What factors do you need to reach a ripe old age and still be in good health?
Studies of people living in the so-called ‘Blue Zones’ have revealed some fascinating insights. A Blue Zone is an area with a remarkably high number of centenarians and there are 5 official Blue Zones in the world: Sardinia (Italy), Okinawa (Japan), Nicoya peninsula (Costa Rica) and Ikaria (Greece). Research conducted over the past 15 years has shown that these areas of longevity are due largely to a result of the lifestyle and to a limited extent, their genes. This offers a learning opportunity for those of us living outside of those areas. What lessons do these areas teach us?
Healthy elderly
At the end of the previous century, scepticism about remarkably long-living populations was still prevalent among experts. They were entirely unconvinced when Italian researchers claimed to have identified an especially long-living population in the mountains of Sardinia. Doctor and biomedical researcher Giovanni Pes vividly recalls the time he presented his results at a conference in Montpellier. Pes told those present that the Sardinians did not only live exceptionally ling, but that the men live as long as the women, too. Everyone thought he was lying…
Belgian demographer Michel Poulain was sceptical as well. But he was the only person prepared to visit Sardinia and see for himself. Together with Pes, he undertook an expedition in January 2000 to verify the ages of the Sardinians using birth registers: 40 centenarians turned out to be as old as Pes had said. Poulain convinced him, however, that there was a more remarkable aspect to his discovery: a particularly high number of healthy elderly people in a concentrated area. Armed with a map of the region, they went from village to village. Each time they confirmed that the inhabitants were indeed very old, they marked the region on the map in blue – hence the term Blue Zone. In total they visited 40 out of the 377 municipalities, and 14 of these, with a total of about 40 000 inhabitants, were coloured blue.
Poulain concluded that Pes and his colleagues had been right. Moreover, by matching data from the birth register with the death register, he noticed that several generations of Sardinians had become exceptionally old. This apparently upset Poulain’s colleagues because they’d counted on him to undermine the Italian findings….
Find more zones
It would take years for Poulain and Pes to convince their colleagues. (In fact, a counter-expedition had been organised without their knowledge). The duo decided to study the Sardinians more extensively, and Poulain began looking for similar areas elsewhere. He was accompanied by National Geographic journalist Dan Buettner, who wanted to write about these enduring communities.
Buettner has read about the population of the Japanese island of Okinawa, which was believed to have the longest healthy life expectancy in the world: about 87 years for women and 81 for men (in The Netherlands its 83 years for women and 80 for men; in the US it’s 81 and 76). Working with a number of researchers, he collected information about the people of Okinawa and managed to gather funds to finance a request to find more Blue Zone regions with Poulain. The latter had managed to find two more area, in addition to Okinawa and Sardinia: the Nicoya peninsula in Costa Rica and the Greek island of Ikaria. There is some difference of opinion on the uniqueness of these areas: Ikaria is said not to be the most ‘blue’ Greek island, for example, but it’s clear that the people in these areas are doing relatively well.
In 2005, Buettner published and extensive cover feature in National Geographic magazine. This feature added a fifth area: Loma Linda in California. Here, a community of Seventh Day Adventists were living about ten years longer than the rest of the US population. According to Poulain, Loma Linda is not strictly speaking a Blue Zone because it’s not a clearly defined area. Seventh Day Adventists live across the world, and the longevity researchers have not gathered any hard data on it. Loma Linda apparently ended up on the list because National Geographic wanted to include an area in the US….
You are what you eat
As these zones were identified, the most intriguing questions needed to be answered: what typifies these communities, in what ways are they alike, and what can people elsewhere learn from them?
One theory states that these relatively isolated populations has simply been blessed with super genes. Poulain was convinced that this was not the case. The people in Blue Zones do not differ substantially from those in the surrounding areas. The key difference though is their lifestyle. Poulain found that, owing to their isolation, these communities have managed to preserve a culture that has disappeared in other places.
