Are you familiar with the notion of ‘Blue Zone living’? Several years ago a quite fascinating study (which began life as a National Geographic cover story, entitled “Secrets of a Long Life”, in 2005) by Dan Buettner and Dr. Luis Rosero-Bixby posited the existence of 5 ‘longevity hotspots’ around the world where the populations routinely live to be 100+ years old. 

The residents don’t do anything special, take any miracle meditation, follow any strict and unforgiving health regimens or sacrifice any of their pleasures or happinesses for the sake of their well-being. They don’t even consciously set out to achieve a longer life, or adhere to checklists to live better. Does it sound too good to be true, or does it sound like we’ve got a few lessons to learn?

The (currently identified) Blue Zones are:

1. Okinawa, Japan
2. Ogliastra, Sardinia
3. Icaria, Greece
4. Nicoya Peninsula, Costa Rica
5. The Seventh-day Adventists in Loma Linda, California

This rather non-specific label hasn’t been applied to these areas on the whim of the author, either, by the way - a number of studies have found them to be home to abnormally high numbers of nonagenarians and centenarians (90 and 100 year olds, respectively).

However, what is most interesting, and the reason we are paying attention to it here, is that genetics seem to only play a part in 20-30% of that longevity. In other words, the remaining 70-80% is attributed to environmental influences.

That means 70-80% of longevity is potentially within our direct control.

So let’s dig in and consider a handful of lifestyle and dietary habits that are common to Blue Zone residents with a view of finding opportunities to experiment with them in our own lives.

Food

The Global Trend for Whole Plant Foods

The fashion for a vegan/plant-based diet has grown faster and faster over the past year or two. You’ve probably noticed it whenever you do your grocery shopping: the plant-based food sections that are filling up increasingly larger sections of the aisles, and the advertisements promoting meat-free burgers and vegan alternatives. It’s hard to miss the active conversation that has gotten louder and louder recently.

Yet for those living in Blue Zones, studies show that they care not for fashion or dietary trends: a diet composed mostly of whole plant foods is both functional and practical.

It is a diet rich in:

• Whole grains - rich in fiber and proven to reduce blood pressure, instances of colorectal cancer and death from heart disease.
• Legumes - also rich in fiber, as well as protein, legumes include lentils, beans, chickpeas and peas and studies have shown high correlation between high, regular consumption and lower rates of mortality.
• Vegetables - packed full of vitamins, minerals and fiber. We all know that 5-a-day can help keep the doctor away.
• Nuts - easily vilified when we’re so accustomed to seeing nuts roasted, oiled and salted, a variety of raw nuts in the diet provides a fantastic source of fiber, protein, poly- and monounsaturated fats.

That said, Blue Zone groups are not strictly vegetarian. Their diets are typically 95% plant-based as they consume meat 4-5 times per month and, in some communities such as Sardinia and Icaria, fish (a great source of omega-3 fats) is consumed often.

A quick note about fat.
We’ve been routinely bombarded with contradictory guidelines concerning the consumption of fat (and carbohydrates, though this is a conversation for another day) through sources such as government health drives and the proliferation of fashionable diets such as the ketogenic diet that celebrities are keen to be seen doing. The calories we consume each day fall into three macronutrient categories: fats, carbohydrates and protein, and none of them should be considered as ‘bad’. The hard and fast rule for all calorie consumption: try to consume as few processed calories as possible (i.e. wholefoods will always be the healthiest foods to eat) within the number of calories you need, not want.

Fasting and Knowing Your Limits

Blue Zone inhabitants also practice calorie restriction (don’t worry, it’s not as scary as it sounds), following the 80% rule and periodically adhering to a period of fasting. Let’s break this down.

Calorie Restriction, the 80% Rule & Fasting

The anecdotal evidence here is derived from studying most closely the Okinawans. Prior to the 1960s, when Japan’s economy began to boom, the residents were predominantly eating less than they required which arguably contributed to some of their longevity. Why? Because eating too many calories leads to weight gain and a higher likelihood of chronic disease.

However, the Okinawans also have a custom called ‘hara hachi bu’ which effectively means they eat until they feel 80% full, rather than the full 100%.

Did you know…
...that it takes the brain a full 20 minutes to fully recognise your satiation level? If you take your time with your meals and eat slowly you will likely eat less as you will feel fuller at a more accurate pace (i.e. you’ll be giving your brain a chance to catch up!). Ever wondered why after a nice big Sunday roast you need to go and have a little rest on the sofa?

