Today’s PrimalMed Prescription…Blue Zones !!!
Can a trip to the Amalfi Coast and Capri provide insights into the Blue Zones and the secrets of longevity?
PrimalMD and PrimalRD just returned from a vacation along the Amalfi Coast in Italy. Look at the pic above. You get to guess which one is Maria. After enjoying a few days with friends in Capri for an awesome destination wedding, we trekked on to Positano and Sorrento. It was at this farm in the Sorrento countryside that we met Maria. Lots of lemon trees. Lots of very large lemons. And lots of Mozzarella. Which brings us to Maria. But first, a song:
When we arrived at the family farm, 3 generations were gathered around the table enjoying a long lunch with typical Mediterranean diet fare. Fruits in season, local breads and meats and cheeses, and some Limoncello for dessert. Our guide introduced us to her great aunt Maria. No one was really sure how old Maria was, but to everyone we asked, she was their great aunt. We went back into the kitchen and Maria showed us her very own special way of braiding the Mozzarella made from Buffalo milk. She separated the curds from the whey, added some water, salt and enzymes, muttered something in Italian and showed us her creation.
OK...say goodbye to Maria for now and hello to the Blue Zones!
So what are the Blue Zones?
The Blue Zones is a term coined by National Geographic writer Dan Buettner in 2009 (His book is titled “The Blue Zones” and is based on research from the Journal of Experimental Gerontology in 2004). He used this term to describe certain areas where he and fellow researchers observed populations that seemed to live longer than average. People in these Blue Zones tended to live well into their nineties and had a far greater percentage of centenarians with little of the chronic disease that we see today. What’s the secret or, more importantly, what does the book claim to be the secret sauce?
There were 5 original Blue Zones:
Okinawa, Japan
Sardinia, Italy
Loma Linda, California
Nicoya Peninsula, Costa Rica
Ikaria, Greece
Nothing particularly BLUE about these areas. Legend has it that these areas were up on the white board and one of the researchers circled them each with a Blue Sharpie. Hence the name.
These people live all over the world and have many different diets and lifestyles but what are the similarities? Now if you remember my past post on longevity and living to 120, you’ll remember that I focused on the granular chemistry, namely the balance of nutrient sensors mTor and AMPK, and the balance of cellular growth and repair.
https://tedmetzgermd.substack.com/p/todays-primalmed-prescriptioncan-525
But let’s dial it back today. Lets look at the many INPUTS into our health that can lead to positive outcomes and evaluate some Blue Zone principles so that we may apply them to our seemingly UNBLUE lifestyle.
For starters, these people smoke less, and move more. They don’t hit the treadmill or gym. I doubt there is an LA Fitness in Sardinia. The countryside IS their gym. Their bodies ARE their gym. They move at moderate levels throughout the day. They prioritize family and social connections.
Diet? All very different but the authors report a definite “plant slant.” I hesitate to use the overplayed “plant-based” phrase, since that implies a disdain for animal products and is tinged with a tribalistic virtue-signalling bias. They tend to get their protein from plant sources but DO INCLUDE meat, fish, fowl, dairy, cheese and eggs. They do keep their protein intake on the low side, perhaps to dampen the potential aging effects of mTor (see prior post).
Let’s put on our detective caps and dig a bit deeper.
So what are these key inputs described by the authors?
MOVE NATURALLY: This would include daily movement. Walk, walk, and walk some more. Many Sardinians are shepards and walk the hilly countryside all day. Many garden and walk to their social commitments.
RIGHT OUTLOOK: I guess this includes having a purpose or a “plan de Vida” according to the Nicoyans. What’s your “why?” When you wake up, do you say “hell yeah!” or dread going in to work? Remember to downshift! How do you release your stress? Do you make time to “think less and live more?” as my wise elder brother has counseled?
EAT WISELY: The big one here, IMHO is the 80% rule or what the Okinawans refer to as Hara Hachi Bu. Eat slowly, mindfully, and stop when you are 80% full. I like to take it one step further and stop eating when you are “no longer hungry.” When you eat mindfully rather than scarfing down your lunch in 5 minutes flat, you are in tune with your satiety signals. The researchers also included this pithy phrase “Wine at 5” to note that with the exception of the Seventh Day Adventists in Loma Linda, the others drank moderate amounts of alcohol, especially red wine. Apparently, Sardinian Cannonau wine was the winner! This is probably due to the polyphenols and antioxidants in the red wine. I submit that we must also remember that alcohol is a direct toxin to the liver, and we can get these polyphenols from coffee and berries. That said, we did enjoy some fine Montepulciano when we were in Capri.
