“Traditions are not just old-fashioned ways of doing things. They are tried and true algorithms for keeping people healthy and happy.”

—Michael Pollan

Do you want to live a long life? At first consideration, there are few who would say no. But when researchers from the University of Pennsylvania qualified the question with the addition of various chronic diseases, it soon became clear that for many, conditions like dementia, incontinence, and lung failure are a fate worse than death.¹ As the poet E. E. Cummings once wrote, “Unbeing dead isn’t being alive.” Human beings want to live long lives, but they also want to live healthy lives—to be vital, able-bodied, and relatively free of chronic disease. The lure of longevity is certainly less sweet if it only means extending the pain and suffering of a growing list of physical ailments.

The power of a whole foods, plant-based diet lies in its capacity to fulfill our twin aspirations to extend our life span and our health span. And perhaps nowhere is this more clearly demonstrated than in the remarkable work of a journalist and explorer named Dan Buettner, who set out to find the longest-lived people on earth and learn the secrets of their lifestyles. His research on these populations, which came to be known as the “Blue Zones,” has offered the world a window into five extraordinary incubators of human health and vitality. Dotted across the globe, with diverse cultures, environments, traditions, and genetics, each of these populations has an unusual concentration of people who live into their nineties and even beyond one hundred. They have a surprising number of things in common, perhaps the most striking that they all eat a whole foods diet, with, on average, 90% of their calories coming from plant foods.

Buettner’s journey into longevity began around the turn of the millennium. For a number of years, he had been leading expeditions around the world, investigating some of history’s most mesmerizing mysteries. Why did the Mayan civilization collapse? Did Marco Polo really go to China? What happened to the Anasazi? As a journalist, entrepreneur, Emmy Award–winning producer, traveler, cyclist, holder of multiple Guinness World Records, and go-to National Geographic writer, Buettner has lived a life of multiple identities.

Health and diet were hardly front and center in his adventures. He describes himself as once having had a “see food diet”—“I would see food… and eat it.”2 That all changed in 2000, when one particularly captivating mystery drew his attention. The World Health Organization had discovered that Okinawans—residents of the Japanese island made famous by American occupation during World War II—had the longest disability-free life expectancy in the world. Why would one particular island civilization have such an outsize health potential? Buettner had found his next adventure.

With help from the National Institute on Aging and National Geographic, he put together a team, flew to Okinawa, and began to investigate local living and eating habits. The more he learned about the lifestyle of this remarkable population of elders, the more convinced he became that he was onto something of real significance. As the project developed, so did its goal. Buettner saw an opportunity, as he puts it, to “reverse-engineer longevity.”3 Research into genetics and longevity, including the well-known Longitudinal Study of Aging Danish Twins, had suggested that genetics account for only 20% to 30% of life span, with the rest due to environmental and lifestyle factors.⁴ If how we live plays such a large role in how long we live, Buettner reasoned, then surely it would be instructive to locate the longest-lived populations and carefully examine their behaviors. He began to look beyond Okinawa for other large concentrations of centenarians, and ask, How do they achieve such remarkable outcomes? Where do they live? What kinds of communities do they have? And perhaps most importantly, what do they eat?

Of course, this is easier said than done. Longevity can be notoriously tricky to determine in older cohorts. Demographers must start in one area with a selection of documented births between ninety and a hundred years earlier and track those people and their lifestyle over almost a century. As Buettner’s team closed in on potential populations, they used a blue Sharpie marker to circle the regions on the map—hence the informal name “Blue Zone,” which stuck.

Okinawa was the first Blue Zone. Japan as a nation boasts the world’s longest life spans, but Okinawans leave their mainland compatriots in the dust. This relatively small tropical island region southwest of mainland Japan has one of the highest ratios of centenarians—6.5 in 10,000 live to be 100. The islanders over sixty-five enjoy the world’s highest life expectancy. They have lower rates of disease than Americans in just about every category, with only half the dementia of those of a similar age.