Many of the Blue Zone communities also have periods of fasting intrinsic to their lifestyles, particularly those where religion plays an important role.

You may have also heard of terms like ‘intermittent fasting’, wherein calorie consumption is limited to a particular window of hours within each day (usually an 8 hour window) or ‘fasting mimicking’ where a person fasts for a few days in a row.

The decision to fast, in any form, requires a certain level of understanding and, certainly if you have an underlying medical condition, it would be advisable to discuss doing so with a doctor first.

The consistent findings across studies looking into fasting are that these practices are likely to considerably reduce the risk factors of particular diseases and increase the length of healthy life.

But remember, restricting caloric intake isn’t self-administered torture! It’s important to know this if you choose to experiment with it.

Alcohol

Arguably a dietary consideration too, though deserving of its own space, alcohol consumption has been observed as a consistent factor across all Blue Zone communities. Want the good news? The Blue Zones are not teetotal.

It is (always) important to acknowledge the breadth of the conversation on any topic and there are certainly studies for and against the moderate consumption of alcohol. However, there is a strong argument for it...

If we pay attention to the communities in Icaria and Sardinia, we can see that it is common for them to enjoy 2 glasses of red wine a day (on average… this isn’t an invitation to drink half a bottle of wine everyday!). Note the type of alcohol: red wine. Red wine is potentially the best type of alcohol to enjoy given that it is so rich in antioxidants.

Why are antioxidants important? The short answer is that these help fight against free radicals, the bodies that damage DNA and, ultimately, contribute to the aging process.

Important note: it is not conclusive that the Icarians and Sardinians are healthier because of the moderate consumption of antioxidant rich red wine (Grenache is the grape with the highest levels of antioxidant although be aware that rich sources of antioxidants include fresh berries and brightly coloured fruits and vegetables) or simply because their lifestyles are, in general, far healthier than most other global communities. What is absolutely conclusive, however, is that the argument for benefits only pertains to instances of moderate consumption. Studies unanimously prove that high levels of alcohol consumption will always increase the risk of earlier death.

Exercise

Some more good news? Communities in the Blue Zones do not tend to carve out 60-90 minutes every day to specifically engage with a workout class, some personal training or go for a run. No. Blue Zone communities have exercise factored into their daily lives.

These activities include things like gardening. Walking. Even daily chores. Everyday things that contrast sharply to mornings spent in cars commuting, days sat at desks working and evenings slouched on the sofa watching TV.

As with our 5-a-day, we all know that exercise is good for us, but how many of us have really adopted a mentality towards incorporating as much movement into our lives as possible? Oftentimes the difference between ‘should’ and ‘will’ is the determination to do it.

Here’s a handful of ideas to think about:

• Why not try walking or cycling to work? Or further than usual if it’s impractical to go the whole way.
• Top and tail your day with a brief stroll around the neighbourhood, or further.
• Spend more time in the garden tending to the plants and flowers and less time bingeing on TV shows.
• Run out of milk? Walk over to the cornershop rather than driving to the store...

The UK government has recently taken steps to promote healthy, active lifestyles in their anti-obesity campaign and the creation of Active Travel England. The NHS’s ‘One You’ campaign is designed to support your journey to better physical and mental health (it includes the fantastic Couch to 5k program) and with the clear evidence of the correlation with poor health and increased risk of Coronavirus complications, the Better Health drive is equally valuable right now.

We don’t need an excuse to look after ourselves better.

Sleep

We’ve discussed the importance of sleep before so it should be no surprise that it is another significant factor in the longevity enjoyed by the Blue Zone communities.

Beyond the incredible volumes of research out there that reinforces just how significant sleep is to our overall health there are a couple of takeaways:

1. 7-9 hours of unbroken sleep is the ideal, with just under 8 hours proving to be the sweet spot (on average).
2. Too little, and indeed too much, can lead to problems such as stroke and heart disease as well as an increased risk of earlier death.

In the study of the Blue Zones there is one factor that stands out: they generally sleep as their body needs, rather than confining their sleep patterns between the trill of an alarm clock each morning and the 5 day prison of set work hours.

Oh, and in the Mediterranean regions of Icaria and Sardinia, it is also common to nap in the day. However, further studies concerning napping, or ‘siestas’, has shown that naps of 30 minutes may be optimal with strong evidence that anything longer can begin to increase the risk of heart disease and/or death.

