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mccoy

'Blue zones' diets

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I just made a double search: by the forum engine and by the google engine. There appears to be no thread specifically on the blue zones in this forum so I'm going to open one.

 

I've just read the chapter on the blue zones diets in Dan Buettner's book: 

41mQepiWB0L._SY346_.jpg

 

He lists 5 verified (where birth certificate confirm exceptional longevity) blue zones as you guys well know:

 

  1. Ikaria island, greece
  2. Okinawa island, japan
  3. Sardinia island, Italy
  4. Loma Prieta adventists, ca., USA
  5. Nicoya peninsula, Costa Rica
Edited by mccoy

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What I realized from the detailed reports of the blue zones diets is that most the areas (except Loma Prieta) are or were pretty rural or isolated and probably poor. Sure the Italian and Costarican zones were poor. Also, most areas are/were pretty isolated (islands or peninsula with montainous terrain) hence maybe more amenable to genetic selection. Some aspects that I realized and were not given maybe very much importance in the book whereas others factors are well known:

 

  1. The zones, except maybe Loma Prieta, all practiced caloric restriction. Food was not abundant and poverty ruled supreme. That is for sure in Sardinia, pretty sure in Nicoya and Ikaria, whereas I'm not sure of Okinawa but there the habits entailed leaving the table with a 20% empty stomach
  2. Most diets were plant based but never 100%, except the adventist vegans
  3. Some of the food items regularly eaten were not healthy at all, like lard (used in Sardinia and Nicoya)
  4. In all the blue zones except possibly Loma prieta (which is the only blue zone in a modern western society) there was extensive use of wild plants and fruit (I'm not sure about Okinawa but that's possible)
  5. Most plant foods were organic, grown on private gardens and chemicals were nto used in those areas
  6. Carbs were prevalent in all zones, with varying quantities of fats (Buettner published no macros, just percentges by weight of various foods), protein usually 10-20%
  7. Life is/was very boring in all zones, again except probably Loma Prieta. No stress but the stress to partly fill the stomach daily
  8. Bland physical exercise is common to all areas, often montainous
  9. Some security against social stressors is given by the community/family in a quasi tribal pattern.

 

Now, I remained pretty perplexed about some areas like the Sardinian shepherds (in my region there is a similar shepherding tradition). That area was extremely poor, isolated, the shepherds led very rough and boring lives, all day long herding sheep or goats in rocky lands, little food, very often eating mainly sheep or goat cheese and drinking their milk, along with dry flat bread and surely some wild plants. While on the move they sure could not follow the diet described by Buettner. I see no recipe of longevity here, maybe the genetic development of a very resilient body, with a brutal natural selection which eliminated the weaker individuals. The life and diet of farmers probably were healthier (as we construe healthy) than the Sardinian shepherds'. 

 

Nowadays we most often don't have that wide access to organic and wild food but we do have access to extreme food variety which was not granted in those areas.

 

I still miss a strong common denominator in those cultures. OK, food was mainly plant based but so was the diet for example in all rural Italy (not just Sardinia) before the fifties. And it was mainly based on whole grain carbs and legumes, the poor men's food because unexpensive. And all the farmers who had their own land plot of whatsoever size did grow their produce and many fell back on wild plants when produce was not available. And in hilly areas they didn't use pig's lard but EVOO as a main source of fat. However, there are no blue zones in the hilly areas of Italy, where apparently diet and life conditions are better than in the rough isolated areas of Ogliastra, Sardinia.

Bottom line, I remain a little perplexed by this blue zones topic, I feel like I'm missing something.  Sure it is an undisputable fact that the diet was prevalently plant based and rich of carbs and fats, very low in animal proteins (with the possible exception of Sardinia). 

 

But again, I cannot pinpoint that something very special that seems to be the cause of extensive longevity in those communities (for most of them the present diet is even very different from the traditional diet, with poverty less a concern). Unless the social aspects of a strong sense of belonging, purpose and so on govern. Sorry if the posts may appear a little confused but that just reflects my mild state of confusion on the issue.