The next Blue Zone that Buettner identified was on the Mediterranean island of Sardinia. If you picture easy-living centenarians taking long naps in hammocks near the turquoise sea, think again—the Blue Zone is specifically an inland region known as Ogliastra, the most mountainous area of the island. The pastoral people of these highlands tend sheep and eke out a simple living amid an unforgiving terrain. It’s not exactly an easy life, but it is a long and rewarding one, particularly for men—the longest-lived males on earth are those who tread the rugged paths of Sardinia’s mountains.

The third Blue Zone he identified was the Seventh-day Adventist religious group in Loma Linda, California, that you read about in chapter 3. Buettner featured these three Blue Zones in a 2005 National Geographic feature that went viral, becoming the third most popular in the esteemed magazine’s hundred-year history. A best-selling book followed, but Buettner was not done exploring.

Before long, two more Blue Zones came to light: Ikaria, Greece, and the Nicoya Peninsula of Costa Rica. A relatively remote island not far from the west coast of Turkey, Ikaria has only a little more than eight thousand inhabitants. It has a rugged terrain that contrasts with the warm Mediterranean climate and relaxed lifestyle of its people, who live almost a decade longer than their counterparts in America with half the rates of heart disease.⁵ Meanwhile, in Costa Rica’s hilly Nicoya region, once used as a refuge by the Contra rebels of neighboring Nicaragua, the mestizos (people of combined European and American Indian descent) reach the age of ninety at two and one-half times the rate of northern Americans and have much less cancer, heart disease, and diabetes.⁶ This hardy population no longer dies from infectious diseases that once were the scourge of their ancestors, such as dysentery, dengue fever, or malaria; yet, they have also stayed relatively free of the diseases of affluence that afflict Costa Rica’s city-dwelling populations.

Buettner and his team spent significant time in each Blue Zone, observing, researching, surveying, and otherwise exploring the lifestyles and daily activities of these remarkable pockets of long-lived peoples. Slowly all five began to yield their secrets, the behaviors most clearly linked to their extraordinary health outcomes. Buettner’s plan to reverse-engineer longevity was paying off, as he was able to find critical lifestyle similarities among all the Blue Zones—even though they were spread across the world.

Dietary Secrets of the Centenarians

Among all the lifestyle factors that distinguish the Blue Zones, one of the most significant is diet. Buettner and his team made friends with the local centenarians, watching them in their kitchens and gardens, walking with them in their neighborhoods, and recording their habits as they went about their days. And they asked questions—lots of questions. Buettner acknowledges that it was a complex task: “If you want to know what a one-hundred-year-old ate to live to one hundred, you have to know what they ate their entire life—what they ate as kids, when they were married, when they were middle-aged, when they were sixty, and when they retired. And today you can’t just ask them, because they don’t remember. So it was a mammoth undertaking.”7

After years of research, Buettner has reams of carefully constructed demographic data, right alongside the notes and remembrances from his numerous personal journeys to these lands that the Grim Reaper seems reluctant to visit. In addition, with support from Harvard’s Walter Willett, he initiated a meta-analysis of every dietary survey done in the last hundred years in each Blue Zone by local and international researchers.

While at first glance the plates of these different peoples might look quite different, a closer look reveals many common patterns. As one example, Buettner points to “Greens and beans. No matter where you go in the Blue Zones, they are eating a lot of green vegetables and about a cup of beans a day.”⁸ In one extended study in Ikaria, a cohort was followed for several years, and the researchers found that those who were doing the best at surviving were eating about a half cup of greens and a cup of beans every day.

The types of beans and greens vary, as do the foods that accompany them. In Okinawa they eat soybeans and various green leafy vegetables, together with their favorite food—sweet potatoes—a starchy vegetable that accounted for up to 67% of the islanders’ calories in the pre- and postwar periods, when meat was scarce. Rice also plays a key role in the Okinawan diet, and while they love pork, they eat very little by Western standards, generally consuming pork or fish in small quantities just two or three times a week. They eat very few dairy products. Before 1940, 80% of their diet was made up of whole food starches, and they flourished—a fact that may surprise “low-carb” dieters.

