"Blue zones" are areas of the world where longevity and health go hand in hand.
Along with a team of demographers and scientists, Buettner spent seven years studying places where people were living longer and better, as outlined in his book, The Blue Zones. That research, funded in party by the National Institute on Ageing, found that people in these four zones are more likely to see their 100th birthday. Many of them also manage to avoid diseases of lifestyle and ageing.
Buettner's blue zones are located in four very different parts of the world: Sardinia, Italy; Okinawa, Japan; the Nicoya Peninsula, Costa Rica ; and among the Seventh Day Adventists in Loma Linda, California.
These four areas are marked not only by a long life expectancy, with a high concentration of centenarians, but also by a long healthy life expectancy. Simply put, people living in the blue zones are living longer without the years of decline marked by illness like heart disease and cancer that many older North Americans face.
Unfortunately, these areas are not part of a new trend. They are the remaining zones where people are living long, healthy lives in a world where globalisation has rapidly spread the western diet and lifestyle, along with its associated health problems. "I think these pockets of longevity are disappearing," Buettner said.
Buettner's exploration of longevity began in Okinawa, Japan. He was planning a series of expeditions to solve ancient mysteries, and was directed to Okinawa by the country's government, which has been studying the notable health and longevity of Okinawans since the mid-1970s. The World Health Organisation (www.who.int/en/) had discovered that Okinawa had the world's longest disability-free life expectancy and Buettner found that a mystery worth investigating.
Okinawa not only has a high number of people who live to 100 and longer, these elderly residents are also in great health for their age. Okinawans show one-fifth the rates of breast and colon cancer and one-sixth the rates of heart disease seen in North America, where those two factors will account for the deaths of about 80 percent of people 65 and older, Buettner said. Obesity rates are also very low, and physical mobility remains good even into advanced ages.
"Something is happening with their lifestyle that is yielding these incredible numbers," Buettner said. Okinawans eat a largely plant-based diet, which includes at least eight times the fermented soy as North Americans. But they also have a culture that supports the health of the elderly. The concept of moai explains the extended support network that people have throughout their lives, and elders are venerated in Okinawan society.
Buettner also explained that, in Okinawa, people live with a defined sense of purpose - ikigai or "the reason for which you wake up in the world." "It's very easy to trivialise a sense of purpose," he said, "but it's a very important determinant of longevity." People who don't know why they wake up in the morning probably live seven or eight years less than those who do, he said, making a sense of purpose key, especially in middle age. The two most lethal years of life are the year you're born and the year you retire, he pointed out.
The other three blue zones feature their own keys to longevity. Elders are also revered in Sardinia, and two glasses a day of heart-healthy red wine are standard. On Costa Rica's Nicoya Peninsula, the average diet of black beans, fruit, and lime-soaked, antioxidant-rich corn hasn't changed much over the past few millennia.
Loma Linda has the highest concentration of Seventh Day Adventists in the world, Buettner said, making it truly a cultural blue zone. Adventists eat a plant-based diet taken from the Bible, have strong faith and family networks, and strictly observe the Sabbath, taking a day to distress and recharge once a week. The Adventist Health Study completed by the National Institutes of Health showed that this lifestyle earns Adventist women in Loma Linda an extra nine years of life than their American peers, while men average 11. "Once again," he said, "you have a heterogeneous population vastly outliving their cohorts for one and one reason alone: their lifestyle."
Though the blue zones are found in four very geographically and culturally different parts of the world, there are nine characteristics common to all of them that are portable to any location and can be used to make healthy lifestyle changes, Buettner said. They include making low-intensity physical activity part of one's daily routine, building good relationships with friends and family, eating a diet lighter on meat and excess calories and heavier on plants, and finding a purpose for and sense of meaning in your life.
Buettner worked with the University of Minnesota over three years building his vitality compass test, which he says has tested to be the most accurate life expectancy calculator of its kind and is featured on his website. The test asks questions about your health and lifestyle, and the results include your life expectancy, your healthy life expectancy, and your body's current age (as opposed to its chronological age). It also identifies particular areas where care is required, he said, and where simple changes based on the nine longevity characteristics, like making your home a bit less convenient to increase daily movement or eating on smaller plates to cut portion sizes and calories, can start to make an impact on your health.
"Adopting any one of these nine will immediately improve your life expectancy at any age," Buettner said. "It's never too late to start."