The Blue Zones: areas of exceptional longevity around the world

The aim of this study was to compare the level of population longevity and the characteristics of four geographic areas where unusually high proportions of long-lived individuals have been observed. For these areas (Ogliastra in Sardinia, Okinawa in Japan, the Nicoya peninsula in Costa Rica and the island of Ikaria in Greece). The term of ‘blue zone’ (BZ) given to these areas is defined as a limited region where the population shares a common lifestyle and environment and whose exceptional longevity has been accurately verified. This paper discusses the use of different indexes to measure the longevity of a population. As a preliminary result of our investigations we confirm the exceptional level of male longevity in the Sardinian BZ and both male and female longevity in Okinawa. Considering possible explanations, we observed that BZ populations are geographically and/or historically isolated (islands and mountainous regions). These populations succeeded in maintaining a traditional lifestyle implying an intense physical activity that extends beyond the age of 80, a reduced level of stress and intensive family and community support for their oldest olds as well as the consumption of locally produced food. This is likely to have facilitated the accumulation of ideal conditions capable of limiting the factors that negatively impact on health in most Western populations. These people experienced the epidemiological transition—and its implications—in relative recent times, and their remarkably good health status during ageing could be the result of a delicate balance between the benefits of the traditional lifestyle and those of modernity (increased wealth, better medical care). All these factors could have promoted an ideal milieu for the emergence of long-lived phenotypes at the population level.