Last year, I wrote a post about the idea of longevity tied to certain lifetsyles and geographic regions… better known as “Blue zones”. The idea is that there are certain locations (Sardinia, Okinawa, Costa Rica, etc) where there are more centenarians than you’d might expect. The inference is that those communities are doing something “right” and experiencing longer than average lifespans. Dan Buettner wrote about this in National Geographic and it eventually exploded in the zeitgeist to include cook books, longevity-based tourism and Netflix documentaries. Last spring I was in Costa Rica and even in the airport there was a “blue zone Nicoya store” that sold books, cooking supplies, and other related things.
Dan studied these communities and came up with a set of characteristics that he calls the “power 9”. Things all these blue zones have in common.
Move naturally (just be an active person, not necessarily a gym rat)
Have a purpose (career, family, community, etc)
Control stress (meditation, prayer, moments of silence or reflection)
Eat only 80% of your plate (basically eating in moderation)
Have a plant-based diet (only one of the blue zones, Loma Linda, is actually vegetarian though)
Have wine at 5PM with friends (drink moderately and with friends and family)
Belong (to a church, a community, an organization, a family)
Put family first (rally around your loved ones)
Have a good tribe (surround yourself with long-term and healthy friendships)
While we have good strong data that these are mostly, or all, healthy things to do, science has always been a little skeptical of the blue zone idea. Many people think its over simplified, uses unreliable metrics or is just a marketing ploy. Recently, demographer Saul Justin Newman has systematically picked this apart. For his efforts, he won the 2024 IgNobel awards (not to be confused with the Nobel awards, the IgNobels are a spoof award for science that “makes people laugh, then think”.
Here are some of the problems that Saul, and others, have brought to light.
The data on aging is very unreliable.
People who are over 100 years old often have no birth certificates. It is therefore impossible to prove that they are the age that they claim. In some communities, being extremely old aged is something to brag about, so someone may fudge their numbers a bit. In Japan it was discovered that 82% of the people that they thought were over 100 were actually dead. Their deaths were just never registered with the government. Newman says: “The secret to living to 110 was, don’t register your death.”
In Italy and Greece, again many of these supposed centenarians were actually dead and their deaths never registered so that their care takers could continue to receive their pensions and benefits. In fact, a study using UN data on mortality showed that Puerto Rico had many centenarians. When you look deeper though, there is so much pension fraud in PR that the country canceled birth certificates as an official document in 2010.
Of course if we don’t have accurate data on people’s ages then it’s impossible to find places where people live longer than average. Or, what “average” is even.
About that wine…
Another head scratcher was how wine can be associated with longevity when literally every scientific study shows that any benefits of wine are negligable at best. I know you’re thinking that "they said wine was good for your heart!” but I’ve discussed many times on this substack how difficult it is to study nutrition in humans. There are just so many confounders, like what if people who drink moderately also do other things that are considered “healthy” like eating moderately, exercise, etc? It would be impossible to tell where the heart-protective benefits were coming from. In fact, a more recent study showed that wine may actually INCREASE cardiovascular disease. So, at best, the data is mixed. Plus there is evidence that alcohol consumption increases the risk of many different types of cancers, including breast, colon, and liver.
Sidebar: alcohol is literally a poison. Bacteria and fungus produce ethanol as a way to kill off their competitors. They use it as a chemical weapon to wipe out other types of bacteria and fungus that are competing for their resources.
So how do we square all of this up? Peter Attia, longevity expert, has an interesting idea. What if the “wine at 5pm with friends and family” being good for your health is not because of the wine… but because of the time spent with friends and family? Considering that we keep seeing, over and over, the importance of community, belonging, family and friendships popping up in these longevity studies… maybe that’s the key here. The idea is that the benefit of socializing is so great that it outweighs any negative effects of moderate drinking. Attia says in his book “Outlive” that “once you remove the effects of other factors that may accompany moderate drinking….any observed benefit of alcohol consumption completely disappears”.
Don’t throw that baby out with the bathwater though.
Just because the original methodology behind Blue zones is seriously flawed, and there are so many confounders in nutritional and behavioral studies that its hard to nail down which behavior in particular is important for longevity… .that doesn’t mean that all of this is garbage. There are still very strong benefits to movement, moderate eating, community and many other blue zone ideals.
It just very well may be that the idea is vastly oversimplified and blown out of proportion because of its attractiveness to advertisers and marketers. As Ian Malcolm once said in Jurassic Park: “You stood on the shoulders of genuises to accomplish something as fast as you could and before you even knew what you had, you patented it, packaged it and slapped it on a plastic lunchbox and now you're selling it!”
I’m looking at you Blue Zone Nicoya Store.
Correction.
Last month I incorrectly listed the viruses included in this year’s flu vaccine, I inadvertantly listed the ingredients for the 2023-2024 flu vaccine instead. Here are the corrected viruses:
an A/Victoria/4897/2022 (H1N1)pdm09-like virus;
an A/Thailand/8/2022 (H3N2)-like virus; and
a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.
Stay happy, healthy and informed,
Jessica at TCA
Meyerowitz-Katz, G. Do “Blue Zones” Really Exist? Slate. Nov, 2023.