The Blue Zones: 9 Lessons for Living Longer From the People Who've Lived the Longest

by Dan Buettner

Scientific studies suggest that only about 25 percent of how long we live is dictated by genes, according to famous studies of Danish twins. The other 75 percent is determined by our lifestyles and the everyday choices we make.

the Blue Zones themselves: the Barbagia region of Sardinia in Italy, Okinawa in Japan, the community of Loma Linda in California, the Nicoya Peninsula in Costa Rica, and the Greek island of Ikaria.

Steven N. Austad, Ph.D., studies the cellular and molecular mechanisms of aging at the University of Texas Health Center at San Antonio. A professor at the Sam and Ann Barshop Center for Longevity and Aging, he is the author of Why We Age: What Science Is Discovering About the Body’s Journey Through Life.

Just think about it: If antioxidants were so healthful, the whole generation that grew up eating Twinkies, Wonder Bread, and the like (the kinds of foods that are loaded with antioxidants to assure that they had a long shelf life and would never spoil) should never grow old.

DHEA, human growth hormone, and melatonin are all extremely questionable, and are probably ill-advised. Using human growth hormone in human beings bulks them up. But it does not just mean more muscle mass. With it can come hypertrophy of the heart, fluid retention, and other problems. And of course there’s a disease, acromegaly, which is actually characterized by an excess of human growth hormone. DHEA is what’s for years been called the “junk hormone.”

The best source of information on hormones is Marc Blackman at the Washington, D.C., Veterans Affairs Medical Center, or Mitchell Harman at the Kronos Longevity Research Institute in Phoenix, Arizona.

Most vitamin requirements are best achieved by eating six to nine servings of fruits and vegetables a day.

If you’re an older man, you should not have a supplement with iron because iron accumulates in the heart and can lead to a condition called hemosiderosis.

As he zeroed in on municipalities that had the greatest numbers of long-lived people, he circled the area on a map with blue ink—giving rise to the term “Blue Zone,” which was later adopted by demographers.

Francalacci popped a disk of Barbagia folk music in his player and the apartment filled with the nomadic, faraway sounds of Sardinia’s highlands—shepherds’ voices harmonizing to the multi-pipe instrument called launeddas.

Latins called a foreigner barbarus, from the ancient Greek word barbaros, which supposedly mimics the sound of someone trying to speak Greek.

Later I was invited into his low-ceilinged kitchen for papassini—a Sardinian cookie made with raisins, almonds, and a jam made from cooked wine (saba).

The region’s Cannonau grapes endured the harsh Sardinian sun by producing more red pigment to protect from the ultraviolet rays. These grapes traditionally were allowed to macerate longer than in any other part of the island during winemaking. The result was a red wine with two to three times the level of artery-scrubbing flavonoids than other wines. Goat’s milk and mastic oil may be Sardinia’s other two longevity elixirs.

Sardinian men seem to possess a temperament that enables them to shed stress. They are at once grumpy and likable, and often joke at the expense of one another. (It’s probably no coincidence that the word sardonic has its roots on this island.)

Gianni Pes thinks it might be something that Sardinians get, of all things, from goat’s milk and cheese. He wrote to me recently to tell me that he’s found a plant, Sardinian dwarf curry, that grows on the slopes of the Gennargentu Mountains and around the village of Arzana. An anti-inflammatory and bactericidal substance has been recently extracted from this plant.

When compared to cow’s milk, goat’s milk delivers a powerful nutritional punch: One glass contains 13 percent more calcium, 25 percent more vitamin B6, 47 percent more vitamin A, 134 percent more potassium, and 3 times more niacin. Results of a 2007 University of Granada study found that it may also be better at preventing iron deficiencies and mineral losses in bones.

In Okinawa people enjoy what may be the highest life expectancy (in 2000 figures that worked out to be 78 years for men and 86 years for women), the most years of healthy life (the Japanese have the greatest number of disability-free years at 72.3 for men; 77.7 for women), and one of the highest centenarian ratios (about as high as 5 per 10,000). They suffer from diseases that kill Americans, but at much lower rates: a fifth the rate of cardiovascular disease, a fourth the rate of breast and prostate cancer, and a third the rate of dementia.

Dr. Greg Plotnikoff,

who completed residencies in both internal medicine and pediatrics at the University of Minnesota, holds a divinity degree from Harvard, and is one of the world’s leading experts on Kampo, Japan’s traditional herbal medicine.

