Wellness

The Geographic Areas Where People Live the Longest—and Clues as to Why

The Geographic Areas Where People Live the Longest—and Clues as to Why

Even as Silicon Valley and scientists all over the world try to crack the code for living longer and aging better, the best ways to increase health and extend longevity remain decidedly low-tech. National Geographic fellow and NYT bestselling author Dan Buettner has studied longevity hotspots—the places where people live the healthiest for the longest—around the world. With a grant from the National Institute on Aging, he (and a team of scientists and demographers) set about, as he puts it, “to reverse-engineer longevity.” They established methods to tease out what might explain the long life spans in these places—there turned out to be five of them, now known as Blue Zone areas. The common denominators, or lessons for living that Buettner gathered from them, are distilled into his books (see The Blue Zones for starters)—and here he shares the most important takeaways for all of us.

(Stay tuned as we plan to catch Buettner—he’s also an avid cyclist who likes to walk and talk—for a follow-up interview on The Blue Zones of Happiness. Because once we’re living longer, we’d like to be happier, too, thanks.)

A Q&A with Dan Buettner

Q

What are the five Blue Zones and what are people doing in them that’s so different?

A

Sardinia, Italy

On the island of Sardinia, you find the world’s longest-lived men. The longevity phenomenon here is mostly concentrated among the shepherds, who typically eat a variation of the Mediterranean diet that’s very high in beans, sourdough bread, and a special kind of wine called cannonau, which contains more flavonoids than most wines.

Okinawa, Japan

These islands are home to the longest-lived women in the world. Their diet is also mostly plant-based, and high in tofu, bitter melon, and turmeric. What stands out in Okinawa are the notions of ikigai (to be imbued with a sense of purpose) and moai (a strong social network).

Nicoya, Costa Rica

The lowest rate of middle-aged mortality is on the Nicoya peninsula—which means these people have the best chance of living to a healthy age of ninety. The people of Nicoya consume what I consider to be the best diet the human species has ever had, dominated by three foods: corn tortillas, black beans, and squash, complemented with tropical fruits, year round. It’s cheap, it’s delicious, it’s high in complex carbohydrates, it has all the amino acids necessary for human sustenance, it’s sustainable for the land, and doesn’t deplete the soil or involve slaughtering animals (both are problematic for the environment).

Loma Linda, California

We’re increasingly finding that these zones are not so much places but, rather, lifestyles. In Loma Linda, the Blue Zone lifestyle belongs to the members of the Seventh-Day Adventist Church, who are the longest-lived Americans. They take their diet from the Bible, which, again, is plant-based (i.e., all plants that bear seeds and all trees that bear fruit), and typically vegetarian. The Adventists tend to hang out with other Adventists, and health is a core value for them—they don’t tend to smoke or drink, and they value religion and relationships.

Ikaria, Greece

In Ikaria, people live about eight years longer than the average American with almost no dementia. So they’re living a long time and staying sharp until the very end. They eat the purest form of the Mediterranean diet (vegetables and fruits, whole grains, beans, olive oil). They also drink a lot of herbal teas with sage, oregano, and rosemary. What’s most interesting about their diet, though, is that it includes about 120 kinds of greens that we would essentially weed-whack in the US. In Ikaria, they cut these greens down gingerly and make them into wonderfully exotic salads, or bake them into beautiful pies. Many of these greens have ten times the antioxidants you’d find in wine. And our study found that eating about half a cup of cooked greens a day is associated with about four extra years of life expectancy.

“What’s most interesting about their diet, though, is that it includes about 120 kinds of greens that we would essentially weed-whack in the US.”

Q

What’s the biggest misconception about Blue Zones?

A

It’s a mistake to think that you can go to a Blue Zone area, find an ingredient there, bring it to your home, and rub it on your face, or eat it, and get the longevity benefits. That’s not how it works. For the most part, it’s about a cluster of factors, none of which are easily packaged or marketed. People should not read about Blue Zone areas and think, “Oh, I’m gonna go buy beets, or turmeric and sweet potatoes and I’ll live a long time.”

Q

Can you explain the cluster of factors?

A

When people live a long time, it’s because longevity ensues from their habits, which ensue from having the right environment. So, what’s the right environment?

It’s an environment that aids you in eating a plant-based diet. In all the aforementioned five places, beans and greens and whole grains and fresh vegetables are cheap and very accessible. What’s most important is that those communities have time-honored recipes to make their plants taste good—so they eat ‘em. Unlike us, who live in a forest of junk food restaurants, where what’s cheap and accessible is burgers, fries, pizzas, and crap.

