There are several areas on this planet where a remarkable number of people manage to live to an unusually old age – while at the same time remaining healthy. These areas are called Blue Zones. Although Blue Zones can be located miles apart, the lifestyle of the residents of the different Blue Zones is very similar. If you would like to not only live for as many years as possible, but also want to remain healthy for as long as possible, you can learn a lot from this Blue Zone lifestyle.
By Willem Koert
Most biomedical scientists are still convinced that it is mainly your genetic characteristics that determine whether you can live to a ripe old age – and how many years you can remain healthy. This idea is not entirely correct, as long-term epidemiological studies have shown in the last century. Genes play a role, but other factors have proven to be more important.
According to a Danish study conducted by researchers at Odense University, genes determine about a quarter of whether you can live to an exceptionally old age. The Danes followed 2,872 twins born between 1870 and 1890 until 1994. At this time, less than 1 percent of the twins were still alive. Based on their data, the researchers were able to calculate that genes determine for 23 percent the age that women can reach. For men this was 26 percent.
The remaining 77-74 percent of the factors that determine how old you will become are lifestyle factors and environmental factors. How important these factors are, and which factors exactly we are talking about, has not been more clearly highlighted than by the Belgian demographer Michel Poulain and the Italian physician-researcher Gianni Pes. They discovered in 2000 that in Barbagia di Seùlo and Ogliastra, two adjacent regions of the Italian island of Sardinia, one of every 200 inhabitants managed to live to be over 100.
There were more such areas, Poulain and Pes discovered in the years that followed. They also found unexpectedly many centenarians in, for example, Acciaroli, Italy, the islands of Okinawa in Japan, the Nicoya Peninsula in Costa Rica, the Greek island of Ikaria, Loma Linda in the US, and Skåne in Sweden. Poulain and Pes called those areas ‘Blue Zones’.
The idea of Blue Zones has become mainstream thanks to the American journalist Dan Buettner, who, in collaboration with Poulain and Pes, wrote books and made documentaries about the evocative zones where people had adopted a way of life that allowed them to remain optimally healthy.
To begin with, the Blue Zones had in common that they were relatively isolated. Many ‘modern’ negative lifestyle habits that were encouraged by multinationals and marketing in centuries past, such as smoking and the consumption of ultra-processed foods, never fully penetrated the Blue Zones.
The absence of those factors undoubtedly has a positive effect. Smokers generally live 10 years shorter than non-smokers. A diet with a lot of ultra-processed foods like sweets, soft drinks and fast food probably shortens human life span as well. We still do not have a complete picture of the harmful impact of ultra-processed foods, soft drinks and junk food, but it is already clear that these foods promote cardiovascular disease and the risk of type 2 diabetes and cancer.
But this absence of negative lifestyle factors was only part of the explanation for the robust health of Blue Zones residents, Buettner emphasized in an interview following the release of his 4-part documentary series on Blue Zones on Netflix.
“The essence of Blue Zones is people live a long time not because of the things we think. They’re not on diets, they’re not on exercise programs, they don’t take supplements,” he said. “They don’t pursue health, which is a big disconnect in America, because we think health is something that needs to be addressed.”
Anyone who lives the traditional way in the Blue Zones lives extremely healthily without having to think about it. In this blog we explain what that way of life looks like. In their articles and books, Buettner, Poulain and Pes distinguish nine different aspects of the Blue Zone lifestyle. In this blog we have reduced this to five.
#1 | Physical activity as a part of life
Residents of Blue Zones are still able to live their lives on their own, with minimal assistance from machines. When they must transport themselves from one place to another, they use their legs. They grow a large part of their food themselves in their vegetable gardens, pick it themselves in the forests or catch it themselves at sea. They process food, but also clean and make minor repairs themselves.
This implies that residents of Blue Zones are physically active for hours every day. We know from research that moderate-intensity exercise is healthy. Healthy people over 60 who walk for half an hour every day at a brisk pace halve their risk of death compared to peers who walk for less than fifteen minutes every day.
Anyone who exercises moderately intensively for half an hour every day has a significantly lower risk of chronic conditions and death as they get older than someone who does not or hardly exercise. Research has shown that more exercise than this amount is even healthier.
This is evident, for example, from an Australian epidemiological study, in which researchers from the University of Sydney followed a group of almost 1,600 people over the age of 50 for ten years. The researchers wanted to know whether there was an association between the amount of exercise and the odds of ‘successful aging’ – that is, growing older without depression, diabetes, cardiovascular disease, cancer, dementia or other chronic aging-related conditions. This association indeed appeared to exist. The group that exercised the most, and was moderately active, for more than 4 hours a day, was more than twice as likely to ‘age successfully’ than the study participants who exercised less than 40 minutes a day. When it comes to moderate-intensity exercise, ‘more’ seems to be synonymous with ‘better’.
