Blue Zones Review: What Are Blue Zones?

Dan Buettner is an American author who has dedicated his career to studying Blue Zones: regions around the world where people live remarkably longer and healthier lives. 

Buettner’s goal is to share the lessons learned from these longevity hotspots to promote global health and well-being around the world. 

As a dietitian, I’ve always been curious if the Blue Zones are legit, or if they’re anomalies in a very different world and an example that the rest of us might never live up to.

A recent  4 episode Blue Zones Netflix series takes viewers to these places to ostensibly teach us the secrets of how to live a longer and healthier life. 

The series kicks off with a profound question: How many years will we live, and do we have any control over it? That is what Buettner wants to find out as he takes a journey to each of the Blue Zones. 

He puts emphasis on how most of our society is investing heavily in diet plans and gym memberships, as he challenges the conventional approach, asserting that it’s not about preventing death, but rather learning how to truly live.

Blue Zone: Okinawa

The journey begins in Okinawa, Japan.

Buettner encounters a remarkable family, led by a 101-year-old woman who embodies the essence of longevity. Her keys to a fulfilling life are simple yet profound: always have fun, avoid anger, spread happiness, be easy-going, forgive easily, and find joy in laughter.

In Okinawa, it’s about being truly happy and enjoying your life stress and worry free. That sounds great! As someone who lives in the 5th largest city in the world, has 2 kids, 3 hamsters, her own business, and a world of responsibility, I can’t even imagine my life being stress and worry-free.

Hello, I have bills to pay here.

The dietary habits in Okinawa include the consumption of purple sweet potatoes and tofu, which are definitely rich in nutrition.

Viewers are told that tofu lowers cholesterol and slows the progression of certain cancers.

This 2023 study published in Nutrients, did not find an association between tofu and cardiometabolic markers, including cholesterol and triglycerides. Moreover, as a dietitian, I’m not sure about the mechanism around tofu slowing progression of cancers, and it seems rather shady.

It’s also important to note that Okinawans make their own tofu, which is higher in healthy fats and protein than the tofu that’s available in our grocery store. That’s a confounding variable right there.

We need to always be aware of not submitting to the ‘golden age fallacy,’ where we believe that something is beneficial just because it has been done for decades without question.

A key practice in Okinawa is the pre-meal ritual of saying “hara hachi bu,” meaning to stop eating when the stomach is 80% full. In Okinaw,a it’s about being satiated without being overstuffed, a practice that aligns with their mindful approach to eating. 

In the bigger picture, the episode paints a vivid portrait of Blue Zone communities, emphasizing the consumption of whole, fresh foods, attentiveness to fullness cues, regular movement through gardening, daily stretches, and the paramount importance of community and self-belief.

Buettner makes a lot of claims in this episode that seem a bit off.

Firstly, he claims that 2/3 of the people on this planet will die prematurely from an avoidable disease.

The World Health Organization states that an estimated 12.6 million deaths each year are attributable to unhealthy environments and can be avoided. This is a large number, but it is not 2/3 of the world’s population. In fact, without a crystal ball, it’s hard to know the true origin of many diseases, and whether they could have been prevented.

He shared that life expectancy is dropping in America, which is in fact true. However, the Harvard Health Publishing Medical School has stated the 2 biggest contributors are from Covid-19 deaths and overdoses, and not because of unhealthy lifestyles and avoidable diseases.

Blue Zones: Loma Linda and Sardinia

The second episode takes viewers into the landscapes of Sardinia, Italy, and the community of Loma Linda, California.

Sardinia, Italy:

The steep villages themselves become a possible contributing factor to the extended lives of their inhabitants. Daily commutes involving climbing multiple steps and navigating challenging terrains are a significant aspect of their lifestyle, increasing overall energy expenditure. 

Sardinians embrace a diet rooted in tradition, with plenty of pasta, bread, and minestrone soup. 

Men often work as shepherds in the hills, engaging in activities like walking, and milking and hiking. There is also emphasis of rest taking and napping throughout the day as this region puts emphasis on managing stress effectively. 

Buettner brings to our attention the lack of long-term care or retirement homes underscores the importance of family and community, where children actively participate in caregiving, cooking, and companionship to their parents when they get a older age. 

This all sounds lovely, but is it feasible in the rest of the world?

Loma Linda, California:

This community follows pillars of behavior, including physical activity, volunteering, and a plant-based diet.

The population, particularly the Adventist community, emphasizes faith, contributing to a healthier lifestyle.

Buettner mentions that their high fruit consumption may play a role in reducing the cancer risk, that a handful of nuts daily contributes to their extended life, and that their regular bean consumption lowers the risk of colon cancer. 

The benefits of these foods are well known in the world of nutrition, but we have to consider what is being proposed here is a bit of a reach: specific foods are likely not the only reason why a population lives longer than others or has specific health outcomes.

