Written by: Maya Patel; SLU Dietetic Intern
Blue Zones
Stamatis Moraitis was a man from Ikaria, Greece. He lived in Ikaria until 22, when he decided to move to the United States to pursue the American Dream. As a painter, he faced immediate success and was able to buy a house, get married, and have three children. However, at the age of 66, he was diagnosed with terminal lung cancer. It was at that time he decided that he would rather die in Ikaria, which prompted him to move home to live with his parents. He said he breathed the air of his homeland, enjoyed the Greek wine, and ate a Mediterranean diet. He had planted a garden a few months after moving back home, not expecting he would see the fruition of his labor. However, 37 years later, he has lived to see not only his garden flourish but also to start his own vineyard, where he produces about 200 liters of wine a year. At the age of 103, he reveals his secret: “I just forgot to die.”
What is the secret to a long and happy life?
Blue Zones may be the answer to that question. The term “Blue Zones” is used to describe five places around the world in which people consistently live to be 100 years old largely without chronic disease1. This term was coined by Dan Buettner, who embarked on a National Geographic expedition in 2004 to discover the secret to longevity and happiness.
Where are these Blue Zones?
There are five Blue Zones: Loma Linda, California (specifically the Adventist Community); Nicoya, Costa Rica; Sardinia, Italy; Ikaria, Greece; and Okinawa, Japan. These areas were located by Dan Buettner through use of epidemiological data, statistics, and birth certificates1. Upon further research and observation of the communities within these zones, Buettner was able to compile a list of commonalities in lifestyle and diet between these regions that might explain their high rates of longevity. These commonalities are known as the Power 91.
The Power 9
Lifestyle and diet have a huge impact on longevity and overall health. In the United States, it is reported the six in ten Americans live with at least one preventable chronic disease, such as heart disease and type 2 diabetes mellitus, which are leading causes of death, primarily influenced by poor diet and lifestyle choices2. However, research has shown that improving one’s diet to incorporate a variety of fruits, vegetables, whole grains, low-fat dairy, lean proteins, and limited consumption of saturated and trans fats, can help reduce one’s risk of developing disease as well as act as a protective affect in those already struggling with a chronic disease3. Additionally, incorporating more activity in one’s lifestyle and limiting negative lifestyle habits, such as high alcohol consumption, tobacco use, and stress-inducing activities, can be beneficial in reducing risk of chronic disease development4. The populations within these Blue Zones follow such guidelines which have been used to develop the Power 9.
Natural Movement
These populations are consistently active. This does not mean they are lifting weights or running marathons. Instead, they live lives in which physical activity is a part of day-to-day life. For example, Sardinia is home to the longest living men1. Sardinia is home to a community of shepherds who walk about 5 or more miles per day. Their daily habit of natural movement has a positive impact on not only their cardiovascular health, but also their bone and muscle health5. Physical activity has been shown to be associated with a reduced incidence of hip fractures in men and prevent bone mineral loss in postmenopausal women5. Additionally, in a systematic review on the literature regarding prevention of cardiovascular disease in women showed that regular physical activity is inversely correlated with the risk of developing cardiovascular disease and cardiovascular-related death6.
Purpose
Ikigai, as the Okinawans call it, or Plan de Vida, a motto passed around by the Nicoyans, translates to “why I wake up in the morning.” Having a sense of purpose has been shown to increase one’s lifespan by several years. In a cohort study of 6985 adults above the age of 50 years in the US, it was found through the use of a psychological questionnaire that life purpose is significantly associated with all-cause mortality as well as some specific mortality factors such as heart, circulatory, and blood conditions7. The study concluded that having a stronger life purpose meant a decreased risk of mortality, as having a sense of purpose boosted dopamine levels, reduced depression, and anxiety, as well as increased an individual’s optimism7.
Downshift
Stress is a major contributor to chronic disease8. Chronic stress has been shown to promote the development of diseases such as atherosclerosis, non-alcoholic fatty liver disease, and depression due to stress signaling the body to release cortisol, the stress hormone, which initiates the release of cytokines, leading to inflammation8. The people inhabiting Blue Zones recognize that stress is not good for one’s overall well-being. In order to prevent excessive stress, the world’s longest living people incorporate daily habits that help reduce stress. For example, the Adventist Population in Loma Linda pray and downshift for 24 hours per week through recognition of the Sabbath, the Ikarians in Greece take an afternoon nap, and Sardinians do happy hour with friends and family1. By spending time reflecting, resting, or doing something joyful with loved ones, the inhabitants of these Blue Zones are able to manage their stress.
80% Rule
Hara Hachi Bu is a 2500-year-old Confucian mantra the Okinawans recite prior to beginning their meals1. It reminds them to stop eating before they become full or eating only until they are 80% full1. This is a strategy used to prevent overeating, which helps them manage their weight and prevent excessive weight gain. Another eating habit followed by the people living in Blue Zones is to have a light meal in the evening, opting for a heavier breakfast or lunch, which helps to promote proper and easier digestion1. In a prospective cohort study following 3457 Framingham Heart Study participants of 30-49 years of age, the mortality rates specific to age and body mass index were studied9. The study revealed that there were large decreases in life expectancy with participants who were overweight or obese, as they are at a higher risk for developing chronic diseases9. While not all overweight and obese individuals face the same risk of developing chronic disease, the percentage of excess adipose tissue is a key contributor to increased inflammation within the body, which can reduce longevity as a consequence9. By refraining from overeating in conjunction with the other Power 9 commonalities, the likelihood of gaining excess weight is reduced.