Purpose

This is one of the elements of the Blue Zone lifestyle that really begins to set these communities apart. Having a life purpose (‘Ikigai’ in Japanese, ‘plan de vida’ in Nicoya, ‘Nunchi’ in Korean… most regions/cultures have their own ‘version’ of it) is associated with a reduced risk of early death.

This may be due to the healthy psychological impact on their well-being. The wonderful thing about having purpose is that it is incredibly personal. If purpose is the reason to get out of bed each morning, purpose in life can be absolutely anything. In Dan Buettner’s TED Talk he cites an Okinawan’s ikigai as being to spend time with her great-grandchildren.

It doesn’t need to be any more complex than that!

Have you realised your life purpose?

Religion & Spirituality

Another common trait across the Blue Zones communities is the involvement of religion or spirituality within them.

Whether this is the Seventh-day Adventists in California or the Buddhist approach to life embraced by the Okinawans, religion and spirituality provide a social support structure and a deep sense of belonging, both of which are likely to reduce levels of depression and, therefore, reduce the risk of early death.

The point here is not to subscribe a healthy life to strict adherence to a religion or belief system, but rather to highlight the commonalities the Blue Zone communities share and for us to derive our own position as to whether we wish to explore them for ourselves.

Mixed Age Communities

In Blue Zone communities grandparents (and even great-grandparents) commonly share a home with their families and studies show this has the potential to decrease the likelihood of early death.

Clearly this is the element of Blue Zone lifestyle observations that is likely to be the most difficult/impractical to replicate. For many of us, sharing multi-generational homes is just not possible.

However, what is more possible, is grandparents spending more time with grandchildren and children making more effort to spend time with their parents.

Socialising & The Health Of Your Network

The people that you surround yourself with can have a considerable influence over your own health. In fact in Okinawa they have a term for it: ‘moai’ (meaning ‘meeting for a common purpose’).

So, if you have a close network of friends and family who are overweight it will appear that weight gain is more socially accepted and so your risk of weight gain could be higher.

Conversely, if your network is filled with peers who are active and eat more healthily then the chances of you being positively influenced by that trend will likewise increase.

Learnings: What Are The Takeaways & How Can You Get Started On Improving Your Longevity?

When we look at it in this simplified fashion, the common traits across the 5 disparate communities, spread across the globe, where average life expectancy is decades longer than the averages elsewhere, begin to paint a picture.

When it comes down to it, is any of the above really all the surprising? Is it unexpected that a life filled with:

• Eating well
• Being active
• Getting enough sleep
• Having a passion and a purpose to get up each morning
• Belonging to a community, whether through religion or another belief system
• Being around different generations of one’s own family
• Having a social network that inspires you

...could help contribute to anything other than a longer life? Of course, contemporary societal construct provides some friction against the above. For many of us sharing a home with multiple generations of our family is not practical, or even possible, and maybe we do not feel inclined to find a religion or subscribe to an established belief system.

But, how many of us can wholeheartedly, and honestly, say that we can’t possibly improve our diet, be more active or find ways of optimising our sleep that work for us? This is not a one size fits all approach to life. We must all approach it smartly and with a clear focus on our own needs and limitations.

One foot in front of the other, no matter how slowly we do it or how big/small those strides are, will take us so much further forwards than staying still ever will. We’ve all got the power to work for a healthier me and we’ve all got the power to support everyone else on their journeys towards doing just that, whether it’s a word of encouragement or the promise to be their ultra-triathlon training partner.

However you choose to approach this, keep your MedicAlert bracelet or necklace on at all times. For the equivalent of just 9p per day, you'll know that we're with you at every step, keeping you safe, just in case.

Learnings Summary

1. A whole plant food-based diet is rich in nutrients
2. Calorie control is not torture! It can lead to lower risk of disease and early death
3. Alcohol, in moderation, may contribute to a healthy diet
4. Exercise can be incorporated into your day as part of an active lifestyle, rather than a requirement to attend a gym
5. Sleeping between 7-9 hours a day, unbroken, is optimal for a healthy body
6. Finding one’s purpose in life can help reduce the risk of early death
7. Belonging to a community unified by a religion or belief framework can reduce levels of depression
8. Sharing an environment with different generations of your family can, particularly for grandparents, reduce the risk of early death
9. You are the sum of those you surround yourself with

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