Edited by mccoy

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Great initiative McCoy, good topic for a thread. My comments, reflections, and comments follow:

 

I use asterisks (*****) for my replies since i can't find an easy way to separate out your sections from my own on my iPad reply

 

What I realized from the detailed reports of the blue zones diets is that most the areas (except Loma Prieta) are or were pretty rural or isolated and probably poor. Sure the Italian and Costarican zones were poor. Also, most areas are/were pretty isolated (islands or peninsula with montainous terrain) hence maybe more amenable to genetic selection. Some aspects that I realized and were not given maybe very much importance in the book whereas others factors are well known:

 

******Genetics has been studied for some of these cultures, for example Okinawa. As expected both genetics and lifestyle play a factor in these places to various extents. Migration studies and changes in epidemiology favor a significant environmental component, for example rapidly deteriorating health in Okinawa as the newer cohorts - especially the men - have adapted a more Western lifestyle including diet*******

 

 

  • The zones, except maybe Loma Prieta, all practiced caloric restriction. Food was not abundant and poverty ruled supreme. That is for sure in Sardinia, pretty sure in Nicoya and Ikaria, whereas I'm not sure of Okinawa but there the habits entailed leaving the table with a 20% empty stomach

     

    ***Okinawa was the only Blue Zones where I have seen reference to carefully chronicled caloric restriction -- I found this in the primary literature. Poor, sure, that much is clear, but food scarcity ( as they grew their own foods) was not so clear to from Buettner's presentation. Do you have a citation chronicling this for the other cultures, or is this (just) your impression?*****

  • Most diets were plant based but never 100%, except the adventist vegans

     

    ******Agree*******

  • Some of the food items regularly eaten were not healthy at all, like lard (used in Sardinia and Nicoya)

     

    *********I don't find this too surprising. It is the overall pattern that matters most. A little lard - including the saturated fat - appears to not matter so much as long as the individual is relatively slender, active, eats mostly plants such that less LDL has a chance to oxidize, etc. The dose makes the poison********

     

    *******I did find it interesting that I learned from Beutner that Okinawans used canola oil for cooking - high in oxidatively vulnerable polyunsaturated fat. PUFA may have beneficial biomarker impact on lipid profile, but I share with Michael R the concern regarding incorporation of PUFA in lipid membranes. I assume here, like I said, the dose makes the poison - their total fat content is so low it may not matter, but I wonder whether anyone here has insight into whether their canola oil also differs from the canola oils used in the West?*******

  • In all the blue zones except possibly Loma prieta (which is the only blue zone in a modern western society) there was extensive use of wild plants and fruit (I'm not sure about Okinawa but that's possible)

     

    ********Very extensive McCoy, please refer to the original "Blue Zones" publication ( I believe you are reading his follow-up book on the "Blue Zones Solution" based on your snapshot. Having said that very disproportionate intake of purple sweet potatoes during some of their hardest years with regard to percent of calories but these are very nutrient dense and still a lot of total diversity if not by calorie per se.******

  • Most plant foods were organic, grown on private gardens and chemicals were nto used in those areas

     

    ******Absolutely.*****

  • Carbs were prevalent in all zones, with varying quantities of fats (Buettner published no macros, just percentges by weight of various foods), protein usually 10-20%

     

    ****Varied quite a bit in macronutrient ratios from very low fat / protein to Mediterranean diet range +/- lots of dairy and homemade bread. I posted somewhere here the numbers. Bottom line though lots of plants, low to not especially high in protein, and not too high in calories.*****

  • Life is/was very boring in all zones, again except probably Loma Prieta. No stress but the stress to partly fill the stomach daily

     

    *******Hard to quantify this one. Depends what you mean by boring. But a strong family, sense of purpose and community as well as incorporating rest and leisure in addition to moderate activity throughout the day appears to be dominant.*****

  • Bland physical exercise is common to all areas, often mountainous

     

    ******Yep, without formal gyms, it is more fundamental to how they get things done including food acquisition.******

  • Some security against social stressors is given by the community/family in a quasi tribal pattern.

