Aging in America conference highlights: Part 1

Part 1:  Being present in Chicago

When I learned that American Society on Aging (ASA) was holding its annual Aging in America conference in Chicago (http://asaging.org/aia12) a week before my mid-terms, I immediately signed up.  While my classmates wondered how I could afford the time and expense to attend another out-of-town aging conference (http://geronature.blogspot.com/2012/11/charting-new-frontiers-in-aging-at-gsa.html), I wondered how I could afford not to attend this leading aging conference for practitioners?  As a full-time grad student, I qualified for the discounted $120 conference registration fee as Volunteer Student ASA Member!

ASA Program Coordinator Nancy Decia asked me to show up for my volunteer shift at 9 am on Tuesday, so I took the red-eye flight from SFO for arrival at ORD before 5 am that day, boarded CTA Blue Line train ($2.25) to check-in my carry-on bag at Hostelling International (HI) in Chicago ($30 per night rate including breakfast).  I’d briskly walk a mile, past the Art Institute and Millennium Park, to and from the hostel and Hyatt Regency conference site (so I passed on its $209 per night rate).

Colombia theme dinner prepared by local high school students at HI-Chicago:  sopa de maize (corn soup), papas chorreadas (creamy cheese with onions, potatoes & tomatoes), molde de papa y carne (meat & potato pie), and torta de coco (coconut bread pudding).  The students seemed initially disappointed to learn that I was American, instead of an international visitor, until I told them that I’m originally from Hawaii, which seemed exotic to them.  We debated on whether Obama Presidential Library should be located in Hawaii (Obama's birthplace despite naysayers) or Chicago (where Obama got his start in politics).  After our delightful intergenerational exchange dinner, the students delivered a presentation on the history, politics and culture of Colombia. 

Eating community

Far from being a starving student, ASA conference offered many opportunities to fill our stomachs at receptions for exhibit hall opening, networking, awards, leadership academy graduation, etc.
  

  

During ASA’s Network on Multicultural Aging reception, ASA Chair Louis Colbert presented Award for Excellence in Multicultural Aging to Hawaii Healthier Aging Partnership for its adaptation of Enhance Fitness and Chronic Disease Self-Management Program (CDSMP) to the multicultural population in Hawaii. 

 

During New Ventures in Leadership (NVL) Graduation & Reception, ASA Chair Colbert presented certificate to NVL graduate Fang Huang of San Francisco.  Her project sounded like a PhD dissertation:  Sustainable Approach to Implement CDSMP (Healthier Living Workshop) in Affordable Housing Settings.  San Francisco has offered CDSMP in six languages:  English, Cantonese, Mandarin, Russian, Spanish and Tagalog (http://www.cahealthierliving.org/?location=san-francisco).

ASA also honored San Francisco-based Patrick Arbore with the Mental Health and Aging Award for founding Center for Elderly Suicide Prevention and Grief Related Services at Institute on Aging (http://www.ioaging.org/documents/news/Patrick_Arbore_Award_March2013.doc)

Behind the scenes with ASA

ASA is based in San Francisco, but I didn’t have the pleasure of meeting its staff until volunteering at the conference in Chicago.  Our volunteer training with Nancy included a review of our assigned duties (including wearing pageant-style volunteer sashes) and a 45-minute tour by Hyatt staff of the maze-like site, which many attendees found challenging.  Instead of referring to floor levels by numbers, Hyatt refers to floor levels by colors using the following association in descending order: 

Every cloud has a SILVER lining,

the sky is BLUE,

the vegetation below is GREEN,

the soil below is BRONZE,

dig below for GOLD,

and then PURPLE at the bottom. 

Only BLUE and BRONZE levels have bridges to cross to and from the East Tower (partly under construction) and West Tower; in between these floors, take escalators or elevators to access bridges to the towers.  Got it?   

At 10:30 am, I headed over to the East Tower’s PURPLE level to assist with Poster set-up led by Steve Moore, whose voice I immediately recognized.  Throughout the conference, I had fun pointing him out like a celebrity sighting to other attendees who were curious to see the face of ASA’s popular webinar host, so now we have an informal Steve Moore fan club!

