Blue zones are regions in the world where a population that shares a common lifestyle and environment exhibits an exceptionally long lifespan.[1] Examples of blue zones include Okinawa Prefecture, Japan; Nuoro Province, Sardinia, Italy; the Nicoya Peninsula, Costa Rica; and Icaria, Greece.[2] The name "blue zones" derived simply during the original survey by scientists, who "used a blue pen on a map to mark the villages with long-lived population."[2]
The concept of blue zones having exceptional longevity has been challenged by the absence of scientific proof,[3] and by the substantial decline of life expectancy during the 21st century in an original proposed blue zone, Okinawa.[4]
The concept of blue zones resulted from demographic work published by Michel Poulain and colleagues in 2004.[5] They identified Sardinia's Nuoro province as the region with the highest concentration of male centenarians, referring to the area as the "blue zone" (a term chosen because the authors used a blue pen to mark a map of the villages with many centenarians).[2][5]
Initial analysis was that the apparent longevity of blue zone populations resulted from practice of a traditional lifestyle, including regular physical activity beyond age 80, providing family and community support for elders, and consuming locally produced food.[2]
Nicoya
Icaria
Loma Linda
Okinawa
Proposed blue zones include:[unreliable source?]
In the original study of centenarians living in 14 mountain villages of Sardinia (the first proposed blue zone), the research team developed an Extreme Longevity Index (ELI) representing the ratio between the number of eventual centenarians born between 1880 and 1900, and the total number of births recorded during the same time interval for the region.[2] The ELI was defined as the number of centenarians per 10,000 newborns, and was equated to the probability for any person born in that municipality to reach 100 years old and remain functional.[2]
During the period of births between 1880 and 1900 in the Sardinia blue zone, 47 men and 44 women eventually reached age 100, giving an average ELI value per 100,000 births of 508 for the blue zone location, whereas the rest of Sardinia had ELI values 2–4 times lower (less longevity).[2]
Another longevity index applied was the Centenarian rate (CR) for the 1900 birth group (number of persons surviving to 100 years old per 10,000 people alive at age 60) in December 2000.[2] The Sardinia and Okinawa blue zones had CR values for men substantially higher compared to several other countries, whereas values for women were mostly above those in other countries, while comparable to others.[2]
Several possible errors or limitations exist for these estimates, such as unreliability or absence of birth records.[2]
Life expectancy in blue zones is proposed to be as much as a decade or longer, compared to the average world life expectancy of 73 years in 2019.[6][7][medical citation needed]
Lifestyle and environmental conditions are classified into nine subcategories. Each blue zone community features their own version of these nine. These groupings are known as the『Power 9®.』These nine facets include: natural movement, sense of purpose, stress-relieving activities, 80% eating rule, moderate drinking, plant-based diet, faith-based community, family, and tribe values. The 9 can be essentialized further into movement, outlook, connection, wise eating habits, and outlook. Natural movement is an environmental and humanistic factor. These five communities have environments that nudge individuals into moving. Houses and gardens for example, have less mechanical conveniences forcing tenets to work and move on their own. Sense of purpose is known as "Ikigai" to the Okinawans, and "plan de vida" for the Nicoyans. Stress-relieving methods, also known as downshift, are daily routines that help shed stress. Happy hour, prayers, napping, and remembering ancestors are the methods of the Blue Zones. The 80% eating rule is the practice of eating until you are 80% full. The 20% gap is said to be the difference between losing and gaining weight. Beans are the central-most part of Blue Zone diets. Fava, black, soy, and lentils are the key players. Meat is only eaten once or twice a week and in small portions. Contrary to popular belief, moderate alcohol consumption is encouraged. 1-2 glasses per day with a meal. Four of five Blue Zones (excluding adventists) practice this. Faith based communities are proven to live longer. Four faith-based services a month adds 4-14 years of life expectancy. Keeping loved ones, and especially parents, close is another key to success for centenarians. Having children to take care of you when you are older increases life expectancy. Living in a tribe or community that promotes good health is also important. Okinawans have "moais" groups. This is a collection of five friends that commit to each other for life. Having social networks is crucial because many habits and traits are contagious. For example happiness, smoking, obesity, and loneliness are all contagious. Having a support group that promotes healthy habits is favorable to long, healthy life. [8]
Loma Linda, California, United States, was included as a blue zone by Dan Buettner, founder of the marketing company, Blue Zones LLC, and popular press, which described the Seventh-Day Adventist community there as having unusual longevity due putatively to a healthy lifestyle and plant-based diet.[6][7] In 2020, Blue Zones LLC was acquired by the Seventh-Day Adventist health care system, Adventist Health.[9]
A study of claimed longevity in Okinawa was unable to verify whether residents were as old as they claimed because many records did not survive World War II.[10] When analyzed in the 21st century, life expectancy in Okinawa was deemed to no longer be exceptional when compared to the rest of Japan, as "male longevity is now ranked 26th among the 47 prefectures of Japan."[4]
Harriet Hall, writing for Science-Based Medicine, stated that there are no controlled studies of elderly people in the blue zones, and that blue zone diets are based on speculation, not solid science.[3]
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Ageing |
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Longevity genes |
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