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Who lives the longest?

Watch Marta Lonnie discuss the concept of the ‘Blue Zones’ and reviewing observational data on which people live longest, and importantly, why.
MARTA LONNIE: Hello. In this lecture, we’ll talk about blue zones which is a term that describes regions of the world where people live the longest, often with unusually high numbers of centenarians. We will look at the observational data and discuss potential factors which can contribute to longevity. But first, let’s have a look at how life expectancy has been changing across centuries. The figures I’m sharing come from a really good online resource, “Our World in Data”, run by the team of scientists from Oxford University where you can find a lot of data on various large scale global problems such as disease, hunger, inequality, and et cetera.
But coming back to the chart, we can see that before the 19th century, the average global life expectancy was as low as under 30 years old. This is the blue line. In the UK, this was a bit higher and it was under 40 years old, here marked as a red line. And that dramatic increase can be observed from the end of the 19th century, beginning of the 20th century, where the life expectancy rocketed to above 70 years old worldwide and over 80 in the UK. And this was driven mainly by improvements in sanitation, housing and education. This trend continued with the development of vaccines and then antibiotics.
We know that penicillin was only discovered in 1928, but was a huge contributor to increasing people’s lifespan. We could observe a shift here from communicable diseases being the major cause of death before to a non-communicable diseases being the biggest threat. And here’s another interesting chart that shows how life expectancy changed from the 1800s to 21st century. And here, we can also see differences between the countries. While in the 1800s, the discrepancies were not as significant between some African countries and Europe, this gap became more prominent in the 20th and 21st century. The yellow and green areas on the chart.
And we can see that currently, life expectancy in, for example, Mozambique is around only 50 years old while it is over 80 in the more developed part of the world on the right. And currently, life expectancy globally is just under 73 years old. And if you’d like to see what is life expectancy in your native country or any other country, let’s say a few decades ago and now, I would recommend to explore this website.
So I’m Polish and I will select Poland here.
And I can see that after the Second World War, we can observe an increase in life expectancy followed by a steady trend during Cold War, and then an increase again when Poland became a Democratic country. So obviously, political events to health care provision will have a significant influence on average lifespan in different countries, but this would appear not to be the only factor. Although these investigations were carried earlier, it was in 2005 when Dan Buettner, an Explorer and National Geographic fellow, published an article on few places on Earth where people live the longest and healthier life than in other regions of the world.
These regions were called blue zones, which are defined as limited and homogeneous geographical areas where population share the same lifestyle, environment and its longevity has been proven to be exceptionally high. And these longevity hotspots are highlighted on this slide. And these are Okinawa in Japan, Ikaira in Greece, Sardinia in Italy, Nicoya Peninsula in Costa Rica, and Loma Linda and California. And the latest region is justified by a large community of Seventh Day Adventists. So the researchers looked closer at these communities exploring what lifestyle characteristics do they share and what do they have in common. And these principles are called a power 9.
And as you can see, there are lifestyle characteristics, but also spiritual and social determinants that centenarians from these regions share. So the first one is people from these regions are physically active throughout their lives but they move naturally rather than using, for example, gyms through maintaining their gardens, growing plants, house work, et cetera. And also, using their hands, their bodies, rather than mechanical devices. Second characteristic is to have a purpose in life, which translates to why I wake up in the morning. Apparently, this approach can extend life expectancy by seven years. Next is downshift, which is establishing a routine that can help to reduce stress levels. As we know, high and sustained levels of stress linked to chronic inflammation.
So as the blue zones expert point out, the Okinawas for example, take a few moments each day to remember the ancestors. The Adventists pray. Ikairians take a nap and Sardinians have a happy hour. Next is the 80% rule and this is about knowing when to stop eating, which is when their stomachs are 80% full. Also, the centenarians from blue zones tend to eat their smallest meals in the late afternoon and late evenings. And we can see how different this is to the Western eating pattern. Another common trait is plant based diet. Abundant in legumes and pulses fruit and vegetables, meat is eaten very rarely and in small portions. And some communities are entirely vegetarian, like the Seventh Day Adventists.
Rule number 6 is moderate alcohol consumption, apart from the Seventh Day Adventists. The observed amount is optimal is around one to two glasses a day, and preferably wine with friends. And as we can see this start to blend with the social aspects of centenarians lives, it has been observed that centenarians in blue zone hotspots belong to same faith based communities. And it has been found that attending weekly faith based services can extend life by 4 to 14 years. The next aspect, which seemed to be important among centenarians, is to prioritise their families. And this includes caring after their loved ones, including the oldest family members, which usually live nearby or in the same household.
They also seem to be committed to their life partners, which supposedly can also extend a lifespan. Lastly, the importance of the tribe, a social circle that supports health promoting behaviours. It has been shown that if we are surrounding ourselves with people who, let’s say, smoke, have unhealthy eating habits and sedentary behaviours, we are more likely to mirror these behaviours. Hence, the social network of friends and family with healthy lifestyle behaviours may encourage our healthy lifestyle. Of course, it can be argued that sometimes adopting a healthy lifestyle cannot guarantee longevity.
There is a large body of research stressing that exceptional longevity is a complex heritable trait that runs across generations and it often correlates either with the presence of protective alleles or the absence. But it needs to be acknowledged that genetics determine only a fraction of our life expectancy. And our chances for a longer life can be increased by modulating this with our lifestyle behaviours. And if you’re interested in this topic, I can recommend watching the TEDx Talk with Dan Buettner, the blue zone expert. The link is provided in further reading section, along with original references and further reading material. So thank you.

Blue zones are regions of the world thought to have a higher than usual number of people living much longer than average. Five “Blue zones” have been posited: Okinawa (Japan); Sardinia (Italy); Nicoya (Costa Rica); Icaria (Greece); and Loma Linda (California, USA).

Blue zones map

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Nutrition Science: Lifestyle Medicine

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