While on volunteer duty, I refrained from taking photos.  At a later poster session, I took this photo of SFSU Gerontology Professor Brian de Vries and 2^nd year grad student Loren Meissner in front of their poster, “HIV and Aging: A Survey in the San Francisco Area.”  Their preliminary findings identified issues related to isolation, stigmatization, housing, economic security and transportation challenges; for more information, join http://health.groups.yahoo.com/group/hivaging/.  de Vries is on ASA’s Aging Today Editorial Advisory Committee; check out his profile at http://www.asaging.org/brian-de-vries-phd.
  

Diversity workshops

Name badge ribbons for ASA Constituent Groups

After lunch break, I began duty as room monitor on BRONZE level for a workshop, U.S. AoA: A Toolkit for Serving Diverse Communities (Multicultural Aging), which held great interest for me and 40 attendees (http://www.aoa.gov/AoAroot/Press_Room/For_The_Press/pr/archive/2010/June/DiversityToolkit.aspx).  While on the lookout for my workshop presenters, standing outside my assigned room and appearing like a beauty contestant with my gold “Ask me, Volunteer” sash, Harry (Rick) Moody approached me to ask for location of his workshop Public Policy and Livable Communities for a Lifetime (Policy & Advocacy), so I directed him to escalators down for GOLD level.  After calling Nancy 10 minutes and then 20 minutes following the 90-minute workshop start time to report that we were waiting for presenters to show up, she advised me to announce cancellation. Yet, a few attendees were hopeful that the speakers would show up so they remained in the room—as I did, though I was very tempted to check out Moody’s workshop. 

 

For next workshop, Religious Affiliation & Successful Aging Among Transgender Older Adults (Aging 101, Spirituality & Aging), attendance was smaller but at least the presenters showed up!  UMass-Boston gerontology grad students, Kristen Porter and Corina Ronneberg, plan to publish their research in a special LGBT issue in Journal of Religion, Spirituality & Aging (http://www.tandfonline.com/loi/wrsa20), which they said has stirred a bit of controversy with some people objecting to this special issue by canceling their subscriptions.  (They also told me UMass-Boston’s graduate gerontology programs are thriving, despite suspension of undergraduate gerontology program due to low enrollment.)

As a foodie, I was interested in the workshop that Kristen presented earlier on Diversity and Inclusion in Congregate Meal Program: A Lifeline to Isolated Elders (H&CBP).  For example, San Francisco’s senior congregate meals program offers an amazing nine different cuisines, including vegetarian options, which reflect the diversity of its residents (http://www.sfhsa.org/356.htm).  Kristen’s research on LGBT meal sites (offered in only 10% of states) reminded me that the value of a congregate meal program is not just about culturally appropriate nutrition that targets specific ethnic preferences, but also about building community—a place where people can feel they belong, to reduce isolation and need for institutionalization.  San Francisco leads with a LGBT Aging Task Force (http://www.sf-hrc.org/index.aspx?page=201) and services for LGBT community (http://www.sfhsa.org/DAAS.htm).

Coming together

My last assignment was to hold a “General Session (with pointed arrow)” sign and direct traffic on the GOLD level to the Grand Ballroom, which rocked with the musical Chicago on stage.  When the music ended, my volunteer duty ended so I took a seat in the second row and brought out my camera.

Debra Whitman, AARP’s Policy EVP, quoted economist Paul Samuelson’s “good questions outrank easy answers,” before presenting her 7 Unsolved Mysteries in Aging Policy, and inviting us to respond via email to askwhitman@aarp.org: 

1.     how do we encourage more people to save for retirement?

2.     how do we make sure people’s nest eggs will last for the rest of their lives?

3.     how do we encourage people to work longer, while taking care of those who cannot?

4.     how can we help consumers play bigger role in managing their own health & wellness?

5.     how will we pay for LTC services & supports?

6.     how can society best deal with growing numbers of people with diminished mental capacity?

7.     how can we get politicians to look at the needs of an aging society? 

Then in a moment of impeccable timing, which made me wonder if this was scripted, such a politician arrived with his entourage, taking reserved seats in front of me . . . and I was tempted to ask Chicago Mayor Rahm Emanuel what he thought about his brother Ezekiel’s new autobiography, Brothers Emanuel (http://www.vanityfair.com/online/daily/2013/01/ari-ezekiel-rahm-emanuel-book-preview#), but then he was called to the stage.  

