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Blue Zones - what are they, and what can they tell us about health and longevity?

  • Blue Zones are areas with much higher rates of people who have reached 100 years of age

  • The term entered public consciousness in 2004 with a National Geographic article written by Dr. Dan Buettner
  • Buettner and his team identified five Blue Zones: one each in the United States, Costa Rica, Italy, Greece, and Japan
  • Dr. Buettner identified nine traits shared by centenarians in these five locations


Worldwide, life expectancy has increased by three decades since the 1950s. This has not been accompanied by a corresponding increase in health; rates of chronic disease have increased among older adults in the same period. 


Is this inevitable? Could we achieve longevity without the frailty associated with age?





Is Longevity In Your Genes?


Conventional wisdom frames longevity as a roll of genetic dice. However, genetics is only a small piece–about 25%--of the puzzle. What accounts for the rest? 


Research into so-called “Blue Zones” has identified remarkable connections between longevity and lifestyle. Where are these Blue Zones? What do they have in common, and what can we learn from them?


Blue Zones: A Brief History


In 2000, Dr. Michel Poulain, a Belgian demographer, and Gianni Mario Pes, an Italian physician-scientist, looked at a map of Italy, circling the Mediterranean island of Sardinia with a blue pen. This is where they had found higher-than-average populations of centenarians (people who have reached 100 years of age). 


In 2004, Poulain and Pes joined Dr. Dan Buettner, a writer working with National Geographic and the National Institute on aging, in his quest to “reverse engineer longevity.” They set out to explore places where reports of people living to age 100 (or even older) were common.




In addition to Sardinia, Buettner and his colleagues verified extraordinary longevity in Ikaria (Greece), Loma Linda (California, USA), Okinawa (Japan), and Nicoya (Costa Rica). Buettner referred to these places by Poulain and Pes’ old term–Blue Zones.


Common Characteristics


The five Blue Zones are geographically noncontiguous, and they are populated by different cultures. They do not share the same diets or religious practices. Nevertheless, anthropologists, epidemiologists, demographers, and other researchers went to work, studying the Blue Zones diligently for common patterns.


The Power 9


As they narrowed down the shared traits, researchers identified nine key characteristics typical of all Blue Zone lifestyles. Dr. Buettner christened these elements “the Power 9;”  

  • Getting plenty of natural movement. The lifestyles of Blue Zone centenarians naturally demand movement. Gardening and walking regularly keep Blue Zone people active.      

  • A sense of purpose. In Okinawa, it’s called Ikigai–In Costa Rica plan de vida. Regardless of language, Blue Zone centenarians believe that their lives have purpose. 

    Sense of purpose has been found to correlate with better heart health and lower rates of disease. Dr. Buettner says that a strong raison d’être can add up to  seven years to life expectancy.

    • Time to destress. In the Blue Zones, stress-reducing routines are built into everyday life: prayer, meditation, nap time–even a nightly happy hour–offer Blue Zone residents a moment of relaxation. Dr. Buettner calls this downshift

      Stress contributes to inflammation,
      which is a major driver of inflammaging. Taking part in relaxing activities reduces both stress and inflammation. After 12 weeks of regular yoga practice, participants in an American study were found to have lower levels of inflammation; cellular aging slowed, and levels of cortisol, the so-called “stress hormone,” tapered off.  

      A 2022 study found that people who took up gardening had fewer markers of inflammation in blood tests.


      Yoga and how it correlates with blue zones


      • Following the 80% rule. Okinawans traditionally adhere to a Confucian concept called Hara hachi bunme (commonly shortened to hara hachi bu)—the practice of eating until you are 80% full. This means eating until you are no longer hungry, but are not yet full. 

        Other mealtime practices in the Blue Zones include serving the lightest meal in the early evening and foregoing food for the remainder of the day. 

      • Eating a plant-centric diet (plant slant). Plants make up the bulk of the diet in the Blue Zones. Beans, nuts, and whole grains offer complex carbohydrates, protein, and fiber. In places where meat is consumed, it is only served about five times a month in portions of three or four ounces. 

        Studies find that plant-based diets significantly lower risks of all disease. Plant-based diets are naturally high in dietary fiber, which have been found to prevent obesity and cholesterol. 

      • Drinking moderately (Wine @ 5). Regular (moderate) alcohol consumption is common in all of the Blue Zones except Loma Linda.

