Longevity blues: learning from people in the world who live the longest

Blue zones are areas on the planet with the highest number of centenarians. People in these areas not only reach and live past 100, but they do it with a surprisingly good quality of health. The stories one hears from people in the blue zones are quite surprising. In Loma Linda, California, Frank Shearer still likes to hop on his water skis once a week. At the time of the picture he was 99. When asked about longevity, he says he has always stayed very active, practicing all kinds of sports year-round.

The first blue zone to be discovered and studied was the island of Sardinia. In the late 90’s, the demographer Gianni Pes noticed how people in the mountains of the island lived to an unusual old age. Together with researcher Michael Poulain they narrowed down the area with the highest longevity to a small cluster of villages (in the mountainous Nuoro province) and coined the term blue zone.

In 2004, Dan Buettner teamed up with National Geographic and set out to investigate other regions on the planet where people live exceptionally long lives. He worked with a number of experts on longevity, including Pes and Poulain, and they identified 4 new blue zones in the world.

These are the main 5 blue zones:

• Barbagia region of Sardinia — Here they found the highest proportion of male centenarians on the planet. It is a mountainous region with a very ancient culture going back to the bronze age. There is a culture of treating the elderly with respect and care.
• Ikaria, Greece — This is a very isolated place, not far from Turkey. Like all blue zones, they grow their own food. It has one of the world’s lowest rates of middle age mortality and one of the lowest rates of dementia.
• Nicoya Peninsula, Costa Rica — The area has the lowest rate of middle age mortality in the world. They have a simple diet: corn tortillas, beans and a type of squash. They spend 1/15 the amount the US spends on health care.
• Seventh Day Adventists — They are concentrated in Loma Linda, California. They practice a 24h “sanctuary in time”, every weekend. During this time they stop everything and focus on their religion and family. They walk in nature a lot and have strong knit communities.
• Okinawa, Japan — Here the oldest living female population on earth is found. The islands of Okinawa have the longest “disability free” life expectancy in the world. They have a tradition called “Moai”, a group of friends they are born into and with whom they travel through life.

What the blue zones have in common

When Buettner started studying these blue zones he knew that the reason for their longevity resided in their lifestyle and environment.

This idea is based on a famous study, called the Danish Twins study, which established that only about 20% of a person’s longevity is determined by genes, the other 80% being environment and lifestyle. As Buettner likes to remind us, people in these communities are not trying to become centenarians. They don’t turn 50 and decide to start being healthy so they can reach 100. However, their environment and lifestyle is set up in a way that is optimal for longevity. The idea that you can “try to live to 100” is a myth, says Buettner. Only 1 in every 5000 Americans reaches 100. You not only need to win the genetic lottery (the 20%), you also need the right environment to nudge you in the right way (the other 80%). And the way most people live in the western world is quite different than the way people live in the blue zones.

Buettner puts it this way: longevity is a product of the environment, the kind of environment that “makes the healthy choice the easy choice” on a daily basis.

This isn’t meant to discourage anybody. In fact, Buettner’s work is also about helping people live healthier lives. He works with communities showing them how they can adopt a healthier lifestyle. The average capacity for the human body is about 90 years, and the average life of a US citizen is around 78 years. So here we have a margin of 12 years! Many people could add them by following some of the lifestyle lessons of blue zones.

These are the common denominators of all the blue zones:

1. Natural movement

In Okinawa, people don’t really exercise the way we do. They don’t join gyms, pump iron or run marathons (at least traditionally), but their lifestyle is set up in a way so that they are constantly moving. They sit on the floor and they stand up many times a day. They walk almost everywhere, have few machines for housework and many of them garden. Movement and exercise are done is small bursts throughout the day.

2. Purpose

Having a clear sense of purpose adds years to your life. In these cultures, they don’t make a big separation between work and retirement. Their whole life has a sense of usefulness, of purpose, even though it may change with time. The Okinawans have a specific word, “ikigai”, to define one’s life purpose. The people of Nicoya in Costa Rica call it “plan de vida”, which means “life plan”.