The Sardinians love fava beans, chickpeas, fennel, and zucchini. Like many Mediterranean cultures, they eat a generous amount of bread made from both barley and durum wheat, and pasta. They enjoy cheese and milk, almost entirely from goats and sheep. They drink the deep red Cannonau wine from the Grenache grape that thrives on their sun-drenched hillsides. Meat and fish consumption in the Sardinian Blue Zone is generally less than in Mediterranean diets, including those of the coastal dwellers on the same island. (See box, here, for further discussion of the Mediterranean diet.)

In the neighboring Mediterranean Blue Zone of Ikaria, the traditional diet includes a variety of wild mountain greens found on the island, along with chickpeas and black-eyed peas. As in Sardinia, the mountain dwellers in Ikaria eat fish less often than those on the coast—in this case due to the legendary rough seas and winds in the area around the island (they are even mentioned in the Iliad) that have made fishing a complicated endeavor and limited local supply—and they live longer. Ikarians enjoy pasta and olive oil in accordance with Mediterranean traditions, but they also eat more legumes and potatoes than are typical for other cultures in the region. They eat meat or poultry in small quantities a few times per week, and enjoy a bounty of fresh vegetables, grown locally or in gardens, year-round. They drink coffee and tea and love wine and honey, but eat very little refined sugar or flour. Their reputation for longevity has its roots in antiquity, when the Greeks would visit this island to soak in its hot springs, all the way back in the fifth century BCE, when the island was part of the Athenian Alliance.

The Nicoyans feast on black beans and locally available green vegetables, as part of a diet rich in maize (corn), squash, yams, rice, and tropical fruits. Meat, poultry, dairy products, and fish are common, but limited in terms of overall dietary calories, as well as the occasional egg.9 Buettner sums it up as follows: “Like residents of other Blue Zones, people here ate a high-carb, moderate-fat, moderate-protein plant-based diet rich in legumes.”¹⁰

The Adventists, as discussed in chapter 3, eat a wide variety of beans, lentils, green vegetables, some nuts, and a variety of other vegetables. Their diets can be mapped on a spectrum from those who eat some meat and/or fish to those who are vegetarian or vegan, but what they all have in common is a focus on real, unprocessed foods. Even those who ate meat did so much less frequently than the average American.

Do you start to see the common patterns emerging? Real, unprocessed foods, mostly plants. Rich in beans and other legumes, whole grains and starchy vegetables, fresh fruits, greens, and other vegetables. In other words, every Blue Zone ate some variation of a whole foods, plant-based diet.

Gardens are common in every one of these regions, often with multiple growing seasons per year, adding to the supply of fresh fruits and vegetables. In fact, most of the food that is consumed in the Blue Zones, Buettner notes, grows within a ten-mile radius of the home.¹¹ Of course, that’s not possible or even desirable for everyone to replicate, but what we can learn from these traditional ways of life, no matter where we live, is to choose whole foods, and include lots of fruits and vegetables.

Another important common factor among the Blue Zone diets that Buettner highlights is their emphasis on carbohydrates, often complex carbohydrates like whole grains, starchy vegetables, and legumes, with much lower levels of animal foods than the Standard American Diet. This flies in the face of the trend toward “low-carb” diets that promote more fats and encourage meat consumption (see chapter 7). Indeed, when it comes to meat and other animal foods, the evidence from the Blue Zones clearly suggests that a significant reduction is in order. The meta-analysis of Blue Zone diets that Buettner and his team conducted revealed that on average, over the entire long lifetimes of the elders, the Blue Zone diets were 90% plant-based, 10% animal products.

Among these longest-lived people, only a small percentage of the Adventists cut out animal foods completely. Every other Blue Zone diet includes meat or fish of various kinds, but in very limited amounts. The longest-lived women in the world, in Okinawa, ate a little fish and pork. The longest-lived men in the world, in Sardinia, ate pork, goat, and lamb, but traditionally only on special occasions. And perhaps the overall longest-lived people in the entire world that we know of are the “vegetarians” of Loma Linda, eating mostly fruits, vegetables, unprocessed starch foods, beans, and nuts, with small amounts of animal products added by some as well.