In the Blue Zone areas, people have a vocabulary for purpose. They wake up in the morning and they know how they’re going to spend their day. They’re not suffering the existential stress of wondering, “What am I here for?” It’s very clear. It’s usually for family, occasionally religion, and occasionally they’re part of a bigger community that they feel responsibility towards.

“In the Blue Zone areas, people have a vocabulary for purpose. They wake up in the morning and they know how they’re going to spend their day.”

The scourge of electronics networks hasn’t destroyed them yet—as it’s destroyed us. Instead of imploding into their devices as we increasingly do in America, there’s an expectation in the Blue Zone areas that people are connected socially. If you don’t show up to church, or if you don’t show up to the village festival, or people don’t see you for a couple of days, you’re going to get a knock on your door. But they also live in communities where you’re always bumping into people organically. You walk out your front door, and you run into people you know every day. Loneliness has been associated with shaving several years off life expectancy.

Q

Diet seems to play such a big role in longevity—how do you account for the differences across the Blue Zones, or individuals?

A

If you want to know about a centenarian’s diet, you can’t just meet him or her and ask, “So what do you like? What did you eat yesterday?” It infuriates me to see media reports where some journalist talks to a hundred-and-ten-year-old woman and she says, “Well, I ate three eggs, and had a glass of whiskey”—and then that’s the headline! If you want to know what a hundred-year-old ate to live to a hundred, you have to know what they ate as kids, when they got married, when they were middle-aged, and when they retired.

We did hundreds of dietary surveys in the Blue Zones (you can see the meta-analysis in the book The Blue Zones Solution), and what’s clear is that 95 to 100 percent of their dietary intake came from low- or non-processed, plant-based food. The pillars of longevity diets everywhere are greens, whole grains, beans, and nuts. Unless you have an allergy or another complicating condition, most of us should be eating those four things every day. And if you are eating them, you’re probably adding five years to your life expectancy.

“It infuriates me to see media reports where some journalist talks to a hundred-and-ten-year-old woman and she says, ‘Well, I ate three eggs, and had a glass of whiskey’—and then that’s the headline!”

In the Blue Zone areas where they do eat meat, it’s occasional—usually no more than five times a month (less in the places with greatest longevity), and typically for celebratory purposes. They eat a little fish—less than twice a week, if they eat it at all. They drink a little bit (wine) but no soda. It’s usually water, tea, and some coffee.

So, it’s a relatively low-protein and high-carb diet. Now, you have to be careful when talking about high-carb diets: Carbs have gotten a bad rap because both lollipops and lentil beans are carbs—and they’re completely different foods. In the Blue Zone areas, about 65 to 70 percent of their dietary intake is coming from complex carbohydrates—mostly plants.

Q

What else has stuck with you about the Blue Zones?

A

There appears to be an inverse relationship between the amount of time you spend on your devices and how long you live, or at least how healthy you are. I’m going to say we’re increasingly going in the wrong direction in America.

Relying on the healthcare system is, I believe, a mistake. The healthcare system waits on you to get sick, and then sells you a drug or a service or a procedure to get you less sick. If you really want to get healthier, lead a charge to make your community healthier—change the defaults—or move to a healthier place. For example, see Boulder, Colorado; Santa Barbara or San Luis Obispo in California; Minneapolis, Minnesota; and Portland, Oregon.

Q

Are you still looking for new Blue Zones areas?

A

Yes, and we have some candidates, but they’re pretty much disappearing. As soon as the standard American diet hits these places, it all goes to hell. Most of the Blue Zones that we’ve found won’t be Blue Zones in a decade. But we’ve distilled out the operating system, the blueprint, and we saved it. That blueprint offers, say, a meaningful plan for other places to become healthier, longer.

Q

Can you talk about the work your group is doing now to create greater longevity in other places?

A

The idea for Blue Zones Project comes from the organizing principle of Blue Zones—that longevity ensues; it’s the product of living in the right environment. We basically assume that human beings are genetically hardwired to eat fat, sugar, and salt, and take rests whenever they can. So, instead of trying to fight that ever-present and strong inclination, we set up environments in which people are nudged into eating more plant-based (and sometimes less overall), and socializing more. We help them find their sense of purpose, usually through some kind of volunteer work. We connect them with other like-minded people. We help them to move naturally. The average American has been said to burn fewer than a hundred calories a day engaged in exercise. Exercise, by the way, is an unmitigated public health failure. It works for a few people, but the average American doesn’t get enough of it. Just by living in the properly designed community, though, you can raise your physical activity level by about 30 percent without even realizing it. And that’s what we help people do.

Q

How do you go about changing these environments?