Robert Blancato presented ASA Leadership in Public Policy Award to Mayor Emanuel for his role in securing passage of Elder Justice Act as part of the Affordable Care Act.  Emanuel mentioned that he introduced the Act when he was a Congressman seven years ago, and got it passed after he got inside the White House as Chief of Staff.  Always the fundraiser, he encouraged us to “spend some money” in Chicago, and mentioned that Chicago was working to get recognition as age-friendly city by WHO.

Lights, camera, action!

We survived the New Year’s “fiscal cliff” with the American Taxpayer Relief Act of 2012, which restored the Social Security (OASDI=Old Age, Survivors and Disability Insurance) payroll tax to its pre-2011 rate of 6.2% and suspended the “sequester” (automatic spending cuts) until March 1.  Though both Social Security and Medicaid are protected from these automatic cuts, the President and Congress have proposed “entitlement” reform, or cutting our social safety net programs (Social Security, Medicare and Medicaid), in exchange for tax reform that raises revenues to lower the deficit.  For a perspective, see http://www.factcheck.org/2011/02/democrats-deny-social-securitys-red-ink/.

In response, local advocates from Senior and Disability Action (http://sdaction.org/), California Alliance for Retired Americans (http://californiaalliance.org/) and Gray Panthers (http://graypantherssf.igc.org/) organized actions to protect our safety net:  Assembly Joint Resolution 7 (http://www.legtrack.com/bill.html?bill=201320140AJR7), town hall meetings, petitions and phone calls to the President and Congressional representatives, etc.

Senior and Disability Action (SDA) University presented a series of four weekly classes focused on Hands Off Our Social Security! covering community organizing, advocacy, public speaking, strategy planning, etc.  SDA's free, hands-on leadership training program ("all ages are welcome" so I signed up) included lunch, prepared by Centro Latino de San Francisco (pictured is spinach souffle with bechamel sauce, steamed beans/carrots/corn/peas, mixed greens and garbanzo salad) because we all know that congregate meals build community! 

February calendar was full of community organizing events, so we put our learning into immediate action by planning, publicizing, showing up, sharing personal stories, providing information/resources and drawing attention to our messages with lots of energetic singing . . .

February 4:  SDA Housing Collaborative and SRO Collaboratives organized a rally to support legislation for Getting a Grip:  Mandatory Grab Bars and Phone Jacks in SRO Hotels before the Land Use Committee meeting in City Hall.  We performed several chants led by Tony Robles:

#1:  Don't TRIP, Get a GRIP!
#2:  Great Minds, Need Landlines!
#3:  Get a handle, Get a GRIP, It's no fun, WHEN YOU SLIP!
#4:  Papa wants a Brand new Phone jack!
#5:  You're trippin' If you think I Like slippin'

Excellent local media coverage at http://www.sfbg.com/politics/2013/02/04/supes-call-stronger-sro-safety-measures

February 13:  SDA created a new holiday, Happy Valentine's Eve, since Valentine's Day this year fell on the 2nd Thursday of the month when SDA and CARA hold their general meetings.

CARA Legislative Director Hene Kelly belts out, "We are the mighty seniors," while Juicye distributes yellow hats for HAT (Healthcare Action Team) supporters.

Canon Kip Senior Center Case Manager James Powell speaks

SDA Healthcare Organizing Director James Chionsini called Juicye a "one man parade" as he twirled his sign

SDA's fact sheet was conversation starter and consciousness-raising tool

Preparing to serenade Supervisors & Mayor inside City Hall

Gathering outside office of Supervisor London Breed

We personally delivered Valentine greeting cards bundled in manila envelopes to Supervisors David Campos, John Avalos and Eric Mar 

Singing San Francisco I'm Coming Home Again:

San Francisco it's city budget time

Gentrification is taking its toll

Supervisors set your priorities

Housing keeps us out of the cold

City budget cuts they got us in a rut

Tell us you won't be the ones to let the doors shut

San Francisco I'm in my home again

Won't be alone again

San Francisco it's city budget time

Aging in place is not a disgrace

People living with disabilities

Use homecare to keep them at home!

Supervisor Jane Kim joined in singing Happy Valentine's Day (eve) to the tune of You Are My Sunshine:

Happy Valentine

We want to stay fine

We want to live and

We want to stay

In our homes

In San Francisco

And we wish you Happy Valentine's Day

(Eve)!