It is also worth noting that the Blue Zones consume very little milk or milk products, and when they do it tends to come from sheep and goats. Cow’s milk and cheese are almost entirely absent, with the exception of the vegetarians and meat-eaters among the Loma Linda Adventists.

Another notable feature of the Blue Zones diets is not what they eat, but what they drink. Most Blue Zones keep it simple—water, coffee, tea, and a little wine. They rarely drink fruit juices, and completely avoid the sodas, sports drinks, energy drinks, sugary cocktails, Frappuccinos, and other calorie-laden beverages common in the United States. Adventists recommend seven glasses of water a day, and are the only Blue Zone population that abstains from alcohol. Okinawans tend to have a glass of tea near them constantly, often green tea, which has been shown to have all kinds of health benefits. Ikarians, Sardinians, and Nicoyans all love to drink coffee.

Nudges and Defaults

It is important to remember that the elders of the Blue Zones were not consciously trying to be fit, healthy, slim, or long lived. They were not deliberately following a “longevity diet” or restricting certain foods because they perceived them as “bad.” “Longevity happened to these people,” Buettner explains. “They didn’t seek it out.”12 They were certainly not reading the latest nutritional science and trying to apply it in their kitchens, gardens, and dining rooms. In these often-remote regions of the world, whole healthy plant foods were simply the cheapest and easiest to get. These people valued convenience in their lives as much as we do, and their unusual health outcomes are largely due to lifestyles that were traditional and easy to maintain. From walking to gardening to eating to cooking to socializing to living with a strong sense of faith and purpose, they followed the patterns that fit conveniently into their community and culture. Their way of life, from dawn to dusk, just happened to also support healthy, positive, life-enhancing behaviors. And they lived in tight-knit social networks that consistently reinforced the same.

While many aspects of the Blue Zones lifestyle harken back to a simpler time and a more traditional diet, it would be a mistake to think that the answer to our modern dietary dilemmas is just to return to the good old days and live like our ancestors. The Blue Zones represent a rare combination of cultural, geographical, and historical conditions. They were lucky enough to benefit from the medical breakthroughs of modernity, but remote enough to escape its nutritional downsides. On the one hand, each of these regions was close enough to the developed world to benefit from public health policy and its ability to end the scourge of infectious disease. No longer were people dying young of dysentery or malaria. On the other hand, they were just far enough removed from the faster-changing urban areas to avoid being overrun by Western eating habits and the new modern epidemics of chronic disease. These geographic sweet spots fortuitously fell between the cracks of cultural trends that overlapped in most parts of the world. And the rare convergence of conditions that made them possible is already past.

There are unlikely to be more Blue Zones discovered, Buettner says, although he continues to search. And the existing five are already under pressure—from globalization, development, Western eating habits, and the “diseases of affluence” that come with them. In Okinawa, people under sixty now have higher rates of chronic disease than Americans! As modernity encroaches, so does the modern lifestyle with its industrial food systems, its greater wealth, and its rise in processed food, meat, and dairy consumption. In his trips Buettner has noticed the changes. “If you’re invited to dinner by a Sardinian today, it’s like they are barbecuing a petting zoo,” he says, with a pained laugh. “They’ll start with prosciutto, and then lamb, and then pork. It’s the complete opposite of the diet that helped make them a Blue Zone.”13

Soon, as the longest lives on earth come to an end, the Blue Zones will be gone, with the possible exception of Loma Linda, a community that is more intentional in preserving its lifestyle. But thanks to Buettner and his team, their secrets are with us forever—impeccably researched, clearly elucidated, and highly replicable. We can apply their longevity principles, today, no matter where in the world we live. The Adventists are prime examples of this. Their Blue Zone wasn’t built on ancient traditions or carefully protected by a quirk of geography. Their religious faith gave them strong-enough conviction and a rich and supportive social network with which to build a barrier against the unhealthy habits of the modern world. We may not be inclined to adopt their faith, but we can learn something from their lifestyle. “To make it to age one hundred, you have to have won the genetic lottery,” Buettner concedes. “But most of us have the capacity to make it well into our early nineties and largely without chronic disease. As the Adventists demonstrate, the average person’s life expectancy could increase by ten to twelve years by adopting a Blue Zones lifestyle.”14

