Lessons for Living Longer?

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By Mary Carpenter

Editor’s Note: While updating her 2017 post on Blue Zones, Mary Carpenter found healthy lessons from the world’s original five Blue Zone regions—those with the world’s highest percentages of centenarians—spreading to communities around the U.S. Although critics note weaknesses and inaccuracies in the data, most everyone applauds healthy Blue Zone practices, such as eating less food and moving more often.  

“THE RESULTS are stunning,” proclaimed Harvard nutrition researcher Walter Willett, referring to “double-digit drops in obesity, smoking and BMI,” reported by the Blue Zones Project organization. What can work better than individuals struggling to make healthy changes is the supportive social structure offered by Blue Zones communities—along with specific policy and environmental changes, such as building sidewalks and paths to create a more walkable environment.

“We aren’t competing with one another, we’re helping each other be successful,” one community participant told Oprah. “It helps to have everyone around you thinking and acting healthier.” The success of Blue Zones programs may come from an “easygoing approach” that urges participants to make small changes–for example, commit to weekly walks at work—rather than to follow challenging exercise routines or restrictive eating rules.

“Putting the responsibility of curating a healthy environment on an individual does not work,” according to author Dan Buettner, who worked with a team from National Geographic to identify the world’s first five Blue Zones—regions in Greece, Sardinia and Costa Rica, along with Okinawa, Japan and Loma Linda, California. The Blue Zones Project—now in “hundreds” of U.S. communities, from beach towns in Florida and California to some 15 towns across Iowa—focuses on the so-called “Power 9” lifestyle changes, with many catchy labels.

“Right tribe,” for example, refers to living in social circles that support healthy behaviors. And “Plant slant” refers to the Blue Zone longevity diet “cornerstone” of beans (including fava, black, soy and lentils) as well as consumption of little meat, on average five times a month and in small portions.

An alternative to Blue Zone community life, vacations on Costa Rica’s Nicoya Peninsula—one of the original Blue Zones—offer the local “big secret,” according to Buettner: “the three sisters of Mesoamerican agriculture, beans, corn and squash.” Located on the northwest coast of Costa Rica around the surfing town of Nosara, lodgings range from boutique hotels and bungalows to an Airbnb treehouse, and offer healthy amenities, such as yoga and spa treatments.

Critics note, however, that longevity data from the original five Blue Zones may be inaccurate. According to a BBC report, of more than 200,000 Japanese reportedly older than 100 years of age, many were missing or dead and only about 40,000 could be located at fixed addresses. Oxford University sociologist Saul Justin Newman points to high rates of smoking and alcohol consumption along with low average lifespans in some Blue Zones.

The greater the number of supercentenarians, the lower the life expectancy in these impoverished, unhealthy communities, according to Newman, which may be due to faulty record-keeping or to pension fraud: people misreporting their ages to collect illegal pension payments. Writes Harriet Hall on Science-based medicine, Blue zones may be a myth; also, Okinawan longevity “may be a thing of the past.”

Okinawa is the Blue Zone reporting the greatest number of centenarians along with the lowest median lifespan. According to Newman, the region has the worst over-65 dependency ratio; ranks first in the nation for obesity and last for consumption per capita for fruits and vegetables; and “has some of the highest levels of clinical depression in Japan.”

But Okinawa is also the source for three of the Blue Zones Project’s Power 9 pillars: “Right Tribe,” from Okinawan moais, groups of five friends committed to each other for life; “Purpose,” from ikiga, explained as “why I wake up in the morning; and the “80% Rule,” from the hara hachi bu mantra Okinawans repeat before meals to remind themselves to stop eating when their stomachs are 80% full.

Of the remaining pillars, “Move naturally” advises living in environments that promote “constant moderate physical activity,” such as gardening, rather than intense exercise routines; “Downshift” suggests daily de-stressing, for example, with a nap or happy hour; and “Belong” refers to joining a faith-based community. Finally, “Loved ones first” involves care for aging relatives and commitment to a life partner: putting family ahead of other concerns is the No. 1 variable on the Venn diagram of overlapping Blue Zone longevity measures.

The Vitality Compass, developed by Buettner along with the University of Minnesota School of Public Health—named Best Online Tool for Retirement and Longevity by the WSJ—includes questionnaires based on the Power 9 and provides users with “12 customized recommendations to help them live longer and better.” Taken as an initial baseline and then again three to six months later, the Compass can be helpful for assessing progress.

In six years beginning in 2009, the three Southern California beach towns working with the Blue Zones Project reported the number of overweight people dropping nine points to 50.8 percent—while the national rate rose four points to 63.7 percent. After the creation of Blue Zone communities in Iowa, the state’s healthiest states ranking improved from #16 in 2011 to #10 in 2013.

The Blue Zones website has 10 food recommendations with additional catchy labels, starting with the “95/5 Rule: Eat plants” – advising that 90-95 percent of your food should be fruits, vegetables, grains, greens and beans.  Others are “Retreat from Meat,” “Take or Leave Fish” (because “modern-day fish has become so contaminated with pesticides and other chemicals”) and “Diminish Dairy” (with an egg limit of three per week).

But a Blue Zone diet may not exist, according to Hall and others—who point to the almost identical precepts found in the universally recommended Mediterranean diet, as well as to vast differences in eating preferences among the original Blue Zones. The Ikarians’ diet is notable for “its emphasis on potatoes, goat’s milk, honey, legumes, wild greens, some fruit,” according to Buettner. The longest-lived Sardinians also consume large quantities of goat’s milk, as well as sheep’s cheese—including a sharp pecorino, with high levels of healthy omega-3s —along with bread, fennel, tomatoes, almonds and wine. And Seventh-Day Adventists in Loma Linda follow a “biblical” diet focused on grains, fruits, nuts and vegetables; and they drink only water.

While trying to follow general Blue Zone precepts, I have trouble with the specifics —determining when my stomach is 80% full;  or, the suggestion to “Move naturally,” forgoing “mechanical conveniences for house and yard work.” I am not involved in a faith-based community, and digestive issues prevent me from eating many beans. Mostly I worry that residence in a Blue Zone community would heighten already-existing pressures to improve my diet—notably by reducing salt and sugar—along with disapproval of regular lapses that include ice cream and cookies.

—Mary Carpenter regularly reports on topical subjects in health and medicine.