Are The Blue Zones REALLY Plant-Based?
Updated 9/3/23 - See our follow up article: The Blue Zones Debunked (Again)
Over and over again we hear about how blue zones are where people live the longest and healthiest lives on the planet - having the most centenarians. By comparison in the US, life expectancy for males was 75.1 years in the first half of 2020, representing a decline of 1.2 years from 76.3 years in 2019. For females, life expectancy declined to 80.5 years, decreasing 0.9 year from 81.4 years in 2019.
Blue Zones were popularized by vegan Dan Buettner, who wrote a book about 5 specific regions of the world with the Blue Zones trait. What is most interesting, is that all but one of the places he chose eat meat and sometimes a lot of it! In an interview with Dr. Mark Hyman Buettner states: “In all honestly, Blue Zones did eat meat… But it was infrequent often as a condiment…. We made the decision to stay 100% plant-based within the Blue Zone family.” So he basically decided to make up a diet that fits his vegan agenda. Later you will learn that meat intake is a staple and not just a condiment of Blue Zones.
Clearly, Blue Zones diets were manipulated by narrowing in on the fruit/vegetables/whole grain aspect of the diets to make Blue Zones appear as a plant-based surrogate. By focusing on meat as the villian, the other important dietary patterns Blue Zones participate in are downplayed such as: eating organ meats, eating seasonally, avoiding processed foods and a general ‘food is medicine’ belief. In his book, he also excluded places with high meat consumption that are also Blue Zones like Hong Kong + Icelandic groups.
Hong Kong: For the second consecutive year, Hong Kong has the longest-lived population in the world. They are officially, the world's foremost Blue Zone. Men are living to 81.3 whilst women live to the ripe old age of 87.3. Residents eat 664 grams of meat per day = 1.5 lbs of meat/day.
Icelandic: In 2019, the life expectancy in Iceland was 81.0 years for men and 84.2 years for women. An Icelandic diet consists of big breakfasts eaten at home instead of on-the-go, fresh seafood, and quality meat and dairy products.
Further, the Blue Zones lifestyles are very important to consider as they are healthier overall. They are lives lived at slower paces, less stress, more green spaces, sunshine, walking, gardening, less smoking and have a strong sense of community. There is also a strong genetic component.
Lastly context of the diet is important. Overseas, people enjoy meat along with a healthy diet and have healthy lives. In America, because we’ve been told meat (especially red meat) is terrible for us, those that eat it often are less likely to be healthy overall because of the rebellious nature. That means along with meat, they most likely eat more fast food, are more likely to smoke, drink soda and eat candy, etc. When we examine observational studies, that is why we can see that eating meat especially in the US, is loosely correlated with poorer health. Outside of the US, observational studies don’t show the same association:
Vegetarian diet and all-cause mortality: Evidence from a large population-based Australian cohort - the 45 and Up Study, 2017: There was also no significant difference in mortality risk between pesco-vegetarians or semi-vegetarians versus regular meat eaters. We found no evidence that following a vegetarian diet, semi-vegetarian diet or a pesco-vegetarian diet has an independent protective effect on all-cause mortality.
Mortality in British vegetarians, 2002: British vegetarians have low mortality compared with the general population. Their death rates are similar to those of comparable non-vegetarians, suggesting that much of this benefit may be attributed to non-dietary lifestyle factors such as a low prevalence of smoking and a generally high socio-economic status, or to aspects of the diet other than the avoidance of meat and fish.
Mortality in vegetarians and comparable nonvegetarians in the United Kingdom, 2015: United Kingdom-based vegetarians and comparable nonvegetarians have similar all-cause mortality.
Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies, 2012: Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries.
Alright, I wanted to take a moment to examine the places Buettner used for his Blue Zones to show how misrepresented they were. The places he selected to work on include Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece, and Loma Linda, California.
Okinawa, Japan: The average Okinawan man lives for 80 years, and women for 86. A study (Nutrition for the Japanese elderly) examined the diet of Japanese centenarians and found: Nutrient intakes in 94 Japanese centenarians showed a higher proportion of animal protein to total proteins than in contemporary average Japanese. 2. High intakes of milk and fats and oils had favorable effects on 10-year (1976-1986) survivorship in 422 urban residents aged 69-71. The survivors revealed a longitudinal increase in intakes of animal foods such as eggs, milk, fish and meat over the 10 years. 3. Nutrient intakes were compared, based on 24-hour dietary records, between a sample from Okinawa Prefecture where life expectancies at birth and 65 were the longest in Japan, and a sample from Akita Prefecture where the life expectancies were much shorter. Intakes of Ca, Fe, vitamins A, B1, B2, C, and the proportion of energy from proteins and fats were significantly higher in the former than in the latter. Intakes of carbohydrates and NaCl were lower. Pork is eaten in abundance in Okinawa; all the pig was eaten, including the fat, face, ears, hooves, leaving nothing behind. This indicates that pork cuisine is not simply a source of protein, but also has health-giving effects as a result of its collagen content. It deserves attention as an integral part of Okinawan longevity food. This is very different compared to the Japanese mainland where a vegetarian diet for religious occasions is observed. We tend to avoid pork in this present era of overeating, but in Okinawa it is a major pillar of the longevity diet.