Plant Slant
The Blue Zones are not home to vegetarians and vegans, however, the populations in these zones follow a primarily plant-based diet. This is attributed to their dietary habit of consuming the produce and livestock available to them throughout the year. In Loma Linda, the Adventists follow their diet directly from the Bible, consuming a vegan diet filled with leafy greens, legumes, and nuts1. In Nicoya, they consume a high amount of tropical fruits, which provides the people with antioxidants, and magnesium and calcium-rich water, which has been shown to reduce the risk of heart disease and promote bone health1. In Ikaria and Sardinia, they follow a version of the Mediterranean diet, which involves consumption of fruits, vegetables, whole grains, beans, potatoes, and olive oil1. Overall, the people living in Blue Zones do not consume a high rate of processed foods, limiting or avoiding consumption completely1. Additionally, meat consumption, mostly pork, is eaten about five times per month in three-to-four-ounce servings1.
Wine @ 5
Every Blue Zone, with the exception of the Adventists in Loma Linda, consume alcohol in moderation. Rather than going for a beer or downing shots of tequila, the people living in these Blue Zones enjoy one or two glasses of red wine per day with friends and family1. In Sardinia, they produce a wine known as Cannonau wine, which has 2 to 3 times more of the “artery-scrubbing” flavonoids compared to other red wines1. Wine consumption is not only beneficial towards cardiovascular health but is a social activity and reduces stress1. In vitro and in vivo studies have shown that moderate daily red wine consumption has a positive effect on reducing risk of chronic disease development10. This is credited to the antioxidant content in wine as well as the wine containing polyphenols, such as resveratrol, anthocyanins, and catechins10. Resveratrol is a key player in reducing risk of cardiovascular disease development through its ability to neutralize free radicals and protective effect on brain and nerve cells10. Additionally, it works to reduce platelet aggregation, which reduces formation of blood clots and thrombi10.
Belong
Buettner interviewed 263 centenarians, individuals who are at least 100 years of age, and out of those 263 individuals, all but 5 were a part of a faith-based community1. However, whether one decides to join a community or practice reflection and gratitude to a higher being or the universe, a sense of belonging has been shown to increase lifespan by several years1. The reason a sense of belonging is beneficial to longevity is similar to why having a sense of purpose contributes to living longer. Loneliness is a large issue amongst older individuals, as isolation can lead to depression which leads to diminished positive outcomes in those individuals regarding their health11. However, engaging in active communities focused on bringing people together through a shared belief or connection can help promote a sense a confidence, companionship, and joy, which promotes a longer life expectancy11.
Loved One’s First
Families come first in the Blue Zones. This means caring for and frequently visiting relatives and grandparents if they are not already living with you. This also means surrounding oneself with a life partner and children. Investing time and maintaining close bonds with family means reducing loneliness, depression, and anxiety1.
Community
Having a strong and involved community is an essential aspect of the Blue Zones. In Okinawa, Moais are groups of five friends who are committed to each other for life1. The Okinawans begin this group when children are at the age of 5. They spend time together during the week to drink and gossip and vent, providing an emotional safety net, but also a financial one too. If a member of the group is struggling, the others will contribute in any way they can. If a friend does not show up one day, the other members will go to their house and check-in on them to ensure they are alright. This sense of community and massive push for support plays a large role in happiness, purpose, and belonging, which have been shown to greatly influence longevity1.
What can we learn from Blue Zones?
While a proper diet and healthy lifestyle play a large role in disease risk prevention, the Blue Zones have taught us that psychosocial components also play a huge role in longevity.
The Blue Zones have taught us that a diet rich in fruits, vegetables, whole grains, legumes, lean protein, and low-fat dairy are key to preventing the development of preventable chronic diseases, as they provide the body with macro and micronutrients that are beneficial for normal bodily function and strength. From Sardinia, we learned that moderate red wine consumption can promote cardiovascular health, reduce stress, and increase happiness stemming from socialization. In Okinawa, we learned that eating until we are almost full can help prevent unwanted weight gain, which can be protective against chronic disease development and promote easy digestion. Additionally, Blue Zones have emphasized that daily physical activity is essential to promote cardiovascular, bone, and muscle health, emphasizing that physical activity does not have to be intense or rigorous to reap the benefits.
However, Blue Zones have taught us that surrounding ourselves with community, whether it be friends, family, or people who share the same beliefs or connections as you, can help boost happiness, create a sense of purpose and belonging, and reduce stress due to the increased amount of support available to a person. Blue Zones have taught us that having a support system can increase our lifespan and make us feel more fulfilled.
Blue Zones may have unlocked the secret to long and happy lives, however, it is our job to incorporate these lessons into our own lives to reap the benefits.