Blue Zones: Ikaria and Nicoya

In Ikaria, Greece, longevity is interwoven with a profound connection to the land. The inhabitants have cultivated a deep understanding of local plants, herbs, and foods, choosing a diet centered around whole, unprocessed foods.

The consumption of local herbal teas for decades is noted, potentially contributing to a lower risk of dementia, and acting as diuretics to lower blood pressure.

I’m actually thinking that using herbal teas as diuretics isn’t always a healthy habit, but here we are.

Honey, the sweetener of choice in Ikaria, is sourced locally from beekeepers and is kept raw and unpasteurized, providing not just a natural sugar alternative but also ‘potential cancer-inhibiting properties.’

Show me the research, Dan.

Nicoya, Costa Rica:

Nicoya, Costa Rica, is one of the poorest places in the country, but its inhabitants have a biological age about 10 years younger than their actual age suggests.

Here, a clear sense of purpose keeps the community moving, just like in other Blue Zones.

The practice of growing their own food ensures a diet rich in beans, corn, and squash, providing essential amino acids and vital nutrients.

Nicoya boasts an efficient healthcare system with health care ambassadors conducting yearly door-to-door check-ups. This is not the case in most countries in the world, and having it most definitely makes an enormous impact on peoples’ health and well-being.

I feel like Buettner is creating straw man arguments with this entire narrative. Sure, having regular medical check-ins can help people live healthier lives, but what is his point? Is this at all applicable to the rest of the world? In cities with millions of people, what are the chances of any sort of similar practice?

Low. They’re very low. But in small towns, some of these things may be feasible.

American Blue Zones?

Buettner became so intrigued by the concept of environment having such an impact on people’s health, he wanted to see if he could make a Blue Zone in America. 

In the heart of Albert Lea, Minnesota, population 18,000, a transformative journey began to turn the town into a Blue Zone. Several of these ‘Blue Zones’ exist in the US, as outlined in this 2021 critical review.

Regular community walks and diverse volunteer opportunities were introduced to residents. People found purpose and connection as they worked together on various projects, building a stronger, more unified community.

Local grocery stores and restaurants joined the effort, offering healthier food options to promote better dietary choices among residents.

Albert Lea embraced the concept of community gardens, providing residents with a chance to grow their own fresh produce.

The collective efforts of Albert Lea resulted in improved health and wellness for the community

Albert Lea stands as an inspiring example for other communities, demonstrating that small, community-driven efforts can lead to significant improvements in overall health and longevity. 

But is it all realistic?

Can we have Blue Zones in the rest of the world? Most of us don’t live in small towns with close-knit communities.

As a dietitian, I love the idea of Blue Zones, but I think it’s inherently flawed.

While diet and lifestyle go a long way in predicting a person’s lifespan, their access to healthcare, stress levels, living conditions, economic conditions, geographical location both in weather and in urban areas (ie – is it safe it walk outside?) and genetics (perhaps most importantly) are the piece of the puzzle that I don’t think Blue Zone’s necessarily addresses.

Take the quiz that the Blue Zones offers on its website.

Essentially, it told me I could add 4.5 years to my life if I ate less meat and was less angry (let’s see them debunk nutrition scammers without getting angry!)

The entire premise of this ‘personalized’ quiz predicting my person life expectancy and potential of added years is absolutely imprecise. It again, ignores genetics and other relevant factors.

This seems like a pattern with BZ.

The Blue Zones have checklists for individuals who are interested in implementing BZ concepts into their lives.

Here is the Blue Zone checklist for home:

While some of these ideas may be doable for many people, what if someone lives in an apartment? In a cold climate? If they can’t afford a pet? If they don’t have space for a ‘destination room’? And I am NOT getting on rollerblades, which I can assure you will shorten, not lengthen, my life.

As a dietitian who encourages a focus on healthy habits and not weight, the Blue Zones Tribe Checkup was a definite eye-opener:

I don’t know about you, but I really don’t feel good about scoring my friends’ habits and weight to figure out whether or not they’re a good person to hang out with.

This is just…honestly, I’m shaking my head in disgust and dismay as I write this. There are really no words.

The Blue Zones underscore how community, a plant-forward diet, activity, and reduced stress may impact our lives for the better. This is undisputed by most health professionals.

However, the absence of any substantial discourse on the impact of genetics prompts a realization that while lifestyle choices play a crucial role, genetic factors may contribute significantly to the exceptional longevity observed in these Blue Zones.

Moreover, the Netflix Blue Zones documentary sidesteps discussions on the cost of living and the affordability of the dietary habits prevalent in these regions. This prompts contemplation about the accessibility of such a lifestyle, raising questions about the feasibility of adopting Blue Zone practices in diverse socioeconomic contexts.

Also, the realization that the lifestyles depicted in Blue Zones are profoundly different from the global norm sparks contemplation about the cultural and environmental disparities.

The scarcity of smartphones, limited engagement with social media, and distinct governmental structures in these regions contribute to an environment that fosters unique health-promoting practices that are much different in most parts of the US and Canada and abroad.