Blue Zones Longevity: Live to be 100, Healthy and Active

Written by Dr. Steve Chaney on . Posted in Blue Zones

Author: Dr. Stephen Chaney

diet warsThe diet wars are raging. Everywhere you turn people are arguing about which diet is best. Each diet is based on plausible sounding hypotheses. Each diet has rigid do’s and don’ts. Proponents of these diets are absolutely convinced they have the only answer for a healthy life.

You’ve heard the arguments. It is fat that’s killing you. No, it’s the carbs. Saturated fats are bad for you. No, they’re good for you. Coconut oil is bad for you. No, you should eat as much of it as possible. Unsaturated fats are good for you. No, they’re bad for you. The list goes on and on.

It is so confusing. The “experts” arguing over which diet is best can’t all be right…or can they? What if they are like the fable of the 6 blind men grabbing different parts of an elephant and trying to describe the elephant. Each is describing part of the elephant, but none of them know what the whole elephant is like.

The problem is most diets are based on hypotheses derived from short-term clinical studies. For example, scientists design a clinical study that makes some changes to the diet, and cholesterol levels improve, or blood pressure improves, or markers of inflammation improve. Someone then incorporates those specific changes into their “diet program” and predicts what the health of people following their diet will be 20 or 30 years into the future. They write a book, and another diet fad is launched.

blue zonesThose diet authors are like one of the blind men. They have grabbed part of the elephant, and they are trying to predict what the whole elephant looks like based on the part they know. In most cases, they have no idea whether people who follow their diet for 20 or 30 years will be healthy. The long-term data to support their hypotheses simply does not exist.

What if you took the opposite approach? What if you started with the elephant? What if you asked people living healthy, active lives well into their 100s what they ate and how they lived?

Someone has done just that. His name is Dan Buettner. He identified five regions of the world, which he called ”Blue Zones,” where an unusually high percentage of people live into their 100s. He then asked the centenarians in each region about their diet and lifestyle. The results of this remarkable study were published in a book called “The Blue Zones.”

How Was The Study Done?

Dan Buettner is not a scientist. He is a journalist, and his initial “Blue Zone” expeditions were sponsored by National Geographic. However, to his credit he collaborated with the top scientists in the fields of demographics, social anthropology and statistics. In short, he did things right.

The demographers helped him locate the Blue Zones and poured over the birth and death records so they could prove beyond a shadow of a doubt these were regions where an extraordinary percentage of people lived to 100 and beyond. The social anthropologists helped him design the questionnaires and interview the centenarians. The statisticians helped him analyze the data.

blue zones longevityThe Blue Zones were very diverse. They consisted of:

  • A mountainous municipality on the Island of Sardinia off the coast of Italy.
  • Rural villages on the Island of Okinawa.
  • The 7th Day Adventist community in Loma Linda, California.
  • Some remote villages in Costa Rica
  • A small island called Ikaria off the coast of Greece.

Many of these locations are remote, but the 7th Day Adventist community lives in the heavily populated Los Angeles basin. In his book, Dan Buettner describes getting off the freeway and driving past all the usual fast food restaurants on his way to interview the 7th Day Adventist centenarians, who obviously never ate at those restaurants.

The people in each of these regions followed a lifestyle that was dramatically different from people in surrounding communities. In the case of the 7th Day Adventists, their lifestyle was based on their religious teachings. People in the other regions were simply following traditions passed down over many generations.

It is fascinating to read about each of these Blue Zone communities. There were some significant differences in the foods they ate and the way they lived their lives. However, Dan Buettner and his scientific collaborators were not interested in the differences. They were interested in the similarities.

The similarities were striking. More importantly, they tell us a lot about the kind of diet and lifestyle that is associated with health and longevity. This isn’t hypothetical health and longevity based on some short-term clinical studies. This is real life health and longevity based on people who have actually lived it.

What Do Blue Zones Tell Us About Longevity?

live to be 100 in blue zonesHere are the common characteristics of every Blue Zone studied. I call them “the secrets of the centenarians.”

#1: They engage in moderate intensity exercise every day. None of them run marathons or engage in high intensity workouts in the gym. Some are shepherds. Others tend their farms. The 7th Day Adventists take nature walks. Exercise isn’t planned. It is part of their daily life.

#2: They stop eating before they are full. As a child, I remember a TV add in which the actor would say “I can’t believe I ate the whole thing” before plopping two Alka-Seltzers in a glass of water. The long-living people in Blue Zones don’t do that. They stop eating when they are no longer hungry, not when they are full. Okinawans call it hara hachi bu, which roughly translates into stopping when their stomachs are 80% full. That simple practice cuts calories by 20% and dramatically reduces the incidence of obesity.