Sardinia, Italy: In 2016, life expectancy for Sardinia was 82.6 years. Blue Zones website states the diet is 47% whole grains, 26% dairy, 12% vegetables, 5% meat, fish and poultry, 1% fruits and 2% added fats. Here is a video showing that their diet consists of goat, dairy, tons of olive oil and fresh foods. Further, here is a recount of a tourist who traveled there and found out what they really eat (surprise: it’s lots of meat, seafood and some pasta!).
Nicoya, Costa Rica: Only the men seem to live longer here. The Nicoya region of Costa Rica: a high longevity island for elderly males, 2013: For a 60-year-old Nicoyan male, the probability of becoming centenarian is seven times that of a Japanese male, and his life expectancy is 2.2 years greater. This Nicoya advantage does not occur in females, is independent of socio-economic conditions, disappears in out-migrants and comes from lower cardiovascular (CV) mortality. Nicoyans have lower levels of biomarkers of CV risk; they are also leaner, taller and suffer fewer disabilities. Two markers of ageing and stress—telomere length and dehydroepiandrosterone sulphate—are also more favourable. The Nicoya diet is prosaic and abundant in traditional foods like rice, beans and animal protein, with low glycemic index and high fibre content.
Ikaria, Greece: One third of Ikaria's population lives past the age of 90. The Blue Zones website states the diet for this location is 5% meat and 6% fish (dairy isn’t listed at all, so 0%?). However, from this video you can see that that is not the case and their diet is substantially meat (pork and goat), organ meat and dairy.
Loma Linda, California: Loma Linda has a longer-than-average life span. This has been attributed to the large population of Seventh Day Adventists with a healthy lifestyle, but it might just be due to the fact that people who are richer tend to live longer. The average male in Loma Linda lives to 89; the average woman to 91. This is the only true vegetarian group. However, it’s a bad sign when your diet reduces your fertility (this isn’t addressed in the Blue Zones book or website either). Food intake diet and sperm characteristics in a blue zone: a Loma Linda Study, 2016: Lacto-ovo vegetarians had lower sperm concentration. Total motility was lower in the lacto-ovo and vegan groups (33.2±3.8% and 51.8±13.4% respectively) versus non-vegetarians (58.2±1.0%). Vegans had lowest hyperactive motility.
Even more recently, the blue zones have been scrutinized by researchers examining the record keeping of those areas. The claims of longevity in those locations may be based on fraud and error. “Like the ‘blue zone’ islands of Sardinia and Ikaria, Okinawa also represents the shortest-lived and second-poorest region of a rich high-welfare state. These regions may have higher social connections and vegetable intakes, yet they also rank amongst the least educated and poorest regions of their respective countries. The hypothesis that these relatively low literacy rates and incomes are generating age-reporting errors and pension fraud, and therefore remarkable age records, seems overlooked.
Instead of prompting skepticism, under the relatively safe assumption that smoking, drinking, poverty, and illiteracy should not enrich for remarkable longevity records, these contra-indications of survival are routinely ignored. In contrast, it could be suggested that the abundance of supercentenarians in these regions reflect high rates of undetected error.
High-quality universal registration systems often contain undetected high-frequency errors. For example, contrary to previous assertions that “Japan has…among the highest quality data for the oldest-old” [24], a 2010 investigation of Japanese records revealed that 238,000 centenarians were actually missing or dead [25].”
Just as interesting, the ‘heart healthy’ Mediterranean diet that we’ve all been accustomed to also has a murky origin. This research was conducted by Ancel Keys, who was trying to understand the association between dietary patterns and the rise of heart disease in the 1950s. To do this, Keys surveyed the dietary intake of people from many countries, though his report highlighted the findings from seven countries: Yugoslavia, Italy, Greece (specifically the islands of Crete and Corfu), Finland, Holland, Japan, and the USA. His famous “Seven Countries Study” cherry picked his findings that areas with lower fat intake, especially saturated fat, had lower rates of heart disease. While there are a wide array of methodological problems with Keys research — that many other writers have thoroughly examined (see The Big Fat Surprise by Nina Tiecholz, for one), we’ll focus on the issues with his conclusions on the Mediterranean diet.