But what really astounded him was the proportion of healthy centenarians. In the United States or Europe, you can expect only about 15 percent of centenarians to be independent in their activities of daily living. Although later cohorts of centenarians tend be less functional than earlier cohorts, amazingly, of the 32 centenarians Dr. Suzuki was able to track down for the second part of his survey, all but 4 were functionally independent.

Even when times were good, all we ate was imo (sweet potato) for breakfast, lunch, and dinner.”

The idea of retirement never occurred to the Okinawan peasant. To this day there’s not a word for it in their language.

Things improved a little in 1605 when an Okinawan brought the sweet potato back with him from China.

By the time of Kamada’s birth in 1902, Okinawans got 80 percent of their calories from sweet potatoes.

Before each meal she takes a moment to say hara hachi bu, and that keeps her from eating too much.”

“All of the old folks say it before they eat. It means ‘Eat until you are 80 percent full.’

It took me a long time to realize that beauty is within. It comes from not worrying so much about your own problems. Sometimes you can best take care of yourself by taking care of others.”

“Eat your vegetables, have a positive outlook, be kind to people, and smile.”

Soy products that contain phytoestrogens are probably better than hormone supplements, he said. Some researchers speculate that they may impart many of the benefits of estrogen without the cancer dangers. Okinawans eat an average of three ounces of soy products per day. Tofu, their main source of soy, may play a role in reducing the risk of heart disease. Greg Plotnikoff recommended that consumers select fermented soy products over nonfermented soy products whenever possible. “The medical literature demonstrates comparatively much better nutritional content in fermented soy,” he said. “And Okinawan tofu has a greater concentration of protein and good fat than even its Japanese or Chinese counterparts.”

“I think the fact that she still retains her duties as a noro is very important,” he replied. “Roles are very important here in Okinawa. They call it ikigai—the reason for waking up in the morning.

I had intentionally timed my visit for the gathering of her moai—the group of lifelong friends who meet at Kamada’s every day.

People don’t realize how bad sugar and meat are for them over time.” “Why’s that?”

“Its called bio-ecological prevention, or risk. Let me explain. Simple, nonprocessed foods, often found in rural societies are associated with positive ecology of friendly bacteria in our intestines. These friendly bacteria include immunomodulating and fiber-fermenting lactic acid bacteria,” Greg said. “Stressors of this healthy ecological system,” he continued, “such as surgery, certain medications, and consumption of meats and processed foods disrupt a natural balance and shift from friendly to unfriendly bacteria. This shift results in increased risk for diseases of urban or ‘sophisticated’ societies, such as inflammatory bowel disease, colon cancer, and more. It’s associated with a low-grade systemic inflammation that is related to increased risk for all diseases of aging, like osteoporosis, heart disease, and dementia.”

“Obesity is certainly a risk factor,” Greg replied. “But eating junk food also creates chronic inflammation of the gastrointestinal tract. The inflammatory response is good if we have an infection, but triggering it all the time by eating bad foods causes the body to produce chemicals that wreak havoc on our organs and arteries. People think that our skin is the main way our bodies interact with the outside world, but it is actually through our digestive tract—our stomach, large intestines, and small intestines. It has a surface area about the size of a tennis court. That’s a lot of inflammation for our bodies to deal with.”

Okinawan mugwort is one species of the genus Artemisia, which contains the most powerful natural substance for fighting malaria. The World Health Organization recently made it a top priority for one form of Artemisia to be available in developing countries.”

Turmeric is one-fifth as powerful as cisplatin, which is one of the most powerful drugs in chemotherapy. Turmeric is an anti-inflammatory, antioxidant, anticancer.

The Okinawan meal has three or four times as much volume and more nutrients but only about half the calories of a burger. So you’re feeling fuller but getting leaner and living longer. And if you remember Kamada’s hara hachi bu and eat only until you’re 80 percent full, you’ll even do better.”

