Caitlin Beale, MS, RDN

Since the dawn of life itself, humans have been searching for ways to live longer and healthier lives. While there isn’t a magic pill or potion that will make us live forever, certain routines and lifestyles seem to extend lifespan.

In his book and research on the “Blue Zones,” author Dan Buettner, a National Geographic explorer, discusses the top five high-concentration habitats of centenarians (people who live to the age of 100 or older) worldwide. These groups have been documented to live longer, healthier lives than their peers in other parts of the world.

The proverbial fountain of youth is a myth. However, people living in these five geographical regions seem to enjoy a lifestyle that has allowed them to live long lives, and more importantly, live them well.

Blue Zone Commonalities: Diet and Exercise for Longevity

According to Buettner, the common lifestyle practices in the Blue Zones feature waking up with the sun, eating a big breakfast and a smaller dinner (aligning with the old adage attributed to Adele Davis, “Eat breakfast like a king and dinner like a pauper.” Meals are eaten with family, not in front of the TV, and are whole food based. Blue Zone residents tend to work outside in a garden that corresponds to the three annual growing seasons. They are physically active from working and walking outside.

Blue Zone Communities Support Healthy Minds

Blue Zone dwellers stand apart not only because of their diet and exercise practices. They are also mentally active because of constant engagement with family, community, and the land. The foundation of their lifestyle is movement and socializing and having purpose. Communities of like-minded people invite health-conscious living with a purpose.

What Are the Blue Zones?

The blue zones include five regions where people live exceptionally long lives (over 100 years). Below is a breakdown of these five regions, with more detailed descriptions of each population’s specific practices. Each location has more than ten times the number of people over the age of 100 compared to the United States.

1. Okinawa, Japan

People living in this Blue Zone region have the highest life expectancies in the world. From a diet perspective you may think they eat a lot of fish; however, it was noted in the Blue Zones research[1] that less than one percent of their diet is fish. Meat, dairy, and eggs also make up less than one percent of the Okinawan diet. Most of the diet consists of vegetables and beans, with the majority of calories coming from orange and purple sweet potatoes. This type of diet contains several antioxidants and can support healthy inflammatory function. Okinawans who follow this type of diet also benefit from

• 6-12x fewer heart disease deaths compared to the United States

• 2-3x few colon cancer deaths compared to the United States

• 7x few prostate cancer deaths compared to the United States

• 5 ½ x lower risk of dying from breast cancer than the United States

However, the younger generations are influenced by fast food that has made its way to the island.

Another point in this region is the 80% rule. Okinawans recite the phrase “Hara hachi bu”[2] before every meal. It’s a Confucian proverb that reminds them to eat only till their stomachs reach 80% fullness. This mindful style of eating is part of the reason Okinawa has a higher percentage of centenarians than other parts of the world.

A sense of purpose is found in all five regions of the Blue Zones. But in Okinawa, this way of life has a name, ikigai. Okinawans are active through biking and walking as well as martial arts and dancing. They are connected socially and have many hobbies that allow them to view life in a positive light.[2]

2. Sardinia, Italy

The Sardinian Blue Zone is in the central-eastern mountains of Sardinia. There are 14 villages located in the Ogliastra and Barbagia subregions that display what researchers have identified as the “extreme longevity index”.[3]

A novel aspect identified in this region shows the high frequency of male representation with a ratio of about 1:1 between males/females. Normally, studies on longevity show female-dominant populations, which makes Sardinia quite unique.[3]

Environment plays a significant role in health and may contribute to longevity. Infectious disease has made its way to Sardinia, and the history of exposure to diseases such as tuberculosis, H. pylori, malaria, and others likely affected the immune systems of individuals living there and influenced their ability to age successfully.[3]

Other aspects that support the Sardinians’ healthy longevity include lifestyle, genetic and epigenetic factors, and infectious agent exposure. [3]

3. Nicoya Peninsula, Costa Rica

Nicoya Peninsula is known for different factors that contribute to it being known as a Blue Zone, one of which is “plan de vida” or “reason to live.” This perspective gives elders a positive outlook and helps keep them moving and active. Another factor is family with the ability to listen and laugh. Centenarians in Nicoya visit with neighbors and live in multigenerational households who help provide support and a sense of purpose. They focus on their families, eat fewer calories at dinner while maintaining a traditional Mesoamerican diet focused around squash, corn, and beans.