Outside the Blue Zones, there is only a small group that exercises daily. A large part of that group consists of athletes who, compared to the residents of Blue Zones, still exercise relatively little in terms of time – but when they do exercise, they exercise more intensively. It’s beyond doubt that intensive exercise has added value when it comes to longevity, but there seems to be an optimal amount of intensive exercise. More hours of exercise per week than this optimal amount adds little. There are even studies that suggest that in the case of endurance athletes, an excess of hours of intensive training per week may even increase the risk of premature death.
#2 | Real foods as building blocks for diet
Dietary patterns in the different Blue Zones vary considerably, but there is one major similarity between all diets: all diets consist almost entirely of whole foods that have been traditionally produced. In the Blue Zone diet, ultra-processed foods are conspicuous by their absence, but hardly processed plant products take a prominent place.
In the Blue Zone dietary patterns there are no snacks from plastic bags and containers, but there are beans, fruit, vegetables, nuts, and whole grain products. There are no soft drinks, but there are tea, coffee, and herbal infusions. There are no hamburgers and other intensively processed meat products, but there are eggs, fresh fish, and unprocessed meats. The food of the residents of Blue Zones does not come from a factory, but from a kitchen. And before the ingredients entered a kitchen, they grew in nature.
Nutrition scientists believe that people eat healthy if they eat 5 servings of vegetables or fruit daily. This amounts to 400-500 grams of fruit and vegetables per day. According to many epidemiological studies, each serving of fruit or vegetables per day reduces the risk of death by 5 percent – until an intake of 5 servings per day is reached. These 5 servings per day would be the optimal intake, but there are also studies that suggest that the optimal intake is higher.
These figures probably underestimate the positive impact of the Blue Zone diet. Because Blue Zone residents grow much of what they eat, their intake of chemicals such as insecticides, pesticides and fungicides is lower – making the Blue Zone diet healthier. Moreover, because they use few ready-made foods, Blue Zone residents also consume more flavorful herbs and spices. So they consume more turmeric, cinnamon, red and black pepper, chamomile and many other spices that scientists have discovered sometimes have unexpectedly strong health-promoting and anti-aging properties.
Finally, plant foods that have not been intensively processed contain a variety of phytochemicals that protect health and slow down aging processes. Hundreds of these natural substances have already been described in biomedical literature, but we probably still do not have a good picture of most of these phytochemicals – and so we cannot yet process them in supplements. And even if we do know them, administering phytochemicals as a supplement is not always successful.
For example, a well-studied phytochemical in fruits and vegetables with anti-aging qualities is beta-carotene. If you find a relatively large amount of this in the blood of elderly people, their molecular clock ticks less quickly and their risk of dementia is smaller. However, experiments in which test subjects received supplements with a high dose of beta-carotene for years had to be stopped prematurely because the supplements increased the risk of lung cancer in smokers and people who came into contact with asbestos.
There are probably no phytochemicals that protect health if you ingest them in high doses. If it were that simple, a healthy diet would be a matter of taking pills. The example of beta-carotene shows that it is not that simple. The optimal diet probably does not contain a handful of phytochemicals in large quantities, but an immense spectrum of phytochemicals in not excessively large, but sufficient quantities. And that is exactly what the diet in the Blue Zones offers.
#3 | Part of something bigger
In Blue Zones, individuals are still included in a larger whole. For example, family ties are particularly close, as are the social networks in the neighborhood and region. In most Westernized societies, the elderly often no longer play a significant role after retirement, while they still play a role of significance in the networks in Blue Zones.
Research shows that feelings of loneliness, which are present in tens of percent of the population in Western societies, increase the risk of death. The more people over 70 have less contact with other people, have fewer people to rely on and feel connected to fewer people, the greater their risk of dying. Good friends have the opposite effect – the more friends you have in old age, the lower your risk of death.
There are several types of social groups that can extend the lifespan of individuals. One of these is the dyad with a life partner. That is why a long-term marriage reduces the risk of death – especially if the life partner in question is happy. But on the other hand, participating in social movements, for example by being active in groups that are committed to preserving nature, also reduces the risk of death. There is even evidence of life-prolonging effects of being part of social media networks.
Being part of social groups is likely to extend lifespan because family members, friends, and close acquaintances can provide help and support. Under difficult conditions this can make a big difference. Talking, exchanging ideas, and developing solutions to problems together also stimulates the brain to continue developing – which reduces the risk of dementia by perhaps 50 percent. Elderly people diagnosed with dementia usually have a life expectancy of a few years at most. Finally, participation in groups can ensure that older people remain physically active.
In Blue Zones, people are interconnected through a tightly knit network of relationships. Older people occupy a prominent place in many of these networks – and therefore older people are active until an exceptionally old age. They attend parties and events, they receive neighbors, friends, and family, they work in the garden with others, they pickle fruit and vegetables with family members, they teach their grandchildren to cook, they are respected for their experience and knowledge and are asked for advice.
Outside the Blue Zones, these networks have largely disappeared – and with them the incentives that allow older people to remain mentally and physically active. When individuals outside the Blue Zones no longer participate in the workforce, they all too often become marginal. What this does to their health is anyone’s guess.
