Blue Zones: lessons from the world’s longevity hotspots

Updated Six Habits Editorial Team
Elderly villagers tending a vegetable garden together on a sunny Mediterranean hillside
The short answerBlue Zones are regions with a high share of long-lived people: Sardinia, Okinawa, Nicoya, Ikaria and the Seventh-day Adventist community in Loma Linda, California. Their shared habits include natural movement, a mostly plant-based diet, purpose in life, community and family. Some of this is supported by research, such as long-term studies of Adventists, but the accuracy of ages in some regions has been criticized.

Key points

Where Blue Zones came from

The term emerged from demographic research in Sardinia, where scientists marked villages with exceptional longevity in blue ink on a map (Poulain et al., 2004). Writer Dan Buettner, working with National Geographic and researchers, later identified five such regions.

The five regions

Nine shared habits (“Power 9”)

Buettner and Skemp (2016) describe nine common habits: natural movement throughout the day, a sense of purpose, routines to shed stress, eating until about 80% full, a mostly plant-based diet, moderate wine in some regions (not among Adventists), belonging to a faith community, putting family first and social circles that support healthy behaviors.

What research confirms

Adventists. California Seventh-day Adventists lived on average 7.3 years longer (men) and 4.4 years longer (women) than other Californians, with vegetarian diet, exercise, nut consumption and not smoking contributing (Fraser & Shavlik, 2001).

Vegetarian diets. In Adventist Health Study 2, with more than 70,000 participants, vegetarians had 12% lower all-cause mortality than non-vegetarians (Orlich et al., 2013).

Criticism

Some researchers argue that age records in certain longevity regions are unreliable. And even accurate observational data show associations, not cause. The habits themselves, though, align well with the evidence on lifestyle medicine.

Frequently asked questions

Is there a Blue Zone in the U.S.?

Yes: the Seventh-day Adventist community of Loma Linda, California, which emphasizes a plant-based diet, no smoking or alcohol, exercise and a weekly day of rest and community.

Can a town become a Blue Zone?

Several U.S. communities have run "Blue Zones Projects" to make healthy choices easier, though rigorous evaluations are limited.

Sources

  1. Buettner et al. (2016). Blue Zones. American Journal of Lifestyle Medicine 10(5):318-321. doi:10.1177/1559827616637066
  2. Poulain et al. (2004). Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. Experimental Gerontology 39(9):1423-1429. doi:10.1016/j.exger.2004.06.016
  3. Fraser et al. (2001). Ten Years of Life. Archives of Internal Medicine 161(13):1645. doi:10.1001/archinte.161.13.1645
  4. Orlich et al. (2013). Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2. JAMA Internal Medicine 173(13):1230. doi:10.1001/jamainternmed.2013.6473

Prepared according to our evidence methodology and the principles of lifestyle medicine. For education only; it does not replace advice from your doctor.

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