Buettner has spent much of the last decade developing methods to bring the longevity secrets to municipalities and even states across America. He has worked intensely to research and develop best practices for embedding Blue Zone principles in places that are rife with obesity, chronic disease, and the food and lifestyle options that create them. Since 2009, Blue Zones Projects are now active in thirty-one American cities. Their approach is light on the rhetoric, focused on education, and all about working with communities—leaders, healthcare organizations, politicians, civic organizations, business leaders, school leaders, students—to get real buy-in.

The key lesson from the Blue Zones that underlies these efforts is this: deep and lasting change happens through what Buettner calls “nudges and defaults” rather than organized, top-down intervention. What the Blue Zones show us is that there are a thousand small ways in which our lives can be set up to nudge us in the direction of healthy decisions. They also show that convenience matters—we need to ensure that our defaults become the healthy options, not the disease-promoting ones.

We all know how difficult it can be to change habits, eating or otherwise, through personal willpower alone. In part this is because our individual habits are intricately connected to every other thing about ourselves and our lives. Diets, in particular, don’t work in isolation. If we don’t live in an environment that supports those changes, or connect with a social network that embodies and encourages them, they will be much more difficult to sustain. However, the Blue Zones demonstrate the powerful flip side of this truth: when we do live in the right environment and community, healthy living can become the norm.

With this in mind, Buettner and his team focus on improving the options on the menu in local restaurants, increasing access to community gardens, installing new walking and biking paths, encouraging grocery stores to put healthy foods right near the checkouts, enrolling local schools in Blue Zone projects, making it possible for more kids to walk to school, setting up social support networks for friends and families, banning smoking in public places, encouraging volunteering and other purposeful activities, and setting up workshops, social events, potlucks, and so on. All of these changes create what Buettner calls “a healthy swarm of nudges and defaults”15 that inspire better eating and better living.

The results have been remarkable, to say the least. In one project, the Blue Zones team worked in three southern California cities—Manhattan Beach, Hermosa Beach, and Redondo Beach (known as the Beach Cities)—and teamed with Gallup to measure the progress. After three years they saw a 14% drop in obesity levels, which represented a savings of more than $2.3 million a year in health costs. They saw a 28% drop in the smoking rate, which represented another $6.97 million savings in health costs. 10% more residents were exercising regularly, and rates of both diabetes and high blood pressure were down. Childhood obesity has fallen an impressive 50%. Other cities have shown similarly striking changes.

Read between the lines of these initiatives and you see another theme: a reinvigoration of America’s civic architecture. Social scientists have worried for years about the breakdown of America’s rich civic society. The Blue Zone Project is a means of appealing directly to our sense of civic pride and engagement, and of encouraging people and communities to work together to improve our health outcomes. If you’re inspired by the stories you’ve read in this chapter, look no further than your own community for ways to promote health and longevity. Can you team up with like-minded friends to create a healthy-eating support network? What are your kids eating at school, and could you help to improve it? Can you join or start a community garden? Is there a local nonprofit where you could volunteer? The possibilities for creating healthy nudges and defaults are endless.

WHOLE FOODIE TAKEAWAYS

• Live longer, better!—The longest-lived populations in the world, with extraordinarily low rates of chronic disease, each eat a variation on a whole foods, predominantly plant-based diet.

• Create healthy nudges and defaults—If you want to change your habits, you need to set up your environment so the healthy option becomes the default option.

CHAPTER 4

Reverse-Engineering Longevity

Food and Culture in the Blue Zones

WHOLE FOODIE HERO

Dietary Secrets of the Centenarians

The Mediterranean Diet:More than Olive Oil and Red Wine

WHOLE FOODIE HERO

Nudges and Defaults

WHOLE FOODIE TAKEAWAYS