#4 | No chronic psychological stress
In modern societies everyone is constantly under stress. That needs no explanation. Time has become a precious commodity. The agendas are full, work and personal social life are increasingly demanding, while the media machine creates unrealistic expectations of life and ourselves. In such a world, disappointed people burn out more and more quickly. This aspect of modern everyday life has also not penetrated Blue Zones. Stress does occur in everyday life in Blue Zones, but the chronic stress of modern society does not.
Scientific research into the health effects of stress is still relatively scarce. This is not due to a lack of interest, but mainly due to methodological problems. It is not easy to get a good picture of a phenomenon to which we are all exposed. But the research we have suggests that stress has little effect on life expectancy if you’re healthy. If you have one or more chronic conditions, this is different. Then stress reduces the number of years you will live. Crucial in this are the positive emotions you experience in everyday life. The more these positive mood states decrease, the stronger the negative effect of stress.
Stress can trigger or worsen diseases. An important mechanism may be that stress suppresses the immune system. Athletes who suffer from stress are therefore more likely to catch a cold or flu. According to a Danish epidemiological study, people who experience a traumatic event such as a divorce are therefore more likely to be admitted to hospital due to an infectious disease. The effect of a divorce appears to last more than 15 years.
If stress has such a negative impact on health, it is not surprising that the effect of chronic stress is visible in the DNA. More stress in personal life and in the sphere of work is associated with more molecular aging of the genetic codes.
#5 | Faith
Religion and spirituality are at odds with life in modern Western societies. Science, mass media, pop culture, the education system, multinationals, and governments in Western societies seem to be in a constant battle with religion and spirituality. This did not happen in Blue Zones. Residents of the Blue Zones still live in a world that not only gains meaning through economy, knowledge, science, and bureaucracy, but also through a higher reality that governments, universities, and major corporations have no control over.
Faith, in the form of religion or spirituality, extends lifespan, according to epidemiological research. American psychologists from Ohio State University analyzed several thousand obituaries that appeared in American newspapers between 2010 and 2012 and estimated that people with religious beliefs lived four years longer than people without religious beliefs. The more serious people are about their faith, the greater the life-extending effect.
Researchers explain the positive health effects of philosophy in several ways. Two obvious explanations are being part of a social group, with all the positives that entails, and being physically and mentally active in volunteer work in a philosophical community until an old age. Less tangible, but perhaps even more important, are the psychological effects of a faith-based life philosophy. In every faith, life has a meaning, a purpose, or a meaning. The realization that life has a purpose also has a life-prolonging effect. In such a philosophy of life, the world ‘makes sense’ and the rules – not the rules of our governments, but the rules from a higher dimension – apply to everyone. This belief in a ‘just world’ appears to extend lifespan as well.
The Blue Zones & you
Studying the Blue Zones teaches us how to extend our lifespan, but applying these insights is sometimes impossible. For example, the Blue Zones have taught the importance of social connections, but applying this insight is not so easy for people living outside these areas. If you were not born in a Blue Zone, and therefore have not been part of the multitude of close-knit social networks in the Blue Zone all your life, it is impossible to organize these social networks on your own.
The same applies to spirituality and religion. If you have nothing to do with religion and spirituality, you cannot force yourself to be spiritual or religious. But in this blog, we have also discussed a few things that you can use. We mention three.
The first is that Blue Zones have taught the importance of a lifestyle that includes lots of physical activity. The positive effect of a lifestyle in which you spend a relatively large amount of time in motion throughout the day is more favorable than a lifestyle in which you exercise intensively for an hour every day but are inactive the rest of the time.
Of course, exercising intensively for an hour or even more every day is one of the healthiest things you can do. If you belong to the select group that trains with weights in a gym every day, then definitely continue. But you could also incorporate moderate-intensive modes of physical activity e into your lifestyle. Maybe you can walk distances that you currently cover in a car. Maybe you can trade in the hours you currently spend staring aimlessly at a screen for gardening or hiking. Maybe you can make your phone calls while walking. We can’t tell you exactly how to do this. It’s about incorporating physical activity into your daily routines in a way that you experience as enjoyable and that adds value to your way of life.
A second lesson you can learn from the Blue Zone research is the importance of a diet that consists of wholesome and minimally processed foods. This means that you cook as much as possible yourself or prepare your food in your own kitchen. Use as much fresh produce as possible, which your great-grandparents might have eaten, and stay away from ultra-processed foods that lack bioactive substances as much as possible. Even if you know little about nutrition and cooking, the food you prepare yourself will almost always be healthier than ready-made food that you mindlessly buy.
And then there is stress. Not the stress that is simply part of life and that you experience occasionally, but the modern stress that is continuous. Modern stress is caused by full schedules, constant pressure to perform, countless obligations you must fulfill and a never-ending participation in a pointless rat race. But how do you escape or reduce modern stress if don’t want to withdraw from society? We don’t have the answer to that question. But hopefully we have been able to explain why it is worth trying anyway.
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