I explained my theory of cultural evolution. After leading 17 expeditions to explore ancient mysteries, I noticed that over time, customs and traditions of successful cultures seem to undergo an unconscious but intelligent natural selection: Practices not good for a society tended to disappear while beneficial ones often survived—no matter how counterintuitive they may seem. I remember a story about a tribe in sub-Saharan Africa that cooked over open fires inside their huts. The huts filled with smoke that the villagers breathed. When a Peace Corps worker saw this he reasoned that the people’s lungs were blackening with smoke. He asked them why they cooked indoors. When no one had an answer for him, he convinced them to move their cooking fires outside. Soon the people started contracting malaria at an alarming rate. It turns out that the smoke kept malaria-carrying mosquitoes out of the huts. This outweighed the negative health effects of the smoke.

Capsaicin, pepper’s active ingredient, is literally caustic to the flesh. But somehow, human taste has evolved to enjoy the taste of pepper. Why? Because capsaicin is a natural disinfectant, and it kills many types of food-borne bacteria. Put hot pepper in slightly rancid meat, and it inhibits bacteria. The person who eats the meal with the pepper lives. The person who eats the meal without the pepper gets sick and could die.

“I think vitamin D is an important ingredient in the longevity recipe,” he said enthusiastically, as if just struck by an epiphany. “Your skin manufactures vitamin D when it comes into contact with the sun. Without that vitamin D, we increase our risk for nearly all age-related diseases including many types of cancer, high blood pressure, diabetes and even autoimmune diseases like MS (multiple sclerosis). “Insufficient vitamin D markedly accelerates heart disease in kidney patients. For everyone, without enough vitamin D, bones become brittle, key hip and leg muscles become weak, and the chance of falling and breaking bones soars.

To find balance, the National Institutes of Health advises 10–15 minutes of sun exposure twice weekly, then applying sunscreen with an SPF of 15 or higher afterward.

“Also,” continued Craig, “do you see how she springs up and down from the mat?” How many 80-year-olds back home can get up from the floor like that? Gozei’s over 100 and probably gets up and down 30 times a day. For her age, she has incredibly good lower body strength and balance. That makes a huge difference in old-age mortality because falls and broken bones are usually fatal when seniors reach a certain age.”

It occurred to me that I was witnessing the happy limits of the human machine. I sensed neither the frailty nor the wistfulness of impeding death but rather serenity—a certain satisfaction with a life now free of the ambition and commitments that dog younger years—a life achieved.

The big difference between centenarians and younger populations was the greater appetite for vegetables, and especially for dairy products, among centenarians. They didn’t necessarily eat more or less than others, relative to body weight, but what they did eat was rich in calcium, vitamins, and iron.

“We see that people over 40 tend to get less happy with age, until about age 80,” he said, drawing a U-shaped curve on a piece of paper. “That’s when their well-being begins to curve upward again. By the time a woman reaches 100, she is happier than a 40-year-old, even though she’s probably functioning poorly. This is due to our favorable social environment. Americans emphasize biological aging. You tend to age alone. In Japan we focus on social, environmental aging. We think about aging in the context of a family or community.”

After being starved for so many centuries, Okinawans seized this new food culture. They quickly developed a taste for canned meat (Hormel to this day still exports approximately five million pounds of SPAM a year to Okinawa) and fast food (Okinawans eat more hamburgers per capita than any of Japan’s other 47 prefectures). A sharp increase in obesity-related diseases such as diabetes has ensued. Okinawa now has Japan’s highest rate of obesity, and, among middle-aged men, one of the highest rates of premature deaths from cardiovascular diseases.

In California, the study showed, a 30-year-old Adventist male lives 7.3 years longer than the average 30-year-old white Californian male. A 30-year-old Adventist female lives 4.4 years longer than the average 30-year-old Californian white female. “If you go to Adventists who are vegetarian,” said Fraser, “it becomes 9.5 years longer for men and 6.1 years longer for women. It is not surprising why this is so. About two-thirds of people either die of heart disease or cancer, and the Adventists do a number of things to protect themselves from heart disease and different cancers.”

‘Does nut consumption matter?’ And every time we saw that it did.”

“Now when you talk about AHS-1 and cancer, it gets a little more controversial,” he cautioned. “Because, despite hundreds of studies and huge amounts of press, what epidemiologists know with certainty about diet and cancer can be stated in a single paragraph. And that would say that consuming fruits and vegetables and whole grains seems to be protective for a wide variety of cancers.”

But if you look at the AHS-1 data, it is very clear that men who drank five or six glasses of water a day had a substantial reduction in the risk of a fatal heart attack—60, 70 percent less—compared to those who drank considerably less water.