We're here at City Hall

We want to tell you all

What we need to

stay in shape:

Food, housing, healthcare

And of course homecare

Help us have a happy

A Happy Valentine's Day

(Eve)!

February 14:  SDA General Meeting featured update on implementation of Affordable Care Act by Rose Auguste of Health Access (http://www.health-access.org/) and free blood pressure screenings.



James Chionsini, who was a former discharge planner/mental health case manager, introduced this wonderful infotainment skit, "It's scary to be discharged on a Friday (without services in place and with no one at home to care for me)" at http://www.youtube.com/watch?v=DKRJ2vaxsVk.  Know your hospital discharge rights!

While SDA focus is on issues that affect San Francisco, CARA focus is on statewide issues.  After lunch at SDA meeting, several of us joined CARA Action Team meeting to plan upcoming Hands Off Our Social Security Town Hall meeting.

February 18: CARA presented Hands Off Social Security, Medicare & Medicaid! Town Hall Meeting in Oakland.  On stage, CARA VP Pauline Brooks introduces omnipresent Hene Kelly (who told us that the busiest person makes the time to do things), journalist Norman Solomon (http://www.normansolomon.com/) and CARA Director Jodi Reid.

Filmmaker Don Goldmacher showed trailer from HEIST: Who Stole the American Dream (http://heist-themovie.com/) about how social security works (http://www.youtube.com/watch?v=mkWib-oW59k)

Occupella (http://www.occupella.org/) led sing-a-long, including this favorite with lyrics by Charlie King to the tune of John Lennon's Imagine:

Imagine you have healthcare, it's easy if you try
Freedom to choose your doctor, coverage money can't buy
Imagine first class treatment when you're unemployed

Imagine no insurance, no greedy middleman
No premium, no co-pay, a single payer plan
Imagine a long illness and you don't lose your home

You may say I'm a dreamer,
I'm not dreaming by myself
I hope someday you'll join us
And the world can live in health

Can you say "Universal?" I wonder if you can
Now try "Comprehensive". Does that sound like a plan?
It's worked for years in Europe, Canada & Japan

FDR intended Social Security to be self-supporting, with payroll tax contributions from workers and their employers:  "We put those payroll contributions there so as to give the contributors a legal, moral, and political right to collect their pensions and unemployment benefits. With those taxes in there, no damn politician can ever scrap my social security program."  (http://www.ssa.gov/history/court.html)

To the tune of God Bless America:

Social Security -- don't privatize

It's our lifeline -- our future

And we won't stand for Wall Street's big lies

There's no crisis.  It's not broken

It's been sound for many years

Social Security -- please stop the lies!

Social security -- don't privatize!

Magnificent magnolias in bloom at http://www.sfbotanicalgarden.org/garden/magnificent-magnolias-2013.html

Lucky you (seniors) live Hawaii!

"Lucky you live Hawaii” was an expression I heard a lot while growing up in Hawaii.  Though born and raised in Honolulu, I always felt like an outsider.  Brought up by my Chinese immigrant parents and grandparents, I inherited their intense work ethic instead of the laid-back, island lifestyle (fun in da sun). 

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 Honolulu where they continue to run our family business.  In doing so, they remain active and fairly secure that they will not outlive their savings.  When I visit them, it’s usually a working vacation—unpaid, but room and board provided.  

This time as a budding gerontologist, I decided my field visit would be an opportunity to study healthy aging in Honolulu.  After all, I could observe kupuna (elders) in my own ohana (family), as the Pake (Chinese) in Hawaii have the nation’s longest average life span at 86 years (http://www.healthtrends.org/status_life_expect.aspx).  Note:  Part-Chinese Sen. Daniel Akaka (born September 11, 1924) outlived Japanese Sen. Dan Inouye (September 7, 1924 – December 17, 2012). 

Palolo Chinese Home’s Senior Day Care resembles a college campus, with menu reflecting foodways of American (SPAM), Chinese, Filipino, Hawaiian, Italian, Japanese, Korean, Thai, etc. cuisines (http://www.palolohome.org/services/food-service.html).  

Lunch menu for Kupuna Wellness Centers, with meals prepared in a centralized kitchen and then delivered by Lanakila Meals on Wheels (http://www.lanakilapacific.org/programs/lanakila-meals-on-wheels/kwc/) for donation of $2 per kupuna—a real bargain considering Hawaii’s high cost of living.  (Recognizing the high cost of food, Hawaii’s Senior Farmers Market Nutrition Program distributes vouchers worth $50 to low-income seniors, while California’s distributes vouchers worth only $20.) 