Another unique aspect of Nicoya Peninsula is that the water has the country’s highest content of calcium. This might explain the lower rate of heart disease, and lower rates of hip fracture thanks to stronger bones. As with other Blue Zones, hard work, being outside, maintaining social networks, and embracing family heritage play a role in their longevity.[4]

4. Icaria, Greece

This small island in Greece is the home to 10,000 people who live 8-10 years longer than Americans and experience significantly less disease (e.g., half the rate of heart disease, fewer cases of cancer, and interestingly, almost no cognitive diseases like dementia).[5] Most Americans over 85 have a high probability of neurodegenerative disease like Alzheimer’s, but in Icaria it’s a less than 10 percent chance. How are they staying sharp through their entire lives?

Icarians eat a strict Mediterranean diet, the strictest in the world. It includes a high percentage of fruit and vegetables, whole grains, beans/legumes, red wine, and olive oil. The Icarians eat significantly less fish and meat, and considerably higher amounts of greens compared to a traditional Mediterranean diet.

Herbal tea is a staple in the Icarian diet, consumed daily. The teas are made with plants from inhabitants’ gardens and those that grow in the wild. The herbs consist of oregano, dandelion, sage, and rosemary. These herbs offer a mild diuretic effect and support healthy inflammatory processes. Diuretics help keep blood pressure low and support excretion of sodium via the kidneys, leading to clean arteries and healthy blood flow.

Daily activity through walking also supports Icarians‘ long lives. Since Icaria is located in the mountains, most visits to neighbors include a walk uphill. This also allows for social support, similar to that seen in the other Blue Zones. They celebrate with friends and family during village festivals, church, and other celebrations. In 2023, the reported prevalence of depression the United States is at its height, with nearly 18% of U.S. adults currently being treated for depression. The daily practice of social support and connection followed by the Icarians seems to foster a culture with far less depression than that of Americans.

5. Loma Linda, California

This is the only Blue Zone in America, and is the home of about 9,000 Seventh Day Adventists. They can live as much as a decade longer than the rest of Americans, likely due to a vegetarian diet, exercise, no smoking, or alcohol.[6]

Other factors that support their long lives include focusing on a 24-hour sabbath to focus on God, family, and nature. They explain the sabbath relieves stress, strengthens relationships, and provides consistent activity. Their social network is usually with other Adventists, thus supporting one another.

While they maintain a vegetarian diet, they consume a high amount of nuts, usually at least five times a week, which can lower risk of heart disease and may help them live two years longer. Studies on the Seventh Day Adventists in this region associate a vegetarian diet with lower obesity and cardiovascular disease rates. Both of these conditions are related to accelerated aging and loss of quality of life. And if meat is eaten, it’s in small amounts and not the focus of the meal.

As with many faiths, giving back and purpose are encouraged in the Adventist church. They are encouraged to volunteer and focus on others.

The Power 9

We have seen the data above from each of the Blue Zones, but what are the primary factors by which they live? Dan Buettner, the author of the Blue Zones, partnered with scientists to dig deep into the secrets of the people from these areas.

The team worked on Blue Zone research document the Danish Twin Study, which indicates that genetics influence lifespan by only about 20 percent, while the remaining 80 percent is determined by lifestyle. The team found the five regions around the world where the residents had the highest life expectancy and the highest proportions of people reaching 100. Researchers found nine traits among the five regions that they had in common, known as the Power 9®.[7]

What Is the 80% Rule?

Residents of the original Blue Zones embody what has been coined Power 9, which includes eating wisely. The Confucian proverb hara hachi bu meaning to eat until you are 80% full originated in Okinawa as a way to manage eating habits. Coincidentally, they happen to have the lowest rates of illness due to heart disease, cancer, and stroke and their life expectancy is quite long. This advice can help reduce calories and support ideal weight.[8]

The premise around hara hachi bu is to decide prior to eating that you how much of your plate will make you full and eat 80% of that.[7] This seems tedious and analytical when it comes to eating, so another way you could look at it may be to be grateful prior to eating and slow down so your brain has time to receive the signal of what you have already eaten.

Many Americans eat in front of the TV or computer and mindlessly clean their plate without tasting their food. When you step away from distraction to have a meal, you’re more likely to savor it, eat mindfully, and enjoy each bite. If you finish your meal and still feel hungry, wait about 20 minutes so your brain catches up to your body. This may seem overwhelming, so start with small steps. One of the easiest is to step away from the TV or computer to have your meal, be grateful, and enjoy!

Blue Zone Takeaways: Simple Practices for a Longer, Healthier Life

While these regions appear to have tapped into the proverbial fountain of youth, their lifestyle reveals many of the simple things in life that can be incorporated into most American’s routines. Many of the factors in the Power 9 are good sense, yet few Americans have mastered them. However, the Adventists in Loma Linda, California, have demonstrated that you can live 10 or so more years by adopting the nine traits of the Blue Zones. Ask yourself, are you able to implement a few of these traits into your daily routine? It just may change your life!