A

Depending on the size of the city, we have a team as small as five people working full-time for five years and as big as thirty-three people doing the same. In each city, we organize into three squads:

First squad is the “people” squad. Their job over the course of five years is to reach 20 percent of the population who want to sign a Blue Zones pledge. This means they agree to let us help connect them with other healthy-minded people, learn their sense of purpose, volunteer, learn more about Blue Zones, and take a test that allows them to measure how long they’re likely to live. It’s called the True Vitality test (you can take it online). We start people with their current baseline and then go from there—if you can’t measure it, you can’t manage it.

We call our second squad the “place” team. We have a Blue Zones certification program for schools, grocery stores, restaurants, and workplaces. Essentially, if they achieve about 80 percent of our list of twenty-something things for creating a healthier environment—they get certified. In restaurants, for example, one goal is offering three plant-based entrees. Another is not automatically serving bread and butter at the beginning of the meal—customers can ask for it, but it’s not the default. You don’t get free sodas; you have to pay for them. There’s a line of desserts that’s only a hundred calories instead of five hundred calories. So you’re not depriving people of dessert, just engineering out eighty percent of the bad calories.

“Instead of trying to fight that ever-present and strong inclination, we set up environments in which people are nudged into eating more plant-based (and sometimes less overall), and socializing more.”

Third is our policy squad. We work on policy around food environment, landscape and building (looking at active living—like, re-designing streets for humans and not just cars), tobacco, and alcohol. If a city wants Blue Zone certification, they have to implement about eight to ten of the best-practices policies we’ve aggregated from around the world—which is the cheapest way to make a place healthier.

To underscore, food is important. Let’s say you live in a place, like much of Iowa for example (where we’ve successfully created Blue Zones communities), where the food choices are limited to places like Dairy Queen, Casey’s, Taco Bell, Taco John’s, McDonald’s. You can tell people all day long that they should be exercising their individual responsibility and making better choices, but if ninety-nine out of a hundred available choices are bad, it’s really difficult. So in our Blue Zone cities, we help them adopt policies to make fruits and vegetables cheaper and more accessible, and we proactively limit the concentration of junk food places.

Q

Will you give an example of the Blue Zones process at work?

A

Perhaps surprisingly, the cities that have embraced this best are more conservative—places that are often willing to forgo a little economic development to build a healthier environment for their children to grow up in.

If you take any one of the ideas I mentioned—just people, or just places, or just policy—you don’t have enough intensity to produce a change. It really relies on unleashing this healthy, comprehensive swarm of nudges and defaults at the city or population level.

We measure the effects of our work with Gallup. For example, outside of LA, in the three cities of Redondo Beach, Manhattan Beach, and Hermosa Beach—we saw the BMI go down by about 15 percent in five years. (This was measured against California controls—so it wasn’t that all cities in the state achieved this.) It means that there are 1,900 fewer obese people in this area now than when we started. Plus, the childhood obesity rate went down by 50 percent.

“The last group is the secret key—people who are civic-minded, hell-bent on making a difference, and not doing it for money or recognition, but because they’re good citizens.”

So, change is possible, and the process is working in every city we go to—but it only happens when you don’t rely solely on individuals to be disciplined and vigilant. Cities have to want to change—they self-select and come to us to be accepted into the program. The leadership in the city has to demonstrate that they really, genuinely want change and that they work well together—we’re not going to show up somewhere, say we’re going to make the healthy choice the easy choice, when secretly the city is against that.

And when I say leadership, I mean three components: 1) the conventional mayor, city manager, city council set-up; 2) the CEOs and the chamber of commerce (if they don’t buy in, you don’t get anything done); and 3) the unelected people who I call “get ‘er done” people. Having done this work in twenty cities, I’ve found that the last group is the secret key—people who are civic-minded, hell-bent on making a difference, and not doing it for money or recognition, but because they’re good citizens. Getting those people involved is the crucial component.

From there, we just engineer people’s choices to be healthier.

Q

Are you accepting more communities that want to be Blue Zones? Where does funding come from?

A

If any community leaders are interested in bringing this to their community, we want to talk to them. Reach out via info@bluezones.com or our contact page.

Once a city is in, we have to find a way to pay for it. Typically, it’s the hospital system, a public health foundation, or more and more it’s the insurance company—Blue Cross and Blue Shield plans pay us to do this.

Dan Buettner is a National Geographic Fellow and multiple New York Times bestselling author. His books include The Blue Zones: 9 Lessons for Living Longer from the People Who’ve Lived the Longest; Thrive: Finding Happiness the Blue Zones Way; The Blue Zones Solution: Eating and Living Like the World’s Healthiest People; and The Blue Zones of Happiness: Lessons From the World’s Happiest People.

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

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