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 Hawaii State Art Museum (http://www.state.hi.us/sfca/).

Then it’s a pleasant half-mile stroll past these elegant banyan trees along Iolani Palace, State Capitol and Main Library (my childhood hangout) to the City and County’s Department of Community Services’ Elderly Affairs Division, the designated Area Agency on Aging that publishes the Honolulu Senior Information and Assistance Handbook (http://www.elderlyaffairs.com/site/449/publications.aspx). 

Successful aging

At the Center on Aging at University of Hawaii (UH) (http://www.hawaii.edu/aging/), Program Assistant Justine Nihipali alerted me to the latest Profile of Successful Aging Among Hawaii’s Older Adults (http://www.hawaiiadrc.org/Portals/_AgencySite/2013Aging.pdf).  Some highlights:

• 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: Hawaii’s older adults report more time in leisure/exercise and labor force participation; and lower rates of disability, smoking, obesity/overweight, and diabetes.  However, they report higher rates of asthma.

Fusion cuisine: Zesty taro hummus (KCC Farmers' Market) and taro pie (Mickey D's)

• Go along to get along:  Hawaii is the most diverse state in the nation, with its mixed ethnic population at 23.8% compared to 2.7% nationally.  Hawaii also leads the nation in multigenerational living (7.2% of households), and 31.7% of older adults live alone compared to 40.6% nationally.

What I liked about Hawaii’s so-called Kupuna Wellness Centers is that they’re housed in larger community centers that serve all ages so it's like one big ohana with keiki (kids) and kupuna.  Since my parents were preoccupied with business, I attended a couple of classes intended for seniors, thinking I’d share information with my parents and ended up learning tips useful for everyone who wants to age in community.

Falls Prevention

Mo’ili'ili Community Center (http://moiliilicc.org/moiliili-senior-center) charges annual dues to participate in its Senior Center, but I was able check out the place by attending a free Falls Prevention class presented by Eileen Phillips, RN at Attention Plus Care (http://www.attentionplus.com/contact-us/events-and-classes).  She shared the following scary local stats:

• 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 is also affected by other disasters (volcanic eruption, flood, earthquake, fire, windstorms, coastal sea storms, terrorism, avalanche/landslide, oil/fuel spills, and community power/utility failure), which makes it an ideal HQ for disaster preparedness training.  Except for the Big Island, Hawaii isn’t affected by heavy snowfall or extreme/prolonged cold spells—lucky you live 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 residents should plan for longer periods, like up to nine days, since most food is shipped in from Matson.  For communication, cell phones will be down but landline phones and texting should be up.

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. 

Hawaii kama'aina (long-time residents) are the nation’s top consumers of SPAM, but my grandparents who lived well into their 90s didn’t eat SPAM.  Why do Hawaii residents live longer than Mainlanders? (Residents of Minnesota, home of Hormel SPAM, have the nation's second highest life expectancy; http://www.manhattan-institute.org/html/mpr_04.htm.)

Generations: Chinese Families in Hawaii 1850-2000 exhibit at Hawaii Heritage Center.  Chinese immigrants to Hawaii came with their Confucian values (respect, honesty, education, kindness, filial piety) and Taoist longevity principles (balanced living with nature). 

·       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.

Instead, plate lunches (aka heart attack on a plate) loaded with animal meats and starches (white rice, mac salad), a carryover from plantation days, are ubiquitous (http://www.nytimes.com/2008/11/12/dining/12plate.html).  KCC Farmers’ Market (http://hfbf.org/markets/markets/kcc/) offers mostly local food on styrofoam 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.

I love eating Korean banchan, or appetizers (mainly vegetarian).  At Korean take-out places, I skip the meats, rice and mac salad (sometimes) in favor of creating my own veggie banchan plate: wakame (seaweed), chapchae (sweet potato noodles, carrots, cabbage), radish, mung bean sprouts, zucchini jun, and mandoo (dumplings)(Korean Hibiscus BBQ).

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).

Okinawan soba with pork, fishcake, green onions and ginger (Hide-Chan)

Okinawan sweet potatoes (Whole Paycheck)

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).

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!

In Hawaii, we live (long) to eat!