     

    *****Not 100% sure what you mean by that one. I think their are stressors across all cultures, just the nature varies and better outlets for stress and connection/meaning in these communities. Seems more communal the tribal, but maybe that is just semantics.*****

Now, I remained pretty perplexed about some areas like the Sardinian shepherds (in my region there is a similar shepherding tradition). That area was extremely poor, isolated, the shepherds led very rough and boring lives, all day long herding sheep or goats in rocky lands, little food, very often eating mainly sheep or goat cheese and drinking their milk, along with dry flat bread and surely some wild plants. While on the move they sure could not follow the diet described by Buettner. I see no recipe of longevity here, maybe the genetic development of a very resilient body, with a brutal natural selection which eliminated the weaker individuals. The life and diet of farmers probably were healthier (as we construe healthy) than the Sardinian shepherds'.

 

********Genetics addressed above... What I got out of this was "eat food, not too much, mostly plants"***********

 

Nowadays we most often don't have that wide access to organic and wild food but we do have access to extreme food variety which was not granted in those areas.

 

I still miss a strong common denominator in those cultures. OK, food was mainly plant based but so was the diet for example in all rural Italy (not just Sardinia) before the fifties. And it was mainly based on whole grain carbs and legumes, the poor men's food because unexpensive. And all the farmers who had their own land plot of whatsoever size did grow their produce and many fell back on wild plants when produce was not available. And in hilly areas they didn't use pig's lard but EVOO as a main source of fat. However, there are no blue zones in the hilly areas of Italy, where apparently diet and life conditions are better than in the rough isolated areas of Ogliastra, Sardinia.

Bottom line, I remain a little perplexed by this blue zones topic, I feel like I'm missing something. Sure it is an undisputable fact that the diet was prevalently plant based and rich of carbs and fats, very low in animal proteins (with the possible exception of Sardinia).

 

But again, I cannot pinpoint that something very special that seems to be the cause of extensive longevity in those communities (for most of them the present diet is even very different from the traditional diet, with poverty less a concern). Unless the social aspects of a strong sense of belonging, purpose and so on govern. Sorry if the posts may appear a little confused but that just reflects my mild state of confusion on the issue.

 

((((*****note: don't miss my replies in the GRAY portion of this post at all... I have not found a way to separate out my comments easily when I use the "quote" option of replies when I use my iPad or iPhone to reply.... last couple comments follow******))))

 

*********I think this is a reflection of the fact there are many versions of eat food, not too much, mostly plants ( plus exercise moderately incorporated, community support, etc) all of which can lead you to an overall healthy pattern. These may be simple rules but they are far from general practice in the West. I don't see it is a "secret" to longevity so much as they walked the talk of a healthy lifestyle - not by choice, but by necessity and cultural background.*******

 

***He also bring in a few other commonalities such as legumes for many, nuts ( studied originally in the Lima Linda seventh day adventists), etc. See this link : https://upload.wikimedia.org/wikipedia/commons/1/12/Vendiagram.gif

***

Edited by Mechanism

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Mechanism, with reference to the genetic component, if the Okinawans have been shown to loose their longevity if they follow a western diet, what about the other zones?

Also, a western diet , rich in junk foods and poor in phytochemicals, might have suppressed the genetic expressions favouring longevity.

That is, both genetics and environmental factors may be at play here, both being necessary. The robust genetics needs the right regimen and phytochemicals and all other conditions to express its fullest potential. Just speculation.

 

Re. caloric restriction, Buettner does not cite that except the Okinawans but he cites a 1800 Kcal daily diet for the Costaricans. He doesn't specify though if it is males, females or both.

