supported by a consortium of nonprofits, the Safe Kupuna program has hosted more than a dozen emergency disaster preparedness workshops in recent weeks tailored to seniors living in high-rises. The workshops were held at the Waikiki Community Center and some low-income senior housing buildings.
Seniors who attend these meetings learn how to script their own emergency disaster plan. They also receive a disaster preparedness kit filled with dozens of items, including bandages, batteries, hot and cold packs and an inflatable water bottle.
Attendees who live in high-rises are also strongly encouraged to coax their resident manager into scripting an emergency disaster plan specific to the building.
…Ralph Shumway, residential manager of the 38-floor Waipuna condominium building in Waikiki, said he has a 30-page booklet for first responders that documents the building’s customized response plans for several kinds of disasters. The plan is printed in big white binders and stashed near various fire alarms throughout the building for easy access by first responders.
The binders include a confidential list of people who would likely need help during a disaster; for example, residents who cannot descend 38 flights of stairs in the event that the elevator shuts down. Shumway said he edits the list every few months to account for new residents and those who have gone.
Shumway also keeps a resident-accessible floor plan with emergency evacuation routes near the elevator on each floor of the building. There are disaster preparedness and fire safety brochures in common areas, such as the mail room. And Shumway said he reminds residents to stock up on essentials like canned foods and water before the start of every hurricane season…
https://www.civilbeat.org/2019/07/helping-seniors-survive-the-hazards-of-high-rise-living-in-honolulu/