A great many of you will be familiar with National Geographic’s study of countries that produce more than their fair share of centenarians (100-year-olds) per capita. It is titled The Blue Zones, and identifies Okinawa (Japan), Sardinia (Italy), Loma Linda (USA), the Nicoya peninsula (Costa Rica) and Ikaria (Greece) as particularly long-lived areas.
I had some problems with this effort. Firstly, they summarised the practices of these countries without providing a summary of comparison countries. So, we have no idea if those practices help them to live longer.
Secondly, the number of centenarians per capita is a rare event and rare events make for unreliable measures.
Thirdly, identifying regions that routinely fail to produce long-lived individuals is just as informative as identifying those that do.
Fourthly, the National Geographic results could have been because those areas were just fortunate in having an environment that is particularly low risk regarding non-lifestyle factors, such as being a non-malaria zone or a mild climate.
Finally, a mere five data points risks producing chance results.
I chose an approach that solves all those issues. My measure was life expectancy, which applies to every person rather than a mere handful of people. I controlled for death rates below age 5 and death rates due to all forms of accidents, various forms of violence, infectious diseases and air pollution.
Then I also controlled for per capita medical spending. I got information on 178 countries – a lot more than five data points. I inferred that countries that had longer life expectancies, given all those factors, must have lifestyles more conducive to health, including, for example, better nutrition, more activity, lower stress, better social relationships and a stronger sense of purpose, than those with shorter life expectancies.
All this applies to the conditions prevailing for the two or three generations leading up to 2018. In other words, it excludes Covid 19.
Life expectancy
I must say upfront that differences in lifestyle make modest differences at best to country variations in life expectancy. If you want to live a long time you ought to make sure your babies survive past 5, that you avoid trauma from any form of accident or violence, that you usually breathe clean air, that you eliminate sources of infection and infectious diseases, and that you have access to decent modern medical care. A healthy diet in no way makes up for becoming a victim of any of the above.
Countries that have longer (Blue Zones) and shorter (Red Zones) life expectancies than expected given the control factors, tend to cluster together. Those you would really expect to be in either group do actually appear there. That is encouraging because it does suggest lifestyle differences are at play.
Each continent turned up multiple areas of Blue and Red Zones. The Blue Zones include east Asia (Japan, Korea, Singapore but not China); south east Asia from Bangladesh to Vietnam; the Mediterranean countries (especially the European side, including Portugal, and Israel but not Egypt, Libya, Turkey, Syria or Lebanon); countries in and around the Alps; most of the Andean countries (Chile, Peru, Colombia, Venezuela) and central America (Honduras, Nicaragua, Costa Rica, Panama); parts of west Africa (Liberia, Guinea, Guinea-Bissau, Burkina Faso) and east and central Africa (Mozambique, Malawi, Rwanda, Zambia, DRC up to South Sudan and CAR); much of the Pacific (Australia, NZ, Papua New Guinea, Samoa, Solomon Islands, Vanuatu and Kiribati), and, finally, some countries like Sweden and Canada. The Mediterranean and east Asia are no surprise and most of the National Geographic Blue Zones lie within these areas.
The Red Zones include all of eastern Europe (the former East bloc) except Slovenia and Albania (both sort of Mediterranean); all of central Asia north of Pakistan plus Mongolia; southern Africa (South Africa, Eswatini, Namibia, Botswana); bits of west-central Africa (Gabon, Equatorial Guinea and Cameroon); some east African islands (Mauritius, Seychelles , Comoros) almost all of the West-Indian islands plus Surinam and Guyana; bits of the Middle East (Saudi Arabia, Jordan, Iraq, Syria, UAE, Egypt, Sudan, Libya, Turkey), and, finally, individual countries like Fiji, Argentina, and, of course, the United States.
Readers will notice that South Africa is deep within the Red Zones. We have one of the world’s most unhealthy lifestyles. America, the poster child of unhealthy eating, is exactly where we expect it to be.
So, what lifestyle factors distinguish countries in the Blue Zones from those in the Red Zones? What can we learn that can aid our own search for a healthy and long life?
One thing I notice is that the Blue Zone countries eat everything. They are not strangers to pastries, booze, meat, dietary fat and even cigarettes. Yet they do tend to be less prone to getting fat than Red Zone countries. They often have cultural rules that restrain overeating, such as dignified eating with people at a table rather than supersize portions in front of the TV. They do eat a wider variety of foods and are more likely to eat whole fresh foods. They tend to be less stressed and have better communal relationships. They are more active.
Getting enough to eat
Red Zone countries are prone to think of health as simply getting enough to eat. The important thing is to not lose weight, to avoid a famine. They tend to more likely rely on refined grains like white bread, sugar, refined mielie meal or cheap fast foods. It saddens me, but refined pap, burnt meat and lots of beer is not a healthy lifestyle.
The basic science of health and longevity, such as it is, is in line with these differences. It says eat a large variety of fresh whole foods, especially plants with fibre. Fermented foods are useful. Keep your fat levels, especially visceral fat, low.
It follows you should not eat a lot of calories but adhering to the first point, along with dignified eating, will help a lot. Don’t smoke. Get exercise, and a variety of it. Get a good amount of high-quality sleep. Avoid stress. And be part of a functional community.
[Image: Marisol Benitez on Unsplash
The views of the writer are not necessarily the views of the Daily Friend or the IRR.
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