The Ogliastra region in Sardinia was such a poor area that it is very plausible to expect scarcity of food and imposed caloric restriction. That's a montainous, rocky, not at all fertile area. No wonder food was little.

 

What I meant by security against social stressors is that those communities supported other members in case of need, economical or other. In okinawa they had these 5-people very close friendships, sort of a compact for life. In Sardinia there is the extended families which provide full support.

 

One point which still is obscure: like you say 

 

 

 

I think this is a reflection of the fact there are many versions of eat food, not too much, mostly plants ( plus exercise moderately incorporated, community support, etc) all of which can lead you to an overall healthy pattern. These may be simple rules but they are far from general practice in the West. I don't see it is a "secret" to longevity so much as they walked the talk of a healthy lifestyle - not by choice, but by necessity and cultural background

 

Of course all of the above is true, but in many other areas different than the blue zones overall healthy patterns were practiced, very often by necessity. I cited the farmers in the mediterranean parts of Italy, the area where I live. This is before hte sixties. They ate lots of EVOO, they ate mostly plants, legumes and grains, very little meat (reserved to the rich people), many wild plants, fruit when in season, usually very little fish, sometimes eggs and cheese but not always. They were compelled to engage in physical exercise. Why these areas usually do not exhibit extraordinaty longevity?

Actually, Valter Longo speaks about this isolated village in Italy (Molochio, Calabria) with a concentration of centenaries. This is closer to the mediterranean lifestyle than Sardinia. Also, in Italy there is another area in Basilicata, again a mediterranean lifestyle, with an unusual concentration of centenarians.

This may suggests that Italy has actually 3 blue zones so far pinpointed, not just one. This might also suggest that Buettner's blue zones list is not a complete one.

Also Again, why the concentration of centenaries in particular, restricted areas if everywhere else the same or very similar regimen was present? Genetics triggered by environment? Some specific environmental factors like exposure to some hormetic compounds unknown to us? 

I still feel that there is something we are missing.

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Thanks for the details ,McCoy

1) , less food is a plausible hypothesis and true for Okinawans, I would personally use caloric estimates for other zones as the gold standard for determining food scarcity -- with data keeping honest plausible hypotheses such as yours ( food scarcity is not uncommon to various cultures around the world today, and when nutritionally adequate and controlling for other factors certainly correlates with longevity and health).

 

2) 100% agree on the presence of other "Blue Zones" not referenced by Beuter. It is a hard job and not simply a matter of going through an Atlas identifying and validating longevity hotspots and I have to hand it to them them,,--- applied sciences are a lot harder and more messy than the pure sciences. Sure, better validated birth records was a key necessary but not sufficient variable of in inclusion but while they did a great job considering what they had to work with I do not view the list as comprehend nor the search systematic in the purest sense of the world and despite a great team of people indeed arbitrary elements, chance, etc, all played a role in their inclusion too. They worked with what they had. This was neither an RCT nor even systematic process though did their best to garner commonalities in a gray and muddy observational epidemiology context.

 

3) genetics vs environment: both, and defer to the literature where they tried to tease apart relative contributions of each, with mostly an environment>genetics picture but certainly both The lessons are those we articulated above so far as can be inferred and should be seen in perspective of the overall longevity research evidence from basic science to RCTs and everything in between.

 

4) hard to say to what extent differences in longevity in blue zones vs. societies purported to also have similar lifestyle yet shorter apparent longevity are due to 1) they do not follow the blue zone areas of distinction to the degree we/you suspect they do 2) differences in birth record accuracy ( whether they live long too but less validation of their true dates thus exclusion from qualifying as a blue zone ,..or else . inaccuracy despite best efforts in the blue zones records themselves). 3) the role of chance 4) genetics 5) differences in known variables 6) differences in unknown variables ( unmeasured optimal nutrition shortcomings, toxins, etc), etc etc. the list can go on and on and we do not know. Evidence / data could in theory tease apart to some extent over time but science is slow and many constraints at play not least of which include sociopolitical differences in records, authority, and culture, funding and study design.