The researchers noted that most centenarians reported a diet that had significant amounts of vegetables and beans and whole grains. The Ikarians of Greece ate a typical Mediterranean diet with nuts, beans, legumes, olive oil and fruits. That doesn’t mean they shun meat. Not at all! They include animal products although somewhat sparingly.
CONNECT: Finding your “tribe.” Prioritizing family and loved ones. Discovering a sense of belonging, be it with faith or common interests. A loyal partner. In Italy, we noticed that aging parents and grandparents lived with their children and were revered. Everyone seemed to have a great aunt Maria helping with the chores or telling a story from the old days. Now I admit I am not the most religious person, but I do enjoy times with family, friends and like-minded Primal folks and other Metabolic Health advocates.
As previously noted, our vacation to Capri was for a friends wedding. We connected with old friends and made some new ones. Even picked up a few new subscribers to the newsletter! We shared long, leisurely dinners. I got my polyphenols from my strict 3 Cappuccino/day regimen!
We were sorta living the Blue Zone lifestyle.
The one underlying commonality I found is that all of the Blue Zone populations JUST ATE REAL FOOD.
The Okinawans ate a ton of root vegetables, including sweet potatoes! No processed foods! The Sardinians diet included a fair amount of animal products such as cheese, pork and poultry. Lots of goat dairy. No processed foods! The Nicoyans enjoyed beans, beans and beans and other legumes and cassava. Lots of fiber-rich fruit. Slow, low glycemic carbs. No high-fructose corn syrup! No processed foods.
The food choices were local and influenced by their own individual cultures. No need to overemphasize a vegetarian bias or shun meat. I suspect that there are most likely other areas on the globe that were not included in Buettner’s work that may have included much more animal protein and meat. Bottom line is use your common sense. No Pringles and go easy on the donuts. No frankenfoods combining sugar and fat in a non-natural dopamine spiking fashion. No hijacking of our hedonic pathways!
So what is my take? What is my PrimalMed perspective?
Diet certainly is an important input in the longevity equation but are the plant slant recommendations in Buettner’s book to limit meat and egg consumption absolute? Just because some blue zone populations are plant slanted, does that means it’s best for us? Can we use these observations as a guide rather than religious canon?
In Okinawa, 2003 data shows daily meat intake actually higher than the national average in Japan. Maybe restricting meat is not the answer. 2012 data showed that other factors such as low calorie consumption were a more relevant input in determining longevity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362219/
The blue zone community in Sardinia actually consumed more animal foods than the other areas in Sardinia not in the actual zone. It seems that the males in Sardinia are very physically active in a hilly, mountainous region.
https://www.nature.com/articles/ejcn2014230
Nicoyan diets include beef, chicken and fish.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241350/
In Loma Linda, the Adventist people avoid alcohol and smoking. Perhaps that is what contributes most to their longevity.
And, here’s a good one. How ‘bout those Mormons? They were not included in the Blue Zone research and they do eat meat regularly and as a population, have an average life-expectancy only slightly below the Seventh-Day adventists.
https://www.sciencedirect.com/science/article/abs/pii/S0091743507003258?via%3Dihub
Perhaps it is the inclusion of a strong family unity, and social interactions and physical activity that are the most important inputs. Diet, as long as it is fresh, local REAL food in moderate portions is important but to over-emphasize the plant slant diet with minimal meat inclusion may be tinged with a bit of bias.
We NEED protein, especially bioavailable protein found in animal sourced foods for maintaining adequate muscle mass. That will enable us not only to live long but live well.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881926/
Focusing on eating REAL foods, whether they come from plants and fruits or the animals that eat the plants and fruits, and avoiding processed and ultra-processed junk seems to be the answer in all of the healthy, long-lived populations.
TL;DR: The lessons from the Blue Zone populations are that daily movement, sense of purpose and community, stress mitigation and family connections are very important! Diet? Of course. Eat like an adult and don’t eat all the time. Being told to limit animal products in isolation without considerations of the other inputs is unlikely to be the answer.
Take time to relax and enjoy downtime with friends and family! Put a little life into living! Eat fresh, local food in responsible portions. The trip to the Amalfi coast and the wedding in Capri was just the right prescription for the PrimalMed team.
BTW, I was honored to be the best man at my friend’s wedding. Here’s the best man displaying the ceremonial wine glass under the Chuppah, just moments before the groom stomped down, and per Jewish tradition, shattered the glass!
I should add that later that evening, on that beautiful moonlit terrace in Capri, Italy, the orthopedic surgeon/rock star groom serenaded his new bride and brought down the house with his rendition of this classic!
`
Thanks for reading and your kind words! Your travels w John inspire us!
Thanks Ted for another insightful and enjoyable read! Loved hearing about your trip to the Amalfi coast ❤🇮🇹