Quick Summary: Blue zones are areas of the world where people are likely to live much longer and healthier lives. There are several things that these areas have in common that are applicable to our daily lives..

In 2004, Gianni Pes and Michel Poulain published an article in Experimental Gerontology called, Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. The article examined an area of Sardinia with the highest proportion of male centenarians in the world. It started a field of study (or a popular movement? A meme?) called Blue Zones.

Blue zones are "longevity hotspots," areas of the world where an individual is much more likely to have a long life, and to do so with a high quality of life. To me, that sounds like a geographic description of our guiding priciples at Sequoia MD-- to help people live long, happy, healthy lives. Subsequent research established several of these longevity hotspots around the world:

The five recognized blue zones are:

1. Sardinia, Italy: The mountainous region of Sardinia has a high number of male centenarians who live active lives, mainly engaged in shepherding and farming.
2. Okinawa, Japan: The inhabitants of Okinawa, an archipelago in Japan, have one of the highest life expectancies in the world. They follow a plant-based diet and practice a philosophy called "ikigai," which translates to "the reason for being."
3. Nicoya Peninsula, Costa Rica: Located in the Pacific coastal region of Costa Rica, Nicoya has a population with lower rates of heart disease, cancer, and dementia. Their lifestyle incorporates a strong sense of community, regular physical activity, and a plant-based diet.
4. Icaria, Greece: This small Greek island is known for its low rates of heart disease, dementia, and other chronic illnesses. The residents follow a Mediterranean diet, engage in daily physical activity, and maintain close social connections.
5. Loma Linda, California, United States: Loma Linda is home to a community of Seventh-day Adventists who live up to a decade longer than the average American. Their longevity can be attributed to their vegetarian diet, regular exercise, strong social support, and emphasis on faith.

So, what do the Seventh Day Adventists in Loma Linda have in common with people in Ikaria and Nicoya, that promote longevity?

1. Plant-based diet: Blue zone populations typically follow a predominantly plant-based diet. They consume a variety of fruits, vegetables, whole grains, legumes, and nuts. Their diets are low in processed foods, sugar, and saturated fats. The emphasis is on natural, locally sourced, and seasonal foods.
2. Moderate calorie intake: Blue zone inhabitants practice portion control and generally eat until they are about 80% full. They avoid overeating and have a more balanced relationship with food.
3. Active lifestyle: The people in blue zones engage in regular physical activity as part of their daily lives. They walk, cycle, garden, and engage in manual labor, which provides them with constant low-intensity exercise. Physical activity is integrated into their routines, and they don't rely heavily on modern conveniences.
4. Strong social connections: Blue zone communities foster strong social bonds and prioritize social interactions. They maintain close relationships with family, friends, and neighbors. Social support and a sense of belonging contribute to reduced stress levels and improved mental well-being.
5. Purposeful life: Having a sense of purpose and meaning in life is a common characteristic of blue zones. The inhabitants engage in activities that give them a sense of fulfillment, whether through work, hobbies, family, or community involvement. This sense of purpose contributes to their overall well-being and longevity.
6. Stress reduction: Blue zone communities tend to have lower levels of chronic stress. They prioritize relaxation, take regular breaks, have designated times for rest and reflection, and incorporate stress-reducing practices like meditation or prayer.
7. Moderate alcohol consumption: While not a universal characteristic, some blue zone regions have a tradition of moderate alcohol consumption. This typically involves drinking in moderation and in the company of others, such as enjoying a glass of red wine with meals.
8. Non-smoking: Smoking rates tend to be low or nonexistent in blue zone populations. Tobacco use is generally discouraged or not prevalent, reducing the risk of smoking-related diseases.

It's important to note that while these characteristics are common in blue zones, there may be some variations within each region. Moreover, adopting these habits alone may not guarantee longevity, as genetics and other environmental factors also play a role. However, incorporating these practices into our lifestyles can contribute to improved health and well-being.

Lastly, I think it’s critical to recognize that within these communities (and they are communities), these habits are not weird, unusual, or uncommon. Instead, these behaviors are deeply embedded in the culture, and represent shared expectations about behavior. This critical, because trying to implement these behaviors in our own lives without the support of others, without the support of our community, is an uphill battle.

So, which of these, if any, can you adopt? How can you build support for a community of health around you?

-Dr. Justin

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