Communities in the Sardinian Blue Zone mainly consists of shepherds. They walk a great deal, eat very little meat and consume a lot of (goat’s) milk and cheese, as well as wholegrain cereals and home-grown fruit and vegetables. In addition, they are strongly attached to their family and friends and regularly drink a glass or two of red wine. Ikarians also consume a great deal of goat’s milk, fruit and vegetables and are close to their families. They, too, drink lots of herbal tea and regularly take afternoon naps. On Okinawa, people spend a great deal of time gardening. Their diet is largely vegetable-based, and it is customary to stop eating well before you’re full. They have a phrase for it: Hara Hachi Bu – eat until you’re 80% full. They consume 15% fewer calories than other Japanese. On Okinawa, social networks, called moai, are remarkably strong and can be relied on in difficult times. In Nicoya, people like to eat a hearty breakfast, a fairly large lunch and a light evening meal – just like most Blue Zoners.
Retire or not?
So what is the common denominator? Blue Zoners lead relatively simple and natural lives. However ,it would be wrong to say that they do not suffer from any stress or have any concerns. They, too, worry about their health, money and their children’s future. However ,they have certain rituals and customs that allow them to deal with those concerns. Moreover, they have a sense of purpose. They know exactly what they are doing for their family or community, for example. Older people are valued for their wisdom, rather than being written off on account of their diminishing physical and mental fitness.
It is striking that Blue Zoners do not make a sharp distinction between work and leisure time, and never officially retire. They simply continue to work until it becomes physically impossible. This gives them great satisfaction. This is quite the contrast to many areas in the rest of the world where the working population would rather retire as soon as possible!
It’s also a misconception that Blue Zones only spring up in primitive areas, where modernity has not yet penetrated. Blue Zones arise at the intersection of modernity and tradition. Their inhabitant enjoys the benefits of modern life, such as electricity and good health care, but not the burdens, such as agitation, lack of exercise and poor nutrition.
Because the delineation between modernity and tradition is so narrow, Blue Zones are coming under pressure. Especially in Okinawa, which was in the hands of the Americans between 1945 and 1972. A Western lifestyle gradually became more prevalent, and the younger generation now lives much less healthy lives than their parents. According to Poulain, Okinawa is no longer a Blue Zone because life expectancy there is no longer significantly higher than in the rest of Japan. The other zones are also grappling with problems. Ikaria, and to a lesser extent Sardinia, are impacted by tourism, partly resulting from their Blue Zone status. This makes is even more important to collect as much information as possible while the areas still exist.
Change the environment
How can we learn from the Blue Zones? In the Western world, the average life expectancy has increased over the past decades thanks to improved health care – there are fewer deaths as a result of cardiovascular diseases and cancer – but if we do adopt more healthy lifestyles, life expectancy would be considerably higher. Poulain estimates that we have gained 10 years through improved healthcare, but have lost 8 years as a result of our unhealthy way of life.
The unhealthy lifestyle is largely the result if environmental factors. The Blue Zones are different in that respect. For Blue Zoners, a healthy life is the ‘default option’: they do not have to worry about resisting the temptation of tasty but unhealthy food, getting enough exercise or seeing their family regularly. This means they suffer far less from cardiovascular disease, cancer and dementia. So perhaps one of the most important lessons is to nudge yourself towards a healthy lifestyle.
According to Buettner, if we want to grow old in the same way as the Blue Zoners, we shouldn’t focus in changing our lifestyle, but on changing our environment. This is not always easy. For example, it might mean finding a different circle of friends. People with healthy friends have a much greater chance of leading a healthy lifestyle. If your friends love smoking, getting drunk and barbecues, it could be difficult for your to avoid these things completely.
So what could you do to make your life more like a Blue Zone life?
Here are 8 Blue Zone findings for growing old healthily:
- Move naturally
The gym isn’t necessary, if you move around enough in your daily life, for example, walking, cycling, gardening and physical work.
- Seek a purpose
In our individualistic society, it can be hard to decide what you’re about. Blue Zoners, though, have a strong sense of purpose. They are committed to their children, community and the common good.
- Take breaks
Take time to rest to avoid physical and mental stress, for example, by meditating.
- Abide by the 80% rule
Eat at a steady pace and stop when your stomach is 80% full.
- Eat more vegetables
Eat meat only a few times each week. Beans are a good basis for the rest of the week’s diet.
- Enjoy your glass of wine
Become a moderate drinker just like the Blue Zoners
- Find the right environment
An environment in which healthy choices are self-evident helps to avoid unhealthy behaviour.
- Being with loved ones
There’s nothing wrong with ambition and pleasure in work and hobbies, but your family and close friends are important too.
Now those sound almost like New Years Resolutions! Happy New Year and may 2019 bring you all that you’d most wish for yourself.