#3: They eat a mostly plant-based diet. They eat mostly fruits, vegetables and whole grains. Nuts also play an important role in their diet. Beans are the major protein source. They avoid processed foods and seldom eat meat. Strict 7th Day Adventists avoid meat entirely. The other Blue Zone populations ate meat primarily on special occasions. When they did eat meat, it was often pork or lamb. Based on the data from these Blue Zone populations, Dan Buettner recommends eating meat no more than twice a week, with each serving being the size of a deck of cards.

#4: They have a libation with their meals. For the Sardinians, it was red wine. For the Okinawans, it was sake. The key is moderation. No more than a glass or two. If you don’t drink, that’s fine too.

#5: They have a purpose in their lives. They have a reason to live. It can be service to others. It can be a hobby. It can be a quest for learning something new. Whatever it is, they have something to look forward to every day.

#6: They set aside time for relaxation. They have a time set aside each day to relax with friends or family and de-stress. This improves their mental outlook and reduces their risk of disease.

centarians#7: They participate in a spiritual community. The religions were different in each Blue Zone, but they all belonged to strong religious communities. As Dan Buettner put it: “The simple act of worship is one of those subtly powerful habits that seems to improve your chances of having more good years.”

#8: They put family first. They build their lives around their families, and when they become old their families take care of them.

#9: They surround themselves with communities that share their values. These social networks provide support, encouragement, and happiness.

As you read through the 9 things that these Blue Zone communities have in common, your first reaction may be one of dismay. In today’s world, it is exceedingly difficult to achieve all 9 elements of a centenarian lifestyle. Just be comforted with the thought that the more of these 9 elements you can incorporate into your personal “Blue Zone,”  the healthier you will be and the longer you will live.

 

What Do Blue Zones Tell Us About Diet?

If you have been trying to figure out what kind of diet is best for you, the biggest take home lesson from “The Blue Zones” is that you can forget all the absolutes you have heard from the proponents of various diet plans. For example:

  • All the Blue Zone communities included whole grains, legumes, and starchy vegetables as part of their diet. You don’t have follow a low carb diet to live to 100.
  • While all the Blue Zone communities ate a plant-based diet, most included some meat in their diet. You don’t have to go meatless to live to 100.
  • Some of the Blue Zone communities ate pork and lamb as their main meat. If you eat meats sparingly as part of a mostly plant-based diet, you can eat red meat and still live to 100.
  • Only two of the five Blue Zones were in the Mediterranean region. You don’t have to follow a Mediterranean diet to live to 100.

In short, the proponents of today’s popular diet plans are indeed like the 6 blind men trying to describe an elephant. When you see the entire elephant, it looks a lot different.

 

The Bottom Line

 

  1. In his book “The Blue Zones,” Dan Buettner described five regions of the world where an exceptionally high proportion of people are living healthy, active lives well into their 100s. He teamed with a group of scientists to find out what they eat and how they live.
  2. Here are the 9 common characteristics of every Blue Zone Community he studied:
    • They engage in moderate intensity exercise every day.
    • They stop eating before they are full.
    • They eat a mostly plant-based diet.
    • They have a libation with their meals.
    • They have a purpose in their lives.
    • They set aside time for relaxation.
    • They participate in a spiritual community.
    • They put family first.
    • They surround themselves with communities that share their values.
  3. As you read through 9 things the Blue Zone communities have in common, your first reaction might be one of dismay. In today’s world, it is exceedingly difficult to achieve all 9 elements of a centenarian lifestyle. Just be comforted with the thought that the more of these 9 elements you can incorporate into your personal “Blue Zone,” the healthier you will be and the longer you will live.
  4. When you look at what people in Blue Zone communities eat, the biggest take home lesson is that you can forget all the absolutes you have heard from the proponents of various popular diet plans. For example:
    • All the Blue Zone communities included whole grains, legumes, and starchy vegetables as part of their diet. You don’t have follow a low carb diet to live to 100.
    • While all the Blue Zone communities ate a plant-based diet, most included some meat in their diet. You don’t have to go meatless to live to 100.
    • Some of the Blue Zone communities ate pork and lamb as their main meat. If you eat meats sparingly as part of a mostly plant-based diet, you can eat red meat and still live to 100.
    • Only two of the five Blue Zones were in the Mediterranean region. You don’t have to follow a Mediterranean diet to live to 100.
  5. For details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (2)

  • Allen Partch

    |

    Thanks Dr Steve Chaney Pam and I just started a plant based diet, and it always gets confusing on which diet is the best, I heard some people on a vegan diet after 19 years or so can be in worse health than people on the Standard American Diet, it is so confusing but this information email helped me know the truth and am convinced we are on the right path eliminating chicken beef pork and any fast food. Dr Steve helped clear up confusion about weather people on kemo should take supplements. Thanks Dr Steve for the info.

    Reply

  • Tammy Johnson

    |

    Thank you for this information. I was talking with a friend about this recently so it was good to have it reviewed and discussed from a Dr’s perspective. Thank you Steve!

    Reply

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Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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