 

5) if you feel like you are missing something I suspect it is at least in part because it is indeed very murky. Despite the in my estimation somewhat arbitrary and stochastic process for identifying these areas I do not feel they entirely lacking merit as part of the research puzzle. It is the complexity of undertaking this kind of work with realistic resources, not a lack of effort or making the best of what is available and I think in many ways laudible what has come out of these efforts not least of which include: 1) hypothesis generation for prospective and studies 2) evidence very high median longevity is acheivable in the context of the set of variables associated with said Blue Zones.

Edited by Mechanism

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Mechanism, 

I confess that I would be tempted to dismiss the blue zones phenomena as fluke situations occurring in very isolated areas where development of a specific genetic pool and natural selection govern. However, the Loma Linda example disproves that, being the genetic pool of Americans so diversified (the same happens in peninsular Italy).

 

All in all, it is very convenient to have an evidence of a diet/lifestyle which allows the expression of the longevity genes, to some extent. In a very concise way this is what I grasped.

 

  • Diet in the blue zones tends to be mainly plant based but with the almost inevitable presence of some animal foods (dairy products, eggs, fish and meat), always in moderate amounts
  • The animal food may be a factor in that it just avoids B12 deficiency, or it maybe that it really provides some necessary ingredients. The example of the Loma Linda vegans would tend to mitigate the importance of animal food
  • Diet in the blue zones tends to be calorically moderated, because of poverty or lack of abundance (with the possible exception of Loma Linda, where dietary abuse would  anyway constitute a sign of disrespect toward God)
  • Diet in the blue zones is usually lacking of pollutants and rich in phytochemicals, although often lacking in variety
  • Diet in Loma Linda probably does carry pollutants but there is the possibility of extreme  variety (this making up for the lack of wild plants)
  • Macros ratios in the blue zones favour carbs, with variable amounts of fats and moderate to small amounts of protein
  • Carbs are usually complex but often simple natural carbs are present (honey, fruit)
  • The lifestyle in the blue zones often includes lenghty periods in outdoor, healthy environments
  • Almost continuos, mild to moderately strenuos physical activity is often present by necessity (Loma Linda being a possible exception)
  • The blue zones communities exhibit customs which constitute robust built-in stress management systems
  • The blue zones communities tend to place an high value on elder people, motivating them to live longer
  • There is a pervasive sense of purpose in the blue zones communities which does not peter out with age

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With reference to the above list, it's interesting to note that the evidence would tend to refute some of the assertions of the paleo and low-carb communities:

  • Meat, fish and dairy products as a main part of a dietary regimen are healty (disproven, possibly true only if in moderate amounts and in the context of a plant-based regimen)
  • A low carb diet is healthy (disproven, at least as far as longevity and healthspan are concerned, carbs is the main macronutrient of all the BZs diets)
  • Lectins in beans, gluten and phytates in grains and nuts are extremely unhealthy (drastically disproven, since the blue zones diets are practically based on lectins and phytates rich foods)
  • simple sugars are unhealthy (disproven, fresh and dried fruits are eaten in abundance when available: tropical fruit in Nicoya, figs, peaches and other mediterranean fruit in Ikaria and Sardinia when available, all fruit by the Loma Linda adventists. Plus natural, unrefined bee honey in modest quantities)

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McCoy- nice; I agree with your major contentions save:

 

1) I think we are underestimating variety a bit. Even in Okinawa- arguably the most homogenous Blue Zone where so much purple sweet potato was consumed to the relative exclusion of other food groups, and granted in the words of my first link only "minuscule" for some of the sweet potato alternatives -- the overall breadth of diet over longer stretches ( including the small quantities and rarely consumed food sources) was still not too shabby: see https://www.superfoodly.com/okinawa-diet-plan-food-list-and-menu-recipes/and also this gem of a publication which describes medicinal foods/spices too: http://okicent.org/docs/500s_willcox_okinawa_diet.pdf . I do agree though by prototypical CR Practioner and cronometer afficanado standards the diversity is modest! Everything is relative and by SAD extremely diverse as far as F&V consumption but modest and humbled in a forum ( and I say this affectionately) imbued with a culture that at times borders on orthorexia ???? To your point though nutrient deficiency was common ( I linked to the manuscript in the past) at least in Okinawa and that may be the ah-hah there.