        Multiple studies indicate that moderate alcohol consumption could offer numerous health benefits, lending support to this practice. In a Chinese study, women consuming low to moderate amounts of alcohol reduced their risk of developing rheumatoid arthritis by 19%. In a study in Spain, wine consumption correlated with a 30% reduction in rates of cardiovascular disease. 

        All drinking is not the same, however. Blue Zone research suggests that alcohol’s benefits are highly dependent upon context; one or two drinks a day over dinner with friends is preferable to three or more drinks consumed alone without an accompanying meal. 

      • Belonging to a faith/spirituality-based community. Of the 263 centenarians interviewed by Blue Zone researchers, all but five belonged to some sort of faith-based community. 

        According to some studies, participation in religious services adds an average of 4 years of life expectancy. Spirituality is a controversial topic, and practices are diverse. What seems to matter is the sense of meaning and community spiritual practice provides. 

      • Prioritizing family. Among the Blue Zone centenarians, multigenerational homes are not unusual. Even in cases where different generations live separately, families remain close and spend time together regularly. Committed relationships with life partners are also important in the Blue Zones.

        Research underscores the importance of family life to health. Strong relationships between grandparents and grandchildren are associated with better physical and mental for both. Marriage is associated with a 2-year increase in life expectancy.


      The importance of family life to health and blue zones.


      • Having a strong social group (right tribe). Blue Zone researchers found that tight-knit social groups support the health of older adults. In Okinawa, for example, moais, social groups composed of about five members, form in childhood and last through adulthood.

        Even in places where extraordinary longevity is rare, belonging to an active social group correlates with lowered risks of  obesity and depression. People with close social groups tend to have  lower rates of mortality and disease

        Social groups can positively influence health-promoting behaviors; in Okinawa, for example, there is a moai that meets daily to walk. This does not explain the relationship fully, though. Loneliness is associated with a doubled risk of mortality from all causes, suggesting that the protective benefits extend beyond merely reinforcing good habits.


      NMN, Collagen, and Blue Zone Diets


      Blue Zone diets, high in vegetables and whole grains, offer protection from obesity and heart disease. They also contain an abundance of compounds that combat the effects of age: NMN and collagen.


      NMN and NAD+


      Our cells depend upon a coenzyme called Nicotinamide adenine dinucleotide (NAD+) to repair themselves. Nicotinamide adenine dinucleotide is also essential to regulating metabolism and communication between neurons. Levels of NAD+ decline markedly as we age. This decrease is associated with increased risk of diseases such as neurodegenerative disorders and cancers. 

      The diets of Blue Zone centenarians are rich in foods containing nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), which are precursors to NAD+. 

      These NAD+ stimulating nutrients are found in vegetables, grains and legumes, as well as in milk and fermented foods. Edamame, cruciferous vegetables (such as cabbage and broccoli), cucumber and avocado are rich in NMN. Almonds, cow’s milk, and yeasts are all rich in NR. Both NMN and NR are found in fermented beverages, which may explain the connection between longevity and moderate alcohol use. 

      Calorie restriction also stimulates NAD+ production. In mouse studies, a 24-hour fast led to higher levels of the liver. Even foregoing food for a few hours, such as the Okinawans do after their early evening meal, can enhance production of NAD+.

      NAD+ stimulating nutrients are found in vegetables



      Collagen: Our Natural Scaffolding


      In Okinawa, Dr. Buettner discovered a tradition of slow-cooking pork meat, along with the bones, for days. This cooking method renders a rich, gelatinous broth.

      This broth is high in collagen, the most abundant protein in the human body. Collagen acts as “scaffolding” throughout the body; it supports the structure of the skin, blood vessels, tendons, and ligaments. Age-related collagen loss leads to a loss of integrity of the tissues it supports, resulting in sagging skin, weaker blood vessels, and increased risk of injury. 

      Regular ingestion of collagen increases bone density and strength. It also is associated with lower rates of atherosclerosis, a build-up of cholesterol and other lipids in the blood vessels that increases the risk of heart disease and stroke. 



      Blue Zones - what can they tell us about health and longevity





      The Blue Zones provide welcome insight into the secrets of longevity. Perhaps more importantly, they show us  that longevity need not mean lowered quality of life. 

      Blue Zone researchers have also shown us that health is multifaceted. Natural movement, a plant-rich diet, eating mindfully, living with purpose, living in community, getting regular stress relief, keeping close family bonds, finding meaning in life (spirituality/faith), a regular drink with friends–the “Power 9” remind us that longevity is about much more than diet and exercise. 


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