3. Relaxation

They have rituals and practices that relax them and allow them to unwind. The people of Ikaria, in Greece, do the very Mediterranean act of napping. The 7th day Adventists of Loma Linda disconnect from all work related stress for a good 24h, focusing on family and prayer. The Okinawans take a few moments each day to remember their ancestors. And the people of Barbagia, Sardinia, do something a bit more fun: enjoy a good glass of wine!

4. 80% rule

People in the blue zones don’t eat until they are completely full. They have little strategies to keep them from overeating. They eat from small plates and eat fewer calories. Instead of eating family style with big servings at the table, they serve at the counter and then put the food away.

There’s an old saying in Okinawa called “Hara hachi bu”, an idea that comes from Confucius. It reminds them to stop eating when their stomachs are 80% full. It takes about half hour for the feeling of being full to travel from your belly to the brain, so stopping at 80% is very useful.

5. Natural, plant based diet

This is where Dan Buettner’s work arouses passions. Native Americans ate a diet heavy on meats and fats and surprised Europeans with their great health and endurance. There’s so many theories about nutrition today, and all kinds of systems seem to work for different people. I think what is most compelling about Buettner’s work is the fact that food is only a small piece of the puzzle. Actually enjoying and living is very likely to be the greatest tonic.

People in the blue zones eat natural foods that they themselves grow. Until recently, almost all blue zones where isolated and didn’t have access to a lot of meat. Because of this, it was eaten a few times month and not a lot more. The basics of their diet are whole grains and garden vegetables. Legumes, for example, are often used in blue zones. They don’t eat processed foods and they have the habit of eating small portions.

6. Moderate consumption of alcohol

The key is moderation. In Okinawa they drink a daily glass of sake with friends, and in Sardinia they drink a glass of red wine with each meal. In general, more than a glass or two a day has a negative effect on the body.

Much has been said about the health risks of drinking alcohol. Some decades ago the idea spread that alcohol in moderation could improve heart health. People observed how in France, despite ample consumption of cheese and other fatty foods, people had lower risks of heart disease. This is known as the French Paradox. One theory is that wine has a kind of polyphenol called resveratrol which has an anti-inflammatory effect on the cardiovascular system. Sardinians, for example, drink a type of wine called Cannonau which is very high in polyphenols.

However, there isn’t a lot of scientific evidence to support the claim that wine improves heart health.

7. Belong

All centenarians in blue zones belong to a religious or spiritual community. There was a study by the Journal of Health and Social Behavior which looked at 3617 people for 7 and a half years and found out that those who attended religious services at least once a month reduced their risk of death by 1/3. There’s different possible explanations. People who have faith might be more likely to take care of themselves and avoid things like smoking, drugs, and drinking and driving. Belonging to a spiritual community offers a way of socializing and meeting new people. And finally, spirituality related practices offer a way for people to destress, reflect and focus on appreciation.

8. Family

This is probably one of the most important points. In all blue zones people keep their loved one’s close. Younger generations and older generations tend to share the same home. This is important because, as Buettner says, “studies have that elders who live with their children are less susceptible to disease, eat healthier diets, have lower levels of stress, and have a much lower incidence of serious accidents”. In blue zones, there is also a sense of reverence for old people, for the wisdom and experience they carry.

9. Tribe

It’s hard to live the way you want when your not part of the right tribe. As Buettner emphasizes, longevity isn’t about applying specific behaviors, but about lifestyle and environment. Be it because of isolation, or in the case of Adventists strict adherence to a spiritual practice, people in blue zones tend to associate with one another. This makes living a healthy life easy because it’s just part of the environment and lifestyle of your social group. In Spain we have a very old saying, “dime con quién andas, y te diré quien eres”, which means, “tell me who you walk with, and I’ll tell you who you are”.

Strong and lasting friendships is one of the fundamental traits of blue zone cultures. In Okinawa, the tradition of a “moai”, originally created for financial reasons, helps people have a supportive group of friends until a very old age. And in the mountainous region of Barbagia, Sardinia, friends gather at the local bar after a day of work. Robert Butler, pulitzer-prize winner and longevity expert, believed this is one of the reasons why women tend to live longer than men. They tend to have better social networks, they actively engage and help each other and are more willing to open up about difficult emotions.

For further learning and enjoying:

Dan Buettner, Blue Zones: lessons for living longer from the people who’ve lived the longest, National Geographic, 2008.