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

Do Omega-3s Lower Blood Pressure in Young, Healthy Adults?

Posted August 14, 2018 by Dr. Steve Chaney

What Is The Omega-3 Index And Why Is It Important?

Author: Dr. Stephen Chaney

 

Do omega-3s lower blood pressure in healthy adults?

omega-3s lower blood pressure young adultsThe literature on the potential health benefits of omega-3s is very confusing. That’s because a lot of bad studies have been published. Many of them never determined the omega-3 status of their subjects prior to omega-3 supplementation. Others relied on dietary recalls of fish consumption, which can be inaccurate.

Fortunately, a much more accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes. Using modern technology, it can be determined from a single finger prick blood sample. It is a very accurate reflection of omega-3 intake relative to other fats in the diet over the past few months. More importantly, it is a measure of the omega-3 content of your cell membranes, which is a direct measure of your omega-3 nutritional status.

A recent extension of the Framingham Heart Study reported that participants with an Omega-3 Index >6.8% had a 39% lower risk of cardiovascular disease than those with an Omega-3 Index <4.2% (WS Harris et al, Journal of Clinical Lipidology, 12: 718-724, 2018 ). Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk, while 8% or better is considered indicative of low cardiovascular risk. For reference, the average American has an Omega-3 Index in the 4-5% range. In Japan, where fish consumption is much higher and cardiovascular risk much lower, the Omega-3 Index is in the 9-11% range.

Previous studies have suggested that omega-3 fatty acids lower blood pressure to a modest extent. Thus, it is not surprising that more recent studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, those studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Unfortunately, there were no studies looking at that population. The current study was designed to fill that gap.

 

How Was The Study Done?

omega-3s lower blood pressure young healthy adultsThe current study (M.G. Filipovic et al, Journal of Hypertension, 36: 1548-1554, 2018 ) was based on data collected from 2036 healthy adults, aged 25-41, from Liechtenstein. They were participants in the GAPP (Genetic and Phenotypic Determinants of Blood Pressure) study. Participants were excluded from the study if they had been diagnosed with high blood pressure and were taking medication to lower their blood pressure. They were also excluded if they had heart disease, chronic kidney disease, other severe illnesses, obesity, sleep apnea, or daily use of non-steroidal anti-inflammatory medications.

Blood samples were collected at the time of their enrollment in the study and frozen for subsequent determination of Omega-3 Index. Blood pressure was also measured at their time of enrollment in two different ways. The first was a standard blood pressure measurement in a doctor’s office.

For the second measurement they were given a wearable blood pressure monitor that recorded their blood pressure over 24 hours every 15 minutes during the day and every 30 minutes while they were sleeping. This is considered more accurate than a resting blood pressure measurement in a doctor’s office because it records the variation in blood pressure, while you are sleeping, while you are exercising, and while you go about your everyday activities.

 

Do Omega-3s Lower Blood Pressure In Young, Healthy Adults?

omega-3s lower blood pressure young adults equipmentNone of the participants in the study had significantly elevated blood pressure. The mean systolic and diastolic office blood pressures were 120±13 and 78±9 respectively. The average Omega-3 Index in this population was 4.6%, which is similar to the average Omega-3 Index in the United States.

When they compared the group with the highest Omega-3 Index (average = 5.8%) with the group with the lowest Omega-3 Index (average = 4.6%):

  • The office measurement of systolic and diastolic blood pressure was decreased by 3.3% and 2.6% respectively
  • While those numbers appear small, the differences were highly significant.
  • The 24-hour blood pressure measurements showed a similar decrease.
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index. [In studies of this kind, a linear dose-response is considered an internal validation of the differences observed between the group with the highest Omega-3 Index and the group with the lowest Omega-3 Index.]

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

 

What Does This Mean For You?

omega-3s lower blood pressure young adults questionPerhaps I should first comment on the significance of the relatively small decrease in blood pressure observed in this study.

  • These were young adults, all of whom had normal or near normal blood pressure.
  • The difference in Omega-3 Index was rather small (5.8% to 4.6%). None of the participants in the study were at the 8% or above that is considered optimal.
  • Liechtenstein is a small country located between Switzerland and Spain. Fish consumption is low and omega-3 supplement consumption is rare.

Under these conditions, even a small, but statistically significant, decrease in blood pressure is remarkable.

We should think of this study as the start of the investigation of the relationship between omega-3 status and blood pressure. Its weakness is that it only shows an association between high Omega-3 Index and low blood pressure. It does not prove cause and effect.

Its strength is that it is consistent with many other studies showing omega-3 fatty acids lower blood pressure. Furthermore, it suggests that the effect of omega-3s on blood pressure may also be seen in young, healthy adults who have not yet developed high blood pressure.

Finally, the authors suggested that a diet rich in omega-3s might reduce the incidence of high blood pressure by slowing the age-related increase in blood pressure that most Americans experience. This idea is logical, but speculative at present.

However, the GAPP study is designed to provide the answer to that question. It is a long-term study with follow-up examinations scheduled every 3-5 years. It will be interesting to see whether the author’s prediction holds true, and a higher Omega-3 Index is associated with a slower increase in blood pressure as the participants age.

 

Why Is The Omega-3 Index Important?

 

The authors of this study said: “The Omega-3 Index is very robust to short-term intake of omega-3 fatty acids and reliably reflects an individual’s long-term omega-3 status and tissue omega-3 content. Therefore, the Omega-3 Index has the potential to become a cardiovascular risk factor as much as the HbA1c is for people with diabetes…” That is a bit of an overstatement. HbA1c is a measure of disease progression for diabetes because it is a direct measure of blood sugar control.

In contrast, Omega-3 Index is merely a risk factor for cardiovascular disease. However, if it is further validated by future studies, it is likely to be as important for predicting cardiovascular risk as are cholesterol levels and markers of inflammation.

However, to me the most important role of Omega-3 Index is in the design of future clinical studies. If anyone really wants to determine whether omega-3 supplementation reduces cardiovascular risk, high blood pressure, diabetes or any other health outcome they should:

  • Start with a population group with an Omega-3 Index in the deficient (4-5%) range.
  • Supplement with omega-3 fatty acids in a double blind, placebo-controlled manner.
  • Show that supplementation brought participants up to an optimal Omega-3 Index of 8% or greater.
  • Look at health outcomes such as heart attacks, cardiovascular deaths, hypertension, stroke, or depression.
  • Continue the study long enough for the beneficial effects of omega-3 supplementation to be measurable. For cardiovascular outcomes the American Heart Association has stated that at least two years are required to obtain meaningful results.

These are the kind of experiments that will be required to give definitive, reproducible results and resolve the confusion about the health effects of omega-3 fatty acids.

 

The Bottom Line

 

An accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes.

Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk while 8% or better is considered indicative of low cardiovascular risk.

Previous studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, these studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Until now, there have been no studies looking at that population.

The study described in this article was designed to fill that gap. The participants in this study were ages 25-41, were healthy, and none of them had elevated blood pressure.

When the group with the highest Omega-3 Index (average = 5.8%) was compared with the group with the lowest Omega-3 Index (average = 4.6%):

  • Both systolic and diastolic blood pressure were decreased
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index.

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

Let me translate that last sentence into plain English for you. The authors were saying that optimizing omega-3 intake in young adults may slow the age-related increase in blood pressure and reduce the risk of them developing high blood pressure as they age. This may begin to answer the question “Do omega-3s lower blood pressure in young, healthy adults?”

Or even more simply put: Aging is inevitable. Becoming unhealthy is not.

For more 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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