 

2) agree the C:F ratio relatively high on average but still quite variable and the absence of a listed blue zone with a higher fat to carbohydrate ratio does not preclude the possibility that such a diet can also be healthiful. We are dealing with a small sample size and availability is a limiting factor for most of these cultures. We would need to observe harm and link it causally to the complementary macronutrient ratio to arrive at that conclusion with confidence.

 

It does however suggest that - contrary to negating claims by some non-scientific subsets of the paleo community - it is possible to have a high ( primarily complex whole food) carbohydrate to fat ratio and still maintain excellent health and longevity, which I think is what you are getting at.

 

I likewise agree the patten is suggestive of moderate Le / limited animal protein as optimal for health and longevity, and there is much stronger evidence for this in other domains of study ( cf- excellent recent ML post on the distinction between methionine restriction and [animal] protein moderation).

 

Great list you put together!

Edited by Mechanism

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Thanks mechanism for the interesting links you posted. It is reported that the average energy consumption of Okinawans was 1785 kCal (not specified man/woman), which is practically the same of the 1800 kCal of the Nicoyans. So the hypothesis of a common condition of calorie moderation or restriction in the blue zones (barring perhaps Loma Linda) appears perhaps more likely.

 

I'm presently ruminating about food diversity and am probably going to start a thread on it. 

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I believe the three most important factors that make Blue Zones are: high intake of fermentable fibers, high polyphenol intake to modulate gut bacteria (wild herbs, anthocyanins from purple sweet potatoes, resveratrol from wine), and abundance of low-moderate intensity exercise.

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Nice visit to Ikaria.

“Now, what are the major factors, that give Ikarians longevity? Researches have shown that there are many key elements that lead to their longevity and here are just a few:

-good physical condition, due to daily exercise of manual work and rural life. The daily walks, which includes mountain hikes enhances good physical condition.

-midday rest, even if it’s a short nap, has proven to protect and improve heart function.

-the Mediterranean diet, combined with fresh, organic produce, that’s consumed on the island. This includes vegetables, fruits, fish, olive oil, local honey and of course the famous red wine. Surveys conducted also show that a significant factor in the longevity of Ikarians is the consumption of Greek coffee and mountain tea, which are key antioxidants for the body.

-the minimal use of medicine.

-sexual activity, even in older people.

-strong family and social ties between Ikarian people.

-and of course, the relaxed pace of daily life, without anxiety and stress, and a full of optimism attitude.

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In small population "blue zones" like Ikaria (less than 10,000), my guess is that genetics plays an important role.

But notably, the diet has changed since those over 90 were in their prime. Olive oil and meat consumption has increased significantly, as well as the consumption of processed foods.

The same trend is seen elsewhere, especially in Okinawa, where dietary changes since the 1950s have been dramatic, with a corresponding increase of disease and mortality.

Edited by Ron Put

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Yes, we've been discussing that, it seems reasonably to assume that:

  1. Given that the blue zones seem to occur in restricted or isolated areas, genetic pooling is a significant governing effect.
  2. Given that the descendants of the original inhabitants of the blue zones tend to lose the longevity benefits because of the change in diet and lifestyle, it also seems that the expression of the genetic setup favourable to longevity must occur trhough interventions which have been part of the traditional lifestyle in these regions.

In conclusion: 

Occurrence of longevity = favourable genetic potential + actual expression of such genes

Edited by mccoy

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